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1.
BMJ Sex Reprod Health ; 48(2): 85-92, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1784851

ABSTRACT

BACKGROUND: Immediate postpartum intrauterine device (PPIUD) insertion is safe and effective but largely unavailable in Europe. Data on maternity staff views on the provision and implementation of PPIUD services are limited. The objective of this qualitative evaluation was to explore the views and experiences of obstetricians and midwives providing PPIUD within a UK maternity setting, in order to identify areas for improvement and inform service provision in other areas. METHODS: Qualitative health services research within two public maternity hospitals in Lothian (Edinburgh and surrounding region), UK. Interviews with 30 maternity staff (obstetricians n=8; midwives n=22) involved in PPIUD provision. Data were analysed thematically. RESULTS: Maternity staff were positive about the benefits of PPIUD for women. Midwives reported initial concerns about PPIUD safety, and the impact on workload; these views shifted following training, and as PPIUD was embedded into practice. Having a large pool of PPIUD-trained staff was identified as an important factor in successful service implementation. Having PPIUD 'champions' was important to address staff concerns, encourage training uptake, and advocate for the service to ensure continued resourcing. CONCLUSIONS: PPIUD in maternity services can help address unmet need for effective contraception in the immediate postpartum period. We emphasise the importance of widespread engagement around PPIUD among all healthcare professionals involved in the care of women, to ensure staff are informed and supported. Clinical champions and leaders play a key role in amplifying the benefits of PPIUD, and advancing organisational learning.


Subject(s)
Intrauterine Devices , Midwifery , Contraception , Family Planning Services , Female , Humans , Postpartum Period , Pregnancy
2.
BMC Pregnancy Childbirth ; 22(1): 309, 2022 Apr 11.
Article in English | MEDLINE | ID: covidwho-1785146

ABSTRACT

BACKGROUND: There are major shortfalls in the midwifery workforce which has been exacerbated by the COVID 19 pandemic. Midwives have high levels of burnout and many, often early career midwives, are planning to leave the profession. There are reports of a poor workplace culture in maternity units, including bullying. Support is essential for the welfare of the workforce to be able to cope with the demands of their jobs. Supportive strategies, such as Clinical Supervision, a recognised approach in healthcare, enable reflection in a facilitated, structured way, and can enhance professional standards. The purpose of this research is to study burnout levels in midwives, those exiting their workplace and perceptions of workplace culture in relation to access to, and attendance of, monthly Clinical Supervision. METHODS: This study will be a cluster randomised controlled trial of maternity sites within Sydney and the surrounding districts. Twelve sites will be recruited and half will receive monthly Clinical Supervision for up to two years. Midwives from all sites will be requested to complete 6-monthly surveys comprising validated measurement tools: the Copenhagen Burnout Inventory (CBI), the Australian Midwifery Workplace Culture (AMWoC) tool and the Clinical Supervision Evaluation Questionnaire (CSEQ) (the latter for intervention sites only). Primary outcomes are the levels of burnout in midwives (using the CBI). Secondary outcomes will be the quality of the intervention (using the CSEQ), perceptions of workplace culture (using the AMWoC tool) and midwives' intention to stay in their role/profession, as well as sick leave rates and numbers of exiting staff. We will also determine the dose effect - ie the impact in relation to how many Clinical Supervision sessions the midwives have attended, as well as other supportive workplace strategies such as mentoring/coaching on outcomes. DISCUSSION: Through attending monthly Clinical Supervision we hypothesise that midwives will report less burnout and more positive perceptions of workplace culture than those in the control sites. The potential implications of which are a productive workforce giving high quality care with the flow-on effect of having physically and psychologically well women and their babies. TRIAL REGISTRATION: The ACTRN Registration number is ACTRN12621000545864p , dated 10/05/2021,.


Subject(s)
Burnout, Professional , COVID-19 , Midwifery , Nurse Midwives , Australia , Burnout, Professional/prevention & control , Female , Humans , Preceptorship , Pregnancy
3.
S Afr Fam Pract (2004) ; 64(1): e1-e12, 2022 Mar 30.
Article in English | MEDLINE | ID: covidwho-1780149

ABSTRACT

BACKGROUND:  Many health systems were poorly prepared for the coronavirus disease 2019 (COVID-19) pandemic and found it difficult to protect maternity and reproductive health services. The aim of the study was to explore the influence of the COVID-19 pandemic on the ability of maternity healthcare providers to maintain the positive practices introduced by the CLEVER Maternity Care programme and to elicit information on their support needs. METHODS:  This multimethod study was conducted in midwife-led obstetric units (MOUs) and district hospitals in Tshwane District, South Africa and included a survey questionnaire and qualitative reports and reflections by the CLEVER implementation team. Two five-point Likert-scale items were supplemented by open-ended questions to provide suggestions on improving health systems and supporting healthcare workers. RESULTS:  Most of the 114 respondents were advanced midwives or registered nurses (86%). Participants from MOUs rated the maintenance of quality care practices significantly higher than those from district hospitals (p = 0.0130). There was a significant difference in perceptions of support from the district management between designations (p = 0.0037), with managers having the most positive perception compared with advanced midwives (p = 0.0018) and registered nurses (p = 0.0115). The interpretation framework had three main themes: working environment and health-system readiness; quality of patient care and service provision; and healthcare workers' response to the pandemic. Health-facility readiness is described as proactive, reactive or lagging. CONCLUSION:  Lessons learned from this pandemic should be used to build responsive health systems that will enable primary healthcare workers to maintain quality patient care, services and communication.


Subject(s)
COVID-19 , Maternal Health Services , Midwifery , COVID-19/epidemiology , COVID-19/prevention & control , Female , Humans , Pandemics/prevention & control , Pregnancy , Quality Improvement
4.
Prof Inferm ; 74(3): 235-240, 2021.
Article in Italian | MEDLINE | ID: covidwho-1776576

ABSTRACT

The COVID-19 pandemic had a great impact on pre and post-natal care, and, more generally, on the female population. Health services have been characterized by significant changes that have involved a review and reorganization of care pathways and clinical practices. The midwife continued to play a key role for the health of women and children, for the continuity of care and for a health-oriented approach throughout their life. The experience of the Pre and Post Natal Care of the Autonomous Province of Trento ensured the continuity of care during the pandemic thanks to the activation of a well-established Hospital-Territory network. The dedicated Case Manager Midwife allowed continuity and appropriateness of care during all phases of the birth pathway. The possibility of having the first interview electronically led to a continuous annual increase in the first interviews. In addition, for all women in the third trimester of pregnancy, the antenatal classes are organized remotely, using simple IT supports, in videoconferencing mode, maintaining homogeneous contents and objectives throughout the territory. The involvement of fathers from the early stages of pregnancy has shown the value of co-parenting even during the pandemic. This organizational model rooted in the territory and in the network of connection between the Territory and the Hospital proved to be a resource to withstand the impact of the emergency and guaranteed appropriate and timely assistance to women, fathers and the family.


Subject(s)
COVID-19 , Midwifery , Child , Female , Humans , Models, Organizational , Pandemics , Pregnancy
5.
BMJ Open ; 12(4): e057292, 2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-1774966

ABSTRACT

OBJECTIVES: Our primary and secondary objectives were to measure and understand the determinants of independent midwives' implementation of teleconsultations and their intention to continue these in the future. DESIGN: A two-phase mixed-methods approach: (1) quantitative data to measure factors determining the initiation and continuation of teleconsultation, collected by an online survey from 29 April to 15 May 2020, at the end of the first COVID-19 lockdown, followed by (2) qualitative data to understand these determinants, by interviewing some participants in May-July 2020 to explore the quantitative findings in more detail. SETTING: Mainland France PARTICIPANTS: The target population comprised independent midwives currently practising in France. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary and secondary outcomes were binary variables: implementation of teleconsultations, and intention to continue them. The qualitative results provided the themes explaining these decisions. RESULTS: We obtained 1491 complete responses from independent midwives, that is, 28.3% of French independent midwives, and interviewed 22 volunteers among them. Among the 1491, 88.5% implemented teleconsultations and 65.8% intended to continue them. Both individual and organisational factors favoured implementation of teleconsultations: older age (adjusted OR (aOR): 0.40, 95% CI: 0.28 to 0.58), female gender (aOR: 6.88, 95% CI: 2.71 to 17.48), married or living with a partner (aOR: 1.67, 95% CI: 1.10 to 2.52) and working in a group practice (midwives only-aOR: 2.34, 95% CI: 1.47 to 3.72; multiprofessional group-aOR: 1.75, 95% CI: 1.16 to 2.64). The qualitative analysis did not identify any new factors but helped us to understand the satisfaction better: midwives adopted telemedicine for their patients' access to and continuity of care, to maintain their professional activity and income, and to limit the risks of infection. CONCLUSION: Personal and organisational factors motivated the implementation of teleconsultation during the pandemic, but maintaining it raises technical, regulatory, and ethical issues.


Subject(s)
COVID-19 , Midwifery , Remote Consultation , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control , Female , Humans , Midwifery/methods , Pregnancy , Surveys and Questionnaires
6.
BMC Health Serv Res ; 21(1): 1364, 2021 Dec 27.
Article in English | MEDLINE | ID: covidwho-1759744

ABSTRACT

In the spring of 2020, the SARS-CoV-2 virus caused the Covid-19 pandemic, bringing with it drastic changes and challenges for health systems and medical staff. Among the affected were obstetricians and midwives, whose close physical contact with pregnant women, women who recently gave birth, and their children was indispensable. In the obstetric setting, births cannot be postponed, and maternity staff had to adapt to assure obstetric safety while balancing evidence-based standards with the new challenges posed by the pandemic. This scoping review gives a comprehensive overview of the effecs the Covid-19 pandemic had on maternity staff. We followed the evidence-based approach described by Arksey & O'Malley: we searched several databases for English and German articles published between January 2020 and January 2021 that discussed or touched upon the effects the pandemic had on maternity staff in OECD countries and China. We found that structural challenges caused by the crisis and its subjective effects on maternity staff fell into two main topic areas. Structural challenges (the first main topic) were divided into five subtopics: staff shortages and restructuring; personal protective equipment and tests; switching to virtual communication; handling women with a positive SARS-CoV-2 infection; and excluding accompanying persons. The pandemic also strongly affected the staff's mental health (the second main topic.) Attempting to meet challenges posed by the pandemic while afraid of contamination, suffering overwork and exhaustion, and struggling to resolve ethical-moral dilemmas had severe negative subjective effects. Several studies indicated increased depression, anxiety, stress levels, and risk of post-traumatic stress symptoms, although the crisis also generated strong occupational solidarity. Care for pregnant, birthing, and breast-feeding women cannot be interrupted, even during a pandemic crisis that requires social distancing. Maternity staff sometimes had to abandon normal standards of obstetric care and were confronted with enormous challenges and structural adjustments that did not leave them unscathed: their mental health suffered considerably. Researchers should study maternity staff's experiences during the pandemic to prepare recommendations that will protect staff during future epidemics.


Subject(s)
COVID-19 , Midwifery , Child , Female , Humans , Pandemics/prevention & control , Parturition , Pregnancy , SARS-CoV-2
7.
J Nurs Res ; 30(2): e203, 2022 Mar 02.
Article in English | MEDLINE | ID: covidwho-1722673

ABSTRACT

BACKGROUND: During the ongoing COVID-19 pandemic period, most university courses in Turkey have been taught via distance education. Beyond knowledge of digital technologies, self-efficacy is known to affect the learning motivation and learning goals of students. PURPOSE: This study was conducted to determine the relationship between eHealth literacy and self-efficacy levels in midwifery students receiving distance education during the current COVID-19 pandemic. The research data were collected using a literature-based questionnaire developed by the researchers, the eHealth Literacy Scale for Adolescents, and the Online Technologies Self-Efficacy Scale. The data were analyzed using IBM SPSS Statistics 25.0, with values of p < .05 considered to be significant. METHODS: This cross-sectional study was carried out during the COVID-19 pandemic on a sample of 578 female midwifery students. Snowball sampling method was used for data collection using an online questionnaire. RESULTS: On the basis of the results, eHealth literacy and self-efficacy levels were relatively low in students who were 20 years old or below, who were in their first year, who were from low-income families, who spent less than an hour a day on the Internet, who had a low level of satisfaction with distance education, and who wanted to continue taking theoretical courses via distance education. In addition, self-efficacy related to online technologies was shown to be relatively low in students who found Internet services to be expensive, who had Internet connection problems, and who preferred asynchronous courses. Furthermore, a significant relationship was found between eHealth literacy and self-efficacy levels for online education. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: In the context of distance education, integrating the teaching/promotion of self-efficacy with regard to eHealth literacy and online technologies into midwifery education curriculum should better enable midwives to increase the quality of healthcare they provide and improve patient safety.


Subject(s)
COVID-19 , Education, Distance , Health Literacy , Midwifery , Telemedicine , Adolescent , Adult , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Internet , Pandemics , Pregnancy , Self Efficacy , Students , Surveys and Questionnaires , Young Adult
8.
Nurse Educ Pract ; 60: 103318, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1720664

ABSTRACT

AIM: To evaluate new practice assessment processes in midwifery placements linked to a United Kingdom university during COVID-19. BACKGROUND: The new regulatory body standards for supervising and assessing practice of student nurses and midwives replaced the former mentorship model. Locally, these were implemented in conjunction with the Practice Assessment Toolkit - a resource developed from the national project exploring grading in midwifery practice. Emergency regulatory standards in response to the global pandemic impacted on student placements and temporarily created greater flexibility in assessing practice. DESIGN: A cohort survey using mixed methods. METHODS: Online questionnaires comprising qualitative and quantitative components targeted each of the four stakeholder groups: second and third-year student midwives, practice supervisors, practice assessors, midwifery academics. Aspects of the assessment process were explored including whether changes in the assessment process had influenced reliability, views of the Practice Assessment Toolkit and grading versus a binary pass/fail approach. RESULTS: Views were mixed about whether the new practice assessment process improved reliability, but the context of the global pandemic was acknowledged. Some clinicians embraced the changes more readily than others, and organisational approaches varied. There was a reliance on students' knowledge and understanding of requirements. Inconsistencies could have a detrimental effect on student learning and the reliability of assessment. Practice assessors relied on a range of practice supervisors' comments to make their decisions. Some participants considered that the separation of these roles enhanced reliability of assessment while others found it challenging. Detachment of students from the assessment process appeared to promote objectivity and honesty, potentially reducing grade inflation. The Practice Assessment Toolkit was useful and assisted reliability, however issues around individual expectations, application and relationships persisted. Most participants were in favour of retaining grading of practice in at least the final year of the midwifery programme. Qualitative themes comprised: Impetus for change; Reliance and reliability; Benefits of detachment; Mind the gap; To grade or not to grade. CONCLUSIONS: This first evaluation of the new practice assessment process suggested it has potential to increase reliability, however this is dependent on individual and institutional understanding and adherence. The context of the global pandemic also influenced implementation and findings. The benefits of using consistent terminology were demonstrated through application of the Practice Assessment Toolkit. Further evidence is presented of the advantages and challenges of grading practice or using the binary approach. Recommendations are made to promote concepts identified in the findings and for future research. TWEETABLE ABSTRACT: The first evaluation of the new NMC practice supervision and assessment process demonstrated its potential to increase reliability but depended on understanding and application. Concurrent use of the Practice Assessment Toolkit enhanced consistency in midwifery student assessment.


Subject(s)
COVID-19 , Midwifery , Students, Nursing , COVID-19/epidemiology , Female , Humans , Midwifery/education , Pandemics , Pregnancy , Reproducibility of Results , Surveys and Questionnaires
9.
Pflege ; 34(3): 159-169, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1709896

ABSTRACT

Leadership in the time of Corona: The perspective of nurses and midwives at a University Hospital - A quality assessment Abstract. Background: The high number of predicted patients arising from the COVID-19 pandemic presents several challenges to hospitals. Data is available on psychological stress in caregivers during pandemics. To date, there are no known studies regarding the impact of leadership on nursing and midwifery practice. Aim: Evaluation of leadership during the COVID-19 pandemic at a Swiss University Hospital. Methods: The approach to this study was based on action research. The authors defined quality indicators and "values of excellence" on the impact of leadership. In May 2020 140 nurses and midwives of different departments were interviewed using one-time questionnaires. The quantitative data was analyzed descriptively and the open questions evaluated by thematic analysis. Results: The results showed that through the combination of different interventions, a mostly positive working situation could be created for the interviewees. Uncertainty existed about the safety measures. The interviewees were highly stressed by their own private situations, the frequent changes in guidelines and the flood of information. However, the staff felt well supported by the leadership teams. Improvements were described in teamwork and decision-making. Conclusions: The results indicate an impact on leadership and demonstrate as well the need for adequate support. The framework of transformational leadership methods, practice development and Lean management empowers the organization to work in a focused manner, effectively and safely during challenging situations.


Subject(s)
COVID-19 , Midwifery , Female , Humans , Leadership , Pandemics , Pregnancy , SARS-CoV-2
10.
JMIR Mhealth Uhealth ; 10(2): e28886, 2022 02 15.
Article in English | MEDLINE | ID: covidwho-1686307

ABSTRACT

BACKGROUND: Women who are pregnant and have obesity and excessive gestational weight gain (GWG) present a higher risk of maternal and perinatal complications. The use of mobile apps and a wristband during pregnancy may contribute to promoting healthy lifestyles and, thus, improving maternal and neonatal health. OBJECTIVE: This study aims to evaluate the effectiveness of a complex digital health intervention, using a smartband and app with midwife counseling, on GWG and physical activity (PA) in women who are pregnant and have obesity and analyze its impact on maternal and perinatal outcomes. In addition, we aim to study the frequency of use, usability, and satisfaction with the mobile apps used by the women in the intervention group. METHODS: A parallel, 2-arm, randomized controlled trial was conducted. A total of 150 women who were pregnant and had obesity were included. The intervention group received a complex combined digital intervention. The intervention was delivered with a smartband (Mi Band 2) linked to the app Mi Fit to measure PA and the Hangouts app with the midwife to provide personal health information. The control group received usual care. The validated Spanish versions of the International Physical Activity Questionnaire-Short Form and the System Usability Scale were used. Satisfaction was measured on a 1- to 5-point Likert scale. RESULTS: We analyzed 120 women, of whom 30 (25%) were withdrawn because of the COVID-19 pandemic. The median GWG in the intervention group was 7.0 (IQR 4-11) kg versus 9.3 (IQR 5.9-13.3) kg in the control group (P=.04). The adjusted mean GWG per week was 0.5 (95% CI 0.4-0.6) kg per week in the control group and 0.3 (95% CI 0.3-0.4) kg per week in the intervention group (df=0.1, 95% CI -0.2 to 0.03; P=.008). During the 35 and 37 gestational weeks, women in the intervention group had higher mean PA than women in the control group (1980 metabolic equivalents of tasks-minutes per week vs 1386 metabolic equivalents of tasks-minutes per week, respectively; P=.01). No differences were observed between the study groups in the incidence of maternal and perinatal outcomes. In the intervention group, 61% (36/59) of the women who were pregnant used the smartband daily, and 75% (44/59) evaluated the usability of the Mi Fit app as excellent. All women in the intervention group used the Hangouts app at least once a week. The mean of the satisfaction scale with the health counseling app and midwife support was 4.8/5 (SD 0.6) points. CONCLUSIONS: The use of a complex mobile health intervention was associated with adequate GWG, which was lower in the intervention group than in the control group. In addition, we observed that the intervention group had increases in PA. No differences were observed in maternal perinatal complications. TRIAL REGISTRATION: ClinicalTrials.gov NCT03706872; https://www.clinicaltrials.gov/ct2/show/NCT03706872.


Subject(s)
COVID-19 , Gestational Weight Gain , Midwifery , Counseling , Exercise , Female , Humans , Infant, Newborn , Obesity/therapy , Pandemics , Pregnancy , Pregnant Women , SARS-CoV-2
11.
Nurse Educ Today ; 111: 105293, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1665314

ABSTRACT

BACKGROUND: Over the past year, the occurrence of COVID-19 pandemic has challenged clinical education for health care students, due to the possibility of exposure to the virus and increased spread of the disease. Clinical training of midwifery students in gynecologic problems, based on the Iran midwifery education curriculum, was also disrupted during this pandemic. OBJECTIVES: This study was aimed at designing, implementing and evaluating a virtual clinical training protocol for midwifery internship in a Gynecology course. DESIGN: A semi-experimental study. SETTINGS: Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran. PARTICIPANTS: Forty-seven midwifery interns in Gynecology course were recruited during two semesters in 2020. METHODS: Five steps based on the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model were taken, which included 1) educational and skills needs assessment, 2) design, 3) development via focused group interviews and brainstorming with the presence of the midwifery department members in three sessions, 4) implementation including pretest and posttest, webinar, uploading the information of virtual patients, questions and correct answers, and 5) evaluation including knowledge assessment by a designed questionnaire and skills evaluation by the modified-Mini-CEX checklist. Data were analyzed using mean, standard deviation and paired t-test. RESULTS: After training, a significant increase (p < 0.001) was observed in scores of knowledge and interview skills, clinical judgment, consultation, efficiency, professionalism, clinical competence and total score of clinical skills. CONCLUSIONS: Training for gynecological diseases through virtual clinic promoted knowledge and clinical skills of midwifery interns. To enhance education, a virtual clinic may be used in crisis situations and in combination with teaching under normal circumstances by strengthening the infrastructure and removing barriers.


Subject(s)
COVID-19 , Gynecology , Internship and Residency , Midwifery , Students, Nursing , Clinical Competence , Curriculum , Female , Gynecology/education , Humans , Midwifery/education , Pandemics , Pregnancy
12.
Hum Vaccin Immunother ; 18(1): 1-9, 2022 Dec 31.
Article in English | MEDLINE | ID: covidwho-1642246

ABSTRACT

This cross-sectional study was conducted during the period between 08 and 28 December 2020 to investigate the association of nurses' and midwives' level of vaccination knowledge and the COVID-19 vaccine acceptance for themselves during the COVID-19 pandemic era in Cyprus. Participants included registered nurses and midwives working in public or private service provision. Data collection was achieved using a self-administered questionnaire with questions on socio-demographic characteristics, questions assessing participants' general vaccination knowledge, and questions related to COVID-19 vaccination. A total of 437 responders answered the survey, with 93% being nurses and 7% midwives. The results indicate that as the vaccination knowledge score increases (higher knowledge) the probability of accepting the COVID-19 vaccination increases too (OR = 1.30, 95% CI: 1.13-1.48). The association between vaccination knowledge and the intention to be vaccinated against COVID-19 remained statistically significant, even after adjusting for age and gender (OR = 1.28, 95% CI: 1.12-1.47), socioeconomic (OR = 1.29, 95% CI: 1.12-1.48), and demographic characteristics (OR = 1.29, 95% CI: 1.11-1.49). Also, as age increases, the probability of accepting the COVID-19 vaccination increases, while female respondents had a lower probability of accepting the COVID-19 vaccination than male respondents. This study demonstrated that COVID-19 vaccination acceptance is related to the vaccination knowledge of the nurses and midwives in Cyprus. Targeted vaccination campaigns are needed to improve nurses' and midwives' level of vaccination knowledge in order to achieve a better coverage among them, as well as to influence their patients' ultimate positive vaccine decision.


Subject(s)
COVID-19 , Midwifery , Nurses , COVID-19/prevention & control , COVID-19 Vaccines , Cross-Sectional Studies , Cyprus , Female , Humans , Intention , Male , Pandemics/prevention & control , Pregnancy , Surveys and Questionnaires , Vaccination
13.
Int J Environ Res Public Health ; 19(2)2022 01 14.
Article in English | MEDLINE | ID: covidwho-1631773

ABSTRACT

BACKGROUND: Due to the significant staff shortages, emigration of health professionals is one of the key challenges for many healthcare systems. OBJECTIVE: The aim of this article is to explore the estimated trends and directions of emigration among Polish health professionals. METHODS: The emigration phenomenon of Polish health professionals is still under-researched and the number of studies in this field is limited. Thus, the authors have triangulated data using two methods: a data analysis of five national registers maintained by chambers of professionals (doctors, nurses, midwives, physiotherapists, pharmacists, and laboratory diagnosticians), and data analysis from the Regulated Profession Database in The EU Single Market. RESULTS: According to the data from national registers, between 7-9% of practicing doctors and nurses have applied for certificates, which confirm their right to practice their profession in other European countries (most often the United Kingdom, Germany, Sweden, Spain, and Ireland). The relatively high number of such certificates applied for by physiotherapists is also worrying. Emigration among pharmacists and laboratory diagnosticians is rather marginal. CONCLUSIONS: Urgent implementation of an effective mechanism for monitoring emigration trends is necessary. Furthermore, it is not possible to retain qualified professionals without systemic improvement of working conditions within the Polish healthcare system.


Subject(s)
Midwifery , Physical Therapists , Physicians , Emigration and Immigration , Female , Humans , Poland , Pregnancy
14.
Midwifery ; 106: 103245, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1616665

ABSTRACT

BACKGROUND AND OBJECTIVE: Newly created midwifery bachelor programmes attract an increasing number of applicants. Hence, educators have moved away from traditional non-standardised selection methods and started developing new tools for the admission of students. Researchers have expressed concerns around the validity of such selection measures and their ability to identify the appropriate candidates. The objective of this study was to develop and implement selection procedures for a new midwifery Bachelor of Science degree in Hamburg, Germany, and assess their psychometric properties. DESIGN: This is a mixed-methods longitudinal study on the reliability, validity and acceptability of newly developed selection criteria. SETTING: The newly established midwifery bachelor of science in Hamburg, Germany. PARTICIPANTS: Upon completion of their online application, all midwifery applicants were invited by email to participate in our research project and thereby informed of its purpose and voluntary nature of their participation. The total number of candidates who took the test was 366, of which 309 agreed to take part in this study. Sixty-five applicants were eventually admitted to the midwifery Bachelor programme, of which 59 were included in the study. MEASUREMENTS AND FINDINGS: We developed two tests for cognitive ability (HAM-Mid I and II) and adapted one test for personal and professional characteristics (Casper - Computer-based Assessment for Sampling Personal Characteristics). Due to the Covid pandemic, we implemented the tests online instead of on site as initially planned. HAM-Mid I had the lowest (Cronbach's Alpha = 0.38) whereas Casper had the highest internal consistency (Cronbach's Alpha = 0.77) of all three tests. Age, previous academic achievement and native tongue were significantly associated with applicants' performance on HAM-Mid II and Casper admission tests. HAM-Mid II was associated with students' performance in the first year midwifery exam (r = 0.31, p < 0.05). Overall evaluation of HAM-Mid II and Casper was good while HAM-Mid I received a more negative feedback. KEY CONCLUSIONS: Evidence on the reliability and predictive validity of the newly developed tests suggests that the applied admission criteria are appropriate for an objective selection of bachelor midwifery students. IMPLICATIONS FOR PRACTICE: The interests of university and clinical stakeholders of a midwifery bachelor degree can be represented through the development of tests for the assessment of cognitive ability and personal and professional characteristics.


Subject(s)
COVID-19 , Midwifery , Students, Nursing , Female , Humans , Longitudinal Studies , Pregnancy , Reproducibility of Results , SARS-CoV-2
15.
J Contin Educ Nurs ; 53(1): 21-29, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1595973

ABSTRACT

BACKGROUND: Midwifery across the world is facing changes and uncertainties. By recognizing plausible future options, a contemporary and strategic scope of midwifery practice and education can be established. The city of Antwerp, Belgium, was the indicative case for this study. Key drivers were identified to serve as input for scenarios. METHOD: Structuration theory and intuitive logics scenario planning methods were used to structure contextual midwifery scenarios. RESULTS: Six certain and six uncertain variables were identified. A two-dimensional framework showed these factors: (a) maternity care services and organization and (b) the society of child-bearing women and their families. Three scenarios described the plausible future of midwifery: (a) midwife-led care monitoring maternal health needs, (b) midwife-led holistic care, and (c) midwife/general practitioner-led integrated maternity care. CONCLUSION: All of the scenarios show the direction of change with a strategic focus, the importance of midwifery authenticity, and digital adaptability in maternity services. Also, the coronavirus disease 2019 (COVID-19) pandemic cannot be ignored in future midwifery. [J Contin Educ Nurs. 2022;53(1):21-29.].


Subject(s)
COVID-19 , Maternal Health Services , Midwifery , Female , Forecasting , Humans , Pregnancy , SARS-CoV-2
16.
Midwifery ; 106: 103242, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1586975

ABSTRACT

Concerns over the soaring number of COVID-19 cases has taken precedence within the healthcare community and overshadows the jarringly high rates of maternal mortality in developing countries. Pakistan is suffering from high maternal mortality, surges of COVID-19 cases, lack of integrated healthcare system, and rural poverty. Amidst fear and uncertainty, Community Midwives are stepping up as maternal healthcare leaders who are reaching out to neglected pregnant women in rural communities of Pakistan. They are responsible for rebuilding trust, delivering comprehensive and respectful maternal care and providing family planning counseling. To accomplish Sustainable Development Goal #3.1, Pakistan must support community midwives and diminish the barriers they face.


Subject(s)
COVID-19 , Maternal Health Services , Midwifery , Female , Humans , Pakistan/epidemiology , Pandemics , Pregnancy , SARS-CoV-2
17.
Midwifery ; 105: 103201, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1574376

ABSTRACT

OBJECTIVE: To explore midwives' perceptions of the advantages of telemedicine during the COVID-19 pandemic in Switzerland. DESIGN: Cross-sectional study based on an online survey using quantitative methods. SETTING: Midwives working in Switzerland. PARTICIPANTS: Self-selected convenience sample of 630 members of the Swiss Federation of Midwives. MEASUREMENT: Open questions on advantages of health care at a distance and workrelated characteristics were used in the online questionnaire. The information was coded and integrative content analysis was applied. FINDINGS: A good half of the respondents associated telemedicine with either an advantage beyond the pandemic ("Reduced workload", "Improved health care provision", "Greater self-care of clients"), while the others saw a pandemic-related advantage ("Protection from COVID-19", "Maintaining care/counseling in an exceptional situation"), or no advantage at all. Older, more experienced midwives were less likely to see an advantage beyond the pandemic. The motive "Reduced workload" was positively associated with professionals aged younger than 40 years and midwives with up to 14 years of professional experience, and "Protection from COVID-19" was more likely cited by midwives aged 50 and more and by midwives working solely in hospitals. Midwives who stated "Maintaining care" and "Improved health care provision" as motives to embrace telemedicine were more likely to experience health care at a distance as a positive treatment alternative. KEY CONCLUSION: Midwives' perceptions of the advantages of health care at a distance vary substantially with age and years of professional experience, as well as workrelated characteristics. Further research is necessary to acquire a sound understanding of underlying reasons, including the sources of the general attitudes involved. IMPLICATION FOR PRACTICE: Understanding the differences in perceptions of health care at a distance is important in order to improve the work situation of midwives and the health care they provide to women and families. Different sensitivities represent an important source in the ongoing discussion about the future use of telemedicine in health care.


Subject(s)
COVID-19 , Midwifery , Nurse Midwives , Aged , Cross-Sectional Studies , Delivery of Health Care , Female , Humans , Middle Aged , Pandemics , Perception , Pregnancy , SARS-CoV-2 , Surveys and Questionnaires , Switzerland
18.
Hum Vaccin Immunother ; 17(12): 4896-4903, 2021 Dec 02.
Article in English | MEDLINE | ID: covidwho-1569474

ABSTRACT

AIM: This study aims to determine the decision of midwifery students, who are the midwives of the future, on getting the COVID-19 vaccine and affecting factors. METHOD: The sample of this online cross-sectional study consisted of 1879 midwifery students in Turkey. The data collection tools of the study included a sociodemographic data form, the Health Literacy Index, Perception of Causes of COVID-19 and Attitudes Toward the COVID-19 Vaccine Scale. Descriptive statistics, correlation and linear regression analyses were used in the analysis of the data. FINDINGS: Among the participants, 65.7% (1235) did not want to get the COVID-19 vaccine. In this study, those who found childhood vaccines beneficial among the students, those reporting positive attitudes toward vaccinations and those who listened to the recommendations of health-care workers had higher rates of not wanting to get the COVID-19 vaccine. It was found that the students' decisions to get the vaccine were not affected by their health literacy levels. However, their attitudes toward vaccination were negatively effective, and their perceptions of COVID-19 causes were positively effective. CONCLUSION: In our study, the midwifery students who perceived the cause of COVID-19 as a conspiracy did not want to be vaccinated. Midwifery students should move away from the perception of conspiracy, and they should be informed about COVID-19 with scientific facts.


Subject(s)
COVID-19 , Midwifery , COVID-19/prevention & control , COVID-19 Vaccines , Child , Cross-Sectional Studies , Female , Humans , Pregnancy , SARS-CoV-2 , Students , Vaccination
19.
Int J Nurs Stud ; 127: 104155, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1568755

ABSTRACT

BACKGROUND: The specific challenges experienced by the nursing and midwifery workforce in previous pandemics have exacerbated pre-existing professional and personal challenges, and triggered new issues. We aimed to determine the psychological impact of the COVID-19 pandemic on the UK nursing and midwifery workforce and identify potential factors associated with signs of post-traumatic stress disorder. METHODS: A United Kingdom national online survey was conducted at three time-points during the first wave of the COVID-19 pandemic between April and August 2020 (T1 and T2 during initial wave; T3 at three-months following the first wave). All members of the UK registered and unregistered nursing and midwifery workforce were eligible to participate. The survey was promoted via social media and through organisational email and newsletters. The primary outcome was an Impact of Events Scale-Revised score indicative of a post-traumatic stress disorder diagnosis (defined using the cut-off score ≥33). Multivariable logistic regression modelling was used to assess the association between explanatory variables and post-traumatic stress disorder. RESULTS: We received 7840 eligible responses (T1- 2040; T2- 3638; T3- 2162). Overall, 91.6% participants were female, 77.2% were adult registered nurses, and 28.7% were redeployed during the pandemic. An Impact of Events Scale-Revised score ≥33 (probable post-traumatic stress disorder) was observed in 44.6%, 37.1%, and 29.3% participants at T1, T2, and T3 respectively. At all three time-points, both personal and workplace factors were associated with probable post-traumatic stress disorder, although some specific associations changed over the course of the pandemic. Increased age was associated with reduced probable post-traumatic stress disorder at T1 and T2 (e.g. 41-50 years at T1 odds ratio (OR) 0.60, 95% confidence interval (CI) 0.42-0.86), but not at T3. Similarly, redeployment with inadequate/ no training was associated with increased probable post-traumatic stress disorder at T1 and T2, but not at T3 (T1 OR 1.37, 95% CI 1.06-1.77; T3 OR 1.17, 95% CI 0.89-1.55). A lack of confidence in infection prevention and control training was associated with increased probable post-traumatic stress disorder at all three time-points (e.g. T1 OR 1.48, 95% CI 1.11-1.97). CONCLUSION: A negative psychological impact was evident 3-months following the first wave of the pandemic. Both personal and workplace are associated with adverse psychological effects linked to the COVID-19 pandemic. These findings will inform how healthcare organisations should respond to staff wellbeing needs both during the current pandemic, and in planning for future pandemics.


Subject(s)
COVID-19 , Midwifery , Stress Disorders, Post-Traumatic , Adult , COVID-19/epidemiology , Female , Humans , Longitudinal Studies , Pandemics , Pregnancy , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Workforce
20.
Int J Nurs Educ Scholarsh ; 18(1)2021 Dec 10.
Article in English | MEDLINE | ID: covidwho-1566568

ABSTRACT

OBJECTIVES: To assess depression, anxiety and stress among undergraduate nursing and midwifery students during the COVID-19 pandemic, and identify socio-demographic and educational characteristics associated with higher depression, anxiety and stress scores. METHODS: Cross-sectional study during August-September 2020, using an anonymous, online, self-administered survey. E-mail invitations with a survey link were sent to 2,907 students enrolled in the Bachelor of Nursing suite of courses, offered across four campuses of a single university in Victoria, Australia. Depression, anxiety and stress were assessed using the DASS-21. Data on socio-demographic and educational characteristics, self-rated physical health and exposure to COVID-19 were also collected. DASS-21 subscale scores were compared with existing data for various pre-pandemic and COVID-19 samples. Multiple regression was used to investigate factors associated with higher scores on depression, anxiety and stress subscales. RESULTS: The response rate was 22% (n=638). Mean scores on all DASS-21 subscales were significantly higher (p<0.001) than means from all comparative sample data. The proportions of students reporting moderate to severe symptoms of depression, anxiety and stress were 48.5%, 37.2% and 40.2% respectively. Being a woman, being younger, having completed more years of study and having poorer self-rated general health were all significantly associated (p<0.05) with higher scores on at least one DASS-21 subscale. CONCLUSIONS: Almost half of participants reported at least moderate symptoms of depression; more than a third reported at least moderate symptoms of anxiety or stress. Poor psychological wellbeing can impact students' successful completion of their studies and therefore, has implications for nursing and midwifery workforce recruitment and retention. During and after pandemics, universities should consider screening undergraduate students not only for anxiety and stress, but also for depression. Clear, low-cost referral pathways should be available, should screening indicate that further diagnosis or treatment is required.


Subject(s)
COVID-19 , Education, Nursing, Baccalaureate , Midwifery , Students, Nursing , Anxiety/epidemiology , Australia/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Female , Humans , Pandemics , Pregnancy , SARS-CoV-2
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