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Patricia M. Corcoran Christine Catling Caroline S.E. Homer 《Women and birth : journal of the Australian College of Midwives》2017,30(1):77-86
Issue
Indigenous women in many countries experience a lack of access to culturally appropriate midwifery services. A number of models of care have been established to provide services to women. Research has examined some services, but there has not been a synthesis of qualitative studies of the models of care to help guide practice development and innovations.Aim
To undertake a review of qualitative studies of midwifery models of care for Indigenous women and babies evaluating the different types of services available and the experiences of women and midwives.Methods
A meta-synthesis was undertaken to examine all relevant qualitative studies. The literature search was limited to English-language published literature from 2000–2014. Nine qualitative studies met the inclusion criteria and literature appraisal – six from Australia and three from Canada. These articles were analysed for coding and theme development.Findings
The major themes were valuing continuity of care, managing structural issues, having negative experiences with mainstream services and recognising success.Discussion
The most positive experiences for women were found with the services that provided continuity of care, had strong community links and were controlled by Indigenous communities. Overall, the experience of the midwifery services for Indigenous women was valuable. Despite this, there were still barriers preventing the provision of intrapartum midwifery care in remote areas.Conclusion
The expansion of midwifery models of care for Indigenous women and babies could be beneficial in order to improve cultural safety, experiences and outcomes in relation to pregnancy and birth. 相似文献2.
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Bridget Kerkin Susan Lennox Jean Patterson 《Women and birth : journal of the Australian College of Midwives》2018,31(3):232-239
Background
Midwives have a professional, ethical and legal obligation to effectively and thoroughly document the care provided to women and the decisions made within the partnership relationship. To appreciate the best approach to documenting midwifery care, it is important to first understand the purpose of midwifery documentation.Aim
The aim of this article is to explore the literature in relation to the purposes of midwifery documentation.Method
A literature search was performed using the CINAHL and Pubmed databases. Hand searching of reference and citation lists was employed to deepen the literature pool.Findings and discussion
No research articles with a midwifery focus were found addressing the purpose of documentation. Broader searching of literature from other healthcare fields was drawn on to identify the contribution of record keeping to: partnership and continuity of care; communication between health professionals; improved standards of care; audits and clinical reviews; research and education; the visibility of midwifery work; the reflective practices of midwives; professional accountability; the legal record of care; the narrative record of experience for women.Conclusion
The purpose of midwifery documentation is complex and multi-factorial, involving much more than the recording of clinical and legal details of a woman’s care. Midwifery documentation may potentially enhance the maternity care experience for women, support the role of the midwife, positively impact collaboration between health professionals, and contribute to organisational processes and research. Further research is needed to clarify how to address the documentation priorities of women and midwives, within the context of the maternity record. 相似文献4.
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Susanne Åhlund Sofia Zwedberg Ingegerd Hildingsson Malin Edqvist Helena Lindgren 《Women and birth : journal of the Australian College of Midwives》2018,31(2):e115-e121
Problem and background
In an earlier research project midwives were asked to perform women-centered care focusing on the assumption that the physiological process in the second stage of labour could be trusted and that the midwives role should be encouraging and supportive rather than instructing. There is no knowledge about how midwives participating in such a research project, uses their skills and experience from the study in their daily work.Aim
The aim in this study was to investigate how midwives experienced implementing woman-centered care during second stage of labour.Methods
A qualitative study was designed. Three focus groups and two interviews were conducted. The material was analysed using content analysis.Findings
The participating midwives’ experiences were understood as increased awareness of their role as midwives. The overarching theme covers three categories 1) establishing a new way of working, 2) developing as midwife, 3) being affected by the prevailing culture. The intervention was experienced as an opportunity to reflect and strengthen their professional role, and made the midwives see the women and the birth in a new perspective.Conclusions
Implementing woman-centered care during second stage of labour gave the midwives an opportunity to develop in their professional role, and to enhance their confidence in the birthing women and her ability to have a physiological birth. To promote participation in, as well as conduct midwifery research, can enhance the development of the midwives professional role as well as contribute new knowledge to the field. 相似文献6.
Kim Russell 《Women and birth : journal of the Australian College of Midwives》2018,31(2):e134-e141
Problem
In hospital units, the network of interdependent relationships between midwives and doctors has positioned midwives within hierarchical relationships of power. Others argue that the physical layout of hospital wards created by biomedicine makes it difficult for midwives to provide midwifery led care. The aim of this review is to identify factors that support change in the delivery of the midwifery led care in hospital settings.Methods
A narrative review was chosen as this method allows for greater flexibility in the selection of studies and can lead to the inclusion of a wider range of literature.Results
Eight high quality papers from the UK, Sweden, Canada and Australia were selected for review. Papers focused on improving the delivery of midwife led care in hospital midwifery units, labour and postnatal wards. Key themes were identified as supporting change in the delivery of midwifery led care were ownership of change, capability to change and transformational leadership.Conclusion
The findings demonstrate the importance of social support and clinical leadership in bringing about subtle changes in hospital based midwifery led care. Ultimately improved understanding of the factors that support the delivery of the midwifery led care in hospital settings may improve women’s choice and highlight the role of the midwife as the practitioner of normal childbirth. 相似文献7.
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Emma L. Kingwell Janice Butt Gavin Leslie 《Women and birth : journal of the Australian College of Midwives》2017,30(2):e73-e77
Background
Maternity high-dependency care has emerged throughout the 21st century in Australian maternity hospitals as a distinct sub-speciality of maternity care. However, what the care involves, how and why it should be provided, and the role of midwives in the provision of such care remains highly variable.Introduction
Rising levels of maternal morbidity from non-obstetric causes have led midwives to work with women who require highly complex care, beyond the standard customary midwifery role. Whilst the nursing profession has developed and refined its expertise as a specialty in the field of high-dependency care, the midwifery profession has been less likely to pursue this as a specific area of practice.Discussion
This paper explores the literature surrounding maternity high-dependency care. From the articles reviewed, four key themes emerge which include; the need for maternity high-dependency care, maternal morbidity and maternity high-dependency care, the role of the midwife and maternity high-dependency care and midwifery education and preparation for practice. It highlights the challenges that health services are faced with in order to provide maternity high-dependency care to women. Some of these challenges include resourcing and budgeting limitations, availability of educators with the expertise to train staff, and the availability of suitably trained staff to care for the women when required.Conclusion
In order to provide maternity high-dependency care, midwives need to be suitably equipped with the knowledge and skills required to do so. 相似文献9.
Bridget Roache Jennifer Kelly 《Women and birth : journal of the Australian College of Midwives》2018,31(3):e216-e221
Background
Priorities of the National Maternity Services Plan (NMSP) are a significant contrast to current standard hospital maternity service provision. This paper demonstrates the applicability of case study methods to explore the views of midwives during a period of midwifery reform.Aim
This research aims to highlight key findings and insights surrounding recommended changes facing midwives that can be shared with education providers to incorporate strategies into education programs to ensure contemporary midwifery practice.Methods
Exploratory Case Study methodology was employed using ethical processes and designing semi-structured interview questions to explore participants’ views. Purposive sampling ensured participants were currently practicing midwives in order to reflect the perspective and intent of this study. Data were analysed and findings presented in categories and subcategories.Results
Case Study methodology enables an in-depth understanding of a phenomenon to be explored within a natural context. The participants of this study formed a single unit of analysis to ensure the research makes a worthwhile contribution to the profession of midwifery.Conclusion
This paper demonstrates that Case Study methodology is a valid research approach to exploring the views of midwives employed in standard care settings during a period of national reform. The rigorous processes and versatility of Case Study methodology ensured a systematic, critical enquiry was undertaken to gain understanding of the views of participants in implementing the NMSP. This understanding is reflective of the real life contexts of midwives to promote understanding and provide a body of knowledge where there is ambiguity and uncertainty. 相似文献10.
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11.
Carolyn M. Bailey Jennifer M. Newton Helen G. Hall 《Women and birth : journal of the Australian College of Midwives》2018,31(5):414-421
Background
Midwives use telephone triage to provide advice and support to childbearing women, and to manage access to maternity services. Telephone triage practises are important in the provision of accurate, timely and appropriate health care. Despite this, there has been very little research investigating this area of midwifery practice.Aim
To explore midwives and telephone triage practises; and to discuss the relevant findings for midwives managing telephone calls from women.Methods
A five-stage process for conducting scoping reviews was employed. Searches of relevant databases as well as grey literature, and reference lists from included studies were carried out.Findings
A total of 11 publications were included. Thematic analysis was used to identify key concepts. We grouped these key concepts into four emergent themes: purpose of telephone triage, expectations of the midwife, challenges of telephone triage, and achieving quality in telephone triage.Discussion
Telephone triage from a midwifery perspective is a complex multi-faceted process influenced by many internal and external factors. Midwives face many challenges when balancing the needs of the woman, the health service, and their own workloads. Primary research in this area of practice is limited.Conclusion
Further research to explore midwives’ perceptions of their role, investigate processes and tools midwives use, evaluate training programs, and examine outcomes of women triaged is needed. 相似文献12.
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Kate Dawson Della A. Forster Helen L. McLachlan Michelle S. Newton 《Women and birth : journal of the Australian College of Midwives》2018,31(3):194-201
Background
Despite high-level evidence of the benefits of caseload midwifery for women and babies, little is known about specific practice arrangements, organisational barriers and facilitators, nor about workforce requirements of caseload. This paper explores how caseload models across Australia operate.Methods
A national cross-sectional, online survey of maternity managers in public maternity hospitals with birthing services was undertaken. Only services with a caseload model are included in the analysis.Findings
Of 253 eligible hospitals, 149 (63%) responded, of whom 44 (31%) had a caseload model. Operationalisation of caseload varied across the country. Most commonly, caseload midwives were required to work more than 0.5 EFT, have more than one year of experience and have the skills across the whole scope of practice. On average, midwives took a caseload of 35–40 women when full time, with reduced caseloads if caring for women at higher risk. Leave coverage was complex and often ad-hoc. Duration of home-based postnatal care varied and most commonly provided to six weeks. Women’s access to caseload care was impacted by many factors with geographical location and obstetric risk being most common.Conclusion
Introducing, managing and operationalising caseload midwifery care is complex. Factors which may affect the expansion and availability of the model are multi-faceted and include staffing and model inclusion guidelines. Coverage of leave is a factor which appears particularly challenging and needs more focus. 相似文献14.
Comprehensive maternity support and shared care in Switzerland: Comparison of levels of satisfaction
Lucia Floris Olivier Irion Jocelyne Bonnet Maria-Pia Politis Mercier Claire de Labrusse 《Women and birth : journal of the Australian College of Midwives》2018,31(2):124-133
Background
According to the woman-centred care model, continuous care by a midwife has a positive impact on satisfaction. Comprehensive support is a model of team midwifery care implemented in the large Geneva University Hospitals in Switzerland, which has organised shared care according to the biomedical model of practice. This model of care insures a follow up by a specific group of midwives, during perinatal period.Aim
The goal of this study was to evaluate the satisfaction and outcomes of the obstetric and neonatal care of women who received comprehensive support during pregnancy, childbirth and the postpartum period, and compare them to women who received shared care.Methods
This was a prospective comparative study between two models of care in low risk pregnant women. The satisfaction and outcomes of care were evaluated using the French version of the Women’s Experiences Maternity Care Scale, two months after giving birth.Findings
In total, 186 women in the comprehensive support group and 164 in the control group returned the questionnaire. After adjustment, the responses of those in the comprehensive support programme were strongly associated with optimal satisfaction, and they had a significantly lower epidural rate. No differences were observed between the two groups in the mode of delivery. The satisfaction relative to this support programme was associated with a birth plan for intrapartum and postnatal care.Conclusions
Team midwifery had a positive impact on satisfaction, with no adverse effects on the obstetric and neonatal outcomes, when compared to shared care. 相似文献15.
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Sandra Healy Eileen Humphreys Catriona Kennedy 《Women and birth : journal of the Australian College of Midwives》2017,30(5):367-375