Comparing the effectiveness of a breastfeeding arm sling with the normal cross-cradle hold position: A quasi-experimental study in Thailand.

INTRODUCTION: In Thailand, the exclusive breastfeeding rate remains low at 14% in 2019, despite the World Health Organization's recommendation of exclusive breastfeeding for the first six months. Many mothers experience challenges such as lack of confidence, fatigue, and discomfort while breastfeeding. To address these issues, the novel arm sling innovation device was developed to provide support during breastfeeding. This study aimed to compare the effectiveness of breastfeeding using the arm sling versus the normal cross-cradle hold among first-time mothers and to evaluate their satisfaction with the breastfeeding arm sling. METHODS: A quasi-experimental crossover design was employed in the postpartum unit at Ramathibodi Hospital, Thailand, in 2022. Forty-six first-time mothers breastfed using both a breastfeeding arm sling and the normal cross-cradle hold, with a washout period in between. Breastfeeding effectiveness was measured by mothers and nurse-midwives using questionnaires, and mothers' satisfaction with the sling was assessed. Data were evaluated using descriptive statistics and t-tests. RESULTS: The breastfeeding arm sling innovation significantly improved breastfeeding effectiveness compared to the normal cross-cradle hold, reported by both mothers (t=4.32, p<0.001) and nurse-midwives (t=8.93, p<0.001). Most mothers expressed satisfaction with the arm sling, though some design aspects, such as ease of use, require improvement. CONCLUSIONS: This study suggests that the breastfeeding arm sling can potentially improve breastfeeding experiences for first-time mothers. Further research is needed on a larger scale and in more diverse settings to confirm these findings and to improve the sling's design for user-friendliness.

A mixed methods evaluation of the breastfeeding memory aide CHINS.

Breastfeeding rates remain persistently low in the United Kingdom (UK) despite wide-scale rollout of UNICEF Baby Friendly Initiative training and accreditation. More must be done to ensure breastfeeding practitioners can provide effective support. The memory aide CHINS (Close, Head free, In-line, Nose to Nipple and Sustainable) could help practitioners remember, recall, and apply breastfeeding theory in practice and this paper presents a UK evaluation of its impact. A concurrent, convergent mixed methods approach was adopted using Normalisation Process Theory (NPT) as an overarching framework. An online survey targeted breastfeeding practitioners and academics from the UK (n = 115). A sub-set (n = 16) of respondents took part in qualitative focus groups. Survey data was subjected to descriptive and inferential statistical analysis, and the focus group data was analysed, using NPT. CHINS is widely used in breastfeeding education and practice largely because of its simplicity and ease of integration in everyday practice, as well as its sustained inclusion in UNICEF Baby Friendly Initiative training. CHINS has introduced a standardised approach to the principles of positioning for effective breastfeeding. Doing so has helped address inconsistencies and poor practice in this area, and CHINS plays a role in assisting practitioners in building confidence in their breastfeeding practice. More needs to be done to ensure the breastfeeding workforce develop and maintain the requisite skills to promote and support breastfeeding, including the role of memory aides such as CHINS in achieving this.

Effect of Behavioral Activation for Women with Postnatal Depression: A Systematic Review and Meta-Analysis.

Evidence shows that behavioral activation (BA), a simple form of psychological therapy, is as effective as the more complex psychological therapy-cognitive behavioral therapy (CBT)-in treating general depression. However, it remains unclear whether BA when compared with treatment-as-usual (TAU) has greater contributions in reducing postnatal depression. This systematic review compared the effect of BA versus TAU in reducing depression symptoms among postnatal women. Five databases (MEDLINE, Embase, Emcare, Cochrane Library, and PsycINFO) were searched. Risk of bias was assessed using the Cochrane Collaboration's 'risk-of-bias 2 tool'. A random-effects meta-analysis was conducted to examine the effect of BA on postnatal depression. Of 2844 initial studies, only two randomized control trials (RCTs) met the inclusion criteria. The overall quality of evidence of these two RCTs was low. When compared to TAU, meta-analysis showed that BA was associated with reduced depression symptoms in postnatal women (standard mean difference -0.56; 95% confidence interval -0.76 to -0.37). This review suggests that BA might be more effective than TAU for alleviating postnatal depression. However, due to concerns about evidence quality, these findings should be interpreted cautiously.

Yourtime: The development and pilot of a perinatal mental wellbeing digital tool using a co-design approach.

INTRODUCTION: Maternal anxiety and depression are major public health issues with prevalence as high as one in five women. There is a need to focus on preventative strategies to enable women to self-monitor their mental health status during pregnancy and postnatally. AIM: To co-design and test a perinatal mental health digital tool to enable women to self-monitor their mental wellbeing during pregnancy and early parenting and promote positive self-care strategies. METHODS AND ETHICS: A sequential mixed methods study utilising two stages 1) co-design workshops; 2) fit for purpose pilot with women through a purpose designed survey to evaluate acceptability, useability, functionality, and satisfaction. FINDINGS: Mothers, midwives, design researchers and students, participated in co-designing a digital tool and prototype application, YourTime. Fourteen participants engaged in the pilot, with all women agreeing that the tool would be beneficial in alerting them to changes in mental wellbeing. Seventy-seven percent agreed that this prototype had the potential to positively affect wellbeing during the perinatal period. DISCUSSION: The need to develop a perinatal mental health digital tool that enables women to self-monitor their wellbeing was identified. Women reported the YourTime app offered an acceptable and effective means to self-assess and monitor their wellbeing. CONCLUSION: The YourTime app responds to the growing agenda for digital approaches to address perinatal mental health challenges. The pilot study demonstrated that the app offered potential to alert women to changes in mental wellbeing, but functionality need further development.

What women want: A reflexive thematic analysis of the healthcare experiences of women with female genital mutilation/cutting in South Australia.

BACKGROUND: Global migration has seen an increase in female genital mutilation/cutting (FGM/C) cases observed in countries where it is not part of the cultural norm. This shift has led to many healthcare professionals (HCPs) reporting a lack of knowledge and skills necessary to support the needs of women with FGM/C. AIM: To explore the experiences and needs of women with FGM/C accessing women's health services in South Australia. METHODS: Women with FGM/C were recruited through purposive and snowball sampling to participate in one-to-one semi-structured interviews. The voice recorded interviews were transcribed verbatim, coded, and analysed using Braun and Clarke's reflexive thematic analysis to determine themes. FINDINGS: Ten migrant and refugee women living in South Australia, were interviewed. Four themes and 13-subthemes were identified. The main themes were, 1) the healthcare experience, 2) cultural values shape the healthcare experience, 3) speaking up about female genital cutting and 4) working together to improve healthcare experiences. DISCUSSION: Women's cultural needs, not their health needs, play a fundamental role on how women experienced healthcare services. When women's cultural values and traditions are acknowledged by HCPs, they are more likely to trust and feel confident to engage with services and seek medical support. Areas identified for improvement included access to the right interpreters, having more time during appointments, opportunities for continuity of care and the inclusion of family in care and treatment decisions. CONCLUSION: Women with FGM/C have specific health and cultural needs that can be met through education and provision of woman-centred care.

Assessing the healthcare quality issues for digital incident reporting in Sweden: Incident reports analysis.

Objective: This study explored healthcare quality issues affecting the reporting and investigation levels of digital incident reporting systems. Methods: A total of 38 health information technology-related incident reports (free-text narratives) were collected from one of Sweden's national incident reporting repositories. The incidents were analysed using an existing framework, i.e., the Health Information Technology Classification System, to identify the types of issues and consequences. The framework was applied in two fields, 'event description' by the reporters and 'manufacturer's measures', to assess the quality of reporting incidents by the reporters. Additionally, the contributing factors, i.e., either human or technical factors for both fields, were identified to evaluate the quality of the reported incidents. Results: Five types of issues were identified and changes made between before-and-after investigations: Machine to software-related issues (n = 8), machine to use-related issues (n = 5), software to software-related issues (n = 5), use to software-related issues (n = 4) and use to use-related issues (n = 1). Over two-thirds (n = 15) of the incidents demonstrated a change in the contributing factors after the investigation. Only four incidents were identified as altering the consequences after the investigation. Conclusion: This study shed some light on the issues of incident reporting and the gap between the reporting and investigation levels. Facilitating sufficient staff training sessions, agreeing on common terms for health information technology systems, refining the existing classifications systems, enforcing mini-root cause analysis, and ensuring unit-based local reporting and standard national reporting may help bridge the gap between reporting and investigation levels in digital incident reporting.

Understanding the barriers and facilitators of vaccine hesitancy towards the COVID-19 vaccine in healthcare workers and healthcare students worldwide: An Umbrella Review.

BACKGROUND: Healthcare workers (HCWs) and healthcare students display high levels of vaccine hesitancy with impact on healthcare provision, patient safety, and health promotion. The factors related to vaccine hesitancy have been reported in several systematic reviews. However, this evidence needs to be synthesised, as interventions to reduce vaccination hesitancy in this population are needed. METHODS: This Umbrella Review aimed to explore the barriers and facilitators of vaccine hesitancy toward the COVID-19 vaccine for HCWs and healthcare students. The review was performed and reported in accordance with Joanna Briggs Institutes guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. A protocol was preregistered on PROSPERO (CRD42022327354). Eight databases were searched from November 2019 to 23rd May 2022 to identify any systematic reviews that explored factors associated with hesitancy towards the COVID-19 vaccine for HCWs or healthcare students. RESULTS: A total of 31 studies were included in the review. The majority of studies (71%) were appraised as strong or moderate quality and there was a slight degree of overlap (<5%) of primary studies between the reviews. Vaccine hesitancy was more common among HCWs and healthcare students in specific occupational roles (e.g. nurses) than others (e.g. physicians). Frequent reasons for hesitancy were related to sociodemographic factors (gender, age, ethnicity), occupational factors (COVID-19 exposure, perceived risk, mandatory vaccination), health factors (vaccination history), vaccine-related factors (concerns about safety, efficacy, side-effects, rapid development, testing, approval and distribution of the vaccine), social factors (social pressure, altruism and collective responsibility), distrust factors (key social actors, pandemic management), information factors (inadequate information and sources, exposure to misinformation). CONCLUSION: The results from this Umbrella Review have wide-reaching implications for the research area, healthcare systems and institutions and governments worldwide. Designing tailored strategies for specific occupational groups is pivotal to increasing vaccine uptake and securing a safe healthcare provision worldwide.

The role of midwives in supporting the development of the mother-infant relationship: a scoping review.

BACKGROUND: The mother-infant relationship is complex and dynamic, informing the psychological development of the infant through bonding and attachment. Positive early interactions influence the quality of this relationship. Midwives are well placed to support the developing relationship between the mother and baby, yet there has been limited research exploring the role of the midwife in this context. AIM: To explore interventions that have been provided by the midwife which support the development of the maternal-fetal or mother-infant relationship amongst a low-risk population from pregnancy, and up to six weeks postnatal. The review also sought to understand the types of interventions developed, format and delivery, outcomes measured and if cultural considerations had been incorporated. METHODS: A scoping review of the research literature was undertaken using the Joanna Briggs Institute framework. Five online databases were searched for relevant articles published in English from 2000 to 2021. FINDINGS: Sixteen articles met the inclusion criteria. Three themes emerged: (1) viewing the fetus as separate from the mother, (2) focused activities on the maternal-infant relationship and (3) targeted educational interventions. DISCUSSION: Providing focused activities and targeted education during the pre and postnatal periods support the development of the mother-infant relationship. Significantly, there was insufficient research that considered the influence of culture in supporting the mother-infant relationship. CONCLUSION: Further research is required to develop interventions that include a diverse sample to ensure culturally appropriate activities can be integrated into care during pregnancy and/or the postnatal period provided by midwives.

Barriers and facilitators of vaccine hesitancy for COVID-19, influenza, and pertussis during pregnancy and in mothers of infants under two years: An umbrella review.

BACKGROUND: Vaccination during pregnancy has been repeatedly demonstrated to be safe and effective in protecting against infection and associated harms for the mother, developing baby, and subsequent infant. However, maternal vaccination uptake remains low compared to the general population. OBJECTIVES: An umbrella review to explore the barriers and facilitators to Influenza, Pertussis and COVID-19 vaccination during pregnancy and within 2 years after childbirth, and to inform interventions to encourage uptake (PROSPERO registration number: CRD42022327624). METHODS: Ten databases were searched for systematic reviews published between 2009 and April 2022 exploring the predictors of vaccination or effectiveness of interventions to improve vaccination for Pertussis, Influenza, or COVD-19. Both pregnant women and mothers of infants under two years were included. Barriers and facilitators were organised using the WHO model of determinants of vaccine hesitancy through narrative synthesis, the Joanna Briggs Institute checklist assessed review quality, and the degree of overlap of primary studies was calculated. RESULTS: 19 reviews were included. Considerable overlap was found especially for intervention reviews, and the quality of the included reviews and their primary studies varied. Sociodemographic factors were specifically researched in the context of COVID-19, exerting a small but consistent effect on vaccination. Concerns around the safety of vaccination particularly for the developing baby were a main barrier. While key facilitators included recommendation from a healthcare professional, previous vaccination, knowledge around vaccination, and communication with and support from social groups. Intervention reviews indicated multi-component interventions involving human interaction to be most effective. CONCLUSION: The main barriers and facilitators for Influenza, Pertussis and COVID-19 vaccination have been identified and constitute the foundation for policy development at the international level. Ethnicity, socioeconomic status, concerns about vaccine safety and side effects, and lack of healthcare professionals' recommendations, are the most relevant factors of vaccine hesitancy. Adapting educational interventions to specific populations, person-to-person interaction, healthcare professionals' involvement, and interpersonal support are important strategies to improve uptake.

Understanding the barriers and facilitators of COVID-19 vaccine hesitancy amongst healthcare workers and healthcare students worldwide: An umbrella review protocol.

Healthcare workers (HCWs) and healthcare students are at increased risk of becoming infected with and being a vector of transmission of COVID-19. Vaccination efforts amongst this group of persons have been hampered in some countries by hesitancy to uptake the COVID-19 vaccine. The factors related to vaccine hesitancy have been reported in several systematic reviews. However, a comprehensive overview of barriers and facilitators of COVID-19 vaccine hesitancy is greatly needed to address effective interventions in this population. Understanding and designing effective strategies to promote vaccination among HCWs is pivotal to secure an appropriate and safe healthcare provision. The current protocol describes the methodology for an Umbrella Review that explores the barriers and facilitators of COVID-19 vaccine hesitancy for HCWs and healthcare students. The databases that will be searched are CINAHL, MedLine, Cochrane Library, PubMed, ProQuest, Web of Science, Science Direct, IBSS, Google Scholar, and Epistemonikos. Studies will be eligible for inclusion if they: (i) conducted a systematic review (with or without meta-analysis); (ii) included primary sources utilizing a quantitative methodology; (iii) investigated factors related to COVID-19 vaccine hesitancy; (iv) and included a sub/population of HCWs or healthcare students aged 18-65. The screening processes and data extraction will be conducted independently by two reviewers. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Systematic Reviews and Research Syntheses will be used to assess the methodological quality of the included reviews. The degree to which the included reviews contain the same primary studies will also be assessed and reported. The outcomes of this review will have wide-reaching implications for the research area, healthcare systems and institutions, and governments worldwide.

Effectiveness of female genital mutilation/cutting education for health professionals: An integrative review.

INTRODUCTION: A plethora of research has identified the lack of educational opportunities for health professionals to support the biopsychosocial and cultural needs of women who have experienced female genital mutilation/cutting (FGM/C). As a result, some women with FGM/C can feel unsupported, discriminated against and fear to communicate their concerns with health providers. The aim of this review is to identify studies that have investigated the effectiveness of FGM/C education for health professionals. METHOD: Toronto and Remington's six-step framework for conducting an integrative literature review was used to identify studies that met the inclusion criteria. Searches were conducted across five primary databases and grey literature, between August and October 2021. The Joanna Briggs Institute critical appraisal tools for quasi-experimental studies was used to critically appraise included studies. The findings of the search were reported using preferred reporting items for systematic reviews and meta-analysis. RESULTS: A total of five studies met the criteria for inclusion. Studies examined education provided to midwives, nurses, obstetricians, gynaecologists, psychosexual counsellors and student nurses, from England, USA, Mali and Kenya. All studies demonstrated that the implementation of FGM/C education was effective in improving learning outcomes (knowledge, attitude and self-efficacy), However, the quality rating of the evidence ranged from very low to moderate and limited inferential analysis reported. CONCLUSION: This review confirms that FGM/C education, which is informed by evidence and developed in collaboration with practicing communities, is an effective way of improving FGM/C knowledge and attitudes among health professionals. STUDY REGISTRATION: Open Science Framework Register 10.17605/OSF.IO/SMJHX.

Midwifery students' knowledge, understanding and experiences of workplace bullying, and violence: An integrative review.

Background: Workplace bullying, and violence within the midwifery profession, has been a well-documented concern in health literature since the early 1990's. However, contemporary research highlights that workplace bullying, and violence is often inflicted upon midwifery students. Workplace bullying, and violence has both short- and long-term effects on the student, including psychological trauma and poor mental health, loss of passion for the midwifery profession and absenteeism. To consider a solution to this phenomenon, current literature regarding midwifery students' knowledge, understanding and experiences of workplace bullying, and violence has been reviewed. Objective: To explore and critique current literature on midwifery students' knowledge, understanding and experiences of workplace bullying, and violence. Design: An integrative review. Review methods: Toronto & Remington's six-stage systematic framework was used to conduct the review, with rigour and validity for the research process. Results: Following critical appraisal, 12 articles met the inclusion criteria. Four themes emerged: (1) Prevalence and types of workplace bullying, and violence towards midwifery students. (2) Impact of workplace bullying, and violence on midwifery students' experiences during the degree. (3) Impact of negative workplace culture on the midwifery profession. (4) The requirement to develop strategies for midwifery students to address workplace bullying, and violence. Conclusions: Workplace bullying, and violence is a global health concern within the midwifery profession with evidenced impact on midwifery students' professional and personal lives. Organisational systems and approaches were identified as causes of a toxic clinical environment and workplace bullying, and violence, which impacted midwifery students' experiences. Suggestions supported universities incorporating conflict resolution strategies into midwifery degree programs, to prepare midwifery students to manage workplace bullying, and violence. Tweetable abstract: Workplace bullying, and violence is a global health concern entrenched within the midwifery profession, impacting midwifery students' professional and personal lives. Incorporating conflict resolution strategies into Bachelor of midwifery degree programs, may help prepare midwifery students to manage workplace bullying, and violence.

Barriers and facilitators to vaccination for COVID-19, pertussis, and influenza during pregnancy: Protocol for an umbrella review.

Pregnant women are particularly vulnerable to infection. Furthermore, infection from pertussis, influenza and COVID-19 increases the likelihood of adverse consequences to the mother and developing baby such as stillbirth, ICU admission, and pre-term caesarean birth. Increased rates of transmission and risk of adverse consequences from infection justifies the provision of national maternal vaccination programmes. Additionally, maternal vaccination helps protect the infant until they are able to receive their own vaccinations; a time when they are most at risk of mortality from influenza and pertussis. Vaccination during pregnancy has been repeatedly demonstrated as safe and effective in reducing harm, although rates of uptake remain low compared to the general population. The current protocol describes the methodology for an umbrella review aiming to explore the barriers and facilitators of vaccination during pregnancy for pertussis, influenza, and COVID-19. Systematic reviews that investigate the barriers and facilitators of at least one of either pertussis, influenza, or COVID-19 will be included in this review. Multiple databases will be searched, and included reviews assessed for quality (using the Joanna Briggs Institute (JBI) quality assessment for systematic reviews) and degree of overlap of included primary studies. Included reviews will be analysed according to the WHO SAGE model of determinants of vaccine hesitancy and separated by whether these explore influenza and pertussis, or COVID-19. The outcomes of this review will help inform the development of interventions to increase uptake of vaccination during pregnancy, and on whether interventions need to be tailored depending on the infectious disease. The key findings will identify the specific barriers and facilitators of vaccination hesitancy by considering contextual influences (e.g. sociodemographic variables), individual/social group influences (e.g. trust in the institutions), and vaccine-specific issues (e.g. safety and recommendations).

The voices of incarcerated women at the forefront of parenting program development: a trauma-informed approach to education.

BACKGROUND: The lives of women experiencing incarceration are complex, impacting many aspects of parenting. Incarceration can present an opportunity for women to access parenting education. However, their specific needs have to be considered. Few parenting programs for women experiencing incarceration have involved the women as part of their development. METHODS: Six focus groups were conducted in a prison setting involving thirty-one women to explore and understand their parenting education needs. RESULTS: Four main themes were identified to reflect the complex lives of the women and their parenting education needs. These themes were: working towards a positive self, communication as a lifeline, supporting and nurturing their children and hopefulness and reconnecting. The trauma women experienced in their lives was apparent during discussions. CONCLUSION: Women requested a non-judgmental parenting program to be developed to meet their specific needs and circumstances. The program needed to be designed to enable them to share stories with women in similar situations. Women gave insights into some of the specific content and topics they would like included in a parenting program. The women revealed experiences of trauma in their lives, demonstrating the importance of the need for a trauma informed approach to parenting education.

Exploratory study of fathers providing Kangaroo Care in a Neonatal Intensive Care Unit.

AIM AND OBJECTIVES: To explore fathers' views and experiences of providing Kangaroo Care (KC) to their baby cared for in a Neonatal Intensive Care Unit (NICU). BACKGROUND: Kangaroo Care has been known to improve the health outcome for preterm, low birth weight and medically vulnerable term infants and achieve the optimal perinatal health wellbeing for parents and infants. Historically, mothers are considered as the dominant KC providers, whereas fathers are spectators and have been overlooked. Little is known about the fathers' perspectives in providing KC in NICUs. METHODS: Individual semi-structured interviews were conducted with 10 fathers who delivered KC to their baby when in the NICU. Data were analysed using Braun and Clarke's six-phase thematical framework. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was followed to report this qualitative study. FINDINGS: Fathers in this study identified they were passing a silent language of love and connecting with their baby by the act of KC in a challenging environment. Three themes emerged: 'Positive psychological connection', 'Embracing father-infant Kangaroo Care' and 'Challenges to father-infant Kangaroo Care'. CONCLUSION: The findings of this study show KC enhances the bonding and attachment between fathers and infants. The conceptualisation of the paternal role in caregiving to a newborn is evolving as a contemporary practice. Further research is warranted to confirm or refute the study findings. Policies and facilities should be modified to include father-infant KC within the fields of neonatal care. RELEVANCE TO CLINICAL PRACTICE: It is important for nurses and other health professionals to support and enable fathers to give KC. Father-infant KC is recommended in neonatal care settings.

Developing Conflict Resolution Strategies and Building Resilient Midwifery Students: Protocol for a Mixed Methods Research Study.

BACKGROUND: Workplace bullying and violence (WBV) are well-documented issues in the midwifery profession. Negative workplace culture, conflict, and bullying are the most common forms of workplace violence experienced by midwives. Workplace violence increases the risk of midwives experiencing burnout, compassion fatigue, psychological trauma, poor mental health, absenteeism, loss of passion for the midwifery profession, job dissatisfaction, and poor job retention. Midwifery students describe workplace violence in the form of physical, emotional, or verbal abuse, and bullying. Therefore, there is a justification to develop conflict resolution strategies and resilience in midwifery students prior to graduation. OBJECTIVE: Our aim is to develop and facilitate a bespoke education program for South Australian midwifery students to enable them to develop skills in conflict resolution, build resilience, and identify self-care strategies. METHODS: This study will undertake a preparatory phase summarizing the body of literature on midwifery students' knowledge, understanding, and experiences of WBV. Following this, a 3-phase sequential mixed methods research design study will be undertaken. In Phase 1, quantitative data will be collected via a semistructured questionnaire and a validated conflict measurement tool, before and after attending an education workshop, and will be analyzed using descriptive and inferential statistics. Results from Phase 1 will inform and guide the development of an interview schedule for Phase 2. In Phase 2, qualitative data will be gathered by facilitating one-to-one interviews and a thematic analysis will be undertaken to gain a deeper understanding of midwifery students' experiences of WBV. In Phase 3, data integration using triangulation will be undertaken and meta-inferences will be developed via the integration of results and findings from Phases 1 and 2. RESULTS: The preparatory phase will commence in October 2021. Phase 1 will commence in 2022 with analysis of pre- and posteducation results anticipated to be completed by December 2022. Phase 2 will be developed from findings of the preparatory phase and results of Phase 1. An interpretation of verbatim interview transcripts is estimated to be undertaken by April 2023. Phase 3 of the study is expected to commence in May 2023, and this will involve the analysis of collective evidence gathered from Phases 1 and 2. The anticipated completion date for the study is December 2023. CONCLUSIONS: The outcomes of this research will provide insights into the prevalence and impact of WBV experienced by midwifery students. The findings of the research will report on levels of knowledge, skills, and confidence, and will assess the impact of a bespoke conflict resolution and resilience education workshop for midwifery students in managing WBV. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/35558.

Self-compassion Education for Health Professionals (Nurses and Midwives): Protocol for a Sequential Explanatory Mixed Methods Study.

BACKGROUND: A few recent studies have reported that having the ability to provide self-compassion can reduce health professionals' levels of anxiety and stress, the risk of compassion fatigue, and burnout, and it can generally improve their well-being. Therefore, there is evidence to support further research into the investigation and exploration of self-compassion education and training for health professionals. OBJECTIVE: This study aims to increase the knowledge and understanding of self-compassion and how this may enhance the health and well-being of health professionals. METHODS: The proposed research study will adopt a sequential explanatory mixed methods design. This study will be conducted in 3 phases. Phase 1 will use a pre-educational self-compassion questionnaire (web-based survey) to collect data from participants at 3 time points (before, immediately after, and after follow-up at 6-8 weeks) after they have attended a self-compassion education and training program. Phase 2 will use an interview schedule to explore the participants' views and experiences through a follow-up focus group or individual interview. Finally, phase 3 will include data integration and dissemination of key findings and recommendations. RESULTS: This study was approved by the Women's and Children's Health Network Human Research Ethics Committee and the Human Research Ethics Committee at the University of South Australia on June 26, 2021 (ID: 204,074). A scoping review was conducted to inform this research study (focusing on nurses and midwives). The preparatory phase was completed in April 2021. Phase 1 is expected to be completed by June 2022 and phase 2 will commence in July 2022. CONCLUSIONS: The key findings from the data integration for this research project will provide in-depth details and insights to broaden the discussion about self-compassion and its influence on health professionals' health and well-being. Health professionals (nurses and midwives) may benefit from self-compassion education and training programs to improve their health and well-being. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/34372.

Female Genital Mutilation/Cutting Education for Midwives and Nurses as Informed by Women's Experiences: Protocol for an Exploratory Sequential Mixed Methods Study.

BACKGROUND: Female genital mutilation/cutting (FGM/C) is a complex and deeply rooted sociocultural custom that is innately entrenched in the lives of those who continue its practice despite the physical and psychological dangers it perpetrates. FGM/C is considered a significant independent risk factor for adverse maternal and fetal outcomes in pregnancy and childbirth. Several studies in high-income countries have explored the experiences and needs of women with FGM/C as well as the knowledge of the health professionals, particularly midwives and nurses, who care for them. However, to date, no studies have evaluated the implementation of education for health professionals in high-income countries to meet the specific needs of women with FGM/C. OBJECTIVE: This study aims to explore the impact of an FGM/C education program for midwives and nurses as informed by the experiences of women with FGM/C accessing maternity, gynecological, and sexual health services in South Australia. METHODS: This study will adopt a three-phase, exploratory sequential mixed methods design. Phase 1 will involve the exploration of women with FGM/C views and experiences accessing maternity and gynecological (including sexual health) services in South Australia. The findings from phase 1 will inform phase 2: the development of an educational program for midwives and nurses on the health and cultural needs of women with FGM/C. Phase 3 will involve the evaluation of the program by measuring midwives' and nurses' changes in knowledge, attitude, and practice immediately before and after the education as well as 4 months after completing the program. Phase 1 of this study has been approved by the Women's and Children's Health Network human research ethics committee (ID number 2021/HRE00156) and the University of South Australia human research ethics committee (ID number 204096). RESULTS: Phase 1 will commence in August 2021, with the interpretation of findings being undertaken by November 2021. Phase 2 will be developed and facilitated by February 2022, and the final phase of this study will begin in March 2022. This study is expected to be completed by February 2023. CONCLUSIONS: The findings of this research will provide insight into the development and evaluation of education programs for midwives and nurses that includes collaboration with women from culturally and linguistically diverse backgrounds to address the specific cultural and health needs of communities. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/32911.

Using Co-design to Explore How Midwives Can Support the Emerging Mother-Infant Relationship During the Early Postnatal Period: Protocol for a Mixed Methods Study.

BACKGROUND: The postnatal period can be a challenging time for women, with mothers experiencing a range of emotions. As a woman transitions to motherhood, she adjusts to a new sense of self and forms a new relationship with her infant. Becoming a mother is a complex cognitive and social process that is unique for each woman and is influenced and shaped by culture. The emerging mother-infant relationship is a significant factor in maternal well-being and infant development, with the bond between the mother and her baby being critical to the development of secure attachment. It has been recognized that the strength of this relationship is the main predictor of how well a child will do throughout life. There has been a global focus on the importance of the first 1000 days, with Australia identifying this as a national priority. Midwives are ideally placed to support mothers during the development of the mother-infant relationship, providing care through the early postnatal period, which has been identified as a sensitive period for the development of the mother-infant relationship. OBJECTIVE: The aim of this study is to explore how midwives can support the emerging mother-infant relationship in the context of cultural diversity and develop an appropriate co-designed intervention in the early postnatal period. METHODS: This study will use a mixed method approach, specifically the exploratory sequential design (intervention development variant). This study will be undertaken in 3 phases: 1 qualitative phase, which is followed by 2 quantitative phases. Phase 1 will include a scoping review to explore interventions that have influenced the development of the mother-infant relationship, and then, interviews will be undertaken with women exploring their early experiences of motherhood, followed by 3 co-design workshops. The workshops will engage with multilevel stakeholder representatives where, through partnership and participation, they will propose and develop an intervention to support the emerging mother-infant relationship. Phase 2 will develop and pilot 2 purpose-designed evaluation surveys to evaluate the co-designed intervention from the perspective of both mothers and midwives. Phase 3 will implement and evaluate the co-designed intervention using pre- and postmeasures and feedback from the purpose-designed surveys. RESULTS: Phase 1 has commenced and is expected to be completed by August 2021. Phase 2 is expected to be completed by September 2021, with phase 3 commencing in October 2021. The study will be completed by March 2023. CONCLUSIONS: The results of this study will be shared with a variety of audiences and will contribute to the body of knowledge on the mother-infant relationship, potentially improving the understanding of this relationship for women and midwives. This may result in improved strategies for care, with mothers benefiting from enhanced experience and satisfaction during the early postnatal period.

Effectiveness of structured education and training in perineal wound assessment and repair for midwives and midwifery students: A review of the literature.

INTRODUCTION: Perineal trauma is a commonly observed complication of childbirth, affecting more than 75% of women who have a vaginal birth. Perineal trauma is associated with significant short- and long-term comorbidities that negatively impact women's quality of life. Severe perineal trauma (SPT) rates in Australia have almost doubled in the last decade. Reasons for increased rates are not completely understood; some researchers suggest improvements in diagnosis and reporting, while others have a view that it may be due to a lack of structured and standardized education in perineal wound assessment and repair for clinicians. METHODS: The Joanna Briggs Institute (JBI) scoping review methodology was adopted as a systemic process to identify studies that have investigated the effectiveness of perineal wound assessment and repair education and training for midwives and midwifery students. RESULTS: Five studies met the inclusion criteria for this review, to have evaluated a type of education or training, on childbirth-related perineal wound assessment and repair that included midwives and midwifery students. A total of 1279 midwives and midwifery students volunteered to participate in all five studies. The length of the education or training implemented varied between each study from a 1-day workshop to 100 hours of education. All five studies measured the effectiveness of each program through changes in participants' confidence, knowledge and skills in perineal assessment and repair before and after an intervention using various self-assessment questionnaires. CONCLUSIONS: The implementation of a structured educational workshop on perineal wound assessment and repair improves the confidence, skills and knowledge of midwives and students.