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Leonie Hewitt Holly Priddis Hannah G. Dahlen 《Women and birth : journal of the Australian College of Midwives》2019,32(2):168-177
Background
Despite well-known benefits of continuity of midwifery care, less than 10% of women have access to this model of care in Australia. Staff retention and satisfaction are strongly related to the quality of management; however, little is known about the attributes required to effectively manage a midwifery group practice.Purpose
To explore the attributes midwifery group practice managers require to be effective managers and how these attributes can be developed to promote service sustainability.Methods
A qualitative interpretive approach, employing in-depth interviews with eight midwifery leaders was undertaken and analysed using thematic analysis.Results
The overarching theme described the ideal midwifery group practice manager as someone who stands up for midwives and women and is ‘Holding the ground for midwifery, for women’. Subthemes demonstrate midwifery group practice management is complex: ‘having it’, describes the intrinsic traits of an effective leader; ‘someone with their hand on the steering wheel’ illustrates the day to day job of being a manager and the role of ‘juggling the forces’ that surround group practice; ‘helping managers to manage better’ explored the need for managers to be educated and supported for the role.Conclusions
Managers require certain attributes to effectively manage these unique services, whilst also juggling the needs of the organisation as a whole. Having transformational leadership qualities with vision to lead the practice into the future are key. There needs to be better support and preparation for the role if midwifery group practice is to be a sustainable option for women and midwives. 相似文献3.
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4.
Rima Kaddoura Jocelyn DeJong Huda Zurayk Tamar Kabakian Christine Abbyad Fadi G. Mirza 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e223-e228
Problem
There is lack of data on the rate of episiotomy in Lebanon and the study’s hospital.Background
Only a few studies have addressed episiotomy practice in Lebanon and the Middle East and they show varying rates.Aim
To identify the rate, and change in rate, of episiotomy practice over the years at a teaching hospital in Lebanon and to assess whether maternal age, parity, fetal weight, woman’s hospital admission class, and physician’s gender were associated with episiotomy. We also tested the association between episiotomy and postpartum hemorrhage and/or high degree perineal tears.Methods
A retrospective observational study was conducted on 1756 records for women having a normal vaginal birth at a single centre from January 2009 to January 2014.Findings
The rate of episiotomy at the hospital was very high, with 97.4% of women receiving an episiotomy in 2009. A major decrease in the rate was identified with a decline from 97.4% in 2009 to 73.3% in January 2014. Episiotomy was found to be associated with parity, maternal age, and with high degree perineal tears.Discussion
The episiotomy rate at this centre remains higher than the 10% rate recommended by the World Health Organization, although there has been a significant reduction after a call for restrictive rather than liberal use.Conclusion
Raising awareness among providers appeared to play a significant role in reducing this rate, although more efforts remain warranted. Other strategies – such as raising awareness of women about potential risks of episiotomy – are also worth exploring. 相似文献5.
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6.
Shefaly Shorey Lina Ang Wilson W.S. Tam 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e145-e158
Problem
The perinatal period is a stressful transition for new parents.Background
Various forms of educational interventions are available and are found to be efficacious in improving maternal and child outcomes. Such interventions for fathers were scarce and western-centric. Fathers should be educated as they have an impact on maternal and child outcomes.Aim
This review aims to evaluate the efficacy of quantitatively-studied informational support-focused interventions for fathers using paternal outcomes only.Methods
The search was carried out in six databases: Cumulative Index to Nursing and Allied Health Literature, PubMed, Scopus, Embase, Psychological Information Database, and MedNar. Cochrane Collaboration’s tools were used to assess the eligibility of the studies.Findings
A total of 17 studies with 18 interventions were identified and included in the narrative synthesis. Most interventions were delivered to the Western population during the antenatal or postpartum period. The method of delivery for these interventions was mainly face-to-face, with inconclusive findings on various paternal psychosocial outcomes.Discussion
Limited father-inclusive interventions were available. Technology-based longitudinal studies with interventions carried out across the perinatal period with longer follow-up periods were recommended for interventions providing informational support for fathers. Future studies can also examine paternal physical health and behavioural outcomes. Interventions in culturally-diverse populations should be designed and tested for their efficacies as fathers have different informational needs, especially in Asia.Conclusion
Informational interventions for fathers were found to be lacking and recommendations for future studies on educational interventions for fathers were discussed. 相似文献7.
Narges Alianmoghaddam Suzanne Phibbs Cheryl Benn 《Women and birth : journal of the Australian College of Midwives》2019,32(2):147-156
Background
Little qualitative research has been done to explore the quality of breastfeeding support through social media in New Zealand.Aim
This article aims to explore the influence of social media on exclusive breastfeeding practice.Methods
A qualitative study involving face-to-face postpartum interviews with 30 mothers who were recruited from the lower North Island of New Zealand. Each participant was followed via short monthly audio-recorded telephone interviews until giving up exclusive breastfeeding or until six months after the birth. The theories “strength of weak ties” and “landscapes of care” are applied to the thematic analysis of the interview material to illuminate the influence of social media on breastfeeding practices.Results
Qualitative analysis of the interview material identified four themes: 1) Mothers need reliable online infant feeding information; 2) Smartphone apps can be a good option for promoting breastfeeding; 3) Information is accessed through weak ties among breastfeeding mothers on Facebook, and 4) the utility of geographically distant infant feeding support via Skype.Discussion
Most participants sourced post-partum information and advice to support breastfeeding through the Internet, while those with geographically distant family members accessed emotional and practical breastfeeding support via Skype.Implications for Practice
Breastfeeding advocates should use social media to promote and support exclusive breast-feeding practice.Conclusion
The influence of social media on breastfeeding points to the relational nature of breastfeeding which is embedded in ‘real’ world and virtual social networks as well as the cultural, geographic and social contexts of a mother’s life. 相似文献8.
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Pranee Liamputtong Sandra Benza 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e216-e222
Problem
In non-Western societies, childlessness carries numerous social consequences and has a significant impact on the gender identity and well-being of the women.Background
The desire of women in non-Western societies is governed by numerous socio-cultural expectations including social norms and their own social position. At present, little is known about how Zimbabwean migrant women living in Australia perceive and experience childlessness and motherhood.Aim
To discuss how children are seen in Zimbabwean culture and examine the personal and social ramification of infertility and cultural expectations of motherhood among Zimbabwean migrant women living in Australia. The perspectives and experiences of this migrant community are crucial so that we can avoid misunderstanding about the essence of motherhood among Zimbabwean women. This will ultimately lead to sensitive and culturally appropriate health and social care for migrants in a multicultural society of Australia.Methods
The study is situated within the constructivist paradigm. Qualitative methods (in-depth interviewing, drawings and photo elicitation) were conducted with 15 Zimbabwean women. Data were analysed using thematic analysis method.Findings
Being able to bear a child in Zimbabwean culture had a significant meaning to the women. Not only children could ensure the continuity of the society, having children was a form of social security as parents would be cared for by their children in old age. Childlessness threatens the social position of a woman and carries social consequences which significantly impact on their gender identity and well-being. Cultural expectations of motherhood placed the sole responsibility of caring for the children emotionally and physically on the mother.Conclusion
The procreative value has not diminished despite having settled in Australia. An increased awareness of procreative needs for Zimbabwean women in a culturally and sensitive manner would enhance the emotional well-being of these women. 相似文献12.
Ingrid Jepsen Edith Mark Maralyn Foureur Ellen A. Nøhr Erik E. Sørensen 《Women and birth : journal of the Australian College of Midwives》2017,30(1):e61-e69
Background
Caseload midwifery is expanding in Denmark. There is a need for elaborating in-depth, how caseload midwifery influences the partner and the woman during childbirth and how this model of care influences the early phases of labour.Aim
To follow, explore and elaborate women’s and their partner’s experiences of caseload midwifery.Methods
Phenomenology of practice was the analytical approach. The methodology was inspired by ethnography, and applied methods were field observations followed by interviews. Ten couples participated in the study. Most of the couples were observed from the onset of labour until childbirth. Afterwards, the couples were interviewed.Findings
The transition from home to hospital in early labour was experienced as positive. During birth, the partner felt involved and included by the midwife. The midwives remembered and recognized the couple’s stories and wishes for childbirth and therefore they felt regarded as “more than numbers”. Irrespective of different kinds of vulnerability or challenges among the participants, the relationship was named a professional friendship, characterised by equality and inclusiveness. One drawback of caseload midwifery was that the woman was at risk of being disappointed if her expectations of having a known midwife at birth were not fulfilled.Key conclusions
From the perspective of women and their partners, attending caseload midwifery meant being recognised and cared for as an individual. The partner felt included and acknowledged and experienced working in a team with the midwife. Caseload midwifery was able to solve problems concerning labour onset or gaining access to the labour ward. 相似文献13.
Meta Weltens Jascha de Nooijer Marianne J. Nieuwenhuijze 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e197-e203
Background
Dutch maternity care is based on the principle that pregnancy and childbirth are physiological processes. However, the last decade an increase of intra-partum referrals to obstetric-led care has been observed. Most of these referrals are among nulliparous women, non-urgent and occur during the first stage of labour. The increase in referrals seems not associated with better perinatal outcomes.Objective
Gain understanding of underlying factors in the decision-making process prior to referral to obstetric-led care among midwives attending childbirth in midwifery-led care.Method
A qualitative study based on in-depth interviews with Dutch midwives (n = 10) working in midwifery-led care. We performed a thematic analysis based on the hypothetico-deductive and the intuitive-humanist theory.Results
Midwives mentioned knowledge as the basis of a reasoned decision. This included both theoretical knowledge, and knowledge from clinical experience. Influences of others, like the needs and wishes of labouring women were another factor influencing the decision-making, especially in non-urgent situations. Under subjective factors, the fear of being held responsible for professional choices emerged.Key conclusion
The decision-making process during childbirth is multi-factorial. The women’s needs and wishes are recognized as of great influence on the decision-making process during childbirth, which is not included as a factor in the hypothetico-deductive or the intuitive-humanist theory.Implication for practice
The influence of women’s needs and wishes should be part of models about the intra-partum decision-making process. Midwives should find strategies to support women to make well-informed choices that include adequate information on the consequences of medicalisation in obstetric-led care. 相似文献14.
Joëlle Darwiche Anne Milek Jean-Philippe Antonietti Yvan Vial 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e264-e271
Background
Pregnancy after infertility is a challenging experience. The first-trimester screening test may add stress. Partner support reduces psychological distress in pregnant women after spontaneous conception. No data are available for women who conceive via assisted reproductive technology.Aim
To assess whether there was a difference between couples who underwent assisted reproductive technology and couples who conceived spontaneously in the support they felt they provided to their partner and whether their perception of support received from their partner reduced their distress.Methods
This longitudinal prospective study included 52 women (spontaneous conception) and 53 women (assisted reproductive technology), as well as their partners. Participants completed the state scale of the State-Trait Anxiety Inventory, the Edinburgh Depression Scale, and two partner-support subscales of the Dyadic Coping Inventory: before prenatal testing (gestational age 12 weeks), immediately after receiving the results (gestational age of approximately 14 weeks), and once all the prenatal screenings had been completed (gestational age 22 weeks).Findings
Women who underwent assisted reproductive technology felt less able to help their partner cope with stress and felt their partner was less able to help them cope with stress than women with spontaneous pregnancy. This difference was not observed in men. Higher perceived partner support lowered the anxiety and depression of couples who conceived spontaneously, but did not benefit couples who followed fertility treatment.Conclusion
These results add to our knowledge of the emotional state of women and their partners during pregnancy after infertility. This knowledge may allow prenatal care providers to offer specialized counselling to women and their partners in the transition from infertility to parenthood. 相似文献15.
Hannah G. Dahlen Maree Johnson Julia Hoolsema Tiffany Patterson Norrie Shilpi Ajwani Anthony Blinkhorn Sameer Bhole Sharon Ellis Ravi Srinivas Albert Yaacoub Andrew Milat John Skinner Ajesh George 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e159-e165
Background
Despite links between poor maternal oral health, adverse pregnancy outcomes and early childhood decay there is limited emphasis on maternal oral health in Australia. To address this, the Midwifery Initiated Oral Health Dental Service (MIOH-DS) program was developed in collaboration with the Australian College of Midwives.Aims
To undertake a process evaluation and explore perceptions of midwives involved in the MIOH-DS program to determine its practicability, acceptability and feasibility if it were to be up-scaled and implemented into clinical practice.Methods
Qualitative content analysis was undertaken on data from three focus groups with 21 midwives.Findings
Midwives generally found the MIOH-DS to be acceptable and feasible with potential for widespread scalability. The trust women had in midwives was an important factor in gaining women’s attention about oral health in pregnancy. The program assisted in increasing midwives’ knowledge and awareness, though some felt it was outside their scope of practice. The oral health assessment tool was acceptable to midwives but some concerns were expressed about undertaking a visual oral inspection. Most midwives stated they were now confident with referring individuals to a dentist. Significant barriers to widespread implementation included the cost of dental care and the continued lack of awareness and misconceptions pregnant women had towards oral health.Conclusion
Midwives found the MIOH-DS to be acceptable and feasible which are two important barriers to potential implementation at scale. Misconceptions over the importance of oral health by women and cost of accessing dental services still need resolving. 相似文献16.
Puremeluan B. Major Shuby Puthussery Yannis Pappas 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e189-e196
Background
Mother-to-child transmission of Human Immunodeficiency Virus continues to be a major problem in Nigeria. Despite several initiatives, the number of infected pregnant women receiving Anti-Retroviral Therapy to prevent mother-to-child transmission of the virus remains low in Nigeria. Evidence suggests that attitudes and perceptions of the pregnant women influence their use of Anti-Retroviral Therapy.Aim
To understand the attitudes and perceptions of Human Immunodeficiency Virus infected pregnant women towards the use of Anti-Retroviral Therapy for prevention of mother-to-child transmission in Nigeria.Method
Twenty four Human Immunodeficiency Virus infected pregnant women were purposively selected from antenatal clinics. Women’s attitudes and perceptions towards the use of Anti-Retroviral Therapy were explored using semi-structured in-depth interviews conducted in May/June 2016. All interviews were recorded, transcribed and analysed using thematic approach.Findings
Overall, participants reflected a positive attitude about using Anti-Retroviral Therapy to prevent mother-to-child transmission and perceived the treatment as beneficial. The main themes identified included: perceived benefits of Anti-Retroviral Therapy; barriers to using Anti-Retroviral Therapy; threat from the susceptibility to the illness and the severity; perceived roles in treatment; and the negative behaviours of healthcare providers.Conclusion
The findings provide useful insights to inform Nigeria’s health policies on Anti-Retroviral Therapy. There is a need to educate the women on the benefits of the treatment as well as how they can cope with side effects and the daily regimen of the therapy during pregnancy. The findings also indicate the need for training healthcare providers on facilitative patient-provider relationship. 相似文献17.
Clare Bellhouse Meredith Temple-Smith Shaun Watson Jade Bilardi 《Women and birth : journal of the Australian College of Midwives》2019,32(2):137-146
Background
Miscarriage is a common event in Australia and is estimated to occur in up to one in four confirmed pregnancies. Prior research has demonstrated that miscarriage is associated with significant distress, grief and loss, and in some cases clinically significant levels of depression, anxiety, and Post Traumatic Stress Disorder. Despite these consequences for women’s emotional and mental health, studies have commonly found that women feel that healthcare providers often lack empathy, support, and acknowledgement of their loss.Aim
The aim of this study is to explore the psychological distress experienced by women as a result of miscarriage, as well as the perceived support provided by healthcare professionals.Methods
Fifteen women were recruited in Australia and participated in semi-structured interviews either in person or over the telephone.Findings
It was found that for most women, the levels of distress, grief, and loss associated with their miscarriages were significant. While women experienced both positive and negative interactions with healthcare providers throughout their miscarriage journeys, all women interviewed expressed their increased distress following negative experiences.Conclusion
A number of recommendations have been provided by women to improve the service of healthcare providers in the event of a miscarriage, including referral to a psychologist, and ongoing follow-up after their miscarriage, which women felt would assist them with managing their distress. 相似文献18.
Saadia Riaz Louise Condon 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e252-e258
Background
Pakistan has a higher infant mortality rate than countries with comparable economies, with around half of all under-5 deaths occurring in the first month of life. Breastfeeding is known to improve infant morbidity and mortality, but rates of formula feeding in Pakistan are increasing. Maternal employment is recognised globally as a major barrier to the continuation of breastfeeding.Aim
To describe the attitudes and experiences of breastfeeding mothers returning to full-time work as nurses in a tertiary hospital in Pakistan.Methods
A qualitative study was conducted using semi-structured interviews with seven purposively sampled participants who were breastfeeding at the time of return to work. Interviews were audio recorded, transcribed and analysed thematically.Results
Three major themes were identified: belief in a child’s right to breastfeed, conflict with institutional power and the importance of family support in maintaining breastfeeding. Antenatally mothers described breastfeeding as the preferred infant feeding option and the child’s right. When returning to work mothers encountered rigid hospital policies and practices, such as a short and non-negotiable period of maternity leave, inflexible shift patterns, and lack of childcare provision. Parents’ strategies to continue breastfeeding included some mothers bringing babies to hospital wards while they worked, and babies’ fathers bringing the baby to the hospital for feeds.Conclusion
This study highlighted the barriers to breastfeeding experienced by mothers working as hospital nurses in Pakistan. Babies can be put at risk due to the strategies parents adopt to reconcile continued breastfeeding with maternal employment. 相似文献19.
Antonio Hernández-Martínez Angel Arias-Arias Antonio Morandeira-Rivas Ana I. Pascual-Pedreño Elias J. Ortiz-Molina Julian Rodriguez-Almagro 《Women and birth : journal of the Australian College of Midwives》2019,32(2):112-118
Background
Oxytocin is the most widely used drug in the induction of labor, but it could have potential adverse effects that derive from uterine hyperstimulation.Aim
To determine the benefits and drawbacks of oxytocin continuation versus oxytocin discontinuation after the active phase of induced labor.Methods
We systematically searched Pubmed, EMBASE, Scopus, ClinicalTrials.gov and Cochrane Library Plus until October 2017, for randomized controlled trials comparing oxytocin continuation with oxytocin discontinuation when the active phase of labor is reached were included. Data was collected by three reviewers and quality of the included studies assessed using the methodology recommended in the Cochrane Handbook. StatsDirect software was used to calculate risk ratios for binary variables and weighted mean differences for continuous variables. A fixed-effects or random-effects model was used as appropriate.Results
Nine studies were selected including 1538 women, 774 in the oxytocin continuation group and 764 in the oxytocin discontinuation group. The incidence of cesarean sections (14.3% vs. 8.6%; relative risk, 1.67; 95% confidence interval: 1.25–2.23), uterine hyperstimulation (12.4% vs. 4.7%; relative risk, 2.59; 95% confidence interval: 1.70–3.93) and nonreassuring fetal heart rate (19.2% vs.12.5%; relative risk, 1.55; 95% confidence interval: 1.18–2.02) were significantly higher in the oxytocin continuation group. An increase in the duration of the second stage of labor in the oxytocin discontinuation group was observed (pooled mean difference, ?7.03; 95% confidence interval: ?9.80 to ?4.26).Conclusions
After the active phase of induced labor, oxytocin continuation increases the risk of cesarean section, uterine hyperstimulation and alterations to the fetal heart rate. 相似文献20.
Shigeki Koshida Tetsuo Ono Shunichiro Tsuji Takashi Murakami Hisatomi Arima Kentaro Takahashi 《Women and birth : journal of the Australian College of Midwives》2019,32(2):127-130