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1.
Midwifery ; 94: 102918, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33418511

RESUMO

OBJECTIVE: The main objective of this survey was to identify how independent midwives, mainly working in primary care, adapted their practices at the beginning of the COVID-19 pandemic in France. Our assumption was that this practice adaptation would vary according to both geographical area (timing of pandemic effect) and whether they practiced alone or in a group. DESIGN: We conducted an online national survey of independent midwives in France from March 16-23, 2020. SETTING: All districts in mainland France and the overseas territories. PARTICIPANTS: Respondents from the population of all independent midwives working in France. MEASUREMENTS AND FINDINGS: The primary outcome measure was the proportion of midwives reporting that they had adapted their practices to the context of the COVID-19 pandemic, and the rank, in order of frequency, of the postponed or cancelled activities. RESULTS: Of the 1517 midwives who responded, i.e., 20.3% of the independent midwives in France, 90.6% reported adapting one or more of their practices . The main adjustment was the postponement or cancellation of consultations deemed non-essential, listed in descending order: postpartum pelvic floor rehabilitation (n = 1270, 83.7%), birth preparation (n = 1188, 78.3%), non-emergency preventive gynaecology consultation (n = 976, 64.3%), early prenatal interview (n = 170, 11.2%), and postnatal follow-up (n = 158, 10.4%). KEY CONCLUSIONS: Without guidelines, each midwife had to decide individually if and how to adapt her practice. Postpartum pelvic floor rehabilitation and birth preparation have been strongly affected. The results of this national survey indicate that a large majority of midwives have adapted their practices, independently of the local course of the pandemic, and that this reduction of contacts with women raises questions in this period of anxiety about intermediate-term adaptations to guarantee the continuity and safety of care. IMPLICATIONS FOR PRACTICE: This study's results can be used to develop tools to handle cancelled consultations. Video, also called virtual, visits and coordination between independent practitioners and hospitals are probably the major challenges in the current context.


Assuntos
Adaptação Psicológica , Tocologia , Enfermeiras Obstétricas/psicologia , Adulto , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Inquéritos e Questionários
2.
Enferm. clín. (Ed. impr.) ; 30(6): 411-418, nov.-dic. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-197671

RESUMO

OBJETIVO: Describir las percepciones y deseos sobre el parto en un grupo de gestantes a término de Zamora. MÉTODO: Estudio cualitativo de carácter fenomenológico. Participantes y ámbito de estudio: embarazadas de 37-38 semanas, centros de salud Zamora Sur y Santa Elena (Zamora). Recogida de datos: entrevistas semiestructuradas, hasta llegar a saturación de datos (16 entrevistas). Análisis de datos: análisis de contenido temático. RESULTADOS: Los sentimientos maternos variaron desde la alegría hasta el miedo o el estrés. Las entrevistadas manifestaron no sentirse capaces de soportar el dolor del parto. Las necesidades que sintieron como más importantes fueron contar con apoyo y acompañamiento en el parto (sobre todo de su pareja) y recibir buen trato de los sanitarios. CONCLUSIONES: La importancia y la repercusión del parto para la mujer no solo atiende al ámbito biológico, sino en gran medida también al mental, al emocional y al social. En él intervienen múltiples factores que lo condicionan: los sentimientos maternos, su capacidad de afrontar el dolor del parto, sus necesidades, sus cambios realizados, el apoyo con el que cuentan y los profesionales sanitarios que atienden a la mujer


OBJECTIVE: To describe perceptions and wishes regarding childbirth in a group of full-term pregnant women in Zamora. METHOD: Qualitative study of phenomenological character. Participants and scope of study: pregnant women (37-38 weeks), Zamora Sur and Santa Elena health centres (Zamora, Spain). Data collection: semi-structured interviews, until data saturation (16 interviews). Data analysis: analysis of thematic content. RESULTS: The maternal feelings varied from joy to fear or stress. The interviewees said they did not feel capable of enduring the pain of childbirth. The needs that they felt most important were having support and accompaniment during delivery (especially of their partner) and receiving good treatment from the healthcare workers. CONCLUSIONS: The importance and repercussion of childbirth for women are not only biological, but also largely mental, emotional and social. It is conditioned by multiple factors: maternal feelings, their ability to deal with the pain of childbirth, their needs, the changes they have made, the support they have and the health professionals who care for them


Assuntos
Humanos , Feminino , Gravidez , Nascimento a Termo , Percepção , Trabalho de Parto/psicologia , Serviço de Acompanhamento de Pacientes/psicologia , Enfermeiras Obstétricas/estatística & dados numéricos , Enfermeiras Obstétricas/psicologia , Parto Obstétrico/métodos , Parto Obstétrico/enfermagem , Amostragem , Dor do Parto/enfermagem , Dor do Parto/psicologia
3.
Arch Psychiatr Nurs ; 34(5): 427-433, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33032769

RESUMO

PURPOSE: The study was carried out to determine the psychological impact levels of nurses and midwives due to the COVID-19 outbreak. METHODS: The research is planned in a descriptive type. Nurses and midwives working in any health institution in Turkey constituted the population of the research. The questionnaire form of the study was shared on social media tools between 01 and 14 April 2020 and a total of 758 nurses and midwives were included in the study sample. Personal Information Form, State-Trait Anxiety Inventory and Intolerance of Uncertainty Scale were used as data collection tools. RESULTS: Participants who attended the study were 56.9% of nurses and 43.1% of midwives. Approximately half of the nurses and midwives (48.8%) participating in our study contacted the patient with suspected COVID-19, and 29.8% provided care to the patient diagnosed with COVID-19. Nurses and midwives were scored 52.75 ± 9.80 for State Anxiety, 44.87 ± 7.92 for Trait Anxiety Inventory and 35.16 ± 9.42 for Intolerance of Uncertainty Scale. It has been determined that 54.5% of nurses and midwives have been making their lives worse since the outbreak started, 62.4% had difficulties in dealing with the uncertain situation in the outbreak, 42.6% wanted psychological support and 11.8% had alienated from their profession. It was determined that there was a difference between scale scores and difficulties in work, family and private life due to COVID-19. CONCLUSION: As a result, it is seen that the midwives and nurses in our country have high psychological effects due to the COVID-19 outbreak.


Assuntos
Transtornos de Ansiedade/psicologia , Esgotamento Profissional/psicologia , Infecções por Coronavirus/psicologia , Enfermeiras Obstétricas/psicologia , Recursos Humanos de Enfermagem/psicologia , Pneumonia Viral/psicologia , Complicações Infecciosas na Gravidez/psicologia , Adulto , Transtornos de Ansiedade/epidemiologia , Atitude do Pessoal de Saúde , Betacoronavirus , Esgotamento Profissional/epidemiologia , Surtos de Doenças , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Inquéritos e Questionários , Turquia/epidemiologia
4.
Niger J Clin Pract ; 23(9): 1201-1206, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32913157

RESUMO

Background: Self-efficacy has become a cross-disciplinary concept. In the field of healthcare, this concept is considered crucial for nurses; who play an important role in improving the health and well-being of the community. Aims: The aim of this study was to develop a "Relationship-with-the-patient self-efficacy scale" (RPSES). Methodology: A sample of 331 university students (310 females and 21 males; 168 from the midwifery and 162 from the nursing departments) were enrolled in the study. Out of 24 items, 8 behavior items with the highest factor loadings were selected regarding the nurse-patient-relationship self-efficacy according to the results of the preliminary exploratory factor analysis. Results: The final exploratory factor analysis revealed that the selected 8 items of RPSES had a single factor, explaining 83.28% of the total variance. The Cronbach alpha reliability coefficient was c alculated as 0.97. Conclusion: This scale has beendemonstrated to be a valid and reliable instrument.The analyses unfolded that RPSES scores of the students were not different between men and womenand did not differ by the departments the students attended; however, the RPSES scores were different by the grade levels of the students (juniors and seniors). The fourth graders' RPSES scores were higher than those of third graders.


Assuntos
Enfermeiras Obstétricas/psicologia , Relações Enfermeiro-Paciente , Autoeficácia , Estudantes de Enfermagem/psicologia , Inquéritos e Questionários/normas , Adulto , Análise Fatorial , Feminino , Humanos , Masculino , Psicometria/instrumentação , Reprodutibilidade dos Testes
5.
Nursing ; 50(9): 64-68, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32826681

RESUMO

PURPOSE: To examine the effect of Benson's relaxation technique on occupational stress in midwives working in a Labor and Delivery (L&D) unit. METHODS: This pre- and post-quasi-experimental study involved 65 midwives with a minimum 1 year of experience using convenience sampling. After training, the participants performed Benson's relaxation technique twice a day for 4 weeks. RESULTS: Occupational stress was measured using standard questionnaires of occupational stress. Data were analyzed using the Statistical Package for Social Sciences software. Statistical analysis was performed using the Kolmogorov-Smirnov goodness-of-fit test, Student's t-test, and Wilcoxon signed rank test. CONCLUSION: This study demonstrated that Benson's relaxation technique may be effective in reducing occupational stress among midwives in L&D units.


Assuntos
Enfermeiras Obstétricas/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Estresse Ocupacional/prevenção & controle , Terapia de Relaxamento/métodos , Adulto , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Pessoa de Meia-Idade , Enfermeiras Obstétricas/estatística & dados numéricos , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Unidade Hospitalar de Ginecologia e Obstetrícia , Estresse Ocupacional/epidemiologia , Gravidez , Inquéritos e Questionários , Adulto Jovem
6.
Malawi Med J ; 32(1): 13-18, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32733654

RESUMO

Background: This paper reports on part of a larger study, the aim of which was to develop an intervention to collaboratively develop innovative strategies to promote effective collaborative practices among midwives and medical professionals working in intrapartum care unit. Collaborative practice is a critical marker for success in improving quality of maternity care. To date, there has been limited exploration of collaborative practices between midwives and medical professionals working in intrapartum care from the African perspective. Aim: This paper reports findings of the discovery phase of appreciative inquiry (AI) set out to understand the perspectives of midwives and medical professionals on collaborative practices at Queen Elizabeth Central Hospital labour and delivery ward in Malawi. Methods: The study used an exploratory qualitative approach framed in an Appreciative Inquiry theoretical perspective. Appreciative Inquiry consists of four phases :(discovery, dream, design and destiny).The discovery phase consisted of 16 in-depth interviews and 2 focus group discussions among purposively selected midwives (4 nurse midwives, 2 midwifery unit matrons) and medical professionals (2 obstetricians, 4 registrars, 2 intern doctors, 2 clinical officers) working in the labour ward. All interviews and discussions were audiotaped and transcribed verbatim. Data were analysed using thematic analysis. Results: Five dominant themes emerged: collaborative breakdown, benefits of collaboration, the importance of positive and respectful attitude, barriers to effective collaborative practices and strategies to improve collaborative practice. Conclusion/Recommendations: Aligning the perspectives of the members of the two disciplines is significant to effective implementation of collaborative intrapartum care. Participants demonstrated that there is increased parallel working of midwives and doctors at QECH. This is not professionally healthy. Therefore, putting together the viewpoints of the professions to create a mutually agreeable professional framework of collaborative intrapartum practice is significant. Additionally, there is an obvious need to address the professional concerns of both disciplines.


Assuntos
Comportamento Cooperativo , Relações Interprofissionais , Serviços de Saúde Materna/organização & administração , Tocologia , Enfermeiras Obstétricas/psicologia , Médicos/psicologia , Adulto , Atitude do Pessoal de Saúde , Feminino , Hospitais Universitários , Humanos , Entrevistas como Assunto , Trabalho de Parto , Malaui , Unidade Hospitalar de Ginecologia e Obstetrícia , Gravidez , Pesquisa Qualitativa
8.
Enferm. clín. (Ed. impr.) ; 30(supl.5): 96-98, jun. 2020.
Artigo em Inglês | IBECS | ID: ibc-196484

RESUMO

Maternity illness and death rate is high in many developing countries, including Indonesia due to bleeding in the post childbirth (28%), miscarriage complication (12%), and sepsis (9%). The main reason for maternity illness in implementation of APN which is in accordance with midwife competence standard is carried out. The objective of the research was to find out the implementation of midwife competence standard in APN implementation behavior. The research used qualitative narrative method. It was conducted at RSU Ridos, Medan. The informants were 4 midwives, 1 owner, and 2 childbirth women. The data were analyzed qualitatively by interpreting the data in the form of sentences. The result of the research showed that the implementation of midwife competence standard in carrying out normal childbirth care in RSU was good. Midwives' knowledge was good since all of them were D-III midwifery graduates. Senior midwives' skill was better than that of young ones although the latter were controlled by their seniors and bay the hospital owner. The skilled midwives had participated in APN training, while the unskilled ones had not. Midwives behavior, especially the seniors' was good in implementing APN in RSU Ridos, but young midwives still needed experience in implementing APN so that their behavior was in accordance with midwife competence standard and to oath of office. It is recommended that the hospital management increase midwives' knowledge and skill in Normal Childbirth Care, and make midwives who not yet followed training participate in it


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Tocologia/normas , Comportamento Infantil/psicologia , Enfermeiras Obstétricas/normas , Competência Profissional/normas , Enfermeiras Obstétricas/psicologia , Padrões de Prática em Enfermagem/normas
9.
Rev. chil. obstet. ginecol. (En línea) ; 85(3): 281-305, jun. 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1126164

RESUMO

INTRODUCCIÓN: Los profesionales tienen un rol significativo en el proceso del duelo perinatal, y la relación que construyan con los padres será decisiva para facilitar u obstaculizar su cuidado. OBJETIVO: Comprender la perspectiva de los profesionales de la salud con relación al duelo perinatal. MÉTODO: Se realizó una búsqueda bibliográfica en las bases de datos CINAHL, CUIDEN, PsycINFO, PubMed y Google Académico. Se realizó un análisis temático de estos, permitiendo delimitar categorías temáticas comunes. RESULTADOS: Se obtuvieron 46 artículos cientificos con menos de 10 años de antiguedad. Se identificaron tres categorias para abordar la experiencia vivida: 1) Sentimientos experimentados por los profesionales, como ansiedad, culpa, resignación, síntomas físicos, frustración y evitación; 2) Necesidades sentidas de apoyo, entre estas, soporte emocional, capacitación formal y experiencia laboral que permitan afrontar de mejor forma el duelo con las familias y el equipo; 3) Facilitadores del proceso, donde se destacan la capacitación, años de trayectoria profesional, confianza en si mismo, apoyo de los pares, equipo multidisciplinario, creencia religiososa y apoyo institucional. CONCLUSIÓN: El duelo perinatal es una situación dramática para los padres, los cuales demandan un cuidado sensible. Y los profesionales desempeñan un rol clave en el apoyo integral a los padres, siendo un proceso exigente tanto en lo personal como en lo profesional. Se sugiere formación de pregrado y postgrado, fomentando el diálogo y apoyo entre los equipos. De esta forma se beneficiarán los padres, su familia y los profesionales, los cuales podrán otorgar un cuidado efectivo y de calidad en situación de duelo perinatal.


INTRODUCCIÓN: Professionals play a significant role in the perinatal mourning. The relationship they established with parent in this process is critical in facilitating or hindering the quality of health care in this context. OBJETIVO: to understand the perspective of health care professionals in relation to perinatal grief. METHOD: A literature review was carried out in CINAHL, CUIDEN, PsycINFO, PubMed and the Google Scholar databases. A thematic analysis of the selected articles was carried out, allowing to define common thematic categories in these articles. RESULTS: 46 scientific articles, published in the last ten years, were obtained. Three topics were identified: 1) feelings experienced by professionals, including anxiety, guilt, anger, resignation, physical symptoms, frustration, avoidance and emotional pain; 2) needs related to support, such as emotional support, formal training and work experience that allows for a better approach with families and parents; and 3) facilitators of the process, where training, years of professional experience, self-confidence, peer support, multidisciplinary team, religious beliefs and institutional support stand out. CONCLUSION: Perinatal grief is a complex situation for parents who demand sensitive care. Professionals play a key role in comprehensive support for them, being a demanding process both personally and professionally. Undergraduate and postgraduate training is suggested, encouraging dialogue and support among teams. This would benefit family and professionals, providing effective and quality care in a situation of perinatal grief.


Assuntos
Humanos , Feminino , Gravidez , Pesar , Atitude Frente a Morte , Pessoal de Saúde/psicologia , Morte Perinatal , Pais , Morte Fetal , Enfermeiras Obstétricas/psicologia
10.
Midwifery ; 83: 102648, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32035343

RESUMO

In the Netherlands, a percentage of newly qualified midwives start work in maternity care as a hospital-based midwife, although prepared particularly for working autonomously in the community. AIM: This study aimed to explore newly qualified Dutch midwives' perceptions of their job demands and resources during their initiation to hospital-based practice. DESIGN: We conducted a qualitative study with semi structured interviews using the Job Demands-Resources model as theoretical framework. METHODS: Twenty-one newly qualified midwives working as hospital-based midwives in the Netherlands were interviewed individually between January and July 2018. Transcripts were analyzed using thematic content analysis. FINDINGS: High workload, becoming a team member, learning additional medical procedures and job insecurity were perceived demands. Participants experienced the variety of the work, the teamwork, social support, working with women, and employment conditions as job resources. Openness for new experiences, sociability, calmness and accuracy were experienced as personal resources, and perfectionism, self-criticism, and fear of failure as personal demands. CONCLUSION: Initiation to hospital-based practice requires from newly qualified midwives adaptation to new tasks: working with women in medium and high-risk care, managing tasks, as well as often receiving training in additional medical skills. Sociability helps newly qualified midwives in becoming a member of a multidisciplinary team; neuroticism and perfectionism hinders them in their work. Clear expectations and a settling-in period may help newly qualified midwives to adapt to practice. The initiation phase could be better supported by preparing student midwives for working in a hospital setting and helping manage expectations about the settling-in period.


Assuntos
Enfermeiras Obstétricas/educação , Enfermeiras Obstétricas/psicologia , Percepção , Fatores de Tempo , Adulto , Feminino , Humanos , Relações Interprofissionais , Satisfação no Emprego , Países Baixos , Enfermeiras Obstétricas/estatística & dados numéricos , Pesquisa Qualitativa , Carga de Trabalho/psicologia , Carga de Trabalho/normas
11.
Women Birth ; 33(6): e558-e566, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32001184

RESUMO

AIM: The aim of this study was to explore the experiences of shared learning between Australian and Balinese midwifery students during a two-week clinical placement in Bali Indonesia. BACKGROUND: Cultural safety in midwifery is a key concept that is underpinned by the provision of holistic quality midwifery care to all women. Therefore, culturally safe midwifery care identifies, protects and promotes women's individual cultures and is a key concept that is fostered in midwifery education. To educate culturally safe midwives, international placements to resource limited countries have become more common within midwifery education programs. METHODS: This study used a qualitative research design with a convenience sampling design. The participants were enrolled in midwifery courses in a University in the Northern Territory of Australia (n=9), a Balinese private midwifery school (n=4) and a Balinese public midwifery school (n=4). Thematic analysis was used to analyse the data. FINDINGS: The findings were categorised into major themes under the headings of "Learning together despite differences"; "Cultural differences", "Communication, Resources", and "Recommendations for future placements". CONCLUSION: This study provides a valuable insight into how shared learning increases students' midwifery knowledge and is fundamental in understanding cultural differences that could be applied to students' clinical midwifery practice.


Assuntos
Assistência à Saúde Culturalmente Competente , Práticas Interdisciplinares , Tocologia/educação , Enfermeiras Obstétricas/psicologia , Adulto , Austrália , Feminino , Humanos , Indonésia , Aprendizagem , Northern Territory , Gravidez , Pesquisa Qualitativa , Estudantes de Enfermagem/psicologia
12.
Women Birth ; 33(6): e519-e526, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32001185

RESUMO

AIM: Midwives are expected to identify and help resolve ethics problems that arise in practice, skills that are presumed to be taught in midwifery educational programs. In this study, we explore how midwives recognize ethical dilemmas in clinical practice and examine the sources of their ethics education. METHODS: We conducted semi-structured, individual interviews with midwives from throughout the United States (U.S.) (n=15). Transcripts of the interviews were analysed using an iterative process to identify themes and subthemes. FINDINGS: Midwives described a range of professional ethical dilemmas, including challenges related to negotiating strained interprofessional relationships and protecting or promoting autonomy for women. Ethical dilemmas were identified by the theme of unease, a sense of distress that was expressed in three subthemes: uncertainty of action, compromise in action, and reflecting on action. Learning about ethics and ethical dilemmas occurred, for the most part, outside of the classroom, with the majority of participants reporting that their midwifery program did not confer the skills to identify and resolve ethical challenges. CONCLUSION: Midwives in this study reported a range of ethical challenges and minimal classroom education related to ethics. Midwifery educators should consider the purposeful and explicit inclusion of midwifery-specific ethics content in their curricula and in interprofessional ethics education. Reflection and self-awareness of bias were identified as key components of understanding ethical frameworks. As clinical preceptors were identified as a key source of ethics learning, midwifery educators should consider ways to support preceptors in building their skills as role models and ethics educators.


Assuntos
Tomada de Decisões/ética , Ética em Enfermagem , Conhecimentos, Atitudes e Prática em Saúde , Tocologia/educação , Enfermeiras Obstétricas/educação , Adulto , Currículo , Feminino , Humanos , Relações Interprofissionais , Entrevistas como Assunto , Enfermeiras Obstétricas/psicologia , Preceptoria , Gravidez , Pesquisa Qualitativa
13.
BMC Womens Health ; 20(1): 37, 2020 02 27.
Artigo em Inglês | MEDLINE | ID: mdl-32103753

RESUMO

BACKGROUND: Physiotherapists and midwives in primary healthcare often encounter women with an increased separation between the two rectus abdominis muscle bellies after pregnancy, a so-called increased inter recti distance (IRD). There are few studies on the contribution of increased IRD to the explanation of post-partum health complaints, and very little guidance in the literature for health professionals on the management of increased IRD. The aim of this study was to describe how physiotherapists and midwives in primary healthcare perceive the phenomenon of increased IRD and its management in women after childbirth. METHODS: A purposeful sampling approach was used to select physiotherapists and midwives working in primary healthcare in three large county council healthcare organisations in Sweden having experience of encountering women with increased IRD after pregnancy. Sixteen physiotherapists and midwives participated in focus group discussions. Four focus groups with four participants in each were undertaken. A semi-structured topic guide was used to explore responses to the research questions and the discussions were analysed using qualitative content analysis. RESULTS: We identified an overarching theme: Ambivalence towards the phenomenon increased IRD and frustration over insufficient professional knowledge. The theme included three categories: Uncertainty concerning the significance of increased IRD as a causal factor for functional problems; perceived insufficient professional knowledge base for the management of increased IRD; and lack of inter-professional collaboration and teamwork in the management of patients with increased IRD. Due to sparse and somewhat contradictory research findings and absence of clinical guidelines, the health professionals lacked basic preconditions for applying an evidence-based practice concerning increased IRD. They obtained their information about increased IRD from the media and fitness coaches, and hence were somewhat unsure about what to believe regarding the phenomenon. CONCLUSIONS: There was no consensus among the health professionals on how to best approach increased IRD in the clinical setting. Our findings stress the importance of more research to increase the professional knowledge base among physiotherapists and midwives. The findings highlight the urgent need for policies and clinical guidelines advising health professionals in the management of increased IRD and for facilitating inter-professional collaboration and teamwork.


Assuntos
Atitude do Pessoal de Saúde , Parto Obstétrico/efeitos adversos , Enfermeiras Obstétricas/psicologia , Fisioterapeutas/psicologia , Transtornos Puerperais/terapia , Adulto , Feminino , Grupos Focais , Humanos , Tocologia/estatística & dados numéricos , Parto/fisiologia , Período Pós-Parto , Gravidez , Atenção Primária à Saúde , Transtornos Puerperais/fisiopatologia , Pesquisa Qualitativa , Reto do Abdome/fisiopatologia , Suécia
14.
Artigo em Inglês | MEDLINE | ID: mdl-32106591

RESUMO

Healthcare professionals find the care of parents following an involuntary pregnancy loss stressful and challenging. They also feel unprepared to support bereaved parents. The challenging nature of this support may have a personal impact on health professionals and the care provided to parents. The aim of this meta-ethnography is to synthesise nurses' and midwives' experiences of caring for parents following an involuntary pregnancy loss. A meta-ethnography of ten studies from five countries was carried out. GRADE CERQual was assessed to show the degree of confidence in the review findings. An overarching metaphor, caring in darkness, accompanied by five major themes provided interpretive explanations about the experiences of nurses and midwives in caring for involuntary pregnancy losses: (1) Forces that turn off the light, (2) strength to go into darkness, (3) avoiding stumbling, (4) groping in darkness, and (5) wounded after dealing with darkness. Nursing staff dealt with organizational difficulties, which encouraged task-focused care and avoidance of encounters and emotional connection with parents. However, nurses and midwives might go beyond in their care when they had competencies, support, and a strong value base, despite the personal cost involved.


Assuntos
Aborto Espontâneo/enfermagem , Atitude do Pessoal de Saúde , Enfermeiras Obstétricas/psicologia , Antropologia Cultural , Feminino , Humanos , Gravidez , Pesquisa Qualitativa
16.
Women Birth ; 33(6): e549-e557, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31980392

RESUMO

BACKGROUND: Efforts to resolve the longstanding and growing staffing crisis in midwifery in the United Kingdom have been hampered by very poor retention rates, with early career midwives the most likely to report burnout and intention to leave the profession. AIMS: To establish the key, self-described factors of satisfaction and dissatisfaction at work for early career midwives in the United Kingdom, and suggest appropriate and effective retention strategies. METHODS: Thematic analysis was undertaken on a subset of free text responses from midwives who had been qualified for five years or less, collected as part of the United Kingdom arm of the Work, Health and Emotional Lives of Midwives project. FINDINGS: Midwives described feeling immense pressure caused by an unremittingly heavy workload and poor staffing. Where relationships with colleagues were strong, they were described as a protective factor against stress; conversely, negative working relationships compounded pressures. Despite the challenges, many of the midwives reported taking great pleasure in their work, describing it as a source of pride and self-esteem. Midwives valued being treated as individuals and having some control over their shift pattern and area of work. DISCUSSION: These results, which reveal the strain on early career midwives, are consistent with the findings of other large studies on midwives' wellbeing. All available levers should be used to retain and motivate existing staff, and recruit new staff; in the meantime, considerable creativity and effort should be exercised to improve working conditions. CONCLUSION: This analysis provides a 'roadmap' for improving staff wellbeing and potentially retention.


Assuntos
Esgotamento Profissional/psicologia , Satisfação no Emprego , Enfermeiras Obstétricas/psicologia , Angústia Psicológica , Carga de Trabalho/psicologia , Adulto , Emoções , Feminino , Humanos , Intenção , Tocologia , Gravidez , Estresse Psicológico , Reino Unido
17.
Midwifery ; 82: 102618, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31887470

RESUMO

OBJECTIVE: The purpose of this study was to examine the ways in the decision to access a planned epidural in labour was topicalised and negotiated between pregnant women and midwives. DESIGN: This article uses conversation analysis to examine how decision-making unfolds in antenatal consultations in a large metropolitan hospital in South Australia. Data were sampled from naturally-occurring interactions between women and midwives in routine antenatal consultations. Analysis focused on talk about planning to access (or, avoid) an epidural during an upcoming labour. FINDINGS: This paper illustrates that in the context of woman-centred care, women are held unilaterally responsible for the decision to accept or reject a planned epidural in labour with little or no input from the midwife. Midwives take a step back from involvement in the discussion beyond the solicitation of a decision from the woman. Women wanting a planned epidural took a strong, assertive stance in the interaction and drew on their previous birthing experience, limiting opportunity for the midwife to engage in meaningful discussion about the risks and benefits. On the other hand, women rejecting a planned epidural were less assertive and engaged in more complex interactional work to account for their decision. KEY CONCLUSIONS: The lack of involvement by midwives may be linked to the non-directive ethos that prevails in maternity care. It is argued that, in this dataset, the institutional imperative for women to know and decide on pain relief while pregnant in order to allocate to a model of care is prioritised over women's aspirations and expectations of childbirth. IMPLICATIONS FOR PRACTICE: By analysing the ways in which midwives and women interact at the point in time at which decisions were made to plan access to an epidural we can continue to reveal underlying forces that drive the rising rates of medical interventions in childbirth. This paper also contributes to research evidence on how midwives manage the potentially contradictory dialect between supporting women's childbirth preferences while also managing institutional requirements and evidence-based practice.


Assuntos
Anestesia Epidural/métodos , Tomada de Decisões , Relações Enfermeiro-Paciente , Encaminhamento e Consulta/normas , Adulto , Anestesia Epidural/normas , Feminino , Humanos , Enfermeiras Obstétricas/psicologia , Enfermeiras Obstétricas/normas , Enfermeiras Obstétricas/estatística & dados numéricos , Gravidez , Gestantes/psicologia , Encaminhamento e Consulta/estatística & dados numéricos , Austrália do Sul
18.
Midwifery ; 82: 102596, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31887471

RESUMO

OBJECTIVE: to investigate how recent graduates from a combined work/study midwifery degree programme in Uganda viewed its effects on their wellbeing and work prospects. DESIGN: Using an adapted version of the Qualitative Impact Protocol (QuIP), a phenomenological approach was applied to thematic analysis to examine semi-structured interviews and WhatsApp group discussion. SETTING: Introduction of enhanced midwifery training (from Diploma to Degree level) combining study with professional practice within a low income country health system facing extreme capacity constraints. PARTICIPANTS: 14 members of the first cohort of graduates from the degree programme. FINDINGS: The graduates were overwhelmingly positive about improved professional knowledge, clinical skills, confidence, career commitment and prospects. They also had to contend with resentment from colleagues, increased workload and debt. Counselling training, peer support, and experience of managing stress during the training helped them to cope with these challenges. CONCLUSIONS: Qualitative feedback from those receiving advanced midwifery training highlights the importance of addressing social as well as technical skills, including leadership capacity and resilience in handling working relationships.


Assuntos
Enfermeiras Obstétricas/psicologia , Autoeficácia , Fatores de Tempo , Adaptação Psicológica , Adulto , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Feminino , Humanos , Enfermeiras Obstétricas/educação , Enfermeiras Obstétricas/estatística & dados numéricos , Pesquisa Qualitativa , Inquéritos e Questionários , Uganda
19.
J Clin Nurs ; 29(1-2): 208-220, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31633845

RESUMO

AIMS AND OBJECTIVES: To understand why Western Australian (WA) midwives choose to remain in the profession. BACKGROUND: Midwifery shortages and the inability to retain midwives in the midwifery profession is a global problem. The need for effective midwifery staff retention strategies to be implemented is therefore urgent, as is the need for evidence to inform those strategies. DESIGN: Glaserian grounded theory (GT) methodology was used with constant comparative analysis. METHODS: Fourteen midwives currently working clinically area were interviewed about why they remain in the profession. The GT process of constant comparative analysis resulted in an overarching core category emerging. The study is reported in accordance with Tong and associates' (2007) Consolidated Criteria for Reporting Qualitative Research (COREQ). RESULTS: The core category derived from the data was labelled-"I love being a midwife; it's who I am." The three major categories that underpin the core category are labelled as follows: "The people I work with make all the difference"; "I want to be 'with woman' so I can make a difference"; and "I feel a responsibility to pass on my skills, knowledge and wisdom to the next generation." CONCLUSION: It emerged from the data that midwives' ability to be "with woman" and the difference they feel they make to them, the people they work with and the opportunity to "grow" the next generation together underpin a compelling new middle-range theory of the phenomenon of interest. RELEVANCE TO CLINICAL PRACTICE: The theory that emerged and the insights it provides will be of interest to healthcare leaders, who may wish to use it to help develop midwifery workforce policy and practice, and by extension to optimise midwives' job satisfaction, and facilitate the retention of midwives both locally and across Australia.


Assuntos
Atitude do Pessoal de Saúde , Satisfação no Emprego , Enfermeiras Obstétricas/psicologia , Adulto , Austrália , Feminino , Teoria Fundamentada , Humanos , Pessoa de Meia-Idade , Tocologia , Enfermeiras Obstétricas/provisão & distribução , Gravidez , Pesquisa Qualitativa
20.
Women Birth ; 33(5): 464-472, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31676324

RESUMO

PROBLEM: The midwifery workforce in Australia is impacted by shortages and attrition. Workplace culture affects midwives' intentions to stay in the profession and their capacity to provide woman-centred care for mothers and infants. BACKGROUND: Staff attrition in maternity services often relates to midwives' workplace experiences and negative perceptions of organisational culture. Broad-based data are essential to fully understand midwifery workplace culture. AIM: This study aimed to examine Australian midwives' perceptions of workplace culture, using a specifically developed instrument. METHODS: A national online survey of Australian midwives, within a wider project on maternity workplace culture. Quantitative data were analysed descriptively. Qualitative data were analysed using content analysis. FINDINGS: Overall, 322 eligible midwives rated workplace culture and 150 provided further qualitative responses. Themes included 'the ability to be a midwife', 'support at work' and 'bullying'. Less than a third of midwives thought their workplace had a positive culture. Many respondents felt disengaged and unsupported by managers and described an inability to use all their midwifery knowledge in medically-dominated environments. Many attributed poor workplace culture to limited resources, poor communication, time pressure and a lack of leadership in their workplaces. Inadequate staffing levels and poor management left many midwives feeling disempowered and despondent about their workplace. Others, however, described highly positive workplace cultures and inspiring role models. CONCLUSION: The survey captured a snapshot of Australian midwifery workplace culture. Findings on leadership, workloads, management support and other aspects of workplace culture can inform future workforce planning and policies. A larger study of the midwifery workplace culture is needed.


Assuntos
Atitude do Pessoal de Saúde , Tocologia/métodos , Enfermeiras Obstétricas/psicologia , Cultura Organizacional , Local de Trabalho/organização & administração , Local de Trabalho/psicologia , Adulto , Idoso , Austrália , Bullying , Feminino , Humanos , Intenção , Entrevistas como Assunto , Pessoa de Meia-Idade , Administração de Recursos Humanos , Gravidez , Pesquisa Qualitativa , Inquéritos e Questionários , Carga de Trabalho
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