Functional consequences of work-related spinal musculoskeletal symptoms in a cohort of Australian midwives

BackgroundEarly evidence suggests spinal musculoskeletal symptoms are as prevalent in Australian midwives as in samples of nurses. Functional consequences of these symptoms include sick leave and functional incapacity, which are costly at both individual and workplace levels. To date there have been no studies of these consequences in midwives.QuestionWhat risk factors are associated with sick leave and functional incapacity among midwives with spinal musculoskeletal symptoms?MethodsWe undertook a cross-sectional study of qualified Australian midwives who completed the baseline survey of the Nurses and Midwives e-Cohort Study. A comprehensive set of independent variables were examined for bivariate associations with the main outcomes of sick leave and functional incapacity due to work-related musculoskeletal symptoms in the neck, upper or lower back. Associations that achieved a p value < .1 were entered into multiple logistic regression models.Findings729 midwives with a mean age of 46 years were eligible for inclusion. Functional incapacity was more than twice as common as sick leave. Severity of worst pain was the explanatory variable most strongly associated with each main outcome and the only one significant for both. Psychological job demands showed a significant association with sick leave, while several individual factors were associated with both outcomes. Only the association of poorer general health with functional incapacity remained significant in all three spinal regions.ConclusionOur sample reported considerable work-related musculoskeletal pain and functional incapacity. Factors associated with sick leave and functional incapacity in midwives should be confirmed by longitudinal studies with the aim of developing tertiary prevention strategies.     

Responses to birth trauma and prevalence of posttraumatic stress among Australian midwives

Background

Midwives frequently witness traumatic birth events. Little is known about responses to birth trauma and prevalence of posttraumatic stress among Australian midwives.

The influence of yarning circles: A cultural safety professional development program for midwives

BackgroundA university educated, First Peoples health workforce is paramount to improving health outcomes for Australia’s First Peoples. However, a significant gap exists between the academic success of First Peoples and non-Indigenous students. The facilitation of culturally safe learning and teaching environments by academics is essential to closing this gap. There is little research on midwifery academics’ understanding of Cultural Safety and the translation of this understanding in learning and teaching.ObjectivesTo explore the influence of yarning circles within a professional development program to enhance midwifery academics’ awareness of Cultural Safety.MethodsA six-month staff development program which consisted of two workshops and a series of yarning circles was offered to all midwifery academics. Eight participants agreed to be interviewed after completion of the program. Interviews were transcribed verbatim, read and re-read, and analysed using a six staged thematic analysis process.ResultsSix key themes centred on participants’ Sense of Belonging, Sense of Safety, Sense Knowing, Sense of Support, Sense of Difference, and Sense of Challenge were identified. These concepts were supportive of participants’ developing awareness of Cultural Safety.ConclusionYarning circles can encourage midwifery academics’ awareness of Cultural Safety. Awareness is the first step towards becoming culturally safe. Yarning provided a safe and supportive space for challenging discussions and reflective learning about racism, white privilege, and difference. Midwifery academics described steps they could take to promote Cultural Safety in the classroom.     

Factors that positively influence in-hospital exclusive breastfeeding among women with gestational diabetes: An integrative review

ProblemWomen with gestational diabetes have higher rates of introducing infant formula before leaving hospital.BackgroundDespite health professional support, less women with gestational diabetes exclusively breastfeed in hospital.AimTo find factors that positively influence in-hospital exclusive breastfeeding practices among women with gestational diabetes.MethodsAn online search was performed in Medline, Scopus, Pubmed, CINAHL and Cochrane databases. Studies containing the keywords gestational diabetes and breastfeeding were retrieved.FindingsAuthors identified 1935 papers from search criteria. Twenty-six papers with no restrictions on research design met inclusion criteria and were included in the review. Factors were divided into personal, antenatal, intrapartum and postnatal factors. The main modifiable factors that were associated with improved in-hospital exclusive breastfeeding rates were having a strong intention to breastfeed, being confident, feeling supported and having continuity of education and support. Women’s main reasons to introduce formula were related to baby’s hypoglycaemia, delayed lactogenesis II and perceived low milk supply. Skin-to-skin contact after birth combined with frequent breastfeeds were effective ways to improve in-hospital exclusive breastfeeding rates.ConclusionInfluencing factors such as women’s breastfeeding intention, confidence and ongoing support are no different to the general population of women. However, promoting skin-to-skin contact after birth combined with frequent feeds are crucial for women with gestational diabetes who are more likely to introduce formula due to delayed lactogenesis II and fear of neonatal hypoglycaemia. There is a need for developing educational and supportive interventions that are tailored specifically for women who have gestational diabetes.     

Educating student midwives around dignity and respect

Focus

There is currently limited information available on how midwifery students learn to provide care that promotes dignity and respect.

城市低保措施满意率的影响因素分析

中国城市居民最低生活保障制度作为社会最后一道"安全网",为社会的稳定发挥了举足轻重的作用。政府为低保政策做出了巨大的努力,但是仍有低保对象对低保措施不满意。为提高低保措施的满意率、增强低保制度的实施效果,本文对影响城市低保措施满意率的因素进行探讨分析。研究采用系统和整群抽样方法对徐州市445名低保对象进行入户调查,调查内容包括一般情况和症状自评量表(SCL-90)。结果显示影响城市低保措施满意率的因素是对生活质量、自身潜在价值的期望值和强大的生存压力。     

人口素质的家庭影响因素分析

家庭是个体社会化的重要场所。家庭背景、家庭结构、家庭关系以及家庭教育等方面对人口素质有着不容忽视的影响 ,在当前家庭发生巨大变革的背景下 ,家庭变迁与人口素质呈动态关系 ,优化家庭因素对提高人口素质具有实践意义。