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1.
J Contin Educ Nurs ; 53(1): 21-29, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34978478

RESUMO

BACKGROUND: Midwifery across the world is facing changes and uncertainties. By recognizing plausible future options, a contemporary and strategic scope of midwifery practice and education can be established. The city of Antwerp, Belgium, was the indicative case for this study. Key drivers were identified to serve as input for scenarios. METHOD: Structuration theory and intuitive logics scenario planning methods were used to structure contextual midwifery scenarios. RESULTS: Six certain and six uncertain variables were identified. A two-dimensional framework showed these factors: (a) maternity care services and organization and (b) the society of child-bearing women and their families. Three scenarios described the plausible future of midwifery: (a) midwife-led care monitoring maternal health needs, (b) midwife-led holistic care, and (c) midwife/general practitioner-led integrated maternity care. CONCLUSION: All of the scenarios show the direction of change with a strategic focus, the importance of midwifery authenticity, and digital adaptability in maternity services. Also, the coronavirus disease 2019 (COVID-19) pandemic cannot be ignored in future midwifery. [J Contin Educ Nurs. 2022;53(1):21-29.].


Assuntos
COVID-19 , Serviços de Saúde Materna , Tocologia , Feminino , Previsões , Humanos , Gravidez , SARS-CoV-2
2.
Nurse Educ Today ; 108: 105159, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34607237

RESUMO

BACKGROUND: Student midwives often encounter perinatal loss including stillbirth and neonatal death as part of their clinical training. There has been limited research on how student midwives cope with perinatal death. OBJECTIVE: To explore the experiences of undergraduate midwifery students facing perinatal death during their internships. DESIGN: Qualitative research design based on interpretive phenomenological approach and COREQ-guided reporting. SETTING: Tertiary maternal and child care center or general hospital. PARTICIPANTS: Undergraduate midwifery students from a medical university in Guangzhou, China. METHODS: Study participants were recruited through purposive sampling. Semi-structured in-depth interviews were conducted between October 2020 and March 2021 with 12 midwifery students. Transcripts of the interviews were analyzed using Diekelmann's interpretive method. RESULTS: Four themes were identified from the data: unavoidable anxiety and avoidance response; overwhelming fear and taboos related to death; self-blame and emotional inhibition; and ethical conflict and reflection on practice. CONCLUSIONS: Undergraduate midwifery students believed they were ill-prepared to care for women who experienced perinatal loss, consciously endured their own negative emotions such as anxiety and fear, and hoped for improved bereavement and stillbirth care in future clinical practice. Students valued support from the bereavement midwife and identified effective strategies that would help them cope with their feelings. It is recommended that adequate education and emotional support be provided to midwifery students, who should be encouraged to provide appropriate care to grieving families.


Assuntos
Luto , Tocologia , Morte Perinatal , Estudantes de Enfermagem , Feminino , Humanos , Recém-Nascido , Gravidez , Pesquisa Qualitativa
3.
Midwifery ; 104: 103197, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34788724

RESUMO

BACKGROUND: Nearly half of new mothers describe their childbirth as traumatic. Perinatal trauma impacts both short and long-term biopsychosocial outcomes for mother and child. Midwife trauma-informed care education and practice is essential to mitigate this risk. OBJECTIVE: This review aimed to identify and describe the nature and extent of trauma informed care education provided for midwives and midwifery students. DESIGN: An integrative review. METHODS: Five databases (Medline, Embase, CINAHL, Psycinfo, and Emcare) were searched to identify primary research regarding trauma informed care education for midwives and midwifery students. Quality appraisal was conducted using the Mixed Methods Appraisal Tool. RESULTS: Three papers were identified. None of the papers were midwifery focused, with midwives representing a small proportion of the participants. Most midwives reported receiving no previous trauma informed care education and lacked confidence to provide quality care to women with lived trauma. Midwives reported trauma informed care education as essential and relevant for providing quality practice. Improvements in knowledge, skills and attitudes was demonstrated following trauma informed care education. More in-depth content and content delivered in multiple ways were recommended. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Midwives are well placed to deliver trauma informed care. Trauma informed care education for midwives is limited. Given the impact of perinatal trauma, further trauma informed care education and research is paramount.


Assuntos
Tocologia , Feminino , Humanos , Tocologia/educação , Mães , Parto , Gravidez , Qualidade da Assistência à Saúde
4.
Nurse Educ Today ; 108: 105168, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34656035

RESUMO

BACKGROUND: Clinical placement is an important component of nursing and midwifery education. It exposes students to the real-world healthcare environment, where theoretical knowledge is put into practice. However, the quality of the clinical learning environment in sub-Sahara Africa has not been well explored. OBJECTIVE: The objectives of this study were to assess trainees' perceptions of the number of students on the ward or clinical unit, and the quality of the clinical learning environment. DESIGN: Cross-sectional survey. SETTING: Nursing and midwifery students were recruited from three public hospitals in the Upper East Region, Ghana, between July and August 2019. PARTICIPANTS: 254 nursing and midwifery students were recruited using the convenience sampling technique. METHODS: Data were collected with the Clinical Learning Environment and Supervision + Nurse Teacher questionnaire. Data were analysed using univariate, bivariate and multivariable analyses. RESULTS: It was found that the participants rated supervisory relationship; pedagogical atmosphere; role of nurse teacher; leadership style of ward managers; and premises of care on the ward as average. Students' perceptions of the quality of the clinical learning environment were predicted by supervisory relationship (ß = 0.219, 95% CI: 0.016-0.070), leadership style (ß = 0.199, 95% CI: 0.011-0.133) and perception of number of students in clinical placement (ß = 0.224, 95%CI: 0.022-0.093). The trainees indicated that the number of students on the ward did not correspond with the amount of medical equipment and supervisors. CONCLUSION: The quality of the clinical learning environment was perceived to be suboptimal. Leadership style, supervisory relationship and perception of the number of students on the ward were the salient factors that influenced students' perceptions of the quality of the clinical learning environment. Leaders of nursing and midwifery training institutions must liaise with stakeholders to enhance the quality of the clinical learning environment.


Assuntos
Bacharelado em Enfermagem , Tocologia , Estudantes de Enfermagem , Estudos Transversais , Feminino , Humanos , Preceptoria , Gravidez , Inquéritos e Questionários
5.
Nurse Educ Today ; 108: 105171, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34689014

RESUMO

BACKGROUND: Due to the high percentage of need for clinical techniques in the field of midwifery, evaluation of clinical skills of graduates is necessary. OBJECTIVE: The aim of this study was to investigate the validation characteristics of comprehensive examination checklists in midwifery students. DESIGN: The present study was a methodological study in which seven checklists related to important midwifery skills were entered into the psychometric process. SETTING: The study was conducted in the School of Nursing and Midwifery and the Persian Gulf martyrs and Salman Farsi Hospitals, Nabi-e-Akram comprehensive health center in Bushehr city. PARTICIPANTS: Quantitative face validity was performed by examining the item impact score based on the opinions of 10 midwifery graduates. Quantitative content validity was performed by examining the content validity ratio and index based on the opinions of 12 experts. For structural validity as well as reliability assessment, checklists were used for 78 midwifery students who had completed their studies and were about to graduate. To determine the convergent validity, the correlation of the score of each checklist with the mean score of the similar fields of each skill was measured. Divergent validity was assessed by measuring the correlation between the score of each checklist and the score of other checklists and comparing it with the internal consistency of each checklist. Internal consistency and agreement between evaluators were used to assess reliability. Data were analyzed using SPSS19. RESULTS: Content validity index and content validity ratio for each item were more than 0.79 and 0.67, respectively. There was a significant correlation between the score of each skill and the mean score of similar fields of that skill (P < 0.05). CONCLUSION: According to the results, it can be concluded that comprehensive midwifery student evaluation checklists are a valid and reliable tool.


Assuntos
Lista de Checagem , Tocologia , Competência Clínica , Feminino , Humanos , Gravidez , Psicometria , Reprodutibilidade dos Testes , Estudantes
6.
Midwifery ; 104: 103158, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34700126

RESUMO

OBJECTIVE: Data from the Nigeria Demographic and Health Survey indicate that many pregnant women in rural Nigeria use traditional birth attendants (TBAs) rather than skilled birth attendants (SBAs) for maternal health care. This is one factor that accounts for the persistently high rate of maternal mortality in Nigeria. The objective of this study was to identify the pervading reasons that women use TBAs for pregnancy care in rural Nigeria and to make recommendations for policy and programmatic reform. DESIGN: Qualitative research design consisting of focus group discussions, key informant interviews, and community conversations, followed by inductive thematic analysis. SETTING: Twenty rural communities (villages) in Etsako East, and Esan South East Local Government Areas of Edo State, South-South, Nigeria. PARTICIPANTS: Twenty focus group discussions with men and women in a marital union; 15 key informant interviews with policymakers, senior health providers, and women leaders; and 10 community conversations with key community leaders. FINDINGS: Some reasons proffered for using TBAs included perceptions of higher efficacy of traditional medicines; age-long cultural practices; ease of access to TBAs as compared to SBAs; higher costs of services in health facilities; and friendly attitude of TBAs. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The continued use of TBA is a major challenge in efforts to achieve the Sustainable Development Goal 3 in Nigeria. We conclude that efforts to address the factors identified by community stakeholders as inhibiting the use of SBAs will promote skilled birth attendance and reduce maternal mortality in rural Nigeria.


Assuntos
Serviços de Saúde Materna , Tocologia , Feminino , Humanos , Masculino , Nigéria , Políticas , Gravidez , População Rural
7.
Nurse Educ Today ; 108: 105184, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34717099

RESUMO

BACKGROUND: Complex physiological processes are often difficult for midwifery students to comprehend when using traditional teaching and learning approaches. Face to face instructional workshops using simulation have had some impact on improving understanding. However, in the 21st century new technologies offer the opportunity to provide alternative learning approaches. AIM: To investigate the impact of using three-dimensional (3D) visualisation in midwifery education on student's experience of learning, and retention of knowledge at three points in time. DESIGN: A pilot study involving a two-armed parallel Randomised Controlled Trial (RCT) comparing the retention of knowledge scores between the control and intervention groups. SETTING: An Australian University in the Northern Territory. PARTICIPANTS: The sample included second year Bachelor of Midwifery students (n = 38). All received traditional midwifery education before being randomly allocated to either the intervention (n = 20) or control (n = 18) group. METHODS: A new immersive virtual environment was introduced to complement existing traditional midwifery education on the third stage of labour. This intervention was evaluated using a demographic survey and multiple-choice questionnaire to collect baseline information via Qualtrics. To measure change in knowledge and comprehension, participants completed the same multiple-choice knowledge questionnaire at three time points; pre, immediately post and at 1 month post intervention. In addition, the intervention group completed a 3D student satisfaction survey. RESULTS: Baseline knowledge scores were similar between the groups. A statistically significant increase in knowledge score was evident immediately post intervention for the intervention group, however there was no significant difference in knowledge score at one month. CONCLUSIONS: The results support the creation of further three-dimensional visualisation teaching resources for midwifery education. However, a larger randomised controlled study is needed to seek generalisation of these findings to confirm enhanced student learning and retention of knowledge post 3DMVR, beyond the immediate exposure time.


Assuntos
Tocologia , Estudantes de Enfermagem , Austrália , Feminino , Humanos , Aprendizagem , Projetos Piloto , Gravidez , Estudantes
8.
Midwifery ; 104: 103170, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34736015

RESUMO

OBJECTIVE: Adolescent motherhood brings many challenges. While much is written about young mothers' transition to motherhood and their support needs, there is little from South-East Asian countries such as Indonesia. The aim of this study was to understand the new motherhood experiences of Indonesian adolescent females living with their extended families. DESIGN: Eleven semi-structured interviews were conducted with new adolescent mothers. SETTING: a large women and children's hospital in Makassar, South Sulawesi, Indonesia. PARTICIPANTS: Purposive sampling was undertaken. Eleven adolescent mother participated in this study. The mean age of the mothers was 17 years, ranging from 16 to 19 years of age. FINDINGS: Four themes emerged: demonstrate transfer of knowledge between generations, sharing tasks with extended family, feeling blessed with extended family and local myth and cultural practice related to caring for the baby. Findingsdemonstrated that transfer of knowledge between generations was important for these adolescent mothers. They shared responsibilities with and felt blessed having their extended families, along with local beliefs and cultural practice related to caring fortheir babies. DISCUSSION AND IMPLICATIONS FOR PRACTICE: Our findings contribute to understandings of experiences to becoming mothers among Indonesian adolescents living with extended family. Results can be used by healthcare providers, especially nurses and midwives, to develop cultural care interventions and educational program for maternity and psychosocial care for adolescent mothers and their families towards success in the transition period and maternal role attainment.


Assuntos
Tocologia , Mães , Adolescente , Criança , Emoções , Feminino , Humanos , Indonésia , Lactente , Gravidez , Pesquisa Qualitativa
9.
Midwifery ; 104: 103173, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34736017

RESUMO

OBJECTIVE: For peer learning to be useful in clinical practice, we need to know how parents experience peer learning during labour and childbirth. This study explored how parents experienced having two students present during labour and childbirth in a peer-learning model. DESIGN: A qualitative approach using individual interviews followed by thematic inductive analysis. SETTING: Three hospitals and obstetric units in Stockholm, Sweden. PARTICIPANTS: Eleven women and nine partners. FINDINGS: The overarching theme was that of a fruitful model of health care, in which there were gains for both parents and students. Parents described feeling seen and cared for, being made aware of what was going on, and never being left alone (subtheme 1, Trustful relationship). Parents appreciated being able to observe student midwives' attendance to the tasks at hand and that they, the two students, learned from each other (subtheme 2, Advantages for students). CONCLUSIONS: The parent couple was able to build a trustful relationship with both students. Furthermore, could parents only see advantages for students in a peer-learning model. Parents reported generous support and were willing to contribute to student education. Parents took advantage of the learning taking place between the two students. The model deserves to be incorporated in the midwifery-student internships to complement more individually assisted births.


Assuntos
Tocologia , Feminino , Humanos , Pais , Gravidez , Pesquisa Qualitativa , Estudantes , Suécia
10.
Nurse Educ Today ; 108: 105163, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34741912

RESUMO

BACKGROUND: There are calls to ensure that evidence-based practice is enabled for every midwife and nurse by means of education, research, leadership and access to evidence. Concurrently, there is a global call for universities to foster 'Research Inspired Teaching'. Yet such teaching must first be defined and may usefully be developed, delivered, and evaluated as part of a framework approach. OBJECTIVE: To co-create a uniform definition of 'Research Inspired Teaching' and a framework for developing, delivering, and evaluating it. DESIGN: A co-creation approach was taken, underpinned by the interpretive framework of communal constructivism. SETTING: United Kingdom. PARTICIPANTS: The sampling strategy was purposive, whereby those who had reportedly actively engaged in 'Research Inspired Teaching' were invited to participate. The resulting multidisciplinary team of co-creators (n = 14) included students, educators, and self-identified facilitators of 'Research Inspired Teaching'. METHODS: The co-creation of outputs was facilitated by two online co-creation workshops. All creative, written, and verbal contributions made by co-creators were collected as data and used to 'co-define', 'co-design' and 'co-refine' outputs. To enhance credibility, triangulation was used throughout. A final review of results presented in this article via all co-creators concluded this process. RESULTS: This article presents a definition of teaching, a definition of research, a founding definition of Research Inspired Teaching and a guiding framework along with 10 core principles for developing, delivering, and evaluating it. CONCLUSIONS: These outputs may be useful for both midwifery and nursing faculties, providing common language for collaboration and inspiring further developments and research. In pursuit of excellence, further international research could usefully investigate how these outputs may further bridge the Research-Teaching Nexus in Higher Education, and partner with other universities looking to cultivate, evidence and promote their own 'Research Inspired Teaching' in practice. In this pursuit, inter-university partnerships would be welcomed.


Assuntos
Tocologia , Estudantes de Enfermagem , Docentes de Enfermagem , Feminino , Humanos , Liderança , Gravidez , Ensino , Universidades
11.
Nurse Educ Today ; 108: 105174, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34741914

RESUMO

PROBLEM: Quantitative feedback from students about their clinical learning experiences is used to inform program quality, but the extent to which tools are reliable, valid and refined receives less attention. AIM: To evaluate the psychometric properties of the Midwifery Student Evaluation of Practice (MidSTEP) tool using Rasch analysis. METHODS: The Midwifery Student Evaluation of Practice tool was completed by Bachelor of Midwifery students (n = 901) attending seven universities in Australia and New Zealand. The tool consists of the Clinical Learning Environment Scale (16 items) and Impact of the Midwifery Preceptor Scale (10 items), each with two subscales. Rasch analysis was conducted on all subscales separately using the partial credit model of RUMM2030. Response format, item fit, dimensionality of the scale and its targeting were assessed. RESULTS: Rasch analysis confirmed the internal construct validity of the Clinical Learning Environment and Impact of the Midwifery Preceptor subscales, with no evidence of mis-fitting items, local dependency or multidimensionality. The 4-point response scale was found to be appropriate, and internal consistency reliability of each subscale was good. DISCUSSION: Results provide support for the reliability and validity of the Midwifery Student Evaluation of Practice tool. The four subscales can confidently be used in undergraduate midwifery clinical education. The use of Rasch analysis is consistent with growing awareness in health and education of the need to apply more advanced, sophisticated psychometric techniques to ensure measures are suitable for their intended use. TWEETABLE ABSTRACT: Midwifery students clinical learning experiences should be measured using robust tools. MidSTEP is reliable and valid.


Assuntos
Tocologia , Estudantes de Enfermagem , Comportamento de Utilização de Ferramentas , Feminino , Humanos , Gravidez , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
12.
Midwifery ; 104: 103172, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34749122

RESUMO

The general discourse in most countries is that technological surveillance during pregnancy and childbirth is synonymous with safety, while women's individual experiences are less likely regarded as critical. The aim of this ethnographic study at a birth center in Germany was to describe how midwives and their clients construct risk and safety. The data collection methods included participant observation and semi-structured interviews. 'Putting the baby back in the body' was the major theme that emerged, supported by three sub-themes. The women in this study relied on scans at the beginning of pregnancy to make their baby real to them, but became more confident in their capacity to sense their baby after experiencing the first fetal movements. The midwives fostered this confidence by using interactive palpation of the abdomen with the women, thus supporting their individual sensory experience, and, in the midwives' view, enhancing overall safety during pregnancy and at birth.


Assuntos
Centros de Assistência à Gravidez e ao Parto , Tocologia , Parto Obstétrico , Feminino , Humanos , Recém-Nascido , Parto , Gravidez , Pesquisa Qualitativa
13.
Midwifery ; 104: 103160, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34753017

RESUMO

Objective Perinatal depression is linked to poor maternal health and infant development outcomes. The World Health Organization recommends expanding the mental health education and training of primary care providers to improve the quality of perinatal depression care. The present study evaluated the effect of various psychological training methods on nurses' and midwives' competence in administering care to and alleviating symptoms in patients with perinatal depression. Methods A comprehensive search of the PubMed, MEDLINE, Cochrane Library, EMBASE, Web of Science, and CINAHL databases was performed. The data were independently extracted by two reviewers, and the critical appraisal tools of the Joanna Briggs Institute were used for quality assessment. Random-effects meta-analysis was conducted using Review Manager 5.4 software. Findings A total of 13 articles including 246 nurses and midwives and 4,381 perinatal women were reviewed. Care administered through both face-to-face (relative risk [RR] 0.70, 95% confidence interval [CI] 0.61-0.74) and digital training (RR 0.44, 95% CI 0.26-0.74) significantly mitigated symptoms of perinatal depression. Significant benefits were observed after 3- to 5-day and 8-day training, for which the RR were 0.75 (95% CI 0.59-0.97) and 0.72 (95% CI 0.66-0.85), respectively. Studies with high intervention fidelity more effectively reduced the risk of depressive symptoms in perinatal women than those with low intervention fidelity. Key conclusions and implications for practice Compared with face-to-face, digital training methods were more effective in reducing the risk of depressive symptoms. High intervention fidelity and 3- to 5-day and 8-day training resulted in better outcomes. The present findings can serve as a reference for the design of psychological training programs for nurses and midwives to equip them with effective strategies for administering care to patients with perinatal depression.


Assuntos
Tocologia , Criança , Depressão , Feminino , Humanos , Recém-Nascido , Parto , Assistência Perinatal , Gravidez
14.
Midwifery ; 104: 103190, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34763178

RESUMO

BACKGROUND: An estimated 24,000 people in the UK report using British Sign Language (BSL) as their first language. Misconceptions about deaf culture and language mean that deaf people have less access to health information and their health literacy is lower. Deaf people's health needs go under the radar in primary care with ensuing poorer health outcomes. Deaf women's experiences of maternity care are poorly understood. METHODS: Using Whittemore and Knafl's method for an integrative review, the following databases were searched: EMBASE, MedLine, CINAHL and Maternity and Infant Care. After reviewing 430 journal article titles and abstracts against the inclusion/exclusion criteria, 11 articles were included for final review. Selected studies were conducted internationally and were available in English. 10 were qualitative studies, 1 used survey design. They were reviewed using the Caldwell Framework. FINDINGS: These show that deaf women avoid seeking care, have a lack of access to health information and healthcare providers, including midwives, have a lack of deaf awareness. For deaf women, during pregnancy, birth and postnatal periods, this can mean having longer hospital stays and more complex postnatal care needs in both the hospital and community setting. CONCLUSIONS: Current care provisions do not always meet the needs of the deaf BSL using women who use maternity services. Midwives should be aware of deafness as a culture and how to best meet the needs of the community to improve health outcomes for women and their babies.


Assuntos
Serviços de Saúde Materna , Tocologia , Feminino , Humanos , Parto , Gravidez , Atenção Primária à Saúde , Pesquisa Qualitativa
15.
Midwifery ; 104: 103167, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34763179

RESUMO

OBJECTIVE: To explore maternity care experiences and needs of women with various types of chronic medical conditions receiving specialised maternity care. Design A qualitative descriptive study. SETTING: A highly specialised hospital providing maternity care to women with high-risk pregnancies in Copenhagen, Denmark. Participants Fourteen purposefully selected women referred to specialist maternity care at a large tertiary hospital due to one or more chronic medical conditions. METHODS: Individual in-depth interviews (n = 14) were performed between January 2018 and June 2019. Analysed using thematic analysis. RESULTS: One overarching theme was identified: Monitored but not sufficiently guided. Three main themes unfolding this overarching theme were: Chronic condition as determining pregnancy care, Childbearing woman as messenger and interpreter, and Feelings of abandonment after giving birth. KEY CONCLUSIONS: Across various types of chronic medical conditions, women expressed a need for increased continuity in specialised maternity care. Healthcare professionals should help women with chronic medical conditions navigate the healthcare system and interpret complex information. IMPLICATIONS FOR PRACTICE: Pregnancy should be recognised as a significant life event, even though the childbearing woman is living with a chronic medical condition, and professionals should emphasise the aspects of pregnancy that develop uncomplicated. Information about the anticipated development of chronic medical conditions postpartum and concerns regarding breastfeeding could preferably be addressed during pregnancy. Continuity of care was particularly important to the women and could relieve some of the worrying women experienced during pregnancy.


Assuntos
Serviços de Saúde Materna , Tocologia , Obstetrícia , Doença Crônica , Feminino , Humanos , Parto , Gravidez , Pesquisa Qualitativa
16.
Midwifery ; 104: 103198, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34800776

RESUMO

BACKGROUND: The way that expectant parents think and feel about the fetus during pregnancy is thought to be somewhat predictive of their later relationship with the child. However, efforts to identify determinants, correlates and consequences of the parental-fetal tie have had conflicting results. This is likely to be partially attributable to issues in existing conceptualisations of the phenomenon. OBJECTIVE: The purpose of the study was to construct substantive theory of expectant parents' fetal conceptual and relational experiences. METHODS: Constructivist grounded theory was used to explore data generated through individual, semi-structured interviews conducted with nine first-time expectant mothers and their male partners residing in Malta, in early, middle and late pregnancy. Analysis included techniques of coding, constant comparison and memo-writing. FINDINGS: Expectant mothers and fathers conceptualise and connect to the fetus through comparable processes, despite physical disparities in the pregnancy experience. Coming to think of the fetus as a known other and part of the intimate family is vital in achieving a sense of relatedness. An increasingly tangible fetus facilitates such an outlook. However, the extent of accessibility to fetal palpability and reciprocity consistently fail to satisfy parental yearnings. CONCLUSIONS: Given the convoluted and individualised nature of the parental-fetal tie, accurate measurement of this through the use of self-report instruments is likely to remain challenging. Instead, midwives can talk to expectant parents in-depth about their feelings regarding the unborn child and seek to address any concerns. Further longitudinal research spanning the transition to parenthood is needed to understand the postpartum sequelae of the processes observed antenatally.


Assuntos
Formação de Conceito , Tocologia , Criança , Emoções , Feminino , Teoria Fundamentada , Humanos , Masculino , Pais , Gravidez
17.
Midwifery ; 104: 103183, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34808526

RESUMO

OBJECTIVE: To explore views and experiences of community midwives delivering postnatal care. DESIGN: A descriptive qualitative study design undertaking focus groups with community midwives and community midwifery team leaders. SETTING: All focus groups were carried out in community midwifery care settings, across four hospitals in two NHS organisations, April to June 2018 in the West Midlands, UK. PARTICIPANTS: 47 midwives: 34 community midwives and 13 community midwifery team leaders took part in 7 focus groups. FINDINGS: Inductive framework analysis of data led to the development of themes and sub-themes relating to factors influencing discharge from hospital, strategies to address increases in discharge and the broader challenges to providing care. Conditions on the postnatal ward and women's experiences of care in the hospital were factors influencing timing of discharge from hospital that resulted in community midwives managing women and babies with more complex needs. In order to manage increased workloads, there was growing but varied use of flexible approaches to providing care such as telephone consultations, postnatal clinics, and maternity support workers. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: In a context of short postnatal hospital stays, community midwives appear to be responding to women's needs and service pressures in the postnatal period. Wider implementation of specific strategies to organise and deliver support to women and babies may further improve care and outcomes.


Assuntos
Tocologia , Feminino , Grupos Focais , Humanos , Cuidado Pós-Natal , Gravidez , Pesquisa Qualitativa , Reino Unido
18.
Gac Sanit ; 35 Suppl 2: S248-S250, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34929823

RESUMO

OBJECTIVE: This research aims to determine the influence of Web-based learning media on improving perineum rupture stitching skills for D-III Midwifery students. METHOD: This study uses a Research and Development (R&D) research design with the Borg & Gall development model to test the use of this product. The Quasi-Experimental research with a non-equivalent control group design was conducted in January-February 2020 at AKBID Pelamonia Makassar. The sample in this study was the second semester of the Midwifery Academy Pelamonia VII Wirabuana Makassar, totaling 64 people who were divided into two groups of intervention and control. The intervention group I (WEB media giving) amounted to 32 people and control 32 people. The sampling technique used is purposive sampling. At the end of the meeting, a post-test was conducted. The statistical test used was the paired sample t-test and Wilcoxon test. RESULTS: The percentage of application assessment using the Technology Acceptance Model (TAM) questionnaire to assess the application's usability level is a very good category and can be interpreted that students accept WEB-based learning media. Statistical tests showed differences in the results of measurement I and measurement II in the removal of grade II perineum rupture in the control group (p<0.05) and contributed 15.6%. In the intervention group I (WEB-based learning media), there were differences in skills before and after media giving (p<0.05) and contributed 89.8% in improving the skills of the second semester Midwifery DIII students regarding the sewing of second-degree perineum rupture. CONCLUSION: The use of Web-Based Learning Media facilitates and enhances students in performing second-degree perineum rupture sewing skills.


Assuntos
Tocologia , Estudantes de Enfermagem , Feminino , Humanos , Internet , Aprendizagem , Períneo/cirurgia , Gravidez , Estudantes
19.
Gac Sanit ; 35 Suppl 2: S284-S287, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34929833

RESUMO

OBJECTIVE: This research was aimed to develop and test virtual reality-based learning media in improving active management skills of the third stage labor in midwifery students. METHODS: This study uses a Research and Development (R&D) research design method developed by Borg and Gall. The stages of this study consisted of; analysis of the needs of virtual reality-based learning media about active management of the third stage, planning of the development of instructional media development, development of instructional media, expert validation, one-on-one trials, small group trials, large group trials, and the final product of learning media. RESULTS: The percentage of instructional media assessment using questionnaires in the expert validation test and large group trials in this study showed the calculation of the results of the learning media rating according to material experts (86%) category is very feasible, according to media experts scored (85%) very feasible. The results of trials to students score (95.3%) so that virtual reality-based learning media about active management of the third stage made are very feasible to be used as learning media for midwifery students in the active management skills of students the third stage. CONCLUSION: Virtual reality-based learning media about active management of the third stage labor are designed according to the needs of lecturers and students with additional features of bleeding warning, anatomy of placental physiology and are declared to be very suitable for use as learning media for midwifery students.


Assuntos
Tocologia , Estudantes de Enfermagem , Competência Clínica , Feminino , Humanos , Terceira Fase do Trabalho de Parto , Placenta , Gravidez , Estudantes
20.
Gac Sanit ; 35 Suppl 2: S302-S305, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34929838

RESUMO

OBJECTIVE: This research was to analyze the correlation of AR-based Learning Media to improving the physical examination of the integumentary system of pregnant women in midwifery students. METHOD: The research method used Quasi-experimental with Non-Equivalent Control Group Design. The sample of 92 students was selected by a purposive sample, divided into two intervention and control groups. The intervention group was 62 students, and the control group was 30 students. Data collection was performed using a checklist to assess the skill of the physical examination of the integumentary system of pregnant women. To test the differences of skill before and after treatment in control and intervention groups used the Mcnemar test, whereas to know the differences in skill from time to time Cochran test was used. RESULT: The results showed differences in the measurement of skills improvement in the control and intervention groups before and after the intervention was given. A more significant increase in skills occurred in the intervention group with a p-value <0.001 contributing after 1week of giving a demonstration, and application-based (AR) skills increased by 66.1%. After two weeks it increased by 93.5%, and after two weeks it increased by 100%. So it could be concluded statistically that AR-based learning media was significant in improving the physical examination skills integumentary systems in pregnant women.


Assuntos
Realidade Aumentada , Tocologia , Competência Clínica , Feminino , Humanos , Tegumento Comum , Exame Físico , Gravidez , Gestantes , Estudantes
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