Knowledge, Perceptions, Attitudes and Practices of Midwives Regarding Maternal Influenza and Pertussis Vaccination: A Qualitative Study.

The coverage of maternal vaccination against pertussis and, particularly, influenza is lower than expected. The lack of recommendation from healthcare providers conditions non-vaccination in pregnant women. The purpose was to determine the knowledge, perceptions, attitudes and practices of midwives regarding maternal influenza and pertussis vaccination. A qualitative descriptive study based on semi-structured, face-to-face interviews with seventeen midwives was conducted, including purposive sampling and thematic analyses. Midwives had disparate knowledge and perceptions about the severity of influenza and pertussis in pregnant women, and influenza was not considered very serious. The vaccines were generally considered safe. However, because midwives did not have enough information about the safety of the influenza vaccine, there was a tendency not to recommend it. While most midwives had a positive attitude toward vaccination, their advocation for vaccination against influenza was not as clear as it was for pertussis. Not wanting to influence the decision and assuming an informative-facilitating role also led providers to recommend the influenza vaccine less frequently. Midwives are among the main sources of professional advice for pregnant women. Addressing their understanding and professional practices regarding maternal vaccination is key to change the attitude of pregnant women and thus increase vaccine uptake among them, particularly for influenza.

Understanding factors that influence the decision to be vaccinated against influenza and pertussis in pregnancy: A qualitative study.

AIMS AND OBJECTIVES: To identify how pregnant women perceive pertussis and influenza and the factors that influence their decision to be vaccinated. BACKGROUND: Suffering from influenza during pregnancy increases complications in the pregnant woman, foetus and newborn. Pertussis in children under six months of age causes severe complications. Maternal vaccination against influenza and pertussis is effective and safe. However, vaccination rates are insufficient. DESIGN: We conducted a qualitative descriptive study, using semi-structured interviews. This research adheres to the COREQ guidelines and checklist. METHODS: We carried out 18 semi-structured face-to-face interviews with pregnant women, using intentional sampling and thematic analysis. RESULTS: We identified an overarching theme, 'factors that influenced participants' decision to be vaccinated or not', which was composed of four subthemes that were in turn made up of 12 categories. The factors that influenced participants' decision to be vaccinated against influenza and pertussis were related to their knowledge of and their perception of risk for these diseases. Participants perceived the risk of pertussis to be greater, and they focused their concern on the newborn. The recommendations and convictions of nurse-midwives were the most important factors encouraging vaccination. Participants trusted their nurse-midwives and most reported that they would have been vaccinated if their midwife had recommended it. Other factors were linked to lack of information, fear and concerns about economic interests. CONCLUSIONS: The convictions and actions of the nurse-midwife in recommending vaccination to pregnant women are decisive. Strategies to improve vaccination rates should be directed to helping health professionals understand how their practice affects the final decision of pregnant women. RELEVANCE TO CLINICAL PRACTICE: Understanding the factors that limit vaccination rates among pregnant women provides valuable information to nurse-midwives that can help to improve vaccination strategies and practices. Increased maternal vaccination rates would reduce morbidity and mortality among pregnant women and newborns.

Efectividad del extracto de hoja de frambueso en la estimulación del parto / Effectiveness of raspberry leaf extract in labor induction

Objetivo: Evaluar la efectividad de la administración de 2,16 g/día de extracto de hoja de frambueso en el inicio del parto espontáneo y en la duración de éste, en comparación con la administración de placebo. Diseño: Estudio experimental, multicéntrico, paralelo, prospectivo y doble ciego, con asignación aleatoria al grupo control y experimental. Ámbito de estudio: Centros de Atención a la Salud Sexual y Reproductiva (ASSIR) de Sabadell y Barcelona, y salas de partos del Hospital Parc Taulí de Sabadell y del Hospital de Sant Pau de Barcelona. Sujetos: La muestra de estudio estará formada por 136 gestantes nulíparas que se encuentren en el tercer trimestre del embarazo, antes de la semana 37 de gestación; serán asignadas aleatoriamente 68 al grupo control y 68 al experimental. Intervención: Las gestantes del grupo experimental tomarán 6 cápsulas diarias (2 c/8 h; 2,16 g/día) de extracto de hoja de frambueso y las del grupo control tomarán, siguiendo la misma pauta, unas cápsulas de idéntica forma y color con un placebo (fructosa). Instrumentación: La matrona del ASSIR rellenará el registro de captación en la consulta de seguimiento del embarazo. La recogida de datos se realizará en la sala de partos. La gestante rellenará el diario de cumplimiento y lo entregará el día del parto. Determinación: Se estudiará si hay diferencias en el inicio del parto y en la duración de éste entre el grupo control y el experimental. Para el análisis de los datos, se utilizará el programa estadístico PASW 18.0 (AU)

To evaluate the effectiveness of the administration of 2.16 g / day of raspberry leaf extract at the beginning of spontaneous labor and duration of it, compared to placebo administration. Design: Experimental, multicenter, parallel, double-blind, prospective, randomized to the control group and experimental study assignment. Field of study: Centers of Attention to Sexual and Reproductive Health (ASSIR) of Sabadell and Barcelona, ​​and delivery rooms of the Hospital Parc Tauli de Sabadell and the Hospital de Sant Pau in Barcelona. Subjects: The study sample will consist of 136 nulliparous pregnant women who are in the third trimester of pregnancy before 37 weeks of gestation; 68 will be randomly assigned to the control group and 68 to the experimental. Intervention: Pregnant women in the experimental group will take 6 capsules daily (2 C / 8 h, 2.16 g / day) of raspberry leaf extract and the control group shall, following the same pattern, capsules of identical shape and color placebo (fructose). Instrumentation: Matron of ASSIR filled registration uptake in the pregnancy follow-up visit. Data collection will take place in the delivery room. Pregnant women fill the daily compliance and deliver the day of delivery. Determination: We will study whether there are differences in the onset of labor and the duration of the between control and experimental groups. For data analysis, the SPSS 18.0 statistical program was used (AU)