ORCID Profile
0000-0002-3046-4143
Current Organisations
Central University of Jammu
,
Griffith University
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Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.WOMBI.2018.03.002
Abstract: Exposure to alcohol prenatally can result in a child being diagnosed with fetal alcohol spectrum disorder. Affected infants experience lifelong impairments that can involve, physical, cognitive, behavioural and emotional difficulties that impact on their functional capacity. Effective prevention of fetal alcohol spectrum disorder is critically needed in Australia. Reduction in the prevalence of this disorder will only be possible if we prevent alcohol consumption during pregnancy. This paper provides an overview of fetal alcohol spectrum disorder and discusses the role of caseload midwifery as part of a multi-level prevention approach. Drawing on previous research, caseload midwifery has potential to support the prevention of fetal alcohol spectrum disorder through continuity of care. Prevention of fetal alcohol spectrum disorder will be more likely if women experience a supportive relationship with a known midwife, who has received appropriate training and can enable women to feel comfortable in discussing and addressing alcohol use.
Publisher: Wiley
Date: 14-03-2005
DOI: 10.1111/J.1365-2648.2004.03345.X
Abstract: This paper discusses a process for research utilization that overcomes well-known barriers in order to influence clinical decision-making and practice change. Read, Think, Do! is a problem-solving approach to research utilization and practice development which has the potential to overcome barriers to research utilization. Any process for research utilization at the practice level needs to overcome numerous barriers in order to influence clinical decision-making and practice change. Access to research-based knowledge is an obvious first step in the evidence-based approach to care delivery, but is clearly inadequate alone in influencing the improvement of practice. Read, Think, Do! acknowledges the complexity of problem-solving processes from the outset by looking for (1) the evidence, (2) assessing the value to practice, and (3) addressing the social and cultural milieu of the practice setting to ascertain the best strategies for initiating and sustaining practice change. This approach draws distal forms of empirical knowledge that have the capacity to improve patient outcomes into the proximal knowledge base of the clinical nurse. This is achieved by collaboration, planning and evaluation involving all levels of staff and a specialist facilitator, the Clinical Nurse Consultant in evidence-based practice. Read, Think, Do! is a method of research utilization and practice development that has the potential to overcome barriers to research utilization and avoid the "misplaced concreteness" that can occur when trying to fit empiricism into practice. By addressing the breadth and ersity of issues surrounding research utilization in a systematic manner it presents a sustainable method for practice change informed by evidence.
Publisher: American Psychological Association (APA)
Date: 08-2012
DOI: 10.1037/A0028781
Abstract: This study evaluated the effectiveness of couple relationship education in assisting couples to sustain relationship functioning and parenting sensitivity, and whether benefits were moderated by risk of maladjustment in the transition to parenthood ("risk"). Two hundred fifty couples expecting their first child were assessed on risk and randomly assigned to either the Couple CARE for Parents (CCP), a couple relationship- and coparenting-focused education program (n = 125), or the Becoming a Parent Program (BAP), a mother-focused parenting program (n = 125). Couples completed assessments of their couple relationship during pregnancy, after intervention at 4 months postpartum, and at 16 and 28 months postpartum. Observed parenting and self-report parenting stress were assessed at 4 months postpartum, and parenting stress was assessed again at 16 and 28 months postpartum. Risk was associated with greater relationship and parenting adjustment problems. Relative to BAP, CCP women decreased their negative communication and showed a trend to report less parenting stress irrespective of risk level. High-risk women receiving CCP reported higher relationship satisfaction, and were less intrusive in their parenting, than high-risk women receiving BAP. There were no effects of CCP on sensitive parenting and parenting intrusiveness for women. High-risk men in CCP showed a trend for higher relationship satisfaction than high-risk BAP men, but there were no effects of CCP for men on any parenting outcomes. CCP is a potentially useful intervention, but benefits are primarily for high-risk women.
Publisher: Elsevier BV
Date: 10-2011
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.WOMBI.2018.11.001
Abstract: There are no validated tools to measure midwives' awareness of Cultural Safety. Cultural Safety is an important component of midwifery practice. Measurement can inform practice and evaluate professional development strategies. To adapt and evaluate the Awareness of Cultural Safety Scale with the midwifery workforce. An online survey was distributed to members of Australian College of Midwives and Congress of Aboriginal and Torres Strait Islander Nurses and Midwives. Measures included the Awareness of Cultural Safety Scale - Revised, Self-assessment of Cultural Knowledge and Perceptions of Racism scales. The revised Awareness scale had a Cronbach's alpha of 0.87. Principal Component Analysis with varimax rotation produced a three-factor structure accounting for 67% of variance. Awareness scores correlated with Self-assessment of Cultural Knowledge (r=0.22 p<0.03) and Perceptions of Racism (r=0.62 p<0.001) scales. Educators scored significantly higher on awareness compared to clinicians (t (1,80)=-3.09, p=0.003). Perceptions of Racism predicted Awareness of Cultural Safety scores (F (2,87) 29.25, adjusted r square=0.39 p<0.001 95% Confidence Interval=1.09, 1.93). The revised scale was a reliable and valid measure of Cultural Safety across a erse s le of midwives. Midwives working in education settings have a higher awareness of Cultural Safety than clinical peers. The Awareness of Cultural Safety Scale can be used with midwives across practice settings. Professional organisations and education providers need to promote the professional responsibilities of midwives towards Cultural Safety in clinical practice and education.
Publisher: Elsevier BV
Date: 2015
Publisher: Wiley
Date: 10-02-2021
DOI: 10.1111/JMWH.13195
Publisher: Elsevier BV
Date: 12-2015
DOI: 10.1016/J.WOMBI.2015.05.002
Abstract: Low intensity anxiety in pregnancy is normal however high levels of fear affect between 20% and 25% of women, with around 10% suffering severe levels. Research from Scandinavian countries includes women with severe levels of fear, with little work undertaken in Australia. This paper explores predictors of fear and the relative benefits of screening women for childbirth fear at high or severe levels. A secondary analysis of data collected for the BELIEF study was conducted to determine differences for demographic, psycho-social and obstetric factors in women with severe fear (W-DEQ ≥85, n=68) compared to women with less or no fear (n=1318). Women with severe fear (W-DEQ ≥85, n=68) were also compared to those with high fear scores (W-DEQ ≥66-84, n=265). Logistic regression modelling was used to ascertain if screening for high or severe levels of fear is most optimal. 1386 women completed the W-DEQ. There were no differences on demographic variables between women with severe or high fear. Depression symptoms, decisional conflict and low self-efficacy predicted high and severe fear levels. Nulliparity was a predictor of high fear. A previous operative birth and having an unsupportive partner were predictors of high fear in multiparous women. Psychosocial factors were associated with both high and severe fear levels. Screening for severe fear may detect women with pre-existing mental health problems that are exacerbated by fear of birth. Australian women with high childbirth fear levels (W-DEQ ≥66) should be identified and provided appropriate support.
Publisher: Wiley
Date: 26-02-2007
Publisher: Wiley
Date: 03-08-2011
DOI: 10.1111/J.1365-2702.2011.03807.X
Abstract: Aim. To determine whether definable profiles exist in a cohort of nursing student with regard to factors associated with nurses’ perceived emotional intelligence, social support and stress level. Background. There is a need to have a basic understanding of a nursing student’s psychological health‐related life quality profile will have a direct effect on their study and contribution to nursing educators to develop an appropriate learning environment for nursing students. Design. A descriptive survey. Methods. Data were collected in January 2009 in one nursing school in Singapore. A s le of 112 full‐time baccalaureate nursing students from year 1–3 completed the stress in nursing students, social support rating scale and Trait meta‐mood scale. Results. Cluster analysis revealed two profiles in four main factors: demographic, perceived emotional intelligence, social support and stress level. Conclusions. Findings might help by providing important information for health care professionals to develop interventions that improve students’ psychological health during their university life. Relevance to clinical practice. The findings will assist nursing educators or health care professionals by creating psychological health‐related life quality profiles that they can use to develop interventions to improve the health of nursing students.
Publisher: Elsevier BV
Date: 07-2021
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.WOMBI.2017.01.004
Abstract: Midwives have a central role in closing the gap in health inequalities between Australias' First Peoples and other childbearing women. The Aboriginal and Torres Strait Islander Health Curriculum Framework (The Framework) identifies five core cultural capabilities (respect, communication, safety and quality, reflection and advocacy) to foster culturally safe health care. To use a decolonising, First Peoples-led approach to develop and validate a tool to measure the development students' cultural capabilities. A pre- post intervention design was used. Development of the Cultural Capability Measurement Tool followed a staged process which centred on First Peoples' knowledges. This process included: item generation, expert review a pilot, test-retest and psychometric testing (reliability, factor analysis and construct validity). All third year midwifery students (n=49) enrolled in a discrete First Peoples health course were invited to complete the survey pre and post course. A response rate of 77.5% (n=38/49) pre-course and 30.6% (15/49) at post-course was achieved. The tool demonstrated good internal reliability (Cronbach alpha=.89-.91). Principal component analysis with varimax rotation produced a five-factor solution. A paired s les t-test revealed a significant increase from pre-course (mean 93.13, SD 11.84) to post-course scores (mean=100.53, SD 7.54) (t (14)=-2.79, p=.014). A First Peoples approach was critical to tool development and conceptual validity. The 22 item Cultural Capability measurement Tool reflected the core cultural capabilities of The Framework. The draft tool appears suitable for use with midwifery students.
Publisher: CSIRO Publishing
Date: 2019
DOI: 10.1071/AH17271
Abstract: Objective Fear of childbirth is known to increase a woman’s likelihood of having a Caesarean section. Continuity of midwifery care is known to reduce this risk, but less than 8% of women have access to this relationship-based, primary care model. The aims of this study were to determine whether healthcare use and access to continuity models are equal across different indicators of socioeconomic status for women who are fearful of birth. Methods A secondary analysis was conducted of data obtained during a randomised controlled trial of a psychoeducation intervention by trained midwives to minimise childbirth fear (the Birth Emotions and Looking to Improve Expectant Fear (BELIEF) study). In all, 1410 women were screened, with 339 women reporting high levels of fear (Wijma-Delivery Expectancy/Experience Questionnaire ≥66). Demographic, obstetric information, birth preference and psychosocial measures were collected at recruitment and at 36 weeks gestation for the 339 fearful women, with the birth method and health service use returned by 183 women at 6 weeks after the birth. Results Univariate analysis revealed no significant difference in the number of general practitioner and midwife visits between women of high and low income and high and low education. However, women with higher levels of education had 2.51-fold greater odds of seeing the same midwife throughout their pregnancy than women with lower education (95% confidence interval 1.25–5.04), after adjusting for age, parity and hospital site. Conclusions Given the known positive outcomes of continuity of midwifery care for women fearful of birth, health policy makers need to provide equity in access to evidence-based models of midwifery care. What is known about this topic? Caseload midwifery care is considered the gold standard care due to the known positive outcomes it has for the mother and baby during the perinatal period. Pregnant women who receive caseload midwifery care are more likely to experience a normal vaginal birth. What does this paper add? There is unequal access to midwifery caseload care for women fearful of birth across socioeconomic boundaries. Midwifery caseload care is not used for all fearful mothers during the perinatal period. What are the implications for practitioners? Health policy makers seeking to provide equity in access to maternity care should be aware of these inequalities in use to target delivery of care at this specific cohort of mothers.
Publisher: Informa UK Limited
Date: 14-10-2015
DOI: 10.1080/07399332.2014.946510
Abstract: This descriptive longitudinal cohort study investigated the prevalence and psychological risk factors for depression in new mothers living in Pingtung County, southern Taiwan. Expectant mothers (n = 236) were recruited through antenatal clinics, and 162 participants were followed up at 6 weeks postpartum. The estimated prevalence of probable depression (at a cut-off score ≧ 13 on the Edinburgh Postnatal Depression Scale) was 17.3% before birth and 24.1% after birth. Several risk factors for postnatal depression were identified, including maternal self-esteem, antenatal depression, and psychiatric morbidity. The regression of intention on predictive variables yielded an adjusted R(2) of.70. The findings can help clinical nurses effectively recognize and implement risk mitigation plans for the health benefits of rural childbearing women.
Publisher: Elsevier BV
Date: 03-2013
Publisher: BMJ
Date: 29-06-2012
Publisher: Elsevier BV
Date: 08-2006
DOI: 10.1016/J.NEDT.2006.01.009
Abstract: Mentoring is an important teaching-learning process in undergraduate nursing curricula. There are relatively few studies specifically evaluating nursing students' perceptions of mentorship. In the period 1999-2002, 39 students were mentored during a year-long program. This descriptive, exploratory study used a quality improvement framework informed by the Deming cycle of Plan, Do, Check and Act [Deming, W.E., 1982. Quality, Productivity and Competitive Position. Massachusetts Institute of Technology, Cambridge] to evaluate the mentorship program from the students' perspective. Information was gathered through surveys, focus group discussions and interviews and analyzed to identify themes of responses. Identified themes were 'The doing of nursing', 'The thinking of nursing' and 'Being a nurse'. The study confirmed the value of mentorship in undergraduate nursing and highlighted the importance of skill competence as a basis for professional role identity by graduating students. The benefits of mentorship were derived from a long term, supportive relationship with the same registered nurse who was committed to the student's professional development.
Publisher: Springer Science and Business Media LLC
Date: 30-04-2008
Abstract: There are few reliable and valid tools to assess lactation and infant feeding knowledge and practices. This study tested the psychometric properties of two new scales, the Newborn Feeding Ability (NFA) questionnaire and Breastfeeding Initiation Practices (BIP) scale to assess midwives' breastfeeding knowledge and practices specific to breastfeeding initiation. A national postal survey of Australian midwives (n = 3500) was conducted in October 2001. Reliability was determined through Cronbach's alpha coefficient and stability determined by a test-retest. Content validity was established through a critical review of literature and review by an expert panel. Construct validity was informed by an exploratory factor analysis and principle component analysis with varimax rotation. Correlations between NFA and BKQ knowledge subscale scores and BIP and BKQ practice subscale scores assessed criterion validity. A multiple hierarchical regression analysis determined predictive validity of the NFA and BIP. A response rate of 31.6% (n = 1107) was achieved. Adequate internal consistency was established for both instruments. Five factors on the NFA questionnaire were congruent with knowledge about effects of skin-to-skin contact, physiological stability, newborn innate abilities, work practices and effective breastfeeding. The BIP revealed three factors related to observing pre-feeding behavior, mother/baby care and attachment and positioning practices. Predictive validity of knowledge was moderate (r = 0.481, p 0.01) and contributed to 31.5% of variance in reported practice. Midwives with high knowledge scores were more likely to report best practice when assisting mothers to initiate breastfeeding. Midwives with more personal breastfeeding experience scored higher on all scales. The Newborn Feeding Ability questionnaire and the Breastfeeding Initiation Practices scale can contribute to practice development by assessing lactation and infant feeding knowledge and practice deficits. In idual learning needs can be identified, and effectiveness of education interventions evaluated using these tools. Further testing is required with other s les of midwives and health professionals involved in the promotion of breastfeeding.
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.NEDT.2012.06.007
Abstract: To investigate nursing students' perceptions of spirituality and spiritual care. Spirituality is an essential part of holistic care but often neglected in practice. Barriers to spiritual care include limited educational preparation, negative attitudes towards spirituality, confusion about nurses' role, perceptions of incompetence and avoidance of spiritual matters. There is limited knowledge about students' perspectives of spirituality and spiritual care. Previous studies have predominantly focused on educational approaches to enhance spirituality. The next generation of clinicians may have different worldviews, cultural beliefs and values about spirituality and spiritual care from current nurses. There is a need to understand students' views and how their spiritual development is shaped in order to inform pre-registration education. A cross-sectional survey of final-year students from three educational institutions in Singapore was conducted from April to August 2010. Data included demographic details and responses on a new composite tool, the Spiritual Care Giving Scale (SCGS). A response rate of 61.9% (n=745 out of 1204) was achieved. The lowest mean score was item 9, "Without spirituality, a person is not considered whole". Highest mean was item 2, "Spirituality is an important aspect of human being". Factor 5 (Spiritual Care Values) had the lowest mean with Factor 2 (Spirituality Perspectives) the highest. Participants considered spirituality as essential to being human developmental in nature and vital for in iduals' state of well-being. Attributes important for spiritual care were identified. Multivariate analyses showed positive association between participants' scores and institution but not with other variables. Participating student nurses reported a high level of spiritual awareness that was not constrained by age. Students affirmed the importance of spiritual awareness in order to address the spiritual needs of patients. There was some congruence between the perceptions of students in this ethno-culturally erse Asian s le and responses by students in the UK and North America on the personal attributes needed to provide spiritual care. Comparative studies using the SCGS could inform our understanding of spirituality and best pedagogical approaches to develop spiritual awareness across the curricula and in clinical practice.
Publisher: Elsevier BV
Date: 09-2020
DOI: 10.1016/J.WOMBI.2019.09.010
Abstract: Little emphasis has been given to the standardised measurement of midwifery students' perceptions of their clinical learning experiences. To develop a tool that evaluates students' perceptions of their clinical learning experiences according to environment and impact of preceptors on professional development. A cross-sectional design was used. Tool development had three phases: item generation expert review to assess clarity, apparent internal consistency and content validity and psychometric testing. All Bachelor of Midwifery students at one university in Australia were invited to complete the online survey. Psychometric testing included dimensionality, internal consistency and test-retest reliability. A 74% (n=279) response rate was achieved. Factor analysis revealed the Clinical Learning Environment Scale and Impact of the Midwifery Preceptor Scale accounting for 53.6% and 71.5% of variance respectively. Both scales were reliable (Cronbach's alpha=.92 and .94) and valid. Overall, students positively rated the clinical learning environment and preceptors' abilities to foster their sense of identity as a midwife. Students were less satisfied with preceptors' understanding of the academic program. The new tool consists of two scales that reliably measure midwifery students' perceptions of how the clinical learning environment develops their skills and reflects a midwifery philosophy. Preceptors had a positive influence on students' skills and professional development. The Midwifery Student Evaluation of Practice tool is the first valid and reliable measure of students' perceptions of their clinical learning experiences. Students' feedback provides valuable information to educators and preceptors on how best to optimise clinical learning.
Publisher: Elsevier BV
Date: 03-2020
Publisher: Wiley
Date: 09-2012
DOI: 10.1111/J.1442-2018.2012.00735.X
Abstract: In the present study, we investigated the prevalence of psychological, physical, and sexual violence perpetrated by an intimate partner, and the effects on health status of postpartum women who gave birth at two tertiary hospitals in northeastern Thailand. Participants were recruited during pregnancy and interviewed at 6 weeks' postpartum. Measures included the Short Form 12-Item Health Survey, Psychological Maltreatment of Women Inventory, and Severity of Violence against Women scale. Participants reported high rates of psychological abuse, threats and/or acts of physical abuse, and sexual violence. Abused postpartum women had lower well-being than non-abused women on all Short Form 12-Item Health Survey subscales, except the general health subscale. These women also had significant poorer health compared to non-abused women, in social functioning and mental health. The study findings suggest that routine screening for intimate partner violence by maternity services is urgently needed.
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.EJON.2017.05.005
Abstract: Family plays an essential role in supporting the patient with cancer, however, relatively little attention has been given to understanding the strengths and resources of the family unit across different settings and countries. This study aims to investigate the strengths and resources of patients and family members in Australia and Denmark. Using a descriptive, cross-sectional design, 232 patient and family participants from inpatient and outpatient oncology services in Australia and Denmark completed paper based surveys that included the Family Hardiness Index (FHI) and Family Crisis Orientated Personal Evaluation Scales (F-COPES), together with demographic and health information. The family's appraisal of the cancer and ways the family worked together predicted the level of external resources used to manage their circumstances. After a cancer diagnosis patients and family respond in different ways related to their family functioning. There is a need for nurses to work closely with the family to understand their strengths and resources, and tailor support and information for family to promote optimal patient outcomes.
Publisher: Elsevier BV
Date: 2006
DOI: 10.1016/S1322-7696(08)60521-1
Abstract: This paper presents 23 mentors' perceptions of their role in a year-long mentorship program during the period 1999- 2002. The majority of mentors were clinical specialists, had bachelor degrees and over five years clinical experience. The mentorship program was informed by the Deming Cycle of Plan, Do, Check and Act. This quality improvement framework was used to evaluate the mentorship program from the mentors' perspective. Information was gathered through surveys and focus group discussions. Responses were analysed to identify three themes of 'Enhancing student learning outcomes', 'Time and resources' and 'Personal and professional growth'. Mentors perceived their role as valuable in students' education and development. Despite concerns regarding adequate time and resources for an effective mentoring program, mentors acknowledged benefits to themselves in terms of personal and professional growth. Their vision and commitment to nursing was also evident in the perceived benefits of the program for the profession.
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.PEDN.2015.10.004
Abstract: To determine vitamin D deficiency and associated risk factors of hypovitaminosis D among Jordanian healthy infants. A total of 171 infants receiving a routine health check at a Maternal and Child Health Care Center were recruited. Plasma vitamin D 25-OHD level was assessed using a standard analysis of a blood s le. Other data collected included age, gender, birth order, season of birth, and mode of feeding. Prevalence of vitamin D deficiency (≤15 ng/mL) was 77% (132 out of 171 infants). Infants at risk of vitamin D deficiency were those between 1 to 6 months of age, male, third born or later, born in winter, and exclusively breastfed. The multivariate model showed birth order to be the largest contributor of vitamin D deficiency (R(2)=0.196), followed by breastfed infants (R(2)=0.071), infants born in winter (R(2)=0.037), male gender (R(2)=0.028), and infants aged between 1 and 6 months (R(2)=0.027). Hypovitaminosis D appears to be more common among healthy infants in Jordan. Hypovitaminosis D was found to be common among third or later exclusively breastfeed male infants aged 1 to 6 months who were born during winter. Maternal and child health nurses have a critical role to play in educating mothers about the importance of preventing hypovitaminosis D through adequate sun exposure and ensuring adequate supplementation. A higher dose of vitamin D supplementation for high-risk infants beyond the age of 1 year from developing countries should be administered.
Publisher: Springer Publishing Company
Date: 2017
DOI: 10.1891/2156-5287.7.3.152
Abstract: BACKGROUND: Around 20% of women report high levels of childbirth fear. An evidence-based psychoeducation intervention delivered by midwives reduced maternal childbirth fear and increased confidence for birth. Implementation of the intervention into practice is now required. Translating evidence into practice, however, remains challenging. AIM: This study aimed to explore organizational factors, including barriers and possible solutions that may impact on the successful application of the midwife psychoeducation intervention in practice. METHODS: Mixed methods data collection included a self-administered survey ( n = 62), clinician-led focus groups ( n = 28), and interviews with key stakeholders ( n = 5). Simple descriptive statistics were used to analyze the quantitative data. Latent content analysis was used to analyze the qualitative data. RESULTS: Midwives were perceived to be best placed to deliver psychoeducation to women fearful of birth. Support for normal birth was high. There was, however, disparity between positive attitudes toward evidence-based practice in theory and its clinical application. Similarly, although the workplace learning culture was generally assessed as positive, many participants believed changing practice was difficult and reported a low sense of agency for challenging or facilitating change. Participants reported that barriers to implementing the evidence included time constraints and heavy workloads. There was a lack of awareness and confidence to implement evidence-based practice (EBP) with participants identifying that resistance to change was often the result of clinician fear and self-interest. The way services were routinely structured was considered problematic as fragmentation actively worked against midwives forming meaningful relationships with women. Enablers included organizational support, education, local ch ions, and continuity of midwifery care. CONCLUSION: The study identified the clinicians’ readiness, barriers, and possible solutions to the widespread implementation of an evidence-based psychoeducation intervention delivered by midwives for women fearful of birth at one maternity facility in South East Queensland, Australia. Many of the identified barriers were commensurate with the international literature on translating evidence into practice.
Publisher: Wiley
Date: 28-02-2013
Publisher: John Wiley & Sons, Ltd
Date: 18-10-2004
Publisher: Wiley
Date: 14-05-2021
DOI: 10.1111/JOCN.15846
Abstract: This study investigated the effects of social support, parenting stress and maternal self‐efficacy on postpartum depression among adolescent mothers in Jordan. Adolescent pregnancy may have serious health, social and economic consequences for young women, families and communities. In Jordan, the incidence of adolescent pregnancy has increased from 5% in 2012 to 15% in 2018. Little attention has been given to postpartum depression among adolescent mothers in Arab and Middle Eastern countries. In a cross‐sectional design using convenience s ling, 200 women aged less than 20 years, six to eight weeks postpartum and who could speak and read Arabic were interviewed in a participating health clinic. The interview occurred before or after a woman's scheduled clinic appointment and included socio‐demographic data, Edinburgh Postnatal Depression Scale (EPDS), Maternity Social Support Scale (MSSS), Parenting Stress Scale (PSS) and Perceived Self‐efficacy Scale (PSES). Data collection took place between December of 2018 and April of 2019. Reporting followed the STROBE guidelines. Results revealed that 28.5% of adolescent mothers had probable postpartum depression. Mothers who reported high social support, high parenting stress, low self‐efficacy, financial stress and marital conflict had significantly higher EPDS scores than those who did not report these stressors. Prevalence of postpartum depression reported in this study warrants immediate action on early assessment, detection and intervention. High levels of social support may feel overwhelming for young mothers and contribute to high parenting stress, low maternal self‐efficacy and marital conflict. Adolescent mothers are at increased risk of PPD compared to mothers over 20 years of age. Perceived quality rather than availability of social support needs to be considered. Young mothers require education and early intervention prevention strategies to better prepared them for motherhood and manage stressors associated with their changing social role.
Publisher: Elsevier BV
Date: 09-2021
Publisher: Elsevier BV
Date: 10-2018
Publisher: Elsevier BV
Date: 09-2004
Publisher: Scientific Research Publishing, Inc.
Date: 2014
Publisher: Wiley
Date: 25-04-2014
DOI: 10.1111/INR.12102
Abstract: Dissatisfaction with childbirth care can have a negative impact on a woman's health and well-being, as well as her relationships with her infant. To investigate the prevalence and associated factors of dissatisfaction with intrapartum care by Jordanian women. A descriptive cross-sectional study was used. Participants (n = 320) who were 7 weeks post-partum were recruited from five maternal and child health centres in Irbid city in northern Jordan. Participants provided personal and obstetric information, and completed the Satisfaction with Childbirth Care Scale. The majority of women (75.6%) were dissatisfied with their intrapartum care. Dissatisfaction was associated with the attendance of unknown and unwanted persons during childbirth, experiencing labour as more painful than expected, and perceptions of inadequate help from healthcare providers to manage pain during labour. Findings are limited to Jordanian women accessing public sector perinatal health services. The high percentage of women reporting dissatisfaction with intrapartum care in this study is of concern. Women's perception of pain and expectations of staff during labour and birth need to be addressed through education and improved communication by staff. Development of national evidence-based policies and quality assurance systems would help reduce the rate of obstetric interventions and give greater emphasis to respect for women's preferences during labour and birth.
Publisher: Springer Science and Business Media LLC
Date: 21-11-2016
Publisher: Mark Allen Group
Date: 02-07-2023
DOI: 10.12968/BJOM.2023.31.7.386
Abstract: The reliability and validity of an Arabic version of the Cambridge worry scale have not been established among Arabic-speaking women. The aim of this study was to validate the Arabic version of the scale with a s le of pregnant women in Jordan. A descriptive cross-sectional study was conducted with pregnant women (n=369) in their third trimester. Exploratory factor analysis and confirmatory factor analysis were conducted to explore the underlying structure of the Arabic scale. The exploratory factor analysis suggested a four-factors construct jointly accounting for 83.7% of variance. The factors were sociomedical, socioeconomic, health of the mother/others and baby, and relationships. The confirmatory factor analysis supported a four-factor model with a root mean square error of approximation of 0.073. The alpha coefficient for the Arabic subscales ranged from 0.86–0.97. The Arabic version of the scale is a valid and reliable measure of common worries during pregnancy. It can provide valuable information on common concerns experienced by Jordanian women and guide psychosocial care. Understanding women's concerns will enable healthcare professionals to provide assistance and support, as well as to better meet pregnancy-related and psychosocial needs of pregnant women.
Publisher: Wiley
Date: 12-2000
DOI: 10.1046/J.1523-536X.2000.00256.X
Abstract: The consistently high cesarean section rate in most developed Western countries has been attributed in part to maternal request. This controversial view demands critical analysis. This paper provides a critique of published research relating to women's request for cesarean delivery. A search of the major databases was undertaken using the search term "cesarean section" with "maternal request," "decision-making," "patient-participation," "decision-making-patient," "patient-satisfaction," "patient-preference," and "maternal-choice." Ten research articles examining women's preferred mode of birth were retrieved, nine of which focused on women's preference for cesarean delivery. The methodology of some studies may result in overreporting women's request for a cesarean delivery. The role of the woman's caregiver in the generation, collection, and entry of data, and the occurrence of post hoc rationalization, recall bias, and women's tendency to be less critical of their care immediately after birth are possible areas of concern. Due consideration is rarely given to the influence of obstetric risk for women who may be requesting a cesarean section or to the information women used in making their decision. Women's perceptions of their involvement in decision-making regarding cesarean section are used to draw conclusions regarding women's request. Few women request a cesarean section in the absence of current or previous obstetric complications. The focus on women's request for cesarean section may ert attention away from physician-led influences on the continuing high cesarean section rates.
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.MIDW.2013.03.001
Abstract: for some women childbirth is physically and psychologically traumatic and meets Criterion A1 (threat) and A2 (intense emotional response) for Posttraumatic Stress Disorder of the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV).This study differentiates Criterion A1 and A2 to explore their in idual relationship to prevalence rates for posttraumatic stress, each other, and associated factors for childbirth trauma. women were recruited at three hospitals from October 2008 to October 2009. Questionnaires were completed at recruitment and at 14 days post partum. women in the third trimester of pregnancy (n=890) were recruited by a research midwife while waiting for their antenatal clinic appointment. Participants were over 17 years of age, expected to give birth to a live infant, not undergoing psychological treatment, and able to complete questionnaires in English. this study found 14.3% of women met criteria for a traumatic childbirth. When the condition of A2 was removed, the prevalence rate doubled to 29.4%. Approximately half the women who perceived threat in childbirth did not have an intense negative emotional response. Predictors of finding childbirth traumatic were pre-existing psychiatric morbidity, being a first time mother and experiencing an emergency caesarean section. the fear response is an important diagnostic criterion for assessing psychologically traumatic childbirth. The identification of risk factors may inform maternity service delivery to prevent traumatic birth and postpartum approaches to care to address long-term negative consequences. prevention and treatment of traumatic childbirth are improved through knowledge of potential risk factors and understanding the woman's subjective experience.
Publisher: Wiley
Date: 12-02-2009
DOI: 10.1111/J.1365-2702.2008.02479.X
Abstract: This study investigated attitudes of Japanese aged care staff toward aggression by people with dementia. Relationships between staff attitudes, professional characteristics and clinical practice were explored. Aggressive behaviour is often demonstrated by people with dementia and may be influenced by many factors including an inability by the in idual to appropriately express their needs, difficulties with assessment, as well as organisational and practice issues. Survey. Twenty-seven facilities/organisations located in the western and middle parts of Japan were surveyed. Staff (n = 675) employed in these facilities provided personal and professional information and completed the Attitudes Towards Aggression Scale. Staff who were older, had more clinical experience, higher education and/or a higher position reported more positive attitudes towards patient aggression. Staff with negative attitudes towards patients who are aggressive reported using chemical and/or physical restraint more often than staff with positive attitudes. Dementia education as well as restraint policy will be useful in addressing negative staff attitudes, in particular it may help to reverse the myth that restraint is necessary for staff protection. Furthermore, staff counseling may help to reduce stressors and to change staff negative attitudes towards people with dementia who display aggression. The findings show that negative staff attitudes may adversely affect clinical decision making and patient care. Measuring attitudes can identify areas requiring education or skill development and enable changes in attitudes to be monitored over time.
Publisher: Informa UK Limited
Date: 15-04-2021
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.MIDW.2013.07.009
Abstract: this paper describes midwives' experiences of learning new counselling skills and delivering a counselling intervention entitled 'Promoting Resilience on Mothers Emotions' (PRIME). a descriptive exploratory approach was used. Data collected included semi-structured interviews (n=42), midwife diary entries (18 pages) and web based postings (169 pages). Data were analysed using manual thematic method. the intervention study was conducted in two tertiary maternity hospitals in the Australian states of Queensland (QLD) and Western Australia (WA) during a 17 month period, from August 2008 to December 2009. midwives were employed as research assistants and trained to deliver a counselling intervention to women reporting a traumatic birth experience. Eighteen of a possible 20 Australian midwives participated in this study. PRIME is a midwife-led counselling intervention based on cognitive-behavioural principles and designed to ameliorate trauma symptoms. It is offered face-to-face within 72 hours of childbirth and by phone around six weeks post partum. participating midwives felt confronted by the level of emotional distress some women suffered as a consequence of their birth experience. Four major themes were extracted: The challenges of learning to change Working with women in a different way Making a difference to women and me and A challenge not about to be overcome. the advanced counselling skills the midwives acquired improved their confidence to care for women distressed by their birthing experience and to personally manage stressful situations they encountered in practice.
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.MIDW.2016.12.001
Abstract: to develop a comprehensive model of personal, trauma event-related and workplace-related risk factors for posttraumatic stress subsequent to witnessing birth trauma among Australian midwives. a descriptive, cross-sectional design was used. members of the Australian College of Midwives were invited to complete an online survey. the survey included items about witnessing a traumatic birth event and previous experiences of life trauma. Trauma symptoms were assessed with the Posttraumatic Stress Disorder Symptom Scale Self-Report measure. Empathy was assessed with the Interpersonal Reactivity Index. Decision authority and psychological demand in the workplace were measured with the Job Content Questionnaire. Variables that showed a significant univariate association with probable posttraumatic stress disorder were entered into a multivariate logistic regression model. 601 completed survey responses were analysed. The multivariable model was statistically significant and explained 27.7% (Nagelkerke R square) of the variance in posttraumatic stress symptoms and correctly classified 84.1% of cases. Odds ratios indicated that intention to leave the profession, a peritraumatic reaction of horror, peritraumatic feelings of guilt, and a personal traumatic birth experience were strongly associated with probable Posttraumatic Stress Disorder. risk factors for posttraumatic stress following professional exposure to traumatic birth events among midwives are complex and multi-factorial. Posttraumatic stress may contribute to attrition in midwifery. Trauma-informed care and practice may reduce the incidence of traumatic births and subsequent posttraumatic stress reactions in women and midwives providing care.
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.MIDW.2022.103386
Abstract: Whether women's preferences for maternity care are informed remains unclear, suggesting that maternal preferences may not accurately represent what women truly want. The aim of this study was to understand and critique research on women's maternity care preferences published since 2010. Systematic mixed studies review. CINHAL, EMBASE, MEDLINE, and ProQuest Nursing and Allied Health electronic databases were searched from January 2010 to April 2022. Thirty-five articles were included. Models of care and mode of birth were the most frequently investigated preference topics. Roughly three-quarters of included studies employed a quantitative design. Few studies assessed women's baseline knowledge regarding the aspects of maternity care investigated, and three provided information to help inform women's maternity care preferences. Over 85% of studies involved women who were either pregnant at the time of investigation or had previously given birth, and 71% employed study designs where women were required to select from pre-determined response options to describe their preferences. Two studies asked women about their preferences in the face of unlimited access and availability to specific maternity care services. Limited provision of supporting information, the predominant inclusion of women with experience using maternity care services, and limited use of mixed methods may have hindered the collection of accurate information from women about their preferences. Women's maternity care preferences research since 2010 may only present a limited version of what they want.
Publisher: CSIRO Publishing
Date: 15-07-2019
DOI: 10.1071/AH18209
Abstract: Objective This study sought to compare costs for women giving birth in different public hospital services across Queensland and their babies. Methods A whole-of-population linked administrative dataset was used containing all health service use in a public hospital in Queensland for women who gave birth between 1 July 2012 and 30 June 2015 and their babies. Generalised linear models were used to compare costs over the first 1000 days between hospital and health services. Results The mean unadjusted cost for each woman and her baby (n = 134 910) was A$17406 in the first 1000 days. After adjusting for clinical and demographic factors and birth type, women and their babies who birthed in the Cairns Hospital and Health Service (HHS) had costs 19% lower than those who birthed in Gold Coast HHS (95% confidence interval (CI) –32%, –4%) women and their babies who birthed at the Mater public hospitals had costs 28% higher than those who birthed at Gold Coast HHS (95% CI 8, 51). Conclusions There was considerable variation in costs between hospital and health services in Queensland for the costs of delivering maternity care. Cost needs to be considered as an important additional element of monitoring programs. What is known about the topic? The Australian maternal care system delivers high-quality, safe care to Australian mothers. However, this comes at a considerable financial cost to the Australian public health system. It is known that there are variations in the cost of care depending upon the model of care a woman receives, and the type of delivery she has, with higher-cost treatment not necessarily being safer or producing better outcomes. What does this paper add? This paper compares the cost of delivering a full cycle of maternity care to a woman at different HHSs across Queensland. It demonstrates that there is considerable variation in cost across HHSs, even after adjusting for clinical and demographic factors. What are the implications for practitioners? Reporting of cost should be an ongoing part of performance monitoring in public hospital maternity care alongside clinical outcomes to ensure the sustainability of the high-quality maternal health care Australian public hospitals deliver.
Publisher: Elsevier BV
Date: 10-2018
Publisher: Wiley
Date: 17-07-2018
DOI: 10.1111/JOCN.13894
Abstract: This study aimed to compare family functioning and perceptions of support from nurses among Danish and Australian adult oncology patients and family members. Family can have a strong influence on the health of in iduals, providing support during a health crisis such as cancer. However, family functioning and supportive care from nurses may vary across cultures and settings. A descriptive, cross-sectional comparative design with patients and family members from Denmark and Australia. Participants were asked to fill in translated versions of the Iceland-Expressive Family Functioning Questionnaire (ICE-EFFQ) and Iceland-Expressive Family Perceived Support Questionnaire (ICE-FPSQ). In total, 232 participants were recruited. The Danish cohort consisted of 56 patients and 54 family members. The Australian cohort consisted of 83 patients and 39 family members. Mean age was 59 years. No significant differences were found between Danish and Australian families. However, compared to patients, family members reported significantly lower overall family functioning, expressive emotions and communication, as well as less emotional support from nurses. Family functioning was comparable between Denmark and Australia. Family members reported less emotional support than patients. Nurses need to consider the patient and the family as a unit with complex needs that require monitoring and attention during oncology treatment. Families supporting a member with cancer have significant and often unmet needs. Assessment, information-sharing and health education need to include the family. Supportive care information may be shared between Denmark and Australia and inspires the development of common guidelines for optimal family nursing practice.
Publisher: Elsevier BV
Date: 04-2004
Publisher: Informa UK Limited
Date: 20-04-2011
Publisher: Springer Science and Business Media LLC
Date: 20-10-2013
Publisher: Elsevier BV
Date: 2015
Publisher: Wiley
Date: 11-12-2019
DOI: 10.1111/AJO.13107
Abstract: Traumatic stress can adversely affect obstetricians' mental health and may affect care provision. Little is known about the impact of traumatic birth on the Australasian obstetric workforce. To assess the feasibility of conducting a binational survey of Australia and New Zealand obstetricians, trainees, and general practitioner obstetricians, to determine the prevalence of trauma exposure and associated factors. Feasibility was assessed using a convergent mixed-methods design. The pilot online survey assessed traumatic exposure and included the Posttraumatic Diagnostic Scale, Copenhagen Burnout Inventory (work subscale), and Posttraumatic Growth Inventory (short form). Qualitative data were generated from survey comments and telephone interviews and thematically analysed. Using various recruitment strategies, 32 participants completed the survey, and eight completed interviews. Most participants were consultant obstetricians. Nearly all (n = 31, 96.9%) had been exposed to traumatic birth(s). Three-quarters had current symptoms of traumatic stress, one-quarter had symptoms of work-related burnout, but over two-fifths reported significant post-traumatic growth. Thematic analysis revealed perceptions that 'obstetricians experience substantial trauma', there is a 'culture of blame in obstetrics', and only 'in some workplaces it's supportive and safe'. Feasibility issues included the need to identify the respondent's level of training at the time when their most traumatic birth occurred, ensure anonymity of responses, and use a different tool to assess traumatic stress symptoms. Conducting a full study of this important topic appeared feasible. Standardised measures were acceptable. Revision of some questions is required. Anonymity needs to be promoted.
Publisher: Elsevier BV
Date: 11-2009
DOI: 10.1016/J.NEPR.2009.01.020
Abstract: Interactions between students and registered nurses are crucial opportunities for clinical learning. Success of this learning partnership is predicated on excellent communication, negotiation, and shared goal setting but these elements are often difficult to achieve. This paper describes the development and preliminary evaluation of the student Clinical Progression Portfolio (CPP). This pocket-size learning resource is carried by students and used as a point of reference to (1) enhance communication between students and registered nurses (2) provide a quick reference for the development and refinement of learning objectives and (3) offer a brief record of progress (via a succinct dot point process). An expert reference group evaluation revealed that the CPP provided a framework for students to initiate and support their clinical learning in partnership with clinicians.
Publisher: Wiley
Date: 27-05-2003
DOI: 10.1046/J.1523-536X.2003.00228.X
Abstract: Many women who suffer from postnatal depression are never diagnosed or treated. The objective of this study was to develop an index for use in maternity settings that identifies women who may be at risk for postnatal depression. Women (n = 1762) attending the "booking-in" clinic were screened for antenatal risk factors for postnatal depression. On the third postnatal day eligible women were screened for postnatal risk factors. The Edinburgh Postnatal Depression Scale was mailed to participants 16 weeks after the birth. A predictive index was developed, based on the mean Edinburgh Postnatal Depression Scale scores for each risk factor. The sensitivity, specificity, positive predictive value, and negative predictive value were used to assess the diagnostic value of the index. Seven hundred and twenty-three (50.1%) of the eligible women completed all phases of the study. Of this group, 93 (12.2%) women scored higher than 12 on the Edinburgh Postnatal Depression Scale. At a cutoff of 6, the index had positive predictive value of 39.8 percent for postnatal depression, a threefold improvement over the base rate. The Brisbane Postnatal Depression Index provides a clinically useful method for identifying women at risk for developing postnatal depression. It has applications for early intervention or to identify high-risk groups for research purposes.
Publisher: Elsevier BV
Date: 05-2013
DOI: 10.1016/J.NEDT.2012.03.001
Abstract: Learning circles are an enabling process to critically examine and reflect on practices with the purpose of promoting in idual and organizational growth and change. The authors adapted and developed a learning circle strategy to facilitate open discourse between registered nurses, clinical leaders, clinical facilitators and students, to critically reflect on practice experiences to promote a positive learning environment. This paper reports on an analysis of field notes taken during a critical reflection process used to create an effective learning community in the workplace. A total of 19 learning circles were conducted during in-service periods (that is, the time allocated for professional education between morning and afternoon shifts) over a 3 month period with 56 nurses, 33 students and 1 university-employed clinical supervisor. Participation rates ranged from 3 to 12 in iduals per discussion. Ten themes emerged from content analysis of the clinical learning issues identified through the four-step model of critical reflection used in learning circle discussions. The four-step model of critical reflection allowed participants to reflect on clinical learning issues, and raise them in a safe environment that enabled topics to be challenged and explored in a shared and cooperative manner.
Publisher: Cambridge University Press (CUP)
Date: 18-05-2019
DOI: 10.1017/S1463423618000336
Abstract: Screening women for depression and psychosocial risk during the perinatal period is recognised best practice. Screening by current pen and paper methods can be time consuming, and prone to scorer error. The lack of readily available translated versions of screening tools also excludes many women from different cultures. To evaluate a perinatal mental health digital screening platform, iCOPE. The trial was conducted in a community maternal and child health setting in Melbourne, Australia. A descriptive, cohort design was used. All women attending the urban clinic were invited to complete their routine perinatal screening on the digital platform, designed to automate score calculations and produce instant clinical and client reports whilst collecting data in real time. Screening included the Edinburgh Postnatal Depression Scale (EPDS) and psychosocial risk questions in line with current national clinical guidelines. Functionality of iCOPE was assessed according to duration of screening, completion rates, accuracy of reporting and level of engagement by women. During the trial, 144 screens were performed. The mean screening time was 6.7 min (SD=3.78). Most (65.7% n =94) women took between 3 and 6 min. Mean EPDS score was 7.2 with 16% ( n =23) scoring 13 or more. The accuracy of reports was 100% and screening completion rate was 99.3%. Many women (81.3%) requested a copy of their personal report. The iCOPE platform was efficient in terms of screening time, scoring accuracy, and engagement of women. The automated production of tailored client and clinical reports enabled screening outcomes to be instantly communicated to women and health professionals. The collection of data in real time facilitated the monitoring of screening rates and evaluation of outcomes by clinicians and service managers.
Publisher: Elsevier BV
Date: 12-2002
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.WOMBI.2017.10.014
Abstract: Asking women about experiences of domestic violence in the perinatal period is accepted best practice. However, midwives and nurses may be reluctant to engage with, or effectively respond to disclosures of domestic violence due a lack of knowledge and skills. To evaluate the impact of training on knowledge and preparedness of midwives and nurses to conduct routine enquiry about domestic violence with women during the perinatal period. A pre-post intervention design was used. Midwives and nurses (n=154) attended a full day workshop. Of these, 149 completed pre-post workshop measures of knowledge and preparedness. Additional questions at post-training explored participants' perceptions of organisational barriers to routine enquiry, as well as anticipated impact of training on their practice. Training occurred between July 2015 and October 2016. Using the Wilcoxon signed-rank test, all post intervention scores were significantly higher than pre intervention scores. Knowledge scores increased from a pre-training mean of 21.5-25.6 (Z=-9.56, p<0.001) and level of preparedness increased from 40.8 to 53.2 (Z=-10.12, p<0.001). Most participants (93%) reported improved preparedness to undertake routine enquiry after training. Only a quarter (24.9%) felt their workplace allowed adequate time to respond to disclosures of DV. Brief training can improve knowledge, preparedness, and confidence of midwives and nurses to conduct routine enquiry and support women during the perinatal period. Training can assist midwives and nurses to recognise signs of DV, ask women about what would be helpful to them, and address perceived organisational barriers to routine enquiry. Practice guidelines and clear referral pathways following DV disclosure need to be implemented to support gains made through training.
Publisher: Mark Allen Group
Date: 02-06-2019
DOI: 10.12968/BJOM.2019.27.6.362
Abstract: Postnatal anxiety is relatively common when transitioning to parenthood however, there are relatively few studies assessing postnatal anxiety in Middle Eastern women. To identify the prevalence of postnatal anxiety among Jordanian women and associated sociocultural factors. A descriptive cross-sectional design was used with 324 women. Participants completed the Depression, Anxiety, and Stress Scale (DASS) and Maternity Social Support Scale at 6-8 weeks postpartum in addition to a sociodemographic data form. Some 45.4% of women scored above ‘mild’ on the DASS scale. Postnatal anxiety was significantly associated with low levels of support, giving birth to a female baby, financial difficulties, and having four or more children. Findings revealed a high level of postnatal anxiety among Jordanian women. There is a need for routine assessment, ongoing support, counselling and emotional care, which are important to enhance maternal satisfaction and psychological wellbeing.
Publisher: MDPI AG
Date: 28-05-2022
Abstract: Background: Although undergoing an abortion is stressful for most women, little attention has been given to their psychological wellbeing. This protocol aims to assess the feasibility, acceptability, and primary effects of a complex intervention to promote positive coping behaviors and alleviate depression symptoms among Chinese women who have undergone an abortion. Methods: A two-arm randomized controlled trial design will be used. Participants will be recruited at their first appointment with the abortion clinic and randomly allocated to receive either the Stress-And-Coping suppoRT (START) intervention (in addition to standard abortion care) or standard care only. All participants will be followed-up at two- and six-weeks post-abortion. Approval has been granted by local and university ethics committees. This research was supported by an Australian Government Research Training Program Scholarship. Discussion: The results will assist refinement and further evaluations of the START intervention, contribute to improved abortion care practices in China, and enrich the evidence on improving women’s psychological well-being following abortion in China. Trial registration: Registered at the Chinese Clinical Trials.gov: ChiCTR2100046101. Date of registration: 4 May 2021.
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1016/J.MIDW.2011.10.003
Abstract: to explore the traditional birthing practices of Singaporean women. a qualitative study using a phenomenological approach. Data were collected using in idual interviews, which were audio-recorded and transcribed verbatim. Colaizzi's phenomenological method was used to analyse the data. obstetric outpatient clinics in a tertiary hospital in Singapore. a purposive s le of 30 women, 1-3 months postpartum. two broad themes emerged-following tradition and challenging tradition. Singaporean women experiencing pregnancy and childbirth follow tradition through the influence of their mother and mother-in-law and because of worry over consequences that may result if they do not. Tradition is also challenged through the modification or rejection of traditional practices and changing family roles and expectations. health professionals need to provide accurate information on traditional birthing practices and scientific evidence to support or refute such practices with the aim of preventing women from adhering to practices that are hazardous to them and the baby.
Publisher: Elsevier BV
Date: 03-2020
Publisher: Wiley
Date: 28-06-2013
DOI: 10.1111/JOCN.12358
Abstract: To explore Singapore hospice nurses' perspectives of spirituality and spiritual care. A descriptive, cross-sectional design was used. Spiritual care is integral to providing quality end-of-life care. However, patients often report that this aspect of care is lacking. Previous studies suggest that nurses' neglect of this aspect of care could be attributed to poor understanding of what spirituality is and what such care entails. This study aimed to explore Singapore hospice nurses' perspectives about spirituality and spiritual care. A convenience s le of hospice nurses was recruited from the eight hospices in Singapore. The survey comprised two parts: the participant demographic details and the Spirituality Care-Giving Scale. This 35-item validated instrument measures participants' perspectives about spirituality and spiritual care. Sixty-six nurses participated (response rate of 65%). Overall, participants agreed with items in the Spiritual Care-Giving Scale related to Attributes of Spiritual Care Spiritual Perspectives Spiritual Care Attitudes and Spiritual Care Values. Results from general linear model analysis showed statistically significant main effects between race, spiritual affiliation and type of hospice setting, with the total Spiritual Care-Giving Scale score and four-factor scores. Spirituality was perceived to be universal, holistic and existential in nature. Spiritual care was perceived to be relational and centred on respecting patients' differing faiths and beliefs. Participants highly regarded the importance of spiritual care in the care of patients at end-of-life. Factors that significantly affected participants' perspectives of spirituality and spiritual care included race, spiritual affiliation and hospice type. Study can clarify values and importance of spirituality and care concepts in end-of-life care. Accordingly, spirituality and care issues can be incorporated in multi-disciplinary team discussions. Explicit guidelines regarding spiritual care and resources can be developed.
Publisher: Hindawi Limited
Date: 02-06-2011
DOI: 10.1111/J.1744-6163.2010.00257.X
Abstract: The purpose of this study was to examine the roles of adherence attitude to antidepressants and patient education as mediators in mediating patients' attitudes toward antidepressant use. A s le of 201 outpatients, 50 years of age or older, with major depressive disorder, completed a drug use questionnaire, attitudes toward and patient education about antidepressants questionnaire, and Adherence Attitude Inventory. Attitudes toward antidepressants were positively associated to antidepressant use, an association explained by the mediating variable, patient education about antidepressants. Adherence attitudes to antidepressants were a mediator that accounted to a significant degree for the causal relationship between attitudes toward antidepressants and antidepressant use. Adequate patient education and an understanding of patients' adherence attitude to antidepressant use are needed in nursing practice to reduce patients' uncertainty about treatment and increase successful treatment.
Publisher: Springer International Publishing
Date: 2021
Publisher: Wiley
Date: 06-2001
DOI: 10.1046/J.1523-536X.2001.00101.X
Abstract: Few studies have examined women's preferences for birth. The object of this study was to determine the incidence of women's preferred type of birth, and the reasons and factors associated with their preference. Three hundred and ten women between 36 and 40 weeks' gestation were recruited from the antenatal clinic of a major metropolitan teaching hospital and the consulting rooms of six private obstetricians in Brisbane, Australia. Participants completed a questionnaire asking about their preferred type of birth, reasons for their preference, preparation for childbirth, level of anxiety and concerns, and the influence of the primary caregiver. Two hundred and ninety women (93.5%) preferred a spontaneous vaginal birth 20 women (6.4%) preferred a cesarean section. Of the latter group, most had a current obstetric complication or experienced a previously complicated delivery (p <0.001) 1 woman (0.3%) preferred a cesarean section in the absence of any known current or previous obstetric complication. Women who preferred a cesarean section were more anxious, were generally poorly informed of the risks of this procedure, and/or overestimated the safety of the procedure. Women who preferred a cesarean section were more likely to have experienced this type of birth previously and to have negative feelings about it. To decrease women's preference for a cesarean section, practitioners should reduce the primary cesarean delivery rate and improve the quality of emotional care for women who require a cesarean section. Caregivers should engage in a sensitive discussion of the risks and benefits of various birth options, including a vaginal birth after cesarean, with women who have previously experienced a cesarean birth before they make decisions about mode of delivery in a subsequent pregnancy.
Publisher: Elsevier BV
Date: 09-2001
DOI: 10.1071/HI01081
Publisher: Wiley
Date: 06-06-2003
DOI: 10.1046/J.1365-2702.2003.00719.X
Abstract: Cultural beliefs are important determinants of health care behaviours. Nurses have an important influence on infant feeding decisions and maternal postpartum care, but little is known about the extent to which their practice is influenced by traditional beliefs and/or recent innovations driven by evidence-based research. The aim of this study was to investigate Thai nurses' traditional beliefs about breastfeeding and related postpartum care, and their impact on nursing practice. A survey of 372 nurses working in hospitals and health services in Ubon Ratchathani, Thailand was undertaken. Questionnaire items were developed from a review of the literature and exploratory interviews with Thai women. Descriptive statistics were used to represent the incidence of particular beliefs and behaviours. Chi-square analyses were conducted to determine relationships between demographic characteristics and traditional beliefs and practices. There were discrepancies between nurses' beliefs and contemporary evidence-based practices. Many nurses supported traditional Thai postpartum practices such as food restrictions and encouraging hot baths. Some traditional beliefs supported by nurses may be detrimental to women and babies such as "lying by fire", discarding of colostrum, and giving boiled water to neonates. Only half the nurses reported that they encouraged mothers to breastfeed immediately following birth. The study was undertaken in the North-East of Thailand, where the population is known to have strong belief systems. Reliability and content validity of the tool would be enhanced through replication studies and qualitative investigations of other breastfeeding issues. There is a need for professional development strategies such as peer review and mentoring to address inadequate knowledge and outdated practices of some health professionals, as well as continuity of care models to assess quality care outcomes that are culturally appropriate.
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.WOMBI.2018.04.003
Abstract: Relatively little is known about the extent of trauma and birth-related fear in midwives and how this might affect practice. (1) Determine prevalence of birth related trauma and fear in midwives and associations with midwives' confidence to advise women during pregnancy of their birth options and to provide care in labour. (2) Describe midwives' experiences of birth related trauma and/or fear. A mixed methods design. A convenience s le of midwives (n=249) completed an anonymous online survey. Descriptive and inferential statistics were used to analyse the quantitative data. Latent content analysis was used to extrapolate meaning from the 170 midwives who wrote about their experiences of personal and/or professional trauma. The majority of midwives (93.6%) reported professional (n=199, 85.4%) and/or personal (n=97, 41.6%) traumatic birth experiences. Eight percent (n=20) reported being highly fearful of birth. Trauma was not associated with practice concerns but fear was. Midwives categorised as having 'high fear' reported more practice concerns (Med 23.5, n=20) than midwives with 'low fear' (Med 8, n=212) (U=1396, z=-3.79, p<0.001, r=0.24). Reasons for personal trauma included experiencing assault, intervention and stillbirth. Professional trauma related to both witnessing and experiencing disrespectful care and subsequently feeling complicit in the provision of poor care. Feeling unsupported in the workplace and fearing litigation intensified trauma. High fear was associated with lower confidence to support childbearing women. Fear and trauma in midwives warrants further investigation to better understand the impact on professional practice.
Publisher: Elsevier BV
Date: 10-2011
Publisher: Elsevier BV
Date: 07-2020
DOI: 10.1016/J.WOMBI.2019.06.018
Abstract: Implementing Domestic and Family Violence (DFV) screening, support, and prevention within maternity services is becoming common practice but women's experiences of screening are not routinely evaluated. (1) Explore pregnant women's experiences of routine DFV screening and perceptions of responses by midwives and (2) undertake preliminary testing of three new tools. Using a cross-sectional design, pregnant women (n = 210) attending an antenatal service were surveyed. Three new measures: beliefs about DFV screening non-disclosure of DFV and midwifery support were tested. Most women (92.3% n = 194) recalled being screened. Twelve (5.8%) respondents had/were experiencing DFV. A quarter (24.1% n = 49) had experienced or witnessed violence in the home as a child. The scales were reliable and factor analysis established validity. Women reported positive beliefs (mean 35.38, SD 3.63 range 19-40) and views about midwifery support (mean 24.88, SD 3.08 range 18-30). There was less agreement about why some women do not disclose DFV (mean 21.97, SD 4.27, range 8-30). Women who experienced or witnessed violence as a child, or were experiencing violence now were less comfortable with screening. Comments (n = 75) revealed support for routine enquiry that was confidential, explained, and occurred in a trusting relationship. Women were supportive of screening, but actual rates of disclosure were low. Women acknowledged the importance of screening but did not want their information shared. Women value screening, even if DFV is not disclosed. Exploring women's experiences is central to ensuring quality care.
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.WOMBI.2018.10.001
Abstract: Awareness of cultural safety by midwifery academics is integral to the provision of a safe learning and teaching environments, use of effective pedagogies, and academic success of Indigenous midwifery students. However, little is known about the scope and efficacy of continuing professional development activities that aim to develop awareness of cultural safety by midwifery academics. To conduct an integrative review of the literature with respect to the scope and efficacy of professional development interventions that aim to increase awareness of cultural safety by midwifery academics. An integrative review of peer-reviewed literature from 2005 -2017 was undertaken. Documents were assessed using the Critical Appraisals Skills Program (CASP) guidelines. Concepts were mapped thematically. Results are reported and discussed using key themes identified in the analysis. Five broad themes emerged from the analysis of studies. The themes were named: Cultural Terms, Knowledge of Culture, Cultural Education, Cultural Aspirations and Culture in Curricula. Midwifery academics requireprofessional development to raise their awareness of cultural safety in order to adopt effective learning and teaching practices. There is currently no agreed best practice framework to support awareness of cultural safety for midwifery academics. The philosophy of midwifery practice has many synergies with the principles of cultural safety. Cultural safety needs to be embedded into professional development plans for midwifery academics.
Publisher: Wiley
Date: 24-03-2021
DOI: 10.1111/INM.12862
Abstract: There is limited research on mental health literacy among undergraduate nursing students in Australia. Overseas studies indicate significant gaps in students’ knowledge and practice. The aims of this study were to (1) assess mental health literacy knowledge in undergraduate nursing students and compare these across year levels, and to (2) identify students’ learning needs about mental health literacy in practice. A convenience s le of 114 Bachelor of Nursing students studying at one Australian University completed the online survey. Results showed that third‐year students reported higher levels of mental health literacy compared to first‐ and second‐year students. Almost 40% of students felt they did not have sufficient understanding of mental health literacy for practice. Most respondents (66.7%) wanted more information on different types of mental illnesses, treatments, how to reduce mental health stigma, and how to care for and communicate with people with mental illness. Students identified that mental health first aid training should be compulsory for all nursing students. Mental health literacy is a crucial area to be addressed in undergraduate nursing education. Explicit content and skill development are required to improve students’ awareness of health literacy and inform their practice.
Publisher: Mark Allen Group
Date: 02-08-2023
DOI: 10.12968/BJOM.2023.31.8.445
Abstract: Childbirth is an important and unique event for mothers and families, but can cause fear and anxiety. All mothers have the right to adequate support for labour and a respectful birth. This study aimed to investigate the impact of supportive intrapartum care on women's perceptions of fear, pain and control during childbirth, as compared to routine care. A quasi-experimental study was conducted at the Jordan University Hospital with 134 pregnant women between August 2019 and January 2020. Participants were assigned to either the intervention (n=65) or control group (n=69). Data were collected using a sociodemographic form, a visual analogue scale for pain, the Wijma delivery expectancy questionnaire (B) for fear during birth, and the perceived support and control in birth scale. Women receiving supportive care reported lower pain scores during the latent (t=4.15, P .001), active (t=4.64, P .001) and transition (t=2.34, P .05) phases of labour, less fear (t=8.66, P .001), and higher perceived control (t=12.46, P .001) and support (t=10.54, P .001), and had a shorter labour (t=10.367, P .001) compared to women receiving routine care. Low control (β=-0.35), high levels of pain (β=0.20) and low support (β=-0.19) contributed to fear during childbirth. Supportive intrapartum care decreased women's perceptions of pain and fear and improved perceptions of control and support. Training and support for midwives could be translated to similar settings in middle-income countries. Policies directed at routine implementation of supportive intrapartum care are essential to decrease pain and fear of childbirth.
Publisher: Springer Science and Business Media LLC
Date: 14-04-2020
DOI: 10.1186/S12884-020-02891-2
Abstract: Variation exists regarding perinatal depression screening. A two-step screening method has been recommended. According to a maternity-focused core outcome set developed by the International Consortium for Health Outcomes Measurement, women who score 3 or more on the PHQ-2 then complete the Edinburgh Postnatal Depression Scale (EPDS). Limited evidence exists regarding the screening accuracy of the PHQ-2 in childbearing women. An alternative case-identification method may be more sensitive for perinatal women. We aimed to [1] evaluate the screening accuracy of the PHQ-2 during the perinatal period using two case-identification methods, and [2] measure the variability of accuracy over four time-points during pregnancy and postpartum. A prospective, longitudinal cohort study was conducted with 309 consecutive women who completed the PHQ-2 and EPDS during pregnancy (booking, 36-weeks) and postpartum (6-, 26-weeks). EPDS was the reference standard using cut-off scores for ‘ at least probable minor depression ’ during pregnancy (≥ 13) and postpartum (≥ 10) and for ‘ probable major depression ’ during pregnancy (≥ 15) and postpartum (≥ 13). PHQ-2 was analysed using two methods: [1] scored (cut-points ≥ 2 and ≥ 3), [2] dichotomous yes/no (positive response to either question) against EPDS cut-points for at least probable minor and probable major depression. Receiver operating characteristic analyses determined accuracy. Probable major depression: Over four timepoints PHQ-2 ≥ 3 revealed lowest sensitivity (36–79%) but highest specificity (94–98%). An alternative case-identification method revealed high sensitivity (93–100%), but lowest specificity (58–71%). Minor depression: PHQ-2 ≥ 3 revealed the lowest sensitivity (19–50%) but highest specificity (95–98%). An alternative case-identification method revealed the highest sensitivity (81–100%) and moderate specificity (60–74%). Recommended method of case-identification (PHQ-2 ≥ 3) missed an unacceptable number of women at-risk of depression. As a clinical decision-making tool, an alternative, dichotomous method maximized case-identification and is recommended. Further, the literature identified inconsistent reporting of the PHQ-2 and the alternative case-identification method hindering the ability to synthesise data. The future use and reporting of consistent question wording and response format will improve outcome reporting and synthesis. Further research in larger and erse maternity populations is recommended.
Publisher: Elsevier BV
Date: 07-2020
DOI: 10.1016/J.WOMBI.2019.06.020
Abstract: Reflective practice is a core professional competency and the hallmark of an autonomous, evidence-based midwife practitioner committed to lifelong learning. Despite this professional imperative little is currently known about how the development of reflective capacity is facilitated with midwifery students. This study aimed to determine (1) the extent to which a holistic, structured model of reflection develops reflective capacity in midwifery students and (2) their perceptions of learning and teaching strategies that build reflective capacity. A qualitative cross-sectional design involving focus groups and thematic analysis. The Bass Model of Holistic Reflection was introduced to promote development of reflective capacity in midwifery students enrolled in entry to practice programs in two Australian universities. Students were provided with guidance on how to apply the model to their reflections. After using the model for at least one trimester twenty-seven (27) participants volunteered to participate in focus groups. Four themes emerged 'safe space within a circle of trust', 'deep personal learning', 'consistency of application by skilled facilitators', and 'integration and connection'. Use of a holistic model combined with integrative and structured reflective activities supports the scaffolded and developmental nature of reflection. Alignment of the model with a woman centred midwifery philosophy generates midwifery knowledge and reflects student expectations of their role as aspiring midwives. Midwives' attitudes regarding reflection influences students' perceptions of value. Quality of feedback provided by educators affects levels of student motivation and engagement with reflection.
Publisher: Wiley
Date: 08-2014
DOI: 10.1111/INR.12120
Abstract: Birth weight is a good indicator of mothers' and neonates' nutritional status, and it contributes to the newborn baby's survival, health, growth and development. This study identified social factors associated with differences in the mean birth weight of newborn babies in Jordan. This retrospective study analysed medical records to determine possible risk factors associated with differences in newborn BW in the Irbid governorate of Jordan. All full-term singleton births during the year 2010 were reviewed. Abstracted data included mother's age, educational level, and monthly family income. Newborn information included birth weight, gender and birth order. A total of 5414 full-term singleton births were included. Of these, 15.1% were low birth weight, 73.6% were normal birth weight, and 11.3% were high birth weight. Bivariate analysis of variance revealed that low mean birth weight was associated with female gender, first-born babies, higher maternal age (>35 years), lower educational level and lower income (<500 JD). Multivariate analysis of variance revealed that mean birth weight was lower in female infants, first-born infants, infants of less educated mothers, higher age and low monthly income. The findings can be generalized to full-term singleton pregnancies in countries who share similar cultural and traditional values. Education of mothers is a modifiable variable that can positively influence birth weight, particularly in the case of female and first-born infants. The findings inform our understanding of some social factors affecting birth weights of neonates in Jordan and development of effective public health interventions that could reduce the adverse effects of such factors on newborn birth weight. Preconception and antenatal care is also important for early detection of such possible risk and targeting mothers who require early interventions and support.
Publisher: Springer Science and Business Media LLC
Date: 11-07-2017
Publisher: Elsevier BV
Date: 12-2023
Publisher: Informa UK Limited
Date: 15-04-2019
Publisher: Elsevier BV
Date: 12-2004
DOI: 10.1071/HI04126
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.WOMBI.2016.06.006
Abstract: Midwives frequently witness traumatic birth events. Little is known about responses to birth trauma and prevalence of posttraumatic stress among Australian midwives. To assess exposure to different types of birth trauma, peritraumatic reactions and prevalence of posttraumatic stress. Members of the Australian College of Midwives completed an online survey. A standardised measure assessed posttraumatic stress symptoms. More than two-thirds of midwives (67.2%) reported having witnessed a traumatic birth event that included interpersonal care-related trauma features. Midwives recalled strong emotions during or shortly after witnessing the traumatic birth event, such as feelings of horror (74.8%) and guilt (65.3%) about what happened to the woman. Midwives who witnessed birth trauma that included care-related features were significantly more likely to recall peritraumatic distress including feelings of horror (OR=3.89, 95% CI [2.71, 5.59]) and guilt (OR=1.90, 95% CI [1.36, 2.65]) than midwives who witnessed non-interpersonal birth trauma. 17% of midwives met criteria for probable posttraumatic stress disorder (95% CI [14.2, 20.0]). Witnessing abusive care was associated with more severe posttraumatic stress than other types of trauma. Witnessing care-related birth trauma was common. Midwives experience strong emotional reactions in response to witnessing birth trauma, in particular, care-related birth trauma. Almost one-fifth of midwives met criteria for probable posttraumatic stress disorder. Midwives carry a high psychological burden related to witnessing birth trauma. Posttraumatic stress should be acknowledged as an occupational stress for midwives. The incidence of traumatic birth events experienced by women and witnessed by midwives needs to be reduced.
Publisher: Springer Science and Business Media LLC
Date: 13-02-2015
Publisher: Elsevier BV
Date: 09-2022
DOI: 10.1016/J.WOMBI.2021.10.001
Abstract: Holistic reflection encompasses reflection as a continuum, incorporating critical reflection, reflexivity, critical thinking and a whole-of-person approach. The development of holistic reflection in midwifery students and midwives is rarely measured in a standardised way. To develop and test a tool to measure holistic reflection in midwifery students and midwives, for use in pre-registration and post-graduate education, and research. The eight-step approach to tool development by DeVellis was followed with psychometric testing of data from a cross-sectional survey. Midwifery students (pre-registration and postgraduate), and midwifery alumni of an Australian university. Draft items (n = 84) were generated from review of the literature, qualitative research, and a theoretical model. An expert panel (n = 19) reviewed draft items resulting in 39 items. The survey included demographic details, the draft Holistic Reflection Assessment Tool, emotional intelligence subscale, and a social desirability scale. Participants repeated the online survey at two weeks to confirm test-retest reliability. The 187 responses were received. Exploratory factor analysis with varimax rotation revealed three factors accounting for 49% of variance. Internal consistency of the tool was high (α = .91) and test-retest reliability at two weeks (α = .93) demonstrated stability. There were low correlations between social desirability (r = .22, p < .001) and emotional intelligence (r = .21, p < .001) with the new holistic reflection scale. The Holistic Reflection Assessment Tool is the first for midwifery. The tool was reliable, stable, and valid. Further research is warranted for criterion validity.
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.WOMBI.2022.02.006
Abstract: Currently there is no discipline-specific definition of critical thinking in midwifery practice. Critical thinking in midwifery practice is the cornerstone for safe, evidence based, and woman centred clinical decision-making. Available definitions of critical thinking in other disciplines do not align with midwifery practice which is distinctive, multidimensional and complex. To develop an international consensus definition of critical thinking in midwifery practice. A two round Delphi study was used. Thirty-two international midwifery experts contributed to the first round which was qualitative in nature. Twenty one of these experts then ranked the relevance and clarity of concepts from round one. A consensus definition of critical thinking in midwifery practice was achieved. The expert panel identified and defined 14 'Habits of Mind' and 12 Skills that are the core of critical thinking in midwifery practice. Skills included analysis, constructive application and contextualisation of best available evidence, problem solving, discriminating, predicting, evaluation of care, collect and interpret clinical cues, collaboration/ negotiation, reflexivity, facilitates shared decision-making, communication, and transforming knowledge. Habits of Mind included intellectual curiosity, reflective, holistic view, intellectual integrity, flexibility, questioning/challenging, participatory, open mindedness, listening with understanding and empathy, cultural humility, woman centred, being brave, confidence, and creativity. This study is an international first and delineates characteristics of critical thinking in midwifery. Development of a consensus definition provides a common and shared understanding of the skills and attributes required for critical thinking in midwifery practice and can also be applied in education and research.
Publisher: Springer Science and Business Media LLC
Date: 15-04-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2011
DOI: 10.11124/01938924-201109090-00001
Abstract: Background As a chronic condition, the prevalence of Type 2 diabetes is increasing worldwide and adherence to oral medications, an essential component of self-management, has been shown to improve glycaemic control. However compliance with oral medication adherence remains poor. Educating people with Type 2 diabetes is an important strategy to enhance self-management ability, including medication-taking behaviour.Objectives The overall objective of the review was to determine the effectiveness of educational interventions to promote oral hypoglycaemic adherence in adults with Type 2 diabetes. Types of participants Studies involving adults over 18 years old with Type 2 diabetes, with or without co-morbidities, currently taking oral hypoglycaemic medication without insulin treatment, and with aglycated haemoglobin (HbA1c) > 7.0% prior to the intervention were considered. Aglycated haemoglobin (HbA1c) concentration of less than 7.0%, is important in order to delay or prevent diabetes-related complications. Participants could be from the primary, tertiary or acute care setting.Types of intervention The review focused on various forms of educational interventions delivered by healthcare professionals aimed at improving participants' knowledge.Types of outcomes The review evaluated outcomes measuring oral hypoglycaemic adherence including HbA1c, fasting blood glucose levels and other relevant indicators.Types of studies Studies that were randomized controlled trials (RCTs) or case-control studies were considered.Search strategy A three-stage search strategy was employed. Papers in English and between the years 1990-2009 were searched in the following databases: CINAHL, Medline, Mosby's Nursing Consult, PsycINFO, PubMed, ScienceDirect, Scopus, TRIP and Web of Science. Full text was retrieved when the titles and abstracts of studies fulfilled the inclusion criteria.Methodological quality Full papers were assessed for methodological quality independently by two reviewers using critical appraisal checklists from the Joanna Briggs Institute (JBI). A third reviewer was consulted whenever there were disagreements between the two reviewers.Data collection/extraction Details of each study included in the review were extracted using standardized data extraction forms developed by JBI. Extraction was conducted independently by two reviewers.Data synthesis Meta-analysis was not possible due to methodological and statistical heterogeneity of the included studies. Hence study findings are presented in narrative form.Results Seven studies included in the final review consisted of seven RCTs. Five studies concluded that the educational intervention was effective in promoting oral hypoglycaemic adherence compared to usual care. These included pharmacist-led interventions, in idual diabetes education provided by nurses and diabetes group education based on a self-management approach. Similarities among these interventions were provision of information on oral hypoglycaemic medication and the need for regular education sessions. However, small s les in some studies limited generalization of results. Implications for practice Increased knowledge of oral hypoglycaemic issues and reinforcement of the importance of medication adherence were useful in promoting adherence. Regular education sessions allow in iduals to reinforce information and educators to identify barriers to medication adherence. Educational interventions focusing on self-management strategies appear more likely to achieve positive outcomes.Implications for research Further trials involving larger s les and populations with poor glycaemic control are needed. The effects of educational interventions, influence of additional take-home written material, the optimal interval length of follow-up and duration of education sessions, and specific processes of in idual or group education which have been identified as effective need further exploration.
Publisher: Elsevier BV
Date: 05-2016
DOI: 10.1016/J.NEDT.2016.03.010
Abstract: The value and importance of incorporating strategies that promote critical thinking in nursing and midwifery undergraduate programmes are well documented. However, relatively little is known about the effectiveness of teaching strategies in promoting CT. Evaluating effectiveness is important to promote 'best practise' in teaching. To evaluate the efficacy of teaching methods used to develop critical thinking skills in nursing and midwifery undergraduate students. The following six databases CINAHL, Ovid Medline, ERIC, Informit, PsycINFO and Scopus were searched and resulted in the retrieval of 1315 papers. After screening for inclusion, each paper was evaluated using the Critical Appraisal Skills Programme tool. Twenty-eight studies met the inclusion criteria and quality appraisal. Twelve different teaching interventions were tested in 8 countries. Results varied, with little consistency across studies using the same type of intervention or outcome tool. Sixteen tools were used to measure the efficacy of teaching in developing critical thinking. Seventeen studies identified a significant increase in critical thinking, while nine studies found no increases, and two found unexplained decreases in CT when using a similar educational intervention. Whilst this review aimed to identify effective teaching strategies that promote and develop critical thinking, flaws in methodology and outcome measures contributed to inconsistent findings. The continued use of generalised CT tools is unlikely to help identify appropriate teaching methods that will improve CT abilities of midwifery and nursing students and prepare them for practise. The review was limited to empirical studies published in English that used measures of critical thinking with midwifery and nursing students. Discipline specific strategies and tools that measure students' abilities to apply CT in practise are needed.
Publisher: Elsevier BV
Date: 12-2004
DOI: 10.1071/HI04120
Publisher: Springer Science and Business Media LLC
Date: 07-10-2021
DOI: 10.1007/S10995-021-03230-3
Abstract: Transitioning to motherhood is an important life event. Stress often arises due to feeding concerns, infant crying, and sleep problems. Neuroprotective Developmental Care (NDC) also known as the Possums programs provides an evidence-based, consistent and holistic approach to maternal and infant wellbeing. To understand maternal characteristics at point of services access and an exploratory evaluation of effectiveness of NDC/Possums services. All mothers accessing NDC/Possums services via clinical services or self-paced online modules were invited to participate in a baseline survey. Follow up occurred when infants were 6 and 12 months of age. Participants who completed the 6-month survey were compared against their own baseline surveys. Those who completed the survey at 12-months were compared against their own baseline surveys. A pseudo-control group who had completed the baseline survey with infants 12 months of age was also compared to those who had accessed NDC/Possums services prior to 12 months of age (termed 'intervention' group). Crying time, mothers' perceptions of infant sleep problems, mothers' own sleep, mothers' Acceptance and Action Questionnaire (AAQ) scores and the mothers' Edinburgh Postnatal Depression Scale (EPDS) scores showed statistically significant improvements from baseline to 12-month old follow-up. Significant differences were also found between the pseudo-control group and 'intervention' groups. This results indicate that accessing NDC/Possums services is efficacious in addressing infant's crying, the mother's perceptions of their baby's sleep problems, the mother's own sleep satisfaction, the mother's experiential avoidance, and the mother's risk of postnatal depression. NDC is relevant to public health, clinical service delivery and education for health professionals.
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.WOMBI.2017.02.004
Abstract: Cultural safety in higher education learning and teaching environments is paramount to positive educational outcomes for Aboriginal and/or Torres Strait Islander (hereafter called First Peoples) students. There is a lack of research evaluating the impact of continuing professional development on midwifery academics' awareness of cultural safety. To implement and evaluate a continuing professional development intervention to improve midwifery academics' awareness of cultural safety in supporting First Peoples midwifery students success. A pre-post intervention mixed methods design was used. Academics (n=13) teaching into a Bachelor of Midwifery program agreed to participate. The intervention consisted of two workshops and five yarning circles across a semester. Data included the Awareness of Cultural Safety Scale, self-assessment on cultural safety and perceptions of racism, evaluation of the intervention, participants' journal entries, and researcher's reflections. Responses on the Awareness of Cultural Safety Scale revealed significant improvement in participants' awareness of cultural safety. There was an upward trend in self-assessment ratings. Participants reported high levels of satisfaction with the intervention or workshops and yarning circles. Participants' journal entries revealed themes willingness to participate and learn, confidence as well as anger and distress. Increased awareness of cultural safety can be transformative for midwifery academics. Workshops and yarning circles can support academics in moving beyond a 'sense of paralysis' and engage in challenging conversations to transform their learning and teaching and in turn foster a culturally safe learning and teaching environment for First Peoples midwifery students towards success.
Publisher: Elsevier BV
Date: 11-2018
Publisher: Elsevier BV
Date: 04-2020
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.NEDT.2018.02.022
Abstract: Health professional graduates require the capacity to work safely, both clinically and culturally, when delivering care to Indigenous peoples worldwide. In the Australian context, the Aboriginal and Torres Strait Islander Health Curriculum Framework (The Framework) provides guidance for health professional programs to integrate, teach and assess Aboriginal and Torres Strait Islander peoples' (First Peoples) health content. There is, however, a lack of validated tools that measure the development of students' cultural capabilities. To validate the Cultural Capability Measurement Tool with a cohort of health professional students. A descriptive cohort design was used. All students (N = 753) enrolled in a discrete First Peoples Health course at an Australian university were invited to complete the Cultural Capability Measurement Tool. The tool was tested for reliability, content and construct validity using confirmatory factor analysis and concurrent validity using and the Cultural Understanding Self-Assessment Tool. A s le of 418 (73% response rate) was recruited. Most participants were enrolled in the Bachelor of Nursing program (n = 369, 82%). The Cultural Capability Measurement Tool had a Cronbach's alpha coefficient of 0.86. A five-factor solution was confirmed which reflected the cultural capability domains and accounted for 51% of the variance. Scores correlated with students' cultural understanding (r = 0.28, p < 0.001). Successful implementation of The Framework requires instruments to measure changes in students' cultural capabilities. Measuring nursing students' cultural capabilities can inform their development, identify areas of strengths and deficits for educators, and will ultimately contribute to the development of a culturally safe nursing workforce.
Publisher: Wiley
Date: 12-2000
Publisher: Wiley
Date: 12-03-2010
DOI: 10.1111/J.1365-2702.2009.02848.X
Abstract: Aims. To investigate patients’ attitudes toward complementary and alternative medicine, the education nurses provided about complementary and alternative medicine for treating depression and to test whether such education mediates the effect of complementary and alternative medicine use and attitudes toward complementary and alternative medicine. Background. Although we know that attitudes influence behaviour, very few studies simultaneously explore the relationship between attitudes, education and complementary and alternative medicine use. Design. Survey. Methods. This study was conducted as part of a larger survey, using face‐to‐face survey interviews with 206 adult patients aged 50 years or over and hospitalised in conventional hospitals in Taiwan for treatment of depression. The attitudes toward complementary and alternative medicine and patient education about complementary and alternative medicine instruments were specially developed for the study. Results. Participants expressed slightly favourable attitudes toward complementary and alternative medicine. Many participants (50%) expressed that they were willing to try any potential treatment for depression. They believed that complementary and alternative medicine helped them to feel better and to live a happier life. However, 66·5% of participants reported that they had inadequate knowledge of complementary and alternative medicine. Participants with a higher monthly income, longer depression duration and religious beliefs hold more positive attitudes toward complementary and alternative medicine. Most participants were not satisfied with the education they received about complementary and alternative medicine. Patient education about complementary and alternative medicine was found to be a mediator for the use of complementary and alternative medicine. Conclusion. Patient education from nurses may predict patients’ attitudes toward complementary and alternative medicine. Continuing nursing education is needed to enable nurses to respond knowledgeably to concerns patients may have about complementary and alternative medicine and treatment options. Relevance to clinical practice. This study highlights the potential role of patient education about complementary and alternative medicine as an effective way of adjusting patients’ attitudes toward complementary and alternative medicine and to link both patients’ preferences for complementary and alternative medicine and health professionals’ concerns about the proper use of complementary and alternative medicine for depression management and adverse drug interactions.
Publisher: Wiley
Date: 15-11-2018
DOI: 10.1002/NUR.21919
Abstract: Postpartum depression (PPD) is recognized as a common maternal health problem, but few studies have investigated the postpartum mental health of refugee women. In this cross-sectional study, we investigated the prevalence of PPD symptoms and associated factors among Syrian refugee women living in north Jordan. Women (N = 365) were recruited from four health care centers in Ramtha and Jarash, cities in northern Jordan. Participants completed a demographic data form, the Edinburgh Postnatal Depression Scale (EPDS), and the Maternal Social Support Scale at 6-8 weeks postpartum. Half (49.6% n = 181) of the Syrian refugee women scored >12 on the EPDS. PPD symptoms were significantly associated with low social support, low monthly income, and recent immigration (less than 2 years). There is a high level of PPD symptoms among Syrian refugee women, many of whom are living in poverty and with limited social support. The results highlight the need for immediate action by governments to support childbearing refugee women with early screening for psychosocial risk and respond to women's physical and mental health, and social needs through interservice collaboration. Social support programs would meet an important need for these women, as would ongoing assessment by health professionals and early intervention for women who screen positive for PPD.
Publisher: Informa UK Limited
Date: 2004
Abstract: A range of developmental risk factors threatens the psychosocial well-being of children with a chronic health condition (CCHC). Early intervention and prevention programs are emerging as an effective response to improving in idual and family coping mechanisms. In particular, efforts to address in idual and family coping throughout the important pre-teen transitional ages for CCHC have gained popularity although their effectiveness has not been adequately demonstrated. We conducted a pre-post intervention study to evaluate an intensive intervention program for CCHC aged 10-14 years that aimed to enhance well-being. Twelve CCHC participated in a pilot 8-week intensive intervention program. At three month follow-up there was a significant increase in children's self esteem (t = 3.39, p < .01). There was a decrease in mean scores for anxiety and depression symptoms. Parental perceptions of the impact of the condition on the child reduced significantly (t = 2.37, p < .05). It was beyond the scope of the present study to conclusively evaluate the effectiveness of the intensive intervention program, however results show that it was a promising strategy to improve a range of outcomes for CCHC. Further research using a larger s le is needed to determine the ways in which this program influences psychosocial well-being of CCHC and their families.
Publisher: Cambridge University Press (CUP)
Date: 11-01-2010
DOI: 10.1017/S0033291709992224
Abstract: Childbirth has been linked to postpartum impairment. However, controversy exists regarding the onset and prevalence of post-traumatic stress disorder (PTSD) after childbirth, with seminal studies being limited by methodological issues. This longitudinal prospective study examined the prevalence of PTSD following childbirth in a large s le while controlling for pre-existing PTSD and affective symptomatology. Pregnant women in their third trimester were recruited over a 12-month period and interviewed to identify PTSD and anxiety and depressive symptoms during the last trimester of pregnancy, 4–6 weeks postpartum, 12 weeks postpartum and 24 weeks postpartum. Of the 1067 women approached, 933 were recruited into the study. In total, 866 (93%) were retained to 4–6 weeks, 826 (89%) were retained to 12 weeks and 776 (83%) were retained to 24 weeks. Results indicated that, uncontrolled, 3.6% of women met PTSD criteria at 4–6 weeks postpartum, 6.3% at 12 weeks postpartum and 5.8% at 24 weeks postpartum. When controlling for PTSD and partial PTSD due to previous traumatic events as well as clinically significant anxiety and depression during pregnancy, PTSD rates were less at 1.2% at 4–6 weeks, 3.1% at 12 weeks and 3.1% at 24 weeks postpartum. This is the first study to demonstrate the occurrence of full criteria PTSD resulting from childbirth after controlling for pre-existing PTSD and partial PTSD and clinically significant depression and anxiety in pregnancy. The findings indicate that PTSD can result from a traumatic birth experience, though this is not the normative response.
Publisher: Elsevier BV
Date: 10-2014
DOI: 10.1016/J.MIDW.2013.12.015
Abstract: This study examined midwives' perceptions of organisational structures and processes of care when working in a caseload model (Midwifery Group Practice MGP) for socially disadvantaged and vulnerable childbearing women. This study used Donabedian's theoretical framework for evaluating the quality of health care provision. Of the 17 eligible midwives, 15 participated in focus group discussions and two others provided written comments. Thematic analysis was guided by three headings clinical outcomes, processes of care and organisational structure. Midwives believed they provided an excellent service to socially disadvantaged and vulnerable childbearing women. Midwives gained satisfaction from working in partnership with women, working across their full scope of practice, and making a difference to the women. However the midwives perceived the MGP was situated within an organisation that was hostile to the caseload model of care. Midwives felt frustrated and distressed by a lack of organisational support for the model and a culture of blame dominated by medicine. A lack of material resources and no identified office space created feelings akin to 'homelessness'. Together these challenges threatened the cohesiveness of the MGP and undermined midwives' ability to advocate for women and keep birth normal. If access to caseload midwifery care for women with erse backgrounds and circumstances is to be enhanced, then mechanisms need to be implemented to ensure organisational structures and processes are developed to sustain midwives in the provision of 'best practice' maternity care. Women accessing midwifery caseload care have excellent maternal and newborn outcomes. However there remains limited understanding of the impact of organisational structures and processes of care on clinical outcomes.
Publisher: SAGE Publications
Date: 05-2007
Abstract: This article presents findings from a research study that examined the impact of a staff education programme on aggression as displayed by people with dementia living in residential aged care. The staff education programme was designed to change staff attitudes and perceptions towards their care management of the person with dementia. A simple interrupted time series, with the resident acting as his/her own comparison, was used to measure residents' aggressive behaviour both before and after the education intervention — Emotional Responses as Quality Indicators (ERIC). Forty-three residents and 85 staff were involved in the study. Staff attitudes to their work were assessed before and six weeks after the education intervention using the Attitude to Elderly Severely Mentally Infirm Care Scale. Findings indicate that people with dementia display cues about impending physical aggression, but such cues are often ignored by staff, as they may not see or understand anger as a legitimate human emotion within the context of the disease process.
Publisher: Elsevier BV
Date: 03-2021
DOI: 10.1016/J.WOMBI.2021.04.004
Abstract: Pre-registration midwifery students in Australia are required to engage in a minimum of ten continuity of care experiences (CoCE). Students recruit and gain consent of each woman to provide CoCE under direct supervision of a registered health professional, usually a midwife. Clinical outcomes for women who had CoCE with a midwifery student placed in a continuity of midwifery care (CMC) or fragmented models are rarely reported. 1. analyse clinical outcomes for women experiencing CMC with CoCE by students 2. analyse clinical outcomes for women in a fragmented care model with CoCE by students and 3. compare clinical outcomes according to women's primary model of care. Students undertaking a Bachelor of Midwifery program at one Australian university recorded clinical outcomes for women experiencing CoCE during pregnancy [n=5972] and labour and birth [n=3933] in an e-portfolio. A retrospective, cohort design compared student recorded maternal data with National Core Maternity Indicators and Queensland Perinatal Data. Midwifery students providing CoCE reported better or equal clinical outcomes for women compared to population data. Women receiving CoCE had reduced likelihood of tobacco smoking after 20 weeks of pregnancy, episiotomy, and third and fourth degree tears. Clinical outcomes for women in fragmented models of care and receiving CoCE by undergraduate, pre-registration midwifery students are equal to or better than State data across 12 variables. CoCE should be offered to all women early in their pregnancy to ensure optimal benefits. Acknowledging midwifery students' potential to make positive impacts on women's clinical outcomes may prompt more health services to reconceptualise and foster CoCE.
Publisher: SAGE Publications
Date: 02-2004
Abstract: Despite well-documented health benefits of breastfeeding for mothers and babies, most women discontinue breastfeeding before the recommended 12 months to 2 years. The purpose of this study was to assess the effect of modifiable antenatal variables on breastfeeding outcomes. A prospective, longitudinal study was conducted with 300 pregnant, Australian women. Questionnaires containing variables of interest were administered to women during their last trimester infant feeding method was assessed at 1 week and 4 months postpartum. Intended breastfeeding duration and breastfeeding self-efficacy were identified as the most significant modifiable variables predictive of breastfeeding outcomes. Mothers who intended to breastfeed for 6 months were 2.4 times as likely to have discontinued breastfeeding at 4 months compared to those who intended to breastfeed for 12 months (35.7% vs 87.5%). Similarly, mothers with high breastfeeding self-efficacy were more likely to be breastfeeding compared to mothers with low self-efficacy (79.3% vs 50.0%). J Hum Lact. 20(1):30-38.
Publisher: Elsevier BV
Date: 12-2001
DOI: 10.1016/S1445-4386(01)80007-0
Abstract: Mothers in the public health care system undergo mandatory early discharge after childbirth. The challenges associated with the decreasing length of hospital stay have rarely been investigated from a service consumer perspective. The aim of this study was to identify mothers' needs in the immediate postpartum period. An inpatient survey of 500 postnatal mothers undertaking the Early Discharge Program. Survey questions aimed to elicit the needs of mothers in the immediate postnatal period perceived barriers to optimal care and suggestions as to how these barriers could be addressed. Forms were distributed to all women on admission to a postnatal ward over a two month period and completed prior to discharge. Of 500 eligible mothers, 151 (30.2%) responded to the anonymous open ended survey. A thematic analysis of comments revealed that women wanted specific information about mothering, the creation of a restful environment, adequate pain relief, practical assistance, education, and set visiting times. For new mothers, early discharge made the need for rest and information a high priority. Constraints within the public health care system and midwifery practice need to be examined to better serve mothers' needs. Midwifery practice within the context of early postpartum discharge should seek to better serve new mothers by giving high priority for rest and information requirements.
Publisher: Elsevier BV
Date: 10-2017
Publisher: Wiley
Date: 12-01-2021
DOI: 10.1111/JAN.14735
Publisher: Informa UK Limited
Date: 03-09-2021
DOI: 10.1080/10376178.2021.1991413
Abstract: In Australia, undertaking cultural safety education often evokes strong emotional responses by health students. Despite the potential for emotion to drive transformative learning in this space, measures of emotion are uncommon. To review existing tools that intend to measure emotional components of learning in relation to cultural safety education. Articles published in English from January 2005 to January 2020 reported studies from Australia, New Zealand, Canada and United States of America and measured an emotional construct/s after an education intervention offered to university students enrolled in a health programme were included. Studies were assessed for quality according to the Critical Appraisals Skills Programme criteria. Eight articles were reviewed five conducted in the United States of America, and three in Australia. Intervention type, measures, methodological rigour and outcomes varied. Studies predominately measured empathy, guilt and/or fear. Although students' emotional responses were measured, processes for students to reflect upon these reactions were not incorporated in the classroom. The review has implications for future research and curricula through developments in measuring and acting upon emotion in cultural safety education for nursing students in Australia.
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/PY13011
Abstract: Problem crying in the first few months of life is both common and complex, arising out of multiple interacting and co-evolving factors. Parents whose babies cry and fuss a lot receive conflicting advice as they seek help from multiple health providers and emergency departments, and may be admitted into tertiary residential services. Conflicting advice is costly, and arises out of discipline-specific interpretations of evidence. An integrated, interdisciplinary primary care intervention (‘The Possums Approach’) for cry-fuss problems in the first months of life was developed from available peer-reviewed evidence. This study reports on preliminary evaluation of delivery of the intervention. A total of 20 mothers who had crying babies under 16 weeks of age (average age 6.15 weeks) completed questionnaires, including the Crying Patterns Questionnaire and the Edinburgh Postnatal Depression Scale, before and 3−4 weeks after their first consultation with trained primary care practitioners. Preliminary evaluation is promising. The Crying Patterns Questionnaire showed a significant decrease in crying and fussing duration, by 1 h in the evening (P = 0.001) and 30 min at night (P = 0.009). The median total amount of crying and fussing in a 24-h period was reduced from 6.12 to 3 h. The Edinburgh Postnatal Depression Scale showed a significant improvement in depressive symptoms, with the median score decreasing from 11 to 6 (P = 0.005). These findings are corroborated by an analysis of results for the subset of 16 participants whose babies were under 12 weeks of age (average age 4.71 weeks). These preliminary results demonstrate significantly decreased infant crying in the evening and during the night and improved maternal mood, validating an innovative interdisciplinary clinical intervention for cry-fuss problems in the first few months of life. This intervention, delivered by trained health professionals, has the potential to mitigate the costly problem of health professionals giving discipline-specific and conflicting advice post-birth.
Publisher: Elsevier BV
Date: 02-2009
DOI: 10.1016/J.APNU.2008.03.004
Abstract: Understanding use of complementary and alternative medicine (CAM) and antidepressants during patient's recovery for depression is important to enhance their psychological functioning and promote positive health care outcomes. This study investigated the use of antidepressant treatment and CAM in outpatients with depression 1 month after discharge from psychiatric hospitalization. Telephone surveys were conducted. Of the 201 participants, 50.2% reported using CAM 1 month after discharge. Nearly 41% (n = 82) used a combination of both antidepressant treatment and CAM after hospital discharge. The most commonly used CAMs were spiritual healing, relaxation techniques, and herbal medicine. Symptom relief was the top reason participants used CAM for depression. A number of factors were associated with higher odds of using CAM. CAM is often considered as a valued component of holistic care plan after discharge. It is important for nurses to identify the CAM approaches patients are using so that this information can assist in the education of patients and family about the benefits of contemporary treatments for depression, possible interactions when combining treatments, and the CAM and conventional medicine that can be helpful to relieve depression symptoms and psychological distress.
Publisher: Informa UK Limited
Date: 12-2005
Abstract: Registered nurse Papanicolaou (Pap) smear providers (RN PSPs) were introduced to improve women's accessibility to Pap smear services through the National Cervical Screening Program. This pilot study assessed women's attitudes towards RNs as providers. One hundred women attending a Family Planning Queensland (FPQ) centre for a routine appointment with a doctor or registered nurse were recruited. Participants completed an anonymous questionnaire. A response rate of 86% (n = 100) was achieved. Only 15% of participants indicated they had seen a RN for a Pap test prior to this visit and 67% were unaware that registered nurses provided Pap smear services. Participants reported positive attitudes toward RN PSPs (M = 44.53, SD = 7.85, range 13 - 60). The majority of participants considered RN PSPs would be responsive to their needs (92%) and well-qualified to perform Pap smears (70%). The majority (79%) would not hesitate to see a RN PSP for a Pap smear. Some uncertainty existed about the competence of nurses to provide this service (25% of respondents were uncertain). Older women were more likely to report less positive attitudes toward RN PSP (r = -.267, p <.05). Women reporting previous awareness of the role of nurses as Pap smear providers were more likely to report positive attitudes (Chi-square = 12.96, p < .0001) compared to women with no awareness of this role. While women are positive about RN PSPs, there is a need for promotion and community education about the role of RNs in providing cervical screening services.
Publisher: CSIRO Publishing
Date: 13-04-2021
DOI: 10.1071/AH20215
Abstract: Objective Health practitioners’ Codes of Conduct and Codes of Ethics articulate practice standards across multiple domains, including the domain of cultural safety. As key tools driving in idual practice and systems reform, Codes are integral to improving health outcomes for Aboriginal and Torres Strait Islander peoples. It is, therefore, critical that their contents specify meaningful cultural safety standards as the norm for institutional and in idual practice. This research assessed all Codes for cultural safety specific content. Methods Following the release of the Australian Health Practitioner Regulation Agency’s (Ahpra) Health and Cultural Safety strategy 2020–25, the 16 Ahpra registered health practitioner Board Codes of Conduct and professional Codes of Ethics were analysed by comparing content to Ahpra’s new cultural safety objectives. Two Codes of Conduct, Nursing and Midwifery, met these objectives. The Aboriginal and Torres Strait Islander Health Practitioners Code partially met these objectives. Results Most Codes of Conduct (14 of 16) conflated Aboriginal and Torres Strait Islander peoples with culturally and linguistically erse (CALD) communities undermining the sovereignty of Australia’s First Peoples. Eleven professions had a Code of Ethics, including the Physiotherapy Code of Conduct, which outlined the values and ethical principles of practice commonly associated with a Code of Ethics. Of the 11 professions with a Code of Ethics, two (Pharmacy and Psychology) articulated specific ethical responsibilities to First Peoples. Physiotherapy separately outlined cultural safety obligations through their reconciliation action plan (RAP), meeting all Ahpra cultural safety objectives. The remaining eight advocated respect of culture generally rather than respect for Aboriginal and Torres Strait Islander cultures specifically. Conclusions The review identified multiple areas to improve the codes for cultural safety content for registered health professions, providing a roadmap for action to strengthen in idual and systems practice while setting a clear regulatory standard to ensure culturally safe practice becomes the new norm. It recommends the systematic updating of all professional health practitioner Board Codes of Conduct and professional Codes of Ethics based on the objectives outlined in Ahpra’s Cultural Safety Strategy. What is known about the topic? Systemic racism and culturally unsafe work environments contribute to poor health outcomes for Aboriginal and Torres Strait Islander peoples. They also contribute to the under-representation of Aboriginal and Torres Strait Islander peoples in the health workforce, denying the system, and the people who use and work in it, much needed Indigenous knowledge. Creating a culturally safe healthcare system requires all health practitioners to reflect on their own cultural background, to gain appreciation of the positive and negative impacts of in idually held cultural assumptions on the delivery of healthcare services. Competence in cultural safety as a required standard of practice is therefore essential if broad, sustainable and systemic cultural change across the health professions and ultimately across Australia’s healthcare system is to be achieved. Given that Codes of Conduct and Codes of Ethics are integral in setting the practical and moral standards of the professions, their contents with respect to cultural competence are of great importance. What does this paper add? A review of this type has not been undertaken previously. Following the establishment of the Ahpra Aboriginal and Torres Strait Islander Health Strategy Group, release of Ahpra’s 2018 Statement of intent, and the 2019 Aboriginal and Torres Strait Islander Health and Cultural Safety strategic plan and Reconciliation Action Plan, we analysed the content of each of the 16 registered health professions Codes of Conduct and Code of Ethics looking for content and guidance in accordance with the new national cultural safety definition. Several opportunities to improve the Codes of Conduct and Codes of Ethics were identified to realise the vision set out in the statement of intent including through the application of the National Law. This analysis provides a baseline for future improvements and confirms that although some current health practitioner Codes of Conduct and Codes of Ethics have begun the journey of recognising the importance of cultural safety in ensuring good health outcomes for Australia’s Indigenous peoples, there is broad scope for change. What are the implications for practitioners? The gaps identified in this analysis provide a roadmap for improvement and inclusion of Aboriginal and Torres Strait Islander Health and cultural safety as a required standard in Codes of Conduct and Codes of Ethics for all registered health practitioners. Although it is recognised that Codes alone may not change hearts and minds, codifying the clinical competency of cultural safety provides a portal, and a requirement, for each in idual practitioner to engage meaningfully and take responsibility to improve practice in idually and organisationally.
Publisher: SAGE Publications
Date: 12-2022
DOI: 10.1177/11771801221137834
Abstract: This article aims to interpret and theorise non-Indigenous health students’ emotional learning experiences within a cultural safety course from an Australian First Peoples’ perspective. All undergraduate health students enrolled in a First Peoples’ health and cultural safety course were invited to complete a post-course online survey. The survey included quantitative items along with six free-text responses about students’ emotional learning experiences. The free-text comments provided by 72 health students are the focus of this article. Drawing upon Kamilaroi Country and the metaphor of the river in drought, flood and when waters become clear, this research provides a synthesis of non-Indigenous health students’ emotions in the cultural safety classroom. Students acknowledged the powerful impact of work undertaken by First Peoples educators in sharing their narratives, creating safe spaces and bearing witness to students’ emotions. The analysis informs an understanding of student learning and recommendations for teaching practice.
Publisher: Informa UK Limited
Date: 08-2002
Publisher: Wiley
Date: 19-06-2015
DOI: 10.1111/NHS.12143
Abstract: This study investigated the health and well-being of Vietnamese foreign brides recently immigrated to southern Taiwan. Forty-four participants were recruited during pregnancy and 23 were followed-up at six weeks post-partum. Standardized measures completed during face-to-face interviews revealed high levels of life stress, poor general health, low social support, and difficulty caring for their infant amongst participants. Estimated prevalence of probable antenatal depression was 32%, and 26% for probable post-partum depression using Edinburgh Postnatal Depression Scale (EPDS) scores of ≥ 13. Probable antenatal depression predicted postnatal depression. Pregnant immigrant women experienced a high level of difficult life circumstances and were significantly more likely to develop depressive symptoms after birth. Immigrant women with low social support during pregnancy were also more likely to report higher EPDS scores than well-supported women. Given these results, prevention and intervention activities are needed to promote maternal psychological well-being in disadvantaged women, especially immigrant brides.
Publisher: Wiley
Date: 11-09-2015
DOI: 10.1111/IJN.12335
Abstract: Prevention is important to reduce the prevalence of preterm births. Although prematurity has been well studied in developed countries, data from developing countries, such as Jordan, are still limited. This retrospective study analysed medical records to determine possible risk factors leading to preterm birth in the Irbid governorate of Jordan. All preterm births during the year 2011 were reviewed. Abstracted data included mother's age and gravidity. Newborn information included gender, birthweight and gestational age at birth. A total of 647 singleton births were included. There were more females than males (54.9% vs. 45.1%), with 75.6% being the second child or more. Half the mothers (50.2%) were 25-35 years of age. Factors associated with preterm birth were male gender (P = 0.008), maternal age > 35 years (P = 0.005) and first birth (P = 0.003). Nurses need to provide support and education to mothers with potential risk about reproductive health and family planning.
Publisher: Springer Science and Business Media LLC
Date: 20-07-2022
DOI: 10.1186/S40814-022-01117-W
Abstract: Evidence for the effectiveness of interventions aimed at improving the health-related quality of life of people living with cancer and/or family members is compelling. However, most interventional research has been conducted in high-income countries, and no intervention had been tested in low-income countries such as Nigeria. It is critical to design a culturally theory-based intervention in a resource-poor setting to address the needs and support coping strategies of cancer patients and their family caregivers. Theory, evidence, and practical issues were considered. The Medical Research Council framework for developing and evaluating complex interventions and Behaviour Change Wheel provided the framework for intervention design. Findings generated by a needs assessment of adult Nigerians with cancer and their family caregivers and relevant theories (the Spirituality and the Supportive Care Framework for Cancer) informed content development. A theory-based, culturally tailored socio-spiritual intervention was developed to address the specific needs of adult Nigerians with cancer and their family caregivers. A 4-week intervention included strategies designed to improve social and spiritual support, information and health literacy, and health-related quality of life. A systemic approach was used to conceptualise an evidence-based and theory-informed intervention tailored to address previously identified shortfalls in support available to adults living with cancer and their family caregivers, in Nigeria. If implemented and effective, such an intervention has the potential to improve the health-related quality of life of people living with cancer and their families in Nigeria.
Publisher: Informa UK Limited
Date: 09-2013
DOI: 10.1080/07399332.2013.794459
Abstract: We investigated the effects of physical, psychological, and sexual violence on the health status of women attending antenatal clinics at two tertiary hospitals in rural Thailand. We asked 421 pregnant women at 32 weeks gestation or later to complete a survey questionnaire. Participants reported high rates of psychological abuse (53.7%) threats, acts of physical abuse, or both (26.6%) and sexual violence (19.2%). Women abused during pregnancy had poorer health compared with nonabused women, in role emotional functioning, vitality, bodily pain, mental health, and social functioning. Given the high prevalence of violence and poor health status, routine screenings by maternity services is urgently required.
Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1016/J.NEDT.2011.03.010
Abstract: Effective clinical learning requires integration of nursing students into ward activities, staff engagement to address in idual student learning needs, and innovative teaching approaches. Assessing characteristics of practice environments can provide useful insights for development. This study identified predominant features of clinical learning environments from nursing students' perspectives across studies using the same measure in different countries over the last decade. Six studies, from three different countries, using the Clinical Leaning Environment Inventory (CLEI) were reviewed. Studies explored consistent trends about learning environment. Students rated sense of task accomplishment high. Affiliation also rated highly though was influenced by models of care. Feedback measuring whether students' in idual needs and views were accommodated consistently rated lower. Across different countries students report similar perceptions about learning environments. Clinical learning environments are most effective in promoting safe practice and are inclusive of student learners, but not readily open to innovation and challenges to routine practices.
Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1016/J.MIDW.2010.12.008
Abstract: to assess Australian midwives' attitudes towards caring for women with emotional distress and their perceptions of the extent to which workplace policies and processes hindered such care. a postal survey. members of the Australian College of Midwives. 815 Australian midwives completed the survey. a modified version of the 17-item REASON questionnaire (McCall et al., 2002) that was originally developed for used by General Practitioners to measure their attitudes towards their role in the management of patients with mental health disorders. An exploratory factor analysis with Varimax rotation identified four factors that reflected midwives' (1) perceptions of systemic problems that hindered emotional care, (2) attitudes towards working with women experiencing emotional health problems, (3) perceived competence in using treatment techniques and (4) attitudes and perceived competence towards the referral of women with depression and anxiety to other health professionals. participating midwives indicated their willingness to offer assistance and acknowledged the importance of providing emotional care to women. In practice, emotional care by midwives is impeded by perceived lack of competency rather than a lack of interest. Midwives' competency in the assessment and care of women with conditions such as depression and anxiety may be enhanced through continuing professional education.
Publisher: BMJ
Date: 29-10-2016
Publisher: IOP Publishing
Date: 11-06-2021
Publisher: Wiley
Date: 14-11-2007
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.MIDW.2017.04.010
Abstract: Develop and test a tool designed for use by pre-registration midwifery students to self-appraise their critical thinking in practice. A descriptive cohort design was used. All students (n=164) enrolled in a three-year Bachelor of Midwifery program in Queensland, Australia. The staged model for tool development involved item generation, mapping draft items to critical thinking concepts and expert review to test content validity, pilot testing of the tool to a convenience s le of students, and psychometric testing. Students (n=126, 76.8% response rate) provided demographic details, completed the new tool, and five questions from the Motivated Strategies for Learning Questionnaire (MSLQ) via an online platform or paper version. A high content validity index score of 0.97 was achieved through expert review. Construct validity via factor analysis revealed four factors: seeks information, reflects on practice, facilitates shared decision making, and evaluates practice. The mean total score for the tool was 124.98 (SD=12.58). Total and subscale scores correlated significantly. The scale achieved good internal reliability with a Cronbach's alpha coefficient of 0.92. Concurrent validity with the MSLQ subscale was 0.35 (p<0.001). This study established the reliability and validity of the CACTiM - student version for use by pre-registration midwifery students to self-assess critical thinking in practice. Critical thinking skills are vital for safe and effective midwifery practice. Students' assessment of their critical thinking development throughout their pre-registration programme makes these skills explicit, and could guide teaching innovation to address identified deficits. The availability of a reliable and valid tool assists research into the development of critical thinking in education and practice.
Publisher: Elsevier BV
Date: 07-2020
Publisher: Springer Science and Business Media LLC
Date: 04-10-2013
DOI: 10.1007/S00737-013-0384-5
Abstract: We investigated the impact of pre-existing mental ill health on postpartum maternal outcomes. Women reporting childbirth trauma received counselling (Promoting Resilience in Mothers' Emotions n = 137) or parenting support (n = 125) at birth and 6 weeks. The EuroQol Five dimensional (EQ-5D)-measured health-related quality of life at 6 weeks, 6 and 12 months. At 12 months, EQ-5D was better for women without mental health problems receiving PRIME (mean difference (MD) 0.06 95 % confidence interval (CI) 0.02 to 0.10) or parenting support (MD 0.08 95 % CI 0.01 to 0.14). Pre-existing mental health conditions influence quality of life in women with childbirth trauma.
Publisher: Springer Science and Business Media LLC
Date: 30-10-2015
Publisher: Elsevier BV
Date: 10-2022
DOI: 10.1016/J.NEDT.2022.105476
Abstract: ePortfolios are increasingly used in health professional clinical education. However, the nature of ePortfolios varies greatly amongst programs, as does the software, purpose, and institutional cost. An integrative review of the literature was conducted to determine how ePortfolios are being used in pre-registration health programs to enhance clinical learning. A systematic search of relevant databases (Cumulative Index of Nursing and Allied Health Literature, Education Resources Information Center, Cochrane, Medline, ProQuest, PubMed, Turning Research Into Practice, and Web of Science) was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Retrieved papers were assessed using the Critical Appraisal Skills Programme tool and findings were analysed. A total of 272 records were identified. Thirty papers were assessed in detail. Five themes were identified by content analysis feedback and communication student-centred learning experiences and competencies access, attitudes, and digital literacy and technological support. ePortfolios offer a range of pedagogical benefits. Clinical learning is enhanced by student-focused ePortfolio design which includes clear learning outcomes development of relationships with peers and instructors via ongoing communication and feedback use of templates links to time-saving applications and guided, assessed reflections. Poor technological support, negative attitudes by clinical supervisors, unreliable access, instructor-focused design, and excessive or repetitive documentation in ePortfolio design hindered clinical learning.
Publisher: Informa UK Limited
Date: 18-10-2016
DOI: 10.1080/01443615.2016.1234443
Abstract: The aims of this study were to explore the vitamin D status among a s le of Jordanian postpartum women and identify factors associated with vitamin D deficiency. A total of 171 postpartum women agreed to participate. Participants completed a questionnaire on factors related to vitamin D deficiency and provided a blood s le to assess their plasma vitamin D (25(OH)D) levels using DIA source Immuno-Assays S.A. The majority of women (76%, n = 130) had vitamin D deficiency and 24% (n = 41) of participants had vitamin D insufficiency. Factors associated with vitamin D deficiency were younger age (< 30 years), low education level, unemployment, multiparity, lactation, dress style, limited sunlight exposure, high BMI, dark skin colour and lack of multivitamin use. Vitamin D supplementation must be considered during pregnancy and lactation to prevent hypovitaminosis in both mother and baby.
Publisher: Elsevier BV
Date: 06-2012
DOI: 10.1016/J.IJNURSTU.2011.11.011
Abstract: Type 2 diabetes is a serious and growing problem in Taiwan where it is the fifth leading cause of death, and health care costs are 4.3 times higher than for people without diabetes. The purpose of this study was to determine whether participation in a motivational interview for people with type 2 diabetes would improve their self-management, psychological and glycemic outcomes. A randomized controlled trial to assess the effects of the motivational interviewing intervention. Participants were drawn from the diabetes outpatient clinic of a large teaching hospital in South Taiwan. A s le of 250 type 2 diabetes people. Type 2 diabetes people were randomly allocated into either the motivational interview group or the usual care group from baseline to 3 months follow-up. The intervention was based on motivational interviewing which encompassed a variety of interviewing techniques, and reflected each person's readiness stage to change. The control group was provided with usual care by nursing staff. A total of 250 type 2 diabetic participants were randomized. The retention rate in the intervention group was 83% (n=104). The motivational interview did improve participants significantly in self-management, self-efficacy, quality of life, and HbA1c among diabetes people with appropriate baseline value (<121.24, <174.57, 7.62, respectively) but not in depression, anxiety and stress (F=0.13, p=0.72) compared to the control group at 3 months follow-up. The findings provided important evidence concerning the positive effect of motivational interventions in self-management, psychological and glycemic outcomes. This research provided evidence for future clinical practices in diabetes care.
Publisher: Springer New York
Date: 2015
Publisher: Elsevier BV
Date: 2021
DOI: 10.1016/J.NEDT.2021.105174
Abstract: Quantitative feedback from students about their clinical learning experiences is used to inform program quality, but the extent to which tools are reliable, valid and refined receives less attention. To evaluate the psychometric properties of the Midwifery Student Evaluation of Practice (MidSTEP) tool using Rasch analysis. The Midwifery Student Evaluation of Practice tool was completed by Bachelor of Midwifery students (n = 901) attending seven universities in Australia and New Zealand. The tool consists of the Clinical Learning Environment Scale (16 items) and Impact of the Midwifery Preceptor Scale (10 items), each with two subscales. Rasch analysis was conducted on all subscales separately using the partial credit model of RUMM2030. Response format, item fit, dimensionality of the scale and its targeting were assessed. Rasch analysis confirmed the internal construct validity of the Clinical Learning Environment and Impact of the Midwifery Preceptor subscales, with no evidence of mis-fitting items, local dependency or multidimensionality. The 4-point response scale was found to be appropriate, and internal consistency reliability of each subscale was good. Results provide support for the reliability and validity of the Midwifery Student Evaluation of Practice tool. The four subscales can confidently be used in undergraduate midwifery clinical education. The use of Rasch analysis is consistent with growing awareness in health and education of the need to apply more advanced, sophisticated psychometric techniques to ensure measures are suitable for their intended use. Midwifery students clinical learning experiences should be measured using robust tools. MidSTEP is reliable and valid.
Publisher: Cambridge University Press (CUP)
Date: 18-09-2019
DOI: 10.1017/JIE.2019.16
Abstract: Abstract To improve healthcare practices and increase cultural safety when working with First Peoples, it is essential that students engage with challenging discourses that critically engage their social, political, personal, professional and historical positioning. Such engagement may provoke emotional responses in students. However, little is known about the nature of non-indigenous students’ emotional engagement when learning First Peoples health content that integrates cultural safety principles. The pedagogy of discomfort is a process of self-examination that requires students to critically engage their ideological assumptions and may be useful in examining the emotional dimension that occurs when learning this content. Eighty-two non-indigenous health students gave permission for their critical reflective essays, submitted as an assessment requirement of a First Peoples health course to be analysed. Elements of the pedagogy of discomfort informed the analytical and theoretical framework. The emotional engagement by students was captured in the following overarching themes: Acknowledging preconceived ideas Uncomfortable emotions Fragile identities Spectating and Witnessing. Findings highlight how students' emotional engagement may contribute to changes in perspective and frames of reference, transpiring to a ‘call to action’ that challenges systems of differential privilege. While many students expressed discomfort when learning about key cultural safety concepts, the extent of transformative potential varied.
Publisher: Elsevier BV
Date: 06-2012
DOI: 10.1016/J.IJNURSTU.2011.11.014
Abstract: Spiritual care is a central element of holistic nursing, but is not often made explicit in the theoretical and practical components of pre-registration nursing programmes. A composite scale will assist in identifying students' perceptions and issues to be addressed in curricula and practice settings. To develop and test the Spiritual Care-Giving Scale that measures student nurses' perceptions towards spirituality and spiritual care. Following a critical review of the literature, review by an expert panel and a pilot study, the SCGS, was administered to a convenience s le of final-year nursing students. Participants also completed the Spirituality and Spiritual Care Rating Scale and Student Survey of Spiritual Care to assess construct validity. Internal reliability was assessed using Cronbach's alpha and test-retest reliability was assessed at 1 week. Principal component analysis was used and the 68-item Spiritual Care-Giving Scale was reduced to 35-items. 745 (out of 1204) students completed the survey giving a 61.9% response rate. A 5-factor solution explaining 61.2% of the variance was supported. Cronbach's alpha of the 35-item scale was 0.86 and test-retest reliability was stable over time (r=0.811). Concurrent validity with the Spirituality and Spirituality Care Rating scale (r=0.587, p<0.01) and Student Survey of Spiritual Care (r=0.507, p≤0.01) showed significant correlation. The Spiritual Care-Giving Scale was found to be a valid and reliable instrument for measuring the multifaceted perspectives of spirituality and spiritual care in practice by students. Further testing of this scale is required with other student populations and clinicians.
Publisher: Informa UK Limited
Date: 17-01-2020
Publisher: Elsevier BV
Date: 11-2011
DOI: 10.1016/J.NEDT.2010.12.018
Abstract: Leadership has been consistently implied in fostering clinical learning. However there is a lack of clarity about the form leadership should take. Limited quantitative research indicated a narrative approach to review literature from a broad perspective. A framework to guide the synthesis was developed to ensure a rigorous review process. Preliminary reading and review of papers using search terms nursing and leadership and clinical learning and learning culture narrowed the inclusion criteria to 245 papers published between 2000 and 2010. Given the ersity of the papers' focus, aim and context, a refined screening process justified the inclusion of twenty-six papers in the review. A critical appraisal of these peer-reviewed quantitative, qualitative and commentary papers identified factors/elements integral to effective leadership. Across the literature leadership was discussed in relation to two broad themes: influence of leadership on organisational learning and development and influence of leadership on undergraduate clinical education. The factors central to leadership emerged as transformative principles, the role of the nurse unit/ward manager, collaboration and relationship building and role-modelling. The review has raised some suggestions for future research aimed at examining the impact of a leadership capacity building intervention that supports clinical learning.
Publisher: American Society of Tropical Medicine and Hygiene
Date: 05-03-1997
Publisher: Elsevier BV
Date: 10-2015
DOI: 10.1016/J.MIDW.2015.05.006
Abstract: recent legislative changes in Australia have enabled eligible midwives to provide private primary maternity care with fee rebates through Medicare. This paper (1) discusses these changes affecting midwifery practice (2) describes Australia's first private midwifery service with visiting rights to hospital for labour and birth care since Medicare funding for midwives was introduced in 2010 and (3) compares outcomes with National Core Maternity Indicators. an audit of all client records (n=323) for the survey period from September 2012 to February 2014 was undertaken. Data were extracted and compared with the 10 perinatal indicators using Chi square statistics. this convenience s le of all-risk women was similar to the national birthing population for age and parity. Compared to national indicators, women were significantly more likely to have spontaneous commencement of labour (79.6% versus 54.8%) (χ(2)=79.88, p<.001), lower rates of induction (10.2% versus 26%) (χ(2)=79.88, p<.001), and not require pharmacological pain relief (54.8% versus 23.9%) (χ(2)=152.2, p<.001). The majority of women had a normal vaginal birth (70.3% versus 55.1%) (χ(2)=28.13, p<.001). The caesarean section rate (22% versus 32.3%) was significantly lower (χ(2)=15.64, p<.001) than the national rate. Average gestation of neonates was 39.3 weeks average birth weight was 3525 gms, and fewer required transfer to the special care nursery (8.4% versus 15.3%) (χ(2)=11.89, p<.001). this is the first report of maternal and neonatal outcomes for a private midwifery service in Australia since the introduction of access to Medicare for midwives. Maternal and newborn outcomes were statistically better than national rates. Routinely reporting and publishing clinical outcomes needs to become the norm for private maternity care. this private midwifery caseload model has been instrumental in the ground-breaking change to primary maternity services that extends women׳s access to safe midwifery care in Australia. The potential impact of private practicing midwives to align maternity care with the best available evidence is significant.
Publisher: Springer Science and Business Media LLC
Date: 22-10-2019
DOI: 10.1186/S12884-019-2546-6
Abstract: Health related quality of life is a critical concept during the perinatal period but remains under-researched. The International Consortium for Health Outcomes Measurement have included the Patient Reported Outcomes Measurement Information System (PROMIS®) Global Short Form (GSF) in their core outcome set for pregnancy and childbirth to measure health related quality of life. The PROMIS GSF has not been fully evaluated as a valid and reliable instrument in this population. This study assessed the psychometric properties of the PROMIS GSF during pregnancy and postpartum period. PROMIS GSF was administered to a s le of 309 pregnant women at four time-points during pregnancy (≤ 27 and 36-weeks) and postpartum (6- and 26-weeks). The structural validity, internal consistency reliability, construct validity, and responsiveness of the PROMIS GSF were evaluated. The internal structure of the PROMIS GSF was explored using Rasch Measurement Theory. Response format, item fit, differential item functioning (item bias), dimensionality of the scale and its targeting were assessed. Two revised subscales (Mental Health: four items and Physical Health: five items) showed good fit to the Rasch model. The revised mental health subscale demonstrated good internal consistency reliability during pregnancy and postpartum period (α = .88 and .87, respectively). The internal consistency reliability of the physical health subscale was adequate (α = .76 and .75, respectively). The revised mental health subscale was sensitive to group differences according to a history of mental health disorder, income, smoking status, drug use, stress levels and planned versus unplanned pregnancy. Differences in scores on the revised physical subscale were detected for groups based on obesity, income, drug use, smoking status, stress, and history of mental health disorders. Scores on both subscales recorded significant changes across the four time-points, spanning pregnancy and postpartum period. The revised version of the PROMIS GSF was better able to measure mental and physical health during pregnancy and postpartum period compared to the original version. Findings support the clinical and research application of the PROMIS GSF within the International Consortium for Health Outcomes Measurement Standard Set of Outcome Measures for Pregnancy and Childbirth. Ongoing psychometric analysis of the PROMIS GSF is recommended in other maternity populations.
Publisher: Wiley
Date: 17-12-2009
DOI: 10.1111/J.1365-2702.2009.02841.X
Abstract: Aim. To assess the impact of an intervention aimed to build capacity of registered nurses to enhance the clinical learning environment for undergraduate nursing students. Workplace learning is vital for the development of skills, attributes and knowledge of student nurses. Registered nurses need to be appropriately prepared to maximise student learning during clinical placement. Background. The quality of student learning during clinical practicum is largely dependent on interactions with ward staff. Design. A quasi‐experimental design. Method. Measurement of students’ perceptions of the psycho social learning environment during and outside of the intervention period was used to evaluate the capacity building intervention. The capacity building intervention consisted of interactive education in clinical areas over a six‐week period for registered nurses in two acute surgical wards. Results. First, second and third year students ( n = 62) who undertook their clinical practicum in the two surgical wards, before, during and six months after the capacity building intervention assessed the psycho‐social learning environment at the time of their clinical practicum. Findings showed that students who undertook their clinical practicum during the intervention period rated the psycho‐social clinical learning environment significantly higher than students who undertook their practicum at times outside of the intervention period. Conclusions. An experienced researcher/educator conducting capacity building sessions can effectively assist and support registered nurses to engage with students. Relevance to clinical practice. Capacity building sessions can improve practice, however, structures and processes that ensure continuation of practice change need to be embedded for improvements to be sustained.
Publisher: Wiley
Date: 09-2020
DOI: 10.1002/IMHJ.21885
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.NEDT.2017.04.016
Abstract: Develop and test an instrument to measure graduate-nurses' perceptions of a structured mentorship program. New graduate nurses may experience difficulties in the transition from student to practitioner. Mentoring is commonly used to support graduates. However, there is a lack of published tools measuring graduate nurses' perceptions of mentorship. As mentoring is resource intensive, development and testing of a validated tool are important to assist in determining program effectiveness. A pretest-posttest interventional design was used. Following a critical review of literature and content experts' input, the 10-item National University Hospital Mentorship Evaluation (NUH ME) instrument was tested with a convenience s le of 83 graduate nurses. Psychometric tests included internal reliability, stability, content validity, and factor analysis. Changed scores were evaluated using paired s les t-test. Seventy-three graduates (88%) out of a possible 83 completed the pre-and post-program survey. Internal reliability was excellent with a Cronbach's alpha of 0.92. Test-retest reliability was stable over time (ICC=0.81). Exploratory factor analysis supported a 1-factor solution explaining 58.2% of variance. Paired s les t-test showed statistical significance between the pre- and post-program scores (p<0.001). The NUH-ME measure was found to be valid and reliable. Confirmatory Factor Analysis of the tool with different groups of nursing graduates is required. Mentorship programs can be an effective recruitment and retention strategy, but are also resource intensive. Measuring new graduates' perceptions of mentoring contributes to program relevance in addressing their personal, professional and clinical skill development needs. As mentoring engages a erse range of mentors, feedback through measurement may also positively alter organizational learning culture.
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.MIDW.2019.03.019
Abstract: Emotional care underpins women's positive experiences during labour andbirth but is under-researched. Applying an attachment theory approach may inform the measurement of emotional aspects of maternity care. To develop and validate a self - report measure for midwives to assess their emotionally attuned intrapartum care. A staged approach to tool development was followed. Item generation was informed by a critical review of the literature and expert review. Following a pilot test, the draft scale was psychometrically assessed. Principal component analysis with varimax rotation was used to establish construct validity. Cronbach's alpha determined internal reliability. Concurrent validity was tested with the 'empathic concern' and the 'personal distress' subscales on the Interpersonal Reactivity Index. The study was conducted with midwives (n = 705) who are members of the Australian College of Midwives. The Cronbach's alpha for the scale was 0.88. Principal component analysis revealed a one- factor solution. Significant but low correlations with Interpersonal Reactivity Index subscales of 'empathic concern' (rho = .256, p <.001) and 'personal distress' (rho = -.249, p<.001) confirmed concurrent validity. The Emotional Availability and Responsiveness in Intrapartum Care Scale appears to be a valid and reliable measure of emotional aspects of midwives' caregiving. An Attachment Theory approach validates women's perspectives and elucidates our understanding of the importance of emotional labour support.
Publisher: Wiley
Date: 27-08-2004
Publisher: Springer Science and Business Media LLC
Date: 09-03-2022
DOI: 10.1186/S12978-022-01366-1
Abstract: To determine the prevalence of stress and depression and associated factors among women seeking a first-trimester induced abortion in China. A cross-sectional study was conducted in a tertiary hospital in Beijing, from April 1st to Oct 31st, 2021. Women seeking termination of an intrauterine first-trimester pregnancy were invited to participate and complete a digital self-administered questionnaire. The survey included socio-demographic and health questions, Perceived Stress Scale-10 (PSS-10), and Patient Health Questionnaire-9 (PHQ-9). Descriptive analyses and binary logistic regression analyses were performed using SPSS 23.0. A total of 253 women participated. Prevalence of high perceived stress (cut-off ≥ 20) and depressive symptoms (cut-off ≥ 10) was 25.3% and 22.5%, respectively. Women were more likely to suffer high stress if they reported low resilience (aOR = 16.84, 95% CI 5.18–54.79), were not-using contraceptives (aOR = 3.27, 95% CI 1.39–6.29), had low social support (aOR = 2.95, 95% CI 1.39–6.29), were non-local residents (aOR = 2.51, 95% CI 1.15–5.92), were dissatisfied with their intimate relationship (aOR = 2.44, 95% CI 1.15–5.16), or held pro-life attitudes towards abortion (aOR = 1.04, 95% CI 1.18–3.53). Odds of experiencing depression were higher among women who also reported high perceived stress (aOR = 19.00, 95% CI 7.67–47.09), had completed higher education (aOR = 12.28, 95% CI 1.24–121.20), and were non-local residents (aOR = 3.38, 95% CI 1.37–8.32). The magnitude of perceived stress and depression was high among Chinese women seeking a first-trimester induced abortion. It is necessary to comprehensively evaluate the mental health of women seeking an abortion, especially those with high risk. Interventions to mitigate relevant associated factors could improve the psychological wellbeing of women.
Publisher: BMJ
Date: 06-07-2002
Publisher: SAGE Publications
Date: 30-12-2018
Abstract: Little is known about the effects of distraction techniques when undertaking medical procedures with hospitalized pediatric patients in Asian countries. This study examined the effects of distraction interventions on behavioral distress related to venipuncture procedures in Taiwanese children aged 3 to 7 years. Using concealed randomization, eligible children were allocated to receive a picture book ( n = 92), or animated cartoon ( n = 92) compared with routine oral instructions ( n = 92), when being injected with an intravenous cannula. Two trained observers independently scored the responses of each child using the Observational Scale of Behavioral Distress–Revised before, during, and after the procedure. All children experienced distress during needle insertion, but distress was less in the distraction-based intervention groups. Moreover, distraction interventions were more effective for children aged 4 to 5 years. Our culturally tailored intervention engaged child participants, was age-appropriate, and could be adapted for use in other Chinese cultures.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2012
Publisher: Elsevier BV
Date: 10-2017
Publisher: Wiley
Date: 06-2000
DOI: 10.1046/J.1523-536X.2000.00104.X
Abstract: Little is known about the relationship between women's birthing experiences and the development of trauma symptoms. This study aimed to determine the incidence of acute trauma symptoms and posttraumatic stress disorder in women as a result of their labor and birth experiences, and to identify factors that contributed to the women's psychological distress. Using a prospective, longitudinal design, women in their last trimester of pregnancy were recruited from four public hospital antenatal clinics. Telephone interviews with 499 participants were conducted at 4 to 6 weeks postpartum to explore the medical and midwifery management of the birth, perceptions of intrapartum care, and the presence of trauma symptoms. One in three women (33%) identified a traumatic birthing event and reported the presence of at least three trauma symptoms. Twenty-eight women (5.6%) met DSM-IV criteria for acute posttraumatic stress disorder. Antenatal variables did not contribute to the development of acute or chronic trauma symptoms. The level of obstetric intervention experienced during childbirth (beta = 0.351, p < 0.0001) and the perception of inadequate intrapartum care (beta = 0.319, p < 0.0001) during labor were consistently associated with the development of acute trauma symptoms. Posttraumatic stress disorder after childbirth is a poorly recognized phenomenon. Women who experienced both a high level of obstetric intervention and dissatisfaction with their intrapartum care were more likely to develop trauma symptoms than women who received a high level of obstetric intervention or women who perceived their care to be inadequate. These findings should prompt a serious review of intrusive obstetric intervention during labor and delivery, and the care provided to birthing women.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2009
Publisher: Springer Science and Business Media LLC
Date: 08-03-2021
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/AH13183
Abstract: Objective This paper describes the effects of a maternity consumer representative training program on participants’ confidence to fulfil this role and engagement in representative activities. Methods The present study was a descriptive, pre–post evaluation design with a 3-month follow-up. Fifty-eight people completed the program and 55 agreed to participate in the evaluation. Participants completed questionnaires to assess confidence to undertake consumer representative roles and reported on their engagement with consumer activities. Results Participants’ perceived confidence to function in the role of consumer representative differed significantly before and after the workshop (F(2,18) = 7.057, P 0.001), as did confidence in decision making (F(2,16) = 7.615, P = 0.005), confidence in negotiating outcomes and liaising with key people (F(2,18) = 7.154, P = 0.005), and confidence in making use of relevant networks (F(2,18) = 4.319, P = 0.029). There was a decline in confidence at 3 months, with confidence at this time no longer significantly different from that at the time of recruitment. Engagement with consumer organisations increased by 45% compared with rates at commencement of the project. Conclusions The program enhanced participants’ confidence to fulfil a maternity consumer representative role but was not sustained. Further research is needed as to how to best support maternity consumer representatives and assess their contribution to promoting woman-centred care. What is known about the topic? Engaging consumers in the development of health policy, planning, service delivery and review can improve services and health outcomes. There is a serious lack of consumers confident to undertake representative roles. There is a paucity of evidence about the best ways to engage and build capacity among prospective consumer representatives. What does this paper add? A training program was developed and implemented for prospective consumer representatives in maternity services. Participants reported enhanced confidence to undertake a consumer representative role, but this was not sustained at the 3-month follow-up. The program improved engagement with consumer representative activities. What are the implications for practitioners? Training and support are essential for effective maternity consumer representation. Programs could involve generic consumer training with additional training offered for specific health services, such as maternity, aged care or mental health. Further attention needs to be given to supporting consumer organisations and consumer representatives in rural and remote areas. There is a significant need for health service committee members to be supported to work effectively with their consumer representatives.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2009
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.MIDW.2017.08.003
Abstract: develop and test a tool designed for use by academics to evaluate pre-registration midwifery students' critical thinking skills in reflective writing. a descriptive cohort design was used. a random s le (n = 100) of archived student reflective writings based on a clinical event or experience during 2014 and 2015. a staged model for tool development was used to develop a fifteen item scale involving item generation mapping of draft items to critical thinking concepts and expert review to test content validity inter-rater reliability testing pilot testing of the tool on 100 reflective writings and psychometric testing. Item scores were analysed for mean, range and standard deviation. Internal reliability, content and construct validity were assessed. expert review of the tool revealed a high content validity index score of 0.98. Using two independent raters to establish inter-rater reliability, good absolute agreement of 72% was achieved with a Kappa coefficient K = 0.43 (p<0.0001). Construct validity via exploratory factor analysis revealed three factors: analyses context, reasoned inquiry, and self-evaluation. The mean total score for the tool was 50.48 (SD = 12.86). Total and subscale scores correlated significantly. The scale achieved good internal reliability with a Cronbach's alpha coefficient of .93. this study establishedthe reliability and validity of the CACTiM (reflection) for use by academics to evaluate midwifery students' critical thinking in reflective writing. Validation with large erse s les is warranted. reflective practice is a key learning and teaching strategy in undergraduate Bachelor of Midwifery programmes and essential for safe, competent practice. There is the potential to enhance critical thinking development by assessingreflective writing with the CACTiM (reflection) tool to provide formative and summative feedback to students and inform teaching strategies.
Publisher: Elsevier BV
Date: 2015
Publisher: Wiley
Date: 10-2009
Publisher: Elsevier BV
Date: 10-2015
Publisher: American Thoracic Society
Date: 02-2001
DOI: 10.1164/AJRCCM.163.2.2003119
Abstract: In healthy subjects, deep inspiration (DI) acts both as a bronchodilator and a bronchoprotector. The latter is impaired in asthmatics. We have now evaluated whether the lack of bronchoprotection is related to bronchial hyperresponsiveness (BHR), and whether the bronchodilatory effect is also lost in asthmatics. Ten healthy subjects (PC20 > 75 mg/ml), 12 asthmatics with moderate to severe BHR (PC20 < 1 mg/ml), 14 asthmatics with mild to borderline BHR (1 < PC20 < 25 mg/ml), and 10 rhinitics with mild to borderline BHR (1 < PC20 < 25 mg/ml) underwent single-dose methacholine provocations inducing at least 20% reduction in FEV1 after 20 min of DI inhibition. To measure the bronchodilatory effect, DIs were taken immediately after the postmethacholine spirometry, and lung function was again tested. To measure the bronchoprotective effect, DIs were taken before the administration of spasmogen. All four groups achieved the same reductions in FEV1 and FVC, in the absence of deep breaths (analysis of variance [ANOVA], p = 0.49). Only healthy subjects showed bronchoprotection (percent bronchoprotection, mean +/- SEM healthy: 79 +/- 4.0 asthmatics with moderate to severe BHR: 12 +/- 14.5 asthmatics with mild to borderline BHR: -7 +/- 19.7 rhinitics with mild to borderline BHR: 2 +/- 14.0). In contrast, DIs were able to partially reverse bronchial obstruction in all four groups, albeit percent bronchodilation in healthy subjects was somewhat stronger. The dissociation between bronchoprotection and bronchodilation suggests that the two effects involve different mechanisms.
Publisher: MDPI AG
Date: 07-08-2022
Abstract: The postnatal period is high-risk time for the first onset and recurrence of maternal mental health disorders. Untreated maternal mental illness can have significant adverse impacts on a woman, her baby, and the wider family unit. For women with mental illnesses that cannot be managed in the community, psychiatric inpatient mother-baby units are the gold standard treatment whereby mothers are co-admitted with their infant for specialist perinatal and infant mental health assessment and treatment. The study explores the model of care and examines the philosophies of care that are used within a psychiatric mother-baby unit. Purposive s ling was used to conduct semi-structured focus group and in idual interviews with multidisciplinary staff members at a single mother-baby unit. Themes derived from these interviews were coded into two primary themes and a range of sub-themes. The first primary theme focused on the Model of Care consisting of the following sub-themes: mental health care, physical health care, babies’ care, building mother-baby relationship, fostering relationships with supports, and facilitating community support. The second primary theme centered around the Philosophy of Care comprising of: person-centered care, trauma-informed care, compassion-centered care, recovery-oriented care, attachment-informed care, non-judgmental care, strengths-based care and interdisciplinary care. The model can be used to provide consistency across mother-baby units and to support core capabilities of staff in providing an optimal level of care.
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.WOMBI.2018.01.004
Abstract: Routine enquiry about domestic violence during pregnancy is accepted best practice. Training is essential to improve knowledge and practice. Few studies have undertaken a comprehensive evaluation of training impact over time. To evaluate the longitudinal impact of a domestic violence training and support program to promote midwives' routine antenatal enquiry for domestic violence using a mixed methods design. Data sources included (1) surveys of midwives at 6 months post-training, (2) interviews with key stakeholders at 12 months, (3) chart audit data of screening, risk, and disclosure rates (for 16 months). Measures included midwives' knowledge, preparation for routine enquiry, knowledge of domestic violence and perceptions of impact of the training and support for practice change. Forty (out of 83) participant surveys could be matched and responses compared to baseline and post-training scores. Wilcoxon signed-rank test identified that all 6-month follow-up scores were significantly higher than those at baseline. Level of preparedness increased from 42.3 to 51.05 (Z=4.88, p<.001) and knowledge scores increased from a mean of 21.15 to 24.65 (Z=4.9, p 90%) reported improved confidence to undertake routine inquiry. A chart audit of screening rates revealed that of the 6671 women presenting for antenatal care, nearly 90% were screened. Disclosure of domestic violence was low (<2%) with most women at risk or experiencing violence declining referral. Training, support processes, and referral pathways, contributed to midwives' sustained preparedness and knowledge to conduct routine enquiry and support women disclosing domestic violence.
Publisher: Elsevier BV
Date: 09-2022
Publisher: Springer Science and Business Media LLC
Date: 14-01-2014
Publisher: Elsevier BV
Date: 04-2011
DOI: 10.1016/J.MIDW.2009.07.003
Abstract: to explore the relationship between maternal role development (MRD), maternal distress (MD) and social support following childbirth. prospective longitudinal survey. three public hospital maternity units in Brisbane, Australia. 630 pregnant women were invited to participate in the study, with a 77% (n=473) completion rate. to measure MRD, the Prenatal Maternal Expectation Scale was used at 36 weeks of pregnancy, and the revised What Being the Parent of a New Baby is Like (with subscales of evaluation, centrality and life change) was used at six and 12 weeks post partum. At all three data collection points, the Edinburgh Postnatal Depression Scale was used to measure MD, and the Maternal Social Support Scale was used to measure social support. at 36 weeks of gestation, optimal scaling for MRD produced a parsimonious model with MD providing 39% of predictive power. At six weeks post partum, similar models predicting MRD were found (evaluation: r(2)=0.14, MD providing 64% of predictive power centrality: r(2)=0.07, MD providing 11% of predictive power life change: r(2)=0.26, MD providing 59% of predictive power). At 12 weeks post partum, MD was a predictor for evaluation (r(2)=0.11) and life change (r(2)=0.26, 54% of predictive power). there is a statistically significant but moderate correlation between MRD and MD. The transition to motherhood can be stressful, but may be facilitated by appropriate acknowledgement and support with an emphasis on MRD.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2011
DOI: 10.11124/01938924-201109270-00001
Abstract: Research has shown that stigma associated with mental illness is pervasive in many countries. Schizophrenia is considered one of the most highly stigmatised psychiatric disorders due to an array of negative stereotypes associated with it. Stigma has deleterious consequences for people suffering a mental illness. A review on the subjective perception and experience of stigma may aid the development of effective anti-stigma programs and raise awareness of clinicians about the meaning of stigma for in iduals in order to minimise harmful health outcomes. The overall objective of this systematic review was to determine perception and experience of stigma among people with schizophrenia. Types of participants Studies that included adults (18 years and over) diagnosed with any types of schizophrenia.Phenomena of interest Primary studies which explored the perception and experience of stigma among people with schizophrenia.Context Studies conducted in either inpatient, outpatient, or community settings and published in English.Types of studies Any interpretive studies and quantitative descriptive studies which explored the phenomena of interest. The literature search sought published studies and papers. Electronic databases searched were: METHODOLOGICAL QUALITY: Qualitative and quantitative studies selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using the standardised critical appraisal instruments from the JBI-SUMARI. Information was extracted by two independent reviewers from each paper using standardised JBI data extraction tools. Meta-synthesis was carried out which resulted in eight synthesised findings. A narrative summary of the quantitative study findings is also presented. Both qualitative and quantitative studies revealed similar findings, including negative attitudes, discrimination and lack of understanding from community, friends, colleagues, family members, as well as mental health professionals due to negative stereotypes and media portrayals. Self stigmatisation among in iduals was revealed too. Stigma affects important domains of in iduals' lives, and is mainly due to a lack of knowledge and understanding of others towards people with schizophrenia. Self stigma, which contributes to negative self concept and perceptions, appears to be a prominent problem too. Education programs should be developed and targeted at various groups of people to enhance knowledge and understanding of mental illness. Additional legislation may be required to protect the rights of in iduals. Media can help to disseminate accurate information to the public. Healthcare professionals have the responsibility to advocate for in iduals, empower them in decision making, and understand the meaning and experience of stigma for in iduals, in order to plan appropriate interventions to help them cope effectively. Further qualitative research investigating stigma could be conducted in different cultural settings. A systematic review on the association between stigma experiences and clinical or demographic characteristics may aid mental health professionals in recognising in iduals at risk of the adverse effects of stigma. Periodic research in this area could evaluate the effectiveness of community-based educational programs or interventions introduced which combat stigma.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2009
Publisher: Elsevier BV
Date: 12-2008
DOI: 10.1016/J.JAD.2008.03.010
Abstract: This descriptive exploratory study investigated the prevalence and type of Complementary and Alternative Medicine (CAM) use among older Taiwanese patients with a diagnosis of depression. Self-report questionnaire. A convenience s le of 206 in-patients (98% response rate) completed the survey. Nearly 70% (69.9%) reported using at least one form of CAM in the past 12 months. Twenty-one kinds of CAM were identified in the treatment of depression, the most common being herbal medicines, spiritual healing, and folk remedies. Only one-third (35.4%, n=73) had discussed CAM use with their psychiatrists. Participants with mild to moderate depression tended to use more CAM than participants with severe depression (GDS-SF: Cramer's V=-.233 HDRS: Cramer's V=.201). This study confirms the high prevalence of CAM use among older adults with a diagnosis of depression in Taiwan. The popularity of CAM appears to be a consequence of people's preference for a more holistic approach to health care. CAM use needs to be explicitly discussed between patients and health professionals as part of ongoing assessment, patient education and management.
Publisher: Wiley
Date: 22-02-2005
DOI: 10.1111/J.0730-7659.2005.00340.X
Abstract: Adverse childbirth experiences can evoke fear and overwhelming anxiety for some women and precipitate posttraumatic stress disorder. The objective of this study was to assess a midwife-led brief counseling intervention for postpartum women at risk of developing psychological trauma symptoms. Of 348 women screened for trauma symptoms, 103 met inclusion criteria and were randomized into an intervention (n = 50) or a control (n = 53) group. The intervention group received face-to-face counseling within 72 hours of birth and again via telephone at 4 to 6 weeks postpartum. Main outcome measures were posttraumatic stress symptoms, depression, self-blame, and confidence about a future pregnancy. At 3-month follow-up, intervention group women reported decreased trauma symptoms, low relative risk of depression, low relative risk of stress, and low feelings of self-blame. Confidence about a future pregnancy was higher for these women than for control group women. Three intervention group women compared with 9 control group women met the diagnostic criteria for posttraumatic stress disorder at 3 months postpartum, but this result was not statistically significant. A high prevalence of postpartum depression and trauma symptoms occurred after childbirth. Although most women improved over time, the intervention markedly affected participants' trajectory toward recovery compared with women who did not receive counseling. A brief, midwife-led counseling intervention for women who report a distressing birth experience was effective in reducing symptoms of trauma, depression, stress, and feelings of self-blame. The intervention is within the scope of midwifery practice, caused no harm to participants, was perceived as helpful, and enhanced women's confidence about a future pregnancy.
Publisher: Elsevier BV
Date: 08-2014
DOI: 10.1016/J.MIDW.2014.03.011
Abstract: around 50% of women report symptoms that indicate some aspect of their childbirth experience was 'traumatic', and at least 3.1% meet diagnosis for PTSD six months post partum. Here we aimed to conduct a prospective longitudinal study and examine predictors of birth-related trauma - predictors that included a range of pre-event factors - as a first step in the creation of a screening questionnaire. of the 933 women who completed an assessment in their third trimester, 866 were followed-up at four to six week post partum. Two canonical discriminant function analyses were conducted to ascertain factors associated with experiencing birth as traumatic and, of the women who found the birth traumatic, which factors were associated with those who developed PTSD. a mix of 16 pre-birth predictor variables and event-specific predictor variables distinguished women who reported symptoms consistent with trauma from those who did not. Fourteen predictor variables distinguished women who went on to develop PTSD from those who did not. anxiety sensitivity to possible birthing problems, breached birthing expectations, and severity of any actual birth problem, predicted those who found the birth traumatic. Prior trauma was the single most important predictive factor of PTSD. Evaluating the utility of brief, cost-effective, and accurate screening for women at risk of developing birth-related PTSD is suggested.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2020
Publisher: Elsevier BV
Date: 03-2012
DOI: 10.1016/J.WOMBI.2011.03.001
Abstract: The detection of maternal depression can be improved with routine screening. This practice is expected to be integrated into midwifery practice under the Australia National Perinatal Depression Initiative. To describe midwives' self-reported practice in caring for women suffering from antenatal and postpartum depressive symptoms and assess midwives' ability to detect depression and their knowledge of therapeutic interventions for depressive symptoms in childbearing women. Using a descriptive cohort study design, a postal survey was sent to all members of the Australian College of Midwives (n=3000). The survey consisted of items drawn from beyondblue's "National Baseline Survey--Screening Evaluation Questionnaire" and questions relating to a hypothetical case study of a depressed woman "Mary" developed by Buist et al. A total of 815 completed surveys were received. 69.1% of midwives reported screening for antenatal and postpartum depression using instruments such as the Edinburgh Postnatal Depression Scale. Time constraints were perceived as the major barrier to effective emotional care. 63.3% of midwives correctly recognised depression in the case study and 82.4% reported that "Mary" required assistance. Antidepressants were more likely to be recommended postnatally (93.2%) than antenatally (61.5%) by midwives. Further training is required to ensure midwives' competency in psychosocial assessment and management of women experiencing antenatal and postpartum depression. Systemic issues (e.g. time constraints) encountered by midwives need to be addressed to support the delivery of effective emotional care to childbearing women.
Publisher: Wiley
Date: 16-03-2021
DOI: 10.1111/NHS.12823
Abstract: This study examined the association of needs, health literacy, and quality of life among adult Nigerians with cancer and family caregivers. A descriptive study was conducted involving 240 adults with cancer and family caregivers attending a tertiary hospital. More than two‐thirds of participants reported moderate or high needs. Information (90.8%) and spiritual support (85%) were the domains of highest need among adults with cancer. Family/social support (85%) and spiritual support (81.7%) ranked the highest among family caregivers. A negative correlation was found between needs and quality of life. Stepwise regression analysis showed that needs and literacy explained 36% of the variance in adults with cancer's quality of life and 28% of the variance in family caregivers’ quality of life. Spiritual need accounted l for 9.5% and 9.1% of variation for adults with cancer and family caregivers, respectively. Findings suggest that interventions with a focus on social/family and spiritual needs may improve wellbeing of adults with cancer and caregivers in Nigeria. This research are generalizable to other low‐income countries where family values and spirituality are often a strong feature of daily life.
Publisher: Wiley
Date: 18-11-2002
DOI: 10.1046/J.1365-2648.2002.02412.X
Abstract: Deliberate self-harm is frequently encountered by emergency department (ED) nurses. However, clients are often dissatisfied with the care provided and clinicians feel ambivalent, helpless or frustrated when working with clients who self-harm. The aim of the study was to develop and test a scale to identify relevant dimensions of ED nurses' attitudes to clients who present with self-injury. Items on Attitudes Towards Deliberate Self-Harm Questionnaire (ADSHQ) were drawn from a literature review and focus group discussions with ED nurses. The tool was piloted with 20 ED nurses not working in the target agencies. A survey of nurses working within 23 major public and 14 major private EDs in Queensland, Australia (n = 1008) was then undertaken. A total of 352 questionnaires were returned (35% response). Analysis revealed four factors that reflected nurses' attitudes toward these clients. The factors related to nurses' perceived confidence in their assessment and referral skills ability to deal effectively with clients, empathic approach and ability to cope effectively with legal and hospital regulations that guide practice. There was a generally negative attitude towards clients who self-harm. Correlations were found between years of ED experience and total score on the ADSHQ, and years of ED experience and an empathic approach towards clients who deliberately self-harm. There is a need for continuing professional development activities to address negative attitudes and provide practical strategies to inform practice and clinical protocols.
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.NEDT.2017.11.026
Abstract: Test the concurrent validity of three newly developed tools (student self-rating, preceptor rating, and reflective writing) that aim to measure critical thinking in midwifery practice. A descriptive matched cohort design was used. Australian research intensive university offering a three year Bachelor of Midwifery programme. Fifty-five undergraduate midwifery students. Students assessed their ability to apply critical thinking in midwifery practice using a 25-item tool and a 5-item subscale in Motivated Strategies for Learning Questionnaire. Clinical preceptors completed a 24-item tool assessing the students' application of critical thinking in practice. Reflective writing by students was assessed by midwifery academics using a 15-item tool. Internal reliability, and concurrent validity were assessed. Correlations, t-tests, multiple regression and confidence levels were calculated for the three scales and associations with student characteristics. The three scales achieved good internal reliability with a Cronbach's alpha coefficient between 0.93 and 0.97. Matched total scores for the three critical thinking scales were moderately correlated student receptor (r=0.36, p<0.01) student/reflective writing (r=0.38, p<0.01) preceptor/reflective writing (r=0.30, p<0.05). All critical thinking mean scores were higher for students with a previous degree, but only significant for reflective writing (t (53)=-2.35, p=0.023). Preceptor ratings were predictive of GPA (beta=0.50, p<0.001, CI=0.10 to 0.30). Students' self-rating scores were predictive of year level (beta=0.32, p<0.05, CI=0.00 to 0.03). The student, preceptor, and reflective writing tools were found to be reliable and valid measures of critical thinking. The three tools can be used in idually or in combination to provide students with various sources of feedback to improve their practice. The tools allow formative measurement of critical thinking over time. Further testing of the tools with larger, erse s les is recommended.
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.MIDW.2016.06.008
Abstract: the predicted midwifery workforce shortages in several countries have serious implications for the care of women during pregnancy, birth and post partum. There are a number of factors known to contribute to midwifery shortages and work attrition. However, midwives assessment of their own professional identity and role (sense of empowerment) are perhaps among the most important. There are few international workforce comparisons. to compare midwives' sense of empowerment across Australia, New Zealand and Sweden using the Perceptions of Empowerment in Midwifery Scale-R (PEMS-Revised). a self-administered survey package was distributed to midwives through professional colleges and networks in each country. The surveys asked about personal, professional and employment details and included the Perceptions of Empowerment in Midwifery Scale-R (PEMS-Revised). Descriptive statistics for the s le and PEMS were generated separately for the three countries. A series of analysis of variance with posthoc tests (Tukey's HSD) were conducted to compare scale scores across countries. Effect size statistics (partial eta squared) were also calculated. completed surveys were received from 2585 midwives (Australia 1037 New Zealand 1073 and Sweden 475). Respondents were predominantly female (98%), aged 50-59 years and had significant work experience as a midwife (+20 years). Statistically significant differences were recorded comparing scores on all four PEMS subscales across countries. Moderate effects were found on Professional Recognition, Skills and Resources and Autonomy/Empowerment comparisons. All pairwise comparisons between countries reached statistical significance (p<.001) except between Australia and New Zealand on the Manager Support subscale. Sweden recorded the highest score on three subscales except Skills and Resources which was the lowest score of the three countries. New Zealand midwives scored significantly better than both their Swedish and Australian counterparts in terms of these essential criteria. midwives in New Zealand and Sweden had a strong professional identity or sense of empowerment compared to their Australian counterparts. This is likely the result of working in more autonomous ways within a health system that is primary health care focused and a culture that constructs childbirth as a normal but significant life event. If midwifery is to reach its full potential globally then developing midwives sense of autonomy and subsequently their empowerment must be seen as a critical element to recruitment and retention that requires attention and strengthening.
Publisher: Wiley
Date: 13-04-2022
DOI: 10.1111/AJO.13529
Abstract: Australia's caesarean section (CS) rate has been steadily increasing for decades. In response to this, we co‐designed an evidence‐based, multi‐pronged strategy to increase the normal birth rate in Queensland and reduce the need for CS. We conducted three workshops with a multi‐stakeholder group to identify a broad range of options to reduce CS, prioritise these options, and achieve consensus on a final strategy. The strategy comprised of: universal access to midwifery continuity‐of‐care and choice of place of birth multi‐disciplinary normal birth education resources to facilitate informed decision‐making respectful maternity care and positive workplace culture and establishment of a Normal Birth Collaborative.
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.WOMBI.2017.03.008
Abstract: Rates of elective and unplanned caesarean section continue to increase in high income countries. Evidence-based clinical guidelines aim to promote and support normal birth but are rarely evaluated. The Queensland Normal Birth Guideline was developed in consultation with stakeholders and disseminated to public and private hospitals and released in 2012. Impact of the Guideline on practice has not been investigated. Although most midwives (90%) were aware of the guideline, only 71% reported that it routinely guided practice.
Publisher: Elsevier BV
Date: 09-2022
Publisher: Wiley
Date: 07-2011
DOI: 10.1111/J.1542-2011.2011.00039.X
Abstract: Emotional care provided by midwives may improve health and well-being reduce stress, trauma, and depressive symptoms and enhance maternal outcomes in childbearing women. The provision of intrapartum and postpartum emotional care can be challenging and requires a good knowledge base for the provider to screen and assist distressed women. This study assessed Australian midwives' levels of knowledge and learning needs regarding antenatal depression and postpartum depression. Eight hundred and fifteen members of the Australian College of Midwives completed a postal survey, which consisted of 20 items drawn from the literature and the National Baseline Survey-Health Professional Knowledge Questionnaire. On average, respondents correctly answered 62.9% of items related to antenatal depression and 70.7% of questions about postpartum depression. Many midwives were unable to identify the risk factors (70.6%) or prevalence of antenatal depression (49.6%). Nearly all (98.3%) respondents underestimated the percentage of antenatally depressed women that attempts suicide. Significant percentages of midwives did not correctly identify the incidence (44.4%), onset period (71%), and treatment options (32%) associated with postpartum depression. About half did not understand the use of antidepressant medications (48.6%) and incorrectly reported that the Edinburgh Postnatal Depression Scale was a suitable instrument to assess symptoms of psychotic depression (43.8%). There are key knowledge deficits relating to onset of, assessment of, and treatment for depressive symptoms during the antenatal and postpartum periods. There is a need for continuing professional education to improve midwives' knowledge and competency in the assessment and care of women suffering depression.
Publisher: Elsevier BV
Date: 10-2020
Publisher: Elsevier BV
Date: 2015
Publisher: Elsevier BV
Date: 09-2003
Publisher: Elsevier BV
Date: 05-2021
Publisher: CSIRO Publishing
Date: 2021
DOI: 10.1071/AH19264
Abstract: ObjectiveTo determine maternal access to continuity of midwifery care in public maternity hospitals across the state of Queensland, Australia. MethodsMaternal access to continuity of midwifery care in Queensland was modelled by considering the proportion of midwives publicly employed to provide continuity of midwifery care alongside 2017 birth data for Queensland Hospital and Health Services. The model assumed an average caseload per full-time equivalent midwife working in continuity of care with 35 women per annum, based on state Nursing and Midwifery Award conditions. Hospitals were grouped into five clusters using standard Australian hospital classifications. ResultsTwenty-seven facilities (out of 39, 69%) across all 15 hospital and health services in Queensland providing a maternity service offered continuity of midwifery care in 2017 (birthing onsite). Modelling applying the assumed caseload of 35 women per full-time equivalent midwife found wide variations in the percentage of women able to access continuity of midwifery care, with access available for an estimated 18% of childbearing women across the state. Hospital classifications with higher clinical services capability and birth volume did not equate with higher access to continuity of midwifery care in metropolitan areas. Regional health services with level 3 district hospitals assisting with & births showed higher levels of access, potentially due to additional challenges to meet local population needs to those of a metropolitan service. Access to full continuity of midwifery care in level 3 remote hospitals (& births) was artificially inflated due to planned pre-labour transfers for women requiring specialised intrapartum care and women who planned to birth at other hospitals. ConclusionsDespite strong evidence that continuity of midwifery care offers optimal care for women and their babies, there was significant variation in implementation and scale-up of these models across hospital jurisdictions. What is known about the topic?Access to continuity of midwifery care for pregnant women within the public health system varies widely however, access variation among different hospital classification groups in Australian states and territories has not been systematically mapped. What does this paper add?This paper identified differential access to continuity of midwifery care among hospital classifications grouped for clinical services capability and birth volume in one state, Queensland. It shows that higher clinical services capability and birth volume did not equate with higher access to continuity of midwifery care in metropolitan areas. What are the implications for practitionersScaling up continuity of midwifery care among all hospital classification groups in Queensland remains an important public health strategy to address equitable service access.
Publisher: Elsevier BV
Date: 08-2010
DOI: 10.1016/J.MIDW.2008.10.011
Abstract: a growing number of childbearing women are reported to prefer a caesarean section in the absence of a medical reason. Qualitative research describing factors influencing this preference in pregnant women is lacking. to describe Australian women's request for caesarean section in the absence of medical indicators in their first pregnancy. advertisements were placed in local newspapers inviting women to participate in a telephone interview exploring women's experience of caesarean section. Thematic analysis was used to analyse data. two states of Australia: Queensland and Western Australia. a community s le of women (n=210) responded to the advertisements. This paper presents the findings elicited from interviews conducted with 14 women who requested a caesarean section during their first pregnancy in the absence of a known medical indication. childbirth fear, issues of control and safety, and a devaluing of the female body and birth process were the main themes underpinning women's requests for a non-medically-indicated caesarean section. Women perceived that medical discourses supported and reinforced their decision as a 'safe' and 'responsible' choice. KEY CONCLUSIONS AND RECOMMENDATIONS FOR PRACTICE: these findings assist women and health professionals to better understand how childbirth can be constructed as a fearful event. In light of the evidence about the risks associated with surgical birth, health-care professionals need to explore these perceptions with women and develop strategies to promote women's confidence and competence in their ability to give birth naturally.
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.ICCN.2022.103248
Abstract: To identify, appraise, and synthesise current evidence on prevalence, correlates, and interventions to enhance compassion satisfaction, resilience, and passion for work among nurses and physicians working in intensive care units. A mixed methods systematic review was conducted. The comprehensive search used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Seven databases (MEDLINE, EMBASE, CINAHL, JBI, ProQuest, PsycINFO, and Cochrane Library) were searched for literature published between January 2011 and June 2021. The Mixed Methods Appraisal Tool was used to assess methodological quality. Data from included studies were analysed using a convergent mixed methods design. The protocol was prospectively registered (PROSPERO 2021 CRD42021252051). A total of 37 studies met the inclusion criteria. Most studies reported moderate levels of compassion satisfaction among intensive care health professionals, whereas levels of resilience varied. Compassion satisfaction and resilience were positively correlated, but relationships between compassion satisfaction and resilience and other correlates (personal factors, psychological factors, and work-related factors) were inconsistently reported. Only four interventions aimed to improve compassion satisfaction or resilience among intensive care health professionals. None of the included studies investigated passion for work. Compassion satisfaction, resilience, and passion for work among staff in the intensive care unit are important in the current global COVID-19 pandemic. Health professionals report a moderate level of compassion satisfaction but findings in relation to resilience are mixed. No studies examined passion for work. Further research to determine ongoing psychological wellbeing and professional quality of life and evaluate tailored interventions to support intensive care staff well-being is recommended.
Publisher: Elsevier BV
Date: 02-2021
DOI: 10.1016/J.MIDW.2021.103228
Abstract: To develop and test a tool to measure Bachelor of Nursing students' perceptions towards respectful maternity care in Nepal, a lower-middle income country. A cross-sectional design was used. Phases of tool development included item generation, expert review for content validity testing, and psychometric testing. The draft tool had 42 items on a 5-point Likert response scale of 1 = strongly disagree to 5 = strongly agree. Psychometric testing included dimensionality, internal consistency, and test-retest reliability. A t-test assessed mean score differences between students who had witnessed or not witnessed disrespect and abuse. Two medical colleges in Chitwan, Nepal PARTICIPANTS: Undergraduate Bachelor of Nursing students (n = 171) undertaking their midwifery clinical practicum were invited to complete the online survey. Principal component analysis generated three factors: Respectful Care, Safety and Comfort, and Supportive Care and explained 37.44% of the variance. The 18-item tool demonstrated good internal reliability (Cronbach's alpha of 0.81). The mean total scale score was 71.23 (SD 7.47, range 52-88 out of 90). Pearson's correlation coefficient confirmed test-retest reliability at one week (r = 0.91, p <0.001). The magnitude of difference in mean scores between those who had witnessed or not witnessed disrespectful and abusive care was very small (η The new Student Perceptions of Respectful Maternity Care tool is the first valid and reliable measure of students' perceptions of respectful maternity care. Validation of the newly developed tool in other low- and middle-income countries is recommended. Measuring students' perceptions provides information to educators on how best to enhance students' understanding and provision of respectful care to women.
Publisher: Elsevier BV
Date: 09-2022
DOI: 10.1016/J.MIDW.2022.103426
Abstract: To compare Nepalese and Jordanian midwifery and nursing students' perceptions of respectful maternity care (RMC) and witnessing of disrespect and abuse and determine factors that predict scores on a scale measuring perceptions of RMC. A descriptive, comparative design was used. Recruitment took place from two medical colleges in Nepal and one University in Jordan. A convenience s le of students (n = 276) enrolled in a Bachelor or Diploma level midwifery or nursing degree who were undertaking or had recently completed their midwifery clinical placement were recruited. The online or hard copy survey included the Students' Perceptions of Respectful Maternity Care (SPRMC) Scale and nine questions on witnessing different types of disrespect and abuse. Nepalese students were slightly older (mean = 23.68 years) than Jordanian students (mean = 21.36). Mean duration of clinical placement was longer for Jordanian students (11.24 compared to 6.28 weeks). However, mean number of births observed was higher among Nepalese students (19.6 compared to 18.62). Overall, perceptions of RMC were more positive among Jordanian students (t (199.97) = 6.68, p < 0.001). A multiple regression analysis found that duration of clinical placement (beta = 0.22, p < 0.001), witnessing disrespect and abuse (beta = 0.11, p = 0.08) and age (beta = -0.14, p = 0.03) explained 12.2% of variance in SPMRC scores. Compared to students in Nepal, all Jordanian students had observed non-consented care during their clinical practicum. However, Nepalese students were more likely to observe poor adherence to women's privacy and confidentiality. This is the first study to compare midwifery and nursing students' perceptions of RMC across two middle-income countries. Although Jordanian students held more positive perceptions of RMC than those in Nepal, more had witnessed different forms of disrespect and abuse. Variations in students' perceptions of RMC and witnessing of abuse across countries highlight the need for assessment of workplace cultures to inform the development of tailored education and practice interventions for students, clinicians, and managers. Future research needs to explore how to best support students to consistently offer RMC and how to improve the experiences of childbearing women.
Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1016/J.EJON.2011.04.013
Abstract: This exploratory descriptive study examined the role and strengths of the family when supporting the younger woman (<50 years) after a diagnosis of breast cancer. The perspectives of women and family members were sought. Participants were recruited from oncology outpatient units in Australia. Semi-structured interviews guided by the Family Resiliency Framework were undertaken with 14 young women with breast cancer and 11 family members who reflected on the roles of family. Transcripts were analysed in idually and in family groupings. Women with breast cancer and their family members experienced a range of emotions during the treatment period. Roles within the family changed as members responded to their circumstances. Analysis of interview transcripts identified the following primary themes 'just being there', 'paradox of help' and 'buffer from society'. A secondary theme related to support, specifically 'the changing role of support for family members', highlighting the strengths and experiences of family. Recognition needs to be given to the complexity of changing roles experienced by young women with breast cancer and their families. Young women with breast cancer require unique forms of support because of the nature of their experience. Family roles were shaped through a shared sense of commitment and open communication amongst members. Families may demonstrate a range of strengths but are also vulnerable during this stressful period. Health professionals need to be aware of the possible needs of families, assess their adaptation to changing circumstances, and intervene through the provision of information, and counselling to enhance coping.
Publisher: Elsevier BV
Date: 08-2015
DOI: 10.1016/J.MIDW.2015.04.006
Abstract: midwifery continuity of care experiences can provide high quality clinical learning for students but can be challenging to implement. The Rural and Private Midwifery Education Project (RPMEP) is a strategic government funded initiative to (1) grow the midwifery workforce within private midwifery practice and rural midwifery, by (2) better preparing new graduates to work in private midwifery and rural continuity of care models. this study evaluated midwifery students׳ experience of an innovative continuity of care clinical placement model in partnership with private midwifery practice and rural midwifery group practices. a descriptive cohort design was used. All students in the RPMEP were invited to complete an online survey about their experiences of clinical placement within midwifery continuity models of care. Responses were analysed using descriptive statistics. Correlations between total scale scores were examined. Open-ended responses were analysed using content analysis. Internal reliability of the scales was assessed using Cronbach׳s alpha. sixteen out of 17 completed surveys were received (94% response rate). Scales included in the survey demonstrated good internal reliability. The majority of students felt inspired by caseload approaches to care, expressed overall satisfaction with the mentoring received and reported a positive learning environment at their placement site. Some students reported stress related to course expectations and demands in the clinical environment (e.g. skill acquisition and hours required for continuity of care). There were significant correlations between scales on perceptions of caseload care and learning culture (r=.87 p<.001) and assessment (r=.87 p<.001). Scores on the clinical learning environment scale were significantly correlated with perceptions of the caseload model (rho=.86 p<.001), learning culture (rho=.94 p<.001) and assessment (rho=.65 p<.01) scales. embedding students within midwifery continuity of care models was perceived to be highly beneficial to learning, developed partnerships with women, and provided appropriate clinical skills development required for registration, while promoting students׳ confidence and competence. The flexible academic programme enabled students to access learning at any time and prioritise continuity of care experiences. Strategies are needed to better support students achieve a satisfactory work-life balance.
Publisher: Elsevier BV
Date: 03-2022
DOI: 10.1016/J.NEPR.2022.103317
Abstract: This systematic review critiqued the impact of educational interventions for midwives, nurses, or midwifery/nursing students to enhance respectful maternity care. Treating women with respect during maternity care has gained considerable global attention. Although research has focused on raising awareness about respectful care among health care professionals, the effectiveness of educational interventions remains uncertain. A mixed-methods systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This review used a convergent segregated approach, and methodology recommended by Joanna Briggs Institute (JBI) mixed-methods systematic reviews, to synthesise and integrate research findings. Multiple databases were searched. JBI critical appraisal checklists for quasi-experimental studies, cross-sectional, and qualitative studies, as well as a mixed-methods appraisal tool were used. Nine educational interventions studies met the inclusion criteria, and most were conducted in Africa. Quantitative evidence supported the effectiveness of interventions to improve knowledge erceptions of midwives and/or nurses regarding respectful maternity care, and woman-provider communication, and reduce women's experience of disrespect and abuse. However, variation in content, intervention delivery mode, duration, timing of pre and post-test, evaluation methods, and difficulty distilling findings from multi-pronged interventions hindered robust conclusions. Only one study used a valid and reliable tool to measure women's experience of respectful care. Qualitative findings suggest continuous education rather than one-off interventions and inclusion of other health care providers as well as managerial staff working in maternity care would help promote respectful care. There is low level evidence that educational interventions can improve midwives', nurses', and students' knowledge and attitudes towards RMC. Outcomes of education and training need to be monitored regularly with valid and reliable tools. There is a need for respectful maternity care education interventions in high as well as middle and low-income countries.
Publisher: Elsevier BV
Date: 10-2010
DOI: 10.1016/J.NEDT.2009.12.006
Abstract: This paper describes the development and psychometric testing of the Clinical Learning Organisational Culture Survey (CLOCS) that measures prevailing beliefs and assumptions important for learning to occur in the workplace. Items from a tool that measured motivation in workplace learning were adapted to the nursing practice context. The tool was tested in the clinical setting, and then further modified to enhance face and content validity. Registered nurses (329) across three major Australian health facilities were surveyed between June 2007 and September 2007. An exploratory factor analysis identified five concepts--recognition, dissatisfaction, affiliation, accomplishment, and influence. VALIDITY AND RELIABILITY: Internal consistency measures of reliability revealed that four concepts had good internal consistency: recognition (alpha=.914), dissatisfaction (alpha=.771), affiliation (alpha=.801), accomplishment (alpha=.664), but less so for influence (alpha=.529). This tool effectively measures recognition, affiliation and accomplishment--three concepts important for learning in practice situations, as well as dissatisfied staff across all these domains. Testing of additional influence items identify that this concept is difficult to delineate. The CLOCS can effectively inform leaders about concepts inherent in the culture important for maximising learning by staff.
Publisher: Springer Science and Business Media LLC
Date: 22-02-2019
DOI: 10.1007/S00520-019-04682-8
Abstract: Many women with ovarian cancer may experience adverse effects from adjuvant chemotherapy after surgery. Non-pharmacological interventions can be used to reduce these side effects. We tested auricular acupressure to reduce treatment side effects in this population. A prospective, quasi-randomized controlled trial was carried out at a publicly-funded hospital in southern Taiwan. Thirty-four women in the intervention group received auricular acupressure at four points (Shenmen, subcortex, endocrine, and heart), three times per day for 3 min per time, for 6 weeks. Thirty-one women in the control group received routine nursing care alone. The M. D. Anderson Symptom Inventory (MDASI) was completed at four time points. After receiving the third cycle of chemotherapy, side effect severity was elevated among both groups. Auricular acupressure reduced side effects such as disturbed sleep (t = - 11.99 p < .001, eta squared = 0.69), fatigue (t = - 2.57 p < .01, eta squared = 0.10), and lack of appetite (t = - 2.37 p = .024, eta squared = 0.08). Auricular acupressure can reduce adverse side effects of chemotherapy in women with ovarian cancer. Future studies with a larger s le and using some laboratory-based tests (such as C-reactive protein, interleukin-6) are warranted to confirm the results.
Publisher: Wiley
Date: 16-08-2022
DOI: 10.1111/NHS.12975
Abstract: The experience of a life‐threatening illness, such as cancer, can have an array of health impacts and social and psychological well‐being can be compromised. This study compared differences in unmet care needs, social support, and hope of Taiwanese women with either newly diagnosed (n = 72) or recurring (n = 39) gynecological cancer at baseline (T0) and three follow‐up surveys every 2 months (T1 T2 T3). Sociodemographic questions and three standardized self‐administered questionnaires were used. The generalized estimating equations (GEE) method was used to analyze data. Women with recurrent cancer reported higher levels of care needs and lower levels of hope than those with a primary diagnosis. Significant positive correlations between social support and hope scores were observed for women with recurring cancer at T1 and T2. However, these women reported less hope at T3 compared to those with a primary diagnosis. Routine assessment of women's care needs related to their medical condition and provision of different kinds of support can aim to improve well‐being and their hope for the future.
Publisher: Elsevier BV
Date: 09-2007
DOI: 10.1016/J.WOMBI.2007.05.003
Abstract: Examining women's preferences for maternity care is overdue. Understanding women's preferences and re-orienting services to meet their expectations is critical to improving health outcomes. A self-report survey of a convenience community s le of 63 women visiting a Maternity Coalition/Association for Improvements in Maternity Services stall at a Mother and Baby Expo in 2003. Over 95% of women ranked birth safety, bonding with the baby, feeling in control during birth, and postnatal care as "very important". Over 85% of women rated educational preparation for birth, the relationship with their caregiver, prenatal care, and breastfeeding successfully as "very important". Avoiding labour pain was considered less important by more women than any other item. Around half the respondents preferred their birth care to be from a chosen midwife with access to medical backup (57.9%, n=37). Some women identified a lack of choice of care options with 45.9% (n=17) reporting "little" or "no" choice in birth care for their previous birth. Poor quality care was also identified with 57.9% (n=22) rating their postnatal care as "mediocre". Given assurance of equal safety and free care, 50% (n=31) of participants would prefer to give birth at a birth centre and 24.2% (15 out of 63) would prefer a homebirth. Factors associated with safety, control, continuity of care and successful mothering are perceived as important for many women. Some women perceived limited birth choices. More needs be done to align the provision of maternity services with women's preferred care options. Given the small self-select, non-representative s le, results should be interpreted with caution.
Publisher: Elsevier BV
Date: 12-1997
DOI: 10.1016/S0266-6138(97)80006-X
Abstract: In this paper a critical analysis of two popular perineal management techniques used during birth, flexing the baby's head and the Ritgen manoeuvre, are presented. Each technique claims to reduce perineal trauma by reducing the presenting diameter of the fetal skull through the woman's vaginal opening. These two techniques are, however, contradictory and act against the normal mechanisms of labour. In normal labour, the smallest diameter of the fetal skull, the suboccipito-bregmatic, presents through the woman's vaginal opening. In order to negotiate the 90 degrees curve in the birth canal, the baby must change from an attitude of flexion to an attitude of extension during birth. The Ritgen manoeuvre encourages early extension of the fetal head which causes a larger fetal head diameter, the occipito-frontal diameter, to present. Flexing the fetal head cannot cause a smaller diameter to present, and the pressure the birth attendant applies to flex the head serves only to retard the emergence of the baby and unnaturally force the emerging fetal head down toward the stretched perineum. The discussion outlines the implications of this analysis for practice.
Publisher: Informa UK Limited
Date: 03-09-2021
Publisher: Springer Science and Business Media LLC
Date: 11-01-2015
DOI: 10.1007/S00737-014-0495-7
Abstract: This cohort study compared 262 women with high childbirth distress to 138 non-distressed women. At 12 months, high distress women had lower health-related quality of life compared to non-distressed women (EuroQol five-dimensional (EQ-5D) scale 0.90 vs. 0.93, p = 0.008), more visits to general practitioners (3.5 vs. 2.6, p = 0.002) and utilized more additional services (e.g. maternal health clinics), with no differences for infants. Childbirth distress has lasting adverse health effects for mothers and increases health-care utilization.
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.BURNS.2016.11.007
Abstract: This study aimed to determine if a scar quality is associated with quality of life (QoL) at six months post-burn and beyond. Quantile regression models adjusted for covariates were used to demonstrate the relationship of modified Vancouver Scar Scale (mVSS) total (with and without pigmentation) and the mVSS components, to the Burn Specific Health Scale-Brief (BSHS-B) scores (full scale, Affect and Relations domain, Skin Sensitivity domain). The s le (n=341) comprised 67% males, 83% with skin grafts with a median age 38 years, total body surface area (TBSA) 4%, length of stay seven days, mVSS total score of five and BSHS-B total score of 153. Between six and 12 months of injury, mVSS total, TBSA and female gender were significantly associated with the BSHS-B, a situation that was not affected by the presence or absence of pigmentation scores. The mVSS components did not in idually influence QoL. mVSS total score, gender and burn size data may be a useful adjunct to experienced clinical judgment for identifying at risk patients and directing appropriate, timely resource allocation.
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.MIDW.2015.12.002
Abstract: develop and test a tool designed for use by preceptors/mentors to assess undergraduate midwifery students׳ critical thinking in practice. a descriptive cohort design was used. participants worked in a range of maternity settings in Queensland, Australia. 106 midwifery clinicians who had acted in the role of preceptor for undergraduate midwifery students. this study followed a staged model for tool development recommended by DeVellis (2012). This included generation of items, content validity testing through mapping of draft items to critical thinking concepts and expert review, administration of items to a convenience s le of preceptors, and psychometric testing. A 24 item tool titled the XXXX Assessment of Critical Thinking in Midwifery (CACTiM) was completed by registered midwives in relation to students they had recently preceptored in the clinical environment. ratings by experts revealed a content validity index score of 0.97, representing good content validity. An evaluation of construct validity through factor analysis generated three factors: 'partnership in practice', 'reflection on practice' and 'practice improvements'. The scale demonstrated good internal reliability with a Cronbach alpha coefficient of 0.97. The mean total score for the CACTiM scale was 116.77 (SD=16.68) with a range of 60-144. Total and subscale scores correlated significantly. the CACTiM (Preceptor/Mentor version) was found to be a valid and reliable tool for use by preceptors to assess critical thinking in undergraduate midwifery students. given the importance of critical thinking skills for midwifery practice, mapping and assessing critical thinking development in students׳ practice across an undergraduate programme is vital. The CACTiM (Preceptor/Mentor version) has utility for clinical education, research and practice. The tool can inform and guide preceptors׳ assessment of students׳ critical thinking in practice. The availability of a reliable and valid tool can be used to research the development of critical thinking in practice.
Publisher: Elsevier BV
Date: 03-2013
DOI: 10.1016/J.MIDW.2011.12.008
Abstract: to describe perceptions of participating in a study testing the effectiveness of a perinatal emotional support intervention (Promoting Resilience in Mothers Emotions PRIME) by women identified as experiencing emotional distress after birth. qualitative descriptive approach. Semi-structured telephone interviews with 33 women recruited as part of a larger RCT to test the efficacy of a counselling intervention (PRIME). Women who received either (1) the intervention (counselling (or PRIME)) (n=16), (2) active control (Parenting support) (n=12), or (3) matched control (standard care) (n=5), were interviewed at 12 months postpartum. Thematic analysis of data was used. 'promoting reflection' and 'feeling cared for', were phrases that all participants used to describe their experience in the project regardless of group allocation. Women receiving PRIME reported 'getting in touch with (their) feelings' and 'moving on' as beneficial outcomes. Two women who received counselling reported 'having things left unresolved' indicating that their needs had not been met. Some women in both the active control and intervention identified that contact was 'nice but not hugely helpful or needed'. positive outcomes of PRIME were evident and most participants desired postpartum contact. Some women needed additional follow up and targeted assistance. Findings support the importance of providing personalised postnatal care that addresses women's emotional health needs.
Publisher: Wiley
Date: 02-2003
DOI: 10.1046/J.1365-2648.2003.02534.X
Abstract: Culture is often related to notions of well-being, illness, healing and health that inform in iduals in their day-to-day activities. The postpartum period is noted for traditional practices related to rest, healing and the consumption of food and drinks, but a contemporary view of these practices is needed. To gain an understanding of the traditional practices that Thai women follow in relation to postpartum care and the rationales underpinning such practices. This descriptive study surveyed 500 Thai women living in Ubon Ratchathani, Thailand and attending their first postpartum hospital clinic appointment. A self-completion questionnaire was specially developed and pilot tested, and then administered to women attending the clinic. Descriptive statistics were used in relation to the incidence of particular behaviours. Chi-square analyses were conducted to determine relationships between demographic characteristics and traditional practices. The majority of Thai women adhered to traditional postpartum practices related to the notion of regaining 'heat'. These included 'lying by fire', food restrictions, taking hot baths and consuming hot drinks. Other activities involved not exposing the body to heat loss by keeping covered, not sh ooing the hair, avoiding the wind and sexual abstinence. Younger, less educated, primiparous women were more likely to report traditional practices. Mothers and mothers-in-law were most influential in recommending these behaviours. Traditional postpartum practices are still dominant in contemporary Thai culture and are perpetuated by close female family relatives. Health professionals need to be aware of clients' culture and consider the extent to which professional care complements the mothers' traditional beliefs. Nurses need to educate women about the benefits of contemporary postpartum care and to provide strategies to help them to integrate their beliefs and the practices recommended in contemporary health care practice.
Publisher: Elsevier BV
Date: 07-2015
DOI: 10.1016/J.NEPR.2015.01.013
Abstract: Collaborative partnerships between health care providers and academics are essential in the provision of quality undergraduate midwifery programs. While health care providers often contribute to clinical assessment and teaching in midwifery programs, they are rarely involved in assessment design and evaluation. This paper describes the evaluation of an assessment task designed to develop critical thinking skills in final year undergraduate midwifery students. Health care providers' involvement sought to confirm the authenticity and validity of the assessment task and facilitate further engagement. A mixed method descriptive study design was used. After reviewing a s le of student work, health care providers completed a 20 item survey and participated in a focus group. Survey items were based on the domains of Educational Acceptability, Educational Impact and Preparation for Practice. Participants gave high scores for each domain and commented positively on the innovative nature of the assessment, students' ability to undertake in-depth analysis of complex cases, and development of student's critical thinking skills. Participants also reported greater confidence in students' competence and the program. Involving health care providers in evaluation of an assessment task validated the assessment, contributed to clinicians' perceptions of student credibility, and fostered strong links between the program and industry.
Publisher: Elsevier BV
Date: 03-2023
Publisher: Elsevier BV
Date: 03-2020
DOI: 10.1016/J.WOMBI.2019.03.016
Abstract: A university educated, First Peoples health workforce is paramount to improving health outcomes for Australia's First Peoples. However, a significant gap exists between the academic success of First Peoples and non-Indigenous students. The facilitation of culturally safe learning and teaching environments by academics is essential to closing this gap. There is little research on midwifery academics' understanding of Cultural Safety and the translation of this understanding in learning and teaching. To explore the influence of yarning circles within a professional development program to enhance midwifery academics' awareness of Cultural Safety. A six-month staff development program which consisted of two workshops and a series of yarning circles was offered to all midwifery academics. Eight participants agreed to be interviewed after completion of the program. Interviews were transcribed verbatim, read and re-read, and analysed using a six staged thematic analysis process. Six key themes centred on participants' Sense of Belonging, Sense of Safety, Sense Knowing, Sense of Support, Sense of Difference, and Sense of Challenge were identified. These concepts were supportive of participants' developing awareness of Cultural Safety. Yarning circles can encourage midwifery academics' awareness of Cultural Safety. Awareness is the first step towards becoming culturally safe. Yarning provided a safe and supportive space for challenging discussions and reflective learning about racism, white privilege, and difference. Midwifery academics described steps they could take to promote Cultural Safety in the classroom.
Publisher: Springer Science and Business Media LLC
Date: 23-07-2021
DOI: 10.1186/S12884-021-03987-Z
Abstract: Woman-centred care is recognised as a fundamental construct of midwifery practice yet to date, there has been no validated tool available to measure it. This study aims to develop and test a self-report tool to measure woman-centred care in midwives. A staged approach was used for tool development including deductive methods to generate items, testing content validity with a group of experts, and psychometrically testing the instrument with a s le drawn from the target audience. The draft 58 item tool was distributed in an online survey using professional networks in Australia and New Zealand. Testing included item analysis, principal components analysis with direct oblimin rotation and subscale analysis, and internal consistency reliability. In total, 319 surveys were returned. Analysis revealed five factors explaining 47.6% of variance. Items were reduced to 40. Internal consistency (.92) was high but varied across factors. Factors reflected the extent to which a midwife meets the woman’s unique needs balances the woman’s needs within the context of the maternity service ensures midwifery philosophy underpins practice uses evidence to inform collaborative practice and works in partnership with the woman. The Woman-Centred Care Scale-Midwife Self Report is the first step in developing a valid and reliable tool to enable midwives to self-assess their woman-centredness. Further research in alternate populations and refinement is warranted.
Publisher: Wiley
Date: 29-08-2002
DOI: 10.1046/J.1440-1800.2002.00148.X
Abstract: Drawing on the Foucauldian concept of 'governmentality' to analyse the evidence-based movement in nursing, we argue that it is possible to identify the governance of nursing practice and hence nurses across two distinct axes that of the political (governance through political and economic means) and the personal (governance of the self through the cultivation of the practices required by nurses to put evidence into practice). The evaluation of nursing work through evidence-based reviews provides detailed information that may enable governments to target and instruct nurses regarding their work in the interest of preserving the health of the population as a whole. Political governance of the nursing population becomes possible through centralised discursive mechanisms, such as evidence-based reviews that present nursing practice as an intelligible field whose elements are connected in a more or less systematic manner. The identity of the evidence-based nurse requires the modern nurse to develop new skills and attitudes. Evidence-based nursing is an emerging technology of government that judges nursing research and knowledge and has the capacity to direct nursing practice at both the political and personal level.
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.WOMBI.2017.06.004
Abstract: Psychoeducation counselling delivered by midwives has been demonstrated to reduce maternal fear and improve women's confidence for birth. Translating the evidence in practice presents challenges. A systematic approach to the implementation of evidence and evaluation of this process can improve knowledge translation. To implement and evaluate the translation of psychoeducation counselling on (1) midwives' knowledge, skills and confidence to provide the counselling (2) perceived barriers and enablers to embedding the psychoeducation counselling in practice and (3) pregnant women's levels of fear. Using a mixed methods approach, data were collected using a pre (n=22) and post (n=21) training survey, recorded interviews (n=17), diaries (n=6), and retrospective audit of fear of birth scores. Data were analysed using descriptive statistics, independent s le t-tests, and chi-square tests. Latent content analysis was used to analyse the qualitative data. Training in the counselling framework significantly improved midwives' knowledge, skills and confidence to counsel women on psychosocial issues and reduce fear scores for women reporting high childbirth fear. The main barriers to midwives introducing counselling into routine care related to the fragmentation of care delivery during pregnancy. Conversely continuity of care by a known midwife was considered an enabler. Psychoeducation provided by midwives is of benefit to women experiencing high levels of birth fear. While psychoeducation training was successful in enhancing midwives' knowledge, skills and confidence embedding the counselling framework in everyday practice was challenging. Counselling is more easily implemented within midwifery caseload models which enable midwives to build relationships with women across their pregnancy.
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.NEDT.2015.10.008
Abstract: Despite numerous recommendations by governments, researchers, and education policymakers the recruitment, retention and success of undergraduate indigenous students in higher education is not commensurate of the wider student population. There is minimal evidence of valuing indigenous worldviews and perspectives in curricula, and effectiveness of educational strategies to strengthen indigenous student success rates in completing undergraduate studies. To conduct an integrative systematic review of educational strategies to promote academic success and resilience in undergraduate indigenous students. Major databases of Scopus, ProQuest, Informit and Web of Science were searched. Inclusion criteria were peer reviewed research articles from scholarly journals that referenced indigenous, aboriginal, First Nation or Māori students in undergraduate programs in higher education. The search was limited to English language and studies conducted from 1995 to 2014. The search yielded 156 research papers which reduced to 16 papers that met the inclusion criteria. The included papers were critiqued from a standpoint theory approach that reflects feminism, cultural respect, and humanism. Much of the literature describes issues, and provides qualitative analyses of experiences, but empirical evaluations of interventions are rare. There was a gap in current research evaluating strategies to improve indigenous student success and resilience. Key strategies for indigenous student success are multi-faceted, layered support, underpinned by the principles of respect, relationships, and responsibility. Implications for nursing and midwifery education, research and health care practice are outlined.
Publisher: AACN Publishing
Date: 11-2008
DOI: 10.4037/AJCC2008.17.6.534
Abstract: Background Admission to intensive care is often a sudden and unexpected event precipitated by a life-threatening condition, 2 determinants thought to influence the development of posttraumatic stress disorder. Objectives To identify the frequency of acute symptoms of posttraumatic stress disorder and to describe factors predictive of these symptoms in patients 1 month after discharge from intensive care. Methods In this prospective cohort study, all patients meeting the inclusion criteria during the study period were invited to participate. Participants completed the Impact of Event Scale-Revised, and demographic and clinical data were accessed from an intensive care unit database. Results During a 9-month period, 114 of 137 patients who met the inclusion criteria consented to participate in the study, and 100 (88%) completed it. The mean total score on the Impact of Event Scale-Revised was 17.8 (SD, 13.4 possible range, 0–88). A total of 13 participants (13%) scored higher than the cutoff score for clinical posttraumatic stress disorder. Neither sex nor length of stay was predictive of acute symptoms of post-traumatic stress disorder. In multivariate analysis, the only independent predictor of symptoms was age. Patients younger than 65 years were 5.6 times (95% confidence interval, 1.17–26.89) more likely than those 65 years and older to report symptoms. Conclusion The rate of symptoms of posttraumatic stress disorder 1 month after discharge from intensive care was relatively low. Consistent with findings of previous research, being younger than 65 years was the only independent predictor of symptoms.
Publisher: Elsevier BV
Date: 2012
DOI: 10.1016/J.IJNURSTU.2011.08.014
Abstract: Depression, a common mental health problem, is projected to be the second leading cause of disability for adults by year 2020. Mindfulness-based interventions (MFIs) have been integrated into therapeutic work on depression, but limited systematic reviews reported their efficacy on heterogeneous groups of mental disorders. This meta-analysis aimed to examine the efficacy of the MFIs on depressive symptoms in people with various mental disorders. A meta-analysis of experimental and quasi-experimental studies was undertaken. Multiple search strategies were undertaken to identify published and unpublished studies conducted between 1995 and 2011. Electronic databases used were Scopus, CINAHL, PubMed, ScienceDirect, PsyINFO, Dissertation Abstract International, Web of Science Index, Controlled-trial.com, and clinicaltrials.gov. Data were extracted and appraised by two reviewers. For each study, the Quality Rating Index (QRI) and Code Sheet for Randomized Controlled Trials (CS-RCT) were used to assess methodological quality and extract relevant data respectively. Data were analysed and synthesized using PASW statistic 17.0 and Comprehensive Meta Analyses Software 2.0. Thirty-nine studies conducted in ten countries were included and 105 effect sizes were calculated. Most studies utilised single group pretest-posttest quasi-experimental design, convenience s ling, and self-reported questionnaires. Between-group comparisons indicated that MFIs are superior to standard care in reducing depressive symptoms and preventing relapse with effect sizes ranging from 0.11 to 1.65. Exposure-based cognitive therapy (d=2.09) appeared to be the most efficacious intervention, followed by mindfulness-based stress reduction programme (d=1.92), acceptance-based behaviour therapy (d=1.33), and stress less with mindfulness (d=1.31). Effect sizes were significantly associated with the length of intervention sessions but not related to methodological quality of studies. The mindfulness-based interventions are efficacious for alleviating depressive symptoms in adults with mental disorders. The interventions could be used in conjunction with other treatments in clinical settings.
Publisher: Wiley
Date: 09-10-2014
DOI: 10.1111/BIRT.12136
Publisher: Elsevier BV
Date: 09-2002
DOI: 10.1071/HI02085
Publisher: Springer Science and Business Media LLC
Date: 08-11-2021
Publisher: Elsevier BV
Date: 10-2018
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.PMN.2013.08.004
Abstract: Elderly people with cognitive impairment are at risk for under-treatment of pain due to their inability to communicate. Poor knowledge and attitudes of nurses toward pain in this population may result in inadequate pain assessment. This study used a descriptive correlational design to develop and validate a tool to assess nurses' knowledge, attitudes, and reported practice of pain assessment in cognitively impaired elderly patients in acute care settings. The Tool for Evaluating the ways Nurses Assess Pain (TENAP) has two sections: (1) nurses' knowledge and attitudes about pain assessment and management and (2) two vignettes to assess reported practice. Content validity was established by an expert panel of three geriatric-trained nurse clinicians, and pilot tested with a convenience s le of 10 nurses. The psychometric properties were tested with a s le of 263 Registered and Enrolled nurses working in medical wards of two public hospitals in Singapore. The final version of TENAP comprised 29 items. Content validity index ranged from 0.84 to 1.00. The scale took 10 to 15 minutes to complete and items were easily understood. Results from the factor analysis suggested that Section A demonstrated one factor (13 items) while Section B had two distinct factors (16 items), one for each vignette, supporting construct validity of the scale. Cronbach's alphas for all factors were acceptable. TENAP was feasible, valid, and reliable for assessing nurses' knowledge, attitudes, and reported practice of pain assessment in cognitively-impaired elderly patients. Further testing of the tool with a larger s le of nurses in other practice contexts is needed.
Publisher: Wiley
Date: 15-09-2010
Publisher: Springer Science and Business Media LLC
Date: 14-08-2014
Publisher: Wiley
Date: 12-2001
DOI: 10.1046/J.1523-536X.2001.00264.X
Abstract: Cesarean section is a major surgical procedure with a relatively short hospital stay. A significant rate of surgical site infection after this procedure is missed by standard inpatient surveillance. This study aimed to evaluate a method of postdischarge surveillance and compare results with the incidence of infection before discharge. A postdischarge survey was sent on day 30 to 277 women who had delivered by cesarean section during the 12-month study period. A follow-up telephone interview was conducted if the questionnaire had not been returned within 2 weeks, if a diagnosis of infection could not be clearly determined from the participant's responses, or to confirm the diagnosis of infection. If follow-up was not completed, a chart audit was undertaken. A total response rate of 89 percent (247/277) was obtained, and 28 women with a surgical site infection were identified from the survey. Telephone follow-up and chart review of patients with possible infection and of nonresponders identified 32 percent more postdischarge infections (14/42). The overall infection rate was 17 percent compared with 2.8 percent at discharge. Postdischarge surveillance is necessary to determine accurate surgical site infection rates after cesarean section, increase awareness of caregivers about infection control problems, and indicate the need for appropriate follow-up care. Women undergoing a cesarean delivery should be informed of the risk of postdischarge infection and educated about the signs and symptoms of infection.
Publisher: CSIRO Publishing
Date: 2013
DOI: 10.1071/AH13044
Abstract: Introduction For women with a lower uterine incision without indication for repeat Caesarean section (CS), vaginal birth for their next pregnancy is a safe option. Although these women should be encouraged to consider vaginal birth after a Caesarean section (VBAC) it is not consistently supported in practice. There is relatively little information on the extent to which maternal preference, birthing decisions and outcomes match best available evidence. Aim To describe current VBAC rates for women in Queensland, Australia and compare this to safe, achievable VBAC rates reported in national and international studies. Method Perinatal data from 2004 to 2011 were reviewed to determine current VBAC rates following a primary CS for women birthing in Queensland. These were compared with VBAC rates reported in the literature. Results Queensland has a high overall CS rate and high repeat CS rate compared with the national average. In 2010, Queensland VBAC rates for next birth following primary CS were 14% (range 13–21% public sector, 7–11% private hospitals). This is substantially lower than achievable Australian rates of 24% and international rates. Conclusion Low VBAC rates reflect low numbers of women commencing labour in a pregnancy subsequent to a primary CS. There is unexplained variation in VBAC rates between maternity facilities. Clinical reviews to support evidence-based practice are warranted. What is known about the topic? Repeat CS is a major contributor to high CS rates in industrialised countries. What does this paper add? Following a primary CS, women in Queensland are less likely to commence labour and achieve a vaginal birth compared with rates reported in national and international VBAC studies. What are the implications for practitioners? Maternity clinicians need to be aware of best practice and contextualise the evidence for in idual women to improve VBAC rates.
Publisher: Elsevier BV
Date: 09-2022
Publisher: Elsevier BV
Date: 06-2003
DOI: 10.1016/S1031-170X(03)80003-X
Abstract: Little is known about how midwives learn about breastfeeding. This study asked midwives to identify breastfeeding information resources used and perceived value for their learning. A mail questionnaire was sent to midwives (n = 3500) through the Australian College of Midwives Inc. (ACMI). A response rate of 31.6% (n = 1105) was obtained. On-the-job experience was the most common source accessed and continuing education the most valuable. Very few respondents (3.1% n = 34) acknowledged either their hospital or university midwifery education program as a valuable breastfeeding information source. There is scope for continuing education programs to address evidence-based lactation and infant feeding information. Midwifery curricula need to teach in-depth knowledge of human lactation and develop clinicians' skill base to assist breastfeeding women. The development of national standards for course accreditation on lactation and infant feeding by ACMI, Baby Friendly Hospital Initiative (BFHI) and Australian Breastfeeding Association (ABA) would be a useful quality measure.
Publisher: Elsevier BV
Date: 07-2015
DOI: 10.1016/J.NEDT.2015.02.023
Abstract: Well developed critical thinking skills are essential for nursing and midwifery practices. The development of students' higher-order cognitive abilities, such as critical thinking, is also well recognised in nursing and midwifery education. Measurement of critical thinking development is important to demonstrate change over time and effectiveness of teaching strategies. To evaluate tools designed to measure critical thinking in nursing and midwifery undergraduate students. The following six databases were searched and resulted in the retrieval of 1191 papers: CINAHL, Ovid Medline, ERIC, Informit, PsycINFO and Scopus. After screening for inclusion, each paper was evaluated using the Critical Appraisal Skills Programme Tool. Thirty-four studies met the inclusion criteria and quality appraisal. Sixteen different tools that measure critical thinking were reviewed for reliability and validity and extent to which the domains of critical thinking were evident. Sixty percent of studies utilised one of four standardised commercially available measures of critical thinking. Reliability and validity were not consistently reported and there was a variation in reliability across studies that used the same measure. Of the remaining studies using different tools, there was also limited reporting of reliability making it difficult to assess internal consistency and potential applicability of measures across settings. Discipline specific instruments to measure critical thinking in nursing and midwifery are required, specifically tools that measure the application of critical thinking to practise. Given that critical thinking development occurs over an extended period, measurement needs to be repeated and multiple methods of measurement used over time.
Publisher: Elsevier BV
Date: 2015
Publisher: Elsevier BV
Date: 09-2022
Publisher: SLACK, Inc.
Date: 10-2007
DOI: 10.3928/01484834-20071001-06
Abstract: h4 ABSTRACT /h4 P Little is known about nursing students’ information literacy skills and perceptions of Web–enhanced educational approaches. This study examined graduating Bachelor of Nursing (BN) students’ perceptions of a Web–enhanced learning environment, their computer literacy skills, and use of technology, and how these influenced their satisfaction. This Australian survey produced a 64% ( I n /I = 170) response rate. The 3–year BN program provides Web–enhanced learning opportunities by incorporating online activities and content such as quizzes, videos, and virtual laboratories that augment on–c us and off–c us learning approaches. Upon graduation, 61.4% of the students reported having competent information literacy skills. The quality and usefulness of the Web–enhanced material was rated I fair to above average /I . The students’ perception of technical and faculty support for Web–enhanced learning was low. Overall satisfaction with the Web–enhanced program was associated with level of information technology (IT) skills and perceived quality and usefulness of the Internet material. A regression analysis of factors contributing to students’ overall satisfaction of a Web–enhanced learning environment (IT literacy skills, access, and perceived quality, usefulness, and support) accounted for 18.5% of variance. As more nursing programs use Web–based resources, greater attention should be given to the initial assessment and development of students’ information literacy skills. Students with good IT skills are more likely to perceive Web–enhanced material as useful. /P h4 AUTHORS /h4 P Received: December 8, 2004 /P P Accepted: January 20, 2006 /P P Professor Creedy is Dean, Dr. Mitchell is Deputy Head of School (Logan), Dr. Seaton–Sykes is Web Learning Coordinator, Dr. Cooke is Deputy Head of School, Associate Professor Patterson is Head of School, Dr. Purcell is Senior Lecturer, Research Centre for Clinical and Community Practice Innovation, School of Nursing & Midwifery, and Dr. Weeks is Educational Designer, Griffith Flexible Learning Assistance Service, Griffith Health, Griffith University, Queensland, Australia. /P P This study was supported by the Griffith University DVC Strategic Teaching–Learning Fund. /P P Address correspondence to Debra K. Creedy, PhD, Dean, Research Centre for Clinical and Community Practice Innovation, School of Nursing & Midwifery, Griffith Health, Griffith University, PMB 50 Gold Coast Mail Centre, Queensland 9726, Australia e–mail: a href="mailto:D.Creedy@griffith.edu.au" D.Creedy@griffith.edu.au /a . /P
Publisher: Wiley
Date: 09-2009
Publisher: Elsevier BV
Date: 05-2011
DOI: 10.1016/J.NEDT.2010.07.010
Abstract: Partnerships between university schools of nursing and health services lead to successful learning experiences for students and staff. A purposive s le of academics and students from a university school of nursing and clinicians from three health institutions involved in clinical learning (n=73) actively participated in a learning circles intervention conducted over 5 months in south east Queensland. Learning circle discussions resulted in enhanced communication and shared understanding regarding: (1) staff attitudes towards students, expectations and student assessment (2) strategies enhancing preparation of students, mechanisms for greater support of and recognition of clinicians (3) challenges faced by staff in the complex processes of leadership in clinical nursing education (4) construction of learning, ideas for improving communication, networking and sharing and (5) questioning routine practices that may not enhance student learning. Pre-post surveys of hospital staff (n=310) revealed significant differences across three sub-scales of 'accomplishment' (t=-3.98, p<.001), 'recognition' (t=-2.22, p<.027) and 'influence' (t=-11.82, p<.001) but not 'affiliation'. Learning circles can positively enhance organisational learning culture. The intervention enabled participants to recognise mutual goals. Further investigation around staff perception of their influence on their workplace is required.
Publisher: Springer Science and Business Media LLC
Date: 09-01-2017
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.NEDT.2022.105405
Abstract: Childbearing women's relationship with maternity care providers enhance childbirth outcomes. Students need to understand and offer respectful care. Evaluate effectiveness and impact of an online education intervention on nursing students' perceptions towards respectful maternity care during labour and childbirth in Nepal. A quasi-experimental pre-post design was used. A total of 89 Third Year Bachelor of Nursing students (intervention n = 40 control n = 49) from three participating colleges. Students completed online pre and post-test surveys using the Students' Perceptions of Respectful Maternity Care scale and questions about impact of the intervention. The intervention group received six hours of education delivered online (three sessions x three weeks). ANCOVA and non-parametric Wilcoxon signed-rank tests measured effects. Compared to controls, students in the intervention group reported a significant increase in perceptions towards respectful maternity care (F (1, 86) = 28.19, p < 0.001, η Relatively few intervention studies to promote respectful maternity care in students have been published. This brief online intervention improved students' perceptions. The intervention package can be integrated into nursing or midwifery curricula and in-service training. A larger study with longer follow-up is needed to support current findings.
Publisher: Elsevier BV
Date: 11-2015
DOI: 10.1016/J.AENJ.2015.08.002
Abstract: Presentations to emergency departments (EDs) and patient acuity continue to increase. Whilst strategies to deliver safe patient care in the ED are evolving, emergency nurses need to be well educated through specialist qualifications to enable delivery of advanced patient care. This paper presents a comparative analysis of available international practice and competency standards for nurses graduating from emergency nursing courses in Australia, Canada, New Zealand, the United Kingdom, and the United States. CINAHL, Scopus, Ovid MEDLINE, and Embase were searched for papers, published in English, using the terms: 'emergency', 'accident and emergency', 'nursing', 'competency', 'practice standards', 'scope of practice', 'regulation', and 'specialist standards'. Secondary sources from relevant reference lists and professional websites were also searched. The standards from the five countries were common across five domains: clinical expertise, communication, teamwork, resources and environment, and legal. None of the standards were specific to the emergency nursing graduate, and there was variability in the level of expertise required for which the standards apply. The available practice standards demonstrated some commonality. Consideration of the utility of a universal framework for informing the development of emergency nursing practice standards and emergency nursing curriculum for nurses wishing to specialise is needed.
Publisher: Elsevier BV
Date: 04-2009
DOI: 10.1016/J.MIDW.2007.04.004
Abstract: to describe the development and application of a brief counselling intervention for women who have experienced a traumatic birth. the birthing trauma counselling model reflecting women's need to establish a therapeutic connection with a midwife, talk about their birth experience and have their feelings validated. Gaps in understanding of events need explanation and explicit connections made between the event and subsequent emotions and behaviours. Developing a rational understanding of birthing events and how labour may have been managed differently assists women to revise their assumptions about maternity care and gain a sense of control. Fostering social support, reinforcing positive approaches to coping and exploring solutions to restoring self-confidence and reducing anxiety may help re-establish psychological equilibrium. the counselling intervention is consistent with trauma theory and draws on cognitive behavioural therapy principles. Midwives are well placed to provide counselling support to women experiencing birth-related distress. Further testing of the intervention in the clinical setting with a large s le is required.
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.WOMBI.2017.06.013
Abstract: Continuity of midwifery care contributes to significant positive outcomes for women and babies. There is a perception that providing continuity of care may negatively impact on the wellbeing and professional lives of midwives. To compare the emotional and professional wellbeing as well as satisfaction with time off and work-life balance of midwives providing continuity of care with midwives not providing continuity. Online survey. Measures included Copenhagen Burnout Inventory (CBI) Depression, Anxiety and Stress Scale-21 and Perceptions of Empowerment in Midwifery Scale (PEMS-Revised). The s le (n=862) was ided into two groups midwives working in continuity (n=214) and those not working in continuity (n=648). Mann Whitney U tests were used to compare the groups. The continuity group had significantly lower scores on each of the burnout subscales (CBI Personal p=.002 CBI Work p<.001 CBI Client p<.001) and Anxiety (p=.007) and Depression (p=.004) sub-scales. Midwives providing continuity reported significantly higher scores on the PEMs Autonomy/Empowerment subscale (p<.001) and the Skills and Resources subscale (p=.002). There was no difference between the groups in terms of satisfaction with time off and work-life balance. Our results indicate that providing continuity of midwifery care is also beneficial for midwives. Conversely, midwives working in shift-based models providing fragmented care are at greater risk of psychological distress. Maternity service managers should feel confident that re-orientating care to align with the evidence is likely to improve workforce wellbeing and is a sustainable way forward.
Publisher: Cambridge University Press (CUP)
Date: 16-09-2011
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.MIDW.2014.09.003
Abstract: around 20% of women suffer childbirth fear causing them significant distress and often leading to requests for caesarean section. In Sweden, fearful pregnant women are offered counselling however, in Australia, no dedicated service caters for the specific needs of these women. Indeed scant research has been conducted in Australia and little is known about women's concerns and if these align to those reported in the international literature. to describe the sources, responses and moderators of childbirth fear in a group of pregnant women assessed as having high levels of childbirth fear. comparative analysis was used to identify common concepts and generate themes that represented women's perspectives of childbirth fear. Data consisted of 43 tape recorded telephone conversations with highly fearful pregnant women who were participating in a large randomised controlled trial known as BELIEF (Birth Emotions, Looking to Improve Expectant Fear). women's fears were conceptualised into three themes: fear stimuli fear responses and fear moderators. Lack of confidence to birth, fear of the unknown, internalising other women's negative stories, perineal tearing and labour pain were common concerns for first time mothers. For multiparous women, not having had personal feelings resolved following their previous birth and negative experiences of last birth influenced current expectations for their upcoming birth. Themes common to both groups were: unmet information and support needs, feelings of loss of control and lack of input in to decision-making. Some women however, chose to avoid birth planning in order to cope during pregnancy. Australian women had similar childbirth concerns to those reported in the international literature. However unique to this study was finding two opposing discourses one of preoccupation with negative events and the other avoidance of planning for labour and birth. Provision of woman centred maternity models that minimise obstetric intervention, offer personalised conversations following birth, and are sensitive to identifying listening and assisting women to modify their fears in early pregnancy are required to promote positive anticipation and preparation for birth.
Publisher: Wiley
Date: 06-1992
DOI: 10.1111/J.1365-2648.1992.TB01971.X
Abstract: This paper addresses the need to adopt teaching-learning approaches in nursing education that develop links between theory and clinical practice in a meaningful way. Problem-based learning (PBL) is such an approach and is gaining popularity in tertiary nursing programmes in Australia. PBL, as an ex le of the constructivist philosophy, focuses on students' existing knowledge as a starting point for conceptual change teaching. The implications for the nurse educator's role when using PBL are discussed in terms of assumptions about the nature of teaching and learning conceptual change teaching ability to focus the role of negotiation and the ability to analyse student learning. These factors are seen to be critical components of the pedagogy necessary for nurse educators to utilize PBL approaches effectively.
Publisher: Springer Science and Business Media LLC
Date: 19-10-2021
DOI: 10.1186/S12913-021-07083-Y
Abstract: Hospital presentations provide unique opportunities to detect DFV. However, up to 70% of women experiencing Domestic and Family Violence (DFV) go undetected by hospital staff. While routine DFV screening is internationally encouraged, there is still much debate surrounding its implementation. The aim of the study was to determine staff perceptions of barriers and enablers of DFV screening and response. A cross-sectional survey was conducted at a tertiary level public hospital and health service. Health care staff in allied health, maternity and mental health isions ( n = 615) were invited to participate by email and through team meetings. 172 responses were analysed. Less than a third of respondents reported routinely asking patients about DFV, with 34.9% reporting they did not have sufficient training to assist with DFV. Increased levels of training were positively correlated with screening practices, preparedness and knowledge. Major barriers were presence of partner and language barriers, while written protocols and supportive work environment were the principal enablers of screening. Staff generally believed that routine screening was important and should encompass all forms of abuse. Many felt ill-equipped to ask about or manage disclosure of DFV. More training improves staff capacity for DFV detection and response, and written guidelines should be made available to all staff.
Publisher: Elsevier BV
Date: 07-2020
Publisher: Informa UK Limited
Date: 10-2019
DOI: 10.1080/02646838.2018.1525695
Abstract: This systematic review explores changes in perinatal empathy and influence on maternal behaviours and child development. The well-being and development of infants are commonly linked to their mothers' capacity for empathy. However, characteristic changes during pregnancy and childbirth including sleep deprivation, mood and cognitive difficulties may disrupt empathic processing. Original research papers (n = 7413) published in English language peer-reviewed academic journals were obtained by searching four electronic databases PsycINFO, PubMed, Scopus and CINAHL. Inclusion criteria were studies reporting empathy of women in the period from pregnancy to 12 months postpartum. Empathy was operationalised as a general tendency of empathic emotional responding and cognitive perspective taking. Thirteen studies were systematically assessed using the Critical Appraisal Skills Programme criteria. Impaired empathy in mothers, due most notably to high personal distress, was associated with risk of neglect or maltreatment of children and was partially explained by mothers' aversive response to infant crying. Few studies present empathy as a central theme. There is a paucity of definitional parameters and theoretical linkages and over-reliance on brief self-report indices of empathy. Future studies need to be theory based, incorporate experimental approaches, and provide greater s ling ersity toadvance our understanding of empathy in perinatal women.
Publisher: Wiley
Date: 16-09-2020
DOI: 10.1111/NHS.12756
Abstract: This systematic review aimed to critique the process of development and psychometric properties of tools measuring respectful or disrespectful maternity care experienced by women during labor and birth in low‐ and middle‐income countries. The MEDLINE, Embase, CINAHL, Web of Science, PubMed, and Cochrane Library electronic databases were systematically searched from their inception to February 2020. Methodological quality was assessed using the COnsensus‐based Standards for the selection of health Measurement INstruments checklist. Six tools measuring respectful maternity care during the intrapartum period were identified. Measurement error, cross‐cultural validity, and responsiveness were not evaluated by any tool developers, while structural validity, internal consistency, and hypothesis testing were the most frequently assessed measurement properties. Interestingly, this review could not identify any measures of disrespectful care even though most included measures focused on disrespect and abuse. No measure was of sufficient quality to determine women's experiences of disrespectful and respectful maternity care in low‐ and middle‐income countries. New valid and reliable measures using rigorous approaches to tool development are required.
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.NEPR.2022.103349
Abstract: Evaluate interventions to prepare preceptors for their role in undergraduate health student clinical education. Preceptor training and development are crucial to quality clinical learning experiences for undergraduate health students. The efficacy of education interventions designed for preceptors and use of reliable, valid outcome measures are unclear. A systematic literature review informed by PRISMA Guidelines. Major databases CINAHL, Medline and Google Scholar were searched between January 2010 and November 2021. 1253 articles were initially retrieved. Removal of duplicates and screening by title, abstract and keywords yielded 156 papers. Twenty-one papers fulfilled the inclusion criteria and were assessed using an adapted 'Critical Appraisal Checklist for Reports of Educational Interventions' and the New World Kirkpatrick Model. Most interventions were developed for the nursing profession and evaluated using pre-post-test (86%) or post-test only (5%). Two studies were considered high quality. Most studies (81%) reported positive short-term impact on preceptor knowledge, skills, attitudes and confidence. Two thirds (62%) of included studies measured preceptor behaviour change. No study measured impact related to quality of health care. Small s le sizes limited inferential analyses. Psychometric testing of tools to measure preceptor outcomes was inconsistent and validity and reliability were not reported in most studies. Structure and content of interventions were erse and lacked rigour in outcome measurement. Most interventions demonstrated some positive impact on preceptor development. Objective measures determining longer term impact or how enhanced preceptor development translated into quality clinical student learning support was lacking. Future research should consider how best to measure the impact of educational interventions on broader outcomes such as quality of client care.
Publisher: Elsevier BV
Date: 12-2016
DOI: 10.1016/J.WOMBI.2016.04.010
Abstract: Reducing violence against women is a national public health priority in Australia. Routine antenatal intimate partner violence screening by a skilled midwife is essential for assessment, support and appropriate referral, but can be challenging to implement. To explore midwives' experiences of routine enquiry, perceptions of facilitators and barriers, and suggested strategies to improve practice. A qualitative descriptive design was used. Participants were recruited from an e-mail bulletin by the Australian College of Midwives. In-depth telephone interviews were conducted with 21 midwives. Data were analysed using an inductive thematic analysis approach. Three themes were identified: The first theme Asking the Question incorporated the belief that whilst asking women about intimate partner violence were within the role of the midwife, participants felt unsupported and unprepared. The second theme The big fear factor represented concerns around positive disclosures of intimate partner violence, including a sense of responsibility, worries about encouraging women to disclose without clear processes and resources to support them. The third theme Building a relationship incorporated the importance of continuity of care, trust and rapport-building. Continuity of care was identified as a positive enabler for routine enquiry. A perceived lack of support, time pressures, and presence of a partner at appointments were all considered barriers to routine enquiry. Routine enquiry about IPV is a valuable and important midwifery role. Midwives described frustration and fear when women disclosed violence. The perceived level of support from health services varied according to practice contexts and needs to be improved.
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.NEDT.2018.07.014
Abstract: To explore the experiences and outcomes of health professional students when undertaking education on Indigenous health. An integrative systematic literature review. The search was undertaken from September 2017-November 2017. Six databases were searched: CINAHL, Scopus, Informit Health Collection, Informit Indigenous Collection, Proquest - Nursing and Allied Health Collection and Proquest - Health and Medical Collection. Reference lists of all articles were scanned for further relevant articles. The search strategy was limited to English articles published in the previous decade. Articles were included if they focused on Indigenous health content provided to health professional university students, with a focus on Indigenous populations of Australia, New Zealand, Canada and the United States of America. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided the review. Studies were evaluated for methodological rigour using the CASP rating checklist. Both qualitative and quantitative data were coded using thematic qualitative analysis methods and presented as a meta-aggregation. Twelve articles were included. Synthesis found significant variability in the ways Indigenous health issues were taught and integrated into health programs, particularly with regards to quality, methodological rigour of evaluation, pedagogical approaches and student experiences. Four themes were developed to describe student experiences and learning outcomes. These included: increasing knowledge of Indigenous health emotional responses to content and teaching processes perceived value of Indigenous health education and cultural competence and critical thinking. Methodologically sound longitudinal studies are required to test if early changes in student knowledge and attitudes may be sustained. How students' 'increase in knowledge' translates to cultural capability is unclear, and there is a need for validated tools to measure this construct. A more sophisticated critique of how students emotionally engage with Indigenous health content, including understanding the relationships between 'discomfort' and transformative experiences is required.
Publisher: Elsevier BV
Date: 2015
Publisher: Wiley
Date: 10-1994
DOI: 10.1046/J.1365-2648.1994.20040696.X
Abstract: Problem-based learning (PBL) employs approaches to teaching and learning in nurse education that develop meaningful links between theory and practice. The adoption of such approaches, however, may require changes in pedagogical beliefs and practices which reflect a student-centred approach to teaching and learning. This paper focuses on a group of volunteer nurse educators (n = 14) who attended a 7-month professional development programme centred on introducing pedagogical changes when adopting PBL. From this group, three nurse educators participated in an in-depth study which aimed to examine the processes of conceptual change associated with adopting PBL as part of alternative teaching strategies. These three participants held common concerns about the changes required to their current teaching practices when moving to a new pedagogical approach. On completion of the programme, varying degrees of change in existing instructional practices were evident. This change was found to result from engaging educators in reflection about practice, providing opportunities to implement the new approaches on a trial basis, and providing feedback and support throughout the change process.
Publisher: Academic Journals
Date: 31-07-2014
Publisher: Wiley
Date: 20-09-2008
DOI: 10.1111/J.1365-2648.2008.04757.X
Abstract: This paper is a report on the examination of demographic, birthing and social correlates of maternal role development in childbearing women. Successful adaptation to the maternal role provides a mother with confidence and satisfaction in her ability to nurture and care for her infant. Despite the importance of this developmental process for maternal well-being, little attention has been given to social and demographic predictors of positive role development in recent years. A prospective study was undertaken at three publicly-funded metropolitan antenatal clinics in Queensland, Australia between March and November 2003. A total of 605 women completed a survey at 36 weeks gestation and 12 weeks postpartum, with a response rate of 78% (n = 473). A self-report questionnaire was used to collect data about personal and birth variables, domestic violence, social support and maternal role development. The majority of women (81%) were of White ethnic background, modal age was 30-45 years (40%, n = 189) and 66 percent (n = 312) were in paid employment. Bivariate analysis identified age, marital status, length of relationship and social support to be statistically significantly associated with maternal role development. Optimal scaling showed social support to be the most important factor in maternal role development. Maternal role development following childbirth is complex and can be adversely affected by older maternal age, married status, inadequate social support and short partner relationships. A deeper understanding of this process is needed if healthcare professionals are to assist mothers in making a smooth transition to motherhood.
Publisher: Elsevier BV
Date: 03-2015
DOI: 10.1016/J.WOMBI.2014.10.002
Abstract: Unexplained late gestation stillbirth is a significant health issue. Antenatal information about foetal movements has been demonstrated to reduce the stillbirth rate in women with decreased foetal movements. Midwives are ideally placed to provide this information to women. To investigate pregnant women's perceptions of information about foetal movements and preferences for receiving information. This prospective, descriptive study was conducted in the antenatal clinic of a large metropolitan maternity hospital. Pregnant women (n=526) at 34 weeks gestation or later were recruited. Only 67% of women reported receiving information about foetal movements. Women reported that midwives (80%), family (57%), friends (48%) and own mother (48%) provided this information. Midwives were the most preferred source of information. Around half (52%) of the women used the internet for information but only 11% nominated the web as their preferred information source. Women prefer to be given as much information about foetal movements as possible. Women favour information from health professionals, mainly from a midwife. Midwives are well-placed to partner with pregnant women and give them unbiased and evidenced based information enabling them to make decisions and choices regarding their health and well-being. While the internet is a prevalent information source, women want to be reassured that it is trustworthy and want direction to reliable pregnancy related websites.
Publisher: Elsevier BV
Date: 06-2014
DOI: 10.1016/J.NEDT.2013.10.020
Abstract: Midwives require well developed critical thinking to practice autonomously. However, multiple factors impinge on students' deep learning in the clinical context. Analysis of actual case scenarios using root cause analysis may foster students' critical thinking and application of 'best practice' principles in complex clinical situations. To examine the effectiveness of an innovative teaching strategy involving root cause analysis to develop students' perceptions of their critical thinking abilities. A descriptive, mixed methods design was used. Final 3rd year undergraduate midwifery students (n=22) worked in teams to complete and present an assessment item based on root cause analysis. The cases were adapted from coroners' reports. After graduation, 17 (77%) students evaluated the course using a standard university assessment tool. In addition 12 (54%) students provided specific feedback on the teaching strategy using a 16-item survey tool based on the domain concepts of Educational Acceptability, Educational Impact, and Preparation for Practice. Survey responses were on a 5-point Likert scale and analysed using descriptive statistics. Open-ended responses were analysed using content analysis. The majority of students perceived the course and this teaching strategy positively. The domain mean scores were high for Educational Acceptability (mean=4.3, SD=.49) and Educational Impact (mean=4.19, SD=.75) but slightly lower for Preparation for Practice (mean=3.7, SD=.77). Overall student responses to each item were positive with no item mean less than 3.42. Students found the root cause analysis challenging and time consuming but reported development of critical thinking skills about the complexity of practice, clinical governance and risk management principles. Analysing complex real life clinical cases to determine a root cause enhanced midwifery students' perceptions of their critical thinking. Teaching and assessment strategies to promote critical thinking need to be made explicit to students in order to foster ongoing development.
Publisher: Elsevier BV
Date: 03-2002
Publisher: Wiley
Date: 17-03-2003
DOI: 10.1002/NUR.10073
Abstract: Many new mothers discontinue breastfeeding prematurely because of difficulties encountered rather than maternal choice. Research has shown that a significant predictor of breastfeeding duration is a mother's confidence in her ability to breastfeed. To measure breastfeeding confidence, the Breastfeeding Self-Efficacy Scale (BSES) was developed and psychometrically tested at 1 week postpartum. The purpose of this methodological study was to psychometrically test the BSES antenatally and at 1 week and 4 months postpartum in a s le of Australian women and to determine predictive validity. The psychometric assessment of the original BSES study was replicated, including internal consistency, principal components factor analysis, comparison of contrasted groups, and correlations with a similar construct. Support for predictive validity was demonstrated through positive correlations and significant mean differences between antenatal BSES scores and infant-feeding method at 1 week and 4 months postpartum. The BSES is now considered ready for both research and clinical use (a) to identify new mothers with low breastfeeding confidence who require additional assistance, (b) to assess breastfeeding behaviors and cognitions in order to have in idualized confidence-building strategies, and (c) to assist in the evaluation of various nursing interventions.
Publisher: Wiley
Date: 06-2022
DOI: 10.1111/JAN.15313
Publisher: Wiley
Date: 27-11-2018
DOI: 10.1111/JAN.13491
Abstract: This study aimed to identify personal, professional and workplace factors that contribute to burnout in midwives. Burnout is prevalent in the midwifery workforce. Burnout adversely affects the well-being of midwives, diminishes the quality of care they provide and can shorten career duration. Self-administered online survey. The survey included the Copenhagen Burnout Inventory and personal and professional variables related to age, children, years of experience, role, model of care and satisfaction with work life. Midwives were invited to participate via an email sent from the Australian College of Midwives and through professional networks between June and July 2014. Variables associated with burnout were entered in a multinomial logistic regression. A total of 1,037 responses were received and 990 analysed. The prevalence of moderate to severe personal (N = 643 64.9%) and work-related burnout (N = 428 43.8%) were high. Having children, providing caseload midwifery care and working in a regional area were associated with low burnout. However, midwives registered for 5-10 years were more likely to report work and client-related burnout. Similarly, midwives reporting a lack of satisfaction with work-life balance were also more likely to report personal and work-related burnout. Family-friendly work environments that facilitate work-life balance can help to reduce the personal and organizational costs of burnout. Similarly, providing continuity of midwifery care in a caseload model can facilitate work-life balance and provide significant mental health benefits to participating midwives.
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.SRHC.2016.08.003
Abstract: The rate of caesarean section continues to increase, and there is evidence that childbirth fear is a contributing factor. Insufficient evidence is available on the impact of reducing childbirth fear on health-related quality of life and health service use. We undertook an economic evaluation of a psycho-education counselling intervention offered by midwives to address women's fear of childbirth in Australia. Pregnant women (n = 339) with high childbirth fear were randomised to a midwife-led psycho-education intervention for childbirth fear or to usual care. This paper presents the economic evaluation of the intervention based on health-related quality of life and health service use from recruitment to six weeks postpartum (n = 184). The changes in health-related quality of life after birth (EQ-5D-3L: 0.016 vs. 0.010, p = 0.833, for usual care and intervention) and total health care use cost (AUS$10,110 vs. AUS$9980, p = 0.819) were similar between groups. The intervention did not increase costs however, in a post hoc analysis, the interventions might be cost-effective for those women with very high childbirth fear. This brief psycho-education intervention by midwives did not improve the health-related quality of life of women, and had no impact on overall cost.
Publisher: Wiley
Date: 19-07-2018
DOI: 10.1002/NUR.21885
Abstract: Sleep disturbance is a significant problem affecting around 50% of cancer patients. Non-pharmacological interventions can be used to improve sleep quality in cancer patients, but little is known about the feasibility, acceptability, and effectiveness of auricular point acupressure (APA) to reduce sleep disturbance in women with ovarian cancer undergoing chemotherapy. A pilot randomized controlled trial was conducted at a publicly funded hospital in southern Taiwan. Fifty-five eligible women were approached and 47 women participated. Women randomly assigned to the control group (n = 24) received sleep hygiene practices alone. Women in the intervention group (n = 23) received sleep hygiene practices and APA treatment which involved gentle fingertip pressure at acupoints on the external ear. The Pittsburgh Sleep Quality Index (PSQI) was completed at four time points. Forty women completed the trial giving a retention rate of 85%. Women receiving the intervention reported a 65% reduction in sleep disturbance according to PSQI global scores from Time 1 (mean = 13.2) to Time 2 (mean = 4.65) after 4 weeks of APA treatment. There was a further 10% decrease in PSQI scores at Time 3 (mean = 4.21) after 6 weeks of APA treatment. Compared to controls, women receiving APA had significantly lower PSQI mean global scores at both Time 2 and Time 3 (p < .001). APA treatment for women with ovarian cancer produced significantly improved sleep. Participants found the procedure easy to perform. Pilot findings support the feasibility of a longitudinal study with a larger, representative s le.
Publisher: Springer Science and Business Media LLC
Date: 15-10-2010
DOI: 10.1007/S11121-009-0152-Y
Abstract: The transition to parenthood is often associated with a decline in couple relationship adjustment. Couples (n = 71) expecting their first child were randomly assigned to either: (a) Becoming a Parent (BAP), a maternal parenting education program or (b) Couple CARE for Parents (CCP), a couple relationship and parenting education program. Couples were assessed pre-intervention (last trimester of pregnancy), post-intervention (5 months postpartum), and follow-up (12 months postpartum). Relative to BAP, CCP reduced negative couple communication from pre- to post-intervention, and prevented erosion of relationship adjustment and self-regulation in women but not men from pre-intervention to follow-up. Mean parenting stress reflected positive adjustment to parenthood with no differences between BAP and CCP. CCP shows promise as a brief program that can enhance couple communication and women's adjustment to parenthood.
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.NEDT.2016.05.012
Abstract: Rates of academic success of Indigenous students compared to other students continues to be significantly lower in many first world countries. Professional development activities for academics can be used to promote teaching, learning and support approaches that value Indigenous worldviews. However, there are few valid and reliable tools that measure the effect of academic development strategies on awareness of cultural safety. To develop and validate a self-report tool that aims to measure nursing and midwifery academics' awareness of cultural safety. This study followed a staged model for tool development. This included: generation of items, content validity testing and expert Indigenous cultural review, administration of items to a convenience s le of academics, and psychometric testing. An online survey consisting of demographic questions, Awareness of Cultural Safety Scale (ACSS), and awareness of racism items was completed by academics undertaking a professional development program on cultural safety. Ratings by experts revealed good content validity with an index score of 0.86. The 12-item scale demonstrated good internal reliability (Cronbach's alpha of 0.87). An evaluation of construct validity through factor analysis generated three factors with sound internal reliability: Factor 1 (Cultural Application, Cronbach's alpha=.85), Factor 2 (Cultural Support, Cronbach's alpha=.70) and Factor 3 (Cultural Acknowledgement, Cronbach's alpha=.85). The mean total scale score was 46.85 (SD 7.05, range 31-59 out of a possible 60). There was a significant correlation between scores on the Awareness of Cultural Safety Scale and awareness of racism scores (r=.461, p=.002). Awareness of cultural safety is underpinned by principles of respect, relationships, and responsibility. Results indicated the ACSS was valid and reliable. Completion of the scale aimed to foster purposeful consideration by nursing and midwifery academics about their perceptions and approaches to teaching in order to improve Indigenous student success.
Publisher: Elsevier BV
Date: 12-2011
DOI: 10.1016/J.MIDW.2010.10.008
Abstract: To investigate the prevalence of depression during pregnancy and postpartum period for Jordanian women and identify associated risk factors and maternity service delivery issues. A prospective cross-sectional study. Participants were recruited during the last trimester of pregnancy, provided personal, social and obstetric information, and completed the Edinburgh Postnatal Depression Scale (EPDS), Depression Anxiety and Stress Scale (DASS-21), the Maternity Social Support Scale (MSSS), the Cambridge Worry Scale (CWS), Perceived Self-Efficacy Scale (PSES) and Perceived Knowledge Scale (PKS). All participants were contacted again at six-eight weeks and six months post partum to complete a telephone or face-to-face interview. The postnatal questionnaire included the EPDS, MSSS, and DASS-21. A teaching hospital and five health centres in Irbid city in northern Jordan. Arabic speaking women (n = 353) between the ages of 18 and 45 years, in their last trimester of pregnancy, at low risk for obstetric complications and receiving antenatal care between November 2005 and August 2006. High rates of antenatal (19%) and postnatal depression (22%) were reported. A regression analysis revealed that stress, anxiety, financial problems, perceived lack of parenting knowledge, difficult relationship with the mother-in-law, unplanned pregnancy, and low self-efficacy were associated with antenatal depression. These seven factors accounted for 83% (r(2) = 0.834) of variance in the development of probable antenatal depression. At six-eight weeks post partum, a regression analysis revealed that antenatal depression, unplanned pregnancy, difficult relationship with mother-in-law, dissatisfaction with overall care, stress, lack of social support, giving birth to a female baby, feeling pressured to birth the baby quickly, and perceived low parenting knowledge were associated with postnatal depression. These nine variables accounted for 82% (r(2) = 0.819) of variance in the development of probable PND. Three intrapartum and postpartum variables associated with PND at six-eight weeks (postpartum haemorrhage, unhelpful doctors during labour and birth, and anxiety) were no longer associated with PND at six months. Jordanian women need support to prepare for labour and birth. Postpartum emotional support and assessment of symptoms of depression needs to be incorporated into routine practice. The opportunity for open discussion along with increased awareness and clarification of common misconceptions about antenatal and postnatal depression are necessary. Quality assurance systems would help reduce the rate of invasive obstetric procedures, and give greater emphasis to emotional care provided to women during the perinatal period.
Publisher: Springer Science and Business Media LLC
Date: 27-06-2011
Publisher: Informa UK Limited
Date: 10-2004
Abstract: Health care staff knowledge of mental health is vital in the provision of quality care for older people in residential aged care settings. This paper aims to describe mental health knowledge competence of health care staff in residential aged care through a review of existing literature and to explore the link between knowledge, attitudes and education about older people and mental health. A literature review was conducted using electronic databases and library catalogues to identify articles published in English during the period 1982-2002. There is insufficient evidence within the literature to draw conclusions about staff knowledge levels in relation to mental health, however, the literature identified a link between continuing education, knowledge levels and staff attitudes to older people with mental health disorders. Future studies are needed to investigate existing levels of mental health knowledge among health care staff in residential aged care and to identify and evaluate strategies to enhance their ability to provide care for this population.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2015
Publisher: Wiley
Date: 26-02-2017
DOI: 10.1111/JOCN.13394
Abstract: In this qualitative study, we explored women's pregnancy intentions and experiences of intimate partner violence before, during and after pregnancy. Unintended pregnancies in the context of intimate partner violence can have serious health, social and economic consequences for women and their children. Feminist and phenomenological philosophies underpinned the study to gain a richer understanding of women's experiences. Eleven women who had been pregnant in the previous two years were recruited from community-based women's refuges in one region of the UK. Of the 11 women, eight had unplanned pregnancies, two reported being coerced into early motherhood, and only one woman had purposively planned her pregnancy. Multiple in-depth interviews focused on participants' accounts of living with intimate partner violence. Experiential data analysis was used to identify, analyse and highlight themes. Three major themes were identified: men's control of contraception, partner's indiscriminate response to the pregnancy and women's mixed feelings about the pregnancy. Participants reported limited influence over their sexual relationship and birth control. Feelings of vulnerability about themselves and fear for their unborn babies' safety were intensified by their partners' continued violence during pregnancy. Women experiencing intimate partner violence were more likely to have an unintended pregnancy. This could be attributed to male dominance and fear, which impacts on a woman's ability to manage her birth control options. The women's initial excitement about their pregnancy diminished in the face of uncertainty and ongoing violence within their relationship. Women experiencing violence lack choice in relation to birth control options leading to unintended pregnancies. Interpreting the findings from the victim-perpetrator interactive spin theory of intimate partner violence provides a possible framework for midwives and nurses to better understand and respond to women's experiences of violence during pregnancy.
Publisher: Elsevier BV
Date: 09-2022
Publisher: Elsevier BV
Date: 09-2022
Publisher: Elsevier BV
Date: 12-2003
DOI: 10.1016/S0266-6138(03)00046-9
Abstract: To investigate midwives' breast-feeding knowledge, assess associations between knowledge and role, and report on the validity and reliability of the Breast-feeding Knowledge Questionnaire for the Australian context. Postal questionnaire. National Australia. Midwives (n=3500) who are members of the Australian College of Midwives Inc (ACMI). A response rate of 31% (n=1105) was obtained. Respondents were knowledgeable of the benefits of breast feeding and common management issues. Key areas requiring attention included management of low milk supply, immunological value of human milk, and management of a breast abscess during breast feeding. Participants over the age of 30, possessing IBCLC qualifications having personal breast-feeding experience of more than three months and more clinical experience achieved higher knowledge scores. Role perceptions were positive with 90% of midwives reporting being confident and effective in meeting the needs of breast-feeding women in the early postnatal period. Midwives' role perception contributed 39% of the variance in general breast-feeding knowledge scores and was a significant predictor of participants' breast-feeding knowledge. The level of basic breast-feeding knowledge of Australian midwives was adequate but there are deficits in key areas. Knowledge variations by midwives may contribute to conflicting advice experienced by breast-feeding women. Further research is needed to investigate in-depth breast-feeding knowledge, breast-feeding promotion practices, and associations between knowledge and practice.
Publisher: Wiley
Date: 27-10-2009
DOI: 10.1111/J.1442-2018.2009.00472.X
Abstract: This exploratory descriptive study is part of a larger program that investigated the prevalence and frequency of different forms of intimate partner violence during pregnancy and the immediate post-partum period among Thai women and the associated maternal and neonatal health outcomes. Two case studies are used to illustrate the different experiences of victims, as well as the barriers to seeking help and the strategies used to manage their circumstances. The study highlights the neglect of women's rights by police and community leaders, the attribution of blame to women, and their perceived sense of powerlessness and a lack of knowledge about the available resources.
Publisher: Elsevier BV
Date: 12-2015
DOI: 10.1016/J.SRHC.2015.05.002
Abstract: The WDEQ-A is the most widely used measure of childbirth fear in pregnant women however there is increasing discussion in the literature that simpler, more culturally transferrable tools may offer a better solution to identifying fearful women in clinical practice. To compare the two item Fear of Birth Scale (FOBS) with the 33 item WDEQ-A in a large cohort of Australian pregnant women. Self-report questionnaires during second trimester including Wijma Delivery Expectancy Questionnaire (WDEQ-A) and Fear of Birth Scale (FOBS). Correlation of FOBS and WDEQ-A was tested using Spearman's correlation coefficients. Receiver operating characteristic (ROC) curve assessed the sensitivity and specificity of possible cut-points on the FOBS against WDEQ-A cut-point of ≥85. Sensitivity, specificity, positive and negative predictive values were determined. Fearful and non-fearful women as classified by both instruments were compared for differences in demographic, psycho-social and obstetric characteristics. 1410 women participated. The correlation between the instruments was strong (Spearman's Rho = 0.66, p < 0.001). The area under the ROC was 0.89 indicating high sensitivity with a FOBS cut-point of 54. Sensitivity was 89%, specificity 79% and Youden index 0.68. Positive predictive value was 85% and negative predictive value 79%. Both instruments identified high fear as significantly associated with first time mothers, previous emergency caesarean and women with self-reported anxiety and/or depression. Additionally FOBS identified a significant association between fearful women and preference for caesarean. This study supports the use of the FOBS in clinical practice to identify childbirth fear in pregnant women.
Publisher: Elsevier BV
Date: 11-2023
Publisher: Wiley
Date: 29-12-2019
DOI: 10.1111/PPE.12621
Abstract: Clinical interventions known to reduce the risk of caesarean delivery include routine induction of labour at 39 weeks, caseload midwifery and chart audit, but they have not been compared for cost-effectiveness. To assesses the cost-effectiveness of three different interventions known to reduce caesarean delivery rates compared to standard care and conduct a budget impact analysis. A Markov microsimulation model was constructed to compare the costs and outcomes produced by the different interventions. Costs included all costs to the health system, and outcomes were quality-adjusted life years (QALY) gained. A budget impact analysis was undertaken using this model to quantify the costs (in Australian dollars) over three years for government health system funders. All interventions, plus standard care, produced similar health outcomes (mean of 1.84 QALYs gained over 105 weeks). Caseload midwifery was the lowest cost option at $15 587 (95% confidence interval [CI] 15 269, 15 905), followed by routine induction of labour ($16 257, 95% CI 15 989, 16 536), and chart audit ($16 325, 95% CI 15 979, 16 671). All produced lower costs on average than standard care ($16 905, 95% CI 16 551, 17 259). Caseload midwifery would produce the greatest savings of $172.6 million over three years if implemented for all low-risk nulliparous women in Australia. Caseload midwifery presents the best value for reducing caesarean delivery rates of the options considered. Routine induction of labour at 39 weeks and chart audit would also reduce costs compared to standard care.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2016
DOI: 10.1097/JNR.0000000000000137
Abstract: An increasing number of women from other countries, mostly Mainland China and Southeast Asia, are marrying Taiwanese husbands and settling in Taiwan. Immigration, marriage abroad, and pregnancy may be stressful and adversely affect maternal health. Relatively little research has compared the life stress and depressive symptoms of pregnant women of different ethnic groups living in nonmetropolitan areas in Taiwan. This study investigates the levels of life stress and depressive symptoms in pregnant Taiwanese women and Vietnamese “foreign brides” currently living in southern Taiwan. Eligible women in their last trimester of pregnancy who attended their local antenatal clinic were recruited for the study. Participants completed standardized measures, including the Difficult Life Circumstances Scale, Social Support APGAR Scale, and Edinburgh Postnatal Depression Scale. Two hundred thirty-six Taiwanese women and 44 Vietnamese women participated. Major life difficulties for both groups of women were related to their marital relationship, housing, or health problems. Taiwanese participants reported perceiving financial strain more often than their Vietnamese peers, whereas Vietnamese participants reported perceiving greater concerns regarding their children’s development and about recent physical abuse than their Taiwanese peers. Furthermore, the Vietnamese participants reported less social support and higher rates of antenatal depression than Taiwanese participants. Clinical nurses and midwives should be sensitive to the particular difficulties and insufficient social support faced by pregnant women from different backgrounds in Taiwan. Women from foreign countries or those under unique challenging circumstances may face a particular risk of adverse outcomes. Identifying stresses informs the development of effective nursing interventions and support activities for new mothers and their families.
Publisher: Elsevier BV
Date: 11-2002
Abstract: Surveillance of surgical site infections (SSIs) is an important clinical indicator of quality patient care, yet an increasing number of SSIs manifest after discharge and are not detected through standard surveillance methods. This study evaluated a multimethod approach to postdischarge surveillance of SSIs with use of a cesarean section procedure as a case study. A postdischarge questionnaire was sent on day 30 to women (n = 277) who had undergone cesarean section. A follow-up telephone interview was conducted if the questionnaire had not been returned within 2 weeks, a diagnosis of infection could not be clearly determined from the responses given, or to confirm the diagnosis of infection. If follow-up could not be made, a chart audit was undertaken. A total response rate of 89% (247/277) was obtained. Twenty-one women with SSI were identified through questionnaire responses. Additional strategies of telephone follow-up and chart review of patients with possible infection and of nonresponders identified more postdischarge infections (33%, 14/42). The overall infection rate was 17% (42/247) compared with 2.8% (7/247) at discharge. Postdischarge surveillance approaches need to achieve the best possible response rate, reflect follow-up health care delivery patterns, be cost-effective, gather data from both patients and treating physicians, and use standard definitions to facilitate benchmarking with other health care facilities and surveillance systems. The inclusion of contacting nonresponders in any method of postdischarge surveillance is recommended to determine the most accurate infection rate.
Publisher: Elsevier BV
Date: 2005
DOI: 10.1016/S1322-7696(08)60490-4
Abstract: Psychosocial support groups play an important role in assisting parents to understand and manage the demands of having a child with diabetes. Actual participation in such groups is marred by problems of poor uptake, irregular attendance and attrition. A survey was conducted with a convenience s le of parents to determine their knowledge needs about preferred program characteristics, the management of diabetes, perceived barriers to program participation, and factors facilitating group attendance. A response rate of 66% (n = 40) was achieved. Parents favoured a program that was only conducted monthly or three to six times a year, held during the evening or weekend and of two or three hours duration. Parents were keen to know more about new developments in the treatment of diabetes, and strategies to assist their child when they refuse medication or treatment. The most commonly reported barriers to group attendance were distance, timing of groups, and employment demands. Participants were more likely to attend a support group in order to learn new information or skills, keep up to date, as well as meet parents in the same situation. Support groups need to address both content and practical issues for enhanced support and empowerment of families.
Publisher: Wiley
Date: 16-07-2018
DOI: 10.1002/ACP.3438
Publisher: Wiley
Date: 24-02-2005
DOI: 10.1111/J.1440-0979.2005.00350.X
Abstract: Older people are at risk for developing psychiatric disorders and require highly skilled and knowledgeable nurse practitioners to provide early recognition and intervention of psychiatric problems. This study sought to identify the aged care mental health knowledge of registered nurses (RNs) employed in long-term aged care and test the validity and reliability of a North American tool for use in an Australian context. The Mary Starke Harper Ageing Knowledge Exam (MSHAKE) was sent to RNs (n = 350) in 70 long-term care facilities (LTCF) in Queensland, Australia, and 107 surveys were returned (30.5% response). Participants were found to be unprepared for the reality of caring for the mental health needs of an older population and to have knowledge deficits related to suicide, prevalence of mental illness, mental health and ethnicity, and a number of issues regarding dementia.
Publisher: Wiley
Date: 28-06-2020
DOI: 10.1002/NOP2.543
Publisher: Wiley
Date: 08-1993
Publisher: Elsevier BV
Date: 11-2023
Publisher: Elsevier BV
Date: 06-2021
Publisher: Wiley
Date: 26-10-2020
DOI: 10.1111/NHS.12779
Publisher: MDPI AG
Date: 31-12-2022
Abstract: Accessing good quality abortion care is a fundamental human right and contributes to achieving Sustainable Development Goals. However, well-designed abortion care that meets women’s needs is limited. This study aims to systematically develop an intervention to promote the psychological well-being of Chinese women undergoing an abortion. A five-step iterative approach informed by intervention mapping was undertaken to determine the intervention design. Step 1 used in-depth interviews with 14 Chinese women undergoing an abortion to assess real-life stressors and support needs. We identified eight stressors and found women’s support needs varied with the time trajectory of the abortion. Step 2 used a focus group discussion with care providers to select modifiable stressors that impact negative psychological outcomes. In Step 3 and Step 4, we determined and integrated the exact strategies to eliminate or mitigate possible modifiable stressors by incorporating information from in-depth interviews and the Transactional Model of Stress and Coping. The integrated strategies were instructional support, informational support, and timely communication. In Step 5, we composed the detailed intervention design according to the best available evidence and, to confirm content validity, consulted 10 women who had undergone abortion in the previous 2–6 weeks. The intervention was titled STress-And-coping suppoRT (START), which included four interacting components: (1) a face-to-face consultation at the first appointment (2) a printed booklet with information on abortion, self-care, and managing emotions and intimate relationships (3) a WeChat-based online public profile page offering the same information as the booklet (4) a telephone hotline. This study paves the way for a new approach to addressing the psychological needs of women experiencing abortion in China. The rigorous process provides an ex le of developing tailored health promotion interventions.
Publisher: BMJ
Date: 03-2023
DOI: 10.1136/BMJOPEN-2022-065720
Abstract: To examine available health engagement tools suitable to, or modifiable for, vulnerable pregnant populations. Systematic review. Original studies of tool development and validation related to health engagement, with abstract available in English, published between 2000 and 2022, s ling people receiving outpatient healthcare including pregnant women. CINAHL Complete, Medline, EMBASE and PubMed were searched in April 2022. Study quality was independently assessed by two reviewers using an adapted COSMIN risk of bias quality appraisal checklist. Tools were also mapped against the Synergistic Health Engagement model, which centres on women’s buy-in to maternity care. Nineteen studies were included from Canada, Germany, Italy, the Netherlands, Sweden, the UK and the USA. Four tools were used with pregnant populations, two tools with vulnerable non-pregnant populations, six tools measured patient–provider relationship, four measured patient activation, and three tools measured both relationship and activation. Tools that measured engagement in maternity care assessed some of the following constructs: communication or information sharing, woman-centred care, health guidance, shared decision-making, sufficient time, availability, provider attributes, discriminatory or respectful care. None of the maternity engagement tools assessed the key construct of buy-in. While non-maternity health engagement tools measured some elements of buy-in (self-care, feeling hopeful about treatment), other elements (disclosing risks to healthcare providers and acting on health advice), which are significant for vulnerable populations, were rarely measured. Health engagement is hypothesised as the mechanism by which midwifery-led care reduces the risk of perinatal morbidity for vulnerable women. To test this hypothesis, a new assessment tool is required that addresses all the relevant constructs of the Synergistic Health Engagement model, developed for and psychometrically assessed in the target group. CRD42020214102.
Publisher: Wiley
Date: 20-09-2012
DOI: 10.1111/J.1545-5300.2012.01420.X
Abstract: This study evaluated if the transition to parenthood is a window of opportunity to provide couple relationship education (CRE) to new parents at high risk for future relationship problems. Fifty-three percent of eligible couples approached agreed to participate in CRE and of these 80% had not previously accessed CRE. Couples were a broad representative of Australian couples having their first child, but minority couples were underrepresented. A third of couples had three or more risk factors for future relationship distress (e.g., cohabiting, interpartner violence, elevated psychological distress, unplanned pregnancy). Low education was the only risk factor that predicted drop out. The transition to parenthood is a window of opportunity to recruit certain types of high-risk couples to CRE.
Publisher: Wiley
Date: 06-08-2019
DOI: 10.1002/NAU.24121
Abstract: The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and the Wexner Scale have been included in the International Consortium for Health Outcomes Measurement core outcome set during pregnancy and childbirth, to measure urinary and anal incontinence. The reliability and validity of these instruments have not been fully evaluated in maternity populations. The aim of this study was to conduct a psychometric evaluation of the ICIQ-UI SF and Wexner Scale. Consecutive pregnant women (n = 309) who booked for care at one Australian birth facility between August 2017 and April 2018 completed the online surveys. Women who screened positive for urinary and/or anal incontinence were administered the ICIQ-UI SF and/or Wexner Scale during pregnancy ( <27 and 36-weeks) and postpartum (6 and 26-weeks). Scale internal consistency, construct validity, and responsiveness were evaluated. In women with urinary incontinence, the ICIQ-UI SF demonstrated good internal consistency during pregnancy (baseline and 36 weeks) and 6-weeks postpartum (mean inter-item correlation: 0.47, 0.39, and 0.46, respectively), recorded significant change across three time-points, and was sensitive to group differences in age and obesity during pregnancy. Wexner Scale was unsuitable for psychometric analysis due to insufficient numbers of women with anal incontinence. The ICIQ-UI SF is a valid and reliable instrument to measure urinary incontinence during pregnancy and postpartum. The findings support the inclusion of the ICIQ-UI SF in the International Consortium for Health Outcomes Measurement core outcome set for use during the perinatal period. Psychometric analysis of the Wexner Scale in larger maternity populations is recommended.
Publisher: Elsevier BV
Date: 09-2015
DOI: 10.1016/J.WOMBI.2015.01.009
Abstract: Intimate partner violence is recognised as a global public health issue. Living with intimate partner violence results in poorer health status with reduced quality of life and higher utilisation of health services. Increased awareness, education and training, and an understanding of multi-agency collaboration are vital in order for health practitioners to respond to women experiencing partner violence and abuse. Midwives are well placed to identify, provide immediate support, and refer women onto appropriate support agencies but may lack appropriate education, training or support. To investigate midwives' knowledge of intimate partner violence against women during pregnancy. An online survey link was distributed through the Australian College of Midwives. The survey included personal, professional and practice details, and 25 questions that tested knowledge about intimate partner violence. 152 midwives completed the online questionnaire. Knowledge scores ranged from 27 to 48 (out of a possible 50), with the mean total score of 42.8 (SD=3.3). Although 60% of participants scored 48, two-thirds did not know about the risks and signs of intimate partner violence. One-third of the midwives did not know about age risks associated with intimate partner violence. Around 25% incorrectly believed that perpetrators are violent because of alcohol or drug use. Nearly 90% (88%) of participants had some education or training about intimate partner violence. Those with some training achieved higher knowledge scores than those with no formal training (Mann-Whitney U=1272, p=0.003). Participating midwives generally reported a high level of knowledge about intimate partner violence but held misconceptions about risks and characteristics of perpetrators of violence. These knowledge gaps may adversely affect their ability to identify women at risk of violence. Education about intimate partner violence was associated with improved knowledge. Future training and education on intimate partner violence should target identified knowledge gaps.
Publisher: MDPI AG
Date: 07-07-2022
DOI: 10.3390/NU14142799
Abstract: Preterm birth is a leading cause of neonatal and child mortality and morbidity worldwide. The aim of this study was to investigate associations between attending a brief antenatal lifestyle education seminar and preterm birth, and whether education timing modifies outcomes. A retrospective cohort study was conducted in a hospital-based antenatal care center in Beijing, China, where a free, 2 h, optional, face-to-face, midwife-led group seminar on healthy lifestyle choices during pregnancy was provided. Among the 3008 eligible women, 1107 (36.8%) attended the seminar during the first trimester, 515 (17.1%) attended during the second trimester or later, and 1386 (46.1%) did not attend. Multiparous women were more likely to not attend or to attend at a later stage. The overall prevalence of preterm birth was 8.7%, but it was higher for women who did not attend the antenatal seminar (11.5%). The risk of preterm birth for first trimester attendees decreased by 53%, and it decreased by 41% for later attendees. Estimates persisted after adjusting pre-existing and gestational covariates. Attending a brief antenatal lifestyle education seminar was associated with lower preterm birth risk, and attending during the first trimester had a better impact than later attendance. The results can inform the development of tailored preterm birth prevention strategies.
Publisher: Elsevier BV
Date: 02-2021
Publisher: Elsevier BV
Date: 12-2001
DOI: 10.1071/HI01111
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.MIDW.2022.103456
Abstract: To investigate the prevalence of depression, anxiety, and stress symptoms in Jordanian midwives and identify associated factors. Setting and participants: This descriptive, cross-sectional study was conducted with a s le of 321 registered midwives from 18 public hospitals in Jordan that provide antepartum, intrapartum, postpartum care, and family planning services. The survey included the Depression, Anxiety, and Stress Scale (DASS-21) and demographic and professional data forms. High rates of depression (76.2%) anxiety (85.3%) and stress (66.8%) symptoms were reported among midwives in Jordan. Midwives aged between 22 - 30 years reported more depression, anxiety, and stress symptoms than midwives in the other age groups. Married midwives had higher depression symptoms than single midwives. Midwives with 10 women per shift had higher anxiety and stress symptoms than midwives caring for five or less women per shift. Midwives who rotated between shifts had higher depression and stress symptoms than midwives who did not rotate. Rates of depression, anxiety, and stress symptoms reported by Jordanian midwives were higher than rates reported by midwives in other countries. The high rates of distress highlight the urgent need for national strategies to support the emotional wellbeing and retention of midwives within Jordanian settings.
Publisher: Elsevier BV
Date: 02-2021
DOI: 10.1016/J.NEDT.2021.105219
Abstract: Undergraduate health students learn cultural safety in complex and emotional ways. Pedagogies that account for these complexities must be developed and evaluated. To evaluate a First Peoples-led emotion-based pedagogical intervention on non-Indigenous health professional students' development towards cultural safety. A pre-post mixed-methods intervention design. All undergraduate health students undertaking a semester-long First Peoples cultural safety course (n = 395) were invited to participate. The intervention involved students' written reflections and comfort (1 = very uncomfortable to 5 = very comfortable) with workshop content, using a gawugaa-gii-mara (head, heart, hands) form. The educator analysed student responses collected on the form, to prompt discussion in a series of four workshops. Students also completed the online 20-item Student Emotional Learning in Cultural Safety Education Instrument (SELCSI) which has two scales, Witnessing and Comfort. gawugaa-gii-mara responses were thematically coded. Paired s le t-tests examined differences over time. Eta squared determined effect size. There were 102 matched pre-post-intervention surveys. Both SELCSI scales had excellent internal consistency (Witnessing α = 0.80, Comfort α = 0.92). A statistically significant difference was observed between students' mean scores on the Witnessing scale prior to the course (M = 47.10, SD = 6.51) compared to post-course (53.04, SD = 4.80), t(95) = 8.70, p < 0.001 (two-tailed) with a large effect size (d = 0.88). Most Comfort scale items increased but were not statistically significant. Data from the gawugaa-gii-mara intervention (n = 162 written responses) revealed students were challenged by self-reflexivity. There was a disconnect between what students had learnt (gawugaa), what they had felt (gii) and how this would be applied in professional practice (mara). The First Peoples-led, emotions-based pedagogical intervention was brief, meaningful and effective. As students grappled with their emotional connection to self-reflexivity as well as their ability to translate new knowledge into culturally safe practice, these offer important avenues for future research.
Publisher: SAGE Publications
Date: 02-12-2016
Abstract: Newborns who are compromised at birth require rapid attention to stabilize their respiration attempts. Lack of knowledge regarding basic newborn resuscitation is a contributing factor to poor newborn health outcomes and increased mortality. The purpose of this study was to explore Jordanian midwives’ experiences, education, and support needs to competently perform basic newborn resuscitation. Qualitative descriptive methodology was used to analyze a convenience s le of 20 midwives. A thematic approach was used to analyze the data. Participants discussed their experiences of basic newborn resuscitation including knowledge, skills, and barriers and suggested solutions to improve practice. Four themes were revealed: lack of knowledge and skills in newborn resuscitation, organizational constraints, inadequate teamwork, and educational needs. The midwives perceived that their ability to perform newborn resuscitation was hindered by lack of knowledge and skills in newborn resuscitation, organizational constraints (such as lack of equipment), and poor co-ordination and communication among team members.
Publisher: Wiley
Date: 05-06-2009
DOI: 10.1111/J.1365-2702.2008.02670.X
Abstract: This study investigated registered nurses' knowledge of documentation used in aged-care nursing home facilities in Queensland, Australia. The purpose of nursing documentation is to communicate health information, facilitate quality assurance and research, demonstrate nurses' accountability and, within Australia, to support funding of residents' care. Little is known about the relationship between RNs' knowledge of nursing documentation, the documentation process within residential aged care and the outcomes of the documentation. Cross-sectional, retrospective design. The study was conducted with a large s le of RNs (n = 360) located in 162 Queensland aged-care facilities. Participants completed a postage-return questionnaire in which they identified factors that influence their knowledge and understanding of documentation. Participants reported that they have considerable knowledge of nursing documentation. They also indicated that they were most knowledgeable about policies on documentation and writing discharge instructions. However, their knowledge of nursing assessments ranked fifth and they were least knowledgeable about reading reports each shift. The modified version of Edelstein's questionnaire provided a valid and reliable instrument for measuring RNs' knowledge of nursing documentation. A factor analysis of the 16 items in the Knowledge scale showed excellent reliability. The data indicated that RNs in aged-care facilities have high levels of knowledge about documentation. Specific recommendations relate to the implementation of comprehensive documentation education programs that reflect the needs of organisations and the level of RNs' skills and knowledge concerning documentation. Accurate nursing documentation is relevant to residents' care outcomes and to government funding allocations. Measuring RNs' knowledge of nursing documentation can identify factors that impede and facilitate their documentation of care.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2019
DOI: 10.11124/JBISRIR-2017-003589
Abstract: The objectives of this review are to:
Publisher: Elsevier BV
Date: 2015
Publisher: Elsevier BV
Date: 08-2021
Publisher: Elsevier BV
Date: 11-2020
Publisher: Springer Science and Business Media LLC
Date: 12-2018
Publisher: Elsevier BV
Date: 12-2010
DOI: 10.1016/J.APNU.2010.04.003
Abstract: This study, which is part of a larger research program, examined the health education needs of family caregivers providing care and support for an adolescent relative with schizophrenia or mood disorder in Taiwan. Family caregivers reported significant unmet information needs, and those with higher incomes or educational levels were more likely to report unmet educational needs. Caregivers using information resources consistently had high unmet educational needs. Results revealed the importance of assessing specific educational needs of families, as educational needs of caregivers differed according to diagnostic group, especially with regard to etiology, symptoms, and coping strategies.
Publisher: Wiley
Date: 03-2012
Publisher: Wiley
Date: 23-06-2016
DOI: 10.1111/JOCN.13290
Abstract: To investigate acute care nurses' perceptions of spirituality and spiritual care and relationships with nurses' personal and professional characteristics. Spirituality and spiritual care are often neglected or absent in daily nursing practice. Nurses' perceptions of spirituality can be influenced by personal, professional and social factors and affect the provision of spiritual care. A cross-sectional, exploratory, nonexperimental design was used. All nursing staff (n = 1008) from a large acute care hospital in Singapore were invited to participate. Participants completed a demographic form and the Spiritual Care-Giving Scale. Completed surveys were received from 767 staff yielding a response rate of 76%. Descriptive statistics and General Linear Modelling were used to analyse data. Acute care nurses reported positive perceptions of spirituality and spiritual care. Religion, area of clinical practice and view of self as spiritual were associated with nurses' reported perspectives of spirituality and spiritual care. Nurses working in this acute care hospital in Singapore reported positive perceptions of spirituality and spiritual care. Respondents tended to equate religion with spirituality and were often unclear about what constituted spiritual care. They reported a sense of readiness to apply an interprofessional approach to spiritual care. However, positive perceptions of spirituality may not necessarily translate into practice. Spiritual care can improve health outcomes. Nurses' understanding of spirituality is essential for best practice. Interprofessional collaboration with clinicians, administrators, educators, chaplains, clergy and spiritual leaders can contribute to the development of practice guidelines and foster spiritual care by nurses. Further research is needed on the practical applications of spiritual care in nursing.
Publisher: Elsevier BV
Date: 09-2004
Publisher: Wiley
Date: 16-07-2002
DOI: 10.1046/J.1440-172X.2002.00359.X
Abstract: Emergency department nurses are often required to assess and manage the needs of people who self-harm. A survey of 352 nurses working within 23 major public and 14 major private emergency departments in Queensland, Australia, investigated the extent to which formal and informal procedures are available and the extent to which these procedures guide how nurses respond to clients who present with deliberate self-harm. The Risk Assessment Questionnaire was developed and found that nurses are frequently called to respond to clients presenting because of deliberate self-harm, but most have no formal training in this area. In some services there is a lack of formal and comprehensive procedures for assessment and treatment. Where procedures do exist, significant therapeutic areas related to assessment are not explored with clients. These findings have implications for continuing professional development activities, nursing education programs and clinical practice procedures.
Publisher: Wiley
Date: 12-2002
DOI: 10.1046/J.1523-536X.2002.00202.X
Abstract: Although much research has focused on identifying factors that influence breastfeeding initiation and duration, many high-risk factors are nonmodifiable demographic variables. Predisposing factors for low breastfeeding duration rates that are amenable to supportive interventions should be identified. The purpose of this study was to assess the effect of maternal confidence (breastfeeding self-efficacy) on breastfeeding duration. A prospective survey was conducted with 300 women in the last trimester of pregnancy recruited from the antenatal clinic of a large metropolitan hospital in Brisbane, Australia. Telephone interviews were conducted at 1 week and 4 months postpartum to assess infant feeding methods and breastfeeding confidence using the Breastfeeding Self-Efficacy Scale. Although 92 percent of participants initiated breastfeeding, by 4 months postpartum almost 40 percent discontinued and only 28.6 percent were breastfeeding exclusively the most common reason for discontinuation was insufficient milk supply. Antenatal and 1-week Breastfeeding Self-Efficacy Scale scores were significantly related to breastfeeding outcomes at 1 week and 4 months. Mothers with high breastfeeding self-efficacy were significantly more likely to be breastfeeding, and doing so exclusively, at 1 week and 4 months postpartum than mothers with low breastfeeding self-efficacy. Maternal breastfeeding self-efficacy is a significant predictor of breastfeeding duration and level. Integrating self-efficacy enhancing strategies may improve the quality of healthcare that healthcare professionals deliver and may increase a new mother's confidence in her ability to breastfeed, and to persevere if she does encounter difficulties.
Publisher: Elsevier BV
Date: 09-2019
Start Date: 2012
End Date: 2014
Funder: National Health and Medical Research Council
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