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Yao Y. Research on influencing factors of college teachers' second child fertility intentions--Taking Jinan as an example. PLoS One 2024; 19:e0299838. [PMID: 38771815 PMCID: PMC11108140 DOI: 10.1371/journal.pone.0299838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 02/16/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Fertility intentions, as a direct driver of fertility behavior, play an important role in the implementation of national fertility policy and population development. This study explored the influencing factors of college teachers' second child fertility intentions in Jinan, China on the basis of TPB. METHODOLOGY/PRINCIPAL FINDINGS Based on the theory of planned behavior, this paper employs basic characteristics analysis, difference analysis, and factor analysis related to the fertility intentions of the participants. Analysis found participants between 31 and 40 years old had the highest second child fertility intentions, and participants with a college-age first child had the lowest second child fertility intentions. Attitude and subjective norms had a positive impact on second child fertility intentions, and policy awareness had a positive impact on attitude, which indirectly affected second child fertility intentions. Subjective norms had the greatest influence on second child fertility intentions, followed by attitude, and policy awareness had the least influence on second child fertility intentions. SIGNIFICANCE/FUTURE RESEARCH The findings of this paper can enrich the theoretical research on fertility intentions, and also provide more optimal practical references for the formulation and propagation of China's fertility policy as well as the improvement of the division of family roles in China. Future research can further explore the impact of fertility policy on the fertility intentions of other groups.
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Affiliation(s)
- Yanling Yao
- School of Information Engineering, Shandong Management University, Jinan, Shandong, China
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Ouma EG, Orango O, Were E, Omwodo KA. Labour pain relief practice by maternal health care providers at a tertiary facility in Kenya: An institution-based descriptive survey. PLoS One 2024; 19:e0299211. [PMID: 38452017 PMCID: PMC10919675 DOI: 10.1371/journal.pone.0299211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 02/07/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Although pain relief is a crucial component of modern obstetric care, it remains a poorly established service in sub-Saharan countries such as Kenya. Maternal health care providers have an extensive role to play in meeting the analgesic needs of women during childbirth. This study sought to examine the practice of labour pain relief among Kenyan maternal health care providers. METHODS This was an institution-based, cross-sectional, descriptive survey. The study included midwives, obstetricians, and anaesthesiologists (n = 120) working at the second-largest tertiary facility in Kenya. A structured, self-administered questionnaire was used. The labour pain relief practice, knowledge, attitude, and perceived barriers to labour pain management were described. RESULTS One hundred and seventeen respondents participated in the study representing a response rate of 97.5%. More than half of maternal health care providers routinely provided the service of labour pain relief (61.5%). Sixty-four (88.9%) respondents reported providing pharmacological and non-pharmacological methods, while 11.1% provided only pharmacological ones. The most common pharmacological method prescribed was non-opioids (12.8%). The most preferred non-pharmacological method of pain management was touch and massage (93.8%). Regional analgesia was provided by 3.4% of the respondents. More than half of the respondents (53%) had poor knowledge of labour pain relief methods. Almost all (94%) of the respondents had a positive attitude towards providing labour pain relief. Non-availability of drugs and equipment (58.1%), lack of clear protocols and guidelines (56.4%), and absence of adequate skilled personnel (55.6%) were reported as the health system factors that hinder the provision of labour analgesia. CONCLUSIONS More than half of maternal health care providers routinely relieve labour pain. Epidural analgesia is still relatively underutilized. There is a need to develop institutional labour pain management protocols to meet the analgesic needs of women during childbirth.
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Affiliation(s)
- Eliazaro Gabriel Ouma
- Department of Reproductive Health, School of Medicine, Moi University, Eldoret, Kenya
| | - Omenge Orango
- Department of Reproductive Health, School of Medicine, Moi University, Eldoret, Kenya
| | - Edwin Were
- Department of Reproductive Health, School of Medicine, Moi University, Eldoret, Kenya
| | - Kimbley Asaso Omwodo
- Department of Reproductive Health, School of Medicine, Moi University, Eldoret, Kenya
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Elgzar WT, Alshahrani MS, Ibrahim HA. Non-pharmacological labor pain relive methods: utilization and associated factors among midwives and maternity nurses in Najran, Saudi Arabia. Reprod Health 2024; 21:11. [PMID: 38268021 PMCID: PMC10809473 DOI: 10.1186/s12978-023-01737-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/29/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Traditionally, pharmacological pain relief methods have been the most acceptable option for controlling labor pain, accompanied by numerous adverse consequences. Non-pharmacological labor pain relive methods can reduce labor pain while maintaining an effective and satisfying delivery experience and delaying the use of pharmacological methods. This study explores the utilization of non-pharmacological labor pain relive methods and its associated factors among midwives and maternity nurses. METHODS A cross-sectional research was conducted in Maternal and Children Hospital/Najran, Saudi Arabia, from April to May 2023 and incorporated a convenience sample of 164 midwives and maternity nurses. The data was collected using a self-reported questionnaire composed of five sections; basic data, facility-related factors, non-pharmacological labor pain relive utilization and attitude scales, and knowledge quiz. A logistic regression was used to determine the associated factors with non-pharmacological labor pain relive utilization. RESULTS The results revealed that 68.3% of participants utilized non-pharmacological labor pain relive methods. The midwives and maternity nurses helped the parturient to tolerate labor pain by applying the non-pharmacological labor pain relive methods, including; positioning (55.5%), breathing exercises (53.7%), comfortable and relaxing environment (52.4%), therapeutic communication (47%), positive reinforcement (40.9%), relaxation (40.2%), and therapeutic touch (31%). In addition, working unit, providers-patient ratio, working hours, non-pharmacological labor pain relive training, years of experience, and non-pharmacological labor pain relive attitude were significant determinants of non-pharmacological labor pain relive utilization (P < 0.05). CONCLUSIONS High non-pharmacological labor pain relive utilization was significantly associated with nurses' older age and higher education, working in the delivery room, lower nurse-patient ratio, lower working hours, in-services training, increased years of experience, and positive attitude. The study sheds light on the importance of handling the pre-mentioned factors to enhance non-pharmacological labor pain relive utilization.
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Affiliation(s)
- Wafaa T Elgzar
- Department of Maternity and Childhood Nursing, Nursing College Najran University, Najran, Kingdom of Saudi Arabia
| | - Majed S Alshahrani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Najran University, Najran, Saudi Arabia
| | - Heba A Ibrahim
- Department of Maternity and Childhood Nursing, Nursing College Najran University, Najran, Kingdom of Saudi Arabia.
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Saleh L. Relationships Among Individual and Hospital Characteristics and Self-Efficacy in Labor Support Among Intrapartum Nurses in Texas. J Obstet Gynecol Neonatal Nurs 2024:S0884-2175(23)00296-4. [PMID: 38215792 DOI: 10.1016/j.jogn.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVE To explore the relationships among individual and workplace characteristics and self-efficacy in labor support among intrapartum nurses. DESIGN Cross-sectional survey. SETTING Online distribution from April to August 2020. PARTICIPANTS Members of the Texas section of the Association for Women's Health, Obstetric, and Neonatal Nurses (N = 106). METHODS I conducted descriptive analysis on individual and workplace characteristics, including scores on the Self-Efficacy Labor Support Scale. I conducted backward stepwise multivariate linear regression to assess the factors associated with self-efficacy in providing labor support. RESULTS Years as an intrapartum nurse had a positive association with self-efficacy in labor support. Experience with open-glottis pushing, the overall cesarean birth rate, and the use of upright positioning during labor and birth were also positively associated with self-efficacy in labor support. Conversely, lack of recognition by providers was negatively associated with self-efficacy in labor support. CONCLUSION Findings suggest that modifiable factors at the individual and hospital levels are associated with nurses' self-efficacy in labor support. Hospitals must work to engage in obstetric practices that are congruent with providing labor support, including the use of experienced nurses to mentor new nurses and the creation of a unit culture to reinforce the intent of individual nurses to provide labor support.
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Wójcik‐Brylska K, Pawlicka P, Tataj‐Puzyna U, Szlendak B, Baranowska B. 'Do we need doulas…?' - Perspectives of maternity care managers on the role of doulas in Poland. Nurs Open 2023; 10:7186-7200. [PMID: 37605550 PMCID: PMC10563425 DOI: 10.1002/nop2.1965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 07/12/2023] [Accepted: 07/29/2023] [Indexed: 08/23/2023] Open
Abstract
AIM The purpose of this study was to analyse perinatal care managers' perspectives on the role of doulas in Poland and to consider how managers' perspectives might affect the opportunities for doulas to practice in individual hospitals. DESIGN This is a qualitative descriptive study. METHOD The total of 17 hospitals was selected for the study. Semi-structured interviews were conducted with 11 manager staff members. RESULTS Three groups of facilities were identified: '0' (n = 6) - refused to give interviews, 'A' (n = 8) - marginal experience in working with doulas, and 'B' (n = 3) - regular experience in working with doulas. The hospitals from Group A showed indifference towards working with doulas. Group B declared a positive attitude towards such cooperation. Attitudes towards doulas vary among executives and are related to the frequency of doula-assisted births. Our results indicate factors that may influence the attitude of medical staff towards doulas and which may contribute to improve future initiatives meant to facilitate collaboration between midwives and doulas. PATIENT OR PUBLIC CONTRIBUTION This study explored the lived experiences of perinatal care managers.
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Affiliation(s)
| | - Paulina Pawlicka
- Department of Cross‐Cultural and Gender PsychologyUniversity of Gdansk, Institute of PsychologyGdanskPoland
| | | | | | - Barbara Baranowska
- Department of MidwiferyCentre of Postgraduate Medical EducationWarsawPoland
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The relationship between attitude and self-efficacy of labor support with supportive behaviors from the perspective of midwives. BMC Nurs 2023; 22:36. [PMID: 36750959 PMCID: PMC9903519 DOI: 10.1186/s12912-023-01197-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 02/02/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND AND AIM Effective support given by a midwife during labor and childbirth is associated with numerous positive outcomes. Yet the delivery of such support can be hindered by negative workplace cultures. The purpose of the current study was to examine the relationship between attitude and self-efficacy of labor support and labor supportive behaviors from the perspectives of midwives working in Iran. METHODS Midwives (n = 213) employed in the labor wards of selected hospitals in an urban area of Iran participated in this cross-sectional study. Participants were recruited via convenience sampling from December 2016 to September 2017. The data were collected using a personal characteristics tool, the Labor Support Questionnaire, the Self-efficacy Labor Support Scale, and attitudes toward the Labor Support Questionnaire. Descriptive statistics along with multiple linear regression was used for data analysis. RESULTS Participants had a supportive behavior score of 74.98 for mean (SD ± 13.39). The informational support dimension had the highest reported score of the supportive behaviors, whereas the tangible support dimension had the lowest score. The mean scores of attitude and self-efficacy toward labor support were 24.79 (SD ± 4.14) and 79.83 (SD ± 13.82). There were also statistically significant correlations between attitude and self-efficacy, and labor support behaviors and its dimensions. Multiple linear regression analysis results indicated that interests in occupation, attitude, and self-efficacy were predictors of labor supportive behaviors. CONCLUSION Midwives' level of interest in the profession, attitude, and self-efficacy of labor support were significantly associated with labor support behaviors. Thus midwives' interest in their profession, along with their attitudes and self-efficacy could usefully be developed to enhance their supportive behaviors during labor.
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Musodza W, Sheehan A, Nicholls D, Dahlen H. Experiences of Maternity Healthcare Professionals Returning to Work Following a Personal Perinatal Loss: A Scoping Review of the Literature. OMEGA-JOURNAL OF DEATH AND DYING 2023; 86:744-768. [PMID: 33509046 DOI: 10.1177/0030222821991312] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND In Australia, midwives care closely for women during pregnancy and birth and the immediate postnatal period. This scoping review aimed to explore the experiences of female maternity healthcare professionals when they return to work following a personal pregnancy loss or neonatal death.Methodology: A scoping review was carried out on published and unpublished research and grey literature looking at how maternity healthcare professionals who have had a personal perinatal loss experience working in a maternity setting following the loss. A search of the literature was performed between October and December 2018, with no set limitations. A search for relevant references from included papers was also carried out. The literature was analysed thematically. The types of perinatal loss were defined as per Australian guidelines. RESULTS 10 articles were included in this scoping review. Four themes emerged from the literature and these were: 1) Impact of being asked, "have you got children?"; 2) Impact on professional practice; 3) Impact of pre-existing professional knowledge; 4) Importance of collegial support on return to work. CONCLUSIONS Return to work in a maternity setting following a personal perinatal loss is emotionally challenging and requires a range of supports. Further research is needed in this area.
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Affiliation(s)
- Wimbayi Musodza
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Athena Sheehan
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Daniel Nicholls
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Hannah Dahlen
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
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Kelly P, Snow N, Quance M, Porr C. Elucidating the Ruling Relations of Nurses' Work in Labor and Delivery: An Institutional Ethnography. Glob Qual Nurs Res 2023; 10:23333936231170824. [PMID: 37152977 PMCID: PMC10159245 DOI: 10.1177/23333936231170824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Obstetrics is a well-known area for malpractice and medical-legal claims, specifically as they relate to injuries the baby suffers during the intrapartum period. There is a direct implication for nurses' work in labor and delivery because the law recognizes that monitoring fetal well-being during labor is a nursing responsibility. Using institutional ethnography, we uncovered how two powerful ruling discourses, namely biomedical and medical-legal risk discourses, socially organize nurses' fetal surveillance work in labor and delivery through the use of an intertextual hierarchy and an ideological circle.
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Affiliation(s)
- Paula Kelly
- Memorial University of Newfoundland, St.
John’s, Canada
| | - Nicole Snow
- Memorial University of Newfoundland, St.
John’s, Canada
| | | | - Caroline Porr
- Memorial University of Newfoundland, St.
John’s, Canada
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Almorbaty H, Ebert L, Dowse E, Chan SW. An integrative review of supportive relationships between child-bearing women and midwives. Nurs Open 2022; 10:1327-1339. [PMID: 36349710 PMCID: PMC9912441 DOI: 10.1002/nop2.1447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 09/10/2022] [Accepted: 10/06/2022] [Indexed: 11/11/2022] Open
Abstract
AIMS To review and evaluate the literature on the factors related to developing supportive relationships between women and midwives, including facilitators and barriers. DESIGN An integrative review. METHOD The search used CINAHL, MEDLINE, Embase, EMcare, Maternity and Infant Care, PsycINFO, and Google Scholar from January 2009-June 2020. Two reviewers screened the eligible studies, and 2,399 records were identified. Quality was assessed with the mixed methods appraisal tool, and 14 articles were included. RESULTS The findings highlight that successful relationships require therapeutic communication, trust, respect, partnership, and shared decision-making. Supportive relationships improve women's satisfaction and birth outcomes, and continuity of care model is an enabling factor. Further research is required to understand supportive relationships in non-continuity of care models and when different cultural backgrounds exist.
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Affiliation(s)
- Hadeer Almorbaty
- School of Nursing and Midwifery, College of Health Medicine and Well‐BeingThe University of Newcastle, University DriveCallaghanNew South WalesAustralia,Nursing DepartmentPrince Sultan Military College of Health SciencesDhahranSaudi Arabia
| | - Lyn Ebert
- Faculty of HealthSouthern Cross UniversityCoffs HarbourNew South WalesAustralia
| | - Eileen Dowse
- School of Nursing and MidwiferyCollege of Health Medicine and Well‐Being, The University of Newcastle, University DriveCallaghanNew South WalesAustralia
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Vottero B, Schuler M, Kratovil A. A model to understand antecedents of nursing attitudes and perceptions influencing outcomes of patients with SUD. J Nurs Scholarsh 2022; 55:577-583. [PMID: 36250585 DOI: 10.1111/jnu.12829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/15/2022] [Accepted: 09/24/2022] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Substance use disorder (SUD) is a persistent and long-standing public health issue in the United States. While SUD is medically considered a chronic illness, it is also one that is viewed as self-inflicted, thereby resulting in judgmental attitudes and stigmatization from care providers, specifically from nurses. DESIGN In 2020, the authors completed an analytical cross-sectional study that included open-ended questions to examine nurses' knowledge and attitudes toward caring for patients with SUD across practice settings. METHODS A conceptual model was constructed by examining original study data and published literature on SUD, re-analyzing themes, determining constructs and variables, then coming to a consensus on critical aspects of the model. CONCLUSION The resulting conceptual model highlights antecedents of nursing behaviors that directly affect patient care outcomes, providing a roadmap to improving patient outcomes. CLINICAL RELEVANCE Understanding antecedents that affect nurses' attitudes and perceptions of patients with SUD highlights changes that can influence patient outcomes.
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Affiliation(s)
- Beth Vottero
- Purdue University Northwest, Hammond, Indiana, USA
| | - Monika Schuler
- University of Massachusetts, Dartmouth, Massachusetts, USA
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Coulton Stoliar S, Dahlen HG, Sheehan A. Insider knowledge as a double-edged sword: an integrative review of midwives' personal childbearing experiences. BMC Pregnancy Childbirth 2022; 22:640. [PMID: 35971098 PMCID: PMC9377084 DOI: 10.1186/s12884-022-04962-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 08/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The majority of maternity care is provided by female midwives who have either become mothers or are of childbearing age, but there is limited research exploring midwives' own personal childbearing experiences. This integrative review aims to explore the published literature and research on midwives' own experiences of pregnancy and childbirth. METHOD An integrative review of the literature was conducted after relevant articles were identified through a search of: five electronic databases (Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, PubMed, Scopus, and Google Scholar), cited reference lists, and networking with peers. Similar and contrasting patterns and relations within the literature were identified and grouped into themes and subthemes. RESULTS Twenty articles were included in the review and four overarching themes were identified. Insider knowledge plays a role in decision making encompassed the way midwives used their knowledge to choose; a preferred mode of birth, maternity care provider, model of care, and place of birth. Navigating the childbirth journey demonstrated how some midwives were able to use their insider knowledge to achieve agency, while others had difficulty achieving agency. This theme also revealed the 'midwife brain' that midwives need to manage during their childbearing journey. The theme impact of care on the birth experience described how the type of care the midwives received from maternity care providers affected their overall birth experience. The fourth theme from midwife to mother explains their preparedness for childbirth and their transition to motherhood. CONCLUSION For childbearing midwives, there is a potential conflict between their position as knowledgeable experts in maternity care, and their experience as mothers. Whilst they can use their insider knowledge to their advantage, they also experience heightened fear and anxiety through their pregnancy. It is important for maternity care providers to acknowledge and support them and provide balanced and tailored care that acknowledges the woman within the professional midwife and the professional midwife within the woman.
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Affiliation(s)
- S Coulton Stoliar
- School of Nursing and Midwifery, Parramatta South Campus, Western Sydney University, NSW, Parramatta, Australia.
| | - H G Dahlen
- School of Nursing and Midwifery, Parramatta South Campus, Western Sydney University, NSW, Parramatta, Australia
| | - A Sheehan
- School of Nursing and Midwifery, Parramatta South Campus, Western Sydney University, NSW, Parramatta, Australia
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Eyeberu A, Debela A, Getachew T, Dheresa M, Alemu A, Dessie Y. Obstetrics care providers attitude and utilization of non-pharmacological labor pain management in Harari regional state health facilities, Ethiopia. BMC Pregnancy Childbirth 2022; 22:389. [PMID: 35509044 PMCID: PMC9066716 DOI: 10.1186/s12884-022-04717-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 04/28/2022] [Indexed: 11/26/2022] Open
Abstract
Background In a woman’s life, labor pain is the most severe pain that they have ever faced. In Ethiopia, the provision of pain relief in labor is often neglected. Furthermore, evidence strongly urged that further research is needed on non-pharmacological labor pain management. Therefore, obstetrics care providers’ attitudes and utilization of non-pharmacological labor pain management need to be assessed. Method A facility-based cross-sectional study was conducted from May 20 to June 10, 2021, in Harari regional state health facilities, Ethiopia. All obstetric caregivers in Harari regional state health facilities were included in the study. A structured questionnaire adapted from the previous studies was used to collect data. The data was entered into Epi-data version 3.1 statistical software. Statistical analysis was carried out by using SPSS for windows version 22. Multivariate linear regression analysis was employed to determine the association between independent variables and the outcome variable. Result The overall utilization of non-pharmacological labor pain relief methods was 59.3% [(95% CI (53.9,63.4)]. Three hundred five (65.5%) of the study participants had unfavorable attitudes. Females compared to males (β = − 0.420; 95% CI: − 0.667, − 0.173), clinical experience (β = − 0.201; 95% CI: − 0.268, − 0.134), knowledge sum score (β =0.227: 95%; CI: 0.18,0.247), and attitude sum score (β = 0.376; 95% CI: 0.283, 0.47) were showed significantly association with utilization of non-pharmacological labor pain management. Conclusion The overall utilization of non-pharmacological labor pain relief methods was relatively good compared to other studies done in Ethiopia but all women’s need for labor relief methods should not be ignored. In this study sex of the respondents, clinical experience, individual preference, attitude and knowledge were factors associated with the utilization of non-pharmacological labor pain management. All stake holds need to work together to improve the attitude of health providers and to increase the utilization of non-pharmacologic labor pain management. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04717-9.
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Affiliation(s)
- Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
| | - Adera Debela
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Gido R, Yadeta TA, Tura AK. Utilization of Obstetric Analgesia for Labor Pain Management and Associated Factors among Obstetric Care Providers in Public Hospitals of Addis Ababa, Ethiopia: A Cross-Sectional Study. Obstet Gynecol Int 2021; 2021:9973001. [PMID: 34853595 PMCID: PMC8629664 DOI: 10.1155/2021/9973001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/28/2021] [Accepted: 10/30/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND In low-income countries, pain-free labor initiative is an emerging concept and still parturient undergoes through painful labor; this is not different in Ethiopia; despite the national direction to use analgesia for labor pain and strong demand from the women, evidence on utilization of obstetric analgesia for labor pain management in Ethiopia is scarce. The objective of this study was to assess level of obstetric analgesia utilization and associated factors among obstetric care providers in public hospitals in Addis Ababa, Ethiopia. METHODS An institution-based cross-sectional study was used. All obstetric care providers working in labor and delivery units in public hospitals in Addis Ababa were included. The data were collected using a self-administered structured questionnaire. After checking for completeness, data were entered into Epi-data 3.1 and analyzed using SPSS 20. Bivariate and multivariable logistic regressions were used to identify factors associated with utilization of obstetric analgesia. RESULT Of 391 obstetric care providers included in the study, 143 (36.6%; 95% CI: 31.5-40.9%) reported providing labor analgesia. Having adequate knowledge (AOR 2.7; 95% CI: 1.37-5.23), ten and more years of work experience (AOR 4.3; 95% CI: 1.81-10.13), and availability of analgesics (AOR 3.3; 95% CI: 1.99-5.53) were significantly associated with providing labor analgesia. CONCLUSION Slightly more than 3 in 10 obstetric care providers reported providing labor analgesics to women. Training of providers and ensuring adequate supply of analgesics is required to make sure that women in labor would not suffer from labor pain.
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Affiliation(s)
- Rediet Gido
- Department of Midwifery, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
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Heelan-Fancher L, Edmonds JK. Intrapartum Nurses' Beliefs Regarding Birth, Birth Practices, and Labor Support. J Obstet Gynecol Neonatal Nurs 2021; 50:753-764. [PMID: 34384771 DOI: 10.1016/j.jogn.2021.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES To examine the relationships among intrapartum (IP) nurses' beliefs regarding birth (physiologic birth/medicalized birth) and their experience, education, and certification; to assess IP nurses' beliefs about birth practices and labor support; to describe the birth practices of the most effective IP nurses; and to elicit recommendations from IP nurses for quality improvement in IP nursing practice. DESIGN Cross-sectional, descriptive study. SETTING Three urban hospitals from one state in the northeastern United States. PARTICIPANTS One hundred twelve IP registered nurses who were primarily staff nurses. METHODS We collected quantitative and qualitative data using a Web-based survey that included the Intrapartum Nurses' Beliefs Related to Birth Practice-Modified scale. We used Burgess's conceptual definition of laborsupport as the framework to analyze findings. RESULTS Participants favored physiologic birth and not medicalized birth, and their beliefs were associated with experience (p = .01) and certification (p = .04). Participants reported that effective IP nurses demonstrate labor practices supportive of physiologic birth. Recommendations from participants for quality improvement in IP nursing practice included ways to optimize physical support, emotional support, informational support, and advocacy for women during labor. Participants made no recommendations related to partner support. CONCLUSION Participants held beliefs that favored physiologic birth and supported many labor practices that can facilitate physiologic birth. However, some labor practices associated with medicalized birth were also supported. Further quality improvement strategies to provide partner support during labor are needed.
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Abstract
PURPOSE The purpose of this scoping review was to synthesize the literature on nursing support during the latent phase of the first stage of labor. In 2014, the definition of the beginning of active labor changed from 4 centimeters (cm) to 6 cm cervical dilation. More women may have an induction of labor based on results of recent research showing no causal increase in risk of cesarean birth with elective induction of labor for low-risk nulliparous women. Therefore, in-hospital latent phase labor may be longer, increasing the need for nursing support. DESIGN Scoping review of the literature from 2009 to present. METHODS We conducted the review using key words in PubMed, CINAHL, and Scopus. Search terms included different combinations of "latent or early labor," "birth," "support," "nursing support," "obstetrics," and "onset of labor." Peer-reviewed research and quality improvement articles from 2009 to present were included if they had specific implications for nursing care during the latent phase of labor. Articles were excluded if they were not specific to nursing, focused exclusively on tool development, or were from the perspective of pregnant women or providers only. RESULTS Ten articles were included. Results were synthesized into six categories; support of physiologic labor and birth, the nurse's own personal view of labor, birth environment, techniques and tools, decision-making, and importance of latent labor discussion during the prenatal period. CLINICAL IMPLICATIONS Support for physiologic labor and birth is an important consideration for use of nonpharmacological methods during latent labor. The nurse's own personal view on labor support can influence the support that laboring women receive. Nurses may need additional education on labor support methods.
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Bishaw KA, Sendo EG, Abebe WS. Knowledge, and use of labour pain relief methods and associated factors among obstetric caregivers at public health centers of East Gojjam zone, Amhara region, Ethiopia: a facility based cross- sectional study. BMC Pregnancy Childbirth 2020; 20:180. [PMID: 32293322 PMCID: PMC7092537 DOI: 10.1186/s12884-020-2844-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 02/26/2020] [Indexed: 04/28/2023] Open
Abstract
Background The study was conducted in public health centers of East Gojjam Zone, Amhara region, Ethiopia. The purpose of this study was to assess knowledge, and use of labour pain relief methods and associated factors among obstetric caregivers in the study setting. Methods A facility-based cross-sectional study design was conducted from March 1–30, 2018. The study was conducted among three hundred and nine sampled obstetric caregivers. Structured questionnaire was used to collect the data. The data were entered into Epi-data version 4.2 Software for cleaning and exported to SPSS version 23.0 for data analysis. Multivariate logistic regression was carried out for variables with a p-value < 0.25 in bivariate logistic regression to determine significant relationships between the dependent and independent variables. Statistical significance was determined at 95% confidence interval (CI) and p-value below 0.05. Result The overall use of labour pain relief methods reported was 34.4%, (30.4% non-pharmacological and 8.4 pharmacological, respectively). More than half of the study participants (54.2%) had adequate knowledge about labour pain relief methods. In multivariate analysis, being a midwifery profession [AOR =2.814, 95% CI = (1.574–5.031)], having positive attitude [AOR = 4.370, 95% CI = (2.523–7.567)], and professionals with a medium level of education [AOR = 3.450, 95% CI = (1.993–5.971)] were factors significantly associated with knowledge of obstetric caregivers about labour pain relief methods. In multivariate analysis, knowledge of obstetric caregivers [AOR = 3.821, 95% CI = (2.091–6.980)], positive attitude of obstetric caregivers [AOR = 2.455, 95% CI = ((1.358–4.436))] and experience of obstetric caregivers [AOR = 2.56, 95% CI = (1.350–4.845) were factors significantly associated with the use of labour pain relief methods. Conclusion In this study, the overall use of labour pain relief methods by obstetric caregivers was low. Systemic opioid (Pethdine) was reportedly one of the most known pharmacological pain relief methods in this study. Providers’ knowledge, attitude and work experience had shown statistical significance with the use of labour pain relief methods. Task-oriented in- service training is required to fortify obstetric caregivers’ knowledge and attitude towards the use of labour pain relief methods.
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Affiliation(s)
- Keralem Anteneh Bishaw
- Department of Midwifery, Debre-Markos University, College of Medicine and Health Sciences, Debre-Markos, Ethiopia.
| | - Endalew Gemechu Sendo
- School of Nursing and Midwifery, Addis-Ababa University, College of Health Science, Addis Ababa, Ethiopia
| | - Workinesh Sinshaw Abebe
- School of Nursing and Midwifery, Addis-Ababa University, College of Health Science, Addis Ababa, Ethiopia
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Breman RB, Low LK, Paul J, Johantgen M. Promoting active labor admission: Early labor lounge implementation barriers and facilitators from the clinician perspective. Nurs Forum 2019; 55:182-189. [PMID: 31746009 DOI: 10.1111/nuf.12414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 10/07/2019] [Accepted: 11/04/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND The cesarean birth rate for low-risk pregnant individuals in the United States exceeds the recommended Healthy People 2020 rate. One recommended strategy to reduce cesarean in this population is delaying hospital admission until active labor commences. A quality improvement program was implemented at a community hospital using the early labor lounge (ELL) to promote admission in active labor. This study focuses on identifying the barriers and facilitators from the clinician perspective to implementing the ELL. METHODS Interviews were conducted with a purposive sample of clinicians. Interview transcripts were open coded and themes identified inductively. A framework analysis was then conducted using the Consolidated Framework for Implementation Research (CFIR). RESULTS Twenty-five staff members participated. Barriers and facilitators were identified in four of the CFIR domains. Facilitators included the strength of the evidence and the ELL itself, including the tools it contained for supporting women in latent labor. Barriers to implementation included clinician self-efficacy and perceived low usage of the ELL. CONCLUSION This analysis using, CFIR identified several barriers and facilitators to the implementation of the ELL. The context of the individual woman presenting in triage and the acceptability and self-efficacy of the individual clinicians represented important factors for implementation.
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Affiliation(s)
- Rachel B Breman
- Department of Partnerships, Professional Education and Practice, School of Nursing, University of Maryland, Baltimore, Maryland
| | - Lisa Kane Low
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Julie Paul
- Department of Obstetrics and Gynecology, South Shore Hospital, Weymouth, Massachusetts
| | - Meg Johantgen
- Department of Organizational Systems and Adult Health, School of Nursing, University of Maryland, Baltimore, Maryland
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Sadeghzadeh N, Amiri-Farahani L, Haghani S, Hasanpoor-Azghady SB. Iranian midwives' attitudes and beliefs toward physiological childbirth: a cross-sectional study. BMC Pregnancy Childbirth 2019; 19:352. [PMID: 31606029 PMCID: PMC6790054 DOI: 10.1186/s12884-019-2509-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 09/13/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The significant role of midwives in providing labor and delivery care underscores the necessity of the identification of attitudes and beliefs of these groups of maternity care providers toward physiological childbirth. The purpose of the current study was to describe midwives' attitudes and beliefs toward physiological childbirth and identify its related factors. METHODS This cross-sectional study was carried out on 200 midwives working in the labor and delivery wards of selected hospitals in an urban area of Tehran, Iran, through the continuous sampling method from May to July 2018. The data were collected using a two-part demographic characteristic form and Midwives' Attitudes and Beliefs Questionnaire-Revised toward physiological childbirth. Data analysis was performed in SPSS software (version 25). The significance level was set at P < 0.05. RESULTS The mean score of midwives' attitudes and beliefs toward physiological childbirth were 119.90 with a standard deviation of 9.30. Moreover, of the different domains of Midwives' Attitudes and Beliefs Questionnaire-Revised, the women's experience of birth (78.53) and the medical model conflict (51.05) obtained the highest and lowest scores, respectively. According to the multiple linear regression model analysis, the total mean score of midwives' attitudes and beliefs toward physiological childbirth was significantly correlated with the level of education and interest in the profession (P < 0.05). Midwives with a master degree obtained higher scores (4.32) in terms of attitudes and beliefs toward physiologic childbirth, compared to those with an associate or bachelor degree. Also, there were 0.09 increases in the attitude and belief score of midwives per one score increase in their interest in the profession. It can be concluded that these two variables explained 16% of the variation in the scores of midwives' attitudes and beliefs to physiological childbirth. CONCLUSION The results of this study showed that midwives with higher levels of education and more interest in their profession had more positive attitudes and beliefs toward physiological childbirth. Therefore, it is necessary to motivate midwives to obtain higher levels of education and increase their interest in the profession to promote physiological childbirth.
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Affiliation(s)
- Narges Sadeghzadeh
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Amiri-Farahani
- Department of Reproductive Health and Midwifery, Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Postal code: 1996713883, Iran.
| | - Shima Haghani
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Syedeh Batool Hasanpoor-Azghady
- Department of Reproductive Health and Midwifery, Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Postal code: 1996713883, Iran
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A Labor Support Workshop to Improve Undergraduate Nursing Students' Understanding of the Importance of High Touch in a High-Tech World. J Perinat Educ 2019; 28:142-150. [PMID: 31341373 DOI: 10.1891/1058-1243.28.3.142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This article presents the development and evaluation of a labor support workshop aimed at providing senior undergraduate nursing students with education on the provision of labor support. In collaboration with a Lamaze educator, a two and half hour interactive educational session was developed. The workshop included both a didactic and a hands-on component which included physical labor support strategies, which could be utilized in the clinical setting. Pre-and postintervention data was collected on students' knowledge and self-efficacy in the provision of labor support, as well as, data on their use of these strategies while in the clinical setting. The labor support workshop was well received by students (4.9/5) and increased their self-reported knowledge (p = <.001) and self-efficacy (p = <.001) in the provision of labor support.
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Green J, Hotelling BA. Healthy Birth Practice #3: Bring a Loved One, Friend, or Doula for Continuous Support. J Perinat Educ 2019; 28:88-93. [PMID: 31118545 DOI: 10.1891/1058-1243.28.2.88] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
All women should be allowed and encouraged to bring a loved one, friend, or doula to their birth without financial or cultural barriers. Continuous labor support offers benefits to mothers and their babies with no known harm.
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Attitudes of Physicians, Midwives, and Nurses About Doulas: A Scoping Review. MCN Am J Matern Child Nurs 2018; 44:33-39. [PMID: 30531588 DOI: 10.1097/nmc.0000000000000488] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Evidence supports numerous positive clinical benefits of doula care. There are varying attitudes among physicians, midwives, and nurses toward support of doulas in a collaborative approach with women in labor. Tension and conflict with use of doulas may occur in some intrapartum settings in the United States. METHODS A scoping review of the literature between January 2008 and January 2018 was conducted using PubMed, CINAHL, Google Scholar, and Scopus database to identify specific attitudes of physicians, midwives, and nurses toward doulas; 1,810 records were identified and initially reviewed. Inclusion criteria included original research published in the last 10 years and in the English language. Articles were excluded if the research was not original and if obstetrical providers' or nurses' attitudes toward doulas were not included. RESULTS Three records met criteria for inclusion. All used a cross-sectional survey design. Two were set in Canada exclusively and one was inclusive of nurses and doulas in both Canada and the United States. Themes emerged that may explain the influence and variances in attitudes toward doulas and the support they provide to laboring women. CLINICAL IMPLICATIONS More research is needed to identify attitudes of members of the maternity care team toward doulas and to better understand implications of their attitudes on working together collaboratively and on patient outcomes.
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