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1.
Int Nurs Rev ; 2024 Jul 08.
Article in English | MEDLINE | ID: mdl-38973369

ABSTRACT

AIM: This study aims to assess the levels of nomophobia among nurses and midwives employed at a gynecology and children's hospital and to explore its impact on their lives. METHODS: This descriptive cross-sectional study was conducted in a gynecology and pediatrics hospital situated in the western region of Turkey. The research sample comprised 112 nurses and midwives. Data collection was facilitated through an "Introductory Information Form" and the "Nomophobia Scale," with adherence to the STROBE checklist for reporting this cross-sectional study. RESULTS: The mean age of the participants was 34.50 ± 9.98 years. The average total score on the nomophobia scale was 68.45 ± 24.62, with 54.5% of participants classified as having moderate levels of nomophobia. Factors such as age, years of experience in nursing or midwifery, work patterns, and the habit of checking their phones immediately upon waking and before sleeping were found to influence their levels of nomophobia. CONCLUSION: The study observed that mobile phone usage among nurses and midwives in a gynecology and pediatrics setting negatively affects their mental and physical health, with a moderate level of nomophobia being prevalent. Notably, older age and increased work experience were associated with lower nomophobia scores. IMPLICATIONS FOR NURSING PRACTICE: Initiatives aimed at preventing the onset of nomophobia are recommended, especially targeting younger nurses and midwives who play a crucial role in health service delivery.

2.
Article in English | MEDLINE | ID: mdl-38974926

ABSTRACT

INTRODUCTION: Perinatal mental health disorders (PMDs) are a global health concern. In industrialized countries, the prevalence of PMDs is estimated to be 20%, and they are associated with serious negative effects for women, their children and their families, along with high societal costs related to long-term impacts. In Switzerland, the PMD detection rate during obstetrical healthcare provision is very low (1-3%), and specialized healthcare services are limited. This study aimed to develop and implement an advanced practice midwife (APM) role at a Swiss obstetrics and gynecology hospital using the PEPPA framework to provide adequate screening and first-consultation services. METHODS: The study uses a qualitative approach and follows the research stages using the 8-step from the participatory, evidence-based, patient-focused process for advanced practice nursing role development, implementation and evaluation (PEPPA) framework to develop and implement the APM role. RESULTS: Utilizing the PEPPA framework, we were able to develop, implement, and evaluate the APM role in the field of perinatal mental health. Through appropriate screening and first-consultation services, we were able to identify affected women early and facilitate treatment. CONCLUSIONS: In addition to stakeholder engagement and interprofessional collaboration, PEPPA serves as a beneficial framework for the process of role development, implementation, and evaluation in the midwifery profession. This study aims to assist midwives with Master's degrees in establishing corresponding roles within their practice areas, thereby enhancing care delivery. Furthermore, the current APM approach is intended to be continuously evaluated to gain new insights into its effectiveness.

3.
Article in English | MEDLINE | ID: mdl-38974928

ABSTRACT

INTRODUCTION: Educational strategies for preventive screening and effective interventions in midwives are needed to improve clinical practice and outcomes for abused women and their families. This scoping review aimed to describe available educational training programs on intimate partner violence (IPV) in pregnancy for midwives/student midwives. METHODS: A scoping review of the literature, which was published in English from January 2010 to March 2023, in PUBMED, EBSCO, and CINAHAL databases, was applied. The following keywords were used in the search: 'evaluation', 'educational training', 'course', 'midwives', 'student midwife', 'intimate partner violence', 'pregnancy', combined with AND and OR Boolean operators. The included studies focused on training programs/courses for midwives/student midwives regarding intimate partner violence. RESULTS: A total of 9 studies were eligible for inclusion, describing six programs for midwives and 3 for student midwives. Educational interventions varied in length (e.g. a few hours to weeks) and educational approaches such as multidisciplinary sessions, lectures, theory, role-playing, practice in screening, group activities, watching videos, and case reports discussion. The programs had similar content, including raising awareness of violence, defining it, discussing gender roles, the impact of IPV on women's health, referral agencies, and the laws regarding violence in each country. CONCLUSIONS: This scoping review highlighted a lack of educational programs on intimate partner violence during pregnancy, suggesting that new programs need to be developed based on contemporary clinical practices and recommendations for midwifery education.

4.
Heliyon ; 10(12): e32504, 2024 Jun 30.
Article in English | MEDLINE | ID: mdl-38975086

ABSTRACT

Introduction: For almost 20 years Latvia has been a member state of European Union. Accessible and constantly evolving information has led to a paradigm change in the woman - midwife relationship; nowadays, it should be horizontal - women's and her family orientated. The question is: how do the midwives perceive their professional identity, its core values, norms and beliefs in this new paradigm? Method and findings: Three interview rounds with 20 midwives were performed. Highlighted themes were asked to be explained in the next round of interview in order to compare them with authors' thematic analysis and formulated pre - understandings.The method of thematic analysis was used in frame of a pilot study to understand how practising midwives describe their professional identity.Eleven themes emerged and were categorised in three larger themes: integral part of midwife's professional identity - courage, patience, ability to provide intimacy, flexibility and creativity, the most beautiful profession; desirable part - the ability to evaluate yourself, the ability to draw boundaries, tolerance and acceptance of diversity, "go with the flow" - ability to allow physiological processes to take place, hindrances - struggle with bureaucratic norms and paperwork, struggle with the finances/salary. Conclusion: Within the present study midwives' voices have been conceptualised for the first time in Latvia. With the repeated reflection on their professional identity, midwives not only conceptualised it, but also let light shine on the shadowy side of its components.

5.
J Adv Nurs ; 2024 Jul 02.
Article in English | MEDLINE | ID: mdl-38956892

ABSTRACT

AIM: To describe the pre-implementation context and implementation approach, for a clinician researcher career pathway. BACKGROUND: Clinician researchers across all health disciplines are emerging to radically influence practice change and improve patient outcomes. Yet, to date, there are limited clinician researcher career pathways embedded in clinical practice for nurses and midwives. METHODS: A qualitative descriptive design was used. DATA SOURCES: Data were collected from four online focus groups and four interviews of health consumers, nursing and midwifery clinicians, and nursing unit managers (N = 20) between July 2022 and September 2023. RESULTS: Thematic and content analysis identified themes/categories relating to: Research in health professionals' roles and nursing and midwifery, and Research activity and culture (context); with implementation approaches within coherence, cognitive participation, collective action and reflexive monitoring (Normalization Process Theory). CONCLUSIONS: The Pathway was perceived to meet organizational objectives with the potential to create significant cultural change in nursing and midwifery. Backfilling of protected research time was essential. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The Pathway was seen as an instrument to empower staff, foster staff retention and extend research opportunities to every nurse and midwife, while improving patient experiences and outcomes. IMPACT: Clinicians, consumers and managers fully supported the implementation of clinician researchers with this Pathway. The Pathway could engage all clinicians in evidence-based practice with a clinician researcher leader, effect practice change with colleagues and enhance patient outcomes. REPORTING METHOD: This study adheres to relevant EQUATOR guidelines using the COREG checklist. PATIENT OR PUBLIC CONTRIBUTION: Health consumers involved in this research as participants, did not contribute to the design or conduct of the study, analysis or interpretation of the data, or in the preparation of the manuscript.

6.
Afr Health Sci ; 24(1): 76-90, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38962358

ABSTRACT

Background: Giving the existing formal education through the internet without a planned transition to distance education negatively affected the learning processes of the students. Objectives: The study aims to identify the midwifery students' changing life conditions and e- learning experiences on the state of their anxiety and hopelessness during the Covid-19 pandemic. Methods: Designed as cross-sectional research, the study was performed with the participation of 1,296 midwifery undergraduate students. The survey form comprised of questions that explored the students' demographic characteristics, life conditions changing during the Covid-19 pandemic and distance education experiences, the Generalized Anxiety Disorder Scale-7, and the Beck Hopelessness Scale were used in the data collection. Findings: It was discerned that, of the participant midwifery students, 55.2% spent the period of the pandemic in the province center, 51.7% used smartphones to have access to the distance education, 50.3% had trouble in following up the courses due to the limited computer and internet access, 63.5% failed to follow up the courses because of the infrastructure problems related to the distance education. It was found that, of the participant midwifery students, 54.6% exhibited anxiety symptoms and 26.3% had hopelessness symptoms. It was identified that having trouble in following up the courses increased anxiety by 1.438 times (CI:1.103-1.875) and hopelessness by 1.980 times (CI:1.459-2.687), having tensions in the family relations increased anxiety by 2.362 times (CI:1.780-3.134) and hopelessness by 1.789 times (CI:1.235-2.594), and having psychological support for anxiety and worry increased anxiety by 2.914 times (CI:2.208-3.8477) and hopelessness by 1.875 times (CI:1.083-3.247). It was ascertained that hopelessness increased anxiety by 2.878 times (CI:2.075-3.991) whilst anxiety increased hopelessness by 2.755 times (CI:1.985-3.823) (p<0.05). Conclusion: As well as the Covid-19 pandemic, health, social life, and economic changes; the digital separation that accompanies distance education also affects the students' mental health. Solving the technical problems experienced in distance education, facilitating the follow-up of the courses, and equipping the midwifery students with problem-solving and coping skills will be useful for reducing the midwifery students' hopelessness and anxiety levels.


Subject(s)
Anxiety , COVID-19 , Education, Distance , Midwifery , SARS-CoV-2 , Students, Nursing , Humans , COVID-19/psychology , COVID-19/epidemiology , Female , Midwifery/education , Cross-Sectional Studies , Anxiety/epidemiology , Students, Nursing/psychology , Adult , Young Adult , Surveys and Questionnaires , Pandemics , Hope , Male
7.
Nurs Health Sci ; 26(3): e13136, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38960587

ABSTRACT

Postpartum depression is one of the most common mental health disorders in women after giving birth. This study was conducted to examine the effect of telecounseling support on depression in primiparous mothers. This study was conducted as a randomized controlled trial with a parallel group pretest-posttest design. The study comprised 50 participants each in the intervention and control groups. Face-to-face interviews were conducted with all participants, and the Maternal Information Form and the Edinburgh Postpartum Depression Scale (EPDS) were administered. The intervention group received telecounseling for 6 weeks, while the control group received routine postnatal care. After the 6-week period, EPDS was re-administered to both groups. In the intervention group, the EPDS mean score decreased from 7.12 ± 3.96 to 6.34 ± 3.73 after telecounseling (p < 0.001). Conversely, in the control group, the EPDS mean score increased from 6.62 ± 3.55 to 7.90 ± 4.65 without any intervention (p = 0.002). The results indicate that telecounseling is an effective method for reducing the risk of depression among mothers during the postpartum period. It is recommended that healthcare professionals extend their support by providing telecounseling for mothers.


Subject(s)
Depression, Postpartum , Mothers , Humans , Female , Adult , Depression, Postpartum/psychology , Depression, Postpartum/prevention & control , Mothers/psychology , Mothers/statistics & numerical data , Pregnancy , Postpartum Period/psychology , Parity , Surveys and Questionnaires
8.
Women Birth ; 37(5): 101638, 2024 Jul 02.
Article in English | MEDLINE | ID: mdl-38959595

ABSTRACT

PROBLEM: Prescribing by Endorsed Midwives has existed in Australia for more than ten years. Significant barriers exist in the bureaucracy surrounding prescribing and state and territory legislation which further constrain midwives capacity to prescribe required medications. BACKGROUND: Current evidence indicates Endorsed Midwives improve timely access to medications and can experience both enablers and barriers to prescribing. AIM: To explore Endorsed Midwives' lived experiences of medication prescribing, including which medications are being prescribed, how this affects the women in their care, midwives' practice, and perspectives on the future of midwifery prescribing. METHODS: A descriptive qualitative approach was used. Data collection occurred through semi-structured interviews (n=10) of Endorsed Midwives from varied Australian practice contexts and locations. Data analysis followed Reflexive Thematic Analysis. FINDINGS: Four themes were developed: Medication prescription as essential healthcare; Prescribing optimises midwifery practice; External structures can both promote and inhibit the capacity to prescribe; The future of prescribing. DISCUSSION: Endorsed Midwife prescribing has the potential to positively impact women's maternity care and enable midwives to fulfil their scope of practice. However, limitations to prescribing need to be addressed to capitalise on these benefits. CONCLUSION: Significant reform of health service policy, state and territory legislation and further development of the Pharmaceutical Benefits Scheme are required to fully embrace and capitalise on the full scope of Endorsed Midwives in the Australian Healthcare system.

9.
J Psychosom Obstet Gynaecol ; 45(1): 2362653, 2024 Dec.
Article in English | MEDLINE | ID: mdl-38950574

ABSTRACT

In the Netherlands adverse perinatal outcomes are also associated with non-medical factors which vary across geographical locations. This study analyses the presence of non-medical vulnerabilities in pregnant women in two regions with high numbers of psychosocial adversity using the same definition for vulnerability in both regions. A register study was performed in 2 regions. Files from women in midwife-led care were analyzed using a standardized case report form addressing non-medical vulnerability based on the Rotterdam definition for vulnerability: measurement A in Groningen (n = 500), measurement B in South-Limburg (n = 538). Only in South-Limburg a second measurement was done after implementing an identification tool for vulnerability (C (n = 375)). In both regions about 10% of pregnant women had one or more urgent vulnerabilities and almost all of these women had an accumulation of several urgent and non-urgent vulnerabilities. Another 10% of women had an accumulation of three or more non-urgent vulnerabilities. This study showed that by using the Rotterdam definition of vulnerability in both regions about 20% of pregnant women seem to live in such a vulnerable situation that they may need psychosocial support. The definition seems a good tool to determine vulnerability. However, without considering protective factors it is difficult to establish precisely women's vulnerability. Research should reveal whether relevant women receive support and whether this approach contributes to better perinatal and child outcomes.


Subject(s)
Pregnant Women , Registries , Vulnerable Populations , Humans , Female , Pregnancy , Netherlands/epidemiology , Adult , Vulnerable Populations/psychology , Vulnerable Populations/statistics & numerical data , Pregnant Women/psychology
10.
Healthcare (Basel) ; 12(11)2024 May 31.
Article in English | MEDLINE | ID: mdl-38891204

ABSTRACT

Midwives' self-efficacy can significantly affect the provided care and, therefore, maternal and neonatal outcomes. The aim of the present study was to investigate associations of perceived self-efficacy with emotional intelligence, personality, resilience, and attitudes towards death among midwives in Greece. From 2020 to 2022, a total of 348 midwives were recruited in this descriptive cross-sectional study. The participants were employed as independent professionals, in public hospitals or regional health authorities. Data collection involved five research instruments: the General Self-Efficacy Scale (GSES), the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), the Eysenck Personality Questionnaire (EPQ), the Connor-Davidson Resilience scale (CD-RISC), and the Death Attitude Profile-Revised (DAP-R) scale. The mean score for the GSES was 29.1 (SD = 4.2), suggesting a moderately elevated level of self-efficacy among midwives. The results revealed that higher scores on the GSES were significantly associated with higher scores on the Extraversion subscale (p < 0.001) and lower scores on the Neuroticism (p < 0.001) and Lie (p = 0.002) subscales of the EPQ. Additionally, high self-efficacy was significantly correlated with high emotional intelligence (p < 0.001), high neutral acceptance of death (p = 0.009), and high resilience (p < 0.001). These findings highlight the relationship between the self-efficacy of Greek midwives and various psychological factors, as well as the multifaceted nature of self-efficacy and its importance for midwives' psychological well-being and professional functioning.

11.
Psychogeriatrics ; 24(4): 959-967, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38877689

ABSTRACT

BACKGROUND: Nursing and midwifery students' perceptions and attitudes toward older adults affect their behaviours, career choices and/or the quality of care provided to older adults after graduation. This study aimed to evaluate the perceptions of second year nursing and midwifery students toward elderly people staying in nursing homes through metaphor analysis. METHODS: This qualitative study has used the phenomenological approach. The sample of the study consisted of 128 nursing and midwifery students by purposive sampling method. Students were prompted to complete a sentence to express their perceptions about the elderly living in nursing homes: 'The elderly in the nursing home is similar to … because …' Participants were required to fill in their responses in two stages, providing metaphors in the first blank and reasons for their metaphors in the second blank. RESULTS: The results indicated that five main themes and 12 sub-themes were obtained from student metaphors: (i) needing help in meeting their needs (need for care and need for love); (ii) the emotional burden of a life away from loved ones (loneliness, abandonment, and helplessness); (iii) exhaustion at the end of the road (end, loss, and unproductive); (iv) holding on to life again (friendship and beginning); and (v) post-traumatic growth (strong and experienced). CONCLUSION: Students should question how to create opportunities and increase interaction for the elderly in the age of changing and developing technology before graduation and should be trained as professional individuals who are willing for this purpose.


Subject(s)
Attitude of Health Personnel , Metaphor , Midwifery , Nursing Homes , Qualitative Research , Students, Nursing , Humans , Students, Nursing/psychology , Students, Nursing/statistics & numerical data , Female , Male , Midwifery/education , Aged , Adult , Homes for the Aged , Young Adult
12.
Women Birth ; 37(4): 101629, 2024 Jun 19.
Article in English | MEDLINE | ID: mdl-38901366

ABSTRACT

BACKGROUND: After the outbreak of the full-scale war in Ukraine, about 2 million people sought protection in Poland. Providing high-quality care for migrants and refugees, especially in times of significant arrivals, can be particularly challenging. AIM: To learn about the experiences and strategies of midwives providing maternity care to Ukrainian migrant women in Poland after the outbreak of the full-scale war in Ukraine. METHODS: Five focus group interviews with 32 midwives providing maternity care in Poland were conducted. The interviews were thematically analysed. RESULTS: We identified the barriers experienced by midwives in providing high quality care to migrants to be mainly on the individual and interpersonal levels and levels of management and organization. First, at the individual and interpersonal level, we have identified: fear for life and well-being related to the threat of war in a neighbouring country, depleting resources and post-pandemic fatigue, language barriers, lack of knowledge on caring for women fleeing war. Second, at the management and organizational level we have identified: lack of organizational support, and interpreting services. In the first months after the outbreak of the full-scale war in Ukraine, most strategies to improve the provision of maternity care for women fleeing the war took the form of grassroots initiatives by the staff of individual care units. CONCLUSIONS: The Polish health care services need systemic solutions prepared jointly by state and local authorities and taking into account the voices of midwives to support the provision of high-quality care to migrant population.

13.
J Clin Transl Sci ; 8(1): e90, 2024.
Article in English | MEDLINE | ID: mdl-38836247

ABSTRACT

Background: A gap in the literature exists pertaining to a global research nurse/research midwife resources and communication skill set necessary to engage with participants of diverse populations and geographic regions in the community or home-based conduct of decentralized clinical trials. Aims: An embedded mixed methods study was conducted to examine research nurse/research midwife knowledge base, experiences, and communication skill sets pertaining to decentralized trials across global regions engaged in remote research: the USA, Republic of Ireland, United Kingdom, and Australia. Methods: An online survey was deployed across international research nurse/research midwife stakeholder groups, collecting demographics, decentralized trial experience, barriers and facilitators to optimal trial conduct, and the self-perceived communication competence (SPCC) and interpersonal communication competence (IPCC) instruments. Results: 86 research nurses and research midwives completed the survey across all countries: The SPCC and IPCC results indicated increased clinical research experience significantly correlated with increased SPCC score (p < 0.05). Qualitative content analysis revealed five themes: (1) Implications for Role, (2) Safety and Wellbeing, (3) Training and Education, (4) Implications for Participants, and (5) Barriers and Facilitators. Conclusions: Common trends and observations across the global sample can inform decentralized trial resource allocation and policy pertaining to the research nurse/research midwife workforce. This study demonstrates shared cultural norms of research nursing and midwifery across varied regional clinical trial ecosystems.

14.
Healthcare (Basel) ; 12(12)2024 Jun 11.
Article in English | MEDLINE | ID: mdl-38921288

ABSTRACT

(1) Background: The transition to twin parenthood is a demanding challenge with a higher risk of maternal and fetal complications during pregnancy and a postpartum period that involves caring for more than one newborn at the same time with similar and simultaneous needs. (2) Aim: To find out about parents' needs when experiencing the transition to twin parenthood and to describe the intervention of their specialized nursing support network. (3) Methodology: A descriptive exploratory study, based on a proper non-probabilistic sample of 15 nurses and 55 couples who are parents of twins, using two online questionnaires publicized on social networks. (4) Results: The couple's needs were identified through knowledge of their experiences and difficulties during pregnancy and after the twin birth. Couples' and nurses' perceptions differed on the identified needs. The specialized nursing support network focuses its intervention on providing informative guidance on twin pregnancy and postpartum period, health education, group sharing experiences, home visits, planning, and including a family support network in the management of twin care and the creation of a daily routine. (5) Conclusions: There is a need to implement a program focused on the needs of parents of twins, promoting realistic expectations for the birth and parenting of twins, preparing parents, improving their well-being, and creating a specialized nursing support network available to this population.

15.
Women Birth ; 37(4): 101628, 2024 Jun 03.
Article in English | MEDLINE | ID: mdl-38833842

ABSTRACT

BACKGROUND: Continuity of midwifery care has been proven to show an improvement in clinical outcomes for women and greater maternal satisfaction with maternity care. Several questionnaires have been developed to measure satisfaction with maternity services although few are suitable for continuity of midwifery maternity care models, and many have not been validated. AIMS: The purpose of this study was to test the reliability and validity of the newly developed Continuity of Midwifery Care Satisfaction Survey (COMcareSS) with a cohort of women who have recently experienced continuity of midwifery care. METHODS: The COMcareSS was distributed to women in Australia who had experienced a live birth within a continuity model of midwifery care and were up to two months postpartum. Factor analysis was conducted, and Cronbach's alpha coefficient calculated for the 34-item scale. FINDINGS: In total 272 completed responses were recorded. Cronbach's alpha coefficient for the scale was 0.96 suggesting some redundancy in items. There was a lack of variation in responses. In factor analysis, only one factor could feasibly be attempted. This accounted for 76 % of variation in responses. CONCLUSION: The COMcareSS scale is the first to be developed to measure maternal satisfaction with continuity of midwifery led care. The 34-item scale has good internal consistency. The scale may be unidimensional though the lack of variation in responses means that other possible latent constructs, were not able to be detected. Use of a standardised scale such as the COMcareSS will facilitate benchmarking between services and, comparison and meta-analysis in research studies.

16.
Int J Nurs Stud ; 157: 104813, 2024 May 22.
Article in English | MEDLINE | ID: mdl-38848646

ABSTRACT

BACKGROUND: There is a severe global shortage of midwives, and the situation worsens when qualified professionals leave their jobs because of inadequate working conditions. Hospitals have increasing difficulties in filling vacancies for midwives. In the case of Germany, midwives tend to give up birth assistance after an average of seven years working in delivery rooms, which are usually led by physicians. OBJECTIVE: We aim to provide concrete recommendations on encouraging qualified professionals to work in maternity wards by examining the job preferences of midwives who currently do not provide such services. These insights shall help policy makers and hospital managers to fill vacancies more quickly and provide adequate care to more women. DESIGN: Discrete choice experiment. SETTING(S): Online survey promoted through email and social media to midwives in Germany. PARTICIPANTS: 415 midwives participated; we examine the subgroup of 241 midwives who do not offer birth assistance. METHODS: We obtain individual parameter estimates through a multinominal logit analysis with hierarchical Bayes estimation techniques, calculate importance weights, and simulate uptake probabilities of different hypothetical job offers that include birth assistance. RESULTS: Participants want to provide birth assistance but fiercely reject doing so under physicians' supervision. With a 15 % increase in income, however, 16 % would accept this least preferred setting. Forty-four percent, however, would choose to offer birth assistance if they could work in a midwife-led unit. An additional increase in income of 5 % (15 %) could even lead to uptake probabilities of 67 % (77 %). CONCLUSIONS: There is a common understanding that midwife-led care is a safe and effective option for healthy women. Policy makers are advised to further extend their initial support for such units to fill vacancies quicker and enable comprehensive healthcare for more childbearing women. TWEETABLE ABSTRACT: Midwife-led units help counter shortages: Midwives want to provide birth assistance but reject doing so under physicians' supervision.

17.
Front Nutr ; 11: 1400174, 2024.
Article in English | MEDLINE | ID: mdl-38854160

ABSTRACT

Background: Globally, 36.5% of pregnancies are affected by anemia, particularly in low-and middle-income countries, posing significant risks to maternal and perinatal health. In rural Pakistan, 44.3% of pregnant women suffer from iron deficiency, contributing to the high prevalence of anemia. Limited accessibility to antenatal care exacerbates the challenge, necessitating innovative solutions. This study assessed a midwife-led continuity of care model, utilizing intravenous (IV) iron therapy for the management of anemia in Karachi, Pakistan. Methods: We performed a retrospective analysis of data from a prospective cohort study conducted in two primary healthcare facilities, which employed a community midwife (CMW)-led continuity of care model for antenatal care, including IV iron therapy. We extracted data from February 2021 to March 2022 for women who were diagnosed with anemia based on hemoglobin (Hb) levels, categorized as mild (10.0 to 10.9 g/dL), moderate (7.0 to 9.9 g/dL), or severe (less than 7.0 g/dL). Assessment occurred at the initial antenatal care (ANC) visit to establish baseline anemia severity, and approximately 2 weeks after intravenous (IV) iron therapy administration to evaluate post-treatment changes were considered. Results: We enrolled 114 pregnant women, where the majority presented with moderate (88.6%) anemia. After IV iron treatment, 48.5% improved to normal-mild levels, while 50% remained unchanged. Severe anemia affected 10.5% at baseline; 42% shifted to moderate and 50% to normal-mild post-treatment, with one remaining unchanged (p < 0.001). Among women enrolled in the first and second trimesters, severe anemia improved to normal-mild (50%) and moderate levels (50%) (pre-treatment: n = 10, post-treatment: n = 0), and moderate anemia decreased by 48% (pre-treatment: n = 92, post-treatment: n = 47). Conclusion: Our midwife-led model of care demonstrated an improvement in iron levels among pregnant women. The model addressed the challenges of anemia prevalence in Pakistan and underscored the significance of empowering front-line healthcare providers, such as community midwives (CMWs) for managing these common conditions.

18.
Glob Health Action ; 17(1): 2354008, 2024 Dec 31.
Article in English | MEDLINE | ID: mdl-38828500

ABSTRACT

BACKGROUND: Postpartum depression (PPD) affects approximately 17% of the women worldwide with nearly half of all cases going undetected. More research on maternal mental health, particularly among healthcare professionals and pregnant mothers, could help identify PPD risks and reduce its prevalence. OBJECTIVE: Given that awareness of PPD is a crucial preventive factor, we studied PPD awareness among midwives and pregnant women in Arkhangelsk, Arctic Russia. METHODS: A qualitative study was conducted using in-depth semi-structured interviews. Midwives and pregnant women were recruited from the women's clinic of the Arkhangelsk municipal polyclinic. Seven midwives and 12 pregnant mothers were interviewed. RESULTS: Midwives described limited time for psychological counselling of pregnant women; they reported that their primary focus was on the physiological well-being of women. Pregnant women have expressed a desire for their families to share responsibilities. The participants considered PPD as a mix of psychological and physiological symptoms, and they also highlighted a discrepancy between the expectations of pregnant women and the reality of motherhood. The present study underscored the limited understanding of PPD identification. CONCLUSIONS: The findings suggest that there is a need for increased awareness among midwives and pregnant women regarding PPD. Prevention programs targeting PPD with a specific emphasis on enhancing maternal mental health knowledge are warranted.


Main findings: Pregnant women and midwives in an Arctic Russian setting have low awareness of postpartum depression.Added knowledge: Improved awareness among pregnant women and midwives about the mental health of women after childbirth, educating pregnant women about symptoms of postpartum depression, encourage them to express their needs and collaboration with family supporters may help to reduce postpartum depression burden.Global health impact for policy and action: Updated campaigns and prevention programs with the focus on increasing the knowledge on mental health among pregnant women and health personnel may be effective support for Primary health care.


Subject(s)
Depression, Postpartum , Health Knowledge, Attitudes, Practice , Midwifery , Qualitative Research , Humans , Female , Depression, Postpartum/psychology , Depression, Postpartum/epidemiology , Pregnancy , Russia , Adult , Pregnant Women/psychology , Arctic Regions , Interviews as Topic , Young Adult
19.
Article in English | MEDLINE | ID: mdl-38873233

ABSTRACT

INTRODUCTION: A shortage of UK midwives has put pressure on clinical placements and supervision of student midwives. Alternative placement solutions are needed to provide students with meaningful learning experiences. One such learning experience was a placement undertaken by student midwives who attended a program teaching English to speakers of other languages (ESOL). This study evaluated the impact of the placement on student midwife learning and experiences of the ESOL participants. METHODS: The 2022 study employed a qualitative design using Kolb's model of experiential learning as a framework. Ten student midwives placed with the ESOL program and three women enrolled in the program participated. Data were collected via online focus groups with the student midwives and a face-to-face focus group with the women. Data were analyzed using thematic analysis and Kolb's model of experiential learning. RESULTS: Four themes were constructed: 'Putting the scripts aside: expectations versus the reality of being an educator', 'Adapting and personalizing teaching', 'We are learning too: an environment for mutual learning', and 'Taking our learning forwards'. Students faced barriers during their placement and had to adapt their teaching accordingly. They gained crucial knowledge of the challenges faced by women who speak other languages. The women valued the students' input and together they forged a reciprocal learning environment. CONCLUSIONS: This study demonstrates how placing student midwives in a unique non-maternity setting has benefits for student learning which are transferrable to future practice. Importantly, it confirms that quality of learning during a novel placement is not compromised for students or participants.

20.
Cureus ; 16(5): e61203, 2024 May.
Article in English | MEDLINE | ID: mdl-38939244

ABSTRACT

Midwifery centers are places where midwives not only provide antenatal checkups and delivery care but also offer a wide range of health guidance to pregnant women, postpartum mothers, newborns, and older women. In recent years, midwives have also provided onsite and online health guidance. However, diagnosis and prescribing medication are impossible in midwifery centers because no doctor is present. If the midwife determines that the patient should consult doctors, the patient may have to go to a hospital and see doctors in person, which can be burdensome. Online telemedicine facilitates midwife-doctor collaboration and may solve this problem. We report a case of headache management by telemedicine that minimized the patient's travel burden by collaborating with a midwifery center that provides onsite, visiting, and online health guidance for patients who have difficulty visiting a hospital due to postpartum period, childcare, and breastfeeding. A 29-year-old woman and her husband were raising an infant in Sado City (a remote island across the sea), Niigata Prefecture. She developed acute back pain and was bedridden for several days due to immobility. She consulted a midwife because of stress and anxiety caused by childcare and acute back pain, as well as newly occurring headaches. The midwife visited her and provided on-site health guidance. The midwife decided that a doctor's diagnosis and treatment with painkillers were desirable for the headache and back pain, so she contacted a doctor based on the patient's request. The doctor provided online telemedicine across the sea, diagnosed her headache as a tension-type headache, and prescribed acetaminophen 500 mg as an abortive prescription. The prescription was faxed to a pharmacy on the island, and the original was sent by post. The midwife picked up the medication and delivered it to the patient. After taking the medication, the patient's back pain and headache went into remission. Collaboration between midwifery centers that provide onsite, visiting, and online health guidance and medical institutions that offer online telemedicine can potentially improve accessibility to medical care. It differs from conventional online telemedicine in the midwife's coordination practice by monitoring the patient's condition and requesting the physician based on the patient's request.

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