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.     

中国助产士人力资源现状调查研究

目的通过调查了解全国的助产士人力资源现状。方法 2017年12月—2018年11月,通过判断抽样和便利抽样法选取中国妇幼保健协会成员机构中的三级和二级医院作为调查对象,使用自行编制的中国助产士人力资源现状调查表进行数据收集,调查单位覆盖国内22个省、自治区、直辖市。结果共发放问卷1 254份,共回收有效问卷1 213份,问卷的有效率为97.4%;国内产科平均床位使用率为90%;平均每所医院拥有助产士12名,以25～34岁、工作年限<10年、初级职称的助产士为主;助产士的平均外出培训率为12%;不同等级和类型医院的年分娩量、产科床位使用率、助产士人数和构成比较,差异有统计学意义(P<0.05)。结论国内助产士的人员紧缺状况有所缓解但人力仍不足,助产士的学历提升,但助产人员内部构成仍不合理,且不同等级和类型助产医疗机构的资源利用率不同,需进一步开展助产专科教育和培训,优化助产士人力资源配置,实现合理利用助产资源。     

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。     

Written nutrition communication in midwifery practice: What purpose does it serve?

Objective

to obtain an in-depth understanding of verbal and written nutrition communication in Dutch midwifery practice.

Design, setting and participants

data were collected by recording 12 initial antenatal consultations (12 weeks into the pregnancy) with primiparous women from four Dutch midwifery practices spread over The Netherlands, followed by two semi-structured qualitative interviews with the women. The interviews were undertaken on the day after the consultation and two weeks later.

Findings

analysis of the recordings revealed that a nutrition brochure was offered in an information pack, but it was not used or referred to by the midwives. Verbally, clients were informed about healthy nutrition in general terms. Specific, personally relevant nutrition-related questions and motivators of nutrition behaviour were rarely clarified and addressed. Midwives tried to create a good relationship with their clients by being friendly, complimentary, confirmative and supportive. Women appreciated talking about nutrition with the midwife because of her expertise. The subsequent interviews with the women revealed, however, that nutrition communication took place relatively late in pregnancy at a point when women were more interested in ‘hearing the baby's heart beat’. Furthermore, clients seldom looked through the nutrition brochure at home.

Key conclusion

the provision of a nutrition brochure does not serve any real purpose.

Implications for practice

to reach optimal synergy between verbal and written nutrition communication in midwifery practice, midwives should actively refer to a nutrition brochure in addition to verbal communication. Moreover, health organisations should realise that the provision of nutrition brochures to midwives does not mean that these brochures will be used as an integral part of midwives’ nutrition communication with clients.     

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.     

助产士门诊对低危初产妇分娩意向改变影响的质性研究

目的：了解助产士门诊的开设对于首次助产士门诊分娩意向为剖宫产的低危孕产妇分娩意向改变的体验,为助产士门诊的开设提供依据。方法：运用质性研究的方法,对符合纳入标准的16例低危孕产妇在助产士门诊进行深度访谈,用现象学方法分析访谈资料。结果：助产士门诊首次分娩意向为剖宫产的低危孕妇主要体验有四个方面：分娩意向的改变;自然分娩疼痛的客观认知及有效心理建设;助产士门诊多元化、长跨度、一对一的宣教形式;产时应对能力的提升。结论：助产士门诊的介入能够改变低危初产妇分娩意向,增加自然分娩的信心及应对能力,给孕妇正性分娩体验。     

助产士主导伙伴式导乐陪伴分娩193例临床观察

目的：探讨助产士主导伙伴式导乐陪伴分娩的临床效果。方法：选取2010年8月-2012年8月在本院分娩的386例产妇,按照随机数字表法将其分为观察组和对照组各193例。对照组产妇给予常规护理措施,观察组产妇在常规护理基础上加以伙伴式导乐陪伴分娩,比较两组产妇分娩方式、产后出血率、新生儿窒息率及总产程时间。结果：观察组自然分娩率为84.5%,对照组自然分娩率为65.3%;观察组自然分娩率显著高于对照组（P〈0.05）;观察组产妇产后出血率、新生儿窒息率及总产程时间均显著低于对照组（P〈0.05）。结论：在产妇分娩时应用助产士主导伙伴式导乐分娩,可有效提高自然分娩率,缩短产程,降低产后出血率和新生儿窒息率,值得在临床上应用和推广。