共查询到20条相似文献，搜索用时 46 毫秒
1.
2.
Valgerdur Lisa Sigurdardottir Jennifer Gamble Berglind Gudmundsdottir Hildur Kristjansdottir Herdis Sveinsdottir Helga Gottfredsdottir 《Women and birth : journal of the Australian College of Midwives》2017,30(6):450-459
Background
Several risk factors for negative birth experience have been identified, but little is known regarding the influence of social and midwifery support on the birth experience over time.Objective
The aim of this study was to describe women’s birth experience up to two years after birth and to detect the predictive role of satisfaction with social and midwifery support in the birth experience.Method
A longitudinal cohort study was conducted with a convenience sample of pregnant women from 26 community health care centres. Data was gathered using questionnaires at 11–16 weeks of pregnancy (T1, n = 1111), at five to six months (T2, n = 765), and at 18–24 months after birth (T3, n = 657). Data about sociodemographic factors, reproductive history, birth outcomes, social and midwifery support, depressive symptoms, and birth experience were collected. The predictive role of midwifery support in the birth experience was examined using binary logistic regression.Results
The prevalence of negative birth experience was 5% at T2 and 5.7% at T3. Women who were not satisfied with midwifery support during pregnancy and birth were more likely to have negative birth experience at T2 than women who were satisfied with midwifery support. Operative birth, perception of prolonged birth and being a student predicted negative birth experience at both T2 and T3.Conclusions
Perception of negative birth experience was relatively consistent during the study period and the role of support from midwives during pregnancy and birth had a significant impact on women’s perception of birth experience. 相似文献3.
Linda Sweet Janice Bass Mary Sidebotham Jennifer Fenwick Kristen Graham 《Women and birth : journal of the Australian College of Midwives》2019,32(2):119-126
Background
Practice-based or clinical placements are highly valued for linking theory to practice and enabling students to meet graduate outcomes and industry standards. Post-practicum, the period immediately following clinical experiences, is a time when students have an opportunity to share, compare and engage critically in considering how these experiences impact on their learning. Reflective practice has merit in facilitating this process.Aim
This project aimed to optimise the learning potential of practice-based experiences by enhancing midwifery students’ capacity for reflective practice through writing.Methods
Design-based research was used to implement an educational intervention aimed at developing reflective practice skills and enhance reflective writing. The Bass Model of Holistic Reflection was introduced to promote the development of reflective capacity in midwifery students. Academics and midwifery students were provided with guidance and resources on how to apply the model to guide reflective writing. Students’ written reflections completed before (n = 130) and after the introduction of the intervention (n = 96) were evaluated using a scoring framework designed to assess sequential development of reflective capacity.Findings
The pre-intervention scores ranked poorly as evidence of reflective capacity. All scores improved post-intervention.Conclusions
The introduction of a holistic structured model of reflection resulted in improved scores across all five components of reflective writing; self-awareness, sources of knowledge, reflection and critical reflection, evidence informed practice and critical thinking. While further work is required the results show that the implementation process and use of the Bass Model enables students to demonstrate their capacity to reflect-on-practice through their writing. 相似文献4.
Roianne West Somer Wrigley Kyly Mills Kate Taylor Dale Rowland Debra K. Creedy 《Women and birth : journal of the Australian College of Midwives》2017,30(3):236-244
Background
Midwives have a central role in closing the gap in health inequalities between Australias’ First Peoples and other childbearing women. The Aboriginal and Torres Strait Islander Health Curriculum Framework (The Framework) identifies five core cultural capabilities (respect, communication, safety and quality, reflection and advocacy) to foster culturally safe health care.Aim
To use a decolonising, First Peoples-led approach to develop and validate a tool to measure the development students’ cultural capabilities.Method
A pre- post intervention design was used. Development of the Cultural Capability Measurement Tool followed a staged process which centred on First Peoples’ knowledges. This process included: item generation, expert review; a pilot, test-retest; and psychometric testing (reliability, factor analysis and construct validity). All third year midwifery students (n = 49) enrolled in a discrete First Peoples health course were invited to complete the survey pre and post course.Findings
A response rate of 77.5% (n = 38/49) pre-course and 30.6% (15/49) at post-course was achieved. The tool demonstrated good internal reliability (Cronbach alpha = .89–.91). Principal component analysis with varimax rotation produced a five-factor solution. A paired samples t-test revealed a significant increase from pre-course (mean 93.13, SD 11.84) to post-course scores (mean = 100.53, SD 7.54) (t (14) = ?2.79, p = .014).Conclusion
A First Peoples approach was critical to tool development and conceptual validity. The 22 item Cultural Capability measurement Tool reflected the core cultural capabilities of The Framework. The draft tool appears suitable for use with midwifery students. 相似文献5.
6.
Tania Fleming Debra K. Creedy Roianne West 《Women and birth : journal of the Australian College of Midwives》2017,30(3):245-252
Background
Cultural safety in higher education learning and teaching environments is paramount to positive educational outcomes for Aboriginal and/or Torres Strait Islander (hereafter called First Peoples) students. There is a lack of research evaluating the impact of continuing professional development on midwifery academics' awareness of cultural safety.Aim
To implement and evaluate a continuing professional development intervention to improve midwifery academics' awareness of cultural safety in supporting First Peoples midwifery students success.Methods
A pre-post intervention mixed methods design was used. Academics (n = 13) teaching into a Bachelor of Midwifery program agreed to participate. The intervention consisted of two workshops and five yarning circles across a semester. Data included the Awareness of Cultural Safety Scale, self-assessment on cultural safety and perceptions of racism, evaluation of the intervention, participants’ journal entries, and researcher’s reflections.Findings
Responses on the Awareness of Cultural Safety Scale revealed significant improvement in participants’ awareness of cultural safety. There was an upward trend in self-assessment ratings. Participants reported high levels of satisfaction with the intervention or workshops and yarning circles. Participants’ journal entries revealed themes willingness to participate and learn, confidence as well as anger and distress.Conclusion
Increased awareness of cultural safety can be transformative for midwifery academics. Workshops and yarning circles can support academics in moving beyond a ‘sense of paralysis’ and engage in challenging conversations to transform their learning and teaching and in turn foster a culturally safe learning and teaching environment for First Peoples midwifery students towards success. 相似文献7.
8.
Annabel Sheehy Rachel M. Smith Joanne E. Gray Caroline S.E. Homer 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e182-e188
Background
Midwives in Australia are educated through a range of routes providing flexible ways to become a midwife. Little is known about whether the route to registration impacts on mid-career experiences, in particular, whether the pathway (post-nursing pathway compared with ‘direct-entry’) makes any difference.Aim
The aim of this study was to explore the midwifery workforce experiences and participation in graduates six to seven years after completing either a post-nursing Graduate Diploma in Midwifery (GradDip) or an undergraduate degree, the Bachelor of Midwifery (BMid), from one university in New South Wales, Australia.Methods
Data were collected from mid-career midwives having graduated from one NSW university from 2007–2008 using a survey. The survey included validated workforce participation instruments — the Maslach Burnout Inventory (MBI), the Practice Environment Scale-Nursing Work Index (PES-NWI) and the Perceptions of Empowerment in Midwifery Scale (PEMS).Results
There were 75 respondents: 40% (n = 30) Bachelor of Midwifery and 60% (n = 45) GradDip graduates. The age range was 27–56 years old (mean age = 36 years) Bachelor of Midwifery graduates being on average 7.6 years older than Graduate Diploma in Midwifery graduates (40 vs 33 years; p < 0.01). Almost 80% (59), were currently working in midwifery. Nine of the 12 not working in midwifery (75%) planned to return. There were no differences in workforce participation measures between the two educational pathways. Working in a continuity of care model was protective in regards to remaining in the profession.Conclusion
Most mid-career graduates were still working in midwifery. There were no differences between graduates from the two pathways in relation to burnout, practice experiences or perceptions of empowerment. 相似文献9.
Maria Noonan Julie Jomeen Rose Galvin Owen Doody 《Women and birth : journal of the Australian College of Midwives》2018,31(6):e358-e366
Background
Midwives have a primary role in facilitating the first stage of perinatal mental health risk reduction through inquiring about perinatal mental health, identifying risk factors and current perinatal mental health problems, providing support or crisis intervention, referring for treatment and decreasing stigmatisation.Aims
The aims of this study were to determine midwives’ (a) knowledge of and confidence to identify and manage perinatal mental health problems, (b) attitudes towards women who experience severe mental illness and (c) perceived learning needs.Design
A cross-sectional survey design.Methods
The study was conducted between September 2016 and April 2017 in seven Maternity services in the Republic of Ireland with a purposeful non-random convenience sample of midwives (n = 157). Data was anonymously collected utilising the Perinatal Mental Health Questionnaire, the Mental Illness: Clinician’s Attitudes scale and the Perinatal Mental Health Learning Needs questionnaire.Findings
Midwives indicated high levels of knowledge (71.1%) and confidence (72%) in identifying women who experience depression and anxiety however, they reported less confidence in caring (43.9%) for women. Only 17.8% (n = 28) of midwives felt equipped to support women whilst 15.3% (n = 24) reported having access to sufficient information. Midwives desire education on the spectrum of perinatal mental health problems. The mean score for the Mental Illness: Clinician’s Attitudes scale was 36.31 (SD = 7.60), indicating positive attitudes towards women with severe mental illness.Conclusion
Midwives require further education on perinatal mental health across cultures with a skill focus and which explores attitudes delivered in a study day format. 相似文献10.
11.
Lyndall Mollart Virginia Skinner Jon Adams Maralyn Foureur 《Women and birth : journal of the Australian College of Midwives》2018,31(1):44-51
Complementary and Alternative Medicine (CAM) have increasingly been used by pregnant women with a steady rise in interest by midwives. Literature describing CAM and self-help options midwives recommend to women experiencing a post-date pregnancy is sparse. This study aimed to investigate if Australian midwives’ personal CAM use impacts on discussions and recommendations of CAM/Self-help strategies.
Methodology/design
A survey of a national midwifery association midwifery members (n = 3,552) was undertaken at a midwifery conference (October 2015) and via e-bulletins (November 2015–March 2016). The self-administered survey included questions on what self-help and CAM strategies midwives discuss and recommend to women with a post-date pregnancy, midwives’ confidence levels on discussing or recommending CAM, midwives’ own personal use of CAM.Findings
A total of 571 registered midwives completed the survey (16%). Demographics (age, years as a midwife, state of residence) reflected Australian midwives and the midwifery association membership. Most respondents discuss (91.2%) and recommend (88.6%) self-help/CAM strategies to women with a post-date pregnancy. The top five CAM recommended were Acupuncture (65.7%), Acupressure (58.1%), Raspberry Leaf (52.5%), Massage (38.9%) and Hypnosis/Calmbirthing/Hypnobirthing (35.7%). Midwives were more likely to discuss strategies if they personally used CAM (p < .001), were younger (p < .001) or had worked less years as midwives (p = .004). Midwives were more likely to recommend strategies if they used CAM in their own pregnancies (p = .001).Conclusion
Midwives’ personal use of CAM influenced their discussions and recommendations of CAM/self-help strategies to women experiencing a post-date pregnancy. This study has implications for inclusion of CAM in midwifery education curricula. 相似文献12.
Ying Zhao Michelle L. Munro-Kramer Shenxun Shi Jing Wang Xinli Zhu 《Women and birth : journal of the Australian College of Midwives》2018,31(6):e395-e402
Background
Information is needed on the prevalence of depression in Chinese women with medically defined complications across the perinatal period, as well as key risk factors to develop appropriate perinatal mental health services and ensure the services target those most in need.Aim
The goal of this study was to examine whether women’s perinatal depression scores change across the perinatal period and evaluate risk factors associated with postnatal depression at 6-weeks after delivery.Methods
A sample of 167 Chinese pregnant women with medically defined complications and an Edinburgh Postnatal Depression Scale ≥ 9 and/or a Postpartum Depression Screening Scale ≥ 60 were followed throughout early pregnancy (<28 weeks), late pregnancy (>28 weeks), 3-days and 6-weeks after delivery.Findings
Repeated measures analysis of variance showed that there were significant differences on the Edinburgh Postnatal Depression Scale and Postpartum Depression Screening Scale scores at each time point between high-risk depressed and low-risk depressed groups. Binary logistic regression indicated a significant association between postnatal depression at 6-weeks after delivery and depression in late pregnancy and 3-days after delivery, postnatal stress events, postnatal complications, and concerns about the fetus.Conclusions
Postnatal depression is a common condition with limited research among Chinese pregnant women with medically defined complications. Additional research is warranted to develop strategies to identify high-risk depressed pregnant women as well as effective treatment options during the perinatal period. 相似文献13.
Karen Matvienko-Sikar Samantha Dockray 《Women and birth : journal of the Australian College of Midwives》2017,30(2):e111-e118
Problem
Low prenatal well-being has adverse outcomes for mother and infant but few interventions currently exist to promote and maintain prenatal well-being.Background
Mindfulness and gratitude based interventions consistently demonstrate benefits in diverse populations. Interventions integrating these constructs have potential to improve psychological and physiological health during pregnancy.Aim
The aim of this pilot study is to examine the effect of a novel gratitude and mindfulness based intervention on prenatal stress, cortisol levels, and well-being.Methods
A pilot randomised controlled trial was conducted with 46 pregnant women. Participants used an online mindfulness and gratitude intervention 4 times a week for 3 weeks. Measures of prenatal stress, salivary cortisol, gratitude, mindfulness, and satisfaction with life were completed at baseline, 1.5 weeks later, and 3 weeks later.Findings
Intervention participants demonstrated significant reductions in prenatal stress in comparison to the control condition (p = .04). Within subjects reductions in waking (p = .004) and evening cortisol (p > .001) measures were observed for intervention participants. Significant effects were not observed for other well-being outcomes.Discussion
Reducing self-report and physiological stress in pregnancy can improve maternal and infant outcomes. The findings of this pilot study indicate potential direct effects of the intervention on self-reported stress in comparison to a treatment-as-usual control. Effects on a biomarker of stress, cortisol, were also observed within the intervention group.Conclusion
A brief mindfulness and gratitude based intervention has the potential to reduce stress in pregnancy. Future research is needed to further explore mechanisms and potential benefits of such interventions. 相似文献14.
15.
Jennifer Fenwick Mary Sidebotham Jenny Gamble Debra K. Creedy 《Women and birth : journal of the Australian College of Midwives》2018,31(1):38-43
Background
Continuity of midwifery care contributes to significant positive outcomes for women and babies. There is a perception that providing continuity of care may negatively impact on the wellbeing and professional lives of midwives.Aim
To compare the emotional and professional wellbeing as well as satisfaction with time off and work-life balance of midwives providing continuity of care with midwives not providing continuity.Method
Online survey. Measures included; Copenhagen Burnout Inventory (CBI); Depression, Anxiety and Stress Scale-21; and Perceptions of Empowerment in Midwifery Scale (PEMS-Revised). The sample (n = 862) was divided into two groups; midwives working in continuity (n = 214) and those not working in continuity (n = 648). Mann Whitney U tests were used to compare the groups.Results
The continuity group had significantly lower scores on each of the burnout subscales (CBI Personal p = .002; CBI Work p < .001; CBI Client p < .001) and Anxiety (p = .007) and Depression (p = .004) sub-scales. Midwives providing continuity reported significantly higher scores on the PEMs Autonomy/Empowerment subscale (p < .001) and the Skills and Resources subscale (p = .002). There was no difference between the groups in terms of satisfaction with time off and work-life balance.Conclusion
Our results indicate that providing continuity of midwifery care is also beneficial for midwives. Conversely, midwives working in shift-based models providing fragmented care are at greater risk of psychological distress. Maternity service managers should feel confident that re-orientating care to align with the evidence is likely to improve workforce wellbeing and is a sustainable way forward. 相似文献16.
Helle Johnsen Jette Aaroe Clausen Dorte Hvidtjørn Mette Juhl Hanne Kristine Hegaard 《Women and birth : journal of the Australian College of Midwives》2018,31(2):e105-e114
Background
Information and communication technologies are increasingly used in health care to meet demands of efficiency, safety and patient-centered care. At a large Danish regional hospital, women report their physical, mental health and personal needs prior to their first antenatal visit. Little is known about the process of self-reporting health, and how this information is managed during the client-professional meeting.Aim
To explore women's experiences of self-reporting their health status and personal needs online prior to the first midwifery visit, and how this information may affect the meeting between the woman and the midwife.Method
Fifteen semi-structured interviews with pregnant women and 62 h of observation of the first midwifery visit were carried out. Conventional content analysis was used to analyse data.Findings
Three main categories were identified; ‘Reporting personal health’, ‘Reducing and generating risk’, and ‘Bridges and gaps’. Compared to reporting physical health information, more advanced levels of health literacy might be needed to self-assess mental health and personal needs. Self-reporting health can induce feelings of being normal but also increase perceptions of pregnancy-related risk and concerns of being judged by the midwife. Although women want to have their self-reported information addressed, they also have a need for the midwife's expert knowledge and advice, and of not being perceived as a demanding client.Conclusion
Self-reported health prior to the first midwifery visit appears to have both intended and unintended effects. During the midwifery visit, women find themselves navigating between competing needs in relation to use of their self-reported information. 相似文献17.
Fatemeh Darsareh Teamur Aghamolaei Minoo Rajaei Abdoulhossain Madani Shahram Zare 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e166-e172
Problem
The steep increase and inappropriateness of caesarean birth represent a healthcare problem in Iran.Aim
The purpose of study was to evaluate the effect of a campaign based on social marketing to promote normal childbirth.Method
The study was designed as a prospective case control study. The social marketing campaign was implemented from March 2016 to January 2017. A demographic data questionnaire, obstetrical history questionnaire, maternal knowledge assessment questionnaire, and maternal health belief questionnaire comprised the instruments for this study. Only women planning a caesarean birth without any medical indications for the caesarean were enrolled in the study as a case. Those who met the same inclusion criteria and did not want to participate in the campaign were assigned to the control group.Findings
In total, 350 first-time pregnant women who composed the campaign group (n = 194) and control group (n = 156) completed the study. The mean baseline level of knowledge and Health Belief Model component score did not differ between the two groups at baseline. However, after the campaign, knowledge scores, perceived severity, perceived susceptibility, self-efficacy, and cues to action scores differed significantly between the campaign and control groups. The follow-up of all participants in both groups showed that 35.6% (n = 69) of participants in the campaign group chose natural birth as their birth method, whereas only 13.5% (n = 21) in the control group delivered their newborn vaginally.Conclusion
The B Butterfly social marketing campaign successfully targeted first-time pregnant women who chose to have unnecessary elective cesarean births. 相似文献18.
Catherine Kilgour Fiona Elizabeth Bogossian Leonie Callaway Cindy Gallois 《Women and birth : journal of the Australian College of Midwives》2019,32(1):e24-e33
Problem
The reasons for low postnatal screening rates for women with gestational diabetes mellitus are not well understood. Multiple care providers, settings and changes to diagnostic criteria, may contribute to confusion over postnatal care. Quality of communication between clinicians may be an important influence for the completion of postnatal gestational diabetes mellitus follow-up.Aim
Describe and analyse communication processes between hospital clinicians (midwives, medical, allied staff) and general practitioners who provide postnatal gestational diabetes mellitus care.Methods
Purposive sampling and convergent interviews explored participants’ communication experiences providing gestational diabetes mellitus postnatal follow-up. Data were analysed with Leximancer automated content analysis software; interpretation was undertaken using Communication Accommodation Theory.Setting and participants
Clinicians who provided maternity care at a tertiary referral hospital (n = 13) in Queensland, Australia, and general practitioners (n = 16) who provided maternity shared care with that hospital between December 2012 and July 2013.Findings
Thematic analysis identified very different perspectives between the experiences of General Practitioners and hospital clinicians; six themes emerged. General practitioners were concerned about themes relating to discharge summaries and follow-up guidelines. In contrast, hospital clinicians were more concerned about themes relating to gestational diabetes mellitus antenatal care and specialist clinics. Two themes, gestational diabetes mellitus women and postnatal checks were shared.Conclusion
Gestational diabetes mellitus follow-up is characterised by communication where general practitioners appear to be information seekers whose communication needs are not met by hospital clinicians. Midwives are ideally placed to assist in improving communication and postnatal gestational diabetes mellitus follow-up. 相似文献19.
Stefanie Kalmakoff Andrew Gray Sally Baddock 《Women and birth : journal of the Australian College of Midwives》2018,31(3):202-209
Problem
Supplementation of breastfed babies is common during the hospital stay.Background
The Baby Friendly Hospital Initiative (BFHI) optimises practices to support exclusive breastfeeding, yet supplementation is still prevalent.Objective
To determine predictors for supplementation in a cohort of breastfed babies in a Baby-Friendly hospital.Methods
Electronic hospital records of 1530 healthy term or near term singleton infants and their mothers were examined retrospectively and analysed to identify factors associated with in-hospital supplementation using Poisson regression (unadjusted and adjusted).Findings
Fifteen percent of breastfed infants were supplemented during their hospital stay. Analysis by multivariable Poisson regression found that supplementation was independently associated with overweight (reference normal weight) (aRR [adjusted relative risk] = 1.46; 95% CI: 1.11–1.93); primiparity (aRR = 1.40; 95% CI: 1.09–1.80); early term gestation (37–376 weeks, aRR = 2.79; 95% CI: 1.88–4.15; 38–386 weeks, aRR = 2.03, 95%CI: 1.46–2.82); birthweight less than 2500 grams (reference 3000–3499 grams) (aRR = 3.60; 95% CI: 2.32–5.60) and use of postpartum uterotonic (aRR = 2.47; 95% CI: 1.09–5.55). Greater than 65 minutes of skin-to-skin contact at birth reduced the risk of supplementation (aRR = 0.66; 95% CI; 0.48–0.92).Conclusion
These identified predictors for supplementation, can inform the development of interventions for mother-infant pairs antenatally or in the early postpartum period around increased breastfeeding education and support to reduce supplementation. It may also be possible to reduce supplementation through judicious use of postpartum uterotonics and facilitation of mother-infant skin-to-skin contact at birth for greater than one hour duration. 相似文献20.
Paula Olsen Moira Williamson Victoria Traynor Chris Georgiou 《Women and birth : journal of the Australian College of Midwives》2018,31(1):31-37