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1.
Pan Afr Med J ; 42: 169, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36187022

RESUMO

Introduction: neonatal mortality accounts for the most significant proportion of under-five mortality worldwide, as in Cameroon. Birth asphyxia is the leading cause of neonatal deaths in Cameroon. Training of health care workers (HCWs) in newborn resuscitation reduces neonatal morbidity and mortality. In this study, we evaluated the effect of in-hospital training on the competence (knowledge and skills) of HCWs in newborn resuscitation at Mboppi Baptist Hospital, Douala, Cameroon. Methods: this was a quasi-experimental study done in five weeks, in which we compared knowledge and skills before and after training. Assessment of knowledge and skills of HCWs in newborn resuscitation was done before training (simulations) and a week after training using World Health Organization (WHO) adapted Emergency Triage Assessment and Treatment (ETAT+) standard tool. Three key informant interviews (KIIs) and a focused group discussion (FGD) were held to determine barriers to effective newborn resuscitation. Data were analyzed using R software version 3.6.2. McNemar test and Cohen´s Kappa were used to analyze quantitative data, while major themes from KIIs and FGDs were selected for qualitative data. Results: we enrolled 30 HCWs, each HCW was observed twice, a total of 60 deliveries observed before and 60 after training. Sixteen HCWs (53%) showed adequate knowledge before and after training. Median scores for skills significantly increased by 28% (p<0.00054) for real-life observations and 26% (p=0.0004) for newborn resuscitation scenario simulations. The main barriers to adequate newborn resuscitation were inadequate knowledge, equipment, shortage of trained staff and poor teamwork between midwives and anesthetists. Conclusion: in-hospital training on newborn resuscitation improved the skills of HCWs but had no significant effect on their knowledge on newborn resuscitation. We would recommend that in-hospital training in newborn resuscitation be done often for HCWs.


Assuntos
Tocologia , Ressuscitação , Camarões , Competência Clínica , Feminino , Hospitais , Humanos , Lactente , Recém-Nascido , Gravidez , Protestantismo , Ressuscitação/educação
2.
JBI Evid Synth ; 20(9): 2312-2318, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36065911

RESUMO

OBJECTIVE: This qualitative systematic review will identify, appraise, and synthesize existing qualitative evidence regarding the experiences of pregnant people during a natural disaster to gain a deeper understanding of the complex factors influencing their experiences. INTRODUCTION: During natural disasters, pregnant people would benefit from health workers, including nurses, midwives, and other professionals, considering their needs and providing support to address complex factors, including family relationships, social support, and stress; however, little is known about the experiences of pregnant people during a natural disaster. This study is the first qualitative systematic review of the experiences of pregnant people during a disaster. INCLUSION CRITERIA: This review will include studies that focus on pregnant people's experiences of living in a disaster area during a natural disaster. It will include both published and unpublished qualitative studies, with data collected through interviews and observations, in either English or Japanese. METHODS: The databases and other sources to be searched include MEDLINE, CINAHL, and PsycINFO (in English); and CiNii and Ichushi-Web (in Japanese). Further, we will cross-check the reference lists of included studies with search outcomes to identify any additional studies suitable for analysis. The search for gray literature will be conducted using Google Scholar and ProQuest. We will use the recommended JBI approach for study selection, critical appraisal, data extraction, and data synthesis. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021265326.


Assuntos
Tocologia , Desastres Naturais , Feminino , Pessoal de Saúde , Humanos , Gravidez , Pesquisa Qualitativa , Apoio Social , Revisões Sistemáticas como Assunto
3.
Sante Publique ; 34(1): 71-85, 2022.
Artigo em Francês | MEDLINE | ID: mdl-36102094

RESUMO

INTRODUCTION: The environment and living conditions of parents during the "first 1000 days" period influence the short- and long-term health trajectories of children. Professionals following pregnancies play an important role in advising future parents to adopt health-promoting behaviors. It appeared necessary to describe the prevention messages transmitted by professionals early in pregnancy. OBJECTIVES: To identify the prevention messages systematically delivered during the first trimester of pregnancy and determine the degree of priority that professionals (midwives, obstetricians, general practitioners) of Bourgogne-Franche-Comté give to them. RESULTS: Prevention messages on infectious risk were addressed by 96.5% of respondents, and those on risk behaviors and addictions by 93.7%. Dietary balance and sports activities (78.5%), as well as risks in the daily life (47.1%) were less delivered. The messages that professionals declared to be delivered systematically to pregnant women during the first trimester were generally those that they considered to be priorities. There were some differences depending on the professional. Regarding information media, the majority of respondents did not use any. They agreed on the importance of a paper-based information medium and wished to be able to rely on a digital medium (62.6%). CONCLUSION: The co-construction of support that meets the needs of both women and professionals and that is validated by health authorities would contribute to better consideration and promotion of health-promoting behaviors by parents, by promoting empowerment of women and couples from the beginning of pregnancy.


Assuntos
Tocologia , Médicos , Criança , Feminino , Humanos , Gravidez , Primeiro Trimestre da Gravidez , Gestantes , Assunção de Riscos
4.
Afr J Prim Health Care Fam Med ; 14(1): e1-e14, 2022 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-36073123

RESUMO

BACKGROUND:  Sensitivity to women's cultural needs and expectations by care providers is essential. Skilled birth services for women are as essential as traditional birth services. Therefore, collaborative skilled and cultural care optimises childbearing experiences. AIM:  This study explored the experiences of birth attendants (BAs) with sensitivity to cultural practices (CPs) during pregnancy and birth among the Keiyo community in Kenya. SETTING:  The study was conducted in the purposively selected public health centres and dispensaries offering maternity services and the villages in Keiyo South Sub County in Kenya. METHODS:  A qualitative interpretive phenomenological study of BAs was conducted. Iterative and inductive interviews using a semistructured guide were conducted with 11 skilled BAs (SBAs) and eight traditional BAs (TBAs). Audio-recorded interviews were transcribed and analysed using ATLAS.ti software version 8.4.4 (1135), following Van Manen's five thematic analysis steps. RESULTS:  Three themes emerged: birth attendants' cultural encounters, response to cultural encounters and collaboration. Birth attendants' responses to different cultural encounters revealed their awareness of CPs. The response was experienced as a sensitivity to the need for a triad (woman, TBAs and SBAs) collaborative care, enabling collaborative, woman-centred and culturally safe care. CONCLUSION:  Birth attendants are exposed to cultural encounters, and their responses determine their awareness of enabling sensitive care for optimal childbearing experiences. The study illuminated the need for further collaborative engagements between the BAs and the community to facilitate positive experiences by women through woman-centred, culturally safe care.


Assuntos
Tocologia , Feminino , Humanos , Quênia , Gravidez , Pesquisa Qualitativa
5.
Afr J Prim Health Care Fam Med ; 14(1): e1-e8, 2022 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-36073129

RESUMO

BACKGROUND:  In South Africa, maternal healthcare guidelines are distributed to primary health care (PHC) facility for midwives to refer and implement during maternal healthcare services. Different training was offered for the use of maternal care guidelines. However, poor adherence and poor implementation of guidelines were discovered. AIM:  This study aimed to develop and prioritise strategies to improve the implementation of maternal healthcare guidelines at PHC facilities of Limpopo province, South Africa. METHOD:  Strengths, weaknesses, opportunities and threats analysis and its matrix together with the nominal group technique were used to develop the current strategy. Midwives, maternal, assistant and operational managers from PHC facilities of the two selected district of the Limpopo province were selected. Criterion-based purposive sampling was used to select participants. Data collection and analysis involved the four steps used in the nominal group technique. RESULTS:  Strategies related to strengths and weaknesses such as human resources, maternal health services and knowledge deficit were identified. Opportunities and threats such as availability of guidelines, community involvement and quality assurance as factors that influenced the provision of maternal healthcare services were identified. CONCLUSION:  Researchers formulated actions that could build on identified strengths, overcome weaknesses such as human resources, explore opportunities and mitigate the threats such as quality assurance. Implementation of the developed strategies might lead to the reduction of the maternal mortality rate.


Assuntos
Serviços de Saúde Materna , Tocologia , Atenção à Saúde , Feminino , Humanos , Mortalidade Materna , Gravidez , África do Sul
6.
Soins ; 67(866): 51-53, 2022 Jun.
Artigo em Francês | MEDLINE | ID: mdl-36127024

RESUMO

Advanced practice nurses in psychiatry and mental health have the opportunity to become involved in perinatal health networks. By building a new form of partnership with maternal and child protection midwives, they can provide second-line skills for the mental health of vulnerable patients and participate in the quality and safety of care.


Assuntos
Prática Avançada de Enfermagem , Tocologia , Feminino , Humanos , Saúde Mental , Gravidez
7.
PLoS One ; 17(9): e0274036, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36129890

RESUMO

Nurse, Midwives and Allied Health Professionals (AHPs), along with other health and social care colleagues are the backbone of healthcare services. They have played a key role in responding to the increased demands on healthcare during the COVID-19 pandemic. This paper compares cross-sectional data on quality of working life, wellbeing, coping and burnout of nurses, midwives and AHPs in the United Kingdom (UK) at two time points during the COVID-19 pandemic. An anonymous online repeated cross-sectional survey was conducted at two timepoints, Phase 1 (7th May 2020-3rd July 2020); Phase 2 (17th November 2020-1st February 2021). The survey consisted of the Short Warwick-Edinburgh Mental Wellbeing Scale, the Work-Related Quality of Life Scale, and the Copenhagen Burnout Inventory (Phase 2 only) to measure wellbeing, quality of working life and burnout. The Brief COPE scale and Strategies for Coping with Work and Family Stressors scale assessed coping strategies. Descriptive statistics and multiple linear regressions examined the effects of coping strategies and demographic and work-related variables on wellbeing and quality of working life. A total of 1839 nurses, midwives and AHPs responded to the first or second survey, with a final sample of 1410 respondents -586 from Phase 1; 824 from Phase 2, (422 nurses, 192 midwives and 796 AHPs). Wellbeing and quality of working life scores were significantly lower in the Phase 2 sample compared to respondents in Phase 1 (p<0.001). The COVID-19 pandemic had a significant effect on psychological wellbeing and quality of working life which decreased while the use of negative coping and burnout of these healthcare professionals increased. Health services are now trying to respond to the needs of patients with COVID-19 variants while rebuilding services and tackling the backlog of normal care provision. This workforce would benefit from additional support/services to prevent further deterioration in mental health and wellbeing and optimise workforce retention.


Assuntos
Esgotamento Profissional , COVID-19 , Tocologia , Complicações Infecciosas na Gravidez , Adaptação Psicológica , Pessoal Técnico de Saúde , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , COVID-19/epidemiologia , Estudos Transversais , Feminino , Humanos , Pandemias , Gravidez , Qualidade de Vida , SARS-CoV-2
8.
PLoS One ; 17(9): e0274790, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36137150

RESUMO

OBJECTIVE: High-quality, respectful maternity care has been identified as an important birth process and outcome. However, there are very few studies about experiences of care during a pregnancy and birth after a prior cesarean in the U.S. We describe quantitative findings related to quality of maternity care from a mixed methods study examining the experience of considering or seeking a vaginal birth after cesarean (VBAC) in the U.S. METHODS: Individuals with a history of cesarean and recent (≤ 5 years) subsequent birth were recruited through social media groups to complete an online questionnaire that included sociodemographic information, birth history, and validated measures of respectful maternity care (Mothers on Respect Index; MORi) and autonomy in maternity care (Mother's Autonomy in Decision Making Scale; MADM). RESULTS: Participants (N = 1711) representing all 50 states completed the questionnaire; 87% planned a vaginal birth after cesarean. The most socially-disadvantaged participants (those less educated, living in a low-income household, with Medicaid insurance, and those participants who identified as a racial or ethnic minority) and participants who had an obstetrician as their primary provider, a male provider, and those who did not have a doula were significantly overrepresented in the group who reported lower quality maternity care. In regression analyses, individuals identified as Black, Indigenous, and People of Color (BIPOC) were less likely to experience autonomy and respect compared to white participants. Participants with a midwife provider were more than 3.5 times more likely to experience high quality maternity care compared to those with an obstetrician. CONCLUSION: Findings highlight inequities in the quality of maternal and newborn care received by birthing people with marginalized identities in the U.S. They also indicate the importance of increasing access to midwifery care as a strategy for reducing inequalities in care and associated poor outcomes.


Assuntos
Serviços de Saúde Materna , Tocologia , Criança , Etnicidade , Feminino , Humanos , Recém-Nascido , Masculino , Tocologia/métodos , Grupos Minoritários , Parto , Assistência Perinatal/métodos , Gravidez , Estados Unidos
9.
BMC Health Serv Res ; 22(1): 1203, 2022 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-36163048

RESUMO

BACKGROUND: Midwifery group practice (MGP) has consistently demonstrated optimal health and wellbeing outcomes for childbearing women and their babies. In this model, women can form a relationship with a known midwife, improving both maternal and midwife satisfaction. Yet the model is not widely implemented and sustained, resulting in limited opportunities for women to access it. Little attention has been paid to how MGP is managed and led and how this impacts the sustainability of the model. This study clarifies what constitutes optimal management and leadership and how this influences sustainability. METHODS: This qualitative study forms part of a larger mixed methods study investigating the management of MGP in Australia. The interview findings presented in this study are part of phase one, where the findings informed a national survey. Nine interviews and one focus group were conducted with 23 MGP managers, clinical midwife consultants, and operational/strategic managers who led MGPs. Transcripts of the audio-recordings were analysed using inductive, reflexive, thematic analysis. RESULTS: Three themes were constructed, namely: The manager, the person, describing the ideal personal attributes of the MGP manager; midwifing the midwives, illustrating how the MGP manager supports, manages, and leads the group practice midwives; and gaining acceptance, explaining how the MGP manager can gain acceptance beyond group practice midwives. Participants described the need for MGP managers to display midwife-centred management. This requires the manager to have qualities that mirror what is generally accepted as requirements for good midwifery care namely: core beliefs in feminist values and woman-centred care; trust; inclusiveness; being an advocate; an ability to slow down or take time; an ability to form relationships; and exceptional communication skills. Since emotional labour is a large part of the role, it is also necessary for them to encourage and practice self-care. CONCLUSIONS: Managers need to practice in a way that is midwife-centred and mimics good midwifery care. To offset the emotional burden and improve sustainability, encouraging and promoting self-care practices might be of value.


Assuntos
Prática de Grupo , Tocologia , Gerenciamento da Prática Profissional , Austrália , Continuidade da Assistência ao Paciente , Feminino , Humanos , Liderança , Gravidez , Pesquisa Qualitativa
10.
HERD ; 15(4): 204-232, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36165447

RESUMO

OBJECTIVES: This article investigates how the physical birth environment is perceived by the users (women and midwives) in different settings, a midwife-led unit and an obstetric-led unit, placed in Italy. BACKGROUND: In the field of birth architecture research, there is a gap in the description of the spatial and physical characteristics of birth environments that impact users' health, specifically for what concerns the perception by women. METHODS: The study focuses on multi-centered mixed methods design, employing both quantitative and qualitative research methods (questionnaire, spatial analysis) and covering different disciplines (architecture, environmental psychology, and midwifery). RESULTS: The results revealed significant differences between the two settings and some associations between perceived and spatial data concerning: calm atmosphere, greater intimacy, spacious birth room, clarity of service points, clarity in finding midwives, sufficient space for labor, noise, privacy, and the birth room adaptability. CONCLUSIONS: The findings confirm the importance of the spatial layout and indicate documented knowledge as an input to consider when designing birth spaces in order to promote user well-being.


Assuntos
Tocologia , Enfermeiras Obstétricas , Feminino , Humanos , Tocologia/métodos , Mães , Enfermeiras Obstétricas/psicologia , Percepção , Gravidez , Pesquisa Qualitativa , Análise Espacial
11.
Appl Clin Inform ; 13(4): 916-927, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36170881

RESUMO

BACKGROUND: Timely multidisciplinary communication is crucial to prevent patient harm related to miscommunication of clinical information. Many health care organizations provide secure communications systems; however, clinicians often use unapproved platforms on personal devices to communicate asynchronously. OBJECTIVE: The aim of the study is to assess clinical communication behaviors by clinicians in a hospital setting. METHODS: Medical, nursing and allied health staff working across seven hospital sites of a large health care organization were invited to complete an anonymous survey on the methods, behaviors, and rationale for clinical communication technology use. The survey included questions on communication methods used by clinicians for intra- and inter-disciplinary communication and sending and receiving clinical information or images. Demographics and qualitative comments were also collected. RESULTS: A total of 836 surveys were completed (299 medical, 317 nursing, and 220 allied health staff). Staff in all clinical groups reported using an unapproved messaging platform to communicate patient information more than three times per day (medical staff n = 167, 55.9%; nursing staff n = 106, 33.4%; allied health staff n = 67, 30.5%). Not one medical staff member indicated they only use the approved methods (n = 0, 0%) while one-third of nursing and allied health respondents only used approved methods (n = 118, 37.2% and n = 64, 29.1%, respectively). All clinician groups reported wasted time from communications sent with missing information, or time spent waiting for responses for further information. Qualitative comments expressed dissatisfaction and frustration with current clinical communication methods and a desire for improved systems. CONCLUSION: Workarounds are being used by all clinician groups to send text and image clinical communications. There are high levels of dissatisfaction with this situation and clinicians are keen for consistency and to have the right tools available. There is a need to ensure standardized clinical communication methods and approved digital platforms are in place and utilized to provide safe, high-quality patient care.


Assuntos
Tocologia , Comunicação , Feminino , Humanos , Política , Gravidez , Tecnologia , Polegar
12.
BMC Public Health ; 22(1): 1731, 2022 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-36096766

RESUMO

BACKGROUND: Domestic and family violence (DFV), including intimate partner violence (IPV), sexual assault and child abuse are prevalent health and social issues, often precipitating contact with health services. Nurses, midwives and carers are frontline responders to women and children who have experienced violence, with some research suggesting that health professionals themselves may report a higher incidence of IPV in their personal lives compared to the community. This paper reports the largest study of DFV against health professionals to date. METHOD: An online descriptive, cross-sectional survey of 10,674 women and 772 men members of the Australian Nursing and Midwifery Federation (ANMF) (Victorian Branch). The primary outcome measures were 12-month and adult lifetime IPV prevalence (Composite Abuse Scale); secondary outcomes included sexual assault and child abuse (Australian Bureau of Statistics Personal Safety Survey) and prevalence of IPV perpetration (bespoke). RESULTS: Response rate was 15.2% of women/11.2% of men who were sent an invitation email, and 38.4% of women/28.3% of men who opened the email. In the last 12-months, 22.1% of women and 24.0% of men had experienced IPV, while across the adult lifetime, 45.1% of women and 35.0% of men had experienced IPV. These figures are higher than an Australian community sample. Non-partner sexual assault had been experienced by 18.6% of women and 7.1% of men, which was similar to national community sample. IPV survivors were 2-3 times more likely to have experienced physical, sexual or emotional abuse in childhood compared to those without a history of IPV (women OR 2.7, 95% CI 2.4 to 2.9; men OR 2.8, 95% CI 2.0 to 4.1). Since the age of sixteen, 11.7% of men and 1.7% of women had behaved in a way that had made a partner or ex-partner feel afraid of them. CONCLUSIONS: The high prevalence of intimate partner violence and child abuse in this group of nurses, midwives and carers suggests the need for workplace support programs. The findings support the theory that childhood adversity may be related to entering the nursing profession and has implications for the training and support of this group.


Assuntos
Maus-Tratos Infantis , Violência por Parceiro Íntimo , Tocologia , Delitos Sexuais , Adulto , Austrália/epidemiologia , Cuidadores , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Gravidez , Prevalência
13.
BMJ Open ; 12(9): e064731, 2022 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-36127079

RESUMO

OBJECTIVES: To explore midwives' and maternity support workers' perceptions of the impact of the COVID-19 pandemic on maternity services and understand factors influencing respectful maternity care. DESIGN: A qualitative study. Eleven semistructured interviews were conducted (on Zoom) and thematically analysed. Inductive themes were developed and compared with components of respectful maternity care. SETTING: Maternity services in a diverse region of the United Kingdom. PARTICIPANTS: Midwives and maternity support workers who worked during the first year of the COVID-19 pandemic. RESULTS: The findings offer insights into the experiences and challenges faced by midwives and maternity support workers during the first year of the COVID-19 pandemic in the UK (March 2020-2021). Three core themes were interpreted that impacted respectful maternity care: (1) communication of care, (2) clinical care and (3) support for families. 1. Midwives and maternity support workers felt changing guidance impaired communication of accurate information. However, women attending appointments alone encouraged safeguarding disclosures. 2. Maternity staffing pressures worsened and delayed care provision. The health service's COVID-19 response was thought to have discouraged women's engagement with maternity care. 3. Social support for women was reduced and overstretched staff struggled to fill this role. The continuity of carer model of midwifery facilitated supportive care. COVID-19 restrictions separated families and were considered detrimental to parents' mental health and newborn bonding. Overall, comparison of interview quotes to components of respectful maternity care showed challenges during the early COVID-19 pandemic in upholding each of the 10 rights afforded to women and newborns. CONCLUSIONS: Respectful maternity care was impacted through changes in communication, delivery of clinical care and restrictions on social support for women and their infants in the first year of the COVID-19 pandemic. Future guidance for pandemic scenarios must make careful consideration of women's and newborns' rights to respectful maternity care.


Assuntos
COVID-19 , Serviços de Saúde Materna , Tocologia , Obstetrícia , COVID-19/epidemiologia , Feminino , Humanos , Recém-Nascido , Pandemias , Gravidez , Pesquisa Qualitativa
14.
BMC Pregnancy Childbirth ; 22(1): 717, 2022 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-36127645

RESUMO

BACKGROUND: For quality-oriented evaluation of prenatal and obstetric care, it is important to systematically consider the perspective of the women receiving care in order to comprehensively assess and optimize quality in a woman-centered manner. Empathy and Shared Decision Making (SDM) are essential components of woman-centered midwifery care. The aim of the study was to analyze measurement invariance of the items of the Consultation and Relational Empathy (CARE) and Shared Decision Making-Questionnaire (SDM-Q-9) scales depending on the prenatal versus obstetric care setting. METHODS: One hundred fifty women retrospectively assessed aspects of woman-centered midwifery care in both prenatal and obstetric care setting. The birth of the child was a maximum of 12 months ago. A structural equation modelling approach was adopted to separate true effects from response shift (RS) effects depending on care setting. The latter were analyzed in terms of recalibration (changing women's internal measurement standards), Reprioritization (changing associations of items and construct) as well as Reconceptualization (redefining the target construct). RESULTS: A response shift model was identified for both assessments (pregnancy/birth: CFI = .96/.96; SRMR = .046/.051). At birth, both scales indicated lower quality of care compared with prenatal care (SDM-Q-9-M/CARE-8-M:|d| = 0.190/0.392). Although no reconceptualization is required for the items of both scales, RS effects are evident for individual items. Due to recalibration and reprioritization effects, the true differences in the items are partly underestimated (SDM-Q-9-M/CARE-8-M: 3/2 items) or overestimated (4/2 items). CONCLUSION: The structure of the constructs SDM and Empathy, indicating woman-centered midwifery care, are moderated by the care settings. To validly assess midwives' empathy and shared decision making from women's perspective, setting-dependent response shift effects have to be considered. The proven item-specific response effects contribute to a better understanding of construct characteristics in woman-centered care by midwives during pregnancy and childbirth.


Assuntos
Tomada de Decisão Compartilhada , Tocologia , Criança , Tomada de Decisões , Empatia , Feminino , Humanos , Recém-Nascido , Participação do Paciente , Gravidez , Estudos Retrospectivos , Vitaminas
15.
BMJ Open ; 12(9): e051747, 2022 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-36130758

RESUMO

INTRODUCTION: Choice of birth setting is important and it is valuable to know how reconfiguring available settings may affect midwifery staffing needs. COVID-19-related health system pressures have meant restriction of community births. We aimed to model the potential of service reconfigurations to offset midwifery staffing shortages. METHODS: We adapted the Birthrate Plus method to develop a tool that models the effects on intrapartum and postnatal midwifery staffing requirements of changing service configurations for low-risk births. We tested our tool on two hypothetical model trusts with different baseline configurations of hospital and community low-risk birth services, representing those most common in England, and applied it to scenarios with midwifery staffing shortages of 15%, 25% and 35%. In scenarios with midwifery staffing shortages above 15%, we modelled restricting community births in line with professional guidance on COVID-19 service reconfiguration. For shortages of 15%, we modelled expanding community births per the target of the Maternity Transformation programme. RESULTS: Expanding community births with 15% shortages required 0.0 and 0.1 whole-time equivalent more midwives in our respective trusts compared with baseline, representing 0% and 0.1% of overall staffing requirements net of shortages. Restricting home births with 25% shortages reduced midwifery staffing need by 0.1 midwives (-0.1% of staffing) and 0.3 midwives (-0.3%). Suspending community births with 35% shortages meant changes of -0.3 midwives (-0.3%) and -0.5 midwives (-0.5%) in the two trusts. Sensitivity analysis showed that our results were robust even under extreme assumptions. CONCLUSION: Our model found that reconfiguring maternity services in response to shortages has a negligible effect on intrapartum and postnatal midwifery staffing needs. Given this, with lower degrees of shortage, managers can consider increasing community birth options where there is demand. In situations of severe shortage, reconfiguration cannot recoup the shortage and managers must decide how to modify service arrangements.


Assuntos
COVID-19 , Parto Domiciliar , Tocologia , COVID-19/epidemiologia , Inglaterra , Feminino , Humanos , Tocologia/métodos , Gravidez , Recursos Humanos
16.
Indian J Public Health ; 66(3): 282-286, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36149105

RESUMO

Background: World report on vision makes integrated people-centered eye care as care model of choice. Integrating eye care with the existing public health system makes services available, accessible, affordable, and sustainable. Being from the community, Accredited Social Health Activists (ASHAs) are better suited to improve people's eye health-seeking behavior. Objectives: This study aims to assess the eye care-seeking behavior of community and to understand their response toward the approach of integrated vision centers (VC) with ASHA involvement. Methods: A cross-sectional descriptive study was conducted in South Delhi district where integrated VC were functional for more than a year. These centers were supervised by medical officer in-charge, under whom ophthalmic assistants, ASHAs, auxiliary nurse midwives, and pharmacist work. ASHAs were trained in community-based primary eye care. The community survey was conducted on eye health-seeking behavior and utilization of VC services. Descriptive statistics were used for data analysis. Results: Out of 1571 study participants, 998 reported any ophthalmic illness in family in the past 6 months as against 1302 who reported nonophthalmic illness in family. The majority (1461, 90%) were aware about integrated VC and half of them (748, 51.2%) visited it. Of them, 64.2% were motivated through ASHAs. ASHAs spread awareness about eye diseases, eye treatment facility, and referred patients from the community. The majority (93%) were happy with the integrated VC and 87.8% were happy with ASHAs. Conclusion: Integrated VC with ASHA engagement could pave the way for universal eye health. Understanding people's needs and engaging community would increase the demand for eye care.


Assuntos
Agentes Comunitários de Saúde , Tocologia , Estudos Transversais , Feminino , Humanos , Índia , Aceitação pelo Paciente de Cuidados de Saúde , Gravidez
17.
BMC Pregnancy Childbirth ; 22(1): 724, 2022 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-36151533

RESUMO

BACKGROUND & OBJECTIVE: Continuity of midwifery-led care during labour and birth is considered optimal. To ensure its sustainability in practice where limited evidence is available, the aim of the present study was to explore midwives' lived experiences of delivering continuous midwife-led intrapartum care. METHODS: This study took a qualitative approach in meeting its aim. Participants were midwives working in the labour wards of private and public hospitals in Iran. The data were purposefully collected in 2019 through in-depth, semi-structured, and face-to-face interviews with midwives (n = 10) aged between 26 and 55 years. A thematic analysis based on descriptive phenomenology was undertaken to make sense of the data collected. RESULTS: "Wanting to lead continuous woman-centered care but being unable to" was identified as an overarching theme. Three other themes "emphasis on the non-interventional care", "midwifery-specific focus" and "barriers and challenges of midwifery care" were also identified. Ultimately, midwives described knowing how to and wanting to lead continuous 'woman'-centered care but being unable to. Perceived barriers included lack of familiarity with and knowledge in relation to childbirth, the insignificant role of midwives in decision making, obstetrician utilitarianism, high workloads along with work-related stress argument-driven communication between midwives and obstetricians and an absence of a 'triangle of trust' in care. CONCLUSION: Future research strategies could usefully include obstetricians and focus on the upscaling of midwifery in Iran using continuity of care models, highlight the value of midwives, identify why uptake of antenatal education in Iran is poor and develop user friendly, evidence based, midwife-led programs. Initiatives aiming to promote mutual professional respect, trust and collegiality and increased remuneration for midwifery work would be also welcomed in pursuit of reducing maternal and infant mortality in Iran.


Assuntos
Tocologia , Enfermeiras Obstétricas , Adulto , Parto Obstétrico , Feminino , Humanos , Irã (Geográfico) , Pessoa de Meia-Idade , Tocologia/métodos , Parto , Gravidez , Pesquisa Qualitativa
18.
Orv Hetil ; 163(39): 1544-1552, 2022 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-36153725

RESUMO

INTRODUCTION: Child abuse is a worrying trend not only in our country but globally. The aim of the article is to present the adverse long-term consequences of child abuse, Adverse Childhood Experiences, which is a classified public health problem according to WHO. The attitude of primary care workers towards the prevention of abuse has a profound impact on the quality of prevention activities. OBJECTIVE: To assess the knowledge and perceptions of paediatricians, midwives and paediatric nurses working in primary and specialised care about the topic child abuse. Contextualising value judgements and societal perceptions of child abuse in order to break the transgenerational effects. METHOD: A self-completed online survey was conducted with 49 structured, standardised questions, the data provided insights about the socio-economic status of respondents, their attitudes to the issue of child abuse, their perceptions of the seriousness of the issue and their obligation to report it under the law. RESULTS: Based on our analysis on a sample of 195 respondents, we can conclude that health care workers perceive abuse as clearly harmful, yet it is perceived as a common phenomenon in our country. Nearly one fifth of respondents believe that society is accepting and mildly judges the phenomenon. A significant difference in the perception of abuse by educational level was found between the high and low educated respondents. We also found significant differences in signalling functioning by type of workplace location (p = 0.020) and job category (p = 0.044). CONCLUSION: The results highlighted that preventive action by health care workers is the key to breaking the transgenerational effects. The authors would like to draw attention to the fact that the improvement of the quality of care depends significantly on the knowledge of professionals. Continuous basic and further training and in-depth knowledge development among primary care workers are necessary. Orv Hetil. 2022; 163(39): 1544-1552.


Assuntos
Maus-Tratos Infantis , Tocologia , Atitude do Pessoal de Saúde , Criança , Maus-Tratos Infantis/prevenção & controle , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Humanos , Gravidez
19.
BMC Res Notes ; 15(1): 306, 2022 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-36138471

RESUMO

OBJECTIVE: Familiarity with the unique tradition and experience of Swedish midwives during the more than 300 years in which midwife-led care has contributed to one of the lowest maternal and neonatal mortality and morbidity ratio in the world might encourage professionals in other countries to follow the Swedish example. The framework described below, reflecting the midwife's role in the Swedish health care system, might, after implementation, strengthen maternal and neonatal outcomes if contextualized to other settings. RESULTS: Using a four-step procedure we identified our topic, made a literature review, identified the key components and their internal relationship, and finally developed the MIDWIZE conceptual framework. In this framework, the midwives in collaboration with obstetricians, provide evidence-based care with continuous quality improvements during the whole reproductive life cycle. Teamwork including specialists for referral and a responsive, relational, trust-based practice is the foundation for provision of midwife-led care for healthy women with a normal pregnancy. The well-educated midwife, of high academic standard, promoting gender equality and equity is the hub in the team and the primary care provider.


Assuntos
Tocologia , Médicos , Atenção à Saúde , Feminino , Humanos , Mortalidade Infantil , Recém-Nascido , Gravidez , Suécia
20.
Medicina (Kaunas) ; 58(9)2022 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-36143986

RESUMO

Background and Objectives: The first inquisitorial processes were developed against Muslims and Jews. Then, they focused on women, especially those dedicated to care. Progressively, they were linked to witchcraft and sorcery due to their great assistance, generational and empirical knowledge. The health historiography of the 15th-18th centuries still has important bibliographic and interpretive gaps in the care provided by women. The main objective was to analyse the care provided by midwives in the legislative and socio-sanitary context of New Castile, in the inquisitorial Spain of the 15th-18th centuries. Materials and Methods: A historical review was conducted, following the Dialectical Structural Model of Care. Historical manuals, articles and databases were analysed. Results: The Catholic Monarchs established health profession regulations in 1477, including midwives. However, all legislations were annulled by Felipe II in 1576. These were not resumed until 1750. Midwives assumed a huge range of functions in their care commitment (teaching, care and religion) and were valued in opposing ways. However, many of them were persecuted and condemned by the Inquisition. They used to accompany therapeutic action with prayers and charms. Midwives were usually women in a social vulnerability situation, who did not comply with social stereotypes. Conclusions: Midwives, forerunners of current nursing and health sciences, overcame sociocultural difficulties, although they were condemned for it. Midwives achieved an accredited title, which was taken from them for two centuries. They acted as health agents in a society that demanded them while participating in a "witch hunt".


Assuntos
Tocologia , Feminino , Humanos , Tocologia/educação , Gravidez , Espanha
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