Interés, motivación y barreras para investigar de las residentes de matrona de Cataluña al inicio y al final de la residencia / Interest, motivation and barriers to research of midwifery residents in Catalonia at the beginning and end of the residency

Objetivo: Analizar la actitud, motivación y barreras percibidas a la investigación en las enfermeras residentes de matrona de Cataluña, al inicio y al final de su periodo formativo. Personas/Material y método: Estudio cuasi experimental pre-post intervención, dirigido a las enfermeras residentes de matrona en Cataluña en el periodo 2019-2021. Se estudiaron las características sociodemográficas y laborales a través de un cuestionario propio. Para estudiar la actitud y motivación a la investigación se utilizó el cuestionario de Cepeda, y para estudiar las barreras a la utilización de la investigación en enfermería se utilizó la escala The Barriers to research Utilization Scale adaptada al castellano por Moreno-Casbas. Resultados: Durante la residencia aumentaron la lectura de literatura científica y la actividad investigadora. Las matronas incrementaron sus conocimientos para realizar un trabajo de investigación. No se observaron diferencias estadísticamente significativas entre la puntuación de las barreras identificadas al inicio y al final de la residencia; no obstante, las barreras relacionadas con las características del profesional tienden a disminuir, y aumentan las relacionadas con la organización, la calidad de la investigación, la presentación y la accesibilidad de los resultados. Conclusiones: Las residentes de matrona consideran la investigación una actividad propia que contribuye al desarrollo de la profesión enfermera. Los elementos facilitadores y las barreras percibidas por las residentes de matrona coinciden con las identificadas por enfermeras de otros contextos, y parecen mantenerse estables a lo largo del tiempo. (AU)

Objective: To analyze the attitude, motivation and perceived barriers to research in midwifery resident nurses in Catalonia, at the beginning and end of their training period. Persons/Material and Method: Quasi-experimental pre-post intervention study, aimed at midwifery resident nurses in Catalonia from 2019-2021. Sociodemographic and labor characteristics were studied through an own questionnaire. To study the attitude and motivation towards research, the Cepeda questionnaire was used. To study the barriers to the use of research in nursing, The Barriers to research Utilization Scale adapted to Spanish by Moreno-Casbas was used. Results: During the residency, the reading of scientific literature and research activity increased. The midwives increased their knowledge to carry out research work. No statistically significant differences were observed between the score of the barriers identified at the beginning and end of the residency; however, the barriers related to the characteristics of the professional tend to decrease, and those related to the organization, the quality of the research, the presentation and accessibility of the results, increase. Conclusions: Midwifery residents consider research as their own activity that contributes to the development of the nursing profession. The facilitating elements and the barriers perceived by the midwifery residents match with those identified by nurses from other contexts and seem to remain stable over time. (AU)

Impact of maternity care policy in Catalonia: a retrospective cross-sectional study of service delivery in public and private hospitals.

BACKGROUND: As a result of the growing number of interventions that are now performed in the context of maternity care, health authorities have begun to examine the possible repercussions for service provision and for maternal and neonatal health. In Spain the Strategy Paper on Normal Childbirth was published in 2008, and since then the authorities in Catalonia have sought to implement its recommendations. This paper reviews the current provision of maternity care in Catalonia. METHODS: This was a descriptive study. Hospitals were grouped according to their source of funding (public or private) and were stratified (across four strata) on the basis of the annual number of births recorded within their respective maternity service. Data regarding the distribution of obstetric professionals were taken from an official government survey of hospitals published in 2010. The data on obstetric interventions (caesarean, use of forceps, vacuum or non-specified instruments) performed in 2007, 2010 and 2012 were obtained by consulting discharge records of 44 public and 20 private hospitals, which together provide care in 98% of all births in Catalonia. Proportions and confidence intervals were calculated for each intervention performed in all full-term (37-42 weeks) singleton births. RESULTS: Analysis of staff profiles according to the stratification of hospitals showed that almost all the hospitals had more obstetricians than midwives among their maternity care staff. Public hospitals performed fewer caesareans [range between 19.20% (CI 18.84-19.55) and 28.14% (CI 27.73-28.54)] than did private hospitals [range between 32.21% (CI 31.78-32.63) and 39.43% (CI 38.98-39.87)]. The use of forceps has decreased in public hospitals. The use of a vacuum extractor has increased and is more common in private hospitals. CONCLUSIONS: Caesarean section is the most common obstetric intervention performed during full-term singleton births in Catalonia. The observed trend is stable in the group of public hospitals, but shows signs of a rise among private institutions. The number of caesareans performed in accredited public hospitals covers a limited range with a stable trend. Among public hospitals the highest rate of caesareans is found in non-accredited hospitals with a lower annual number of births.

Aplicación de termoterapia en el periné durante el parto para reducir las lesiones que precisan sutura posparto / Application of perineum heat therapy during partum to reduce injuries that require post-partum stitches

OBJETIVO: Evaluar la eficacia de la termoterapia, húmeda o seca, en el periné durante el parto para reducir las lesiones que precisan sutura posparto y valorar su seguridad en relación a la adaptación del recién nacido a la vida extrauterina. MÉTODO: Ensayo clínico multicéntrico, abierto, dirigido desde la Escuela de Enfermería de la Universidad de Barcelona y realizado durante los años 2009-2010 en 5 hospitales catalanes. La muestra fue de 198 gestantes a las que se aplicó el protocolo para la asistencia natural al parto normal. Se realizó una asignación aleatoria a los 3 grupos de estudio: grupo control (GC), calor húmedo (GCH) o calor seco (GCS). Durante el expulsivo se realizó en todos los grupos el cuidado habitual del periné y en los grupos de intervención se aplicó, además, GCH o GCS en el periné. Posteriormente se valoró el estado del periné posparto y el test de Apgar en el neonato. Se realizaron pruebas de contraste estadístico utilizando un intervalo de confianza del 95% y análisis estadístico con PASW 17. RESULTADOS: Perinés sin sutura: GCH 71% (47) versus GC 56% (37), OR: 1.803 (IC:95%:0,881-3,687); GCS 62% (41) versus GC 56% (37), OR:1.285 (IC:95%:0,641-2,577); GCH 71% (47) versus GCS 62% (41), OR:1.402 (IC:95%:0,680-2,890). Medias test de Apgar 5', GCH: 9,91; GCS: 9,98; GC: 9,98. p = 0,431. CONCLUSIONES: La aplicación de termoterapia en el periné no redujo la sutura perineal durante el parto. Se obtuvieron mejores resultados perineales con la termoterapia húmeda. La termoterapia no modificó los resultados neonatales medidos mediante test de Apgar

OBJECTIVE: Evaluate the effectiveness of heat, moist or dry to the perineum during delivery in order to reduce injuries requiring perineal suturing after birth, and to assess its safety in relation to the adaptation of the newborn to extrauterine life. METHOD: An open multicentre clinical trial directed from the School of Nursing at the University of Barcelona was carried out between 2009 and 2010 in 5 Catalan Hospitals. The sample consisted of 198 pregnant women subjected to the natural protocol for normal delivery assistance. The pregnant women were randomized to three study groups: moist heat (MHG), dry heat (DHG), and control (CG). Usual care of the perineum was performed during labour in all groups and MHG or GCS was also applied in the perineum in the intervention groups. The Apgar score in the newborn and perineum postpartum was then assessed. Statistical tests were performed using a 95% confidence interval. Statistical analyses were performed using the SPSS version 17. RESULTS: Perinea that required no suturing: MHG 71% (47) versus CG 56% (37), OR: 1.803; (95% CI: 0.881-3.687); DHG 62% (41) versus CG 56% (37), OR:1.285 (95% CI: 0.641-2.577); MHG 71% (47) versus DHG 62% (41), OR:1.402 (95% CI: 0.680-2.890). Mean: Apgar score 5', MHG: 9.91; DHG: 9.98, CG: 9.98. p = 0.431. CONCLUSIONS: The application of heat therapy to the perineum during labour did not significantly reduce perineal suturing after birth. However, better perineal results were observed with moist heat. Heat therapy does not alter neonatal outcomes measured by Apgar score

[Application of perineum heat therapy during partum to reduce injuries that require post-partum stitches]. / Aplicación de termoterapia en el periné durante el parto para reducir las lesiones que precisan sutura posparto.

OBJECTIVE: Evaluate the effectiveness of heat, moist or dry to the perineum during delivery in order to reduce injuries requiring perineal suturing after birth, and to assess its safety in relation to the adaptation of the newborn to extrauterine life. METHOD: An open multicentre clinical trial directed from the School of Nursing at the University of Barcelona was carried out between 2009 and 2010 in 5 Catalan Hospitals. The sample consisted of 198 pregnant women subjected to the natural protocol for normal delivery assistance. The pregnant women were randomized to three study groups: moist heat (MHG), dry heat (DHG), and control (CG). Usual care of the perineum was performed during labour in all groups and MHG or GCS was also applied in the perineum in the intervention groups. The Apgar score in the newborn and perineum postpartum was then assessed. Statistical tests were performed using a 95% confidence interval. Statistical analyses were performed using the SPSS version 17. RESULTS: Perinea that required no suturing: MHG 71% (47) versus CG 56% (37), OR: 1.803; (95% CI: 0.881-3.687); DHG 62% (41) versus CG 56% (37), OR:1.285 (95% CI: 0.641-2.577); MHG 71% (47) versus DHG 62% (41), OR:1.402 (95% CI: 0.680-2.890). MEAN: Apgar score 5', MHG: 9.91; DHG: 9.98, CG: 9.98. p=0.431. CONCLUSIONS: The application of heat therapy to the perineum during labour did not significantly reduce perineal suturing after birth. However, better perineal results were observed with moist heat. Heat therapy does not alter neonatal outcomes measured by Apgar score.