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481.

Background

The conduct of research regardless of the subject or methods employed brings responsibilities and challenges. These are greater when dealing with sensitive topics and vulnerable groups and therefore researchers must navigate a range of complex issues and make choices in relation to practical, ethical and philosophical concerns. While literature dealing with research methodologies and research design may assist to some degree, it cannot provide a clear pathway or template as each research project must respond to a unique set of circumstances. We can however, also learn from sharing our stories and critical reflections on our research processes.

Objective

The purpose of this article is to highlight the practical and methodological issues arising from researching a sensitive topic with vulnerable women experiencing an Assumption of Care.

Discussion

Research involving topics that are deeply personal and private combined with a vulnerable population can be complex and challenging for the researcher. Although some issues were anticipated from the literature, others encountered in this study were unexpected. Special considerations and prerequisites were necessary to build mutual trust and share power with women who had experienced an Assumption of Care at birth. Narrative Inquiry was a good methodological fit for this study as it privileged the voices of women and insisted that their experiences be considered within the context of their lives.

Conclusion

Although Narrative Inquiry is a suitable choice for researching sensitive topics with vulnerable women specific considerations are still required to ensure the benefits of this research for both participants and researchers.Family and Community Service (FACS) have now replaced the formerly known Department of Community Services (DoCS) and in consideration of the timing of this study this article uses the terminology as DoCS.  相似文献   
482.

Background

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

Aim

To assess exposure to different types of birth trauma, peritraumatic reactions and prevalence of posttraumatic stress.

Methods

Members of the Australian College of Midwives completed an online survey. A standardised measure assessed posttraumatic stress symptoms.

Findings

More than two-thirds of midwives (67.2%) reported having witnessed a traumatic birth event that included interpersonal care-related trauma features. Midwives recalled strong emotions during or shortly after witnessing the traumatic birth event, such as feelings of horror (74.8%) and guilt (65.3%) about what happened to the woman. Midwives who witnessed birth trauma that included care-related features were significantly more likely to recall peritraumatic distress including feelings of horror (OR = 3.89, 95% CI [2.71, 5.59]) and guilt (OR = 1.90, 95% CI [1.36, 2.65]) than midwives who witnessed non-interpersonal birth trauma. 17% of midwives met criteria for probable posttraumatic stress disorder (95% CI [14.2, 20.0]). Witnessing abusive care was associated with more severe posttraumatic stress than other types of trauma.

Discussion

Witnessing care-related birth trauma was common. Midwives experience strong emotional reactions in response to witnessing birth trauma, in particular, care-related birth trauma. Almost one-fifth of midwives met criteria for probable posttraumatic stress disorder.

Conclusion

Midwives carry a high psychological burden related to witnessing birth trauma. Posttraumatic stress should be acknowledged as an occupational stress for midwives. The incidence of traumatic birth events experienced by women and witnessed by midwives needs to be reduced.  相似文献   
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Since the subordination of midwifery by medicine and nursing in the 19th and 20th centuries the standard approach to childbirth has been dominated by rationality. This approach proceeds by creating dichotomies and then prioritising one half of the dichotomy whilst rejecting the opposite term. Rationality itself is prioritised, for example, by contrasting it with the rejected opposite: irrationality. Expert clinical practice is, however, increasingly identified as being inclusive of more than merely rational ways of knowing and behaving. This paper is based on a post-structural study concerning changes to women's embodied sense of self during childbearing. We expose the limitations of pure rationality in the context of childbirth and use the concept of safety to exemplify the limitations that pure rationality imposes. The paper draws on philosophical and spiritual theory to present an analysis of ideas about mind, body, soul and spirit. The standard rational/irrational dichotomy is critiqued and contrasted with the embodied reality of nonrational experiences that are individual, contextual and 'in-the-moment'. Nonrational experiences are identified to be inclusive of power and knowledge that are both rational and nonrational. This revised conceptualisation provides a theoretical basis that allows for and promotes more possibilities and thus more holistic ways of knowing in midwifery. Our thesis is that midwives and women need to take conscious account of nonrational knowledge and power during the childbearing year. We argue that pure rational thinking limits possibilities by excluding the midwife's embodied ways of knowing along with the ways of knowing embodied by the woman. The inclusion of women's and midwives'nonrational ways of knowing in childbearing situations opens us up to knowledge and power that provides for a more complete, and therefore a more optimal, decision-making process.  相似文献   
486.
The current study evaluates two predictors of adolescent sexual risk‐taking, specifically whether impulse control or future expectations predict condom use and casual sex. We examine whether risky sex occurs among youth who tend to act without thinking about the future, or instead, youth who report low future expectations. We consider these relations longitudinally among a sample of sexually active justice‐involved adolescent males (N = 752, M age = 15.58) a group at heightened risk for sexual risk‐taking. We found that optimistic expectations for the future predict a higher likelihood of engaging in consistent condom use, whereas high impulse control is related to a lower likelihood of casual sex. Implications for intervention and research on positive sexual health are discussed.  相似文献   
487.
Van Long  Nguyen  Cheng  Yuning  Le  Tu Dam Ngoc 《Urban Ecosystems》2020,23(3):675-687
Urban Ecosystems - Natural conditions and indigenous culture are fundamental factors creating the hydrological landscape system of the Vietnamese Mekong Delta. A study of the indigenous landscape...  相似文献   
488.
With the dearth of empirical research related to the experiences of domestic violence among South Asian communities in Hong Kong, this study engages with migrant South Asian women’s subjective understanding and experience of domestic violence. Presenting women’s narratives of their experiences with domestic violence allow for a better understanding of the complexities that inform and shape women’s experiences and decision-making in the face of partner violence. This empirical study investigated South Asian women’s experience of domestic violence in the context of Hong Kong through in-depth interviews with 14 South Asian women who had experienced abuse and 6 helping professionals from 4 social service agencies. Analysis of the data revealed that the nature and context of abuse posed as a barrier in their help seeking. The findings highlight the importance of understanding the influence of cultural and structural conditions and the difficulties and complexities women face that increases women’s vulnerability to abuse. This paper offers an analysis of how structures thereby come to impact on women’s distress and vulnerability. The study also highlights the need for inclusive service provision for minority ethnic women experiencing domestic violence.  相似文献   
489.

Background

The objective of the present study was to investigate 1) the role of different admission diagnoses and 2) the degree of functional loss, on the rate of recovery of older patients after acute hospitalization. Furthermore, to compare the predictive value of simple assessments that can be carried out in a hospital lacking geriatric service, with assessments including geriatric screening tests.

Methods

Prospective, observational cohort study, including 961community dwelling patients aged?≥?70 years, transferred from medical, cardiac, pulmonary and orthopedic acute hospital departments to intermediate care in nursing home. Functional assessment with Barthel index (BI) was performed at admission to the nursing home and further geriatric assessment tests was performed during the first week. Logistic regression models with and without geriatric assessment were compared concerning the patients having 1) slow recovery (nursing home stay up to 2 months before return home) or, 2) poor recovery (dead or still in nursing home at 2 months).

Results

Slow recovery was independently associated with a diagnosis of non-vertebral fracture, BI subgroups 50–79 and <50, and, in the model including geriatric assessment, also with cognitive impairment. Poor recovery was more complex, and independently associated both with BI?<?50, receiving home care before admission, higher age, admission with a non-vertebral fracture, and in the geriatric assessment model, cognitive impairment.

Conclusions

Geriatric assessment is optimal for determining the recovery potential of older patients after acute hospitalization. As some hospitals lack geriatric services and ability to perform geriatric screening tests, a simpler assessment based on admission diagnoses and ADL function (BI), gives good information regarding the possible rehabilitation time and possibility to return home.
  相似文献   
490.
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