Introduction: Ultrasound is an essential component of antenatal care. Midwives provide most of the antenatal care but they do not perform ultrasound as it has been beyond their scope of practice. This leaves many wome...Introduction: Ultrasound is an essential component of antenatal care. Midwives provide most of the antenatal care but they do not perform ultrasound as it has been beyond their scope of practice. This leaves many women in Low and Middle-Income Countries without access to ultrasound scanning. The aim of this study was to identify competencies in ultrasound scanning in midwifery education. Methods: A desk review and needs assessment were conducted between July and October 2023. Articles and curricula on the internet, Google scholar and PubMed were searched for content on ultrasound scanning competencies. A Google form consisting of 20 questions was administered via email and WhatsApp to 135 participants. Descriptive statistics were used to analyse data. Results: The desk review showed that it is feasible to train midwives in ultrasound scanning. The training programs for midwives in obstetric ultrasound were conducted for 1 week to 3 months with most of them running for 4 weeks. Content included introduction to general principles of ultrasound, physics, basic knowledge in embryology, obstetrics, anatomy, measuring foetal biometry, estimating amniotic fluid and gestational age. Experts like sonographers trained midwives. Theory and hands on were the teaching methods used. Written and practical assessments were conducted. Needs assessment revealed that majority of participants 71 (53%) knew about basic ultrasound training for midwives. All participants (100%) said it is necessary to train midwives in basic ultrasound scan in Zambia. Some content should include, anatomy, measuring foetal biometry, assessing amniotic fluid level, and gestational age determination. Most participants 91 (67%) suggested that the appropriate duration of training is 4 - 6 weeks. Conclusion: Empowering every midwife with ultrasound scanning skills will enable early detection of any abnormality among pregnant women and prompt intervention to save lives.展开更多
BACKGROUND There are many drawbacks to the traditional midwifery service management model,which can no longer meet the needs of the new era.The Internet+continuous midwifery service management model extends maternal m...BACKGROUND There are many drawbacks to the traditional midwifery service management model,which can no longer meet the needs of the new era.The Internet+continuous midwifery service management model extends maternal management from prenatal to postpartum,in-hospital to out-of-hospital,and offline to online,thereby improving maternal and infant outcomes.Applying the Internet+continuous midwifery service management model to manage women with highrisk pregnancies(HRP)can improve their psycho-emotional opinion and,in turn,minimize the risk of adverse maternal and/or fetal outcomes.AIM To explore the effectiveness of a midwife-led Internet+continuous midwifery service model for women with HRP.METHODS We retrospectively analyzed the clinical data of 439 women with HRP who underwent prenatal examination and delivered at Shanghai Sixth People's Hospital(affiliated to the Shanghai Jiao Tong University School of Medicine)from April to December 2022.Among them,239 pregnant women underwent routine obstetric management,and 200 pregnant women underwent Internet+continuous midwifery service mode management.We used the State-Trait Anxiety Inventory,Edinburgh Postnatal Depression Scale,and analysis of delivery outcomes to compare psychological mood and the incidence of adverse delivery outcomes between the two groups.RESULTS The data showed that in early pregnancy,the anxiety and depression levels of the two groups were similar;the levels gradually decreased as pregnancy progressed,and the decrease in the continuous group was more significant[31.00(29.00,34.00)vs 34.00(32.00,37.00),8.00(6.00,9.00)vs 12.00(10.00,13.00),P<0.05].The maternal self-efficacy level and strategy for weight gain management were better in the continuous group than in the traditional group,and the effective rate of midwifery service intervention in the continuous group was significantly higher than in the control group[267.50(242.25,284.75)vs 256.00(233.00,278.00),74.00(69.00,78.00)vs 71.00(63.00,78.00),P<0.05].The incidence of adverse delivery outcomes in pregnant women and newborns and fear of maternal childbirth were lower in the continuous group than in the traditional group,and nursing satisfaction was higher[10.50%vs 18.83%,8.50%vs 15.90%,24.00%vs 42.68%,89.50%vs 76.15%,P<0.05].CONCLUSION The Internet+continuous midwifery service model promotes innovation through integration and is of great significance for improving and promoting maternal and child health in HRP.展开更多
BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventio...BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventions are necessary to improve maternal and fetal outcomes and alleviate primiparas’negative emotions(NEs).AIM To discusses the impact of nursing responsibility in midwifery and postural and psychological interventions on maternal and fetal outcomes as well as primiparas’NEs.METHODS As participants,115 primiparas admitted to Quanzhou Maternity and Child Healthcare Hospital between May 2020 and May 2022 were selected.Among them,56 primiparas(control group,Con)were subjected to conventional midwifery and routine nursing.The remaining 59(research group,Res)were subjected to the nursing model of midwifery and postural and psychological interventions.Both groups were comparatively analyzed from the perspectives of delivery mode(cesarean,natural,or forceps-assisted),maternal and fetal outcomes(uterine inertia,postpartum hemorrhage,placental abruption,neonatal pulmonary injury,and neonatal asphyxia),NEs(Hamilton Anxiety/Depressionrating Scale,HAMA/HAMD),labor duration,and nursing satisfaction.RESULTS The Res exhibited a markedly higher natural delivery rate and nursing satisfaction than the Con.Additionally,the Res indicated a lower incidence of adverse events(e.g.,uterine inertia,postpartum hemorrhage,placental abruption,neonatal lung injury,and neonatal asphyxia)and shortened duration of various stages of labor.It also showed statistically lower post-interventional HAMA and HAMD scores than the Con and pre-interventional values.CONCLUSION The nursing model of midwifery and postural and psychological interventions increase the natural delivery rate and reduce the duration of each labor stage.These are also conducive to improving maternal and fetal outcomes and mitigating primiparas’NEs and thus deserve popularity in clinical practice.展开更多
Introduction: International migration has always existed, primarily as a means to find economic opportunity. Recently, the number of health care professionals seeking to work outside Albania is growing rapidly. In 202...Introduction: International migration has always existed, primarily as a means to find economic opportunity. Recently, the number of health care professionals seeking to work outside Albania is growing rapidly. In 2021 alone, 1073 nurses left Albania. The departure of health care professionals is reflected in education where it can be observed that a good part of the students who finished the bachelor’s level program did not enroll to continue the second level of study in the master’s. The student’s decision not to continue further levels of education has brought consequences from programs shutting down due to lack of students and forcing the university to spread out the few remaining students to other programs. Objective: The purpose of the study was to explore the opinions of Midwifery Students studying at the Bachelor level, regarding their professional future and continuing education. Methodology: This is a cross-sectional study. In this study are included the students of the bachelor level of education. Student participating are studying Midwifery in the 2022-2023 academic year, at the Faculty of Technical Medical Sciences at the University of Medicine, Albania. Results: The students on average believe they can find a job as a midwife. The career is relatively safe and the profession of midwifery will ensure economic well-being for them. Most of the students hope to emigrate and develop their professional career outside of Albania. This was a surprise given that most frequent answers given by the students for not continuing their Master’s level education was the fact that the program was not accredited, their Bachelor’s diploma was also not accredited and so not recognized by other countries, the cost of continuing their studies was too high and their desire for a better economic and social status which they cannot get in Albania. The majority of students participating in the study identified emigration as the main way they plan to further their studies. Conclusions and Recommendations: Although the students had willingly chosen to continue the midwifery diploma, as they thought it would provide them with a proper future, this dignified professional future was seen as unattainable in Albania so they are seeking it out in more developed countries. A significant number of health professionals prefer to continue their second cycle studies in another country. The professional security within their home country does not satisfy the students. As the market demand for nurses around the globe escalates, the changes and consequences associated with nurse migration are increasingly in need of policy solutions that will address the needs of all parties involved. .展开更多
Background: Many countries across the world are facing an ongoing shortage of midwife practitioners due to several reasons such as increased workload, working overtime, poor-quality midwifery care, low staff morale, s...Background: Many countries across the world are facing an ongoing shortage of midwife practitioners due to several reasons such as increased workload, working overtime, poor-quality midwifery care, low staff morale, stress and burnout, lack of opportunity for training, lack of management support, financial issues and lack of recognition and compromised autonomy. Purpose: To explore the reasons behind nurses’ hesitance to apply for midwifery specialization. The objectives of this study were to understand the challenges that lie in front of Omani nurses and the motivational factors to apply for a midwifery programme. Method: Exploratory qualitative study was conducted at the largest tertiary hospital in Oman. Purposive sampling was applied for participant recruitment. Face-to-face interviews and focus group discussions were used as data collection methods. The study included general nurses, nurses in charge working in the maternity unit as well as nurses whose applications were accepted for midwifery education. Qualified midwives were excluded. The data collection process yielded twenty-five nurses. The interview protocol highlighted the impact and perception of the midwifery specialization on nurses’ careers. Thematic analysis was employed for data analysis. Results: Three over-arching major themes were identified. These are 1) nurses’ perceptions about the nature of work in maternity wards, the nurses have positive perception toward working in maternity wards and labor room because of working exclusively with female patients and their babies 2) factors influencing the decision to study midwifery specialization, work overload, stress, lack of support from administration were the most common reason behind the nurses not to apply for midwifery specialization and 3) support and recommendations required for midwives, the nurses mentioned that their identity, promotions and support from the administration will encourage them to apply for midwifery specialization. Conclusion: One of the main reasons that hindered nurses from applying to midwifery specialization is the false belief that midwives cannot work outside the delivery suite (DS). The second reason was the stress that midwives encounter at DS, and this was perceived by general nurses who did not work at DS. These challenges could be mitigated by leadership support, midwifery profession identity, as well as financial recognition for the midwives.展开更多
Background and Aim: Given the dramatic decline in the ability of test due to test anxiety, the goal of this study was to evaluate the relationship between test anxiety and academic performances in students. Materials ...Background and Aim: Given the dramatic decline in the ability of test due to test anxiety, the goal of this study was to evaluate the relationship between test anxiety and academic performances in students. Materials and Methods: This descriptive-analytical study was performed on 216 Iranian nursing and midwifery students in 2011-2012, utilizing Sarason Anxiety Inventory, demographic checklist and the average mark of students in the period of midterm and final exam. Multinomial logistic regression analyses by reporting odds ratios and their 95% confidence intervals were performed by SPSS17 software to assess the relationship between test anxiety and academic performances. Results: Mild, moderate and sever test anxiety was observed in 30.6, 43.1 and 26.4 percent of students respectively. Test anxiety was significantly related to academic performance (average), major and city. Also, there was 52.9% decrease for odds of having sever anxiety (compared to mild anxiety) with 1 point increase in average (OR = 0.471, 95% CI = (0.298 - 0.745) and p = 0.001). Conclusions: Due to inverse relationship between test anxiety and academic performance, performing preventive programs such as in time treatment of anxiety, empowering the students to deal with anxiety and conducting consulting services for how to studying are very important. Consequently it would be a big step in decreasing the test anxiety and therefore in improving the academic performance.展开更多
Background: The skills of midwives in childbirth care competence are still inadequate. This problem is influenced by limitation experience of midwifery students of childbirth care in the field of practice area. That c...Background: The skills of midwives in childbirth care competence are still inadequate. This problem is influenced by limitation experience of midwifery students of childbirth care in the field of practice area. That condition related to the proportion of midwifery students and case of childbirth woman was an imbalance. Midwifery students must prepare this competence in an education with childbirth care experience from practice in the laboratory and in the field of practice. Reflective learning is an appropriate learning method that uses experience as the basis of learning to improve childbirth care competence of midwifery students. Objective: This study is to analyze the effect of reflective learning implementation in childbirth care practice to improve students’ competence. Method: This research uses quasi-experimental design with non-equivalent control group design. The respondents were midwifery students in the fourth semester who had experienced the theory of childbirth care. There were totally 64 samples, 34 samples for treatment group and 30 samples for control group. Data were analyzed by using unpaired t test, Mann Whitney U and linear regression. Results: The respondents were homogeny in motivation and grade point of average (GPA). The improvement of childbirth care competency is influenced by treatment of 19.064 with R2 = 57.7%. Conclusion: The implementation of reflective learning in childbirth care practice affected the improvement of students’ competence.展开更多
BACKGROUND: Final comprehensive exam is the most important examination for midwifery students to evaluate their professional ability and Test anxiety is a common phenomenon among college students. Because test anxiety...BACKGROUND: Final comprehensive exam is the most important examination for midwifery students to evaluate their professional ability and Test anxiety is a common phenomenon among college students. Because test anxiety is one of the problems of educational systems, this study was performed to compare test anxiety in objective structured clinical examinations (OS-CEs) and traditional assessment methods (TAM) among Undergraduate Midwifery Students. Methods: In this descriptive-analytical study, 52 students of Babol Midwifery College were participated in the study. 20 students were evaluated using TAM in November 2010, and 32 students were evaluated using the OSCE method in July 2011. Data were collected via a two-component questionnaire including demographic data and the test anxiety inventory (TAI). Results: All of midwifery students were women;the mean age of students, ages of father and mother’s were 23.1 ± 0.7, 52.3 ± 3.5 and 47.8 ± 4.9 years, respectively. Most of the students were single (61.5%). The mean education levels of father and mother’s were 11.6 ± 4.5 and 9.9 ± 4.0 years, respectively. The mean score of test anxiety in students was 42.51 ± 13.16. The most of participants did have moderate test anxiety (56.9%), two present not had any test anxiety, 37.3% had low test anxiety, and 3.9% had severe test anxiety. In sum, 98% had some degrees of test anxiety. There were the statistical differences in the mean score of text anxiety in OSCEs Compared with TAM in Undergraduate Midwifery Students (39.38 ± 13.81 vs. 47.35 ± 10.67, P = 0.033). Also, the mean severity of anxiety was different in two groups. The mean of moderate/severe test anxiety was more in TAM compared with OSCEs (52.57% vs. 49.56%, p = 0.000). The test anxiety had a positive correlation with father’s education, mother’s education (0.286, p = 0.042), father’s age, mother’s age, marital status, residency (0.292, p = 0.042). Also, there are negative correlations with student age, satisfaction, total Grade Point Average (GPA) (-0.387, p = 0.007), final score, type of assessment (-0.298, p = 0.033). There is a significant difference between the severity anxiety residency in total (p = 0.10) and OSCEs (p = 0.049) groups, mother’s education in total (p = 0.005) and OSCEs groups (0.012) and GPA (p = 0.028). Conclusion: OSCEs were superior to TAM in the reduction of test anxiety in midwifery students. The prevalence of test anxiety was in TAM than OSCEs method;therefore, using OSCEs is acknowledged as an effective assessment tool and is seen as the gold standard for evaluating clinical performance.展开更多
Due to the chronic shortage of health personnel, nurses and midwives now play a fundamental role in the care and treatment of people living with HIV/ AIDS (PLHIV) in Cameroon. This study was therefore designed to asse...Due to the chronic shortage of health personnel, nurses and midwives now play a fundamental role in the care and treatment of people living with HIV/ AIDS (PLHIV) in Cameroon. This study was therefore designed to assess the level of knowledge, attitude and practice with regard to care of PLHIV among nursing and midwifery students in Fako division of Cameroon. A survey was performed between May and July 2015, among 227 nursing and midwifery students (in their second to final year of study), selected from 8 government accredited training institutions in Fako division of Cameroon. An anonymous self-administered semi-structured questionnaire was used to collect data. The Pearson’s chi-square test, univariate and multivariate logistic regression analyses adjusting for possible confounders were all performed as part of the statistical analyses. The cutoff of statistical significance was set at p ≤ 0.05. Nursing and midwifery students had a moderate level of HIV/AIDS knowledge (average score of 7.02 on a scale of 11). Attitude towards PLHIV was generally positive (68.7%) but there were some misconceptions and prejudice about PLHIV, with considerable stigmatization (31.3%), unwillingness to share a room with someone infected with HIV (27.7%), and unwillingness to work on PLHIV (23.8%). Good HIV/AIDS knowledge was observed to be the sole independent predictor (p = 0.004) of positive attitude towards PLHIV. Fur-thermore the confidence of the respondents regarding care of PLHIV was generally moderate. Our results suggest the need for the development of a more appropriate education program in nursing and midwifery institutions in Fako division to reduce the discrepancies between the general knowledge, attitude and practice regarding care of PLHIV.展开更多
Background: The Ministry of Health and Family Welfare of the Government of Bangladesh developed a midwifery education strategy in 2011 and starting in 2013, BRAC University developed a three-year Diploma in Midwifery....Background: The Ministry of Health and Family Welfare of the Government of Bangladesh developed a midwifery education strategy in 2011 and starting in 2013, BRAC University developed a three-year Diploma in Midwifery. A survey was developed to understand the challenges of the newly graduated midwives and to identify resource and educational needs. The survey feedback will help develop and strengthen curriculum for primary and postgraduate midwifery training. Methods: A 30-question survey was given to midwives at the Hope Hospital in Cox’s Bazar and at the birth centers in the surrounding rural communities. Questions explored the midwives’ clinical experience, patient problems in the prenatal, intrapartum, and postnatal period, and asked about what education;training and clinical resources were needed. Results: Thirty-two midwives answered the surveys. The midwives’ average time from graduation from the midwifery diploma program was sixteen months. All the respondents felt comfortable managing most maternal issues but felt further training was important. They also identified the lack of many clinical resources including blood products, medicines, vaccines, and ultrasound. They identified significant maternal health issues among their patients including adolescent pregnancy, malnutrition, anemia, sexual violence, pregnancy-induced hypertension, hemorrhage, low birth weight infants, prolonged and obstructed labors. Conclusion: Training and increasing the number of midwives are crucial strategies for reducing maternal and neonatal mortality. There is a significant need for long-term placement and commitment of midwives to rural areas in Bangladesh. Health systems and organizations employing midwives must be accountable for the continuing education, mentorship, and supportive needs of midwives.展开更多
Introduction: Midwifery is the art of caring for women during childbearing. It is practiced throughout the world according to the norms, traditions and cultural practices found in each country. Maternal mortality in N...Introduction: Midwifery is the art of caring for women during childbearing. It is practiced throughout the world according to the norms, traditions and cultural practices found in each country. Maternal mortality in Nigeria is high but there are wide variations between the geopolitical zones of the country. Government has established the midwives service scheme (MSS) as part of efforts towards reversing the country’s unacceptably high maternal mortality trends. To improve these indices, the MSS in Nigeria engaged newly graduated unemployed and retired midwives to work temporarily in rural areas. The midwives are posted for twelve months to selected primary care facilities linked through a cluster model in which four such facilities with the capacity to provide basic essential obstetric care are clustered around a secondary care facility with the capacity to provide comprehensive emergency obstetric care. This brief review is an attempt at exploring the impact of the midwives service scheme on maternal and neonatal indices in Nigeria. Main content: The outcome of the MSS four years has been an improvement though unevenly and marginally, in these indices in the various geopolitical zones of Nigeria. Improvements have been noticed in maternal indices such as antenatal care attendance, women receiving two doses of tetanus toxoid and number of deliveries by skilled personnel. Also reduction in maternal and neonatal mortality has been observed over the years following introduction of the scheme. Major challenges however, include lack of essential drugs, poor accommodation facilities for MSS staff, irregular payment of their remuneration and lack of water/power supply to some designated facilities for the scheme. Recommendations and conclusions: It is therefore recommended that 24 hours availability of essential drugs at primary healthcare centers be maintained. This should happen in conjunction with regular payment of full entitlements and benefits and provision of secured, habitable and good accommodation for MSS staff. Finally, aggressive community mobilization should continue in order to engender community involvement and participation for sustainable program development.展开更多
<strong>Background: </strong>Quality education is one of the important factors in empowering midwives to provide quality health care services to mothers and newborns irrespective of their practice settings...<strong>Background: </strong>Quality education is one of the important factors in empowering midwives to provide quality health care services to mothers and newborns irrespective of their practice settings. Due to lack of standardization of the duration, content, and structure of midwifery education and different pathways to midwifery across the world, midwives may lack the confidence to deliver quality health care services in the main domain of the ICM competences. <strong>Aim:</strong> To assess the confidence of final year midwifery students in the domain of new-born care based on the ICM midwifery competencies. <strong>Methods:</strong> The first phase consisted of a quick situation analysis of midwifery education and regulation in Zambia, followed by a cross-sectional survey through a self-administered questionnaire to assess the confidence of final year midwifery students. <strong>Results: </strong>Most (51.9%) of the respondents were aged between 18 and 28 years, and majority of them were placed in Levels 1, 2 and 3 Hospitals and also clinics for their clinical practice, with between one hundred to ten thousand annual births, followed by 16.9% who were placed in Level 3 hospitals only. Most students (38.3%) reported receiving classroom instruction by both Lecture and Demonstration. Few students (22.7%) responded that they were not satisfied with their clinical supervision, while 77.3% were satisfied. There was significant association between confidence to perform skills independently and having enough time to practice on models in the labs (p value = 0.024), confidence when practiced for the first time on mothers (p value = 0.007) and satisfaction with supervision during clinical practice (p value = 0.000). Binary logistic regression of characteristics associated with confidence to perform new-born skills independently revealed significant association between satisfaction with clinical supervision and confidence to perform skills independently, 95% CI [1.83, 15.37]. <strong>Conclusion: </strong>Midwifery students need quality training both theoretically and practically in order for them to gain confidence in newborn care upon completion of their training. They need adequate time to practice on models in the skills laboratory, and need adequate clinical supervision for them to gain confidence in performing new born skills independently.展开更多
Objective:This study aimed to explore the existing knowledge about midwives’views and experiences of providing care for women in the context of task shifting.Methods:We conducted a qualitative systematic review using...Objective:This study aimed to explore the existing knowledge about midwives’views and experiences of providing care for women in the context of task shifting.Methods:We conducted a qualitative systematic review using meta-ethnography to describe the views and experiences of midwives on providing care in the context of task shifting.Comparative textual analysis of published qualitative studies involved translation of first-order key concepts and meanings from included studies to generate second-and third-order concepts.A grid was made to identify core findings and compare them reciprocally.Results:Thirty-six qualitative studies met the inclusion criteria.The literature comprised of 32 first key concepts.Eight second-order constructs emerged,and three third-order interpretations were generated.The three overarching themes were:(1)midwives perceived themselves as providing culturally competent and high quality women-centered care;(2)they valued their profession but saw it as complex and challenging;(3)as health professionals,they reported a variety of organizational,cultural,and professional barriers to providing women-centered care.Conclusions:While performing a specific task in the task shifting context,midwives perceived their crucial roles and responsibilities,along with achieved value and reward.However,due to a range of existing barriers,the caring task posed great challenges in completely implementing women-centered care.It is essential for systems to identify and eliminate these barriers early,to consider midwives’emotional well-being,and to develop overall strategies to better support the midwifery workforce.Policy makers and administrators should establish a supportive environment to facilitate midwives to perform women-centered caring tasks in more effective and efficient ways.展开更多
Background: An Advanced Practice Nurse is a generalist or specialized nurse who has acquired thorough graduate education a minimum of a master’s degree. The need for Advanced Practice Nurses is increasingly recognize...Background: An Advanced Practice Nurse is a generalist or specialized nurse who has acquired thorough graduate education a minimum of a master’s degree. The need for Advanced Practice Nurses is increasingly recognized globally. This paper describes the process, which was undertaken by School of Nursing Sciences, University of Zambia in reviewing and developing advanced practice nursing and midwifery curricula which will be implemented using the Early and Enhanced Clinical Exposure model (EECE). Materials and Methods: The curricula development/review process utilized a modified Taba’s Model which followed a step-by-step approach including: 1) desk review, 2) diagnosis of needs (needs assessment), 3) stakeholder consultations, 4) content development, 5) validations and approval from which several lessons were learnt and recommendations made. Findings and recommendations from different stages were used as a basis for reviewing and developing advanced practice nursing and midwifery curricula. Results: Desk review needs assessment and stakeholder consultations identified both strengths and weaknesses in the existing curricula. Major strengths were duration and core courses which met the minimum requirement for postgraduate nursing and midwifery training. Major weaknesses/gaps included some content that was too basic for the master’s level and the delayed exposure to practicum sites which limited the development of advanced practice skills. Others were inadequate competence for advanced practice, inadequate research methodology course, lack of content to foster development of personal soft skills and predominant use of traditional teaching methods. Stakeholders recommended implementing advanced, clinical and hands-on Masters of Nursing and Midwifery programmes which resulted in the review of four existing and development of five demand-driven curricula. Conclusion: The reviewed and developed curricula were strengthened to close the identified gaps. Both the reviewed and developed curricula have been implemented using the Early and Enhanced Clinical Exposure Model with a view to producing Advanced Practice Nurses and Midwives who are competent to meet diverse health care needs and contribute to improving patient outcomes.展开更多
Objective:This paper mainly explores the application value of unprotected midwifery care for primipara natural childbirth.Methods:120 primiparas in our hospital from January 2017 to February 2019 were divided into rou...Objective:This paper mainly explores the application value of unprotected midwifery care for primipara natural childbirth.Methods:120 primiparas in our hospital from January 2017 to February 2019 were divided into routine group and Research Group,60 cases in each group.The routine group was given routine perineal protection midwifery,and the Research Group was given routine midwifery nursing.The nursing intervention effects of the two groups were compared statistically.Results:After statistics,VAS score and bleeding volume of perineal pain in the Research Group were lower than those in the conventional group,and the length of hospital stay in the Research Group was less than that in the conventional group,P<0.05;There was no significant difference in the time of the first stage of labor,the second stage of labor and the third stage of labor between the Research Group and the conventional group(P>0.05);The incidence of complications in the Research Group was lower than that in the conventional group(P<0.05).Conclusion:The application value of unprotected midwifery nursing intervention in primipara natural childbirth is significant.展开更多
Objective:To explore the role of midwifery care in the prevention of neonatal asphyxia.Method:The 100 cases of parturient received in our hospital from January 2018 to January 2021 were divided into two groups,respect...Objective:To explore the role of midwifery care in the prevention of neonatal asphyxia.Method:The 100 cases of parturient received in our hospital from January 2018 to January 2021 were divided into two groups,respectively,the control group and the experimental group with 50 cases in each group.The control group received routine care,and the experimental group received midwifery care.The psychological status of the mothers and the occurrence of neonatal asphyxia were compared between the two groups.Results:Before nursing,there was no significant difference in the mental state of the two groups of parturient(P>0.05).After the nursing,the mental state of the parturient in the experimental group was significantly better than that of the control group(P<0.05);After different ways of nursing,the incidence of asphyxia in neonates in the control group was significantly higher than that in the experimental group(P<0.05),and the comparison between the groups was statistically significant.Conclusion:The timely delivery of midwifery care for parturient can improve the mental state of the parturient and help reduce the incidence of neonatal asphyxia.It is worthy of clinical attention and promotion.展开更多
Objective:To conduct changes in sexual activity during pregnancy and its related factors in pregnant women.Methods:The present descriptive cross-sectional study was conducted in 2017 on pregnant women who referred to ...Objective:To conduct changes in sexual activity during pregnancy and its related factors in pregnant women.Methods:The present descriptive cross-sectional study was conducted in 2017 on pregnant women who referred to the women's clinic of Afzalipour Hospital in the southeast of Iran.Participants were included in the study through convenient sampling.The data collection tool was a researcher-made questionnaire consisting of two parts of personal social information of the couple and questions to measure the level of sexual activity and the attitude of the subjects during pregnancy compared to before pregnancy.Results:201 Pregnant women were included.The average age of pregnant women was(27.3±6.1)years and their average gestational age was(24.7±11.8)years.More than 62%of women had decreased sexual activity.There was a significant relationship between the amount of changes in sexual activity and delivery time(P=0.013),abortion history(P=0.001)and premature birth history(P=0.002).Most pregnant women believed that sex during pregnancy caused damage to the fetus(67.7%).A decrease in the intensity of sexual desire was reported in 63%of pregnant women.More than 60%of the subjects did not consult with doctors and midwives with regards to sexual issues(63.5%).The most common reason for not consulting was not feeling the need(32%).Most women experienced back pain during(42.8%)and after(39.8%)intercourse.Conclusions:Changes in sex life during pregnancy are often caused by the lack of sexual knowledge and the increase in misconceptions among couples,which can affect the quality of relationships.The role of education is essential.Therefore,it is suggested that by including sexual counseling along with pregnancy care,wrong beliefs and information among women will be corrected.展开更多
Objective To assess the level of participation of nurses and midwives in health-related research,determine the status of utilization of research to inform nursing and midwifery practice in Kenya,and explore perspectiv...Objective To assess the level of participation of nurses and midwives in health-related research,determine the status of utilization of research to inform nursing and midwifery practice in Kenya,and explore perspectives of nurses and midwives about strategies to empower nurses/midwives to engage in health research in Kenya.Methods Data were extracted from online survey responses of 156 nurse and midwife educators,practitioners,and managers/administrators.SPSS version 26 was used to analyze quantitative data;qualitative data were analyzed using Excel to organize data into categories.Results Over one-third of participants reported ever publishing research(37.2%,58/156).Participants reported using knowledge gained in nursing school to guide practice most frequently(n=148).Utilization of research findings to guide practice was reported by 80.3%(110/137)of participants.Strategies to enhance participation in the research included research training,research forums,policy reforms,and emphasis on research in curricula.Conclusions There is need to intensify and prioritize proposed strategies to empower nurses/midwives to engage in health research.展开更多
Background: Maternal-fetal transmission is the most frequent mode of hepatitis B virus (HBV) contamination in Africa. Prevention of mother-to-child transmission (PMTCT) of hepatitis B is still poorly understood, and t...Background: Maternal-fetal transmission is the most frequent mode of hepatitis B virus (HBV) contamination in Africa. Prevention of mother-to-child transmission (PMTCT) of hepatitis B is still poorly understood, and training of the health workers involved, such as midwives, is rare. Objective: The aim of this study was to assess the knowledge and practices of midwives prevention of HBV’ mother-to-child transmission (PMTCT) in Brazzaville. Patients and Methods: This was a cross-sectional analytical study conducted in Brazzaville from June 1 to July 31, 2023. Midwives present at the time of the survey in the various Brazzaville health centers visited and who agreed to answer the questionnaire during a face-to-face interview with the investigator were included. Univariate analyses were performed using epi info7.2 software. Pearson’s chi-square and Student’s t-tests were used to compare proportions and means, which were significant at the 0.05 level. Results: At the end of our study, 93 midwives out of 127 agreed to take part in the study, i.e. a participation rate of 73.2%. Their median age was of 41.7 years, a median professional experience of 13.7 years, and they worked mainly in primary health care facilities. Global knowledge of HBV PMTCT was satisfactory in 51 (54.3%) midwives. Knowledge of the HBV vaccine was significantly related to professional experience (p = 0.0167). PMTCT practice was poor in 48 (51.6%) cases. Overall, the practice of PMTCT was statistically associated with the midwives’ place of practice (p = 0.0262). Conclusion: Midwives had good knowledge but insufficient practice of PMTCT in Brazzaville. Training and awareness-raising are needed to reduce mother-to-child transmission of HBV.展开更多
This study examined the searching skills and extent of usage of electronic databases by Nursing, Midwifery and Public Health Nursing students in the University of Health and Allied Science (UHAS). The focus was on for...This study examined the searching skills and extent of usage of electronic databases by Nursing, Midwifery and Public Health Nursing students in the University of Health and Allied Science (UHAS). The focus was on forty (40) level 300 students drawn from a universe of two hundred and forty six (246) of the School of Public Health (SPH). The study used quantitative method approach and the survey instruments were questionnaire, interview and observation. The data collected were analyzed and classified into the following themes: usefulness, extent of use, determinants of use of e-databases, searching skills, and main drawbacks of learning information literacy skills (ILS). Although all the respondents strongly agreed that e-databases are indispensable for academic and professional practice, findings revealed that majority of them have low quality of searching skills and that accounts for the sparse use of the e-databases. This positive association is proven by Pearson’s chi square test (0.000). The study also established that students’ attitude, academic loads and methodology of teaching were the challenges hindering the acquisition of ILS of students. As a consequence, the study recommends that Academic librarians should intensify their education on e-databases, the development of research guides and encourages stronger collaboration with faculty members in the teaching of ILS so that student nurses would be more adept in searching for information to enhanced scholarship and professional practice.展开更多
文摘Introduction: Ultrasound is an essential component of antenatal care. Midwives provide most of the antenatal care but they do not perform ultrasound as it has been beyond their scope of practice. This leaves many women in Low and Middle-Income Countries without access to ultrasound scanning. The aim of this study was to identify competencies in ultrasound scanning in midwifery education. Methods: A desk review and needs assessment were conducted between July and October 2023. Articles and curricula on the internet, Google scholar and PubMed were searched for content on ultrasound scanning competencies. A Google form consisting of 20 questions was administered via email and WhatsApp to 135 participants. Descriptive statistics were used to analyse data. Results: The desk review showed that it is feasible to train midwives in ultrasound scanning. The training programs for midwives in obstetric ultrasound were conducted for 1 week to 3 months with most of them running for 4 weeks. Content included introduction to general principles of ultrasound, physics, basic knowledge in embryology, obstetrics, anatomy, measuring foetal biometry, estimating amniotic fluid and gestational age. Experts like sonographers trained midwives. Theory and hands on were the teaching methods used. Written and practical assessments were conducted. Needs assessment revealed that majority of participants 71 (53%) knew about basic ultrasound training for midwives. All participants (100%) said it is necessary to train midwives in basic ultrasound scan in Zambia. Some content should include, anatomy, measuring foetal biometry, assessing amniotic fluid level, and gestational age determination. Most participants 91 (67%) suggested that the appropriate duration of training is 4 - 6 weeks. Conclusion: Empowering every midwife with ultrasound scanning skills will enable early detection of any abnormality among pregnant women and prompt intervention to save lives.
文摘BACKGROUND There are many drawbacks to the traditional midwifery service management model,which can no longer meet the needs of the new era.The Internet+continuous midwifery service management model extends maternal management from prenatal to postpartum,in-hospital to out-of-hospital,and offline to online,thereby improving maternal and infant outcomes.Applying the Internet+continuous midwifery service management model to manage women with highrisk pregnancies(HRP)can improve their psycho-emotional opinion and,in turn,minimize the risk of adverse maternal and/or fetal outcomes.AIM To explore the effectiveness of a midwife-led Internet+continuous midwifery service model for women with HRP.METHODS We retrospectively analyzed the clinical data of 439 women with HRP who underwent prenatal examination and delivered at Shanghai Sixth People's Hospital(affiliated to the Shanghai Jiao Tong University School of Medicine)from April to December 2022.Among them,239 pregnant women underwent routine obstetric management,and 200 pregnant women underwent Internet+continuous midwifery service mode management.We used the State-Trait Anxiety Inventory,Edinburgh Postnatal Depression Scale,and analysis of delivery outcomes to compare psychological mood and the incidence of adverse delivery outcomes between the two groups.RESULTS The data showed that in early pregnancy,the anxiety and depression levels of the two groups were similar;the levels gradually decreased as pregnancy progressed,and the decrease in the continuous group was more significant[31.00(29.00,34.00)vs 34.00(32.00,37.00),8.00(6.00,9.00)vs 12.00(10.00,13.00),P<0.05].The maternal self-efficacy level and strategy for weight gain management were better in the continuous group than in the traditional group,and the effective rate of midwifery service intervention in the continuous group was significantly higher than in the control group[267.50(242.25,284.75)vs 256.00(233.00,278.00),74.00(69.00,78.00)vs 71.00(63.00,78.00),P<0.05].The incidence of adverse delivery outcomes in pregnant women and newborns and fear of maternal childbirth were lower in the continuous group than in the traditional group,and nursing satisfaction was higher[10.50%vs 18.83%,8.50%vs 15.90%,24.00%vs 42.68%,89.50%vs 76.15%,P<0.05].CONCLUSION The Internet+continuous midwifery service model promotes innovation through integration and is of great significance for improving and promoting maternal and child health in HRP.
文摘BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventions are necessary to improve maternal and fetal outcomes and alleviate primiparas’negative emotions(NEs).AIM To discusses the impact of nursing responsibility in midwifery and postural and psychological interventions on maternal and fetal outcomes as well as primiparas’NEs.METHODS As participants,115 primiparas admitted to Quanzhou Maternity and Child Healthcare Hospital between May 2020 and May 2022 were selected.Among them,56 primiparas(control group,Con)were subjected to conventional midwifery and routine nursing.The remaining 59(research group,Res)were subjected to the nursing model of midwifery and postural and psychological interventions.Both groups were comparatively analyzed from the perspectives of delivery mode(cesarean,natural,or forceps-assisted),maternal and fetal outcomes(uterine inertia,postpartum hemorrhage,placental abruption,neonatal pulmonary injury,and neonatal asphyxia),NEs(Hamilton Anxiety/Depressionrating Scale,HAMA/HAMD),labor duration,and nursing satisfaction.RESULTS The Res exhibited a markedly higher natural delivery rate and nursing satisfaction than the Con.Additionally,the Res indicated a lower incidence of adverse events(e.g.,uterine inertia,postpartum hemorrhage,placental abruption,neonatal lung injury,and neonatal asphyxia)and shortened duration of various stages of labor.It also showed statistically lower post-interventional HAMA and HAMD scores than the Con and pre-interventional values.CONCLUSION The nursing model of midwifery and postural and psychological interventions increase the natural delivery rate and reduce the duration of each labor stage.These are also conducive to improving maternal and fetal outcomes and mitigating primiparas’NEs and thus deserve popularity in clinical practice.
文摘Introduction: International migration has always existed, primarily as a means to find economic opportunity. Recently, the number of health care professionals seeking to work outside Albania is growing rapidly. In 2021 alone, 1073 nurses left Albania. The departure of health care professionals is reflected in education where it can be observed that a good part of the students who finished the bachelor’s level program did not enroll to continue the second level of study in the master’s. The student’s decision not to continue further levels of education has brought consequences from programs shutting down due to lack of students and forcing the university to spread out the few remaining students to other programs. Objective: The purpose of the study was to explore the opinions of Midwifery Students studying at the Bachelor level, regarding their professional future and continuing education. Methodology: This is a cross-sectional study. In this study are included the students of the bachelor level of education. Student participating are studying Midwifery in the 2022-2023 academic year, at the Faculty of Technical Medical Sciences at the University of Medicine, Albania. Results: The students on average believe they can find a job as a midwife. The career is relatively safe and the profession of midwifery will ensure economic well-being for them. Most of the students hope to emigrate and develop their professional career outside of Albania. This was a surprise given that most frequent answers given by the students for not continuing their Master’s level education was the fact that the program was not accredited, their Bachelor’s diploma was also not accredited and so not recognized by other countries, the cost of continuing their studies was too high and their desire for a better economic and social status which they cannot get in Albania. The majority of students participating in the study identified emigration as the main way they plan to further their studies. Conclusions and Recommendations: Although the students had willingly chosen to continue the midwifery diploma, as they thought it would provide them with a proper future, this dignified professional future was seen as unattainable in Albania so they are seeking it out in more developed countries. A significant number of health professionals prefer to continue their second cycle studies in another country. The professional security within their home country does not satisfy the students. As the market demand for nurses around the globe escalates, the changes and consequences associated with nurse migration are increasingly in need of policy solutions that will address the needs of all parties involved. .
文摘Background: Many countries across the world are facing an ongoing shortage of midwife practitioners due to several reasons such as increased workload, working overtime, poor-quality midwifery care, low staff morale, stress and burnout, lack of opportunity for training, lack of management support, financial issues and lack of recognition and compromised autonomy. Purpose: To explore the reasons behind nurses’ hesitance to apply for midwifery specialization. The objectives of this study were to understand the challenges that lie in front of Omani nurses and the motivational factors to apply for a midwifery programme. Method: Exploratory qualitative study was conducted at the largest tertiary hospital in Oman. Purposive sampling was applied for participant recruitment. Face-to-face interviews and focus group discussions were used as data collection methods. The study included general nurses, nurses in charge working in the maternity unit as well as nurses whose applications were accepted for midwifery education. Qualified midwives were excluded. The data collection process yielded twenty-five nurses. The interview protocol highlighted the impact and perception of the midwifery specialization on nurses’ careers. Thematic analysis was employed for data analysis. Results: Three over-arching major themes were identified. These are 1) nurses’ perceptions about the nature of work in maternity wards, the nurses have positive perception toward working in maternity wards and labor room because of working exclusively with female patients and their babies 2) factors influencing the decision to study midwifery specialization, work overload, stress, lack of support from administration were the most common reason behind the nurses not to apply for midwifery specialization and 3) support and recommendations required for midwives, the nurses mentioned that their identity, promotions and support from the administration will encourage them to apply for midwifery specialization. Conclusion: One of the main reasons that hindered nurses from applying to midwifery specialization is the false belief that midwives cannot work outside the delivery suite (DS). The second reason was the stress that midwives encounter at DS, and this was perceived by general nurses who did not work at DS. These challenges could be mitigated by leadership support, midwifery profession identity, as well as financial recognition for the midwives.
文摘Background and Aim: Given the dramatic decline in the ability of test due to test anxiety, the goal of this study was to evaluate the relationship between test anxiety and academic performances in students. Materials and Methods: This descriptive-analytical study was performed on 216 Iranian nursing and midwifery students in 2011-2012, utilizing Sarason Anxiety Inventory, demographic checklist and the average mark of students in the period of midterm and final exam. Multinomial logistic regression analyses by reporting odds ratios and their 95% confidence intervals were performed by SPSS17 software to assess the relationship between test anxiety and academic performances. Results: Mild, moderate and sever test anxiety was observed in 30.6, 43.1 and 26.4 percent of students respectively. Test anxiety was significantly related to academic performance (average), major and city. Also, there was 52.9% decrease for odds of having sever anxiety (compared to mild anxiety) with 1 point increase in average (OR = 0.471, 95% CI = (0.298 - 0.745) and p = 0.001). Conclusions: Due to inverse relationship between test anxiety and academic performance, performing preventive programs such as in time treatment of anxiety, empowering the students to deal with anxiety and conducting consulting services for how to studying are very important. Consequently it would be a big step in decreasing the test anxiety and therefore in improving the academic performance.
文摘Background: The skills of midwives in childbirth care competence are still inadequate. This problem is influenced by limitation experience of midwifery students of childbirth care in the field of practice area. That condition related to the proportion of midwifery students and case of childbirth woman was an imbalance. Midwifery students must prepare this competence in an education with childbirth care experience from practice in the laboratory and in the field of practice. Reflective learning is an appropriate learning method that uses experience as the basis of learning to improve childbirth care competence of midwifery students. Objective: This study is to analyze the effect of reflective learning implementation in childbirth care practice to improve students’ competence. Method: This research uses quasi-experimental design with non-equivalent control group design. The respondents were midwifery students in the fourth semester who had experienced the theory of childbirth care. There were totally 64 samples, 34 samples for treatment group and 30 samples for control group. Data were analyzed by using unpaired t test, Mann Whitney U and linear regression. Results: The respondents were homogeny in motivation and grade point of average (GPA). The improvement of childbirth care competency is influenced by treatment of 19.064 with R2 = 57.7%. Conclusion: The implementation of reflective learning in childbirth care practice affected the improvement of students’ competence.
文摘BACKGROUND: Final comprehensive exam is the most important examination for midwifery students to evaluate their professional ability and Test anxiety is a common phenomenon among college students. Because test anxiety is one of the problems of educational systems, this study was performed to compare test anxiety in objective structured clinical examinations (OS-CEs) and traditional assessment methods (TAM) among Undergraduate Midwifery Students. Methods: In this descriptive-analytical study, 52 students of Babol Midwifery College were participated in the study. 20 students were evaluated using TAM in November 2010, and 32 students were evaluated using the OSCE method in July 2011. Data were collected via a two-component questionnaire including demographic data and the test anxiety inventory (TAI). Results: All of midwifery students were women;the mean age of students, ages of father and mother’s were 23.1 ± 0.7, 52.3 ± 3.5 and 47.8 ± 4.9 years, respectively. Most of the students were single (61.5%). The mean education levels of father and mother’s were 11.6 ± 4.5 and 9.9 ± 4.0 years, respectively. The mean score of test anxiety in students was 42.51 ± 13.16. The most of participants did have moderate test anxiety (56.9%), two present not had any test anxiety, 37.3% had low test anxiety, and 3.9% had severe test anxiety. In sum, 98% had some degrees of test anxiety. There were the statistical differences in the mean score of text anxiety in OSCEs Compared with TAM in Undergraduate Midwifery Students (39.38 ± 13.81 vs. 47.35 ± 10.67, P = 0.033). Also, the mean severity of anxiety was different in two groups. The mean of moderate/severe test anxiety was more in TAM compared with OSCEs (52.57% vs. 49.56%, p = 0.000). The test anxiety had a positive correlation with father’s education, mother’s education (0.286, p = 0.042), father’s age, mother’s age, marital status, residency (0.292, p = 0.042). Also, there are negative correlations with student age, satisfaction, total Grade Point Average (GPA) (-0.387, p = 0.007), final score, type of assessment (-0.298, p = 0.033). There is a significant difference between the severity anxiety residency in total (p = 0.10) and OSCEs (p = 0.049) groups, mother’s education in total (p = 0.005) and OSCEs groups (0.012) and GPA (p = 0.028). Conclusion: OSCEs were superior to TAM in the reduction of test anxiety in midwifery students. The prevalence of test anxiety was in TAM than OSCEs method;therefore, using OSCEs is acknowledged as an effective assessment tool and is seen as the gold standard for evaluating clinical performance.
文摘Due to the chronic shortage of health personnel, nurses and midwives now play a fundamental role in the care and treatment of people living with HIV/ AIDS (PLHIV) in Cameroon. This study was therefore designed to assess the level of knowledge, attitude and practice with regard to care of PLHIV among nursing and midwifery students in Fako division of Cameroon. A survey was performed between May and July 2015, among 227 nursing and midwifery students (in their second to final year of study), selected from 8 government accredited training institutions in Fako division of Cameroon. An anonymous self-administered semi-structured questionnaire was used to collect data. The Pearson’s chi-square test, univariate and multivariate logistic regression analyses adjusting for possible confounders were all performed as part of the statistical analyses. The cutoff of statistical significance was set at p ≤ 0.05. Nursing and midwifery students had a moderate level of HIV/AIDS knowledge (average score of 7.02 on a scale of 11). Attitude towards PLHIV was generally positive (68.7%) but there were some misconceptions and prejudice about PLHIV, with considerable stigmatization (31.3%), unwillingness to share a room with someone infected with HIV (27.7%), and unwillingness to work on PLHIV (23.8%). Good HIV/AIDS knowledge was observed to be the sole independent predictor (p = 0.004) of positive attitude towards PLHIV. Fur-thermore the confidence of the respondents regarding care of PLHIV was generally moderate. Our results suggest the need for the development of a more appropriate education program in nursing and midwifery institutions in Fako division to reduce the discrepancies between the general knowledge, attitude and practice regarding care of PLHIV.
文摘Background: The Ministry of Health and Family Welfare of the Government of Bangladesh developed a midwifery education strategy in 2011 and starting in 2013, BRAC University developed a three-year Diploma in Midwifery. A survey was developed to understand the challenges of the newly graduated midwives and to identify resource and educational needs. The survey feedback will help develop and strengthen curriculum for primary and postgraduate midwifery training. Methods: A 30-question survey was given to midwives at the Hope Hospital in Cox’s Bazar and at the birth centers in the surrounding rural communities. Questions explored the midwives’ clinical experience, patient problems in the prenatal, intrapartum, and postnatal period, and asked about what education;training and clinical resources were needed. Results: Thirty-two midwives answered the surveys. The midwives’ average time from graduation from the midwifery diploma program was sixteen months. All the respondents felt comfortable managing most maternal issues but felt further training was important. They also identified the lack of many clinical resources including blood products, medicines, vaccines, and ultrasound. They identified significant maternal health issues among their patients including adolescent pregnancy, malnutrition, anemia, sexual violence, pregnancy-induced hypertension, hemorrhage, low birth weight infants, prolonged and obstructed labors. Conclusion: Training and increasing the number of midwives are crucial strategies for reducing maternal and neonatal mortality. There is a significant need for long-term placement and commitment of midwives to rural areas in Bangladesh. Health systems and organizations employing midwives must be accountable for the continuing education, mentorship, and supportive needs of midwives.
文摘Introduction: Midwifery is the art of caring for women during childbearing. It is practiced throughout the world according to the norms, traditions and cultural practices found in each country. Maternal mortality in Nigeria is high but there are wide variations between the geopolitical zones of the country. Government has established the midwives service scheme (MSS) as part of efforts towards reversing the country’s unacceptably high maternal mortality trends. To improve these indices, the MSS in Nigeria engaged newly graduated unemployed and retired midwives to work temporarily in rural areas. The midwives are posted for twelve months to selected primary care facilities linked through a cluster model in which four such facilities with the capacity to provide basic essential obstetric care are clustered around a secondary care facility with the capacity to provide comprehensive emergency obstetric care. This brief review is an attempt at exploring the impact of the midwives service scheme on maternal and neonatal indices in Nigeria. Main content: The outcome of the MSS four years has been an improvement though unevenly and marginally, in these indices in the various geopolitical zones of Nigeria. Improvements have been noticed in maternal indices such as antenatal care attendance, women receiving two doses of tetanus toxoid and number of deliveries by skilled personnel. Also reduction in maternal and neonatal mortality has been observed over the years following introduction of the scheme. Major challenges however, include lack of essential drugs, poor accommodation facilities for MSS staff, irregular payment of their remuneration and lack of water/power supply to some designated facilities for the scheme. Recommendations and conclusions: It is therefore recommended that 24 hours availability of essential drugs at primary healthcare centers be maintained. This should happen in conjunction with regular payment of full entitlements and benefits and provision of secured, habitable and good accommodation for MSS staff. Finally, aggressive community mobilization should continue in order to engender community involvement and participation for sustainable program development.
文摘<strong>Background: </strong>Quality education is one of the important factors in empowering midwives to provide quality health care services to mothers and newborns irrespective of their practice settings. Due to lack of standardization of the duration, content, and structure of midwifery education and different pathways to midwifery across the world, midwives may lack the confidence to deliver quality health care services in the main domain of the ICM competences. <strong>Aim:</strong> To assess the confidence of final year midwifery students in the domain of new-born care based on the ICM midwifery competencies. <strong>Methods:</strong> The first phase consisted of a quick situation analysis of midwifery education and regulation in Zambia, followed by a cross-sectional survey through a self-administered questionnaire to assess the confidence of final year midwifery students. <strong>Results: </strong>Most (51.9%) of the respondents were aged between 18 and 28 years, and majority of them were placed in Levels 1, 2 and 3 Hospitals and also clinics for their clinical practice, with between one hundred to ten thousand annual births, followed by 16.9% who were placed in Level 3 hospitals only. Most students (38.3%) reported receiving classroom instruction by both Lecture and Demonstration. Few students (22.7%) responded that they were not satisfied with their clinical supervision, while 77.3% were satisfied. There was significant association between confidence to perform skills independently and having enough time to practice on models in the labs (p value = 0.024), confidence when practiced for the first time on mothers (p value = 0.007) and satisfaction with supervision during clinical practice (p value = 0.000). Binary logistic regression of characteristics associated with confidence to perform new-born skills independently revealed significant association between satisfaction with clinical supervision and confidence to perform skills independently, 95% CI [1.83, 15.37]. <strong>Conclusion: </strong>Midwifery students need quality training both theoretically and practically in order for them to gain confidence in newborn care upon completion of their training. They need adequate time to practice on models in the skills laboratory, and need adequate clinical supervision for them to gain confidence in performing new born skills independently.
基金The study was funded by the National Natural Science Foundation of China(Grant No.71874030).
文摘Objective:This study aimed to explore the existing knowledge about midwives’views and experiences of providing care for women in the context of task shifting.Methods:We conducted a qualitative systematic review using meta-ethnography to describe the views and experiences of midwives on providing care in the context of task shifting.Comparative textual analysis of published qualitative studies involved translation of first-order key concepts and meanings from included studies to generate second-and third-order concepts.A grid was made to identify core findings and compare them reciprocally.Results:Thirty-six qualitative studies met the inclusion criteria.The literature comprised of 32 first key concepts.Eight second-order constructs emerged,and three third-order interpretations were generated.The three overarching themes were:(1)midwives perceived themselves as providing culturally competent and high quality women-centered care;(2)they valued their profession but saw it as complex and challenging;(3)as health professionals,they reported a variety of organizational,cultural,and professional barriers to providing women-centered care.Conclusions:While performing a specific task in the task shifting context,midwives perceived their crucial roles and responsibilities,along with achieved value and reward.However,due to a range of existing barriers,the caring task posed great challenges in completely implementing women-centered care.It is essential for systems to identify and eliminate these barriers early,to consider midwives’emotional well-being,and to develop overall strategies to better support the midwifery workforce.Policy makers and administrators should establish a supportive environment to facilitate midwives to perform women-centered caring tasks in more effective and efficient ways.
文摘Background: An Advanced Practice Nurse is a generalist or specialized nurse who has acquired thorough graduate education a minimum of a master’s degree. The need for Advanced Practice Nurses is increasingly recognized globally. This paper describes the process, which was undertaken by School of Nursing Sciences, University of Zambia in reviewing and developing advanced practice nursing and midwifery curricula which will be implemented using the Early and Enhanced Clinical Exposure model (EECE). Materials and Methods: The curricula development/review process utilized a modified Taba’s Model which followed a step-by-step approach including: 1) desk review, 2) diagnosis of needs (needs assessment), 3) stakeholder consultations, 4) content development, 5) validations and approval from which several lessons were learnt and recommendations made. Findings and recommendations from different stages were used as a basis for reviewing and developing advanced practice nursing and midwifery curricula. Results: Desk review needs assessment and stakeholder consultations identified both strengths and weaknesses in the existing curricula. Major strengths were duration and core courses which met the minimum requirement for postgraduate nursing and midwifery training. Major weaknesses/gaps included some content that was too basic for the master’s level and the delayed exposure to practicum sites which limited the development of advanced practice skills. Others were inadequate competence for advanced practice, inadequate research methodology course, lack of content to foster development of personal soft skills and predominant use of traditional teaching methods. Stakeholders recommended implementing advanced, clinical and hands-on Masters of Nursing and Midwifery programmes which resulted in the review of four existing and development of five demand-driven curricula. Conclusion: The reviewed and developed curricula were strengthened to close the identified gaps. Both the reviewed and developed curricula have been implemented using the Early and Enhanced Clinical Exposure Model with a view to producing Advanced Practice Nurses and Midwives who are competent to meet diverse health care needs and contribute to improving patient outcomes.
文摘Objective:This paper mainly explores the application value of unprotected midwifery care for primipara natural childbirth.Methods:120 primiparas in our hospital from January 2017 to February 2019 were divided into routine group and Research Group,60 cases in each group.The routine group was given routine perineal protection midwifery,and the Research Group was given routine midwifery nursing.The nursing intervention effects of the two groups were compared statistically.Results:After statistics,VAS score and bleeding volume of perineal pain in the Research Group were lower than those in the conventional group,and the length of hospital stay in the Research Group was less than that in the conventional group,P<0.05;There was no significant difference in the time of the first stage of labor,the second stage of labor and the third stage of labor between the Research Group and the conventional group(P>0.05);The incidence of complications in the Research Group was lower than that in the conventional group(P<0.05).Conclusion:The application value of unprotected midwifery nursing intervention in primipara natural childbirth is significant.
文摘Objective:To explore the role of midwifery care in the prevention of neonatal asphyxia.Method:The 100 cases of parturient received in our hospital from January 2018 to January 2021 were divided into two groups,respectively,the control group and the experimental group with 50 cases in each group.The control group received routine care,and the experimental group received midwifery care.The psychological status of the mothers and the occurrence of neonatal asphyxia were compared between the two groups.Results:Before nursing,there was no significant difference in the mental state of the two groups of parturient(P>0.05).After the nursing,the mental state of the parturient in the experimental group was significantly better than that of the control group(P<0.05);After different ways of nursing,the incidence of asphyxia in neonates in the control group was significantly higher than that in the experimental group(P<0.05),and the comparison between the groups was statistically significant.Conclusion:The timely delivery of midwifery care for parturient can improve the mental state of the parturient and help reduce the incidence of neonatal asphyxia.It is worthy of clinical attention and promotion.
文摘Objective:To conduct changes in sexual activity during pregnancy and its related factors in pregnant women.Methods:The present descriptive cross-sectional study was conducted in 2017 on pregnant women who referred to the women's clinic of Afzalipour Hospital in the southeast of Iran.Participants were included in the study through convenient sampling.The data collection tool was a researcher-made questionnaire consisting of two parts of personal social information of the couple and questions to measure the level of sexual activity and the attitude of the subjects during pregnancy compared to before pregnancy.Results:201 Pregnant women were included.The average age of pregnant women was(27.3±6.1)years and their average gestational age was(24.7±11.8)years.More than 62%of women had decreased sexual activity.There was a significant relationship between the amount of changes in sexual activity and delivery time(P=0.013),abortion history(P=0.001)and premature birth history(P=0.002).Most pregnant women believed that sex during pregnancy caused damage to the fetus(67.7%).A decrease in the intensity of sexual desire was reported in 63%of pregnant women.More than 60%of the subjects did not consult with doctors and midwives with regards to sexual issues(63.5%).The most common reason for not consulting was not feeling the need(32%).Most women experienced back pain during(42.8%)and after(39.8%)intercourse.Conclusions:Changes in sex life during pregnancy are often caused by the lack of sexual knowledge and the increase in misconceptions among couples,which can affect the quality of relationships.The role of education is essential.Therefore,it is suggested that by including sexual counseling along with pregnancy care,wrong beliefs and information among women will be corrected.
文摘Objective To assess the level of participation of nurses and midwives in health-related research,determine the status of utilization of research to inform nursing and midwifery practice in Kenya,and explore perspectives of nurses and midwives about strategies to empower nurses/midwives to engage in health research in Kenya.Methods Data were extracted from online survey responses of 156 nurse and midwife educators,practitioners,and managers/administrators.SPSS version 26 was used to analyze quantitative data;qualitative data were analyzed using Excel to organize data into categories.Results Over one-third of participants reported ever publishing research(37.2%,58/156).Participants reported using knowledge gained in nursing school to guide practice most frequently(n=148).Utilization of research findings to guide practice was reported by 80.3%(110/137)of participants.Strategies to enhance participation in the research included research training,research forums,policy reforms,and emphasis on research in curricula.Conclusions There is need to intensify and prioritize proposed strategies to empower nurses/midwives to engage in health research.
文摘Background: Maternal-fetal transmission is the most frequent mode of hepatitis B virus (HBV) contamination in Africa. Prevention of mother-to-child transmission (PMTCT) of hepatitis B is still poorly understood, and training of the health workers involved, such as midwives, is rare. Objective: The aim of this study was to assess the knowledge and practices of midwives prevention of HBV’ mother-to-child transmission (PMTCT) in Brazzaville. Patients and Methods: This was a cross-sectional analytical study conducted in Brazzaville from June 1 to July 31, 2023. Midwives present at the time of the survey in the various Brazzaville health centers visited and who agreed to answer the questionnaire during a face-to-face interview with the investigator were included. Univariate analyses were performed using epi info7.2 software. Pearson’s chi-square and Student’s t-tests were used to compare proportions and means, which were significant at the 0.05 level. Results: At the end of our study, 93 midwives out of 127 agreed to take part in the study, i.e. a participation rate of 73.2%. Their median age was of 41.7 years, a median professional experience of 13.7 years, and they worked mainly in primary health care facilities. Global knowledge of HBV PMTCT was satisfactory in 51 (54.3%) midwives. Knowledge of the HBV vaccine was significantly related to professional experience (p = 0.0167). PMTCT practice was poor in 48 (51.6%) cases. Overall, the practice of PMTCT was statistically associated with the midwives’ place of practice (p = 0.0262). Conclusion: Midwives had good knowledge but insufficient practice of PMTCT in Brazzaville. Training and awareness-raising are needed to reduce mother-to-child transmission of HBV.
文摘This study examined the searching skills and extent of usage of electronic databases by Nursing, Midwifery and Public Health Nursing students in the University of Health and Allied Science (UHAS). The focus was on forty (40) level 300 students drawn from a universe of two hundred and forty six (246) of the School of Public Health (SPH). The study used quantitative method approach and the survey instruments were questionnaire, interview and observation. The data collected were analyzed and classified into the following themes: usefulness, extent of use, determinants of use of e-databases, searching skills, and main drawbacks of learning information literacy skills (ILS). Although all the respondents strongly agreed that e-databases are indispensable for academic and professional practice, findings revealed that majority of them have low quality of searching skills and that accounts for the sparse use of the e-databases. This positive association is proven by Pearson’s chi square test (0.000). The study also established that students’ attitude, academic loads and methodology of teaching were the challenges hindering the acquisition of ILS of students. As a consequence, the study recommends that Academic librarians should intensify their education on e-databases, the development of research guides and encourages stronger collaboration with faculty members in the teaching of ILS so that student nurses would be more adept in searching for information to enhanced scholarship and professional practice.