助产士在职教育现状与需求的调查分析

目的了解助产士在职教育现状与需求,为助产士在职教育的开展提供有效依据。方法采用自制问卷于2010年11月对杭州市263名在职助产士的在职教育现状与需求进行调查。结果 86.7%助产士认为在职教育有必要;65.8%助产士在职接受进修和短期培训;50.2%助产士认为应重视实践技能培训。结论在职教育是以提高助产士的业务知识、服务态度和专业技能为目标,必须体现在职教育的有效性;培训内容和方式应从培训者的需求出发,对临床助产有一定的指导意义和实用价值,能真正体现职后教育的实效性。     

PDCA在助产士实习生带教中应用体会

临床实习是护理教学的重要环节,是综合培养学生运用所学的知识和基本理论分析问题、解决问题能力的重要环节。如何做好临床带教工作,加强学生全面素质的临床综合能力的培养,是护理带教老师面临的重要问题。为了提高产房教学质量,我们依据PDCA带教系统,使教与学有程序,质与量可监控,促进教学质量的良性循环。     

Midwives’ perspectives of the challenges in mentoring students: A qualitative survey

ProblemNational professional standards dictate that all practitioners should provide mentorship to students, however students often report a lack of interest from many mentors while on placement.BackgroundIt is important that academic researchers investigate issues that can inform us of how the student/mentor relationship is facilitated and supported.AimThe aim of the project was to explore the perspectives of midwifery mentors who had experienced challenges with mentoring students, to determine what the challenges are, and what support they need, as mentors.MethodsAn online anonymous survey containing qualitative questions was used to identify the challenges faced by mentors, and asked them to provide recommendations for improving their delivery of mentorship. Three themes emerged; challenges of providing mentorship – student related; challenges of providing mentorship – work related; and what needed to be done to improve mentoring.DiscussionMentors shared their experiences of mentoring students and the issues they had faced.ConclusionsRecommendations are made that acknowledges the important role of midwifery mentorship and suggest the introduction of preparation for mentorship training for midwives working with students.     

广东省助产士心理暴力状况的调查研究

目的 了解广东省的助产士工作场所心理暴力的流行情况及其影响因素.方法 采用分层随机整群抽样的方法对广东省21个市共110家医院的1092名助产士进行自制式问卷调查,调查内容包括调查对象的一般情况、组织环境管理因素、社会因素、个人因素和心理暴力发生情况,回收有效问卷1018份.结果 助产士心理暴力的发生率为83.8％,6.6％的助产士在半年内遭受心理暴力的次数＞11次.结合单因素分析结果,助产士心理暴力的发生受医院等级、医院性质、发生职业暴露后及时处理并上报主管部门情况、超负荷工作、助产专业隶属于护理专业5个因素影响.结论 助产士的心理暴力发生率较高,需针对产房的工作性质开展工作场所暴力防范与应对措施教育,提高助产士防范心理暴力的能力.     

An important task: Midwives’ experiences of identifying children at risk of neglect

BackgroundNeglect is a form of child abuse in which the child’s basic needs are not met. Early identification of the risk factors and protective factors is key to intervention strategies when a child is at risk of neglect. Few international studies describe midwives’ experiences of identifying children at risk of neglect, and no Swedish studies have been found.ObjectivesThe aim was to describe midwives’ experiences of identifying children at risk of neglect.MethodA qualitative method with a phenomenological reflective lifeworld approach. Interviews with ten midwives from two hospitals and six antenatal clinics in the western part of Sweden, with six from antenatal care and four from postpartum care.ResultsThe essential structure of midwives’ experiences is described as an important dimension of their profession that is a difficult, complex, ambiguous, and divided task. There is a fear of losing the relationship with the woman and worry about misinterpreting signals. Professional differences may arise when midwives are questioned by colleagues on decisions they have made when identifying children at risk of neglect. Midwives expressed their desire to work in a cohesive maternity healthcare system so that the women experience continuity during pregnancy, childbirth, and postpartum care.ConclusionsThe study shows how midwives, during both antenatal and postpartum care, have an important but difficult task in identifying children at risk of neglect. During pregnancy and postpartum care, midwives in Sweden meet almost all women and therefore have a unique opportunity for early detection and action.     

基层医院助产士核心自我评价对工作倦怠的负向预测

目的探讨基层医院助产士核心自我评价对工作倦怠的预测。方法采用核心自我评价量表和工作倦怠量表对45名临床一线助产士进行调查。结果核心自我评价的总分为(33.46±4.96)分;工作倦怠测评中,个人成就感降低得分低于杭州常模,情感耗竭和去人格化得分高于杭州常模;核心自我评价与工作倦怠中的去人格化、情感耗竭有相关性。结论基层医院助产士的核心自我评价水平与工作倦怠呈负相关。     

Eat Well Keep Active: Qualitative findings from a feasibility and acceptability study of a brief midwife led intervention to facilitate healthful dietary and physical activity behaviours in pregnant women

Backgroundoverweight and obesity in the pregnant population is increasing and this is a public health concern. Many women have difficulty in following the recommendation to maintain a healthy diet and to keep active, indeed some identify pregnancy as the start of their concern with being overweight.Objectiveto assess the feasibility and acceptability of the ‘Eat Well Keep Active’ intervention programme designed to promote healthy eating and physical activity in pregnant women. This brief midwife led intervention was based upon the Self Determination Theory (SDT) framework and utilised Motivational Interviewing and individualised goal setting.Designthis was a prospective qualitative study to explore women's views on the acceptability and perceived efficacy of the ‘Eat Well Keep Active’ programme obtained through one-to-one interviews 6 weeks after the delivery of the intervention. Data were also analysed to assess fidelity of the intervention to the psychological constructs of SDT; autonomy, competence and relatedness.SettingWales, UK.Participantspregnant women suitable for Midwife Led Care and therefore deemed to be ‘low risk’ were recruited from a large maternity unit in South Wales (n=20).Findingsthe results indicated that the ‘Eat Well Keep Active’ intervention programme was well received by participants who reported that it positively influenced their health behaviours. There was clear evidence of the intervention supporting the three SDT psychological needs.Key conclusionsThe Eat Well Keep Active intervention was designed to be incorporated into existing antenatal provision and findings from this study have demonstrated its acceptability. The brief midwife led intervention based on SDT was found to be acceptable by the participants who embraced the opportunity to discuss and explore their lifestyle behaviours with a midwife.Implications for practicetheoretically designed interventions that can facilitate women to pursue a healthy lifestyle during pregnancy are lacking and the ‘Eat Well Keep Active’ programme has the potential to address this. Further research is needed in order to assess the acceptability of the intervention to midwives and other groups of pregnant women prior to assessing its efficacy in changing and maintaining healthful behaviours.     

'She sort of shines': midwives' accounts of 'good' midwifery and 'good' leadership

Objective

to explore midwives’ accounts of the characteristics of ‘good’ leadership and ‘good’ midwifery.

Design and methods

a phenomenological interview survey. Participants were asked about what made both good and poor midwives and leaders.

Setting

two maternity departments within National Health Service trusts in the North West of England.

Participants

qualified midwives, selected by random sampling stratified to encompass senior and junior grades.

Analysis

thematic analysis, carried out manually.

Findings

ten midwives were interviewed. Sixteen codes and six sub-themes were generated. Across the responses, two clear dimensions (themes) were identified, relating on the one hand to aspects of knowledge, skill and competence (termed ‘skilled competence’), and on the other hand to specific personality characteristics (termed ‘emotional intelligence’). This study suggests that the ability to act knowledgeably, safely and competently was seen as a basic requirement for both clinical midwives and midwife leaders. The added element which made both the midwife and the leader ‘good’ was the extent of their emotional capability.

Conclusions and implications for practice

this small-scale in-depth study could form the basis for hypothesis generation for larger scale work in this area in future. The findings offer some reinforcement for the potential applicability of theories of transformational leadership to midwifery management and practice.