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281.
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282.
Kathleen Baird Debra K. Creedy Amornrat S. Saito Jennifer Eustace 《Women and birth : journal of the Australian College of Midwives》2018,31(5):398-406
Background
Routine enquiry about domestic violence during pregnancy is accepted best practice. Training is essential to improve knowledge and practice. Few studies have undertaken a comprehensive evaluation of training impact over time.Aim
To evaluate the longitudinal impact of a domestic violence training and support program to promote midwives’ routine antenatal enquiry for domestic violence using a mixed methods design.Method
Data sources included (1) surveys of midwives at 6 months post-training, (2) interviews with key stakeholders at 12 months, (3) chart audit data of screening, risk, and disclosure rates (for 16 months). Measures included midwives’ knowledge, preparation for routine enquiry, knowledge of domestic violence and perceptions of impact of the training and support for practice change.Findings
Forty (out of 83) participant surveys could be matched and responses compared to baseline and post-training scores. Wilcoxon signed-rank test identified that all 6-month follow-up scores were significantly higher than those at baseline. Level of preparedness increased from 42.3 to 51.05 (Z = 4.88, p < .001); and knowledge scores increased from a mean of 21.15 to 24.65 (Z = 4.9, p < .001). Most participants (>90%) reported improved confidence to undertake routine inquiry. A chart audit of screening rates revealed that of the 6671 women presenting for antenatal care, nearly 90% were screened. Disclosure of domestic violence was low (<2%) with most women at risk or experiencing violence declining referral.Conclusions
Training, support processes, and referral pathways, contributed to midwives’ sustained preparedness and knowledge to conduct routine enquiry and support women disclosing domestic violence. 相似文献283.
Learning about customers takes place through relevant dialogues with those customers, also known as customer relationship management (CRM). As relationships develop, information about the customer is gathered in the firm's customer information systems (CIS): the content, processes, and assets associated with gathering and moving customer information throughout the firm. This research develops a measure of CIS management capabilities based on learning organization theory and measured by the ability to get, store, move, and use information throughout the business unit. This measure is then used to analyze customer learning processes and associated performance in the context of marketing strategic decision making. This study of 209 business services firms finds that generic marketing strategy positioning (low‐cost and differentiation) and the marketing tactics of personalization and customization are related to CIS development. Customer information systems development in turn is associated with higher levels of customer‐based performance, which in turn is associated with increased business growth. Since the strongest association with customer‐based performance is strategy selection, the long‐term benefits of the knowledge gained from the CIS may be in the ability to assist in measuring customer‐based performance, rather than in the ability to immediately contribute to performance. Finally, for these firms, customization and personalization are not directly associated with performance and thus may not be necessary to support every firm's marketing strategy. 相似文献
284.
Moral identity, defined as a self-consistent commitment to lines of action benefiting others, is described in the contexts of adolescence and poor, urban neighborhoods. A model of moral identity development is proposed. According to the model, stable characteristics of the individual and the individual's family, in conjunction with social attitudes, self-conceptions, and opportunities for the exploration of prosocial action, influence the development of moral identity. Analyses from the National Longitudinal Survey of Youth provide support for the model, and demonstrate that urban poverty is associated with few opportunities for development of moral identity. We argue that the provision of these opportunities should be given a high priority both to foster good individual development and as a means for increasing social capital in neighborhoods. 相似文献
285.
Little research has focused on alcohol and illicit drug use among deaf and hard of hearing youth. Findings are reported from survey data collected among high school students at two phases of a program of research primarily focusing on tobacco use [Phase 1: (1999/2000) n = 226, Phase 2: (2004) n = 618). Evidence of considerable ever (lifetime) drinking (59.1%, 42.6%) and other substance use (21.1%, 18.9%) was found. Gender, age, race/ethnic, grade, school type (mainstream vs. school for the deaf), age when deafened, and aspects of self-perception were examined for their possible association with substance use. Current use rates are reported, and study findings are discussed in relation to national data. Understanding these use patterns is critical to developing interventions for this culturally and linguistically unique population. 相似文献
286.
Debra Nelson-Gardell 《Child and Adolescent Social Work Journal》2001,18(6):401-416
This exploratory project had two goals: (1) to ask child and adolescent sexual abuse victims/survivors what they believed counseling and/or therapy designed to help them should entail; and (2) to learn from survivors how others (e.g., parents, social service workers, law enforcement, siblings, etc.) may have helped them deal with the negative impact of child sexual abuse victimization. A focus group methodology, using thematic analysis, was used to learn about how child and adolescent sexual abuse survivors saw these matters and to evaluate the usefulness of focus groups with this population. 相似文献
287.
The proportional hazards life table is a recently developed approach to the analysis of survival data when mortality risks vary among individuals. It assumes that at a given age (or duration since the start of a life) the force of mortality is a constant (specific to that age) multiplied by a proportionality factor which is determined by the characteristics of the individual and does not change unless these covariates do. In this paper, the method is reviewed for the case where the covariates are fixed at the start of the lifetime and illustrated by an application to marital dissolution in the United States. 相似文献
288.
Debra Renee Kaufman 《Symbolic Interaction》1989,12(2):299-314
Although it seems obvious why men might turn to a community steeped in patriarchal tradition, it is much more difficult to explain women's attraction. To explain their attraction the author conducted in-depth interviews with 75 newly orthodox Jewish women. Although many of these women began their journeys toward Jewish Orthodoxy partly as a backlash against feminism or any liberation movement they perceived as placing individual freedom above social responsibility, the data also suggest that almost all of them selectively incorporate and adapt some protofeminist values about the family and about men. This article explores the ways in which these women seem to make “feminist” sense out of patriarchal religion and social strucuture. 相似文献
289.
This article reviews recent research (1999 - 2009) on the effects of parenthood on wellbeing. We use a life course framework to consider how parenting and childlessness influence well-being throughout the adult life course. We place particular emphasis on social contexts and how the impact of parenthood on well-being depends on marital status, gender, race/ethnicity, and socioeconomic status. We also consider how recent demographic shifts lead to new family arrangements that have implications for parenthood and well-being. These include stepparenting, parenting of grandchildren, and childlessness across the life course. 相似文献
290.
Using 1970 and 1980 census block data for Washington, D.C., we test several hypotheses about the racial residential consequences of neighborhood revitalization. Areas located in the revitalizing core of the city have a) become whiter in both absolute and proportional terms, consistent with the displacement hypothesis, and b) experienced substantial though difficult to interpret shifts in segregation. The types of racial changes occurring in the core are not apparent elsewhere in Washington, and tract data for 1940-1980 show the core changes to be temporally as well as spatially specific. Because different racial residential trends have accompanied revitalization in other cities, we treat Washington as an exceptional case that helps specify the conditions under which conventional wisdom about neighborhood change is least applicable. 相似文献