Level of Job Burnout among Midwives Working in Labour Rooms in Barcelona Region: A Cross-Sectional Study.

BACKGROUND: Nowadays, burnout syndrome (BS) symptoms appear to have increased in healthcare workers, specifically midwives, but there are no studies on burnout among midwives in Catalonia. The present study aimed to assess and describe the prevalence of BS in midwives working in labour rooms. METHODS: A cross-sectional descriptive study was conducted on 122 midwives working in 24 maternity hospitals in the Barcelona (region) which were selected using purposive sampling from January to March 2017. Data were collected using two questionnaires (demographic information, job burnout using Spanish Burnout Inventory with 20 items and four subscales). Data analysis was performed using SPSS software version 21 and Chi-Square, U Mann-Whitney, and Kruskall-Wallis. P<0.05 was considered statistically significant. RESULTS: None of the participants obtained a critical level of BS. 37 (30.33%) participants scored medium burnout and 47 (38.52%) recorded low burnout. Statistically, work stress (P=0.01), marital status (P=0.006), attendance of more than three women per shift (P=0.001), the number of children (P=0.01), parity (P=0.005), health status (P=0.04), and being on sick leave over last year (P=0.04) were significantly correlated with medium-high levels of burnout. Burnout scores were higher in midwives having a life partner and those without children. CONCLUSION: Following the results, no participant obtained a critical level of BS; about one-third of them scored medium-high burnout. However, specific interventions are suggested to be conducted to maintain the midwives' motivation and prevent burnout development.

Ansiedad y depresión en las madres de recién nacidos prematuros. Estrategias de intervención y revisión de la bibliografía / Anxiety and depression in mothers of preterm infants. Intervention strategies and literature review

INTRODUCCIÓN: El parto prematuro es una situación muy estresante para las mujeres que lo sufren, ya que supone enfrentarse a una realidad no esperada, en la que se pierden sus expectativas sobre la vivencia del embarazo y el parto normal. Además, deberán afrontar no sólo la separación inicial de su hijo, sino también la pérdida de su rol maternal, ya que los cuidados se asumirán en la unidad neonatal (UNN). Por todo ello, durante el puerperio estas mujeres serán especialmente vulnerables a los problemas de salud mental, y tendrán más riesgo de sufrir niveles altos de ansiedad, depresión e incluso síntomas de estrés postraumático. OBJETIVOS: Conocer y valorar las estrategias de intervención que han demostrado ser eficaces para prevenir, mejorar y/o tratar los riesgos para la salud mental de las madres que pasan por el proceso de tener un hijo prematuro. METODOLOGÍA: Se ha realizado una búsqueda de la bibliografía publicada en los últimos 5 años en las bases de datos CINHAL, PubMed, Web of Science y PsycINFO. RESULTADOS: Las estrategias que han demostrado ser eficaces para mejorar la salud mental son las que incluyen a las madres como cuidadoras, ya sea a través de la promoción de la lactancia materna, el método canguro o los masajes en la UNN, y también las intervenciones que aumentan los conocimientos, tanto en referencia al ambiente de la UNN como a los cuidados y progresos de sus hijos. CONCLUSIONES: La matrona, como profesional de referencia del cuidado del puerperio, ha de conocer el riesgo para la salud mental de estas puérperas, con el fin de detectarlo precozmente y promover actividades preventivas que faciliten su rol maternal, y así contribuir a mejorar la experiencia de tener un hijo prematuro

INTRODUCTION: Preterm birth represents a stressful situation for women who suffer it. They have to face an unexpected reality. A new reality far from their initial expectations about pregnancy and birth, as well as the separation from their baby after giving birth. Premature babies need special cares assumed by the neonatal intensive care unit so mothers have to delegate her maternal role to health professionals. Therefore, all women who have to face a preterm birth are especially vulnerable during the postpartum period to develop mental health problems and to present more anxiety, depression and even post-traumatic stress. OBJECTIVE: Identify and evaluate intervention strategies that proved to be effective in order to prevent, improve and/or treat the risks in mental health of all mothers who have to face a preterm baby. METHODOLOGY: Bibliographic research in the scientific literature published during the last five years in the databases CINHAL, PubMed, Web of Science and PsycINFO. RESULTS: The strategies which demonstrated to be more effective to improve the mental health are interventions that included mothers as the responsible of giving care to the baby. There are different strategies such the promotion in breastfeeding, the kangaroo method or the introduction in massage techniques in the neonatal unit. The activities that help them to increases the knowledge about the function of the neonatal intensive care unit and giving them all the information about the care and progress of their baby are effective options as well. CONCLUSIONS: The midwife is the responsible to take care of mothers during the postpartum. This professional has to know the risk of this women to develop mental health problems during this process. In that case, they have to detect it early and work to promote preventive activities that help mothers to develop her maternal role in this way they will contribute to improve the experience of having a premature baby

Underscreened Women Remain Overrepresented in the Pool of Cervical Cancer Cases in Spain: A Need to Rethink the Screening Interventions.

OBJECTIVE: Audit of women with invasive cervical cancer (CC) is critical for quality control within screening activities. We analysed the screening history in the 10 years preceding the study entry in women with and without CC during 2000-2011. METHODS: 323 women with CC from six pathology departments in Catalonia (Spain) and 23,782 women with negative cytology were compared. Age, previous history of cytologies, and histological type and FIGO stage were collected from the pathology registries. Logistic regression analysis was used to estimate odds ratios (OR) and 95% confidence intervals (CI95%). RESULTS: History of cytology was registered in 26.2% of CC cases and in 78% of the control women (P < 0.0001) and its frequency decreased with increasing age. Compared to women with squamous cell carcinoma, adenocarcinoma cases were significantly more likely to have a cytology within the 3-year interval preceding cancer diagnosis (OR = 2.6 CI 95%: 1.2-5.6) and to have normal cytology results in previous screenings (OR = 2.4 CI 95%: 1.2-4.5). FIGO II-IV cases were more common among older women (older than 60 years). CONCLUSIONS: Absence of prior screening history was extremely common among CC cases compared to controls. Organized actions to reduce underscreened women and use of highly sensitive HPV-based tests could be important to reduce CC burden.