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
This article examines how, in the decade following India's independence, the psychology of childhood became a locus of experimentation, and an avenue through which approaches to postcolonial development were expressed. Tracing the ideas of educational reformers, psychological researchers and child welfare advocates, we show how a ‘science of childhood’ in this period emphasised both the inherent potential and the emotional complexity of India's young citizens. However, while identifying this potential, these actors at times circumscribed it by deploying culturalist assumptions about Indian childhood that were linked to a teleology of the new nation state. These were ideas that shaped a ‘pedagogic’ approach to postcolonial modernisation. Nation‐building was not just a technocratic undertaking, but an educative project that was scientific, spiritual, and therapeutic in orientation. The article argues for greater attention to the pedagogy of the state in analyses of past and present state‐citizen relations. 相似文献
Due to extensive areas of impermeable surfaces, combined sewer overflow (CSO) is currently a major problem in urban areas across the United States. In CSO systems, sewage can travel through underground pipes to be decontaminated in treatment facilities, or it can combine with stormwater after a precipitation event and discharge into local waterways. Many cities are implementing green infrastructure installations, which use vegetation and bioactive soil microbial communities to enhance soil water-holding capacity, thereby minimizing CSO events. Understanding the factors that structure soil microbial communities in green infrastructure will facilitate more effective management of these engineered ecosystems; however, few studies to date have evaluated ecological patterns and processes of microbes in the urban environment. Nitrogen loading is known to be a major factor structuring fungi and bacteria in non-urban soils, and since cities also contain large populations of canines, N-rich urine deposition is a potential factor that could be important for structuring soil microbes in ground-level green infrastructure installations. Our study investigated the effects of canine urine on the urban soil microbial communities in a greenhouse experiment by treating Liriope muscari, a common plant found in New York City green infrastructure, with different concentrations of canine urine for 4 weeks in an experimental setting. We found that urine application significantly decreased total soil microbial biomass and microbial richness, and increased water runoff volume. These findings indicate that canine urine may have negative consequences for soil water-holding capacity and nutrient cycling in urban green infrastructure installations by directly decreasing the abundance and richness of soil microbial communities.
The theory of Birth Territory describes, explains and predicts the relationships between the environment of the individual birth room, issues of power and control, and the way the woman experiences labour physiologically and emotionally. The theory was synthesised inductively from empirical data generated by the authors in their roles as midwives and researchers. It takes a critical post-structural feminist perspective and expands on some of the ideas of Michel Foucault. Theory synthesis was also informed by current research about the embodied self and the authors' scholarship in the fields of midwifery, human biology, sociology and psychology. In order to demonstrate the significance of the theory, it is applied to two clinical stories that both occur in hospital but are otherwise different. This analysis supports the central proposition that when midwives use 'midwifery guardianship' to create and maintain the ideal Birth Territory then the woman is most likely to give birth naturally, be satisfied with the experience and adapt with ease in the post-birth period. These benefits together with the reduction in medical interventions also benefit the baby. In addition, a positive Birth Territory is posited to have a broader impact on the woman's partner, family and society in general. 相似文献
What are the risks associated with child sexual abuse? Who is at risk? From whom? For professionals working in the field of child abuse, the main answers to such questions are straightforward. There is a broad consensus that children are at risk from adults (and young people), often from men (and sometimes women) that they know. Fathers, step-fathers, uncles and brothers are often implicated. This is not, however, the focus of news coverage. Abductions, paedophile rings and abuse in children's homes attract intermittent but occasionally intense media attention. In contrast, sexual abuse of children within their own families is rarely front page news—except, that is, where the accusations are contested. Almost as soon as the existence of widespread abuse within ‘ordinary’ homes became public knowledge, this was over-shadowed by a series of high-profiled ‘scandals’, such as Cleveland, Rochdale and Orkney. The focus turned to questions of misdiagnosis, inappropriate intervention and the supposed coaching of children to make false accusations. More recently ‘false memory syndrome’ has hit the headlines suggesting that some adults' accounts of abuse can also be discredited. The news coverage often gives the impression that the main risks are not tochildren, but to parents, particularly fathers. How has this come to be the focus of public debate? Why is it that these risks have proved so much more ‘newsworthy’? This paper examines the media profile of the risks associated with sexual abuse and draws on interviews with journalists to seek to explain the shape of the coverage. 相似文献
This article examines the strategies used by some third sector organizations in Australia to advocate. The purpose of this
article is to identify the kinds of activities that organizations in New South Wales and Queensland use to promote advocacy,
the kinds of language that is used to describe these activities, and the reasons given for the particular strategies adopted.
The extent to which the organizations adopt “softer” (that is more institutional forms of advocacy) rather than more openly
challenging forms of activism is examined, particularly in light of a neo-liberal political and economic environment. In this
analysis emergent strategies are identified that are not easily categorized as either “institutional” or “radical” advocacy.
The article presents an exploratory analysis of some of the implications of the strategies adopted, in terms of their democratic
effects and potential to strengthen the capacity of third sector organizations. The article is informed by the findings of
a qualitative research project involving interviews with 24 organizations in the community services and environmental fields. 相似文献
This paper will give an overview of Murray Bowen's theory of family systems. It will describe the model's development and outline its core clinical components. The practice of therapy will be described as well as recent developments within the model. Some key criticisms will be raised, followed by a case example which highlights the therapeutic focus of Bowen's approach. 相似文献