暂无摘要。

The purpose of this study was to examine the effect of psychological well-being on job performance among nurses and midwives in rural and urban hospitals in Ghana amidst COVID-19. The study adopted a purely quantitative approach, using the explanatory research design. Data were collected from 262 nurses and midwives in two selected hospitals in the Central Region of Ghana. The Structural Equation Modelling was used to analyze the data collected. The results revealed that the levels of psychological well-being and job performance were high in both hospitals amidst the pandemic. Further, it was observed that although psychological well- being had significant influence on job performance among the nurses and midwives in both rural and urban communities, the effect was more significant in the urban settlements. Given these findings, the study recommended that in order to effectively improve the job performance of nurses and midwives, management must adopt policies such as, flexible work arrangements, leave policy, and counselling services to support their psychological well-being.

BACKGROUND: Recognizing the positive impact of movement and positions on labor progression and maternal and neonatal outcomes, there is a strong recommendation to empower women for active labor during antenatal education. This study investigates nurse-midwives\' interventions in empowering women for active labor, during antenatal education within primary healthcare settings.
METHODS: A qualitative descriptive study was conducted in Primary Healthcare Units that provide antenatal education for childbirth in Portugal. Semi-structured interviews were conducted with 10 nurse-midwives between August and October 2023. Content analysis, utilizing NVIVO software, was employed for data analysis, and the study adhered to the COREQ reporting guidelines.
RESULTS: Six themes emerged: 1) Perspective of nurse-midwives and contextual influences; 2) Assessment of women\'s needs; 3) Enhancing women\'s knowledge; 4) Enhancing women\'s capabilities; 5) Supporting women in decision-making; and 6) Nurse-midwives\' perspective on intervention outcomes. It is necessary to create environments conducive to knowledge and skill acquisition and invest in developing body awareness and its impact on labor progression. Encouraging women\'s involvement in decision-making is crucial, especially in less flexible hospital environments.
CONCLUSIONS: This study highlighted the value nurse-midwives place on empowering women for active labor. Interventions featured sharing evidence-based practices and birth stories to foster reflection, emphasizing pelvic mobility training and partner involvement. Reflective practices could enable women to explore options and communicate effectively with healthcare professionals during labor.

OBJECTIVE: Conflicts are ubiquitous in human societies and manifest in varied forms and scales within societies, communities and organisations. While many studies have investigated workplace conflicts, least attention has been paid to how midwives differently experience these conflicts and the impacts of these conflicts on their wellbeing. This study fills this gap by investigating the multifaceted impact of workplace conflicts on the wellbeing of midwives.
METHODS: The study employed a purely qualitative approach within the analytical framework of the Stress Theory of organisational conflicts. Thirty-five participants were selected for the study through an expert purposive sampling technique. Interviews and Focus Group Discussions were used to collect primary data for the study. Collected data were analysed using an inductive thematic analytical technique.
RESULTS: The findings highlight the multifaceted impact of conflict on both the professional and personal well-being of midwives. Conflicts induce severe physical and psychological strains on midwives, generate fears, angst, and anxieties, and disrupt social harmony prompting exclusion and discrimination among midwives in the hospital.
CONCLUSIONS: We argue that apart from task-demand generated stress, workplace conflicts prompt both physical and psychological stress on midwives which culminate into a myriad of physical, emotional, and mental health issues.
CONCLUSIONS: Initiation of conflict resolution and mediation training programs for midwives so as to equip them with essential skills for effectively managing and resolving workplace conflicts. Setting up internal grievance mechanisms for midwives in their work places and training of midwives on social skills, and stress management skills.

BACKGROUND: Simulation-based training has been widely used as a valuable strategy for learning and evaluating clinical skills at different levels of nursing and midwifery education. The impact of simulation training on intensive management for high-risk pregnancy in a low-resource setting has been limited.
OBJECTIVE: To examine the effect of simulation-based training with low-fidelity mannequins on obstetrical nurses and midwives\' knowledge, attitude, and skills for high-risk pregnancy management in a low-resource setting.
METHODS: During September 2023, twenty-five obstetrical nurses or midwives who worked in five tertiary public hospitals in Vientiane Prefecture participated in the three-day training workshops for intensive management in high-risk pregnant women and newborns that used a simulation-based training approach integrating problem-based learning. The evaluated criteria of knowledge, attitudes, and skills pre- and post-test scores were statistically compared.
RESULTS: Workshop trainees demonstrated an increase significantly in knowledge for high-risk pregnancy management (p = 0.012), attitude toward high-risk pregnancy management (p = 0.000), and attitude toward simulation-based training design (p = 0.002). The clinical skills were used on the simulation performance checklist, and the pre-posttest gain in overall performance scores had a statistically significant difference (p = 0.000). The mean score of postpartum hemorrhage management skills was 11.48±2.23, which increased the highest score among all skills.
CONCLUSIONS: The simulation-based training in high-risk pregnancy management improves the knowledge, attitude, and skills of nurses and midwives in low-resource settings. Next steps include direct observation of trainees in the clinical setting to assess their competence in ensuring patient safety, achieving positive pregnancy outcomes, and enhancing satisfaction.

BACKGROUND: Preeclampsia and eclampsia are among the leading direct causes of maternal death and morbidity worldwide. Up to 34% of maternal deaths in Tanzania are due to preeclampsia/ eclampsia. Magnesium sulfate is recommended for preventing and treating convulsions in women with Preeclampsia or eclampsia. However, evidence suggests limited knowledge of its dosage and proper toxicity assessment after administration among health care providers.
OBJECTIVE: This study explored nurse-midwives\' perspectives on providing MgSO4 to patients with preeclampsia or eclampsia in Tanzania.
METHODS: A descriptive exploratory qualitative study using in-depth interviews was conducted to understand nurse-midwives\' perspectives on providing magnesium sulfate to patients with PE/E. Nineteen nurse-midwives were interviewed from three hospitals in the Dar es Salaam region. We used a semi-structured interview guide in Kiswahili language to collect data. All interviews were digitally recorded and transcribed verbatim. We analyzed data using inductive content analysis.
RESULTS: This study revealed that nurse-midwives provide magnesium sulfate to save the lives of women and their unborn children. Nurse-midwives reasoned that confidence in their skill enhances provision of magnesium sulfate. However, they were concerned about its effect on the progress of labour. Ineffective use of magnesium sulfate emerged from inadequate training, an unsupportive work environment, and underutilization of the existing guidelines.
CONCLUSIONS: Nurse-midwives have clear drive to provide magnesium sulfate to women with preeclampsia or eclampsia. However, inadequate training, underutilization of guidelines and unsupportive work environment lead to ineffective use of magnesium sulfate. Targeted practical training should be emphasized for nurse-midwives mastery of clinical competencies.

Transfer of learning in the workplace depends on various factors, one of which is the work environment. The aim of this study was to describe the interplay between the primary healthcare work environment, the performance of advanced antenatal care trained nurse-midwives, and birth outcomes. A cross-sectional, quantitative study was conducted in two purposely selected districts in South Africa. Document analyses were also completed. Statistical Analysis Software version 9.4 was used for descriptive statistical data analysis. The participating clinics, in the TM and LJ districts, both achieved ideal clinic status. The scores for the management of low- and high-risk pregnancies ranged between 86-89% and 87%, respectively. Babies born had Apgar scores of between 7-9 and 8-10 in 1 minute and 5 minutes after birth, respectively. Nurse-midwives scored low on interpreting assessment findings. Contrary to the Transfer of Learning Theory, nurse-midwives performed better in poorer work environments. The study suggests that the performance of advanced antenatal care trained nurse-midwives may not solely depend on a well-equipped work environment. Further studies should highlight the broader determinants of advanced antenatal care nurse-midwives services output.
Le transfert des apprentissages en milieu de travail dépend de divers facteurs, dont l\'environnement de travail. Le but de cette étude était de décrire l\'interaction entre l\'environnement de travail des soins de santé primaires, la performance des infirmières sages-femmes formées en soins prénatals avancés et les résultats de l\'accouchement. Une étude transversale et quantitative a été menée dans deux districts délibérément sélectionnés en Afrique du Sud. Des analyses de documents ont également été réalisées. Le logiciel d\'analyse statistique version 9.4 a été utilisé pour l\'analyse de données statistiques descriptives. Les cliniques participantes, dans les districts de TM et LJ, ont toutes deux atteint le statut de clinique idéale. Les scores pour la gestion des grossesses à faible et à haut risque variaient respectivement entre 86 et 89 % et 87 %. Les bébés nés avaient des scores d’Apgar compris entre 7-9 et 8-10 respectivement 1 minute et 5 minutes après la naissance. Les infirmières sages-femmes ont obtenu de faibles résultats dans l’interprétation des résultats de l’évaluation. Contrairement à la théorie du transfert de l’apprentissage, les infirmières sages-femmes ont de meilleurs résultats dans des environnements de travail plus pauvres. L’étude suggère que la performance des infirmières sages-femmes formées en soins prénatals avancés ne dépend peut-être pas uniquement d’un environnement de travail bien équipé. D’autres études devraient mettre en évidence les déterminants plus larges de la production des services avancés d’infirmières et de sages-femmes en soins prénatals.

OBJECTIVE: The aim of this pilot study was to explore clinician\'s experience of transitioning from midwifery clinical practice into university in an academic teaching role within one jurisdiction in Australia.
BACKGROUND: There is a dire shortage of midwifery academics globally. In Australia the shortage is symbiotic with the persistent deficit in the midwifery clinical workforce, which is the predominant recruitment pool for universities. The midwifery workforce cannot be replenished without sufficient academics to provide education.
METHODS: Phenomenology was selected as the most appropriate research approach for the study seeking to illuminate the lived experiences of clinicians as they transition into their new role as academics.
METHODS: Seven participants were recruited purposively from one jurisdiction in Australia between November 2022 and March 2023. Qualitative conversational interviews were performed facilitating each participant to share their narrative. Participants were then able to direct the conversation to share their lived experience of the transition from a midwifery clinician in practice to a midwifery academic in a university. Demographic details were collected for context.
RESULTS: Thematic analysis was used following Giorgi\'s four stage phenomenological process. Four themes were identified from commonalities between the participants, \'Being a drifter\", \'Keeping a foot in both camps to maintain clinical credibility\', \'In at the deep end: Not prepared for the reality of academia\' and \'Best of both worlds\'.
CONCLUSIONS: The lived experiences of the participants in this study, as they transitioned from clinical midwifery practice to academia can be related to the Theory of Transition where participants navigate: Preparation, Encounter, Adjustment and Stabilisation. A new role in higher education requires adjustment to the reality of working in academia. Midwives who had experiences of being a casual staff member felt they had the best of both worlds, as they gained an insight into the role of an academic whilst remaining in clinical practice. However, many reported that mentorship would have been beneficial to facilitate stabilisation.

暂无摘要。

OBJECTIVE: There is little documented evidence of job satisfaction in midwives who work in birthing rooms.
BACKGROUND: Job satisfaction in midwives who work in birthing rooms may have changed in recent decades due to the medicalization of maternal health.
OBJECTIVE: To analyse job satisfaction levels among midwives working in birthing rooms.
METHODS: We searched Web of Science, SCOPUS, MEDLINE, CUIDEN and CINAHL for observational and mixed method studies. The literature search was carried out from September to October 2022.
RESULTS: A total of 13 studies were included in the systematic review. A meta-analysis of the variable \"midwives\' job satisfaction\" was performed on 12 of the studies. Midwives rated their job satisfaction positively: DME, CI (95%) = 1.24 [0.78, 1.69]. Subgroup 1: DME, CI (95%) = 2.41 [2.05, 2.76]); Subgroup 2: DME, CI (95%) = 0.76 [0.65, 0.86]; subgroup 3: DME, CI (95%) = 1.11 [0.95, 1.27]; subgroup 4: DME, CI (95%) = 0.10 [-0.11, 0.31].
CONCLUSIONS: Although midwives show high levels of satisfaction, the heterogeneity of instruments, lack of specificity and limited number of studies found restrict the outcomes.
CONCLUSIONS: There are no specific measurement instruments for assessing job satisfaction among midwives working in labour wards, so it is possible that these data do not correspond to reality as they do not take into account specific professional aspects within this field of practice.