A Mindfulness-Based App Intervention for Pregnant Women: Protocol for a Pilot Feasibility Study.

BACKGROUND: Pregnancy is a complex time characterized by major transformations in a woman, which impact her physical, mental, and social well-being. How a woman adapts to these changes can affect her quality of life and psychological well-being. The literature indicates that pregnant women commonly experience psychological symptoms, with anxiety, stress, and depression being among the most frequent. Hence, promoting a healthy lifestyle focused on women's psychological well-being is crucial. Recently developed digital solutions have assumed a crucial role in supporting psychological well-being in physiologically pregnant women. Therefore, the need becomes evident for the development and implementation of digital solutions, such as a virtual coach implemented in a smartphone, as a support for the psychological well-being of pregnant women who do not present psychological and psychiatric disorders. OBJECTIVE: This study aims to assess the feasibility, acceptability, and utility of a mindfulness-based mobile app. The primary objective is to explore the feasibility of using a virtual coach, Maia, developed within the TreC Mamma app to promote women's psychological well-being during pregnancy through a psychoeducational module based on mindfulness. Finally, through the delivery of this module, the level of psychological well-being will be explored as a secondary objective. METHODS: This is a proof-of-concept study in which a small sample (N=50) is sufficient to achieve the intended purposes. Recruitment will occur within the group of pregnant women belonging to the pregnancy care services of the Trento Azienda Provinciale per i Servizi Sanitari di Trento. The convenience sampling method will be used. Maia will interact with the participating women for 8 weeks, starting from weeks 24 and 26 of pregnancy. Specifically, there will be 2 sessions per week, which the woman can choose, to allow more flexibility toward her needs. RESULTS: The psychoeducational pathway is expected to lead to significant results in terms of usability and engagement in women's interactions with Maia. Furthermore, it is anticipated that there will be improvements in psychological well-being and overall quality of life. The analysis of the data collected in this study will be mainly descriptive, orientated toward assessing the achievement of the study objectives. CONCLUSIONS: Literature has shown that women preferred web-based support during the perinatal period, suggesting that implementing digital interventions can overcome barriers to social stigma and asking for help. Maia can be a valuable resource for regular psychoeducational support for women during pregnancy. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/53890.

Socio-cultural and clinician determinants in the maternal decision-making process in the choice for trial of labor vs. elective repeated cesarean section: a questionnaire comparison between Italian settings.

Objective To identify socio-cultural and clinician determinants in the decision-making process in the choice for trial of labor after cesarean (TOLAC) or elective repeat cesarean section (ERCS) in delivering women. Methods A tailored questionnaire focused on epidemiological, socio-cultural and obstetric data was administered to 133 patients; of these, 95 were admitted for assistance at birth at Fondazione Policlinico Universitario "A. Gemelli" (FPG) IRCCS, Rome, and 38 at S. Chiara Hospital (SCH), Trento, Italy. Descriptive analysis and logistic regression modeling were performed. Results Vaginal birth after cesarean (VBAC) rates were higher at SCH than at FPG (68.4% vs. 23.2%; P < 0.05). Maternal age in the TOLAC/VBAC group was significantly higher at SCH than at FPG (37.1 vs. 34.9 years, P < 0.05). High levels of education and no-working condition corresponded to a lower rate of VBAC. Proposal on delivery mode after a previous CS was missed in the majority of cases. Participation in prenatal course was significantly less among women in the ERCS groups. Using logistic regression, the following determinants were found to be statistically significant in the decision-making process: maternal age [odds ratio (OR) = 0.968 (95% confidence interval [CI] 0.941-0.999); P = 0.019], education level [OR = 0.618 (95% CI 0.419-0.995); P = 0.043], information received after the previous CS [OR = 0.401 (95% CI 0.195-1.252); P = 0.029], participation in antenatal courses [OR = 0.534 (95% CI 0.407-1.223); P = 0.045] and self-determination in attempting TOLAC [OR = 0.756 (95% CI 0.522-1.077); P = 0.037]. Conclusion In the attempt to promote person-centered care, increases in TOLAC/VBAC rates could be achieved by focusing on individual maternal needs. An ad hoc strategy for making birth safer should begin from accurate information at the time of the previous CS.

[Standardization of data collection in midwifery care: a literature review]. / La standardizzazione della raccolta dati nella Midwifery Care: revisione della letteratura.

INTRODUCTION: midwifery records currently do not systematically collect data regarding midwifery care provided. Midwifery Minimum Data Sets (MMDS) have been developed to perform uniform and standardized data collection. AIM: to describe features, purposes and use of MMDSs in obstetrical care. METHOD: a literature review was conducted using Medline, CINAHL and Scopus databases. The following key words were used: "data set", "midwifery" and "maternity care. RESULTS: twelve of 752 potentially eligible articles were included. Six MMDS were identified: Nurse - Midwifery Clinical Data Set, Optimality Index-United States, ACNM Benchmarking Data Collection Form, Midwives Alliance of North America Data Set, American Association of Birth Centers Uniform Data Set, Women's Health Care Minimum Data Set. Overall, the purpose of the different MMDSs was to record systematically the midwifery care provided and patient outcomes. The various MMDS had differing features; different data were collected related to women (e.g. socio-demographic data, anamnesis), their newborns (e.g. Apgar score, weight) and the midwifery care provided in different phases (e.g. antepartum, intrapartum). Generally, MMDS were used in north-American countries and their use showed the efficacy of midwifery interventions and the importance of systematic data collection. DISCUSSION: an organized and standardized approach is needed to provide accurate data collection of maternal and neonatal health outcomes and midwifery care. The development and validation of MMDS in the Italian context is needed.

Teaching midwife students how to break bad news using the cinema: an Italian qualitative study.

Delivering bad news is a difficult task that involves all healthcare professionals, including midwives. The hypothesis is that, in order to learn how to disclose and to discuss bad news, students need a phase of personal reflection, of awareness of their own emotional processes. The use of films in healthcare education can foster this process evoking different emotions concerning suffering and disease, in a "safety zone". This study examines the effects that a course, which uses reflection as a method of learning and the cinema as a teaching tool, produces on a little group of Italian third-year Midwifery students. From the content analysis (supported by Atlas-Ti(®) software) of the texts produced by the students after the vision of two entire films, it appears that they correctly identified many elements related to good and poor communication of bad news and that they were able to describe the emotions felt while watching the film, but still revealed a certain difficulty to interpret them. The course helped students to recognize the value of reflection on their emotions to better understand others, to empathize with people who suffer, but also to recognize their difficulties and compete with their own limits.