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Feeley C, Stacey T. Novel solutions to the midwifery retention crisis in England: an organisational case study of midwives' intentions to leave the profession and the role of retention midwives. Midwifery 2024; 138:104152. [PMID: 39217912 DOI: 10.1016/j.midw.2024.104152] [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: 06/27/2024] [Revised: 08/14/2024] [Accepted: 08/18/2024] [Indexed: 09/04/2024]
Abstract
PROBLEM/BACKGROUND Midwifery retention is a global issue, but less is known regarding what motivates midwives' intention to stay or leave within individual organisations. In 2021, NHS England funded maternity organisations to employ retention midwives. To date, the impact of these roles has not been evaluated. AIM To explore the views of midwives regarding their intentions to leave or stay within one English organisation and to provide insights into the perceived impact of the role of retention midwives. METHODS An instrumental case study was carried out in one organisation. Data a mixed methods survey (n=67/91) and interview data (n=7). Quantitative data was analysed using descriptive and inferential statistics; qualitative data using thematic analysis. All data was synthesised together. FINDINGS The three themes included 'Values-based tensions: The eroding role of the midwife'; 'Discerning differences: Intentions to leave or stay'; 'Retention midwives: Activities and impact'. DISCUSSION We found that there was a clear link between midwives' intention to leave or stay and their workplace roles; specialist midwives were more likely to stay, report satisfaction, autonomy, and feel a sense of contribution or effectiveness in their role compared to those in other roles. The retention midwives were making a positive difference to midwives' experience of the workplace. CONCLUSION Midwives working within the same organisation have different experiences of their role and job satisfaction. Future work should consider applying the positive elements of the specialist roles to the wider midwifery workforce to enhance retention. The retention midwife role shows promise, but further evaluation is required.
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Affiliation(s)
- Claire Feeley
- Methodologies division, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Kings College London
| | - Tomasina Stacey
- Methodologies division, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Kings College London.
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Prosen M. A systematic integrative literature review of the factors influencing the professionalization of midwifery in the last decade (2009-2019). Midwifery 2021; 106:103246. [PMID: 35007977 DOI: 10.1016/j.midw.2021.103246] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 09/03/2021] [Accepted: 12/26/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The professionalization of midwifery is not only important for midwives themselves, but for women and society in general since professionalism is associated with high-quality services and moral and ethical standards. AIM This systematic integrative literature review seeks to investigate the factors that have affected the professionalization of midwifery in the last decade (2009-2019). METHODS Systematic searches were conducted in EBSCO, PubMed, ScienceDirect, SAGE and the Web of Science Core Collection. Critical appraisal was conducted using the Mixed Methods Appraisal Tool (MMAT). The findings were synthesised through a thematic analysis. The PRISMA statement was used to guide the reporting. FINDINGS Analysis of the 20 studies included detected two main themes: professionalization barriers and professionalization opportunities. The first theme includes issues concerning power imbalance, social recognition, conflicting perspectives on childbirth, professional autonomy, work characteristics, midwifery associations, and regulation. The second theme includes opportunity issues related to woman-centred care, expansion of professional competency, interprofessional collaboration, and education. KEY CONCLUSIONS Over the last decade, the midwifery profession has faced several barriers that seem to be historically entrenched in the professionalization of midwifery, yet changes in the professionalization process are visible in the shift towards elements of the 'new professionalism' that is rising to the surface during this process. IMPLICATIONS FOR PRACTICE The findings suggest the socialisation process of midwifery candidates must focus on raising their self-awareness, self-esteem and confidence in their professional role; woman-centred care needs to be further promoted and implemented; and interprofessional collaboration should be addressed in educational programmes for all health professionals.
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Affiliation(s)
- Mirko Prosen
- University of Primorska, Faculty of Health Sciences, Polje 42, 6310 Izola, Slovenia.
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Thompson SM, Low LK, Budé L, de Vries R, Nieuwenhuijze M. Evaluating the effect of an educational intervention on student midwife self-efficacy for their role as physiological childbirth advocates. NURSE EDUCATION TODAY 2021; 96:104628. [PMID: 33160156 DOI: 10.1016/j.nedt.2020.104628] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 09/25/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Midwifery education that strengthens self-efficacy can support student midwives in their role as advocates for a physiological approach to childbirth. METHODS To assess the effect of an educational intervention on self-efficacy, a pre- and post-intervention survey was administered to a control group and an intervention group of third year student midwives. The General Self-Efficacy Scale (GSES) was supplemented with midwifery-related self-efficacy questions related to behaviour in home and hospital settings, the communication of evidence, and ability to challenge practice. RESULTS Student midwives exposed to midwifery education designed to strengthen self-efficacy demonstrated significantly higher levels of general self-efficacy (p = .001) when contrasted to a control cohort. These students also showed significantly higher levels of self-efficacy in advocating for physiological childbirth (p = .029). There was a non-significant increase in self-efficacy in the hospital setting in the intervention group, a finding that suggests that education may ameliorate the effect of hospital settings on midwifery practice. DISCUSSION In spite of the small size of the study population, education that focuses on strengthening student midwife self-efficacy shows promise.
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Affiliation(s)
- Suzanne M Thompson
- Midwifery Science, Zuyd University of Applied Sciences, Maastricht, the Netherlands; Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
| | - Lisa Kane Low
- School of Nursing, University of Michigan, Ann Arbor, United States
| | - Luc Budé
- Midwifery Science, Zuyd University of Applied Sciences, Maastricht, the Netherlands
| | - Raymond de Vries
- Midwifery Science, Zuyd University of Applied Sciences, Maastricht, the Netherlands; Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, United States
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Kristienne McFarland A, Jones J, Luchsinger J, Kissler K, Smith DC. The experiences of midwives in integrated maternity care: A qualitative metasynthesis. Midwifery 2019; 80:102544. [PMID: 31655307 DOI: 10.1016/j.midw.2019.102544] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 09/16/2019] [Accepted: 09/29/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To conduct a metasynthesis of eight qualitative studies of the experiences of midwives in integrated maternity practice; to identify common motifs among the eight studies through a thematic interpretive integration known as reciprocal translation; and to explore the effects on midwifery processes of care in the setting of integrated maternity practice. DESIGN A qualitative metasynthesis to analyze, synthesize, and interpret eight qualitative studies on the experiences of midwives and the effect on the midwifery processes of care in the setting of integrated maternity practice. SAMPLE AND SETTING Participants from the primary studies included a total of 160 midwives providing hospital-based intrapartum care. All primary studies were conducted in settings with midwives and obstetricians working together in an integrated or collaborative manner. FINDINGS Three overarching themes emerged from the data: professional dissonance, functioning from a position of risk, and practicing down. KEY CONCLUSIONS The findings indicated that integrated maternity practice affects the professional experience of midwives. Through a qualitative exploration, a clear process of deprofessionalization and deviation from the midwifery model of care is detailed. Midwives experienced decreasing opportunity to provide the quality woman-centered physiologic care that evidence shows benefits childbearing women. IMPLICATIONS FOR PRACTICE Integrated maternity practice, where low-risk and high-risk pregnancies are managed by midwife/physician teams, have proliferated as a solution to the need for quality, safe, and efficient health care. Insufficient evidence exists detailing the success or failure of this model of care. Qualitative studies suggest that the increasing medicalization occurring in integrated maternity practices minimizes the profession of midwifery and the ability to provide evidence-based quality midwifery care.
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Affiliation(s)
- A Kristienne McFarland
- University of Colorado, Anschutz Medical Center College of Nursing 13120 E 19th Ave, Aurora, CO 80045, United States.
| | - Jacqueline Jones
- University of Colorado, Anschutz Medical Center College of Nursing 13120 E 19th Ave, Aurora, CO 80045, United States
| | - Jackie Luchsinger
- University of Colorado, Anschutz Medical Center College of Nursing 13120 E 19th Ave, Aurora, CO 80045, United States
| | - Katherine Kissler
- University of Colorado, Anschutz Medical Center College of Nursing 13120 E 19th Ave, Aurora, CO 80045, United States
| | - Denise C Smith
- University of Colorado, Anschutz Medical Center College of Nursing 13120 E 19th Ave, Aurora, CO 80045, United States
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Meyer Y, Pehlke-Milde J, Muntwyler FS, Fleming V. Integrative power in Swiss home-like childbirths: A qualitative multiple case study. Midwifery 2019; 78:97-103. [PMID: 31419782 DOI: 10.1016/j.midw.2019.08.005] [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: 02/01/2019] [Revised: 06/30/2019] [Accepted: 08/08/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To increase understanding of integrative power in decision-making in home-like childbirth from midwives' and women's perspectives. DESIGN A qualitative multiple case study. SETTING Two regions of Switzerland, a French and a German-speaking. PARTICIPANTS Twenty interviews with midwives and 20 with women and some partners who had experienced complications in home-like births. METHODS Data were collected from in-depth interviews relevant for casestudy. Four cases during second stage of labour were carefully selected using literal replication logic. Interview transcripts were analysed in developing case descriptions and in interpreting mechanisms related to perception of power in making decision. FINDINGS The analysis of each case and a cross-case comparison showed that mechanisms for building integrative power, such as creation of relationships, cooperation, loyalty, legitimacy and respect, were highly visible in midwifery decision-making activities. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The study highlighted the visibility of integrative power mechanisms in decision-making in homelike settings. Until now, mechanisms of positive power in midwifery have been poorly described in literature. Integrative power could be a promising strategy to reinforce decision-making strategies. Therefore, clinical and policy measures explicitly addressing the positive aspects of power should be developed and evaluated.
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Affiliation(s)
- Yvonne Meyer
- School of Health Sciences (HESAV), University of Applied Sciences and Arts, Western Switzerland (HES-SO), Av. de Beaumont 21, 1011 Lausanne, Switzerland.
| | - Jessica Pehlke-Milde
- Institute of Midwifery, School of Health Professions, Zurich University of Applied Sciences, Switzerland
| | - Franziska Schläppy Muntwyler
- School of Health Sciences (HESAV), University of Applied Sciences and Arts, Western Switzerland (HES-SO), Av. de Beaumont 21, 1011 Lausanne, Switzerland
| | - Valerie Fleming
- Liverpool John Moore's University, Faculty of Education, Health and Community, Liverpool, United Kingdom
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Lamé G, Liberati E, Burt J, Draycott T, Winter C, Ward J, Dixon-Woods M. IMproving the practice of intrapartum electronic fetal heart rate MOnitoring with cardiotocography for safer childbirth (the IMMO programme): protocol for a qualitative study. BMJ Open 2019; 9:e030271. [PMID: 31256041 PMCID: PMC6609047 DOI: 10.1136/bmjopen-2019-030271] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/22/2019] [Accepted: 06/10/2019] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Suboptimal electronic fetal heart rate monitoring (EFM) in labour using cardiotocography (CTG) has been identified as one of the most common causes of avoidable harm in maternity care. Training staff is a frequently proposed solution to reduce harm. However, current approaches to training are heterogeneous in content and format, making it difficult to assess effectiveness. Technological solutions, such as digital decision support, have not yet demonstrated improved outcomes. Effective improvement strategies require in-depth understanding of the technical and social mechanisms underpinning the EFM process. The aim of this study is to advance current knowledge of the types of errors, hazards and failure modes in the process of classifying, interpreting and responding to CTG traces. This study is part of a broader research programme aimed at developing and testing an intervention to improve intrapartum EFM. METHODS AND ANALYSIS The study is organised into two workstreams. First, we will conduct observations and interviews in three UK maternity units to gain an in-depth understanding of how intrapartum EFM is performed in routine clinical practice. Data analysis will combine the insights of an ethnographic approach (focused on the social norms and interactions, values and meanings that appear to be linked with the process of EFM) with a systems thinking approach (focused on modelling processes, actors and their interactions). Second, we will use risk analysis techniques to develop a framework of the errors, hazards and failure modes that affect intrapartum EFM. ETHICS AND DISSEMINATION This study has been approved by the West Midlands-South Birmingham Research Ethics Committee, reference number: 18/WM/0292. Dissemination will take the form of academic articles in peer-reviewed journals and conferences, along with tailored communication with various stakeholders in maternity care.
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Affiliation(s)
- Guillaume Lamé
- The Healthcare Improvement Studies Institute (THIS Institute), University of Cambridge, Cambridge, UK
| | - Elisa Liberati
- The Healthcare Improvement Studies Institute (THIS Institute), University of Cambridge, Cambridge, UK
| | - Jenni Burt
- The Healthcare Improvement Studies Institute (THIS Institute), University of Cambridge, Cambridge, UK
| | - Tim Draycott
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- Women and Children's Health, North Bristol NHS Trust, Westbury on Trym, UK
| | - Cathy Winter
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- Women and Children's Health, North Bristol NHS Trust, Westbury on Trym, UK
| | - James Ward
- Engineering Design Centre, University of Cambridge, Cambridge, UK
| | - Mary Dixon-Woods
- The Healthcare Improvement Studies Institute (THIS Institute), University of Cambridge, Cambridge, UK
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Caring for women making unconventional birth choices: A meta-ethnography exploring the views, attitudes, and experiences of midwives. Midwifery 2019; 72:50-59. [PMID: 30776740 DOI: 10.1016/j.midw.2019.02.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 02/05/2019] [Accepted: 02/08/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Women can face opposition when exerting autonomous decision-making regarding their birth choices, particularly when the decisions involve going against medical advice and/or outside of national guidelines. Termed 'unconventional birth choices', some research has explored women's reasons and experiences of making such choices, but less is known about the midwives caring for them. OBJECTIVES To synthesize existing qualitative literature on the views, attitudes, and experiences of midwives caring for women who make unconventional birth choices. METHODS A systematic search and meta-ethnography informed by Noblit and Hare and Schutz was undertaken. Eight databases were searched using predetermined search terms, alongside author, reference, citation chasing, and hand searching. Searches were conducted in July 2016 and updated in October 2017. Qualitative studies published since 1993 in English were included. Included studies were subjected to quality appraisal, conducted independently by two reviewers. Analysis was informed by the interpretative meta-ethnography methods. MAIN RESULTS Five studies met the inclusion criteria. Eight subthemes emerged. These resulted in three higher level interpretative themes emerged: perceptions of women's decision making, conflicting tensions as caregivers, ways of working with-woman. CONCLUSIONS Midwives can play a pivotal role in ensuring that respectful maternity care includes supporting women in their birthing decisions. Whilst limited research has been undertaken in this area, available insights suggest that midwives' views in this area are situated along a spectrum from 'willingly facilitative' to 'reluctantly accepting'. Views were influenced by context, as well as prior philosophies and values. While further research is needed, this study offers insights into the challenges women can face in seeking unconventional birth choices if they require support from midwives to do so.
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Clancy A, Gürgens Gjaerum R. Home as a place for giving birth-A circumpolar study of the experiences of mothers and midwifes. Health Care Women Int 2019; 40:121-137. [PMID: 30681940 DOI: 10.1080/07399332.2018.1531002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This article explores what home birth mothers and midwives say about the birth experience and the interaction between mother, partner and midwife. It is based on an explorative empirical study of the narratives of seven home birth mothers and the experiences of five midwives. The authors examine how these subjective experiences can help us to understand the phenomenon of home birth. The article is grounded in a philosophy of place and feminist theory, understood within a health promotion framework. Home birth manifests itself as a place-based esthetic experience characterized by gender, body, nature and culture. The participants spoke of the significance of giving birth at home. The authors discover that giving birth at home involves celebration, togetherness and ontological security. It also encompasses a broad understanding of risk, power structures, responsibility and co-determination. Openness about the challenges of home births can boost the position of home birth among both clinicians and the general public.
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Affiliation(s)
- Anne Clancy
- a Department of Health and Care Sciences , UiT The Arctic University of Norway , Harstad , Tromso , Norway
| | - Rikke Gürgens Gjaerum
- b Department of Social Education , UiT The Arctic University of Norway , Harstad , Tromso , Norway
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Challenges to midwives' scope of practice in providing women's birthing care in an Australian hospital setting: A grounded theory study. SEXUAL & REPRODUCTIVE HEALTHCARE 2018; 18:37-42. [PMID: 30420085 DOI: 10.1016/j.srhc.2018.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 08/20/2018] [Accepted: 09/11/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To identify and explore processes midwives use to exercise their scope of practice whilst caring for women during normal birth. METHODS Strauss and Corbin's (1998) grounded theory approach was used. Data were collected from 17 midwife participants using participant observation of women's labour and birth care followed by semi-structured interviews. RESULTS The core category of promoting normal birthing: aspiring to develop a midwife-led scope of practice conceptualises midwives working to develop their scope of practice to promote and facilitate normal birthing for women. Two interrelated categories, promoting and maintaining healthy birthing and optimising scope of practice further explicate how midwives provide woman-centred care within their scope of practice. CONCLUSIONS The theoretical framework generates conceptual knowledge of how midwives aspire to promote healthy, safe and responsive birthing care for women in their scope of practice in a hospital setting. Findings provide greater insights into the competing perspectives of birthing care challenging midwives' capacity to provide woman-centred care, influencing the degree to which midwives are able to exercise their scope of practice in promoting normal birth.
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Russell K. Factors that support change in the delivery of midwifery led care in hospital settings. A review of current literature. Women Birth 2018; 31:e134-e141. [DOI: 10.1016/j.wombi.2017.08.129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 08/10/2017] [Accepted: 08/18/2017] [Indexed: 10/18/2022]
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Joynes VCT. Defining and understanding the relationship between professional identity and interprofessional responsibility: implications for educating health and social care students. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2018; 23:133-149. [PMID: 28516242 PMCID: PMC5801384 DOI: 10.1007/s10459-017-9778-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 04/25/2017] [Indexed: 05/06/2023]
Abstract
This paper is concerned with exploring the relationship between perceptions of professional identities, interprofessional education (IPE) and collaborative practice. It seeks to introduce the concept of interprofessional responsibility as both a shift in the way in which to conceptualise the professional identity of Health and Social Care (H&SC) staff and as a new set of practices that help to inform the way in which students are prepared for collaborative working. The presented research, undertaken as part of a Ph.D. study, is based upon semi-structured interviews (n = 33) with H&SC staff who were recruited from both the United Kingdom (UK) Health Service and UK universities. Drawing upon thematic analysis of the data, the results of the research identified that previous conceptualisations of professional identity aligned to a whole profession do not relate to the way in which professionals perceive their identities. Senior professionals claimed to be more comfortable with their own professional identity, and with working across professional boundaries, than junior colleagues. Academic staff also identified that much IPE currently taught in universities serves the purpose of box-ticking rather than being delivered in meaningful way. It is proposed that the findings have implications for the way in which IPE is currently taught, and that adoption of the proposed concept of 'interprofessional responsibility' may help address some of the concerns these findings raise.
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Affiliation(s)
- Viktoria C T Joynes
- Faculty of Health and Life Sciences, School of Medicine, Institute of Clinical Sciences, The University of Liverpool, Room 2.15, 2nd Floor, Cedar House, Ashton Street, Liverpool, L69 3GE, UK.
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Healy S, Humphreys E, Kennedy C. A qualitative exploration of how midwives’ and obstetricians’ perception of risk affects care practices for low-risk women and normal birth. Women Birth 2017; 30:367-375. [DOI: 10.1016/j.wombi.2017.02.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 12/11/2016] [Accepted: 02/11/2017] [Indexed: 10/20/2022]
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Keedle H, Schmied V, Burns E, Dahlen H. The Design, Development, and Evaluation of a Qualitative Data Collection Application for Pregnant Women. J Nurs Scholarsh 2017; 50:47-55. [PMID: 28898529 DOI: 10.1111/jnu.12344] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE This article explores the development and evaluation of a smartphone mobile software application (app) to collect qualitative data. The app was specifically designed to capture real-time qualitative data from women planning a vaginal birth after caesarean delivery. This article outlines the design and development of the app to include funding, ethics, and the recruitment of an app developer, as well as the evaluation of using the app by seven participants. ORGANIZING CONSTRUCT Data collection methods used in qualitative research include interviews and focus groups (either online, face-to-face, or by phone), participant diaries, or observations of interactions. This article identifies an alternative data collection methodology using a smartphone app to collect real-time data. CONCLUSIONS The app provides real-time data and instant access to data alongside the ability to access participants from a variety of locations. This allows the researcher to gain insight into the experiences of participants through audio or video recordings in longitudinal studies without the need for constant interactions or interviews with participants. CLINICAL RELEVANCE Using smartphone applications can allow researchers to access participants who are traditionally hard to reach and access their data in real time. Evaluating these apps before use in research is invaluable.
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Affiliation(s)
- Hazel Keedle
- Doctoral Candidate, Lecturer, School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Virginia Schmied
- Professor of Midwifery, School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Elaine Burns
- Midwifery Lecturer, School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Hannah Dahlen
- Professor of Midwifery, School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
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Jenkinson B, Kruske S, Kildea S. The experiences of women, midwives and obstetricians when women decline recommended maternity care: A feminist thematic analysis. Midwifery 2017; 52:1-10. [DOI: 10.1016/j.midw.2017.05.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 04/24/2017] [Accepted: 05/06/2017] [Indexed: 11/25/2022]
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Schlüter-Cruse M, Schnepp W, Sayn-Wittgenstein FZ. Interprofessional cooperation by midwives in the field of out-of-hospital obstetrical care: an integrative review / Interprofessionelle Kooperation von Hebammen im Handlungsfeld der ambulanten geburtshilflichen Versorgung: ein integratives Review. INTERNATIONAL JOURNAL OF HEALTH PROFESSIONS 2016. [DOI: 10.1515/ijhp-2016-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
The central objective of early prevention in Germany is an improved cooperation between professional groups of the health services and child and youth welfare in interprofessional networks. This objective derives from the realisation that proper care for families with infants can only be achieved if the various groups act in close integration. The ‘Federal Initiative early prevention’ explicitly calls for freelance midwives to be integrated in this context. However, only a few scientific findings on midwives’ cooperation in networks of early prevention have been published to date. This integrative review aims to identify the central themes of interprofessional cooperation of midwives in out-of-hospital obstetrical care from national and international research literature.
A systematic search of five research databases for publications between 2005 and 2015 was performed, complemented by a manual search.
25 studies were identified describing various contexts where midwives in out-of-hospital obstetrical care cooperate with other professional groups. Four key themes were analysed: contexts of cooperation, benefits of cooperation, facilitating and restrictive factors of cooperation, and competencies of cooperation. The studies show that there is only limited research coverage of the midwives’ perspective regarding interprofessional cooperation. The existing studies examine the cooperation of midwives primarily with health care professionals, and secondarily with professionals in the social services.
In order to expand knowledge on the cooperation of freelance midwives in the networks of early prevention, future research should focus on the perspective of midwives regarding cooperation with other professional groups, both in the health care sector and in the field of social services.
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Affiliation(s)
- Martina Schlüter-Cruse
- Osnabrück University of Applied Sciences, Faculty of Business Management and Social Sciences , Barbarastr. 24, 49076 Osnabrück , Germany
- Witten/Herdecke University, Faculty of Health, Department of Nursing Science , Stockumer Straße 12, 58453 Witten , Germany
| | - Wilfried Schnepp
- Witten/Herdecke University, Faculty of Health, Department of Nursing Science , Stockumer Straße 12, 58453 Witten , Germany
- Osnabrück University of Applied Sciences, Faculty of Business Management and Social Sciences , Barbarastr. 24, 49076 Osnabrück , Germany
| | - Friederike zu Sayn-Wittgenstein
- Osnabrück University of Applied Sciences, Faculty of Business Management and Social Sciences , Barbarastr. 24, 49076 Osnabrück , Germany
- Witten/Herdecke University, Faculty of Health, Department of Nursing Science , Stockumer Straße 12, 58453 Witten , Germany
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Ebert L, Tierney O, Jones D. Learning to be a midwife in the clinical environment; tasks, clinical practicum hours or midwifery relationships. Nurse Educ Pract 2016; 16:294-7. [DOI: 10.1016/j.nepr.2015.08.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 02/09/2015] [Accepted: 08/09/2015] [Indexed: 11/27/2022]
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Boyle S, Thomas H, Brooks F. Women׳s views on partnership working with midwives during pregnancy and childbirth. Midwifery 2016; 32:21-9. [DOI: 10.1016/j.midw.2015.09.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 05/23/2015] [Accepted: 09/01/2015] [Indexed: 10/23/2022]
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Hunter B, Segrott J. Renegotiating inter-professional boundaries in maternity care: implementing a clinical pathway for normal labour. SOCIOLOGY OF HEALTH & ILLNESS 2014; 36:719-737. [PMID: 24640992 PMCID: PMC4244180 DOI: 10.1111/1467-9566.12096] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This article presents findings from a study of a clinical pathway for normal labour (Normal Labour Pathway) implemented in Wales, UK. The study was conducted between 2004 and 2006. The pathway aimed to support normal childbirth and reduce unnecessary childbirth interventions by promoting midwife-led care. This article focuses on how the pathway influenced the inter-professional relationships and boundaries between midwives and doctors. Data are drawn from semi-participant observation, focus groups and semi-structured interviews with 41 midwives, and semi-structured interviews with five midwifery managers and six doctors, working in two research sites. Whereas some studies have shown how clinical pathways may act as 'boundary objects', dissolving professional boundaries, promoting interdisciplinary care and de-differentiating professional identities, the 'normal labour pathway' was employed by midwives as an object of demarcation, which legitimised a midwifery model of care, clarified professional boundaries and accentuated differences in professional identities and approaches to childbirth. The pathway represented key characteristics of a professional project: achieving occupational autonomy and closure. Stricter delineation of the boundary between midwifery and obstetric work increased the confidence and professional visibility of midwives but left doctors feeling excluded and undervalued, and paradoxically reduced the scope of midwifery practice through redefining what counted as normal.
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Affiliation(s)
- Billie Hunter
- School of Health Care Sciences, Cardiff UniversityUK
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