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31.

Background

Asking women about experiences of domestic violence in the perinatal period is accepted best practice. However, midwives and nurses may be reluctant to engage with, or effectively respond to disclosures of domestic violence due a lack of knowledge and skills.

Aim

To evaluate the impact of training on knowledge and preparedness of midwives and nurses to conduct routine enquiry about domestic violence with women during the perinatal period.

Method

A pre-post intervention design was used. Midwives and nurses (n = 154) attended a full day workshop. Of these, 149 completed pre-post workshop measures of knowledge and preparedness. Additional questions at post-training explored participants’ perceptions of organisational barriers to routine enquiry, as well as anticipated impact of training on their practice. Training occurred between July 2015 and October 2016.

Findings

Using the Wilcoxon signed-rank test, all post intervention scores were significantly higher than pre intervention scores. Knowledge scores increased from a pre-training mean of 21.5–25.6 (Z = ?9.56, p < 0.001) and level of preparedness increased from 40.8 to 53.2 (Z = ?10.12, p < 0.001). Most participants (93%) reported improved preparedness to undertake routine enquiry after training. Only a quarter (24.9%) felt their workplace allowed adequate time to respond to disclosures of DV.

Conclusions

Brief training can improve knowledge, preparedness, and confidence of midwives and nurses to conduct routine enquiry and support women during the perinatal period. Training can assist midwives and nurses to recognise signs of DV, ask women about what would be helpful to them, and address perceived organisational barriers to routine enquiry. Practice guidelines and clear referral pathways following DV disclosure need to be implemented to support gains made through training.  相似文献   
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33.

Problem

Research suggests that the skill and experience of the attendant significantly affect the outcomes of vaginal breech births, yet practitioner experience levels are minimal within many contemporary maternity care systems.

Background

Due to minimal experience and cultural resistance, few practitioners offer vaginal breech birth, and many practice guidelines and training programmes recommend delivery techniques requiring supine maternal position. Fewer practitioners have skills to support physiological breech birth, involving active maternal movement and choice of birthing position, including upright postures such as kneeling, standing, squatting, or on a birth stool. How professionals learn complex skills contrary to those taught in their local practice settings is unclear.

Question

How do professionals develop competence and expertise in physiological breech birth?

Methods

Nine midwives and five obstetricians with experience facilitating upright physiological breech births participated in semi-structured interviews. Data were analysed iteratively using constructivist grounded theory methods to develop an empirical theory of physiological breech skill acquisition.

Results

Among the participants in this research, the deliberate acquisition of competence in physiological breech birth included stages of affinity with physiological birth, critical awareness, intention, identity and responsibility. Expert practitioners operating across local and national boundaries guided less experienced practitioners.

Discussion

The results depict a specialist learning model which could be formalised in sympathetic training programmes, and evaluated. It may also be relevant to developing competence in other specialist/expert roles and innovative practices.

Conclusion

Deliberate development of local communities of practice may support professionals to acquire elusive breech skills in a sustainable way.  相似文献   
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36.

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   
37.
The present contribution shows conceptual and methodological approaches for the study of social context effects within families. Family members mutually constitute the social context in which family behavior and personality development take place. Social influence in families becomes evident empirically in family members’ significant similarity concerning a wide variety of characteristics. The present study focuses on intrafamily convergence with regard to religiousness. In an empirical illustration, both (a) horizontal intracouple alignment and (b) vertical intergenerational transmission processes are examined. Besides the finding that experiences during religious socialization in the parental home have a stronger impact than partner influences in adulthood, our analyses show that social context effects are more pronounced the stronger the cohesion of the respective interaction dyad is (e.g., according to measures of relationship quality).  相似文献   
38.
With the integration of evidence-based practice central to all areas of social work education and training across the globe, it is crucial that we continue to engage with the methodological challenges inherent in gathering this evidence, particularly when it is related to the nature of social work education itself. As a result, this paper addresses some of the methodological challenges involved in examining the education available to social workers on engaging with substance use, both within the social work academy and local authorities in England. Drawing on experiences of implementing large scale online surveys from three substantial research projects completed by the authors, this paper highlights four methodological themes: (1) Constructing a representative sampling frame; (2) Identifying participants within organisations with many departments; (3) Response rates; and (4) Questionnaire design. While these are familiar methodological considerations, this article draws attention to the specific complexities of gathering ‘representative’ knowledge to inform educational strategies on substance use within social work education and employment contexts. Finally this paper offers lessons learned and guidance for social work academics, students and practitioners who are minded to build, or draw from, an evidence-base using representative samples from and within these environments.  相似文献   
39.
The authors integrate theoretical work on the performance of gender with a life course perspective to frame an analysis of in-depth interviews with 17 long-term married couples. The findings indicated that couples' sexual experiences are characterized by change over time, yet that change is shaped by the intersection of gender and age. Midlife couples (ages 50 - 69) were distressed by changes in their sex lives likely because they impede couples from performing gendered sexuality. The source of this distress stems from age-related physical changes; however, it manifests in different ways for husbands and wives. In contrast, later life couples (ages 70 - 86) were more likely to emphasize the importance of emotional intimacy over sex as they age. Marital sex is a source of conflict for many midlife couples because of husbands' and wives' incongruent experiences, but later life husbands and wives tend to have more congruent experiences of marital sex.  相似文献   
40.
With increases in the overall number of individuals with posttraumatic stress disorder (PTSD), nurse educators must provide experiences that help nursing students learn how to better communicate and care for individuals with this disorder. This article describes how two learning strategies-case studies and standardized patients-were combined to facilitate the development of therapeutic communication and assessment skills. Two case studies on PTSD were written, and actors were trained to portray the individuals in the case studies. Fourteen baccalaureate nursing students enrolled in a senior-level psychiatric nursing clinical course participated in this pilot alternative learning activity. This article describes the learning activity and presents student evaluations of the assignment.  相似文献   
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