Quality and measurement properties of sexual health knowledge tools for adolescents: A rapid review.

OBJECTIVE: To evaluate the effectiveness of instruments designed for assessing sexual and reproductive health knowledge among adolescents. METHODS: Rapid review using the 2018 version of the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist. RESULTS: This review included fourteen studies from 1983-2022, identifying sixteen Patient-Reported Outcome Measures (PROMs), mainly using Likert scales and self-administration. The overall methodological quality was deemed "Inadequate" per COSMIN standards. Although studies often addressed reliability and structural validity, only five covered hypothesis testing. Responsiveness and interpretability were addressed in one study each, while criterion validity was neglected. Among the instruments, the Sexual Health Questionnaire (SHQ) was distinguished for its robustness in several areas including notable construct validity, explaining 68.25% of the variance, high internal consistency (Cronbach's alpha: 0.90), and reliable test-retest results over 7 weeks, confirmed by Wilcoxon nonparametric test. CONCLUSION: The study underscores the urgent need for standardised, comprehensive development and validation of the PROMs on sexual health in adolescents. PRACTICE IMPLICATIONS: This review highlights the urgent need for research to refine existing PROMs and develop new ones for assessing adolescent sexual and reproductive health knowledge, aligning with global educational commitments and advancing the field.

Development and psychometric evaluation of the sexual and reproductive health needs of incarcerated women scale: a methodological study.

BACKGROUND: This study aimed to develop and validate a comprehensive tool designed to assess the sexual and reproductive health (SRH) needs of incarcerated women. METHODS: A methodological study was conducted from January to March 2023 in two female prisons in Tehran and Hamedan, Iran. The participant pool consisted of women who had been incarcerated for a minimum of 6 months and were aged between 15 and 49 years. The instrument development involved two phases. Phase I involved a literature review and interviews with incarcerated women to understand their SRH needs. Phase II assessed psychometric properties to establish the scale's validity and reliability. RESULTS: The SRH Needs of Incarcerated Women (SRH-NIW) scale was refined, comprising 37 items across six domains: pregnancy and childbirth services, parenting services, family planning and sexual health services, personal and medical care services, screening services and infection control services. Exploratory factor analysis explained 66.15% of variance. The Content Validity Ratio and Content Validity Index were 0.8 and 0.94, respectively, indicating high content validity. Average Variance Extracted values ranged from 0.592 to 0.698. The whole scale showed a Cronbach's alpha of 0.823, and the Intra-class Correlation Coefficient was 0.879. CONCLUSION: The SRH-NIW scale is a valid and reliable tool for assessing the SRH needs of incarcerated women. It can enhance healthcare services and interventions for incarcerated women, potentially leading to policy improvements within the prison system.

Promoting generalisation in qualitative nursing research using the multiple case narrative approach: a methodological overview.

Background: The ability to generalise research generated findings to different contexts is a significant, yet overlooked, feature in qualitative studies conducted in nursing, where evidence-based clinical practice is highly regarded. The multiple case narrative is a constructivist-narrative approach, claimed to not only have the potential for analytical and case-to-case generalisation but also sample-to-population generalisation. Methods: This paper provides an overview of multiple case narrative by comparing it with similar methodologies, reviewing studies that have used this approach and critically evaluating its capacity for producing generalisable results. Results: The multiple case narrative approach addresses limitations of collective case study, case survey and meta-ethnography by employing greater sample sizes and more generalisable results. Most studies previously using this approach have been performed in the education field and with the purpose of overcoming sample size limitations in qualitative research. The approach offers a uniquely systematic approach to analysis by finding associations between categories generated from collective analysis of large number of cases and providing the potential for sample to population generalisation. Conclusion: Multiple case narrative, which to date has been underutilised, is a systematic approach with characteristics that make it an efficient research technique to provide valid qualitative evidence.

Labouring women perspectives on mistreatment during childbirth: a qualitative study.

BACKGROUND: Respectful care during labour and childbirth, which has recently received a great deal of attention around the world, is vital for providing high-quality maternity care. However, this area has been underexplored in developing countries including Iran. RESEARCH AIM: This study aimed to assess postpartum women's views regarding disrespect and abuse during labour and childbirth in Iran. METHODS: A qualitative study that involved a purposive sample of 21 postpartum women was conducted in Tehran, Iran, between 2019 and 2020. Following the semi-structured individual interviews, a conventional content analysis was performed. ETHICAL CONSIDERATIONS: This research approved by Shahid Beheshti University of Medical Sciences in Tehran, Iran, with the ethical approval number 1396.810. Following explanation of the study's objectives, eligible women consented to participate in the study. The confidentiality of the participants' information and the anonymity of the analysis were maintained at all stage of the study. All data was stored on the password protected file in the researcher computer The findings were only disseminated in summary form, with no identifying of individual participants. RESULTS: Analysis of the data resulted in two main themes: 'inappropriate interaction' and 'inadequate quality care'. The 'inappropriate interaction' theme includes 'lack of empathy' and 'verbal abuse'. The second theme includes five sub-themes 'lack of participation in decision-making', 'lack of privacy', 'ignorance of women's pain and medical needs', 'rushed labour and painful procedures', and "unsatisfying facilities'. CONCLUSION: Providing supportive care, respectful communication, adequate participation in decision-making, maintaining privacy, attending to women's labour pain and medical needs, and improving the quality of the physical birth environment are all examples of what labouring women consider to be respectful maternity care. To minimise disrespect and maltreatment of women during childbirth, an all-inclusive strategy engaging women, communities, healthcare professionals, managers, and educators is required.

The evolution of registration standards for internationally qualified midwives in Australia.

BACKGROUND: Registration as an internationally qualified midwife in Australia can be challenging, as the individual must meet rigorous education and professional competency assessment standards. AIM: The purpose of this discussion is to present an overview of the evolution of registration standards for internationally qualified midwives in Australia from 2000 to 2020 and evaluate their effectiveness in promoting internationally qualified midwives' professional integration. RESULTS: Australian registration policies for internationally qualified midwives have undergone significant change over the last 20 years. In 2010, registration policy and governance moved from state or territory to national jurisdiction, then these standards were upgraded in 2014, and finally transitioned to an outcome-based assessment (OBA) program in 2020. Inconsistency and lack of transparency in established registration policies and their implementation were revealed, most notably when bridging programs for internationally qualified midwives from non-English speaking backgrounds were discontinued in Australia in 2015, despite reference in the NMBA policy as an available transition program from 2000 to 2020. The implementation of OBA in 2020, which occurred after a significant delay, complicated registration processes further with inclusion of two levels of assessment (MCQ examination and OSCE) and associated expenses. CONCLUSION: Evidence-based strategies and regulatory adjustments are necessary to effectively register internationally qualified midwives in Australia, particularly those from non-English speaking backgrounds.

Transition experiences of Middle Eastern midwives into Australian practice: A multiple case narrative study.

AIM: To explore transition experiences of Middle Eastern qualified midwives into practice in Australia. DESIGN: This was a qualitative study using multiple case narrative approach underpinned by structuration theory. METHODS: A total of 19 Middle Eastern qualified midwives from different states of Australia participated in this study. Individual semi-structured interviews were conducted between November 2020 and September 2021, digitally recorded and then transcribed. Transcriptions were analysed in three stages, with three main categories generated in the second stage and a core category that was developed in third. RESULTS: Entering the Australian workforce, Middle Eastern qualified midwives had to reframe their professional identities to fit the new system by adjusting to three aspects of the practice, including preparation for practice, scope of practice and context of practice. While they were prepared by medically oriented curricula, worked in systems that had limitations for midwives to practise in antenatal and postnatal and lacked regulation standards, they learned to practise autonomously in their full scope in a standardized context in Australia. CONCLUSION: Middle Eastern qualified midwives in Australia re-evaluated their practice in their home countries, realized the gaps and adjusted to new ways of practising in Australia. IMPACT: To effectively use the potential of Middle Eastern midwives for workforce sustainability in Australia, support should be available to enable them to develop the necessary competencies for safe practice in Australia including provision of context-specific transition programmes prior to registration and supporting mentorship after their integration into the Australian healthcare workforce. PATIENT OR PUBLIC CONTRIBUTION: Patient or public contribution does not apply to this study as its purpose was to explore the transition experiences of Middle Eastern qualified midwives themselves.

Women's experience and perspectives toward genital cosmetic surgery in Erbil city/Iraq: a qualitative study.

BACKGROUND: Nowadays, Female Genital Cosmetic Surgery is quite prevalent, resulting in a wide range of medical and cultural implications. The majority of women who undergo this operation suffer from anxiety, depression, and other emotional symptoms. The present study was carried out in order to explore women's perspective on and experience of genital cosmetic surgery given their special context and cultural aspects. METHODS: The qualitative study applying content analysis examined the experiences of nine women who received genital cosmetic surgery in Erbil, Kurdistan-Iraq, between 2021 and 2022. Each of the semi-in-depth face-to-face interviews lasted between 40 and 60 min and was conducted at the physician's clinics. RESULTS: Semi-structured interviews led to emergence of two main themes, namely "husband satisfaction" and "self-confidence". Interpreting the participants' stories resulted in some relevant subthemes and meaning units like "ugly appearance", "anxiety related to husband undesirable intercourse", and "dyspareunia". Finally, the related conclusions of each theme were explored. CONCLUSION: As suggested by the study findings, female genital cosmetic surgery improves the women's body image and sexual function and the couples' sexual satisfaction, especially that of husbands. Because of the people's sociocultural aspects in Kurdistan region, their awareness of female sexual needs and marital relationship needs to be raised.

Transition experiences of internationally qualified health care professionals: A narrative scoping review.

BACKGROUND: The migration of health care professionals exposes the individual to a variety of challenges as they adjust to the host country's workforce system. While there is a growing body of literature on the individual transition stage of internationally qualified health care professionals, little is known about the overall process and how each stage interacts with the others. AIM: To examine what is known about factors impacting transition experiences of internationally qualified health care professionals at various stages from pre- to post-arrival in their new country. DESIGN: Scoping review incorporating narrative synthesis was conducted. DATA SOURCES: A range of databases were searched, including CINAHL, Medline, Scopus, and ProQuest, as well as reference lists. REVIEW METHODS: The adapted framework methodology described by the Joanna Briggs Institute informed this review. The review included qualitative and quantitative primary peer-reviewed research studies focusing on transition experiences of internationally qualified health care professionals. Included studies were analysed and synthesised using a three-step narrative synthesis. RESULTS: A total of 48 studies were included in the review from nursing, medicine, dentistry, physiotherapy, occupational therapy, and midwifery, with the majority from nursing. The majority of the internationally qualified health care professionals migrated from Philippine, India, and South Africa to the US, UK, Canada, and Australia. Four themes emerged from the review: misguided migration (pre-arrival), a shocking reality (early arrival), challenging accreditation and orientation (registration), and multidimensional work challenge (post-registration). Identified issues impacting the transition experience of internationally qualified health care professionals across different disciplines and nations were generally similar. CONCLUSIONS: Misinformation resulted in unexpected realities upon arrival in destination countries, ineffective accreditation procedures during registration and inadequate support in destination countries led to workplace challenges. With ongoing recruitment of international health care workers, a holistic approach that considers the various stages of transition is necessary to assist in establishing new identities and integrating into the destination country's workforce. This includes informing internationally qualified health professionals accurately about professional and cultural expectations in host countries prior to migration, implementing culturally specific training upon arrival in the destination country, developing and implementing effective accreditation and registration policies, and providing structured mentorship and support following employment.

Midwifery in Middle Eastern and North African countries: A scoping review.

BACKGROUND: While midwives are positioned as critical providers for improving sexual, reproductive, maternal and newborn health outcomes in the Middle East and North African (MENA) countries, the standards of midwifery have not been explored systematically in this region. AIM: The purpose of this scoping review was to provide an overview of existing literature on midwifery practice, education, and regulation in MENA countries in the context of ICM standards. METHODS: A search was conducted inclusive of English and Persian written studies published between 2000 and 2019 in CINAHL plus; Ovid MEDLINE; PubMed; Scopus; and grey literature. Title and abstract and full-text review were performed in Covidence, and data extraction and synthesis performed using NVivo 12. RESULTS: The initial search identified 7,994 articles. Overall, 139 studies were included in the review. Although, the primary concept of most included studies was "midwifery practice", "midwifery regulation" was addressed in limited way. Approximately 90% were from Middle Eastern countries. Forty-two per cent of studies used cross-sectional designs, and most originated from Iran, Jordan, and Palestine. Diversity was found in midwifery education, practice and regulation across the MENA countries. Midwives from different nations had uneven levels of proficiency, scope of practice, and education. Midwifery curricula were aligned with ICM competencies in some countries. Most countries had midwifery associations and were members of ICM. Some countries had regulations recognising midwifery as an autonomous profession. CONCLUSION: Midwifery practice, education and regulation in MENA countries were not always comparable with ICM standards, although some progress was evident.

Correction to: Perspectives and pregnancy outcomes of maternal Ramadan fasting in the second trimester of pregnancy.

Following publication of the original article [1], the author notified us about the incorrect values on Table 4.

Perspectives and pregnancy outcomes of maternal Ramadan fasting in the second trimester of pregnancy.

BACKGROUND: There are controversies over the effects of Ramadan fasting on pregnancy outcomes, and women's perspectives of fasting are diverse. This study aimed to assess the perspectives and pregnancy outcomes of maternal Ramadan fasting in the second trimester of pregnancy. METHODS: A case-control study was conducted at Hawler Maternity Teaching Hospital of Erbil, Iraq from October 2017 to January 2018. Out of 301 participating women, 155 fasted during the second trimester of their current pregnancy, while the remaining 146 did not. Mothers were asked concerning their fasting behaviors and perception of fasting during pregnancy. The main outcomes of this study were gestational diabetes, preterm labour, preeclampsia, low birth weight, Apgar score, height, weight, and head circumference of the newborn. RESULTS: About 80% of the women in the fasting group fasted for 21-29 days during Ramadan, out of whom 38.7% completed fasting for the entire Ramadan period. The results revealed that the decision to fast during pregnancy was negatively associated with the mother's educational level and occupation. Weight gain during pregnancy in the fasting women was approximately 0.4 kg less than those who did not fast. The incidence of gestational diabetes was 2.6% in the fasting women, while it was 8.3% in the non-fasting mothers (P = 0.02). Regression analysis showed that women who did not fast during the second trimester of pregnancy were 1.51 times more likely to develop gestational diabetes [odd ratio (OR) 1.51; 95% confidence intervals (CI) 0.06, 0.74, P = 0.01]. It was also found that among the women in the fasting categories, those who fasted for 21-29 days during pregnancy had a lower risk of gestational diabetes compared to the other groups. More than half of the mothers in the fasting group (60%) perceived that fasting during pregnancy was compulsory for healthy and non-healthy women, comparing with those who did not fast. CONCLUSION: It was found that fasting during the second trimester of the pregnancy decreased the risk of gestational diabetes and excessive weight gain during pregnancy. Most of Iraqi women did not fully recognize their right to be exempted from fasting during pregnancy by the Islamic law.

The effect of mother and newborn early skin-to-skin contact on initiation of breastfeeding, newborn temperature and duration of third stage of labor.

Background: Mother and newborn skin-to-skin contact (SSC) after birth brings about numerous protective effects; however, it is an intervention that is underutilized in Iraq where a globally considerable rate of maternal and child death has been reported. The present study was conducted in order to assess the effects of SCC on initiation of breastfeeding, newborn temperature, and duration of the third stage of labor. Methods: A quasi-experimental study was conducted on 108 healthy women and their neonates (56 in the intervention group who received SSC and 52 in the routine care group) at Hawler maternity teaching hospital of Erbil, Iraq from February to May, 2017. Data were collected via structured interviews and the LATCH scale to document breastfeeding sessions. Results: The mean age of the mothers in the SSC and routine care groups were 26.29 ± 6.13 (M ± SD) and 26.02 ± 5.94 (M ± SD) respectively. Based on the LATCH scores, 48% of mothers who received SSC and 46% with routine care had successful breastfeeding. Newborns who received SSC initiated breastfeeding within 2.41 ± 1.38 (M ± SD) minutes after birth; however, newborns who received routine care started breastfeeding in 5.48 ± 5.7 (M ± SD) minutes. Duration of the third stage of labor in mothers who practiced SSC after birth was 6 ± 1.7 min, compared to 8.02 ± 3.6 min for mothers who were provided with routine care (p <  0.001). Moreover, the prevalence of hypothermia in the newborns who received SSC and routine care was 2 and 42% respectively. Results remained unchanged after using regression modelling to adjust for potential factors and background characteristics. Conclusion: Skin-to-skin contact provides an appropriate and affordable yet high quality alternative to technology. It is easily implemented, even in small hospitals of very low-income countries, and has the potential to save newborns' and mothers' lives. It is necessary to prioritize training of health providers to implement essential newborn care including SSC. Community engagement is also needed to ensure that all women and their families understand the benefits of SSC and early initiation of breastfeeding. Trial registration: ClinicalTrials.gov: NCT03548389.

Knowledge, attitude, and experience of health professionals of female genital mutilation (FGM): A qualitative study in Iraqi Kurdistan Region.

We aimed to assess the knowledge, attitude, and experience of health professionals of female genital mutilation (FGM). The study involved content analysis of semistructured interviews with 21 health professionals. The participants had poor knowledge regarding different aspects of FGM including its types, prevalence, and complications as well as the existing legislation that prohibits FGM. They believed that FGM is mainly practiced for religious reasons and to reduce sexual desire/arousal. Health professionals are apparently not involved in performing FGM, and they do not support its continuation. Health professionals can take a leading role in raising the awareness of women and combating FGM.