ORCID Profile
0000-0002-4443-4471
Current Organisation
University College Cork
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Publisher: Elsevier BV
Date: 09-2021
Publisher: Springer Science and Business Media LLC
Date: 12-2016
Publisher: Wiley
Date: 23-12-2021
DOI: 10.1111/PHN.13039
Abstract: Public health, primary health care, and nursing are founding principles of public health nursing. Thus, the underpinning curriculum needs to reflect these core principles. Public health nursing educators sought to delve deeper into curricula and training of public health nurse (PHNs) in Ireland and Norway To compare PHNs’ educational training in Ireland and Norway through a collaborative process This study used a descriptive comparative design A panel of expert educators (the authors) compared national Public health nursing education strategies, guidelines, and curricula used to train PHN students Four core categories emerged from the analysis: general characteristics, theoretical and empirical knowledge base for PHNs practice, applying theory to clinical practice, and professional/ethical dimensions for practice. Results revealed more similarities than differences in both countries’ educational models. The central difference related to the specialist role in Norway versus the generalist role in Ireland Workforce requirements drive the delivery of Public Health Nursing programs and educational curricula. However, it is imperative that educators evaluate their curricula in terms of fitness and practice, not just purpose.
Publisher: Mark Allen Group
Date: 02-11-2014
DOI: 10.12968/BJCN.2014.19.11.534
Abstract: As the population ages, the risk and prevalence of urinary incontinence (UI) will increase. Although this is the case, many women do not seek help or treatment. It is therefore important to investigate women's knowledge of UI. This pilot study aimed to describe community-dwelling women's knowledge of UI. A convenience s le method was used to recruit 50 community-dwelling women aged 50 and over. Some 36 participants completed a demographic questionnaire and the Urinary Incontinence Knowledge Scale (UIKS)—a response rate of 72%. The findings indicated that participants had poor knowledge of UI, principally in relation to risk, prevention, treatment and management factors. Fewer than 20% of participants indicated they had been given information on bladder and bowel health issues. The findings suggested that women had unmet educational needs relating to UI. Community nurses have a key role to play in promoting targeted awareness and continence education advice regarding UI to community-dwelling women.
Publisher: Oxford University Press (OUP)
Date: 06-2022
Abstract: Lung cancer is the leading cause of cancer death globally. Most cases are diagnosed late. Primary healthcare professionals are often the first point of contact for symptoms of concern. This study explored primary healthcare professionals’ experience of referring in iduals with signs and symptoms suggestive of lung cancer along the appropriate healthcare pathway and explored strategies to help primary healthcare professionals detect lung cancer early. Focus groups and in idual interviews were conducted with 36 general practitioners, community pharmacists, practice nurses, and public health nurses. Data were analysed thematically. Participants identified typical lung cancer signs and symptoms such as cough and coughing up blood (i.e., haemoptysis) as triggers for referral. Atypical/non-specific signs and symptoms such as back pain, pallor, and abnormal blood tests were perceived as difficult to interpret. Participants often refrained from using the word ‘cancer’ during conversations with patients. Ireland’s Rapid Access Lung Clinics were perceived as underused, with some general practitioners referring patients to these clinics only when clear and definitive lung cancer signs and symptoms are noted. Lack of communication and the resulting disruption in continuity of care for patients with suspected lung cancer were highlighted as healthcare system flaws. Education on early referral can be in the form of communications from professional organizations, webinars, interdisciplinary meetings, education by lung specialists, and patient testimonials. Lung cancer referral checklists and algorithms should be simple, clear, and visually appealing, either developed as standalone tools or embedded into existing primary care software rogrammes.
Publisher: Informa UK Limited
Date: 2013
DOI: 10.1080/08946566.2012.712864
Abstract: Aging populations and chronic illness increase vulnerability of older people for self-neglect, which is a serious public health issue. Many referrals received by Elder Abuse Services (EAS) in Ireland are categorized as self-neglect. The aim of the research was to observe and describe the living circumstances of a purposive s le of eight older people who were deemed self-neglectful by senior case workers. An exploratory descriptive research design was used. The themes that emerged were early life experiences and lifestyle, disconnectivity, vulnerability, frugality, and service refusal. The majority of participants were content so decisions to live in this way must be respected.
Publisher: Hindawi Limited
Date: 16-10-2019
DOI: 10.1111/JONM.12867
Abstract: To explore the differences in perceived importance and actual performance of clinical leadership for all grades of nurses and midwives engaged in clinical practice. Clinical leadership is central to the provision of person-centred care. However, little is known about how nurses and midwives perceive this in practice. Data were collected on a s le of nurses and midwives in the Republic of Ireland, using a cross-sectional study design (n = 324). The clinical leadership needs analysis instrument was used to measure perceived importance and performance of clinical leadership in practice. Grades of nurses/midwives included staff, manager, advanced practitioner and senior manager. Senior managers were more likely to report significantly higher scores than staff grades for perceived importance of Technology & Care Initiatives (p < .01) and Financial & Service Management (p = .02). Performance of Staff & Care Delivery was significantly higher for senior managers than staff grades [F(5,309) = 6.06 p < .01]. There was a mismatch between the perceived importance and actual performance of clinical leadership in practice between different grades of staff. Leadership training for all grades and mentoring of staff grades can promote the building of confidence and empower staff in leading clinical practice.
Publisher: BMJ
Date: 27-07-2020
DOI: 10.1136/BMJEBM-2020-111385
Abstract: Fostering a culture of clinical effectiveness in healthcare is crucial to achieving optimum outcomes for patients. Evidence-based practice (EBP) is a cornerstone of clinical effectiveness. An EBP capacity-building project commenced in Ireland in 2016, in collaboration with the Centre of Evidence-Based Medicine in Oxford. A key part of this project, reported here, was the development of a competency framework for education in EBP and clinical effectiveness to ensure responsiveness of education standards and curricula of healthcare professionals in this area. Following a review of national and international reports, professional guidance documents and empirical literature pertaining to clinical effectiveness education (CEE), a preliminary competency framework was developed. Stakeholder consultations were conducted over a 6-month period, which consisted of 13 focus groups (n=45) and included representatives from clinical practice, higher education and professional training sectors, regulator/accrediting bodies, the Department of Health (Ireland) and patient/service user groups. An overarching interprofessional competency framework for CEE was proposed and included the following domains: EBP, quality improvement processes, implementation strategies and collaborative practice: a total of 16 competencies and 60 indicators. A competency framework for CEE for health and social care professionals is presented. It is intended that this framework will provide guidance to healthcare educators and regulators in the construction and revision of curricula, learning outcomes, teaching and assessment strategies, and graduate/clinician attributes.
Publisher: Wiley
Date: 20-03-2019
DOI: 10.1111/AOGS.13599
Abstract: There is growing evidence of the considerable impact of fear of childbirth on women's health and well-being, but prevalence reports of high and severe fear of childbirth and reported risk factors have been inconsistent in various studies. Therefore, this study aimed to determine the prevalence of high and severe fear of childbirth, and to identify risk factors of childbirth fear. A cross-sectional study was conducted among a convenience s le of 882 pregnant women attending antenatal care in Cork, Ireland. Fear of childbirth was assessed using the Wijma Delivery Expectancy Questionnaire version A (W-DEQ A) using a cut-off ≥66 to define high fear and ≥85 to define severe fear. Associated risk factors were investigated using univariate and multivariate multinomial logistic regression analyses. Four W-DEQ A subscales were calculated using a cut-off ≥2.5 to determine the nature of childbirth fear. Overall prevalence of severe fear of childbirth was 5.3% and high fear of childbirth was 36.7%. The prevalence of severe fear of childbirth was 7.4% in nulliparous women and 4.3% in multiparous women however, the difference was not statistically significant (P < 0.07). The prevalence of high fear of childbirth was 43% in nulliparous women and 33.6% in multiparous women, and this difference was statistically significant (P < 0.005). High fear of childbirth was associated with single marital status when compared with married or co-habiting women (P < 0.008). In a multivariate analysis, high fear of childbirth was significantly associated with low perceived informational support (adjusted relative risk ratio 2.62, 95% confidence interval [CI] 1.34-5.13) and possible depression (assessed by the Edinburgh Postnatal Depression Scale) (adjusted relative risk ratio 12.87, 95% CI 6.07-27.25). In the W-DEQ A subscales, 35.6% of women scored ≥2.5 in Negative Emotions, 29.4% scored ≥2.5 in Lack of Positive Emotions, 9.9% scored ≥2.5 in Social Isolation and 7.8% scored ≥2.5 in Moment of Birth. Fear of childbirth is relatively common, with varying severity, and was more common in first-time mothers. Using W-DEQ A subscales provided additional information about the nature of the fear, in addition to severity of fear of childbirth.
Publisher: Elsevier BV
Date: 04-2017
DOI: 10.1016/J.WOMBI.2016.10.002
Abstract: Breastfeeding rates in Ireland are among the lowest in Europe. Breastfeeding groups can provide support, information, and friendship for women. However, there is little research exploring community breastfeeding groups led by Public Health Nurses providing universal maternal and child care to all postnatal mothers in the community in Ireland. The aim of this study was to explore breastfeeding women's experiences of a Public Health Nurse led support group. A qualitative descriptive design to explore women's experiences of a community breastfeeding support group was conducted. Data were collected using one to one interviews with breastfeeding women (n=7) in a primary healthcare setting. Transcripts were analysed using Burnard's thematic content analysis. The overall theme identified was 'normalising breastfeeding' which emerged from the subthemes 'socialising and sharing', 'information and support seeking', 'building confidence', 'overcoming embarrassment', 'negative perceptions of others', and 'promoting breastfeeding to others'. Women who attended the PHN led breastfeeding support group found it to be a cocoon of 'normality', whereas breastfeeding was considered almost something to be ashamed of in other circumstances. Many women attributed their success with breastfeeding to the support group. Facilitating a sense of normalcy for breastfeeding women at in idual, community and societal levels was essential in promoting breastfeeding. The community support group was influential in normalising breastfeeding for a s le of women, by minimising the potential for embarrassment, promoting social interaction and sharing, building confidence and knowledge. This buffered the effects of negative attitudes of others and personal feelings of shame.
Publisher: SERDI
Date: 2016
DOI: 10.14283/JFA.2016.86
Abstract: Background: Although caregivers are important in the management of frail, community-dwelling older adults, the influence of different caregiver network types on the risk of adverse healthcare outcomes is unknown. Objective: To examine the association between caregiver type and the caregiver network subtest of The Risk Instrument for Screening in the Community (RISC), a five point Likert scale scored from one (“can manage”) to five (“absent/liability”). To measure the association between caregiver network scores and the one-year incidence of institutionalisation, hospitalisation and death. Design: Observational cohort study. Setting and Participants: Community-dwelling adults, aged ,attending health centres in Ireland,(n=779). Procedure and Measurements: The caregiver network subtest of the RISC was scored by public health nurses. Caregivers were grouped dichotomously into low-risk (score of one) or high-risk (scores two-five). Results: The majority of patients had a primary caregiver (582/779 %), most often their child (200/582 %). Caregiver network scores were highest, indicating greatest risk, when patients had no recognised primary caregiver and lowest when only a spouse or child was available. Despite this, patients with a caregiver were significantly more likely to be institutionalised than those where none was required or identified (11.5% versus 6.5%,p=0.047). The highest one-year incidence of adverse outcomes occurred when state provided care was the sole support the lowest when private care was the sole support. Significantly more patients whose caregiver networks were scored high-risk required institutionalisation than low-risk networks this association was strongest for perceived difficulty managing medical domain issues, odds ratio (OR) 3.87:(2.22-6.76). Only perceived difficulty managing ADL was significantly associated with death, OR 1.72:(1.06-2.79). There was no association between caregiver network scores and risk of hospitalisation. Conclusion: This study operationalizes a simple method to evaluate caregiver networks. Networks consisting of close family (spouse/children) and those reflecting greater socioeconomic privilege (private supports) were associated with lower incidence of adverse outcomes. Caregiver network scores better predicted institutionalisation than hospitalisation or death.
Publisher: Cambridge University Press (CUP)
Date: 28-05-2019
DOI: 10.1017/S2040174419000187
Abstract: Breastfeeding may reduce obesity risk, but this association could be confounded by breastfeeding families’ characteristics. We investigated if body composition differs at birth among infants who were either exclusively breast- or formula-fed. We hypothesized the two groups would differ in body composition, even at birth, prior to their post-natal feeding experience. Healthy primiparous carrying singleton pregnancy were recruited at 15 weeks’ gestation. PEA POD® measured body composition within 72 hours of delivery and infant feeding was prospectively captured. Out of the 1,152 infants recruited, 117 (10.2%) and 239 (20.7%) went on to be either exclusively breast- or formula-fed, respectively. Breastfed infants were heavier at birth, but their percentage fat mass (FM) was lower than that of exclusively formula-fed infants (covariate adjusted β = −1.91 percentage points of FM 95% CI −2.82 to −1.01). Differences in intra-uterine exposures, irrespective of early diet, may partly explain an infant’s obesity risk.
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.MIDW.2017.09.016
Abstract: despite the evidence that fatherhood has a long-term positive and protective effect on men's health, there is also evidence that fatherhood in the perinatal period can be complex and demanding. Due to the potential increase in stressors in the perinatal period, there is reason to hypothesise that it is a time of increased stress for fathers. However, it is not clear how significant a problem stress is for fathers during this stage of life. This is in part, due to the fact that the available research has not been systematically reviewed. the purpose of this systematic review was to critically appraise the empirical evidence that examined stress in fathers in the perinatal period. systematic review. a systematic review protocol was developed and registered with PROSPERO (Reference number: CRD42016035821). The review was guided by the PRISMA reporting process. Electronic databases Medline, CINAHL, the Cochrane Library, PsycARTICLES, PsycINFO, Psychology and Behavioural Sciences Collections were searched to identify studies that met the inclusion criteria. Studies that researched fathers in the perinatal period were included if stress was the principal focus of the research, if stress was in the title and/or aim of the study or if stress was an outcome or dependent variable. Data were extracted and presented in narrative form including tables and figures. eighteen studies met the inclusion criteria. The findings indicate that fathers experience stress in the perinatal period, particularly at the time of birth. Stress levels were found to increase from the antenatal period to the time of birth, with a decrease in stress levels from the time of birth to the later postnatal period. There are a number of factors that contribute to stress in fathers in the perinatal period and these included negative feelings about the pregnancy, role restrictions related to becoming a father, fear of childbirth and feelings of incompetence related to infant care. The review found that stress has a negative impact on fathers, with higher stress levels contributing to mental health issues such as anxiety, depression, psychological distress and fatigue. during the perinatal period fathers experience stress and face unique stressors that can impact negatively on their health and social relationships.
Publisher: Elsevier BV
Date: 04-2007
DOI: 10.1016/J.APNU.2006.10.006
Abstract: This article presents an overview of research on postnatal depression conducted with postnatal women only. Research spanning three areas is reviewed, namely, prevalence, mothers' experiences ,and treatments. The review shows prevalence rates varying from 4.4% to 73.7%, with the most recent systematic review suggesting a rate of 13%, indicating a serious clinical issue for nurses providing postnatal care to mothers. Mothers' experiences of living with postnatal depression exemplify such feelings as loneliness, anxiety, hopelessness, and loss of control at a time when expectations of joyousness are anticipated. Results of research on treatment options show limited success with antidepressant medications, some success with psychotherapeutic options, and the importance of social support for mothers with postnatal depression. Comparisons of studies are made from methodological perspectives, drawing on their strengths and limitations. Overall, this review highlights the high prevalence rates of postnatal depression, negative feelings exemplified by mothers' living with this condition, and the limited success of treatment options available to mothers. Postnatal depression is a significant clinical issue for nurses providing postnatal care for mothers and is underassessed, misunderstood, and very often poorly treated.
Publisher: Elsevier BV
Date: 09-2021
Publisher: Springer Publishing Company
Date: 2016
Abstract: Self-neglect is a significant international public health issue. Estimates suggest that there may be over one million cases per year in the United States. Aging populations will put more people at risk of self-neglect. This chapter presents background literature, self-neglect definitions and policy context, risk factors, and a brief overview of research on perspectives of self-neglect from both clients and community health and social care professionals. A case study is presented from the perspective of an in idual and is used to explore ethical issues therein. A person-centered assessment within a multidisciplinary team approach is required for building a therapeutic relationship with clients. Capacity is a central issue in the management of responses to self-neglect. Ethical considerations of importance for community health and social care professionals include beneficence and nonmaleficence, autonomy and capacity, and respect for people's rights and dignity. A model of ethical justification is presented to explain dilemmas, challenges, and actions. Competence of professionals, multidisciplinary team working, informed consent, privacy, confidentiality, and best interest are also critical considerations. Effective decision making by an interdisciplinary team of professionals needs to be person-centered and give due consideration to the best interest of self-neglecting clients. The purpose of this chapter is to provide an in-depth discussion and examination of ethical issues and challenges relating to self-neglecting clients.
Publisher: Elsevier BV
Date: 11-2022
Publisher: Elsevier BV
Date: 11-2019
DOI: 10.1016/J.JPSYCHORES.2019.109813
Abstract: Social support facilitates a woman's transition to motherhood. This major developmental transition can be stressful as it includes adaptation of self as well as learning new infant care practice skills. Although a number of instruments have been developed to measure social support, none have been developed or underpinned by theory in the context of perinatal infant care practices. To develop a reliable and valid instrument to measure social support for new mothers in the perinatal period. Phase 1 involved the development of instrument structure and content. Constructs to be measured were defined through an analysis of relevant theoretical and empirical literature. Phase 2 established the psychometric properties of the functional domain of the PICSS. Exploratory factor analyses and principal Component Analyses were undertaken with a s le of first-time mothers (n = 371) from postnatal wards of a large maternity hospital. Item reduction and Cronbach's alpha reliability tests were performed. The structural social support domain was not amenable to psychometric testing. Exploratory Factor Analyses and Principal Component Analyses of the functional domain resulted in a logically coherent 19-item, two-factor solution. The first factor 'Supporting Presence' has nine items (Cronbach's alpha = 0.90) and the second factor 'Practical Support' has ten items (Cronbach's alpha = 0.86). The PICSS is a coherent and valid measure of social support for new mothers in the postnatal period in the context of infant care practices.
Publisher: BMJ
Date: 17-08-2011
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-05-2022
Publisher: Wiley
Date: 17-05-2017
DOI: 10.1111/AOGS.13138
Abstract: Tocophobia is defined as a severe fear of pregnancy and childbirth. There is increasing evidence that tocophobia may have short-term and long-term adverse effects on mother and baby. We performed a systematic review and meta-analysis to determine the global prevalence of tocophobia in pregnancy. Relevant articles were identified through searching six relevant databases: MEDLINE, CINAHL, Pubmed, PsycINFO, Maternity & Infant Care and Scopus between 1946 and April 2016. We used search terms for tocophobia prevalence in pregnant women that we agreed on with a medical librarian. There were no language restrictions. Two review authors independently assessed data for inclusion, extracted data and assessed quality using a standardized appraisal tool. Meta-analysis was performed to determine the overall pooled-prevalence of tocophobia. Several subgroup and sensitivity analyses were conducted. Thirty-three studies were included in the systematic review from 18 countries of which data from 29 studies were used in the meta-analysis of 853 988 pregnant women. Definition of tocophobia varied, whereas prevalence rates ranged between 3.7 and 43%. The overall pooled prevalence of tocophobia, using a random-effects model, was 14% (95% CI 0.12-0.16). Significant heterogeneity was observed (I The prevalence of tocophobia is estimated at 14% and appears to have increased in recent years (2000 onwards). Considerable heterogeneity (99.25%) was noted that may be attributed to lack of consensus on the definition of tocophobia, so our results should be interpreted with caution.
Publisher: Wiley
Date: 09-02-2018
DOI: 10.1111/INR.12434
Abstract: To examine the perceptions of nurse managers, registered nurses and healthcare assistants of physical restraint use on older people in a long-term care setting in the Republic of Ireland. The use of physical restraint, although controversial, persists in long-term care settings, despite recommendations for restraint-free environments. Perception and attitude of staff can influence use of physical restraint. A descriptive cross-sectional design was used. A total of 250 nursing and healthcare assistant staff were recruited. A questionnaire incorporating demographics and the Perceptions of Restraint Use Questionnaire was used. Descriptive and inferential statistical analyses were conducted. Mean age of respondents (n = 156) was 41 years, and the majority were female. Overall, a low level of importance was attached to the use of restraint. Nurse managers and registered nurses compared favourably with healthcare assistants who attached a higher importance to use of restraint. Across all three staff groups, greatest importance was attached to the use of physical restraint for reducing falls, followed by prevention of treatment interference. Restraint was least favoured as a means of impairment management. Education was not an explanatory factor in perceived importance of physical restraint use. Nurse managers and registered nurses are unlikely to use physical restraint. However, there is concern regarding perception of healthcare assistants on use of restraint. Results from this study compare favourably with those in countries that have no policy on physical restraint use. Educational programmes alone are insufficient to address use of physical restraint. Attention to skill mix with adequate support for healthcare assistants in long-term care settings is recommended.
Publisher: Cold Spring Harbor Laboratory
Date: 10-05-2021
DOI: 10.1101/2021.05.08.21256829
Abstract: Throughout the perinatal period from pregnancy to the first year postpartum, both men and women experience significant physical, psychological, and social changes which may increase their risk of a mental illness, including anxiety and depression. There has been significant growth in the frequency literature around anxiety and depression across the perinatal period over the past decades with significant variation in definition, measurement outcomes, and populations. To focus future research and identify gaps, it is important to explore current patterns and trends in the current literature. The objective of this bibliometric analysis is to analyze the characteristics and trends in published research on anxiety and depression across the perinatal period from January 1, 1920 to end of 2020. All published literature in Web of Science on perinatal anxiety and depression from January 1, 1920 to December 31, 2020. Web of Science will be used to analyze bibliometric information through their built-in analysis feature and citation report that generates a list of leading publications, publication years, document types, authors, source titles, countries/regions, organizations, and research areas. VOSViewer will be utilized to analyze and visualize the networks of linkages between the identified reports, including bibliometric networks, including co-authorship, co-occurrence, and co-citation, as well as co-occurrence between keywords. The findings from this study will provide useful information to guide future work on perinatal anxiety and depression. This bibliometric review will provide an overview of the work to date in perinatal mental health, identify key contributions to the field, and identify knowledge gaps and future directions.
Publisher: Wiley
Date: 02-05-2019
Publisher: Mark Allen Group
Date: 02-03-2015
DOI: 10.12968/BJCN.2015.20.3.110
Abstract: Self-neglect is a worldwide and serious public health issue that can have serious adverse outcomes and is more common in older people. Cases can vary in presentation, but typically present as poor self-care, poor care of the environment and service refusal. Community nurses frequently encounter self-neglect cases and health and social care professionals play a key role in the identification, management and prevention of self-neglect. Self-neglect cases can give rise to ethical, personal and professional challenges. The aim of this article is to create a greater understanding of the concept of self-neglect among community nurses.
Publisher: Elsevier BV
Date: 10-2014
Publisher: Wiley
Date: 09-05-2005
DOI: 10.1111/J.1365-2648.2005.03425.X
Abstract: This paper reports a study whose primary aim was to explore the relationship between social support for first-time mothers and their confidence in infant care practices. A secondary aim was to identify their sources of support in the postnatal period. Policy documents emphasize the importance of support for new mothers in the postnatal period in caring for their infants. Nurses/midwives require a working knowledge of how social support influences maternal confidence in infant care practices, specifically during the first 6 weeks postdelivery. A descriptive, correlational design was used. A 28 item questionnaire was designed to measure social support in the specific context of first-time motherhood and confidence in infant care practices. Content validity was sought and the instrument demonstrated reliability using Cronbach's alpha. A convenience s le of 135 first-time mothers was recruited and 74% completed questionnaires at 6 weeks after birth. Data were collected in 2000. Appraisal support had a statistically significant moderate relationship with confidence in infant care practices (r = 0.4, P < 0.01). Informational support had a weaker but statistically significant relationship (r = 0.2, P < 0.05). Respondents' primary sources of appraisal support were husbands artners and their own mothers. Public health nurses and mothers were primary sources of informational support. First-time mothers' husbands artners need to become active participants in antenatal and postnatal care. Interdisciplinary educational programmes need to be developed so that public health nurses and midwives work collaboratively in facilitating social support for first-time mothers in caring for their infants. Curricula for public health nurses and midwives need to be evidenced-based with respect to social support.
Publisher: Oxford University Press (OUP)
Date: 15-06-2012
DOI: 10.1093/BJSW/BCR082
Publisher: Elsevier BV
Date: 04-2023
Publisher: Wiley
Date: 27-02-2021
DOI: 10.1111/JOCN.15690
Abstract: To explore midwives’ experiences of caring for women's emotional and mental well‐being during pregnancy. Transitioning to motherhood is a major life event for any woman and while it is a joyful experience for the majority, 15%–25% of women will experience a perinatal mental health problem. Providing psychological support to mothers by midwives is acknowledged internationally. The 2016 Irish National Maternity Strategy identifies midwives as being ideally placed to assess women's emotional needs. The research revealed a paucity of qualitative research from an Irish context in this area therefore, this study addressed this gap in the literature. Qualitative descriptive design. Semi‐structured interviews were conducted with a purposive s le of 10 midwives recruited from the Irish midwifery e‐group. Data were analysed using Burnard ( Nurse Educ. Today , 11, 1991, 461) thematic content analysis. Transcripts were coded, and meanings were formulated to reflect significant statements, which were categorised. Categories were then evolved into subthemes, and eventually, three themes were emerged using the COREQ checklist. Three salient themes emerged from the data are as follows: ‘awareness of Perinatal Mental Health’, ‘discussing emotional well‐being’ and ‘the woman has something to ulge’. The themes convey the midwife's awareness, recognition and perceptions of mental well‐being during pregnancy. How midwives discuss and assess emotional well‐being, the observational skills they use, and what they perceive as the barriers and facilitators to discussing mental well‐being were all identified. Midwives reported an awareness and acceptance that women's emotional health was as important as their physical health. Midwives used every antenatal opportunity to raise awareness about perinatal mental health, whilst also identifying key challenges in getting women to talk. Care pathways for assessing and identifying Perinatal Mental Health issues should be available in all maternity services. More support for midwives is required to debrief, which would assist them in supporting women's emotional well‐being.
Publisher: Wiley
Date: 27-07-2023
DOI: 10.1111/JOCN.16460
Abstract: The aim of this study was to explore fathers’ perceptions and experiences of support in the perinatal period. Change in society has seen the increased visibility of fathers being involved during pregnancy and engaging in their infants’ lives and the expectation and benefits of men playing an equal and direct role in caring for their children. However, less is known about the nature of support that fathers require to facilitate this role transition. A scoping review was conducted in accordance with Arksey and O’Malley’s six‐step scoping review framework and the PRISMA‐ScR guidelines. A systematic search of CINAHL Plus, MEDLINE, the Cochrane Library, PsycARTICLES, PsycINFO, Psychology, Soc INDEX and Behavioural Sciences Collections databases for qualitative or mixed methods studies with qualitative data was undertaken. Qualitative data were extracted from original studies for coding and theme generation. Thematic synthesis was employed for the final stages of analysis. Overall, 23 papers were included. Men desired to fulfil their rite of passage to be an involved father to their child. This transitional process commenced with men articulating their commitment to creating a role as an involved father and to be a role model for their children. Becoming a father is seen as having a significant status in society which contributes to their self‐efficacy as fathers. Fathers require support from all levels of the ‘ecosystem’ including policy, socio‐cultural and workplace changes as well as recognition and support from partners, family, peers and in particular from health service providers. Developing the parenting partnership requires a co‐production approach and commitment at macro, meso and micro levels. Supporting men to be engaged fathers requires policy, socio‐cultural and workplace changes however, maternity services and particularly midwives have an important role in this change.
Publisher: Springer International Publishing
Date: 2015
Publisher: Elsevier BV
Date: 11-2019
DOI: 10.1016/J.MIDW.2019.07.015
Abstract: Empowerment is expected to have a beneficial effect on a woman's well-being during the perinatal period and her readiness to face the challenges of motherhood. In the literature on pregnancy and childbirth, empowerment is used widely in different contexts, with different connotations and often without a definition, thus indicating a lack of clarity of what is actually meant by the concept. To report an analysis of the concept of women's empowerment in the context of the perinatal period. We used the concept analysis framework of Walker and Avant to analyse the concept of women's empowerment during pregnancy and childbirth. In July 2018, we did a systematic search in EBSCOhost, including the database MEDLINE, CINAHL, PsycINFO, PsycARTICLES and SocINDEX, using keywords: empower, women, childbirth and their synonyms. All selected papers were analysed for definitions of empowerment, defining attributes, antecedents and consequences. Ninety-seven scientific papers from all continents were included in the analysis. Defining attributes, antecedents, consequences and empirical referents are discussed, and a model case as well as related and contrary cases are presented. Attributes, external and internal to the woman, were identified. Both types of attributes need to be considered within the broader socio-cultural-economic-political landscape of the in idual woman, in conjunction with a woman's belief in herself and her meaningful interconnectedness with carers. This study resulted in an understanding of empowerment in the context of pregnancy and childbirth that can be used in research and for the development of interventions preparing women for childbirth and their subsequent transition to motherhood.
Publisher: Wiley
Date: 20-04-2018
DOI: 10.1111/PHN.12408
Abstract: The Public Health Intervention Wheel (PHIW) is a population-based practice model that encompasses three levels of practice (community, systems, and in idual/family) and 17 public health interventions. Each intervention and practice level contributes to improving population health. Public health nurses (PHNs) provide care at the three levels of practice. Prevention of falls is a public health issue and the majority of falls happen at home. Therefore, prevention and management of falls in the community could benefit from a public health systems approach by PHNs underpinned by the PHIW. A hypothetical case is presented of a 78-year-old gentleman who had a fall which resulted in a fractured right acetabulum and surgery before being discharged home. The aim of this paper was to use a case summary to illustrate PHN practice in the context of the PHIW as applied to falls management and prevention. This paper focuses on fall incidence and PHN response in Ireland and Norway. The PHIW is described and relevant interventions from the PHIW are applied to PHN practice in managing the case. The PHIW model provides insight into the potential scope of public health nursing in falls, articulating PHN practice in the community.
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.WOMBI.2021.07.002
Abstract: The humanisation of childbirth has been identified as a practice of care focusing on the physical, psychological, and emotional wellbeing of women. Healthcare professionals (HCPs) are expected to understand and embed humanised practice when supporting women in childbirth. The aim of this paper is to present a meta-synthesis of the experiences and perspectives of HCPs who undertake care for women at the time of birth regarding the humanisation of childbirth. A systematic search of the electronic databases CINAHL, Medline, PsycINFO, and SocINDEX were conducted in July 2020. Qualitative studies exploring HCPs' experiences and perspectives of humanisation in childbirth were eligible. Studies were synthesised using a meta-ethnographic approach. Fourteen studies involving 197 participants were included. Two themes were identified: 'Women at the centre' and 'Professional dissonance'. Two line of argument synthesis were identified: 'invisible boundaries' and 'unconscious undermining'. HCPs recognised that women required positive interactions which met both their emotional and physical needs. Human touch supported bonding between HCPs and women. HCPs understood humanisation as the reduction of unnecessary intervention and/or technology but had difficulties enacting this and often used disempowering language when discussing women's choices. The management of pain and the presence of a companion were considered important by HCPs. This synthesis revealed that HCPs do understand the humanisation of childbirth but have difficulties in enacting it in practice. Women classified as high risk were identified as having specific needs such as increased emotional support. Further research is required for women classified as high risk who may require technology and/or interventions to maintain a safe birth.
Publisher: Wiley
Date: 18-05-2018
DOI: 10.1111/BLD.12230
Publisher: Elsevier BV
Date: 06-2011
DOI: 10.1016/J.APNU.2010.08.005
Abstract: Postnatal depression (PND) is a significant public health issue, with variable prevalence and a dearth of research on risk and protective factors. This quantitative longitudinal study of 512 first-time mothers identified the prevalence of PND and examined the relationships between functional and structural social support at 6 and 12 weeks postpartum. The prevalence of PND was 13.2% at 6 weeks and 9.8% at 12 weeks. At 6 and 12 weeks, the only social support dimension independently associated with PND was total functional social support. At-birth formal structural support and emotional functional support were independently predictive of PND at 12 weeks.
Publisher: MDPI AG
Date: 10-07-2019
Abstract: Increasing pressure on limited healthcare resources has necessitated the development of measures promoting early discharge and avoiding inappropriate hospital (re)admission. This systematic review examines the evidence for interventions in acute hospitals including (i) hospital-patient discharge to home, community services or other settings, (ii) hospital discharge to another care setting, and (iii) reduction or prevention of inappropriate hospital (re)admissions. Academic electronic databases were searched from 2005 to 2018. In total, ninety-four eligible papers were included. Interventions were categorized into: (1) pre-discharge exclusively delivered in the acute care hospital, (2) pre- and post-discharge delivered by acute care hospital, (3) post-discharge delivered at home and (4) delivered only in a post-acute facility. Mixed results were found regarding the effectiveness of many types of interventions. Interventions exclusively delivered in the acute hospital pre-discharge and those involving education were most common but their effectiveness was limited in avoiding (re)admission. Successful pre- and post-discharge interventions focused on multidisciplinary approaches. Post-discharge interventions exclusively delivered at home reduced hospital stay and contributed to patient satisfaction. Existing systematic reviews on tele-health and long-term care interventions suggest insufficient evidence for admission avoidance. The most effective interventions to avoid inappropriate re-admission to hospital and promote early discharge included integrated systems between hospital and the community care, multidisciplinary service provision, in idualization of services, discharge planning initiated in hospital and specialist follow-up.
Publisher: Wiley
Date: 09-12-2012
DOI: 10.1111/J.1365-2702.2011.03975.X
Abstract: Aims and objectives. The aim of the study was to review breastfeeding support provided by Public Health Nurses in Ireland. The objectives were to identify the availability of appropriate guiding policies, educational preparation, attitude of Public Health Nurses and the availability and use of other supportive services. Background. Breastfeeding rates in Ireland are among the lowest in Europe. The main source of formal support for breastfeeding mothers in the community in Ireland is from Public Health Nurses who can make referral to other non‐statutory resources. The nature of this support is determined by policies guiding clinical practice and education that increases breastfeeding confidence and competence of all personnel. Consequently, an assessment of breastfeeding resources requires an analysis of all these variables. Design. A large quantitative, cross‐sectional study was conducted, involving Public Health Nurses and mothers. This paper represents the results from the perspective of Public Health Nurses. Method. Directors of Public Health Nursing ( n = 24) and Public Health Nurses ( n = 204) completed self‐report questionnaires by mail and online. Data were analysed using the Statistical Package for Social Sciences and reported using descriptive and inferential statistics. Results. Public Health Nurses are well educated to support breastfeeding and have a positive attitude and a high degree of self‐assessed confidence and competence. A wide variety of non‐statutory support exists for breastfeeding but is not always used to their full potential. Conclusion. Standardising educational requirements for Public Health Nurses in supporting breastfeeding is an area that requires attention. Ultimately, service delivery in relation to supporting breastfeeding mothers would benefit from being more timely and responsive. Relevance to clinical practice. Awareness of support resources is necessary for Public Health Nurses to make appropriate referrals for breastfeeding mothers. Furthermore, Directors of Public Health Nursing need to encourage the breastfeeding supportive role of Public Health Nurses and facilitate continuing professional development.
Publisher: Mark Allen Group
Date: 02-01-2016
DOI: 10.12968/BJCN.2016.21.1.31
Abstract: The extent of self-neglect on public health nurses' (PHNs) caseloads in Ireland is unknown. People who self-neglect may be vulnerable or hidden and, as a consequence, difficult to profile. PHNs in Ireland profile their areas to identify the nursing needs of their population. This paper aims to: collate caseloads on self-neglect on the basis of a review of community profile and health need assessments (CPHNA) and identify the geographical and demographic factors within which self-neglect cases were found. A retrospective review of the CPHNA of student PHNs (n=88) was undertaken from 2010 to 2014 in a university in Ireland. In all, 88 community profiles were manually reviewed. A total of 374 self-neglect cases were identified—79 cases were aged between 18–64 years and 295 were over 65 years. The range of self-neglect cases per profiled area was between 0 to 25. The geographic and demographic factors linked to self-neglect across profiles were higher rates of older people, deprivation, disadvantage, and cultural factors. This retrospective review illustrates that self-neglect is a prominent feature in PHN caseloads, which has not been identified previously. Early identification is important to promote the mental health and wellbeing of self-neglecting clients.
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.MIDW.2013.01.008
Abstract: The aim of this research was to identify factors associated with mothers breast feeding and to identify, for those who breast fed, factors associated with breast feeding for as long as planned. breast feeding rates in Ireland are amongst the lowest in Europe. Research evidence indicates that in order for mothers to be successful at breast feeding, multiplicities of supports are necessary for both initiation and duration. The nature of these supports in tandem with other influencing factors requires analysis from an Irish perspective. cross-sectional study involving public health nurses and mothers in Ireland. This paper presents the results of the mothers' evaluation. mothers (n=1715) with children less than three years were offered a choice of completing the self-report questionnaires online or by mail. Data were analysed and reported using descriptive and inferential statistics. four in every five participants breast fed their infant and two thirds of them breast fed as long as planned. The multivariate logistic regression analysis identified that third level education, being a first time mother or previously having breast fed, participating online, having more than two public health nurse visits, and having a positive infant feeding attitude were independently and statistically significantly associated with breast feeding. Among mothers who breast fed, being aged at least 35 years, participating online, having a positive infant feeding attitude and high breast feeding self-efficacy were independently and statistically significantly associated with breast feeding for as long as planned. findings from this study reinforce health inequalities therefore there needs to be a renewed commitment to reducing health inequalities in relation to breast feeding. this study has identified factors associated with initiation and duration of breast feeding that are potentially modifiable through public health interventions.
Publisher: Springer Science and Business Media LLC
Date: 18-10-2022
DOI: 10.1038/S41533-022-00312-9
Abstract: Patients with lung cancer (LC) often experience delay between symptom onset and treatment. Primary healthcare professionals (HCPs) can help facilitate early diagnosis of LC through recognising early signs and symptoms and making appropriate referrals. This systematic review describes the effect of interventions aimed at helping HCPs recognise and refer in iduals with symptoms suggestive of LC. Seven studies were synthesised narratively. Outcomes were categorised into: Diagnostic intervals referral and diagnosis patterns stage distribution at diagnosis and time interval from diagnosis to treatment. Rapid access pathways and continuing medical education for general practitioners can help reduce LC diagnostic and treatment delay. Awareness c aigns and HCP education can help inform primary HCPs about referral pathways. However, c aigns did not significantly impact LC referral rates or reduce diagnostic intervals. Disease outcomes, such as LC stage at diagnosis, recurrence, and survival were seldom measured. Review findings highlight the need for longitudinal, powered, and controlled studies.
Publisher: Elsevier BV
Date: 10-2010
Publisher: Hindawi Limited
Date: 2015
DOI: 10.1155/2015/256414
Abstract: The Risk Instrument for Screening in the Community (RISC) is a short, global risk assessment to identify community-dwelling older adults’ one-year risk of institutionalisation, hospitalisation, and death. We investigated the contribution that the three components of the RISC ( concern , its severity , and the ability of the caregiver network to manage concern) make to the accuracy of the instrument, across its three domains (mental state, activities of daily living (ADL), and medical state), by comparing their accuracy to other assessment instruments in the prospective Community Assessment of Risk and Treatment Strategies study. RISC scores were available for 782 patients. Across all three domains each subtest more accurately predicted institutionalisation compared to hospitalisation or death. The caregiver network’s ability to manage ADL more accurately predicted institutionalisation (AUC 0.68) compared to hospitalisation (AUC 0.57, P = 0.01 ) or death (AUC 0.59, P = 0.046 ), comparing favourably with the Barthel Index (AUC 0.67). The severity of ADL (AUC 0.63), medical state (AUC 0.62), Clinical Frailty Scale (AUC 0.67), and Charlson Comorbidity Index (AUC 0.66) scores had similar accuracy in predicting mortality. Risk of hospitalisation was difficult to predict. Thus, each component, and particularly the caregiver network , had reasonable accuracy in predicting institutionalisation. No subtest or assessment instrument accurately predicted risk of hospitalisation.
Publisher: Wiley
Date: 03-04-2017
DOI: 10.1111/PHN.12324
Abstract: The coordination and integration of health care is compromised by complex challenges related to transitions between care settings, greater prevalence of chronic health conditions, and older in iduals with increasing levels of dependency. Transitional care incorporates a broad range of services designed to provide care continuity. This systematic review aims to synthesize and present findings regarding the relevance of transitional care interventions to community nursing. A systematic search of electronic databases was conducted as part of a larger review to identify evidence-based interventions to support a model to guide nursing and midwifery in the community in Ireland. All relevant empirical studies published in English between 2010 and 2015 were included. Studies were assessed based on inclusion criteria. The Cochrane Risk of Bias and AMSTAR tools were used to assess the methodological quality of studies. Key themes and concepts were extracted and synthesized. Transitional care interventions had significant positive effects in reducing all-cause readmissions, mortality, and heart failure-related rehospitalizations. Effective transitional care requires excellent communication between acute and primary care providers. This has implications for integration and organization of care across settings and nursing competence.
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.JPSYCHORES.2019.03.013
Abstract: To compare pregnancy outcomes for women with and without severe fear of childbirth (FOC) reported in the second trimester of pregnancy. In a prospective cohort study, 389 singleton pregnancies were followed up using medical records of participants in a study investigating FOC in Cork, Republic of Ireland. FOC was measured using the Wijma Delivery Experience Questionnaire Part A (W-DEQ A). Severe FOC was defined as W-DEQ A ≥ 85, moderate FOC, W-DEQ-A 66-84 and low FOC, W-DEQ A 0-65. Outcome measures were birthweight, birthweight centile, gestational age, and Apgar scores at 1 min and Apgar at 5 min. Linear regression was used to assess the association between FOC and each outcome measure with adjustment for maternal age, smoking, parity and marital status. There was no statistically significant difference in mean birthweight (mean difference = -0.03 [95% CI: -444.69, 315.82]), mean birthweight centile (mean difference = 0.03 [95%CI: -15.97, 23.53]), or mean gestational age (mean difference = -0.06 [95%CI: -11.69, 4.82]) in women with severe FOC (n = 18) compared with women with low FOC (n = 371). In the adjusted models, there was only a slight correlation between severe FOC and Apgar scores at 1 min (mean difference = -0.09 [95%CI: -1.28, 0.32]) and Apgar scores at 5 min (mean difference = -0.18 [95%CI: -1.16, 1.08]). While a slight association was noted between severe FOC and Apgar scores, overall findings are reassuring and could inform educational interventions which may alleviate FOC. Awareness of FOC for health care professionals is vital to consider women's mental well-being.
Publisher: Elsevier BV
Date: 06-2015
Publisher: Springer Science and Business Media LLC
Date: 10-2021
DOI: 10.1186/S12884-021-04106-8
Abstract: Women across the world value choice and control throughout their maternity care experiences. In response to this health policy and frameworks are adapting and developing. The concepts of choice and control are extrinsically complex and open to interpretation by healthcare professionals and service users, with the two not necessarily aligning. Depending on a number of factors, women’s experiences of choice and control within the same maternity care system may be very different. This study aimed to investigate the factors influencing women’s perceptions of choice and control during pregnancy and birth in Ireland. We conducted a cross-sectional study using an adapted version of the UK national maternity experience survey (National Perinatal Epidemiology Unit). During March – July 2017, a s le of 1277 women were recruited from the postnatal wards of three maternity units and a tertiary maternity hospital. Poisson regression was used to assess the association between twelve factors and a series of measures of the women’s perception of choice and control. Most women reported not having choice in the model or location of their maternity care but most reported being involved enough in decision-making, especially during birth. Women who availed of private maternity care reported higher levels of choice and control than those who availed of public maternity care. This factor was the most influential factor on almost all choice and control measures. Most women experiencing maternity care in Ireland report not having choice in the model and location of care. These are core elements of the Irish maternity strategy and significant investment will be required if improved choice is to be provided. Availing of private maternity care has the strongest influence on a woman’s perceived choice and control but many women cannot afford this type of care, nor may they want this model of care.
Publisher: Elsevier BV
Date: 12-2011
DOI: 10.1016/J.MIDW.2010.07.008
Abstract: To present an integrated literature review on maternal parental self-efficacy (MPSE) in the postpartum period. A literature search of CINAHL with full text and MEDLINE and PsycINFO from their start dates to February 2010. Inclusion criteria were English written research articles which reported the measurement of MPSE in the postpartum period. Articles were reviewed based on purpose, theoretical framework, data collection method, s le, main findings and nursing implications for maternal parenting. In addition, data related to the instruments that were used to measure MPSE were included. Data revealed is a statistically significant increase in MPSE over time from baseline a positive relationship between MPSE and number of children, social support, maternal parenting satisfaction and marital satisfaction and a negative relationship between MPSE and maternal stress, anxiety and postpartum depression. A variety of instruments to measure MPSE were used but the majority were based on Bandura's framework. Findings from this review may assist women's health researchers and clinical nurses/midwives in assessing and developing appropriate interventions for increasing risk awareness, enhancing MPSE and subsequent satisfaction with parenting and emotional well-being. Further research is necessary underpinned by theoretical frameworks using domain-specific instruments to identify predictors of MPSE.
Publisher: Wiley
Date: 18-03-2022
DOI: 10.1111/JOCN.16297
Abstract: This study examines the relationship between social status and postpartum depression by migrant generation and determines whether social support moderates the relationship between migrant generations and postpartum depression. Postpartum depression (PPD) afflicts more than 1 in 10 childbearing women worldwide and this mental health problem may be higher among vulnerable populations of women such as migrants, an increasingly prevalent group in many countries. Social support and migrant generation (1 st generation—mother and her parents born outside the host country 2 nd generation—mother born in the host country but not her parents 2.5 generation—mother and one parent born in the host country) may contribute to the conflicting findings on migrant mothers and postpartum depression. This study used a cross‐sectional design. S le recruitment of migrant and non‐migrant first‐time mothers (n=515) was implemented through an online platform. A STROBE checklist guided the reporting of this study. PPD was lower among mothers with social support. While social support was negatively associated with PPD for all mothers, PPD was not associated with migrant generation nor was a moderation effect found. Social support is negatively associated with PPD for all mothers, but levels of PPD for migrant mothers may be linked to country‐specific healthcare resources and immigration policies. Immigrant policies influence migrant mothers’ healthcare access thus, immigration policies may influence PPD among first‐time migrant mothers and the manner in which nurses can provide formal support. This study finds that social support, including the formal social support provided by nurses, decreases the likelihood of PPD. Demands on nurses’ technical and assessment skills are high, but nurses also need to remember that their skills of providing social support are equally important, and for first‐time mothers, may contribute to decreasing PPD.
Publisher: Elsevier BV
Date: 09-2019
DOI: 10.1016/J.MIDW.2019.05.013
Abstract: fatherhood in the perinatal period can be a time of great excitement, happiness and joy. However, a growing body of literature indicates that fathers are at risk for elevated levels of anxiety symptoms during the perinatal period. the purpose of this systematic review is to determine the prevalence and levels of anxiety in fathers during the perinatal period, identify the risk factors and impact of anxiety, and establish if there are effective interventions that reduce father's anxiety. Systematic review. A systematic review protocol was developed and registered with PROSPERO (reference number: CRD42017073760). The review was guided by the PRISMA reporting process. Electronic databases Medline, CINAHL, Embase, the Cochrane Library, PsycARTICLES, PsycINFO, and Psychology were searched to identify eligible studies. Studies that researched fathers during the perinatal period were included if anxiety was the primary focus of the research or was an outcome or dependent variable. Data were extracted and presented in narrative form including tables and figures. Thirty-four studies met the inclusion criteria. Findings from these studies indicate that fathers experience anxiety in the perinatal period, particularly at the time of birth. Anxiety increased from the antenatal period to the time of birth, with a decrease in anxiety from the time of birth to the later postnatal period. The prevalence of anxiety ranged between 3.4% and 25.0% during the antenatal period and 2.4% and 51.0% during the postnatal period. Factors contributing to anxiety included lower education levels, lower income levels, lower co-parenting support, lower social support, work-family conflict, a partner' anxiety and depression, and being present during a previous birth. Anxiety had a negative impact on fathers' mental health, physical health, social relationships and parenting skills. Anxiety contributed to stress, depression, fatigue and lower paternal self-efficacy. Five studies reported on interventions to reduce anxiety and all the studies found that anxiety significantly decreased following the intervention. Fathers experience increased anxiety from the antenatal period to the time of birth, with a decrease in anxiety from the time of birth to the later postnatal period. Anxiety during the perinatal period that can impact negatively on fathers physical and mental health, and social relationships.
Publisher: Public Library of Science (PLoS)
Date: 05-08-2020
Publisher: Informa UK Limited
Date: 04-2011
DOI: 10.1002/EDN.171
Publisher: Elsevier BV
Date: 05-2021
Publisher: Mark Allen Group
Date: 02-09-2016
DOI: 10.12968/BJCN.2016.21.9.469
Abstract: Predicting risk of adverse healthcare outcomes is important to enable targeted delivery of interventions. The Risk Instrument for Screening in the Community (RISC), designed for use by public health nurses (PHNs), measures the 1-year risk of hospitalisation, institutionalisation and death in community-dwelling older adults according to a five-point global risk score: from low (score 1,2) to medium (3) to high (4,5). We examined the inter-rater reliability (IRR) of the RISC between student PHNs (n=32) and expert raters using six cases (two low, medium and high-risk), scored before and after RISC training. Correlations increased for each adverse outcome, statistically significantly for institutionalisation (r=0.72 to 0.80, p=0.04) and hospitalisation (r=0.51 to 0.71, p .01) but not death. Training improved accuracy for low-risk but not all high-risk cases. Overall, the RISC showed good IRR, which increased after RISC training. That reliability fell for some high-risk cases suggests that the training programme requires adjustment to improve IRR further.
Publisher: Public Library of Science (PLoS)
Date: 28-07-2020
Publisher: Informa UK Limited
Date: 27-05-2018
Publisher: Elsevier BV
Date: 09-2015
DOI: 10.1016/J.MIDW.2015.04.015
Abstract: to investigate the influence of parental and infant characteristics on exclusive breast feeding from birth to six months of age and breast feeding rates at two, six and 12 months of age in Ireland. secondary data analysis from the Cork BASELINE Birth Cohort Study (www.baselinestudy.net/). Infants were seen at birth and two, six, and 12 months of age. Maternal and paternal history, neonatal course and feeding data were collected at birth and using parental questionnaires at each time point. 1094 singleton infants of primiparous women recruited at 20 weeks' gestation who were breastfeeding on discharge from the maternity hospital. at discharge from the maternity hospital and at two months, neonatal intensive-care unit admission had the strongest influence on exclusive breast feeding status (adjusted OR 0.17, 95% CI 0.07-0.41 at discharge) and at two months (adjusted OR=0.20, 95% CI 0.05-0.83). A shorter duration of breast feeding was significantly associated with younger maternal age, non-tertiary education, Irish nationality and neonatal intensive-care unit admission. There was a significant difference in the duration of any breast feeding between infants who were and were not admitted to the neonatal intensive-care unit, 28(10.50, 32) weeks versus 32(27, 40) weeks. Mothers whose maternity leave was between seven and 12 months (adjusted OR=2.76, 95% CI 1.51-5.05) breast fed for a longer duration compared to mothers who had less than six months of maternity leave. admission to the neonatal intensive care unit negatively influenced both exclusivity and duration of breast feeding. Length of maternity leave, and not employment status, was significantly associated with duration of breast feeding. additional support may be required to ensure continued breast feeding in infants admitted to the neonatal intensive-care unit. Length of maternity leave is a modifiable influence on breast feeding and offers the opportunity for intervention to improve our rates of breast feeding.
Publisher: Springer Science and Business Media LLC
Date: 06-11-2021
DOI: 10.1186/S12913-021-07238-X
Abstract: High numbers of women experience a traumatic birth, which can lead to childbirth-related post-traumatic stress disorder (CB-PTSD) onset, and negative and pervasive impacts for women, infants, and families. Policies, suitable service provision, and training are needed to identify and treat psychological morbidity following a traumatic birth experience, but currently there is little insight into whether and what is provided in different contexts. The aim of this knowledge mapping exercise was to map policy, service and training provision for women following a traumatic birth experience in different European countries. A survey was distributed as part of the COST Action “Perinatal mental health and birth-related trauma: Maximizing best practice and optimal outcomes”. Questions were designed to capture country level data care provision (i.e., national policies or guidelines for the screening, treatment and/or prevention of a traumatic birth, service provision), and nationally mandated pre-registration and post-registration training for maternity professionals. Eighteen countries participated. Only one country (the Netherlands) had national policies regarding the screening, treatment, and prevention of a traumatic birth experience/CB-PTSD. Service provision was provided formally in six countries (33%), and informally in the majority (78%). In almost all countries (89%), women could be referred to specialist perinatal or mental health services. Services tended to be provided by midwives, although some multidisciplinary practice was apparent. Seven (39%) of the countries offered ‘a few hours’ professional re-registration training, but none offered nationally mandated post-registration training. A traumatic birth experience is a key public health concern. Evidence highlights important gaps regarding formalized care provision and training for care providers.
Publisher: Springer Science and Business Media LLC
Date: 29-06-2017
Publisher: Wiley
Date: 14-12-2015
DOI: 10.1111/BIRT.12211
Abstract: Pregnant women are recommended to 1) perform daily moderate-intensity physical activity and 2) limit the amount of sedentary time. Many women do not meet these recommendations. Reduced physical activity and increased sedentary behavior may result from women actively intending to rest during pregnancy. The Theory of Planned Behavior (TPB) has been used to assess attitudes (e.g., positive/negative beliefs), subjective norms (e.g., perception of others' views), perceived behavioral control (PBC) (e.g., self-efficacy), and intention toward exercising while pregnant but has not been applied to aspects pertaining to resting during pregnancy. Pregnant women (n = 345) completed a cross-sectional questionnaire that included two TPB Questionnaires where the target behaviors were 1) being physically active and 2) resting. Bootstrapped paired t tests, ANOVA, and linear hierarchal regression analyses were performed to identify predictors of intentions and whether intentions toward the two behaviors varied at different stages of pregnancy. As women progressed in their pregnancy, their attitude, PBC, and intention toward being physically active all significantly declined. A positive attitude, subjective norms, and intention toward resting all significantly increased with the advancing trimester. Self-reported health conditions predicted lower intention for physical activity but not for resting. The significantly inverse relationship between physical activity and resting across time suggests that women feel they should focus on one behavior at the expense of the other. Finding that women generally do not perceive these behaviors as mutually compatible has implications in strategizing as to how to encourage women to be active during pregnancy.
Publisher: Wiley
Date: 07-07-2021
Publisher: Public Library of Science (PLoS)
Date: 12-11-2013
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2007
Publisher: Dougmar Publishing Group, Inc.
Date: 06-03-2020
Abstract: The perinatal period, which covers the time when a man’s partner becomes pregnant through to the first year after birth can be a time of great excitement, happiness, and joy. However, it can also be a time of great disruption and change. Despite the positive and protective long-term effect that fatherhood has on men’s health, a significant proportion of fathers’ experience depressive symptoms during the perinatal period. This paper aims to review studies that assessed symptoms of depression in fathers during the perinatal period and to describe the prevalence estimates, identify the risk factors and impact of depression, and establish if there are interventions that effectively reduce depression among fathers. A systematic search of relevant electronic databases including Medline, CINAHL, Cochrane Library, PsycARTICLES, PsycINFO, and Psychology and Behavioural Sciences Collection were searched using keywords related to paternal perinatal depression. Prevalence estimates of paternal perinatal depression varied widely between studies, ranging from 1 to 46%. Several sociodemographic variables that contribute to depression in fathers in the perinatal period were reported and these include paternal age, lower education levels, parity, an unplanned pregnancy, and maternal depression. Paternal perinatal depression is associated with morbidity within the father’s family, including depression in his partner, maladjustment to parenthood and future psychological problems in his children. In conclusion, evidence from this review adds further support for the need to review how we plan, provide and resource our health services, to recognize the influence that pregnancy, birth, and fatherhood in the perinatal period can have on men’s mental health.
Publisher: Elsevier BV
Date: 05-2011
DOI: 10.1016/J.APNR.2010.10.002
Abstract: Diabetes has reached pandemic proportions worldwide. To address and assist health care professionals in maintaining and updating their knowledge base on diabetes care, a multilateral project within the framework of the Lifelong Learning Programme and the Erasmus Curriculum Development - sub programme was initiated in 2008. Four European countries are involved in the project - Estonia, Finland, Ireland and Lithuania. Across all four countries the prevalence of diabetes is rising rapidly. The project's (DIPRA - Counselling for Practice - a pilot of improving counselling quality of diabetes) main product will be an on-line study module on patient education and counselling for health care professionals. The management of diabetes demands a broad range of skills which include, communication, leadership, counselling, teaching and research to name but a few. While it is acknowledged that nurses can incorporate these skills into practice and so benefit the care of the patient there is no uniformity across the four countries studied as to what constitutes a specialist diabetes nurse. The study module and all the materials (databank, on-line lectures, and interactive exercises) will be developed in English and translated into partners' national languages (Estonian, Finnish, Lithuanian) to maximize the accessibility of all professionals in partner countries.
Publisher: Wiley
Date: 23-01-2020
DOI: 10.1111/JOCN.15152
Abstract: To undertake a concept analysis of humanisation in pregnancy and childbirth. Humanisation in pregnancy and childbirth has historically been associated with women who do not require medical intervention. However, the increasing recognition of the importance of emotional and mental health and the physical outcome of pregnancy has meant that there is a need to identify clinical attributes and behaviours that contribute to a positive emotional outcome. Failure to support and protect the emotional health of the woman in pregnancy and childbirth can have effects on the long-term mental health of the mother and the long-term physical and mental health of the child. Concept Analysis METHODS: Eight-step method of concept analysis proposed by Walker and Avant. Defining attributes include being a protagonist, human being interaction and benevolence. Antecedents identified were a recognition of women's rights, birth models, professional competence and the environment. Consequences were identified for women and healthcare professionals: for women, increased feelings of confidence, satisfaction of the experience and safety and for healthcare professionals, increased satisfaction and confidence in their job and increased esteem in their profession. Humanisation of pregnancy and childbirth now encompasses all women regardless of care pathway. Humanisation does not obstruct the prioritisation of life-saving procedures or the use of medical intervention where required. Women who are able to identify their rights when accessing maternity care will be better equipped to ensure their care planning is in idualised. The identification of humanised care practices, attributes and behaviours can support healthcare professionals in the clinical area who wish to identify a pathway of humanised care in pregnancy and birth.
Publisher: BMJ
Date: 15-11-2018
DOI: 10.1136/BMJEBM-2018-111019
Abstract: Internationally, evidence-based practice (EBP) is recognised as a foundational element of healthcare professional education. Achieving competency in this area is a complex undertaking that is reflected in disparities between ‘best EBP’ and actual clinical care. The effective development and implementation of professional education to facilitate EBP remains a major and immediate challenge. To ascertain nuanced perspectives on the provision of EBP education internationally, interviews were conducted with five EBP education experts from the UK, Canada, Australia and New Zealand. Definitive advice was provided in relation to (1) EBP curriculum considerations, (2) teaching EBP and (3) stakeholder engagement in EBP education. While a considerable amount of EBP activity throughout health profession education is apparent, effectively embedding EBP throughout curricula requires further development, with a ‘real-world’ pragmatic approach that engenders dialogue and engagement with all stakeholders required.
Publisher: BMJ
Date: 10-2018
DOI: 10.1136/BMJOPEN-2017-020347
Abstract: To synthesise qualitative studies on women’s psychological experiences of physiological childbirth. Meta-synthesis. Studies exploring women’s psychological experiences of physiological birth using qualitative methods were eligible. The research group searched the following databases: MEDLINE, CINAHL, PsycINFO, PsycARTICLES, SocINDEX and Psychology and Behavioural Sciences Collection. We contacted the key authors searched reference lists of the collected articles. Quality assessment was done independently using the Critical Appraisal Skills Programme (CASP) checklist. Studies were synthesised using techniques of meta-ethnography. Eight studies involving 94 women were included. Three third order interpretations were identified: ‘maintaining self-confidence in early labour’, ‘withdrawing within as labour intensifies’ and ‘the uniqueness of the birth experience’. Using the first, second and third order interpretations, a line of argument developed that demonstrated ‘the empowering journey of giving birth’ encompassing the various emotions, thoughts and behaviours that women experience during birth. Giving birth physiologically is an intense and transformative psychological experience that generates a sense of empowerment. The benefits of this process can be maximised through physical, emotional and social support for women, enhancing their belief in their ability to birth and not disturbing physiology unless it is necessary. Healthcare professionals need to take cognisance of the empowering effects of the psychological experience of physiological childbirth. Further research to validate the results from this study is necessary. CRD42016037072.
Publisher: Springer Science and Business Media LLC
Date: 30-07-2015
Publisher: Springer Science and Business Media LLC
Date: 29-04-2020
DOI: 10.1186/S12884-020-02956-2
Abstract: The estimated global premature birth rate for 2014 was 10.6%, equating to an estimate of 14.84 million live premature births. The experience of premature birth does not impact solely on the infant and mother as in iduals but occurs in the context of a critical point in time when they are developing a relationship with one another. The aim of this study was to investigate the relationships between social support, mother to infant attachment, and depressive symptoms of mothers with preterm infants within the first 12 months’ post discharge from the Neonatal Intensive Care Unit (NICU). A correlational cross-sectional study design was used. Data were collected using a four-part online survey which included the Perinatal Social Support Questionnaire (PICSS), Maternal Postnatal Attachment Scale (MPAS) and the Edinburgh Postnatal Depression Scale (EPDS) with mothers of preterm infants ( n = 140). The prevalence of postnatal depression was 37.9% (95% CI: 29.8 to 46.4%). In univariable analyses, history of depression ( p = 0.005), aged 35–39 years ( p = 0.006), no formal social support ( p = 0.040), less informal social supports ( p = 0.018), lower overall maternal attachment ( p 0.001) and lower overall functional social support ( p 0.001) were significantly associated with a higher level of depressive symptoms. Lower scores on two of the maternal attachment subscales (quality of attachment and absence of hostility) and all four of the functional social support subscales were significantly associated with a higher level of depressive symptoms ( p 0.001 for all). In the multivariable analysis, prior history of depression ( p = 0.028), lower score of maternal attachment ( p 0.001) and lower emotional functional social support ( p = 0.030) were significantly associated with a higher level of depressive symptoms. Women who experience a premature birth, have a prior history of depression, poor infant attachment and poor emotional social support have a higher level of depressive symptoms. Results emphasise the need for professionals to encourage mobilisation of maternal formal and informal social supports. It is important to intervene early to address maternal emotional well-being and enhance the developing mother-preterm infant relationship.
Publisher: Hindawi Limited
Date: 31-08-2018
DOI: 10.1111/JONM.12672
Abstract: The aim of this study is to report the development and psychometric testing of the clinical leadership needs analysis instrument (CLeeNA). Limited emphasis is placed on the clinical leadership needs of nurses and midwives that are fundamental to supporting the delivery of high quality, safe patient care. A development and validation study of CLeeNA was undertaken using cross-sectional data. A s le of 324 registered nurses and midwives completed the questionnaire using a 7-point adjectival scale. Principal component analysis was conducted to explore scale grouping of items (n = 103 items). Principal component analysis, item reduction and parallel analysis on the items of the instrument resulted in seven factors consisting of 56 items. These factors were identified as: Staff and Care Delivery Technology and Care Initiatives Self and Team Development Standards of Care Financial and Service Management Leadership and Clinical Practice Patient Safety and Risk Management. The identified factors are reflective of an ever-changing health care environment. Potentially, after further testing, this instrument could be used by nursing management and educators to measure clinical leadership needs, inform the design of clinical leadership training programmes and provide valuable information about health care leadership development.
Publisher: Wiley
Date: 25-03-2011
DOI: 10.1111/J.1365-2702.2011.03701.X
Abstract: Aims and objectives. To examine the relationships between social support, maternal parental self‐efficacy and postnatal depression in first‐time mothers at 6 weeks post delivery. Background. Social support conceptualised and measured in different ways has been found to positively influence the mothering experience as has maternal parental self‐efficacy. No research exists which has measured the relationships between social support, underpinned by social exchange theory and maternal parental self‐efficacy using a domain‐specific instrument, underpinned by self‐efficacy theory and postnatal depression, with first‐time mothers at 6 weeks post delivery. Design. A quantitative correlational descriptive design was used. Method. Data were collected using a five‐part questionnaire package containing a researcher developed social support questionnaire, the Perceived Maternal Parental Self‐Efficacy Scale and the Edinburgh Postnatal Depression Scale. Four hundred and ten mothers completed questionnaires at 6 weeks post delivery. Results. Significant relationships were found between functional social support and postnatal depression informal social support and postnatal depression maternal parental self‐efficacy and postnatal depression and informal social support and maternal parental self‐efficacy at 6 weeks post delivery. Conclusion. Nurses and midwives need to be aware of and acknowledge the significant contribution of social support, particularly from family and friends in positively influencing first‐time mothers’ mental health and well‐being in the postpartum period. The development of health care policy and clinical guidelines needs to define and operationalise social support to enhance maternal parental self‐efficacy. Relevance to clinical practice. These findings suggest that nurses and midwives need to be cognisant of the importance of social support for first‐time mothers in both enhancing maternal parental self‐efficacy and reducing postnatal depressive symptomatology in the early postpartum period.
Publisher: Elsevier BV
Date: 07-2023
DOI: 10.1016/J.WOMBI.2022.11.009
Abstract: An important aspect of achieving the provision of woman-centred maternity services is to seek women's experiences of maternity care. To explore women's experiences of the care received within the Irish maternity system and to identify aspects of positive care and areas requiring improvement. The Babies Born Better pan-European online survey asked open-ended questions on positive aspects of care and aspects of care that could be improved. Data from women who birthed in Ireland within the previous five years were included. Socio-demographic data were analysed descriptively, and descriptive content analysis was conducted for the qualitative comments. Data from 736 participants were included. Four categories were generated from the analysis: Women's interactions with healthcare professionals included five sub-categories of competence and expertise, continuity and consistency, respectful care, communication, and shared decision-making Interventions and procedures included the five sub-categories of medical interventions, breastfeeding support, pain relief, birth partner's presence and involvement, and facilitating mother and baby attachment Organisational and infrastructural issues contained three sub-categories of facilities and services, environment and atmosphere, and staffing levels and the fourth category, Overall evaluations and specific statements, showed the ersity of women's experiences within the services. Several positive aspects of care within the Irish maternity services were identified, many of which related to interpersonal factors and interactions with healthcare professionals. The findings also revealed what could be changed, some of which would require minimal resources or effort, so that women would experience positive care.
Publisher: Springer Science and Business Media LLC
Date: 18-05-2022
DOI: 10.1186/S12875-022-01730-X
Abstract: Lung cancer is the leading cause of cancer incidence and mortality worldwide. Prompt patient help-seeking for signs and symptoms suggestive of lung cancer is crucial for early referral, diagnosis, and survivorship. However, in iduals with potential lung cancer symptoms tend to delay help-seeking. This qualitative study explored perceived barriers to patient help-seeking and strategies to enhance help-seeking for lung cancer warning signs and symptoms from the perspective of primary healthcare professionals. Semi-structured focus groups and in idual interviews were conducted with 36 primary healthcare professionals. Data were collected via videoconferencing. Inductive thematic analysis was conducted. The following two themes were created from the data: (i) perceived barriers to patient help-seeking for signs and symptoms of concern and (ii) facilitating early patient presentation for signs and symptoms of concern. Some participants believed that the high cost of a general practitioner visit, long waiting times, and previous bad experiences with the healthcare system would deter patients from seeking help for symptoms of lung cancer. Perceived patient-related barriers to help-seeking related to the different emotions associated with a potential cancer diagnosis as well as stigma, embarrassment, and guilt felt by smokers. Sociodemographic factors such as drug use, homelessness, living in rural areas, and being male and older were also perceived to impede patient help-seeking. The negative impact of the COVID-19 pandemic on cancer help-seeking also featured strongly. Participants recommended several strategies to enable patients to seek help for symptoms of concern including targeted educational c aigns focussing on symptoms (e.g., cough) rather than behaviours (e.g., smoking), accessible and free health services, and using patients’ support networks. Patient-related and healthcare system-related barriers to help-seeking for lung cancer warning signs and symptoms include cost of healthcare, cancer fear, and various sociodemographic factors. Participants suggested that increased awareness and early patient help-seeking for symptoms of concern could be achieved through targeted patient education, national c aigns, the use of community support networks, and free and accessible targeted screening services.
Start Date: 2021
End Date: 2023
Funder: Health Research Board
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