Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 60
Filtrar
1.
Jpn J Nurs Sci ; : e12456, 2021 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-34581494

RESUMO

AIMS: To explore and describe Myanmar student midwives' perceptions of professional learning using storytelling videos of women's childbirth experiences by conducting a qualitative study and to assess potential pedagogical uses of storytelling videos in midwifery education. METHODS: This pilot study used a qualitative content analysis study design implemented as part of the Diversity and commonalities of birth from women's voice sharing project of the Toyota Foundation. Storytelling videos of the childbirth experiences of seven Asian women (three Myanmar, three Lao, and one Japanese women) were viewed by the students. Thereafter, a semistructured interview with focus group discussion was conducted to explore and assess the students' perceptions. SETTING: Kyaing Tong township, Shan State, Myanmar. PARTICIPANTS: Five second-year midwifery students from a single midwifery training school in Myanmar. RESULTS: Data analysis of their perceptions yielded four major categories: (1) deep reverence for women/mothers;; (2) respectful attitude as a midwife to support mothers; (3) wish for a safe and secure birth environment; and (4) importance of learning from the mother's voice. CONCLUSIONS: The student midwives realized the importance of listening to the mothers' voices regardless of the nationalities or cultural background. The findings indicated that the storytelling videos broadened the students' perspectives of pregnancy and childbirth, and motivated them to provide better maternity care. Storytelling videos of childbirth experiences can be powerful educational materials for enhancing professional learning of student midwives.

2.
BMC Med Educ ; 21(1): 444, 2021 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-34419030

RESUMO

BACKGROUND: The lecture-based learning (LBL) implemented in most Indonesian nursing/midwifery schools underlies the students' lack of ability in clinical reasoning. Team-based learning (TBL) was proposed to improve the students' ability in clinical reasoning as it is applying a course concept of real complex scenarios. In this study, we aimed to assess and compare the effects of TBL and LBL of postpartum hemorrhage topics on the clinical reasoning and classroom engagement of midwifery students in Indonesia. METHODS: We conducted a cluster randomized controlled trial to compare the effects of TBL and LBL. The unit was schools and random allocation was conducted using a simple random sampling method (i.e., coin flipping). There was 1 cluster in the intervention group (n = 62 students) and 1 cluster in the control group (n = 53 students). The students in the intervention group participated in a TBL class (90 min) three times, whereas the students in the control group attended an LBL class on postpartum hemorrhage topics. The primary outcome was the clinical reasoning on postpartum hemorrhage score measured at pre-test, post-test, and 2 weeks post-test. The secondary outcome was Classroom Engagement Survey (CES) score measured after each class finished. We used an unpaired t-test to evaluate the differences between the two groups. The baseline characteristics of the participants were compared using standardized difference. RESULTS: We evaluated a total of 115 participants. Regarding the baseline characteristics, there was a small difference in the age, Grade Point Average and knowledge at pre-test between the intervention and control groups. The mean clinical reasoning on postpartum hemorrhage scores were significantly higher in the TBL students than in the LBL students at post-test (p < .001; Cohen's d = 1.41) and 2 weeks post-test (p < .001; Cohen's d = 1.50). The CES showed a significantly higher in the intervention group than in the control group. CONCLUSIONS: TBL is an effective learning method for enhancing the clinical reasoning ability of students. This learning method allows for more independent and active learning. Having a strong background knowledge, and discussing cases comprehensively with peers can sharpen the clinical reasoning ability of students.


Assuntos
Raciocínio Clínico , Aprendizagem Baseada em Problemas , Feminino , Humanos , Indonésia , Estudantes , Inquéritos e Questionários
3.
BMC Pregnancy Childbirth ; 21(1): 555, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34388970

RESUMO

BACKGROUND: Despite the benefits of breastfeeding for women with Gestational Diabetes Mellitus (GDM) and their infants, breastfeeding is less likely to be performed by this group. This study aimed to examine the current levels of implementation of breastfeeding support to women with GDM in Japan and to clarify barriers to promoting breastfeeding among this population. METHODS: A 25-item questionnaire was developed by the authors to investigate the current levels of implementation of breastfeeding support for women with GDM provided in hospitals, and to explore barriers for promoting breastfeeding among these women. The questionnaire was sent to all 1046 hospitals facilitating childbirth in Japan. Descriptive statistics were used to analyze the quantitative data, and content analysis was used to analyze qualitative data from the open-ended questions. RESULTS: All 296 respondents were included in this study. Regarding breastfeeding support, 95.2% of the respondents provided general information on breastfeeding to GDM women during antenatal midwife consultations. However, the benefits of breastfeeding for preventing type 2 diabetes were addressed by only 48.0%. Likewise, although follow-up services (e.g., telephone support or breastfeeding consultations) were conducted in 88.9% of hospitals, only 50.7% of hospitals informed women that breastfeeding decreases the risk of developing type 2 diabetes after GDM. Regarding barriers, seven categories and 20 subcategories about promoting breastfeeding for women with GDM were extracted and abstracted into the following three themes: Barriers associated with mother and infant, Barriers associated with health professionals, and Organizational barriers. CONCLUSIONS: In Japan, most hospitals that responded provided general breastfeeding support from the antenatal to postpartum periods. However, the benefits of breastfeeding in terms of preventing the incidence of type 2 diabetes following GDM were insufficiently communicated to women with GDM. Furthermore, there were numerous barriers to promoting breastfeeding among women with GDM.

4.
Reprod Health ; 18(1): 170, 2021 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-34372864

RESUMO

BACKGROUND: The use of a decision aid in clinical settings has been beneficial. It informs and educates patients about the available treatment options that can help them reduce decision-making conflicts related to feeling uninformed compared with routine care. There is a scarcity of published data about using a decision aid during family planning counseling with postpartum women focusing on long-acting reversible contraception in Tanzania. Therefore, we developed a "postpartum Green Star family planning decision aid" and assessed its feasibility. The study outcomes were practicality, usefulness, and acceptability perceived by pregnant adolescents and nurses/midwives. METHODS: We used an exploratory qualitative in-depth interview involving six nurses/midwives with three or more years of experience in family planning services and 12 pregnant adolescents aged 15-19 years. Purposive sampling was used to select the participants, and selection relied on the saturation principle of data collection. We used a semi-structured interview guide translated into the Kiswahili language. Data were transcribed and analyzed following inductive content analysis. RESULTS: The amount of information presented was just right, with the time of reading the data ranging from 20 min to 1 h. The study participants perceived the flow of information to be good, with small significant changes suggested. Kiswahili language was used and reported to be appropriate and well elaborated. However, a few words were told to be rephrased to reduce ambiguity. The nurses/midwives said that the decision aid included most of the vital information the participants wanted to know during their family planning counseling. Pregnant adolescents stated that the decision aid improved their knowledge and provided new details on the long-acting reversible contraception methods (intrauterine copper devices and implants) offered immediately after childbirth. The participants stated that the decision aid addressed long-acting reversible contraception methods' benefits and side effects and dispelled myths and misconceptions. The study participants considered the decision aid helpful in complementing the family planning counseling offered and improving pregnant adolescents' knowledge. CONCLUSION: The postpartum Green Star family planning decision aid was practical, useful, and acceptable in enhancing the objectivity of counseling about long-acting reversible contraception methods. It improved the knowledge of pregnant adolescents in Tanzania about the available contraception methods (i.e., the use of intrauterine copper devices and implants), which can be immediately used postpartum. Further research is needed to assess the effects of the decision aid on long-acting reversible contraception postpartum uptake among pregnant adolescents in Tanzania.


Assuntos
Serviços de Planejamento Familiar , Período Pós-Parto , Adolescente , Anticoncepção , Técnicas de Apoio para a Decisão , Estudos de Viabilidade , Feminino , Humanos , Gravidez , Tanzânia
5.
Jpn J Nurs Sci ; 18(4): e12438, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34235854

RESUMO

AIM: This study aimed to identify the current situation of interprofessional collaboration for gestational diabetes mellitus (GDM) management in Japan including the professionals involved, the collaboration methods employed, and the barriers perceived by nurses and midwives. METHODS: This nationwide cross-sectional survey of 1,046 total hospitals facilitating childbirth in Japan used an original 60-item questionnaire to investigate GDM management practice through interprofessional collaboration. The questionnaire required one responder to be a midwife or nurse who was familiar with the management practices for GDM women in their respective hospitals. Quantitative data were analyzed using descriptive statistics, and framework analysis was conducted for qualitative data collected by open-ended questions. RESULTS: All 308 respondents (response rate 29.4%) were included. The professionals included in interprofessional collaboration were limited, and the only strategy used for interprofessional collaboration by a majority (91.5%) of hospitals was medical charts. There were 50.8% of hospitals that provided postpartum GDM follow-ups and 54.5% of hospitals that did not engage in external collaboration for GDM management. The barriers to interprofessional collaboration extracted were seven categories and 23 subcategories, which were aligned within the following units of analysis: individual, team, organization, and community. CONCLUSIONS: This survey shows that interprofessional collaboration, including support for GDM postpartum follow-up in Japan remains insufficient. Furthermore, nurses and midwives perceive numerous barriers to interprofessional collaboration for continuous GDM management at the individual, team, organizational and community levels.


Assuntos
Diabetes Gestacional , Tocologia , Estudos Transversais , Parto Obstétrico , Feminino , Humanos , Japão , Gravidez
6.
J Prof Nurs ; 37(4): 771-776, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34187677

RESUMO

We report an international collaborative project to develop the first Doctor of Nursing Practice (DNP) program in Japan. We described the development and implementation of the first DNP program at the St. Luke's International University in Tokyo and the collaboration with the University of North Carolina at Chapel Hill in the United States. Faculty perceptions in both parties gradually evolved from the traditional perspective of international collaboration to the transitional and the beginning of the holistic partnership perspectives. The collaboration resulted in an innovative DNP program that directly addressed the gap between nursing education programs and Japan's clinical needs. The collaborative project cultivated a holistic international partnership. Rather than reporting a manual for international collaboration, we present our reflections and outcomes as narratives that others could use to achieve a holistic global partnership.


Assuntos
Educação de Pós-Graduação em Enfermagem , Educação em Enfermagem , Currículo , Humanos , Japão , North Carolina , Estados Unidos , Universidades
7.
Nurse Educ Today ; 105: 105015, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34175565

RESUMO

BACKGROUND: Poor quality of care by midwives in Indonesia has become a barrier to improving maternal health. To eliminate this barrier, reforming the educational system (i.e., teaching and learning processes) is an urgent concern. Herein, we propose the use of team-based learning (TBL) as an active learning strategy to enhance knowledge of postpartum hemorrhage (PPH) and learning satisfaction of midwifery students in Indonesia. OBJECTIVES: To assess and compare knowledge of PPH, long-term retention of knowledge, and learning satisfaction of midwifery students attending a TBL class versus a didactic lecture on PPH topics. METHODS: A quasi-experimental design was used. The participants were second-year diploma level midwifery students who have (a) no TBL experience, (b) completed the previous semester, and (c) graduated from senior high school (without nursing background). We recruited 118 participants. The midwifery students in the intervention group participated 3 times in the TBL class (90 min), whereas those in the control group participated in the didactic lecture on PPH topics. An unpaired t-test was used to evaluate differences between groups. ANOVA was used to evaluate differences within groups. RESULTS: A total of 115 participants (intervention = 62, control = 53) were finally evaluated. The demographic data and pre-test scores were not significantly different between the 2 groups. The mean knowledge of PPH scores were significantly higher in the TBL students than in the control students at post-test, 2 weeks post-test, 6 weeks post-test, and 12 weeks post-test (all p < .001). The nursing student satisfaction scale score was significantly higher in the intervention group than in the control group. CONCLUSION: The findings showed that TBL is an effective active learning strategy to improve knowledge of PPH of Indonesian midwifery students before clinical practice exposure. Further long-term evaluation (e.g., 1 semester) of the effectiveness of TBL is warranted.


Assuntos
Tocologia , Hemorragia Pós-Parto , Estudantes de Enfermagem , Avaliação Educacional , Feminino , Humanos , Indonésia , Gravidez , Aprendizagem Baseada em Problemas
8.
Int Breastfeed J ; 16(1): 47, 2021 06 26.
Artigo em Inglês | MEDLINE | ID: mdl-34174915

RESUMO

BACKGROUND: Although breastfeeding guidelines for infants admitted to the neonatal intensive care unit (NICU) have been introduced in Japan, these guidelines have not been reflected in practice. To improve this situation, it is important for nurses and nurse-midwives to acquire knowledge of appropriate care. This study examined changes in nurse-midwives' knowledge, attitude, and implementation of appropriate care after implementing an education program focused on early essential care for breast milk expression among mothers of preterm infants. METHODS: This pre- and post-intervention study using a single group was conducted from June 2018 to May 2019 and enrolled 36 nurse-midwives in one perinatal medical center. The education program content included nurses' roles in early essential care for milk expression and the necessary care to promoting breast milk production among mothers of preterm infants. The nurse-midwives' knowledge and attitude on care were investigated 3 months before (pre-1), just before (pre-2), just after (post-1), and 3 months after (post-2) the program. The nurse-midwives' care implementation was investigated at pre-1, pre-2, and post-2. During this time, 11 mothers (before: 7, after: 4) reported the status of milk expression for 10 days after birth. RESULTS: The mean knowledge scores of the nurse-midwives at post-1 and post-2 were significantly higher than that at pre-2 (post-1: p <  0.001, post-2: p <  0.001). The attitude on care scores at post-1 and post-2 were significantly higher than that at pre-2 (post-1: p < 0.001, post-2: p = 0.010). The care implementation score at post-2 was significantly higher than that at pre-2 in eight items (e.g., Q7 Explain about the effect of initiating milk expression early and assist mothers in it). However, the education program did not cause any changes in the mothers' initiation and frequency of milk expression, and breast milk volume after birth. CONCLUSIONS: The significant increases in the knowledge, attitude on care, and care implementation scores of the nurse-midwives suggest the beneficial effects of the education program. The small number of mothers in the survey on the practice of breast milk expression limited the full determination of the benefits of the education program for nurse-midwives.

9.
Jpn J Nurs Sci ; 18(4): e12426, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33999503

RESUMO

AIMS: We conducted a pilot trial to compare the effects of smoke and smokeless moxibustion with a control as a possible supplement to external cephalic version (ECV) for converting breech to cephalic presentation and increasing adherence to cephalic position, and to assess their effects on the well-being of the mother and child. METHODS: We used a quasi-experimental design with 3 arms: a smoke moxibustion (SM) (n = 20) and smokeless moxibustion (SLM) (n = 20) groups (20-min acupoint BL67 stimulation once or twice daily for 10-14 days), and a control group (n = 20). The participants had singleton breech presentations between 33 and 35 gestation weeks. The primary outcome was cephalic presentation at the conclusion of intervention. The secondary outcomes were cephalic presentation at birth and effects on mother and child well-being. RESULTS: At the conclusion of intervention, cephalic presentation was higher in the SLM (60.0%) than the control groups (25.0%), Relative Risk 2.40, 95% Confidence Interval [1.04-5.56]; there was no significant difference for SM. At birth, there were no significant differences in cephalic presentation or well-being. CONCLUSION: SLM treatment showed an increasing trend towards cephalic presentation at the conclusion of intervention. Although significant differences were not observed at birth possibly due to the small samples and non-randomization, moxibustion was safe, and not associated with perinatal morbidity and mortality. A randomized controlled trial with a larger sample is warranted to ascertain SLM treatment as a possible ECV supplement for converting and increasing adherence to cephalic position.


Assuntos
Apresentação Pélvica , Moxibustão , Apresentação Pélvica/terapia , Criança , Feminino , Humanos , Recém-Nascido , Lobelina , Projetos Piloto , Gravidez , Fumaça
10.
BMC Pregnancy Childbirth ; 21(1): 162, 2021 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-33627086

RESUMO

BACKGROUND: During pregnancy, physiological, psychological, and social changes affect pregnant women's childcare anxiety and childrearing behavior. However, there are scarce reports on hormonal evaluation related to such anxiety and behavior. Herein, we evaluated changes in salivary cortisol (primary outcome) and oxytocin (secondary outcome) levels of first-time pregnant women when interacting with an infant and discussed the relation of these changes to the women's stress level. METHODS: This was a two-arm randomized controlled trial. Participants were randomly assigned using a web-based randomization system. The experimental group involved interaction with an infant for 30 min. The control group involved watching a DVD movie of an infant for 30 min. Saliva samples were collected at preintervention and postintervention. Saliva samples were assayed, and all data were compared between and within the groups using independent t-test and paired t-test with a two-sided 5% significance level. This study was approved by the Research Ethics Committee of St. Luke's International University. RESULTS: A total of 102 women were randomly assigned to the experimental (n = 51) and control (n = 51) groups. Finally, 38 women in the experimental group and 42 women in the control group were analyzed. The salivary cortisol level significantly decreased after the interventions in both groups (t = 4.57, p = 0.00; t = 5.01, p = 0.00). However, there were no significant differences in the salivary cortisol (t = 0.349, p = 0.73) and oxytocin (t = - 1.945, p = 0.58) levels between the two groups. CONCLUSIONS: The salivary cortisol level of first-time pregnant women significantly decreased in the experimental and control groups postintervention, although no significant difference was found between the two groups. Such decrease indicates stress reduction and release among these women. The absence of a significant increase in salivary oxytocin level in both groups may be related to the limitations of an insufficient number of samples that could be analyzed owing to the small saliva volume in some samples and the lack of adequate tactile stimulation of the intervention protocol. These results and procedural limitations provide useful insights into approaching subsequent studies aiming at continuously optimizing detection procedures. TRIAL REGISTRATION: UMIN000028471 (Clinical Trials Registry of University Hospital Information Network. July 31, 2017- Retrospectively registered.


Assuntos
Hidrocortisona/análise , Relações Interpessoais , Ocitocina/análise , Gestantes , Adulto , Feminino , Humanos , Lactente , Gravidez , Saliva/química
11.
Jpn J Nurs Sci ; : e12406, 2021 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-33470059

RESUMO

AIMS: This study aimed to clarify (a) the association of the delivery mode (i.e., epidural anesthesia or no epidural) with women's changes in longitudinal salivary oxytocin (OT) levels from late pregnancy to early postpartum, and (b) the association of these changes with postpartum maternity blues (MB) and fatigue. METHODS: We used a longitudinal observational design. We performed measurements of the saliva samples at four measurement points: (a) 36-37 gestational weeks, (b) 38-39 gestational weeks, (c) 1-2 days after birth, and (d) 4-5 days after birth. The inclusion criterion was low-risk primiparous women who were planning to have vaginal delivery. We used Stein's MB scale to evaluate postpartum data and a visual analog scale to examine "postpartum fatigue". We determined the association between the MB/fatigue scores and the changes in the OT levels by Spearman's rank correlation coefficient. RESULTS: There were 29 women who delivered with epidural anesthesia and 29 women who did not. A significantly higher mean salivary OT level was observed in the women with epidural anesthesia at 1-2 days after birth than at 36-37 gestational weeks. The mean OT level at 4-5 days postpartum was significantly lower than that at 1-2 days postpartum. The correlation of the MB score with the salivary OT level at 4-5 days postpartum was ρ = -0.33, p = .01. CONCLUSIONS: Early postpartum OT level decreased with epidural anesthesia and showed a negative correlation with postpartum MB and fatigue. Healthcare providers should recognize that women who had epidural anesthesia need specific supportive care.

12.
Nurs Open ; 8(1): 241-250, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33318832

RESUMO

Aim: This pilot study aimed to evaluate the effects of team-based learning about postpartum haemorrhage on the learning outcomes and experience of midwifery students in Indonesia. Design: One-group pre-test-post-test study. Methods: This study enrolled 64 midwifery students as participants from an Indonesian health polytechnic school. This group attended two team-based learning class sessions (90 min weekly for 2 weeks) on postpartum haemorrhage. Student learning outcomes and experience were assessed quantitatively. Results: The mean knowledge score (0-100) was significantly higher at post-test (mean = 85.9, SD 9.8) than at pre-test (mean = 61.4, SD 12.9) (p < .001). There was a significant difference in the mean clinical reasoning score (12-60) between post-test (mean = 35.4, SD 5.8) and pre-test (mean = 21.3, SD 7.9) (p < .001). Most students (98.4%) engaged in classroom activities.


Assuntos
Tocologia , Hemorragia Pós-Parto , Feminino , Humanos , Indonésia/epidemiologia , Projetos Piloto , Hemorragia Pós-Parto/epidemiologia , Gravidez , Estudantes
13.
PLoS One ; 15(11): e0242351, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33180856

RESUMO

OBJECTIVE: Decision aids (DAs) are useful in providing information for decision-making on using epidural anesthesia during birth. To date, there has been little development of DAs for Japanese pregnant women. Herein, we investigated the effect of a DA on the decision of pregnant women whether to have epidural anesthesia or not for labor during vaginal delivery. The primary outcome was changes in mean decision conflict score. METHODS: In this non-randomized controlled trial, 300 low-risk pregnant women in an urban hospital were recruited by purposive sampling and assigned to 2 groups: DA (intervention) and pamphlet (control) groups. Control enrollment was started first (until 150 women), followed by intervention enrollment (150 women). Pre-test and post-test scores were evaluated using the Decision Conflict Scale (DCS) for primary outcome, knowledge of epidural anesthesia and satisfaction with decision making for secondary outcomes, and decision of anesthesia usage (i.e., with epidural anesthesia, without epidural anesthesia, or undecided). RESULTS: Women in the DA group (n = 149: 1 excluded because she did not return post-test questionnaire) had significantly lower DCS score than those in the pamphlet group (n = 150) (DA: -8.41 [SD 8.79] vs. pamphlet: -1.69 [SD 5.91], p < .001). Knowledge of epidural anesthesia and satisfaction with decision-making scores of women who used the DA were significantly higher than those of women who used the pamphlet (p < .001). Women in the DA group showed a significantly lower undecided rate than those in the pamphlet group. The number of undecided women in the DA group significantly decreased from 30.2% to 6.1% (p < .001), whereas that in the pamphlet group remained largely unchanged from 40.7% to 38.9%. CONCLUSION: This study indicates that a DA can be useful in helping women make a decision whether to have epidural anesthesia or not for labor during vaginal delivery.


Assuntos
Anestesia Epidural/tendências , Técnicas de Apoio para a Decisão , Participação do Paciente/métodos , Adulto , Comportamento de Escolha/fisiologia , Parto Obstétrico/métodos , Parto Obstétrico/tendências , Feminino , Humanos , Trabalho de Parto/efeitos dos fármacos , Folhetos , Gravidez , Gestantes/educação , Gestantes/psicologia , Inquéritos e Questionários
14.
BMC Pregnancy Childbirth ; 20(1): 584, 2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-33023499

RESUMO

BACKGROUND: Facility-based childbirth has increased globally. Unfortunately, there have also been reports of women experiencing disrespect and abuse by healthcare providers during childbirth. This study aimed to measure the prevalence of self-reported disrespect and abuse (D&A) by healthcare providers of women during childbirth in health facilities in Tanzania, and to clarify the factors related to D&A. METHODS: A cross-sectional survey was conducted in public health facilities of three regions in Tanzania from September 2016 to October 2016. Nurses and midwives who had ever conducted deliveries completed a 22-item section about D&A and three sections about working conditions and environment. A model for predicting D&A based on several factors such as their characteristics, working conditions, and working environment was developed by conducting multiple regression analysis. RESULTS: Thirty public health facilities in three regions within Tanzania were selected to reflect different levels of hospitals. Among 456 participants (nurses, midwives, and nursing assistants), 439 were included in the analysis. Average number of self-reported D&A out of 22 items was five, and nearly all participants (96.1%) reported enacting one form of D&A at the least and two forms of D&A at the most. About 25-44% of D&A items were in the forms related to women's experiences with childbirth psychologically. Moreover, at least 10-30% of the participants enacted some form of D&A which could directly affect the well-being of mothers and babies. D&A scores increased with an increase in 'working hours per week' and 'taking a break during evening shifts'. D&A scores decreased with an increase in the scores of the 'two components of the Index of Working Satisfaction (professional status and interaction between nurses)', and 'any type of supervision for new nurse-midwives'. CONCLUSION: Most studies about D&A of healthcare providers previously focused on the reports of women. To our knowledge, this is the first report that focused on D&A reported by healthcare providers. Working conditions and systems including personal relationships with colleagues were both positively and negatively related to D&A of healthcare providers rather than the provider's individual and facility structural characteristics.


Assuntos
Tocologia/estatística & dados numéricos , Enfermeiras e Enfermeiros/estatística & dados numéricos , Abuso Físico/estatística & dados numéricos , Relações Profissional-Paciente , Violência no Trabalho/estatística & dados numéricos , Adulto , Estudos Transversais , Parto Obstétrico/psicologia , Parto Obstétrico/estatística & dados numéricos , Feminino , Humanos , Satisfação no Emprego , Enfermeiras e Enfermeiros/psicologia , Gravidez , Respeito , Estudos Retrospectivos , Autorrelato/estatística & dados numéricos , Tanzânia/epidemiologia , Violência no Trabalho/psicologia , Adulto Jovem
15.
Women Birth ; 2020 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-33041236

RESUMO

BACKGROUND: Team-midwifery care remains limited in Japan. To introduce changes to the midwifery system, an in-depth understanding of women's perception of receiving team-midwifery care is crucial. AIM: This study aimed to describe women's experience of receiving team-midwifery care in Japan and to understand the central essence of this form of care. METHODS: This study used a descriptive research design and involved focus group interviews in a birth clinic in central Tokyo. This birth clinic provided continuous team-midwifery care involving five to six midwives in one team from pregnancy to the postpartum period. Interview data were analysed by content analysis. The ethical review board of St. Luke's International Hospital, Tokyo approved this study (12-R178). FINDINGS: Thirteen women who gave birth within 19 months were included. The women's experience of receiving team-midwifery care was described as "feelings of becoming closer and connected through a warm mutual relationship" with the midwives. The women felt that the midwives genuinely focused on their care and noticed their desire for their family to be involved. A trusting relationship was built through regular meetings. The women also described their experience as "a lasting feeling of ease and security". The midwives' continuity of care empowered the women even after their discharge. CONCLUSION: The underlying assumption for the women's empowerment was the continuity of woman-centred care built through a trusting relationship between the women and the midwives. These important elements constitute the central essence of team-midwifery care which can be adopted regardless of the care system.

16.
Int Breastfeed J ; 15(1): 36, 2020 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-32375834

RESUMO

BACKGROUND: The total neonatal mortality in Tanzania remains high reaching as much as 44,900 deaths per year, particularly among low birthweight (LBW) babies. This makes Tanzania the fourth African country with the highest number of annual neonatal deaths. Studies have shown the advantages of breast milk for LBW babies and the effectiveness of interventions from healthcare workers (HCWs) to encourage mothers to achieve exclusive breastfeeding (EBF). Although these interventions can substantially reduce mortality in this vulnerable group, they remain insufficient in practice particularly in resource-limited countries. Therefore, there is an urgent need to establish the most appropriate interventions for mothers with LBW babies, particularly in these countries. To help address this need, we evaluated the breastfeeding care and education given to mothers with LBW babies by HCWs during hospitalization in Tanzania. METHODS: A qualitative study using semi-structured interviews with mothers of LBW babies at an urban hospital in Tanzania was conducted. We assessed their understanding of breastfeeding at discharge. All the interviews were conducted in local Swahili and then translated to English. Data were analyzed using content analysis. RESULTS: Among the 19 mothers interviewed, only four breastfed their baby within an hour after birth. Nine mothers received no support from HCWs when they breastfeed their baby for the first time. Ten mothers received no education on EBF, and there were mothers who misunderstood the EBF definition. Eight answered that they had difficulty breastfeeding their baby at discharge. Four mothers were dissatisfied with the care and education given by HCWs, and six mothers provided suggestions for improvements. Although six mothers had a high reliance on HCWs, they had difficulty asking HCWs questions because of their authoritative attitude and behavior. CONCLUSIONS: Mothers with LBW babies need special support to increase their ability to breastfeed and ensure EBF continuance. To address the gaps between the currently provided breastfeeding interventions and the ideal breastfeeding interventions, improvements in the quality and quantity of breastfeeding care and education are required. Training HCWs to systematize standard interventions, confirming mothers' understanding, and ensuring a comfortable environment for mothers are absolutely needed.


Assuntos
Aleitamento Materno/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Mães/psicologia , Relações Profissional-Paciente , Adolescente , Adulto , Aleitamento Materno/estatística & dados numéricos , Feminino , Educação em Saúde , Pessoal de Saúde , Hospitais , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Entrevistas como Assunto , Pesquisa Qualitativa , Tanzânia , População Urbana , Adulto Jovem
17.
Early Hum Dev ; 145: 105046, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32353647

RESUMO

An infant's circadian sleep-wake rhythm is established during the first three months after birth. It is crucial to identify how entrainment factors, such as maternal behavioural influences, feeding conditions, and others, contribute to the infant's obtaining circadian rhythm. This study examined the influence of feeding method on the mother's rhythm and on the development of her infant's circadian rest-activity rhythm. The subjects were 24 healthy primiparas (mean age, 29.8) and their full-term infants. We retrospectively divided the subjects into two groups based on feeding method (breastfeeding, 17; mixed-feeding, 7). Actographic recordings for the infants and their mothers were made over 3-5 consecutive days during the 2nd-3rd week, the 6th week, and the 12th week. First, we calculated the mean values of the autocorrelograms from the autocorrelation coefficients and calculated their statistical significance to see their rhythmicity for all the mothers and their infants at each of the periods. Second, we evaluated the mean values of the autocorrelograms to see statistical differences between the feeding methods. For the breastfed infants, the mean values of the autocorrelograms at 24-h for the 6th week were significant. However, the mean values for the mixed-fed infants were unclear. At the 12th week, the mean values of the autocorrelograms at 24-h for both groups of infants were significant. The mean value for the breastfeeding mothers at 24-h was significantly larger than that for the mixed-feeding mothers. In conclusion, the breastfeeding mothers contributed more to their infants achieving circadian rhythm than did the mixed-feeding mothers.

18.
Sex Reprod Healthc ; 24: 100499, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32050123

RESUMO

OBJECTIVES: Despite the accessibility of modern family planning (FP) methods, unwanted pregnancies remains a serious problem in Tanzania. This study aimed to identify the barriers to the uptake of modern FP methods among female youth reached by the Chaguo la Maisha project in Temeke District, Tanzania. STUDY DESIGN: Qualitative study conducted in March 2017 involving 15 female youths aged 18-24 years. MAIN OUTCOME MEASURES: Purposive sampling was used to select study participants and sampling followed the principle of data saturation. The study participants were those who received contraceptive counseling from community health mobilizers and agreed to visit a nearby health facility for FP services but did not go for the services. A semi-structured interview guide, translated into Kiswahili language was used. Data were transcribed; analyzed following qualitative content analysis. Major categories and subcategories that hindered visitations were identified. RESULTS: Three categories and their subcategories were identified as hindering FP method uptake. (1) individual perception factors: (a) myths and misconceptions, (b) fear of side effects, (c) fear of the possibility of being pregnant at the time of FP counseling; (2) community perception factors: discouragement from an intimate partner and closest friends; and (3) health facility system factors: unavailability of the preferred method and absence of the trained personnel for the FP method. CONCLUSIONS: The main barriers to FP uptake were myths and misconceptions, and fear of side effects. The intimate partner or closest friends were significant decision influencers on contraceptive use, implying that FP campaigns should focus beyond the individual level.


Assuntos
Comportamento Contraceptivo/psicologia , Anticoncepção/psicologia , Utilização de Instalações e Serviços , Serviços de Planejamento Familiar , Adolescente , Feminino , Humanos , Pesquisa Qualitativa , Tanzânia/etnologia , Adulto Jovem
19.
BMC Pregnancy Childbirth ; 19(1): 351, 2019 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-31604456

RESUMO

BACKGROUND: Breast stimulation is performed to self-induce labor. However, there are apparently no reports on hormonal evaluation during stimulation for consecutive days in relation to induction effect. We evaluated the salivary oxytocin level following 3 consecutive days of own breast stimulation for 1 h each day compared with no breast stimulation. METHODS: We used a quasi-experimental design. The participants were low-risk primiparas between 38 and 39 gestational weeks. Eight saliva samples per participant were collected at preintervention and 30, 60, and 75 min postintervention on the first and third days. The primary outcome was change in the salivary oxytocin level on the third day after 3 consecutive days of breast stimulation for 1 h each day compared with no breast stimulation. The secondary outcomes were the rate of spontaneous labor onset and negative events including uterine hyperstimulation and abnormal fetal heart rate. RESULTS: Between February and September 2016, 42 women were enrolled into the intervention group (n = 22) or control group (n = 20). As there were differences in the basal oxytocin levels between the 2 groups, to estimate the change in the oxytocin level from baseline, we used a linear mixed model with a first-order autoregressive (AR1) covariance structure. The dependent variable was change in the oxytocin level from baseline. The independent variables were gestational weeks on the first day of intervention, age, education, rs53576 and rs2254298, group, time point, and interaction of group and time. After Bonferroni correction, the estimated change in the mean oxytocin level at 30 min on the third day was significantly higher in the intervention group (M = 20.2 pg/mL, SE = 26.2) than in the control group (M = - 44.4 pg/mL, SE = 27.3; p = 0.018). There was no significant difference in the rate of spontaneous labor onset. Although there were no adverse events during delivery, uterine tachysystole occurred in 1 case during the intervention. CONCLUSIONS: The estimated change in the mean oxytocin level was significantly higher 30 min after breast stimulation on the third day. Thus, consecutive breast stimulation increased the salivary oxytocin level. Repeated stimulations likely increase the oxytocin level. TRIAL REGISTRATION: UMIN000020797 (University Hospital Medical Information Network; Prospective trial registered: January 29, 2016).


Assuntos
Mama , Ocitocina/metabolismo , Estimulação Física , Adulto , Feminino , Frequência Cardíaca Fetal , Humanos , Início do Trabalho de Parto , Trabalho de Parto , Paridade , Polimorfismo de Nucleotídeo Único , Gravidez , Receptores de Ocitocina/genética , Saliva/química , Contração Uterina
20.
PLoS One ; 14(9): e0221821, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31479475

RESUMO

OBJECTIVES: This pilot study aimed to 1) follow the longitudinal changes in the salivary oxytocin level of pregnant women from late pregnancy to early postpartum, 2) examine the factors related to these changes, and 3) clarify the association of these changes with mother-infant bonding. METHODS: This study used a longitudinal observational design and questionnaires to obtain objective and subjective data. For oxytocin evaluation, saliva samples were collected and their oxytocin levels were measured at 4-time points [i.e., 1) 36-37 gestation weeks, 2) 38-39 gestation weeks, 3) 1-2 days postpartum, 4) 4-5 days postpartum]. The oxytocin level was assayed in duplicates by enzyme-linked immunosorbent assay. Baseline data were evaluated using the Parental Bonding Instrument (25 items), State Trait Anxiety Inventory (20 items), and Center for Epidemiologic Studies Depression Scale. Postpartum data were evaluated using the Mother to Infant Bonding Scale Japanese Version (10 items), Maternity Blues Scale (13 items), and 'Fatigue after Childbirth' using the Visual Analogue Scale (VAS: 0-100 mm). RESULTS: The participants were 13 primiparas with a mean age of 33 years. They had no depression or anxiety at the baseline. Their mean salivary oxytocin levels significantly increased from late pregnancy (36-39 gestation weeks) up to 1 day postpartum and then decreased until 5 days postpartum. There was a negligible correlation between the bonding disorder and the salivary oxytocin level on the 5th day after childbirth. A moderate correlation was observed between the maternity blues score and the salivary oxytocin level. There was a significant negative correlation between the postpartum fatigue and the salivary oxytocin level 1 day and 5 days after childbirth. CONCLUSION: The mean salivary oxytocin levels significantly increased from the baseline up to 1 day postpartum and then decreased until 5 days postpartum. The salivary oxytocin level was moderately associated with maternity blues and significantly with postpartum fatigue.


Assuntos
Relações Mãe-Filho/psicologia , Ocitocina/metabolismo , Período Pós-Parto/metabolismo , Período Pós-Parto/psicologia , Gravidez/metabolismo , Gravidez/psicologia , Saliva/metabolismo , Adulto , Depressão Pós-Parto/metabolismo , Fadiga/metabolismo , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Apego ao Objeto , Projetos Piloto , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...