ABSTRACT
OBJECTIVES: to develop and validate an instrument for the classification of pregnant and postpartum women according to the demand for nursing care. METHODS: a methodological study conducted in three stages: 1) construction of the instrument based on literature review; 2) content validation using the Delphi technique with 12 experts; and 3) Evaluation of the convergent construct validity through the correlation between the scores of the constructed instrument and the Fugulin instrument. RESULTS: an instrument with ten indicators of specific care for pregnant and postpartum women was developed. A content validity index higher than 0.9 was obtained, requiring only one round of the Delphi technique. The Spearman coefficient was 0.64 between the instruments, indicating a strong correlation. CONCLUSIONS: the classification instrument specifically constructed for pregnant and postpartum women showed evidence of content validity and convergent construct validity with a widely used instrument in the national territory.
Subject(s)
Delphi Technique , Obstetric Nursing , Humans , Female , Pregnancy , Obstetric Nursing/standards , Obstetric Nursing/methods , Surveys and Questionnaires , Adult , Reproducibility of Results , Psychometrics/instrumentation , Psychometrics/methods , BrazilABSTRACT
OBJECTIVE: To examine the effect of psychological distress, overall distress, and institutional support following a traumatic workplace event on absenteeism, turnover intention, and resilience among labor and delivery nurses. DESIGN: A quantitative cross-sectional survey. SETTING: Online distribution from January 13, 2021, to February 2, 2021. PARTICIPANTS: A nationwide convenience sample of labor and delivery nurses recruited from the Association of Women's Health, Obstetric and Neonatal Nurses (N = 171). METHODS: Participants completed a survey that included the Second Victim Experience and Support Tool-Revised and the Second Victim Support Desirability survey. We compared available versus desired support options using descriptive analyses. We examined levels of psychological distress and lack of institutional support in relation to turnover intention, absenteeism, and resilience using multiple regression analyses. RESULTS: Participants identified and described various traumatic experiences in the workplace, including neonatal and maternal death, complicated births, and workplace violence. Participants indicated that the available support services did not meet their needs. Psychological distress, overall distress, and lack of institutional support were associated with absenteeism and turnover, whereas only institutional support was associated with resilience. CONCLUSION: Labor and delivery nurses encounter various traumatic events in the workplace, and the support services provided after an event do not meet their needs. Additional research is needed to understand the scope of the problem and investigate best practices to assist labor and delivery nurses following traumatic events.
Subject(s)
Workplace , Humans , Female , Adult , Cross-Sectional Studies , Pregnancy , Surveys and Questionnaires , Workplace/psychology , Obstetric Nursing/methods , Middle Aged , Personnel Turnover/statistics & numerical data , Social SupportABSTRACT
OBJECTIVE: To explore the relationships among individual and workplace characteristics and self-efficacy in labor support among intrapartum nurses. DESIGN: Cross-sectional survey. SETTING: Online distribution from April to August 2020. PARTICIPANTS: Members of the Texas section of the Association for Women's Health, Obstetric, and Neonatal Nurses (N = 106). METHODS: I conducted descriptive analysis on individual and workplace characteristics, including scores on the Self-Efficacy Labor Support Scale. I conducted backward stepwise multivariate linear regression to assess the factors associated with self-efficacy in providing labor support. RESULTS: Years as an intrapartum nurse had a positive association with self-efficacy in labor support. Experience with open-glottis pushing, the overall cesarean birth rate, and the use of upright positioning during labor and birth were also positively associated with self-efficacy in labor support. Conversely, lack of recognition by providers was negatively associated with self-efficacy in labor support. CONCLUSION: Findings suggest that modifiable factors at the individual and hospital levels are associated with nurses' self-efficacy in labor support. Hospitals must work to engage in obstetric practices that are congruent with providing labor support, including the use of experienced nurses to mentor new nurses and the creation of a unit culture to reinforce the intent of individual nurses to provide labor support.
Subject(s)
Self Efficacy , Humans , Female , Texas , Pregnancy , Adult , Cross-Sectional Studies , Labor, Obstetric/psychology , Surveys and Questionnaires , Obstetric Nursing/methods , Workplace/psychology , Nursing Staff, Hospital/psychology , Nursing Staff, Hospital/statistics & numerical data , Delivery, Obstetric/methods , Delivery, Obstetric/statistics & numerical data , Delivery, Obstetric/psychology , Delivery, Obstetric/nursingABSTRACT
OBJETIVO: Caracterizar os fatores que ocasionam a violência obstétrica e a importância da enfermagem no desenvolvimento de medidas preventivas. MÉTODOS: Trata-se de uma revisão sistemática da literatura com metassíntese, com utilização do protocolo PRISMA. Realizou-se a pesquisa referida na fonte de busca: Biblioteca Virtual em Saúde (BVS) e nas bases de dados: SCIELO e LILACS, apresentando uma totalidade de 61 documentos. Após estabelecimento e aplicação dos critérios de inclusão: artigos disponíveis gratuitos, publicados entre 2015 a 2020, em língua portuguesa, inglesa e espanhola e exclusão: não apresentassem à temática, repetitivos, dissertações e resumos, resultando em um total de 10 artigos. RESULTADOS: O processo do parto é um acontecimento repleto de possíveis equívocos, condutas dolorosas e negligências, que podem gerar a violência obstétrica causando traumas físicos e psicológicos irreversíveis. CONCLUSÃO: Por meio desse estudo buscou destacar a importância de minimizar as praticas abusiva, com o uso de estratégias que efetivem programas e políticas voltadas ao binômio mãe-filho.(AU)
OBJECTIVE: To characterize the factors that cause obstetric violence and the importance of nursing in the development of preventive measures. METHODS: This is a systematic review of the literature with metasynthesis, using the PRISMA protocol. The research was reported in the search source: Virtual Health Library (VHL) and in the databases: SCIELO and LILACS, presenting a total of 61 documents. After establishment and application of inclusion criteria: free available articles, published between 2015 and 2020, in Portuguese, English and Spanish and exclusion: do not present to the theme, repetitive, dissertations and abstracts, resulting in a total of 10 articles. RESULTS: The delivery process is an event full of possible misunderstandings, painful behaviors and negligence, which can generate obstetric violence causing irreversible physical and psychological trauma. CONCLUSION: Through this study, we sought to highlight the importance of minimizing abusive practices, with the use of strategies that effectively implement programs and policies aimed at the mother-child binomial.(AU)
OBJETIVO: Caracterizar los factores que causan la violencia obstétrica y la importancia de la enfermería en el desarrollo de medidas preventivas. METODOS: Se trata de una revisión sistemática de la literatura con metasíntesis, utilizando el protocolo PRISMA. La investigación fue reportada en la fuente de búsqueda: Virtual Health Library (VHL) y en las bases de datos: SCIELO y LILACS, presentando un total de 61 documentos. Tras el establecimiento y aplicación de criterios de inclusión: artículos gratuitos, publicados entre 2015 y 2020, en portugués, inglés y español y exclusión: no se presentan al tema, repetitivos, disertaciones y resúmenes, dando como resultado un total de 10 artículos. RESULTADOS: El proceso de entrega es un evento lleno de posibles malentendidos, comportamientos dolorosos y negligencia, que puede generar violencia obstétrica causando traumas físicos y psicológicos irreversibles. CONCLUSION: A través de este estudio, buscamos destacar la importancia de minimizar las prácticas abusivas, con el uso de estrategias que implementen eficazmente programas y políticas dirigidas al binomio materna-infantil.(AU)
Subject(s)
Humans , Female , Pregnancy , Maternal Health , Obstetric Violence , Maternal Health Services , Obstetric Nursing/methodsABSTRACT
Introducción: El alto grado de utilidad de un instrumento diseñado para medir cuidados humanizados en enfermería, unido a las carencias de estudios en el contexto cubano sobre su aplicación, exigen desde esta perspectiva, su implementación en el proceso del parto, pues aportaría elementos que permiten evaluar la humanización del cuidado de la enfermería obstétrica en Cuba. Objetivo: Describir la percepción de mujeres sobre el cuidado humanizado de enfermería durante la atención en el parto el parto. Métodos: Estudio no experimental, descriptivo, de corte transversal, entre enero y diciembre del 2019. Participaron 121 mujeres hospitalizadas en el servicio de puerperio del Hospital Ciro Redondo de Artemisa, Cuba. Se aplicó la 3ra versión del instrumento "Percepción de los Comportamientos de Cuidado Humanizado en Enfermería" y se empleó distribución de frecuencia absolutas, relativas y acumuladas, la media aritmética y la escala evaluativa tipo Likert. Resultados: En las 121 mujeres encuestadas, se obtuvo que 96,69 por ciento percibió solo algunas veces una relación de cuidado humanizado en el personal de enfermería de la institución que la atendió durante su trabajo de parto y parto seguido de 88,42 por ciento que lo percibió casi siempre y de las tres dimensiones del instrumento: cualidades del hacer de enfermería obtuvo el mayor porcentaje en la categoría de siempre con 75,20 por ciento. Conclusiones: La mayor cantidad de la muestra percibió que solo algunas veces el profesional de enfermería le brindó cuidados humanizados durante la atención al parto(AU)
Introduction: The high degree of usefulness of an instrument designed to measure humanized nursing cares, together with the lack of studies in the Cuban context about its application, demand from this perspective, its implementation in the delivery process, since it would provide elements that allow to assess humanization of obstetric nursing care in Cuba. Objective: To describe women's perception about humanized nursing care during childbirth care. Methods: Nonexperimental, descriptive and cross-sectional study, carried our between January and December 2019. One hundred and twenty-one women participated who had been hospitalized in the puerperium service of Ciro Redondo Hospital in Artemisa, Cuba. The third version of the instrument "Perception of Humanized Care Behaviors in Nursing" was applied and absolute, relative and cumulative frequency distribution were used, together with arithmetic mean and the Likert-type assessment scale. Results: In the 121 women surveyed, it was obtained that 96.69 percent perceived only "sometimes" a relationship of humanized care from the nursing personnel of the institution where they were attended during labor and delivery, followed by 88.42 percent, which perceived such relationship "almost always." Of the three instrument dimension, qualities of nursing work obtained the highest percentage in the category "always," accounting for 75.20 percent. Conclusions: Most of the sample perceived that only "a few times" did the nursing professional provide humanized cares during delivery care(AU)
Subject(s)
Humans , Female , Perception , Labor, Obstetric , Nursing Care/methods , Obstetric Nursing/methods , Cross-Sectional Studies , Humanizing DeliveryABSTRACT
The Covid-19 pandemic has further illuminated the already existing need for methods of building resilience in perinatal caregivers. Using a scoping review approach, literature was examined to identify evidence-based models of resilience building in a cohort of perinatal clinicians. Research published between January 2015 and 2020 was evaluated using PubMed, CINAHL, EMBASE, and PsycINFO databases. Of the initial 3399 records reviewed, 2 qualitative studies met the inclusion criteria. Given the deleterious effects of Covid-19 on perinatal care providers, and in light of the paucity of available studies, personnel, time, and funding should be allocated for research to address these issues.
Subject(s)
Burnout, Professional , COVID-19 , Nurses, Neonatal/psychology , Occupational Stress , Perinatal Care/methods , Resilience, Psychological , Adaptation, Psychological , Burnout, Professional/prevention & control , Burnout, Professional/psychology , COVID-19/epidemiology , COVID-19/psychology , Crew Resource Management, Healthcare/methods , Female , Humans , Infant, Newborn , Midwifery , Mindfulness/methods , Obstetric Nursing/methods , Occupational Stress/prevention & control , Occupational Stress/rehabilitation , Pregnancy , SARS-CoV-2ABSTRACT
Para la valoración de las gestantes es indispensable incorporar parámetros que permitan la identificación de alteraciones de parte del personal de enfermería y medicina. Esta valoración en la atención de salud no se realiza en todas las instituciones en las cuales consultan las gestantes, llevarlo a cabo permite detectar a tiempo las alteraciones clínicas que incrementan la morbilidad y la mortalidad materna. El estudio determina las alteraciones en gestantes cuando se aplica la Escala de Alerta Temprana en una institución de alta complejidad en Colombia. MÉTODO: Investigación observacional descriptiva, en 308 gestantes con más de un día de encontrarse en hospitalización y unidad de cuidados especial obstétrico, recolectando información contenida en las historias clínicas digitales y las evaluaciones realizadas por el personal de salud durante el periodo enero a diciembre del 2017, a través de un formato general de condiciones de salud y la escala de alerta temprana en una institución de alta complejidad. RESULTADOS: La edad de las gestantes se encuentra entre 14 y 45 años. El diagnóstico más frecuente de ingreso fue preclampsia con un 38.2% IC95% (32.62-43.98). La mayor frecuencia de alteraciones está en la tensión arterial sistólica con un 70.1% IC95% (50.75-62.07), tensión diastólica 56.5% IC 95% (50.75-62.07) y alteración respiratoria 28.9% IC (23.97-34.36). Se encontró significancia estadística entre la estancia y los antecedentes patológicos con p < 0.03. Los procedimientos de valoración, diagnóstico y registro oportuno por el personal de enfermería y médico son de vital importancia en la detección precoz de la morbilidad materna extrema
For the assessment of pregnant women, it is essential for nursing and medical staff to incorporate parameters to identify alterations in antenatal health status. This health care assessment is not performed by all institutions that provide antenatal care to pregnant women. Performing antenatal health care assessment assists in the early detection of clinical alterations that can increase morbidity and maternal mortality. The study aims to determine the alterations in pregnant women with the application of the Early Warning Scale in a highly complex institution in Colombia. METHOD: This research is observational, descriptive, and was carried out on 308 pregnant women who were hospitalized or admitted in a Special Obstetric Care Unit (SOCU) for more than one day in a highly complex institution. Data contained in digital medical records were collected and evaluations were carried out by healthcare staff between January 2017 and December 2017, by way of an overall format for health conditions and the Early Warning Scale. RESULTS: The age of pregnant women ranged between 14 and 45 years. The most common diagnosis for admission was preeclampsia with 38.2% CI 95% (32.62-43.98). The highest frequency of alterations was found in systolic blood pressure with 70.1% Confidence Interval (CI) 95% (50.75-62.07), diastolic blood pressure 56.5% CI 95%(50.75-62.07), and respiratory distress 28.9% CI (23.97-34.36). Statistical significance was found between hospital stay and pathological history with p < 0.03. Timely assessment, diagnosis, and registration procedures by nurses and medical staff are of vital importance in the early detection of extreme maternal morbidity
Subject(s)
Humans , Female , Pregnancy , Adolescent , Young Adult , Adult , Middle Aged , Pre-Eclampsia/epidemiology , Pregnancy Complications/epidemiology , Obstetric Nursing/methods , Hypertension/epidemiology , Indicators of Morbidity and Mortality , Early Diagnosis , Evidence-Based Nursing/methods , Mass Screening/instrumentationABSTRACT
BACKGROUND: Numerous studies have identified a relationship between nurse staffing and adverse patient outcomes in medical / surgical patient populations. However, little is known about the impact of labor and delivery (L&D) nurse staffing and adverse birth outcomes, such as unintended cesarean delivery, in low-risk term-gestation women. PURPOSE: We examined nurse staffing patterns on the likelihood of cesarean sections (C-sections) among low- risk, full gestation births and provided a testing framework to distinguish optimal from ineffective levels of nurse staffing. METHODS: This retrospective descriptive study used hours of productive nursing time per delivery as the treatment variable to determine direct nursing time per delivery and its impact on the likelihood of a C-section. For comparisons, we also assessed the likelihood of augmentations and of inductions, as well as the number of neonatal intensive care unit (NICU) hours per birth. We limited our sample to those births between 37 and 42 weeks of gestation. Two complimentary models (the quadratic and piecewise regressions) distinguishing optimal staffing patterns from ineffective staffing patterns were developed. The study was implemented in eleven hospitals that are part of a large, integrated healthcare system in the Southwest. DISCUSSION: While a simple linear regression of the likelihood of a C-section on nursing hours per delivery indicated no statistically distinguishable effect, our 'optimal staffing' model indicated that nurse staffing hours employed by using a large sample of hospitals were actually minimizing C-sections (robustness checks are provided using similar model comparisons for the likelihood of augmentation and induction, and NICU hours). Where the optimal staffing models did not appear to be effective for augmentations, inductions, and NICU hours, we found significant differences between facilities (i.e., significant fixed effects for hospitals). In all specifications, we also controlled for weeks of gestation, race, sex of the child, and mother's age.
Subject(s)
Cesarean Section/nursing , Nurses/supply & distribution , Personnel Staffing and Scheduling/standards , Workload/standards , Adult , Cesarean Section/standards , Cesarean Section/trends , Female , Humans , Infant, Newborn , Nurses/statistics & numerical data , Obstetric Nursing/methods , Obstetric Nursing/standards , Obstetric Nursing/trends , Personnel Staffing and Scheduling/statistics & numerical data , Pregnancy , Quality of Health Care/standards , Quality of Health Care/statistics & numerical data , Retrospective Studies , Risk Factors , Workload/psychology , Workload/statistics & numerical dataABSTRACT
Leaders in nursing education embrace innovative, real-world learning environments that transform today's generation of nursing students into critical thinkers. Scheduling exclusive child-bearing practicums are challenging due to staffing, time, and maternal client presentation. Utilizing transformative learning theory a perinatal continuum of care clinical learning experience evolved. This paper will discuss the qualitative, descriptive study of Bachelor of Science in Nursing students in rural, Midwestern United States who completed maternal/infant didactic, high-fidelity simulation, and real-world experiences relative to women during the perinatal period. Participants (n = 50) consisted of third-semester baccalaureate nursing students enrolled in the maternal/infant course. Data were collected from students' reflective journal blogs at the end of the semester. The aim of this study was to identify the outcomes of students learning through this perinatal experience. Three themes emerged from this study: self-analysis, critical thinking, and self-efficacy. Students' reflection indicated that through this comprehensive clinical experience, they developed a new self-awareness. Students noted that the experience was unique to any they had encountered. The perinatal assignment provided an opportunity for professional growth in this specialty area due to the interface of theory, simulation, and clinical applications expounded in the reflective clinical blog throughout the experience.
Subject(s)
Continuity of Patient Care , Obstetric Nursing/education , Obstetric Nursing/methods , Perinatal Care/methods , Students, Nursing/psychology , Adolescent , Adult , Education, Nursing, Baccalaureate/methods , Female , Humans , Male , Obstetric Nursing/trends , Problem-Based Learning/methods , Qualitative Research , Students, Nursing/statistics & numerical dataABSTRACT
Objetivo: descrever o uso das tecnologias de cuidado da enfermeira obstétrica qualificada na modalidade de residência e sua relação com a práxis profissional. Método: estudo qualitativo com 13 enfermeiras obstétricas atuantes em duas maternidades públicas do Rio de Janeiro, Brasil. Dados coletados por entrevista individual, semiestruturada e análise hermenêutica-dialética. Resultados: a transição do modelo intervencionista estrutura-se no cuidado humanizado com a incorporação de um modelo centrado nas boas práticas e nas tecnologias não invasivas de cuidado da enfermeira obstétrica. A práxis da enfermeira obstétrica contribui para a transformação qualitativa deste cenário, com resgate sobre a fisiologia, o fortalecimento de vínculo e empoderamento da mulher, ressignificando o momento do parto. Conclusão: a prática da enfermeira e o uso das tecnologias não invasivas constituem possibilidades para ruptura do modelo hegemônico culturalmente instituído no Brasil, sendo necessária ainda a constituição de um consenso que supere o senso comum(AU)
Objective: to describe the use of care technologies by residency-qualified nurse midwives and their relationship with professional praxis. Method: in this qualitative study with 13 nurse midwives at two public maternity hospitals in Rio de Janeiro, Brazil, data were collected by individual, semi-structured interview and hermeneutic-dialectic analysis. Results: the transition from the interventionist model builds on humanized care by incorporating a model centered on nurse midwives' use of best practices and noninvasive care technologies. Their praxis contributes to qualitative change in this scenario by reinstating physiology, fostering stronger bonding, and empowering women, so as to re-signify the moment of childbirth. Conclusion: nurse midwives' praxis and use of noninvasive technologies constitute opportunities to break with the culturally established model hegemonic in Brazil, while a consensus still needs to be built to surmount common sense(AU)
Objetivo: describir el uso de tecnologías asistenciales por parte de enfermeras parteras tituladas en residencia y su relación con la praxis profesional. Método: en este estudio cualitativo con 13 enfermeras parteras de dos maternidades públicas de Río de Janeiro, Brasil, los datos fueron recolectados mediante entrevista individual, semiestructurada y análisis hermenéuticodialéctico. Resultados: la transición del modelo intervencionista se basa en la atención humanizada al incorporar un modelo centrado en el uso de las mejores prácticas y tecnologías de atención no invasiva por parte de las enfermeras parteras. Su praxis contribuye al cambio cualitativo en este escenario al reinstaurar la fisiología, fomentar vínculos más fuertes y empoderar a las mujeres, para resignificar el momento del parto. Conclusión: la praxis de las enfermeras parteras y el uso de tecnologías no invasivas constituyen oportunidades para romper con el modelo hegemónico culturalmente establecido en Brasil, mientras que aún debe construirse un consenso para superar el sentido común(AU)
Subject(s)
Humans , Female , Adult , Humanizing Delivery , Delivery, Obstetric/trends , Nurse Midwives/education , Obstetric Nursing/methods , Brazil , Power, Psychological , Epidemiology, Descriptive , Qualitative Research , Hermeneutics , Hospitals, MaternityABSTRACT
INTRODUCCIÓN: La atención humanizada del parto se centra en el buen trato a la gestante, sin embargo, algunas maternas experimentan violencia obstétrica, lo cual afecta a su bienestar. Se hace necesario contar con herramientas validadas que permitan informar, comunicar y educar sobre prácticas que contribuyen a hacer del parto una experiencia humanizada. MATERIAL Y MÉTODO: Estudio de validación con el objetivo de desarrollar una cartilla educomunicativa sobre parto humanizado, a partir de la revisión bibliográfica, la posterior validación por parte de 16 especialistas y 100 participantes del público objetivo, en 2019. RESULTADOS: Los especialistas calificaron la cartilla con una media del índice de Validez de Contenido (IVC) de 0,94 y una confiabilidad, Alfa de Cronbach de 0,81. En población objetivo, el nivel de respuesta positiva osciló entre el 87 y el 100 %, con una media de 97,9%. DISCUSIÓN: Haciendo revisión de literatura y cuidando los detalles de escritura, forma y fondo, se logró elaborar una cartilla que mostró alto IVC para brindar educación sobre parto humanizado a gestantes y familiares. Algunas fortalezas fueron: la rigurosidad del proceso, la idoneidad de las encuestadoras y el tamaño de muestra. La principal debilidad es que la recolección de la información se llevó a cabo en instituciones de Salud. CONCLUSIONES: La cartilla elaborada es válida para garantizar el entendimiento, por parte de maternas y familiares, del parto humanizado. Se considera material relevante e innovador para educar en este tema, como un evento de impacto en la vida del binomio madre-hijo y su familia
INTRODUCTION: Humanized childbirth care focuses on the good treatment of pregnant women; however, some mothers experience obstetric violence, which affects their wellbeing. It is necessary to have validated tools that permit informing, communicating, and educating on practices that contribute to making the delivery process a humanized experience. METHODS: This was a validation study consisting on the development of an educational-communicative booklet on humanized childbirth, from a bibliography review, along with subsequent validation by 16 specialists and 100 participants from the target population, in 2020. RESULTS: The specialists scored the booklet with a content validity index (CVI) median of 0.94 and Cronbach's alpha reliability of 0.81. In the target population, the level of positive response ranged between 87% and 100%, with a median of 97.9%. DISCUSSION: Through a literature review and by heeding to writing details, form, and depth, the study managed to elaborate a booklet that showed high CVI to provide education on humanized childbirth to pregnant women and relatives. Study strengths included process rigor, pollster suitability, and simple size. The principal weakness is that information collection was carried out in health institutions. CONCLUSIONS: The booklet elaborated is valid to guarantee understanding, by mothers and their relatives, of humanized childbirth. It is considered relevant and innovative material to educate on this theme, as an impacting event in the lives of the mother-child binomial and their family