Midwives' experience of maternal death / Vécu de la mort maternelle par les sages-femmes

Introduction: In Morocco, maternal mortality is a crucial public health problem with a current rate of 72.6/100000 live births. This phenomenon is emotionally overwhelming, and the midwife's experience of this drama is disordering. Purpose of research: To explore how midwives experience maternal death, the resulting consequences, and the coping strategies used to overcome it. Results: 19 midwives were interviewed and reported 39 cases of maternal death. The results show that no midwife remains indifferent to maternal death. The experience is painful, and the grief of the families is transferred to the midwife. Sadness, denial, fear, feelings of guilt and failure have characterized almost all the victims. In the face of her suffering, the midwife mobilizes coping strategies. The consequences are diverse: psychological, somatic, and professional. Conclusions: The experience of maternal death associated with unfavorable working conditions and lack of recognition increases stress and leads to the intention to abandon the profession. The improvement of working conditions, the focus on teamwork, the implementation of discussion groups, professionalize the experience of maternal death.

Introduction: Au Maroc, la mortalité maternelle est un problème de santé publique crucial dont le taux actuel est de 72,6/100 000 naissances vivantes. Ce fléau est à charge émotionnelle importante, et le vécu de ce drame par la sage-femme est une expérience désorganisatrice. But de l'étude: Explorer la manière dont la sage-femme vit la mort maternelle, les conséquences qui en résultent et les stratégies d'ajustement mobilisées pour la surmonter. Résultats: 19 sages-femmes ont été interviewées rapportant 39 cas de décès maternels vécus. Les résultats montrent qu'aucune sage-femme ne reste indifférente devant la mort maternelle. Le vécu est douloureux, et le deuil des familles est transféré vers la sage-femme. La tristesse, le déni, la peur, le sentiment de culpabilité et d'échec caractérisent les vécus. Devant sa souffrance, la sage-femme mobilise des stratégies de coping. Les conséquences sont diverses : psychologiques, somatiques et professionnelles. Conclusions: Le vécu de la mort maternelle associé aux conditions de travail défavorables, au manque de reconnaissance, accentue le stress et conduit à l'intention d'abandonner la profession. L'amélioration des conditions de travail, la focalisation sur le travail d'équipe, la mise en place de groupes de discussion professionnalisent le vécu de la mort maternelle.

Knowledge of hypertensive disorders in pregnancy of Moroccan women in Morocco and in the Netherlands: a qualitative interview study.

BACKGROUND: Hypertensive disorders in pregnancy (HDP) are the most common medical disorders in pregnancy and the greatest single cause of maternal mortality worldwide. Ethnicity appears to be a significant risk factor for pregnancy related mortality and for severe maternal morbidity. Most of the complications caused by HDP may be reduced by early detection and proper management. Health education during antenatal care attendance may play an important role in preventing the disease to aggravate. The purpose of this study was to investigate the status of knowledge that Moroccan pregnant women, both in Morocco and in the Netherlands, have of HDP in terms of symptoms, complications, treatment and management. METHODS: A qualitative research design was used to explore and describe the knowledge of HDP of pregnant Moroccan women. Interviews were held on the basis of a topic list. The interviews were recorded, transcribed, coded and analysed. RESULTS: Nineteen Moroccan women were interviewed, nine in the Netherlands and ten in Morocco. Half of them never heard about hypertension in pregnancy and had no knowledge of symptoms or alarm signals related to HDP. All women acknowledged the importance of knowledge of HDP because of the possibly dangerous complications. The interviewees stated that information on symptoms, alarm signs and complications is the most important information. Nearly all women stated that communicating information via movies was the most appropriate tool to inform Moroccan pregnant women about HDP. CONCLUSIONS: The knowledge of Moroccan women, living in Morocco or in the Netherlands, of symptoms and alarm signs related to hypertensive disorders of pregnancy was very limited, if not absent. Since early detection provides the opportunity for follow-up management and/or treatment, this may reduce complications of HDP. Therefore, it is important to inform pregnant women about the signs and symptoms of HDP.

Quality of life in Arab women with breast cancer: a review of the literature.

BACKGROUND: Quality of life has become an important concept in cancer care. Among the quality of lifestudies in cancer patients, breast cancer has received most attention. This review reports on quality of life in Arab patients with breast cancer. METHODS: The search was conducted using inclusion and exclusion criteria and in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The databases consulted were PubMed, Sciences Direct, Index Medicus for Wordl Health Organization Eastern Mediterranean, African Journals Online and African Index Medicus. RESULTS: Thirteen articles from eight countries met the inclusion criteria. The EORTC quality of life questionnaires (QLQ-C30 and QLQ-BR23) were the most used instrument (7 out of 13). The results showed that good scores of global health were recorded at Arab women living in United Arab Emirates (mean score = 74.6) compared to other countries. The results indicated that there was a difference in quality of life scores and its associated factors among Arab women with breast cancer. CONCLUSION: This paper is the first that reviewed published research on quality of life among Arab women with breast cancer. We found that insufficient results-related information is available.

The Effect of Nursing Consultation Based on Orem's Theory of Self-care and Bandura's Concept on Infertility Stress.

INTRODUCTION: Infertility is one of the most stressful experiences in a couple's life. Several approaches have been proposed to manage infertility stress during the medically assisted technology process. OBJECTIVE: The objective was to examine the effect of nursing consultation on the stress experienced by infertile couples before starting infertility treatment. MATERIALS AND METHODS: This cross-sectional study was conducted from November 2017 to November 2018 among 120 infertile couples (240 patients) for whom stress was assessed. One hundred and thirteen patients of them who had a high infertility stress level were invited to participate in this randomized study (57 were assigned to the control group and 56 were included in the intervention group). The intervention group received nursing consultation based on Orem's theory and Bandura's concept in addition to the routine nursing care. Perceived Stress Scale-10 (PSS-10) and General Self-Efficacy Scale (GSES) were used before and after nursing intervention. STATISTICAL ANALYSIS: The Chi-square test followed by a paired t-test and independent t-test was used for data analysis by SPSS software (version 20). RESULTS AND DISCUSSION: There were no statistically significant differences before nursing intervention between the two groups in terms of PSS-10 (t = 1.18, P = 0.23) and GSES (t = -0.40, P = 0.689) scores, but a significant difference emerged in the intervention group following the nursing intervention: a reduction of the PSS score (t = -8.91, P = 0.000) and an increase in the GSES score (t = -5.25, P = 0.000, with 95% confidence interval (CI)). CONCLUSION: Nursing consultation has been shown to be beneficial in decreasing perceived stress and increased self-efficacy for infertile couples undergoing assisted reproductive technologies.

Determinants of Patient Delay in Seeking Diagnosis and Treatment among Moroccan Women with Cervical Cancer.

Introduction. This study sought to investigate potential determinants of patient delay among Moroccan women with cervical cancer. Methods. A cross-sectional study was conducted from June 2014 to June 2015 at the National Institute of Oncology in Rabat. Data were collected using questionnaire among patients with cervical cancer locally advanced or metastatic (stages IIA-IVB). Medical records were abstracted to complete clinical information. An interval longer than 90 days between discovery of initial symptoms and presentation to a provider was defined as a patient delay. Results. Four hundred and one patients with cervical cancer enrolled in this study. The mean age was 52.4 years (SD = 11.5). 53.6% were illiterate. Abnormal vaginal bleeding was identified for 65.8% of patients. 60.1% were diagnosed at stages IIA-IIB. 55.4% were found having patient delay. The regression analyses showed the association between literacy (p < 0.001), distance of the place of the first consultation (p = 0.031), abnormal vaginal bleeding as an earlier symptom (p < 0.001), stage at diagnosis (p < 0.03), knowledge of symptoms (p < 0.001), knowledge of causes (p = 0.008), and practice of gynecological exam during the last three years (p = 0.018) and the patient delay. Conclusion. Educational messages should aim at increasing awareness of cervical cancer, assisting women in symptom recognition, and encouraging earlier presentation.