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Zou Y, Lan Q, Chen L, Yao Z, Zhai J. Undergraduate midwifery students' experiential learning of perinatal bereavement care: A qualitative analysis. NURSE EDUCATION TODAY 2024; 141:106324. [PMID: 39116473 DOI: 10.1016/j.nedt.2024.106324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 07/09/2024] [Accepted: 07/25/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND It is widely acknowledged that midwives are essential in providing care for mothers experiencing perinatal death. However, midwifery students lack the knowledge and skills needed to deal with perinatal death, and. There is limited research on perinatal bereavement care training for midwifery students. AIM To investigate undergraduate midwifery students' experiential learning of perinatal bereavement care and serve as a reference for future perinatal bereavement care teaching and training. DESIGN Qualitative descriptive design. SETTING University in Guangzhou, China. PARTICIPANTS Undergraduate midwifery students at a university in Guangzhou, China. METHOD This research was conducted at a university in Guangzhou, China. The participants were recruited using purposeful sampling. Semi-structured, in-depth interviews were conducted with 11 midwifery students who participated in perinatal bereavement care training from May to June 2023. The Colalizzi 7-step data analysis method was used for data analysis. RESULTS From the data, five themes emerged: 1) immersive experience of perinatal bereavement care, 2) formation of perspectives on perinatal bereavement care, 3) clarification of the service boundaries and internalization of the professional service spirit, 4) emotional impact and coping strategies, and 5)) factors influencing practice optimization. CONCLUSIONS Experiential learning is an effective teaching strategy. However, participants continued to feel unprepared to provide perinatal bereavement care. Implementing relevant training, disseminating perinatal bereavement care knowledge and skills, and enhancing the ability of midwifery students to manage and cope with the psychological impact of perinatal death are important.
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Affiliation(s)
- Yinting Zou
- Department of Nursing, Guangdong Maoming Health Vocational College, Maoming 525400, China
| | - Qinqin Lan
- School of Nursing, Southern Medical University, Guangzhou 510515, China
| | - Lijin Chen
- School of Nursing, Southern Medical University, Guangzhou 510515, China
| | - Zheng Yao
- School of Nursing, Southern Medical University, Guangzhou 510515, China
| | - Jinguo Zhai
- School of Nursing, Southern Medical University, Guangzhou 510515, China.
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Segal K, Kagan I. Traumatic experiences, quality of life, and organizational commitment among midwives: A cross-sectional study. Birth 2024. [PMID: 39225410 DOI: 10.1111/birt.12868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 12/22/2023] [Accepted: 08/08/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND The work of midwives is emotionally challenging. Midwives share moments of joy, when a baby is born, and attend complex events of loss and trauma. Exposure to childbirth complications, emergencies, and loss can affect their professional quality of life and functioning. This aspect of midwives' practice has not been sufficiently researched. AIM To examine the associations between exposures to traumatic events, post-traumatic symptoms, and personal resilience with professional quality of life and organizational commitment among hospital midwives. METHODS Participants in this cross-sectional study conducted in 2020 included 131 midwives from three large hospitals in central Israel. Data were collected using a structured self-administered questionnaire that examined socio-demographic characteristics, exposure to traumatic events during childbirth, personal resilience, post-traumatic symptoms, professional quality of life, and organizational commitment. RESULTS The three most traumatic events for midwives were: neonatal death or feared death, maternal death or feared death, and stillbirth. The more frequent the exposure to traumatic events, the more numerous and intense the post-traumatic symptoms. The more numerous and intense the post-traumatic symptoms, the higher the level of professional burnout and compassion fatigue and the lower the compassion satisfaction. Higher compassion satisfaction and lower professional burnout were associated with higher organizational commitment. Personal resilience, country of birth, post-traumatic symptoms, and organizational commitment predicted compassion satisfaction. CONCLUSIONS Midwives' exposure to traumatic events is associated with the onset of post-traumatic symptoms, impaired professional quality of life, and reduced organizational commitment, and is accompanied by burnout and compassion fatigue. There is a need to address this issue in training programs and to develop organizational support and policies to improve midwives' well-being and quality of care.
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Affiliation(s)
- Kinneret Segal
- Beilinson Women's Hospital, Rabin Medical Center, Clalit Health Services, Tel Aviv, Israel
| | - Ilya Kagan
- Nursing Department, Ashkelon Academic College, Ashkelon, Israel
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Slade P, Smart C, Krahé C, Spiby H. Maternity support workers' experiences of workplace trauma and post-traumatic stress symptoms. Midwifery 2024; 136:104071. [PMID: 38972197 DOI: 10.1016/j.midw.2024.104071] [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: 05/31/2023] [Revised: 06/14/2024] [Accepted: 06/16/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND Maternity support workers (MSWs) are now a key part of the maternity workforce. They work in environments with potential exposure to traumatic events, but little is known about their rates of exposure or psychological responses. OBJECTIVES We aimed to identify the proportion of MSWs reporting exposure to a traumatic work event and consequential rates of post-traumatic stress disorder (PTSD). We also aimed to identify factors associated with PTSD and to describe levels of burnout, empathy, and functional impairment, and to explore their potential associations with PTSD symptoms. METHODS MSWs were recruited via the Royal College of Midwives newsletter, which is sent to all MSW members, and via social media on the College MSW Facebook page. Participants completed an online survey. They provided information on demographic details, job role, and exposure to traumatic events, and completed questionnaires covering PTSD symptoms related to work events, related functional impairment, burnout, and empathy. Data were analysed via correlations and multiple regression. FINDINGS Of 98 respondents, 88 had been exposed to a traumatic work event; 79 of these through being present and nine through hearing about traumatic events. Of those exposed, 14.8% (n = 13) participants had probable PTSD, while a further 5.7 % (n = 5) met the subclinical threshold. Over a third (35.2 %) of the sample showed high levels of emotional exhaustion, a key feature of burnout, and 27.3 % reported functional work impairment. PTSD symptoms were associated with younger age, higher empathic concern, and direct exposure to traumatic perinatal events. CONCLUSIONS AND CLINICAL IMPLICATIONS MSWs are routinely exposed to traumatic events at work and are at risk of work-related PTSD. Younger and more empathic staff appear more at risk, although our methods could not distinguish cause and effect. It must also be noted that the survey took place during the COVID-19 pandemic, and findings could be influenced by this context. MSWs need to be routinely included in programmes to support staff in relation to trauma exposure at work.
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Affiliation(s)
- Pauline Slade
- Department of Primary Care and Mental Health, Eleanor Rathbone Building, University of Liverpool, Liverpool L69 7ZA, United Kingdom.
| | - Charlotte Smart
- Department of Primary Care and Mental Health, Eleanor Rathbone Building, University of Liverpool, Liverpool L69 7ZA, United Kingdom
| | - Charlotte Krahé
- Department of Primary Care and Mental Health, Eleanor Rathbone Building, University of Liverpool, Liverpool L69 7ZA, United Kingdom
| | - Helen Spiby
- Faculty of Medical and Health Sciences, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, United Kingdom
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Hüner B, Kehl S, Stelzl P, Friedl TWP, Janni W, Reister F, Lunkenheimer F. ["Who cares about us?" Results of a cross-sectional study on the psychosocial health of obstetricians and midwives after traumatic birth experiences]. Z Geburtshilfe Neonatol 2024. [PMID: 39121876 DOI: 10.1055/a-2361-4211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2024]
Abstract
BACKGROUND Traumatic births not only cause emotional stress for expectant parents but can also affect the psychosocial health of midwives and obstetricians due to their professional demands. AIM To evaluate the impact of traumatic birth experiences on the psychosocial health of obstetric healthcare professionals. METHODS A cross-sectional study using validated measurement tools (Impact of Event Scale Revised IES-R, Copenhagen Burnout Inventory CBI) and assessing post-traumatic growth (PGI-SF) through an online survey of midwives and obstetricians in German-speaking areas. RESULTS The study included 700 participants with peripartum and/or personal traumas. Of the 528 participants who completed the IES-R, 33 (6.3%) with post-traumatic stress disorder (PTSD) received less support from colleagues (p = 0.007) and were more likely to experience workplace consequences (p < 0.001) than participants without PTSD. A moderate to high level of burnout was found in 66.2% of the 542 participants who completed the CBI. Personal growth through experiencing trauma was reported by 75.9% of the 528 participants who completed the PGI-SF. CONCLUSION The psychosocial health of midwives and obstetricians is at risk due to traumatic birth experiences. Screening tests and the provision of collegial and professional debriefings to strengthen resilience are essential preventive interventions.
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Affiliation(s)
- Beate Hüner
- Frauenklinik, Universitätsklinikum Ulm, Ulm, Germany
| | - Sven Kehl
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Patrick Stelzl
- Universitätsklinik für Gynäkologie, Geburtshilfe und Gyn. Endokrinologie, Kepler Universitatsklinikum Linz, Linz, Austria
| | | | | | - Frank Reister
- Frauenklinik, Universitätsklinikum Ulm, Ulm, Germany
| | - Frederike Lunkenheimer
- Abteilung Klinische Psychologie und Psychotherapie, Institut für Psychologie und Pädagogik, Universität Ulm, Ulm, Germany
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Miao Q, Zhu L, Shu W, Huang XQ, Zhu CY. To explore the impact of traumatic birth experiences on midwives' experience of empathy: A qualitative study. NURSE EDUCATION TODAY 2024; 139:106216. [PMID: 38696883 DOI: 10.1016/j.nedt.2024.106216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 04/03/2024] [Accepted: 04/09/2024] [Indexed: 05/04/2024]
Abstract
OBJECTIVE This study aimed to investigate the experiences of Chinese midwives during traumatic birth experiences and their impact. By doing so, we hope to develop effective empathetic educational strategies and provide valuable insights to improve the midwifery support system in China. METHODS This study adopted Colaizzi's phenomenological approach, which aimed to understand and explore human experiences from the standpoint of the participants. A purposive sampling method was used to select 16 midwives for semi-structured interviews. The Colaizzi 7-step method was used to analyze the interview data. FINDINGS Three themes and eight sub-themes were developed by analyzing and integrating the interview data. These included intertwined negative experiences (self-blame and guilt, regurgitated disturbances, intense and persistent physical and psychological discomfort, and low confidence in midwifery decision-making behaviours), the coexistence of positive effects (increased ability to tolerate life uncertainty, increased sense of control in coping with traumatic birth experiences), and needs and expectations (confiding in co-workers, an expectation of professional psychological support interventions). CONCLUSIONS The experiences of midwives in showing empathy during traumatic birth experiences are complex and multifaceted. It is crucial to recognize and address negative empathic experiences, provide coping strategies, and enhance positive empathic experiences. Midwives' grief counselling competence education should be strengthened, as should their psychological well-being and the midwifery support system.
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Affiliation(s)
- QunFang Miao
- Affiliated Hospital of Hangzhou Normal University (School of Clinical Medicine), Hangzhou City, Zhejiang Province, China; Department of Clinical Psychology, Affiliated Hospital of Hangzhou Normal University, Hangzhou City, Zhejiang Province, China
| | - Li Zhu
- School of Nursing, Hangzhou Normal University, Hangzhou City, Zhejiang Province, China
| | - Wan Shu
- School of Nursing, Hangzhou Normal University, Hangzhou City, Zhejiang Province, China
| | - Xiao Qin Huang
- School of Nursing, Hangzhou Normal University, Hangzhou City, Zhejiang Province, China
| | - Chun Ying Zhu
- Department of Clinical Psychology, Affiliated Hospital of Hangzhou Normal University, Hangzhou City, Zhejiang Province, China.
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Collins EC, Burns ES, Dahlen HG. 'It was horrible to watch, horrible to be a part of': Midwives' perspectives of obstetric violence. Women Birth 2024; 37:101631. [PMID: 38861852 DOI: 10.1016/j.wombi.2024.101631] [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: 12/19/2023] [Revised: 05/02/2024] [Accepted: 05/27/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND Obstetric violence, including unconsented interventions, coercion and disrespect, violates human rights; impacting the physical and psychosocial health of women. The perspective and experience of midwives related to obstetric violence have been explored in low and middle-income countries, with limited research into the experience of midwives in high income nations. AIM To explore Australian midwives' perspectives of obstetric violence. METHODS Thematic analysis of qualitative in-depth interviews with 15 midwives experienced in supporting women during birth. Critical feminist theory underpinned each stage of the research. FINDINGS Interviews with 15 Australian midwives from diverse care settings were analysed thematically. Four key themes were developed from the data: 'the operationalisation of obstetric violence', 'the impact of obstetric violence' 'the historical and situational context' and 'hope for the future'. Midwives considered entrenched patriarchal structures and gender inequity as fundamental to the occurrence of obstetric violence. This societal scaffold is intensified within health care systems where power imbalances facilitate maternal mistreatment through coercion and grooming women for compliance in the antenatal period. Fragmented care models expose women to mistreatment with continuity models being protective only to a point. Midwives experience their own trauma, as a result of what they have witnessed, and due to the lack of support they receive when advocating for women. CONCLUSIONS Obstetric violence occurs in Australian maternity systems with unconsented interventions, overmedicalisation, coercion, and disrespect observed by midwives. Care-related trauma impacts on the mental health of midwives, raising workforce concerns for policy makers, consumer advocates and professional bodies.
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Affiliation(s)
- Emma C Collins
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2715, Australia.
| | - Elaine S Burns
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2715, Australia
| | - Hannah G Dahlen
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2715, Australia
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Cates EC, Ramlogan-Salanga C, MacKenzie RK, Wilson-Mitchell K, Darling EK. A cross-sectional survey of the mental health of midwives in Ontario, Canada: Burnout, depression, anxiety, stress, and associated factors. Women Birth 2024; 37:101613. [PMID: 38615516 DOI: 10.1016/j.wombi.2024.101613] [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: 10/24/2023] [Revised: 03/15/2024] [Accepted: 03/30/2024] [Indexed: 04/16/2024]
Abstract
PROBLEM Burnout and the psychological co-morbidities stress, anxiety and depression have a significant impact on healthcare providers, including midwives. These conditions impact the quality of care provided to women, and midwives' ability to remain in the profession. BACKGROUND There is growing concern regarding the retention of maternity care providers in Canada, particularly midwives. Nationally, 33% of Canadian midwives are seriously considering leaving practice; impacts of the profession on work-life-balance and mental health being commonly cited reasons. Burnout has been shown to contribute to workplace attrition, but little is known concerning burnout among Canadian midwives. AIM To assess levels of stress, anxiety, depression, and burnout among midwives in Ontario, Canada and potential factors associated with these conditions. METHODS A cross-sectional survey of Ontario midwives incorporating a series of well-validated tools including the Copenhagen Burnout Inventory and the Depression, Anxiety and Stress Scale. FINDINGS Between February 5, and April 14, 2021, 275 Ontario midwives completed the survey. More than 50% of respondents reported depression, anxiety, stress, and burnout. Factors associated with poor mental health outcomes included having less than 10-years practice experience, identifying as a midwife with a disability, the inability to work off-call, and having taken a prior mental health leave. DISCUSSION & CONCLUSION A significant proportion of Ontario midwives are experiencing high levels of stress, anxiety, depression, and burnout, which should be a serious concern for the profession, its leaders, and regulators. Investment in strategies aimed at retaining midwives that address underlying factors leading to attrition should be prioritized.
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Affiliation(s)
- Elizabeth C Cates
- McMaster Midwifery Research Centre, McMaster University, Hamilton, ON, Canada; Department of Pathology & Molecular Medicine, McMaster University, Hamilton, ON, Canada; Midwifery Education Program, Mc McMaster University, Hamilton, ON, Canada
| | - Claire Ramlogan-Salanga
- McMaster Midwifery Research Centre, McMaster University, Hamilton, ON, Canada; Midwifery Education Program, Mc McMaster University, Hamilton, ON, Canada; Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada
| | - R Katie MacKenzie
- McMaster Midwifery Research Centre, McMaster University, Hamilton, ON, Canada
| | - Karline Wilson-Mitchell
- Midwifery Education Program, Faculty of Community Services, Toronto Metropolitan University, Toronto, ON, Canada
| | - Elizabeth K Darling
- McMaster Midwifery Research Centre, McMaster University, Hamilton, ON, Canada; Midwifery Education Program, Mc McMaster University, Hamilton, ON, Canada; Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada.
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Keedle H, Keedle W, Dahlen HG. Dehumanized, Violated, and Powerless: An Australian Survey of Women's Experiences of Obstetric Violence in the Past 5 Years. Violence Against Women 2024; 30:2320-2344. [PMID: 36452982 PMCID: PMC11145922 DOI: 10.1177/10778012221140138] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Globally, significant numbers of women report obstetric violence (OV) during childbirth. The United Nations has identified OV as gendered violence. OV can be perpetrated by any healthcare professional (HCP) and is impacted by systemic issues such as HCP education, staffing ratios, and lack of access to continuity of care. The current study explored the experiences of OV reported in a national survey in 2021 by Australian women who had a baby in the previous 5 years. A content analysis of 626 open text comments found three main categories: "I felt dehumanised," "I felt violated," and "I felt powerless." Women reported bullying, coercion, non-empathic care, and physical and sexual assault. Disrespect and abuse and non-consented vaginal examinations were the subcategories with the most comments.
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Affiliation(s)
- Hazel Keedle
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Warren Keedle
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Hannah G. Dahlen
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
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Long T, Aggar C, Grace S. Trauma-informed care education for midwives: Does education improve attitudes towards trauma-informed care? Midwifery 2024; 131:103950. [PMID: 38359645 DOI: 10.1016/j.midw.2024.103950] [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: 04/02/2023] [Revised: 12/13/2023] [Accepted: 02/05/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION Continuing education is important to improve midwives' attitudes to trauma-informed care in addressing the needs of women during the perinatal period. This study aimed to evaluate if there was a significant difference in attitudes towards trauma-informed care between midwives who participated in a 2-day trauma-informed care education program and those who did not. METHOD A static group comparison design was adopted with a convenience sample of midwives to analyse differences in attitudes towards trauma-informed care between midwives who received a 2-day TIC education (n = 19, intervention group) and their peers who did not receive the education (n = 18, comparison group). RESULTS The results suggest that midwives who participated in a 2-day trauma-informed care education program had significantly higher scores for positive attitudes towards trauma-informed care compared to those who did not take part in the program and that this effect was sustained at 6 months. CONCLUSION To minimise perinatal trauma for mothers and babies, midwives require specific trauma-informed care education. This study proposes that trauma-informed care education is a foundational pathway for implementing a trauma-informed care framework across a maternity service.
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Affiliation(s)
- Trish Long
- Northern NSW Local Health District, Australia.
| | - Christina Aggar
- Northern NSW Local Health District, Australia; Southern Cross University, Faculty of Health, Australia
| | - Sandra Grace
- Southern Cross University, Faculty of Health, Australia
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Linetsky I, Grinberg K, Granot M. The role of self-criticism and self-compassion in the development of PTSD among midwives. Midwifery 2024; 130:103932. [PMID: 38271789 DOI: 10.1016/j.midw.2024.103932] [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: 03/05/2023] [Revised: 12/11/2023] [Accepted: 01/19/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVE Healthcare providers might develop emotional distress following direct and indirect exposure to traumatic events. Evidence shows that midwives, who care for women in complicated situations, are often exposed to circumstances that have a potential to lead to a variety of psychological reactions, including symptoms identified with post-traumatic stress disorder (PTSD). Nevertheless, the positive-healthy context in which childbirth is mainly perceived raises questions regarding the protective role of personality traits, which are related to processing methods of stress and pain, in the development of PTSD among this unique population. This study aimed to explore the associations between traits such as self-compassion, self-criticism, resilience, cognitive thinking, and pain catastrophizing and PTSD symptoms among Israeli midwives. SETTING Using a quantitative cross-sectional study,123 midwives from ten hospitals in Israel anonymously reported their characteristics and severity of stress and/or PTSD symptoms by filling out the Psychopathy Checklist questionnaire. Analysis of personality traits was performed via the following questionnaires: Self-Compassion Scale - Short Form, Depressive Experiences Questionnaire - Self Criticism, and the Connor-Davidson Resilience Scale. Additionally, we measured the level of catastrophizing pain by employing the Pain Catastrophizing Scale questionnaire. FINDINGS Most of the midwives reported existing post-trauma symptoms, among them 11.38% had been diagnosed with PTSD. Severity of the PTSD correlated with their self-criticism and the pain catastrophizing rates. Additional examination of the involvement of personality traits showed that midwives with high self-criticism, low mental resilience, besides a high rate of pain catastrophizing, were more vulnerable to developing PTSD. CONCLUSIONS The findings can help to refine the understanding regarding the involvement of midwives' personality characteristics in the process of PTSD onset. Vulnerable midwives have been identified as those at risk to develop PTSD symptoms. IMPLICATIONS FOR PRACTICE The clinical significance of these insights is to promote the ability to identify midwives who are at risk to develop PTSD. Furthermore, this information might help to produce training programs and a support network to empower self-compassion and mental resilience, and to minimize self-criticism in order establish a support network, which would help to deal with the difficult experiences they face at work.
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Affiliation(s)
- Irina Linetsky
- Nursing Sciences Department, Faculty of Social and Community Sciences, Ruppin Academic Center, Emek- Hefer 402500, Israel
| | - Keren Grinberg
- Head of Nursing Sciences Department, Faculty of Social and Community Sciences, Ruppin Academic Center, Emek- Hefer 402500, Israel.
| | - Michal Granot
- Faculty of Social Welfare and Health Studies, Mount Carmel, University of Haifa, Haifa 31905, Israel
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Bayrı Bingöl F, Karaçam Yılmaz ZD, Topaloğlu S. Partners in Pain, Two Sides of a Zipper - Midwives' Experiences With Stillbirth: A Qualitative Study. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241235429. [PMID: 38404056 DOI: 10.1177/00302228241235429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
This study was conducted to explore and understand the experiences of midwives who care for women experiencing stillbirth and the challenges they face in this process. A qualitative study was conducted with 11 midwives using the phenomenological method. Descriptive analysis of the data revealed four main themes: 1) Silent screams in the face of despair (women's reactions to stillbirth), 2) Being a partner in pain, "two sides of a zipper" (midwives' experience of stillbirth), 3) Efforts to cope with the pain, and 4) Just two words: "if only." The impact of stillbirths on midwives should not be disregarded. Emotions such as shock, horror, fear, guilt, and anger experienced by midwives following a stillbirth can adversely affect their mental health. The guilt experienced by midwives can also negatively impact their health and quality of life, as well as cause burnout and distancing from the profession.
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Affiliation(s)
- Fadime Bayrı Bingöl
- Midwifery Department, Health Sciences Faculty, Marmara University, Istanbul, Türkiye
| | - Zeynep Dilşah Karaçam Yılmaz
- Midwifery Department, Health Sciences Faculty, Marmara University, Istanbul, Türkiye
- Istanbul University-Cerrahpasa, Institute of Graduate Studies, Istanbul, Türkiye
| | - Seçil Topaloğlu
- Midwifery Department, Health Sciences Faculty, Istanbul Medipol University, Istanbul, Türkiye
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Nieuwenhuijze M, Leahy-Warren P, Healy M, Aktaş S, Aydin R, Calleja-Agius J, Goberna-Tricas J, Hadjigeorgiou E, Hartmann K, Henriksen L, Horsch A, Lange U, Murphy M, Pierron A, Schäfers R, Pajalic Z, Verhoeven C, Berdun DR, Hossain S. The impact of severe perinatal events on maternity care providers: a scoping review. BMC Health Serv Res 2024; 24:171. [PMID: 38326880 PMCID: PMC10848539 DOI: 10.1186/s12913-024-10595-y] [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: 09/15/2023] [Accepted: 01/12/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Severe events during the perinatal period can be experienced as traumatic by pregnant women, their partners or others who are closely involved. This includes maternity care providers who can be affected by being involved in or observing these events. This may have an impact on their personal well-being and professional practice, influencing quality of care. The aim of this study is to map research investigating the impact of severe events during the perinatal period on maternity care providers, and how these experiences affect their well-being and professional practice. METHOD A scoping review following the manual of the Joanna Briggs Institute was undertaken. The electronic bibliographic databases included PubMed/MEDLINE, CINAHL, PsycINFO, PsycARTICLES, SocINDEX, Cochrane, Scopus, Web of Science and databases for grey literature. Records passing the two-stage screening process were assessed, and their reference lists hand searched. We included primary research papers that presented data from maternity care professionals on the impact of severe perinatal traumatic events. A descriptive content analysis and synthesis was undertaken. RESULTS Following a detailed systematic search and screening of 1,611 records, 57 papers were included in the scoping review. Results of the analysis identified four categories, which highlighted the impact of traumatic perinatal events on maternity care providers, mainly midwives, obstetricians and nurses: Traumatic events, Impact of traumatic events on care providers, Changes in care providers' practice and Support for care providers; each including several subcategories. CONCLUSION The impact of traumatic perinatal events on maternity care providers ranged from severe negative responses where care providers moved position or resigned from their employment in maternity care, to responses where they felt they became a better clinician. However, a substantial number appeared to be negatively affected by traumatic events without getting adequate support. Given the shortage of maternity staff and the importance of a sustainable workforce for effective maternity care, the impact of traumatic perinatal events requires serious consideration in maintaining their wellbeing and positive engagement when conducting their profession. Future research should explore which maternity care providers are mostly at risk for the impact of traumatic events and which interventions can contribute to prevention.
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Affiliation(s)
- Marianne Nieuwenhuijze
- CAPHRI, Maastricht University, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands.
| | | | | | | | | | | | | | | | | | | | | | - Ute Lange
- University of Applied Sciences Bochum, Bochum, Germany
| | | | | | | | | | - Corine Verhoeven
- Amsterdam University Medical Centres, Amsterdam, The Netherlands
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Guzzon A, Nones G, Camedda C, Longobucco Y. Exposure to Traumatic Events at Work, Post-Traumatic Symptoms, and Professional Quality of Life among Italian Midwives: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:415. [PMID: 38391791 PMCID: PMC10888074 DOI: 10.3390/healthcare12040415] [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: 11/30/2023] [Revised: 01/24/2024] [Accepted: 01/28/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The aim of this study is to investigate the potential occurrence of post-traumatic stress disorder (PTSD) symptoms, following exposure to traumatic events, in Italian midwives and their consequent influence on the quality of midwives' professional lives. In addition, data were collected on the major traumatic events described by midwives. METHOD A cross-sectional study related the socio-demographic characteristics of 286 midwives with the scores obtained on two assessment scales, one for post-traumatic stress disorder (IES-R) and the other for quality of life (ProQOL V). The percentage of midwives who obtained a score higher than the predetermined threshold value in both questionnaires was noted, and the correlations that emerged were highlighted. Through this qualitative method, their significant work-related traumatic events were investigated to finally detect the prevalence percentage of each category. RESULTS The proportion of midwives scoring higher than 33 on the IES-R scale, indicating a higher likelihood of PTSD, was 48.6%. Freelancers or outpatient clinic midwives had lower mean IES scores (p = 0.049). A significant inverse correlation was observed between age and IES-R score and between the compassion satisfaction subscale and time since completing education (p = 0.028). A comparison between the IES-R and ProQOL scales showed a statistically significant correlation (p < 0.001), in particular, between the burnout (BO) (p < 0.001) and secondary traumatic stress (STS) (p < 0.001) subscales. The thematic categorization of traumatic events included mother/child death, mother/child medical complications, relational problems with patients or team members, and organizational problems/medical staff's inexperience. CONCLUSIONS The emerging data may confirm the data in the literature, namely those showing that midwives are prone to developing work-related PTSD, particularly due to their exposure to traumatic events such as maternal and neonatal death.
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Affiliation(s)
- Alice Guzzon
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Giulia Nones
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Claudia Camedda
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Yari Longobucco
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
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Isobel S. Trauma and the perinatal period: A review of the theory and practice of trauma-sensitive interactions for nurses and midwives. Nurs Open 2023; 10:7585-7595. [PMID: 37775971 PMCID: PMC10643851 DOI: 10.1002/nop2.2017] [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: 03/14/2023] [Revised: 08/30/2023] [Accepted: 09/17/2023] [Indexed: 10/01/2023] Open
Abstract
AIM With high rates of trauma in the population, known links between trauma and perinatal distress, and the intimate and close nature of the nursing and midwifery roles, ensuring awareness and understandings of trauma is crucial for guiding practice. This paper aims to explore the relationship of trauma to the perinatal period, based on theory and practice, to consider on how nurses and midwives can deliver trauma-sensitive interactions. DESIGN AND METHODS This discursive discussion draws on relevant research from the fields of trauma therapy, attachment theory and nursing and midwifery practice to consider elements of trauma-sensitive practice in the perinatal period. RESULTS Nurses and midwives can foster safety for people who have experienced trauma through noticing and responding to triggers, supporting awareness of attachment and its relationships to trauma, undertaking psychosocial screening with care, supporting linearity and cohesion in narratives and developing collaborative care plans that maximise safety and agency. For nurses and midwives, understandings of the relationship between trauma, pregnancy, birth, early parenting and distress is crucial for effective care delivery. Delivering perinatal nursing or midwifery care of any kind, without universal trauma precautions risks reinforcing, misinterpreting or re-enacting dynamics of trauma. To be trauma-sensitive in this period requires nurses and midwives to have awareness of the dynamics of trauma in relation to pregnancy, birth and attachment. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE This paper fills a gap in the translation of theory to practice for trauma-sensitive care in the perinatal period, with a focus on the therapeutic relationship formed by nurses and midwives. The findings highlight that nurses and midwives can foster safety for people who have experienced trauma within their practice, when they hold a robust understanding of the relationship between trauma, pregnancy, birth, early parenting and distress. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Sophie Isobel
- University of SydneySydneyNew South WalesAustralia
- Perinatal Mental Health, Sydney Local Health DistrictSydneyNew South WalesAustralia
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Bingham J, Kalu FA, Healy M. The impact on midwives and their practice after caring for women who have a traumatic childbirth: A systematic review. Birth 2023; 50:711-734. [PMID: 37602792 DOI: 10.1111/birt.12759] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Women's birth experiences can range from positive and satisfying to negative and traumatizing. Midwives caring for women can also be exposed to these traumatic childbirth experiences. There is a paucity of research on the impact these experiences have on midwives and their practice. The PEO framework guided the research review question. METHODS Seven electronic databases were systematically searched. The quality of each included study was assessed using the tool appropriate to the study's methodological approach; Critical Appraisal Skills Program (CASP) criteria and the Mixed Methods Appraisal Tool (MMAT) Version 2018. The Consolidated Criteria for Reporting Qualitative Research (COREQ) tool was utilized to assess reported findings. Confidence in the Evidence from Reviews of Qualitative research (CERQual) was used to grade the confidence in the evidence of the qualitative research. Data were thematically analyzed to formalize the identification and development of themes. RESULTS A total of 12 studies were included. Synthesis of the evidence generated one overarching theme, "Midwives, the forgotten victims", and three themes describing the essences of midwives' experiences: "Bruised and battered but still smiling"; "Wearing armour to protect my soul"; "Members of my team are holding me up, others are pulling me down". CONCLUSIONS Midwives expressed feelings of shock, fear, responsibility, and powerlessness which may contribute to some experiencing serious mental illness. They reported a shaken belief in the normal physiologic birth process which consequently led to more defensive practice. Research is needed to identify high-quality interventions to support midwives after these events. This systematic review protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO; Registration CRD42021252033).
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Affiliation(s)
- Janet Bingham
- Obstetric Unit, Antrim Area Hospital, Antrim, Northern Ireland, UK
| | - Felicity Agwu Kalu
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Maria Healy
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK
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Limmer CM, Stoll K, Vedam S, Leinweber J, Gross MM. Measuring disrespect and abuse during childbirth in a high-resource country: Development and validation of a German self-report tool. Midwifery 2023; 126:103809. [PMID: 37689053 DOI: 10.1016/j.midw.2023.103809] [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: 06/12/2022] [Revised: 06/27/2023] [Accepted: 08/29/2023] [Indexed: 09/11/2023]
Abstract
INTRODUCTION Increasing evidence on disrespect and abuse during childbirth has led to growing concern about the quality of care childbearing women are experiencing. To provide quantitative evidence of disrespect and abuse during childbirth services in Germany a validated measurement tool is needed. RESEARCH AIM The aim of this research project was the development and psychometric validation of a survey tool in the German language that measures disrespect and abuse of women during childbirth. METHODS A survey tool was created including the following measures: German adaptations of the short and long form of the "Mothers on Respect" (MOR) index (MOR-7 and MOR-G); the "Mothers' Autonomy in Decision Making" (MADM) scale; a mistreatment-index (MIST-I) comprising indicators of mistreatment during childbirth; and a set of items that measure experiences of discrimination during maternity care. Internal consistency reliability and construct validity of the scales were assessed using Cronbach's alpha, unweighted least squares factor analysis and non-parametric correlation analysis with a scale that measures a related construct, the Posttraumatic Symptom Scale - Self Report (PSS-SR) scale. We distributed the survey online, recruiting through snowball sampling via social media. A selection bias towards women who had experienced disrespect and abuse during their birth was intended and expedient for tool validation. The final sample of participants (n = 2045) had given birth in Germany between 2009 and 2018. FINDINGS More than 77% of the study participants reported at least one form of mistreatment with non-consented care being the most commonly reported type of mistreatment, followed by physical violence, violation of physical privacy, verbal abuse and neglect. All included scales showed good psychometric properties with high Cronbach's alphas (0.95 for both MOR versions and 0.96 for MADM). Factor analysis generated one factor scales with high factor loadings (0.75 to 0.92 for MOR-7; 0.37 to 0.90 for MOR-G and 0.83 to 0.92 for MADM). MOR-7, MOR-G, MADM and MIST-I scores were significantly (p<0.001) correlated with PSS-SR scores (Spearman's rho -0.70, -0.61 and 0.68 for MOR-G, MADM and the MIST-I, respectively). CONCLUSIONS This study presents a valid and reliable instrument for the quantitative assessment of disrespect and abuse during childbirth in Germany. Childbearing women's experiences of disrespect and abuse are a relevant phenomenon in German hospital based maternity care. Disrespect and abuse during childbirth appear to contribute to post-traumatic symptoms and may be associated with severe mental health problems postpartum.
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Affiliation(s)
- Claudia M Limmer
- Hannover Medical School, Midwifery Research and Education Unit, Carl-Neuberg-Str. 1, Hannover D-30625, Germany; Department Nursing and Management, Faculty of Business and Social Sciences, Hamburg University of Applied Science, Alexanderstr. 1, Hamburg D-20099, Germany
| | - Kathrin Stoll
- Hannover Medical School, Midwifery Research and Education Unit, Carl-Neuberg-Str. 1, Hannover D-30625, Germany; UBC Midwifery, Faculty of Medicine, University of British Columbia, 304-5950 University Boulevard, Vancouver, BC V6T 1Z3, Canada
| | - Saraswathi Vedam
- UBC Midwifery, Faculty of Medicine, University of British Columbia, 304-5950 University Boulevard, Vancouver, BC V6T 1Z3, Canada
| | - Julia Leinweber
- Institute of Midwifery, University Medicine Berlin, Charite, Oudenarder Strasse 16, Berlin 13347, Germany
| | - Mechthild M Gross
- Hannover Medical School, Midwifery Research and Education Unit, Carl-Neuberg-Str. 1, Hannover D-30625, Germany.
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Cohen R, Sela Y, Nissanholtz-Gannot R. Addressing the second victim phenomenon in Israeli health care institutions. Isr J Health Policy Res 2023; 12:30. [PMID: 37667398 PMCID: PMC10476320 DOI: 10.1186/s13584-023-00578-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/31/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND The 'second victim' phenomenon (SVP) refers to practitioners who experience a negative physical or emotional response, as well as a professional decline, after participating or witnessing an adverse event. Despite the Israeli Ministry of Health's implementation of specific protocols regarding the overall management of adverse events in health organizations over the past decade, there is limited knowledge regarding healthcare managers' perceptions of the 'second victim' occurrence. METHODS A phenomenological qualitative approach was used to identify an accurate view of policy. Fifteen senior risk manager/and policy makers were interviewed about their knowledge and perceptions of the 'second victim'. Topics addressed included reporting mechanisms of an adverse event, the degree of organizational awareness of 'second victim', and identifying components of possible intervention programs and challenges to implementing those programs. RESULTS Examining current procedures reveals that there is limited knowledge about uniform guidance for health care organizations on how to identify, treat, or prevent SVP among providers. The employee support programs that were offered were sporadic in nature and depended on the initiative of a direct manager or the risk manager. CONCLUSIONS Currently, there is little information or organizational discussion about the possible negative effects of AE on healthcare practitioners. To provide overall medical care that is safe and effective for patients, the health system must also provide a suitable response to the needs of the medical provider. This could be achieved by establishing a national policy for all healthcare organizations to follow, raising awareness of the possible occurrence of SVP, and creating a standard for the subsequent identification, treatment and future prevention for providers who may be suffering.
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Affiliation(s)
- Rinat Cohen
- Department of Health System Management, School of Health Science, Ariel University, Ariel, Israel
- Nursing Department, Ramat Gan Academic College, Ramat Gan, Israel
- Rishon Le Zion, Israel
| | - Yael Sela
- Nursing Department, Ruppin Academic College, Emek-Hefer, Israel
| | - Rachel Nissanholtz-Gannot
- Department of Health System Management, School of Health Science, Ariel University, Ariel, Israel
- Smokler Center for Health Policy Research, Meyers JDC-Brookdale Institute, Jerusalem, Israel
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18
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Cohen R, Sela Y, Halevi Hochwald I, Nissanholz-Gannot R. Nurses' Silence: Understanding the Impacts of Second Victim Phenomenon among Israeli Nurses. Healthcare (Basel) 2023; 11:1961. [PMID: 37444795 DOI: 10.3390/healthcare11131961] [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: 06/09/2023] [Revised: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
INTRODUCTION The 'second victim' phenomenon, (SVP) refers to a health professional who was involved in an adverse event (AE) and continues to suffer from the event to the detriment of personal and professional functioning. The second victims' natural history of recovery model predicts stages of the phenomenon from AE occurrence until the 'moving on' stage and serves as a suitable structure for many organizational support programs worldwide. PURPOSE Using the second victims' natural history of recovery model to examine the impact of the SVP on Israeli nurses, with a specific focus on the organizational support they felt they required compared with the support they felt that they had received from their organizations. METHODS Fifteen in-depth interviews were conducted, using a semi-structured questionnaire, among nurses who had experienced the SVP. The interviews were recorded subject to the interviewees' consent, transcribed, and analyzed using thematic content analysis. FINDINGS Throughout all six stages of recovery, all interviewees reported physical and emotional manifestations following exposure to an AE, regardless of the type of event or severity. They also reported difficulty in emotion regulation, as well as damage to functioning and overall quality of life. Most of the nurse interviewees reported a need to share the events with someone, but, despite this desire to receive appropriate support, almost none of them proactively requested help from a professional source, nor did their organizational management initiate proactive support. This lack of referral for further assistance is possibly explained through limited awareness of the SVP as a valid response to an AE, a perceived lack of legitimacy to receive organizational support, and personal barriers that accompany the phenomenon. CONCLUSIONS Appropriate organizational support, offered proximal to an AE as well as over time, is essential for the nurse, the patient, and the organization. Personal barriers, together with limited awareness, may challenge the identification and provision of appropriate assistance. Hence, it is important to address the phenomenon as part of the general organizational policy to improve the quality of care and patient safety.
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Affiliation(s)
- Rinat Cohen
- Department of Health Systems Management, Ariel University, Ariel 4076405, Israel
- Nursing Department, Ramat Gan Academic College, Ramat Gan 5211401, Israel
| | - Yael Sela
- Nursing Department, Faculty of Social and Community Sciences, Ruppin Academic Center, Emeq-Hefer 4025000, Israel
| | - Inbal Halevi Hochwald
- School of Nursing, Max Stern Yezreel Valley College, The Yezreel Valley, Emeq Yezreel 1930600, Israel
| | - Rachel Nissanholz-Gannot
- Department of Health Systems Management, Ariel University, Ariel 4076405, Israel
- Smokler Center for Health Policy Research, Meyers-JDC-Brookdale Institute, Jerusalem 9103702, Israel
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19
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Schoene BEF, Oblasser C, Stoll K, Gross MM. Midwifery students witnessing violence during labour and birth and their attitudes towards supporting normal labour: A cross-sectional survey. Midwifery 2023; 119:103626. [PMID: 36842428 DOI: 10.1016/j.midw.2023.103626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/08/2022] [Accepted: 02/05/2023] [Indexed: 02/13/2023]
Affiliation(s)
- Bettina E F Schoene
- Midwifery Research and Education Unit, Hannover Medical School, Germany; now: FHM, University of Applied Sciences, Germany.
| | - Claudia Oblasser
- Midwifery Research and Education Unit, Hannover Medical School, Germany; now: IMC University of Applied Sciences Krems, Austria
| | - Kathrin Stoll
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia
| | - Mechthild M Gross
- Midwifery Research and Education Unit, Hannover Medical School, Germany.
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20
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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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Kuipers YJ, Thomson G, Goberna-Tricas J, Zurera A, Hresanová E, Temesgenová N, Waldner I, Leinweber J. The social conception of space of birth narrated by women with negative and traumatic birth experiences. Women Birth 2023; 36:e78-e85. [PMID: 35514007 DOI: 10.1016/j.wombi.2022.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Many women experience giving birth as a negative or even as a traumatic event. Birth space and its occupants are fundamentally interconnected with negative and traumatic experiences, highlighting the importance of the social space of birth. AIM To explore experiences of women who have had a negative or traumatic birth to identify the value, sense and meaning they assign to the social space of birth. METHODS A feminist standpoint theory guided the research. Secondary discourse analysis of 51 qualitative data sets/transcripts from Dutch and Czech Republic postpartum women and 551 free-text responses of the Babies Born Better survey from women in the United Kingdom, Netherlands, Belgium, Germany, Austria, Spain, and the Czech Republic. FINDINGS Three themes and associated sub-themes emerged: 1. The institutional dimension of social space related to staff-imposed boundaries, rules and regulations surrounding childbirth, and a clinical atmosphere. 2. The relational dimension of social space related to negative women-healthcare provider interactions and relationships, including notions of dominance, power, authority, and control. 3. The personal dimension of social space related to how women internalised and were affected by the negative social dimensions including feelings of faith misplaced, feeling disconnected and disembodied, and scenes of horror. DISCUSSION/CONCLUSION The findings suggest that improving the quality of the social space of birth may promote better birth experiences for women. The institutional, relational, and personal dimensions of the social space of birth are key in the planning, organisation, and provision of maternity care.
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Affiliation(s)
- Yvonne J Kuipers
- Artesis Plantijn University College, Noorderplaats 2, 2000 Antwerp, Belgium; Edinburgh Napier University, School of Health and Social Care, Sighthill Court, Edinburgh EH11 4BN, Scotland, United Kingdom.
| | - Gill Thomson
- School of Community Health & Midwifery, University of Central Lancashire, Preston, United Kingdom.
| | - Josefina Goberna-Tricas
- University of Barcelona, Faculty of Medicine and Health Sciences, Bellvitge Health Sciences Campus, Carrer de la Feixa Llarga, s/n. 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Alba Zurera
- University of Barcelona, Faculty of Law, Avinguda Diagonal, 684, 08028 Barcelona, Spain.
| | - Ema Hresanová
- Charles University, Faculty of Social Sciences, U Krize 8, 158 00 Prague, Czech Republic.
| | - Natálie Temesgenová
- Charles University, Faculty of Social Sciences, U Krize 8, 158 00 Prague, Czech Republic.
| | - Irmgard Waldner
- Universitätsklinik Graz, Auenbruggerplatz 14, 8036 Graz, Austria.
| | - Julia Leinweber
- Institute for Midwifery, Charite Universitätsmedizin Berlin, Berlin, Germany.
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Mharapara TL, Clemons JH, Greenslade-Yeats J, Ewertowska T, Staniland NA, Ravenswood K. Toward a contextualized understanding of well-being in the midwifery profession: An integrative review. JOURNAL OF PROFESSIONS AND ORGANIZATION 2023. [DOI: 10.1093/jpo/joac017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Abstract
Our integrative review synthesizes and evaluates two decades of empirical research on well-being in the midwifery profession to reveal (1) how researchers have studied midwives’ well-being; (2) key findings of research on midwives’ well-being; (3) underlying assumptions of this research; and (4) limitations of this research. We find that research on midwives’ well-being is disproportionately focused on individual midwives, who are assumed to be largely responsible for their own well-being, and that well-being in the midwifery profession is generally equated with the absence of mental health problems such as burnout, anxiety, and stress. Researchers have largely taken a narrow and instrumental approach to study midwives’ well-being, focusing on work-related antecedents and consequences, and overlooking the influence of nonwork factors embedded in the broader socioeconomic and cultural environment. Drawing on more comprehensive and contextualized well-being frameworks, we propose a research model that (1) expands the well-being construct as it applies to midwives and (2) situates midwives’ well-being in broader social, economic, political, and cultural contexts. Although developed in the midwifery context, our proposed research model can be applied to a host of professions.
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Affiliation(s)
- Tago L Mharapara
- Management Department, Auckland University of Technology , 120 Mayoral Drive, Auckland, 1010 , New Zealand
| | - Janine H Clemons
- Midwifery Department , MH Building 640 Great South Road, Manukau, 2025 , New Zealand
| | - James Greenslade-Yeats
- Management Department, Auckland University of Technology , 120 Mayoral Drive, Auckland, 1010 , New Zealand
| | - Tanya Ewertowska
- Management Department, Auckland University of Technology , 120 Mayoral Drive, Auckland, 1010 , New Zealand
| | - Nimbus Awhina Staniland
- Management Department, Auckland University of Technology , 120 Mayoral Drive, Auckland, 1010 , New Zealand
| | - Katherine Ravenswood
- Management Department, Auckland University of Technology , 120 Mayoral Drive, Auckland, 1010 , New Zealand
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Beer J, Bazaraah R, Fouly H. Describing the lived experiences of nurses and midwives in caring for mothers and families during a fetal loss. SAUDI JOURNAL FOR HEALTH SCIENCES 2023. [DOI: 10.4103/sjhs.sjhs_137_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
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Leinweber J, Fontein-Kuipers Y, Thomson G, Karlsdottir SI, Nilsson C, Ekström-Bergström A, Olza I, Hadjigeorgiou E, Stramrood C. Developing a woman-centered, inclusive definition of traumatic childbirth experiences: A discussion paper. Birth 2022; 49:687-696. [PMID: 35403241 DOI: 10.1111/birt.12634] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/18/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Many women experience giving birth as traumatic. Although women's subjective experiences of trauma are considered the most important, currently there is no clear inclusive definition of a traumatic birth to help guide practice, education, and research. AIM To formulate a woman-centered, inclusive definition of a traumatic childbirth experience. METHODS After a rapid literature review, a five-step process was undertaken. First, a draft definition was created based on interdisciplinary experts' views. The definition was then discussed and reformulated with input from over 60 multidisciplinary clinicians and researchers during a perinatal mental health and birth trauma research meeting in Europe. A revised definition was then shared with consumer groups in eight countries to confirm its face validity and adjusted based on their feedback. RESULTS The stepwise process confirmed that a woman-centered and inclusive definition was important. The final definition was: "A traumatic childbirth experience refers to a woman's experience of interactions and/or events directly related to childbirth that caused overwhelming distressing emotions and reactions; leading to short and/ or long-term negative impacts on a woman's health and wellbeing." CONCLUSIONS This definition of a traumatic childbirth experience was developed through consultations with experts and consumer groups. The definition acknowledges that low-quality provider interactions and obstetric violence can traumatize individuals during childbirth. The women-centered and inclusive focus could help women to identify and validate their experiences of traumatic birth, offering benefits for practice, education, and research, as well as for policymaking and activism in the fields of perinatal mental health and respectful maternity care.
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Affiliation(s)
- Julia Leinweber
- Institut of Midwifery, Charité-University Medicine Berlin, Berlin, Germany
| | - Yvonne Fontein-Kuipers
- School of Midwifery, Health and Social Work, University College Antwerp, Antwerp, Belgium.,Edinburgh Napier University, School of Health and Social Care, Edinburgh, Scotland
| | - Gill Thomson
- Maternal and Infant Nutrition & Nurture Unit, School of Community Health & Midwifery, University of Central Lancashire, Preston, UK
| | | | - Christina Nilsson
- Faculty of Caring Science, Work Life and Social Welfare, University in Borås, Borås, Sweden
| | | | - Ibone Olza
- European Institute of Perinatal Mental Health, Madrid, Spain
| | - Eleni Hadjigeorgiou
- Nursing Department, Faculty of Health Science, Cyprus University of Technology, Limassol, Cyprus
| | - Claire Stramrood
- Department of Obstetrics and Gynaecology, OLVG Hospital, Amsterdam, The Netherlands
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Uddin N, Ayers S, Khine R, Webb R. The perceived impact of birth trauma witnessed by maternity health professionals: A systematic review. Midwifery 2022; 114:103460. [DOI: 10.1016/j.midw.2022.103460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 08/03/2022] [Accepted: 08/11/2022] [Indexed: 11/27/2022]
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Qian J, Cai W, Sun S, Wang M, Yu X. Influencing factors of perinatal bereavement care confidence in nurses and midwives: A cross-sectional study. NURSE EDUCATION TODAY 2022; 117:105479. [PMID: 35863087 DOI: 10.1016/j.nedt.2022.105479] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 06/11/2022] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Most nurses and midwives are not prepared to provide bereavement care. The conflict between the need for high-quality care of bereaved parents and the lack of confidence in providing perinatal bereavement care among nursing staff is becoming increasingly prominent in China. OBJECTIVE To describe the current situation and identify influencing factors of perinatal bereavement care confidence (PBCC) among nurses and midwives in China. METHODS This descriptive and cross-sectional survey was conducted in 2021. A convenience sample was created by recruiting 571 nurses and midwives in 11 hospitals in Zhejiang Province. Collected the data of PBCC, secondary traumatic stress (STS) and emotional exhaustion (EE) in this study. RESULTS The average score of the PBCC was 67.83 ± 10.78. Average levels of STS were (23.32 ± 7.39) and EE (17.87 ± 8.62). PBCC was found to be most often associated with self-awareness, organisational support and training in perinatal bereavement care. CONCLUSIONS Managers should take measures to improve PBCC and optimise perinatal bereavement care practice from the perspective of enhancing self-awareness of nursing staff, strengthening organisational support and providing training in perinatal bereavement care. The mental health of nursing professionals in the context of perinatal bereavement care needs to be emphasised. Nursing managers should make clear policies and establish a communication platform for nursing staff. Professional training should be conducted in the future.
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Affiliation(s)
- Jialu Qian
- Zhejiang University School of Medicine, NO. 268 Kaixuan Road, Hangzhou, Zhejiang 310016, China; Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, 1st Xueshi Road, Hangzhou, Zhejiang 310006, China
| | - Wenyu Cai
- Department of General Surgery, Huashan Hospital Fudan University, No. 12, Middle Urumqi Road, Jingan District, Shanghai, China
| | - Shiwen Sun
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, 1st Xueshi Road, Hangzhou, Zhejiang 310006, China.
| | - Man Wang
- Zhejiang University School of Medicine, NO. 268 Kaixuan Road, Hangzhou, Zhejiang 310016, China; Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, 1st Xueshi Road, Hangzhou, Zhejiang 310006, China
| | - Xiaoyan Yu
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, 1st Xueshi Road, Hangzhou, Zhejiang 310006, China.
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Kesbiç Ş, Boz İ. Experiences of perinatal nurses regarding compassion fatigue and compassion satisfaction: a phenomenological study. J Psychosom Obstet Gynaecol 2022; 43:359-367. [PMID: 34432586 DOI: 10.1080/0167482x.2021.1967927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
AIM This study aims to understand the essence of perinatal nurses' experiences, thoughts, and feelings on compassion satisfaction and compassion fatigue. METHODS The descriptive phenomenological design was used in this study. Data were collected at in-depth interviews with 16 perinatal nurses. The thematic analysis method was used in data analysis. RESULTS Five main themes and 14 subthemes were determined. The first theme 'Compassionate Caring Behaviors' has four subthemes: affectionate behaviors, responsiveness to women' needs, and authentic informing. The theme of 'Gains of Compassionate Care' has two subthemes: easier with same-sex patients and achieving moral satisfaction. The theme of 'The Other Side of Care' contained the subthemes not being understood, challenging care moments, specific nursing expectations, and a demanding work environment. The theme of "Relieving Burden of Care' has three subthemes trying to understand, taking deliberate breaks in communication, and coping with the experience. The last theme 'Cost of Caring: Compassion Fatigue' has two subthemes: avoiding women and multidimensional fatigue. CONCLUSION This study concluded that perinatal nurses were satisfied with compassionate care, caring for same-sex patients, and achieving moral satisfaction increased their compassion satisfaction while witnessing challenging care moments such as fetal loss, and a demanding work environment triggered compassion fatigue.
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Affiliation(s)
- Şule Kesbiç
- Neonatal Intensive Care Unit, Akdeniz University Hospital, Antalya, Turkey
| | - İlkay Boz
- Nursing Faculty, Akdeniz University, Antalya, Turkey
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Osório FDL, Rossini Darwin AC, Bombonetti EA, Ayers S. Posttraumatic stress following childbirth: psychometric properties of the Brazilian version of the City Birth Trauma Scale. J Psychosom Obstet Gynaecol 2022; 43:374-383. [PMID: 34570669 DOI: 10.1080/0167482x.2021.1977278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To seek validity and reliability evidence of the Brazilian version of the City Birth Trauma Scale (BiTS-Br) and establish diagnostic accuracy. METHOD A total of 343 mothers (up to one year after childbirth, 30.8 years old on average) completed the BiTs-Br and other instruments screening for posttraumatic stress disorder (PTSD), depression, and anxiety for convergent validity analysis. Structural validity was verified using exploratory techniques (principal components analysis), while discriminant validity was checked using the known-groups method and ROC curve. The Structured Clinical Interview for DSM-5 was applied via telephone interviews. Test-retest reliability was obtained in a 15-30-d interval. RESULTS A two-factor structure was found (birth-related and general symptoms), with excellent test-retest reliability (0.73) and internal consistency (0.91). Moderate/strong associations (>0.62) were found with correlated symptoms and posttraumatic stress. The scale had a diagnostic accuracy of 86.7% and a cutoff point >28 was the most appropriate, with a sensitivity of 72% and specificity of 83%. CONCLUSIONS BiTS-Br presented excellent psychometric indexes, similar to the original version and other cross-culturally adapted versions. Thus, it can be widely used in scientific research and clinical settings to support the identification and treatment of PTSD.
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Affiliation(s)
- Flavia de Lima Osório
- Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.,National Institute for Science and Technology (INCT-TM, CNPq), Brasília, Brazil
| | | | | | - Susan Ayers
- Division of Midwifery and Radiography, School of Health Sciences, City-University of London, London, UK
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Qian J, Sun S, Wang M, Liu L, Yu X. Effectiveness of the implementation of a perinatal bereavement care training programme on nurses and midwives: protocol for a mixed-method study. BMJ Open 2022; 12:e059660. [PMID: 35918109 PMCID: PMC9351341 DOI: 10.1136/bmjopen-2021-059660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The psychological outcomes for many parents who experience perinatal loss depend on nursing staff's ability to provide effective bereavement support. However, most nurses and midwives lack the ability to provide bereavement care and suffer from heavy emotional burden. The study aims to investigate the effectiveness of the perinatal bereavement care training programme on nurses and midwives to increase their perinatal bereavement care confidence (PBCC) and to reduce secondary traumatic stress and emotional exhaustion. METHODS AND ANALYSIS This study will follow a mixed methodology consisting of two stages. The first stage will adopt a pre/post repeated quasi-experimental design without a control group. The second stage will use a qualitative interview study. This study will be conducted in a tertiary maternity hospital in China in 2022-2023. Ethical approval was obtained from the institutional review board in January of 2020. Outcome measures will be assessed using the Chinese version of the PBCC, STS and the EE subscale of Chinese Burn-out Inventory at baseline, postintervention and at the 3-month follow-up. Participants will be interviewed to understand their perceptions of the training programme. ETHICS AND DISSEMINATION This research protocol was approved by the Ethics Committee of the Women's Hospital School of Medicine, Zhejiang University (IRB no. 20210091). The results will be disseminated through peer-reviewed journals and academic conferences. TRIAL REGISTRATION NUMBER ChiCTR2100049730.
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Affiliation(s)
- Jialu Qian
- School of Nursing, Zhejiang University School of Medicine, Hangzhou, China
- Obstetrics Department, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang, China
| | - Shiwen Sun
- Obstetrics Department, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang, China
| | - Man Wang
- School of Nursing, Zhejiang University School of Medicine, Hangzhou, China
- Obstetrics Department, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang, China
| | - Lu Liu
- School of Nursing, Zhejiang University School of Medicine, Hangzhou, China
- Obstetrics Department, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang, China
| | - Xiaoyan Yu
- Obstetrics Department, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang, China
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Qu L, Gao J, Liu L, Lun B, Chen D. Compassion fatigue and compassion satisfaction among Chinese midwives working in the delivery room: A cross-sectional survey. Midwifery 2022; 113:103427. [PMID: 35853335 DOI: 10.1016/j.midw.2022.103427] [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: 04/28/2022] [Revised: 06/11/2022] [Accepted: 07/06/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Compassion fatigue can negatively affect not only healthcare professionals' physical and mental health but also the quality of care they provide and organizational outcomes. However, little is known about compassion fatigue among Chinese midwives working in the delivery room. This study aimed to examine compassion fatigue and compassion satisfaction levels among Chinese midwives working in the delivery room and correlate their compassion fatigue and compassion satisfaction. METHODS A multisite cross-sectional study with a convenience sampling approach was conducted at 62 hospitals in Henan Province, central China, from May to July 2020. The participants were recruited through an online survey. A self-designed sociodemographic and work-related data sheet, the Social Support Rating Scale (SSRS), and the Professional Quality of Life Scale (ProQoL) were used to measure the participants'basic information, level of social support, compassion fatigue(consists of burnout and secondary traumatic stress) and compassion satisfaction. Descriptive analysis was used to describe the characteristics of the participants' social support, compassion fatigue and compassion satisfaction. Multiple linear regression analysis was employed to identify associations with the participants' sociodemographic and professional characteristics, compassion fatigue and compassion satisfaction. RESULTS A total of 213 questionnaires were completed, 206 of which were valid (96.71%). The majority of the participants reported moderate risks for compassion satisfaction (75.24%) and burnout (59.71%) and low risks for secondary traumatic stress (61.65%). Higher job satisfaction as a midwife, lower average working hours per week in the past year, higher social support, extroverted personality, and work recognition in the past month were positively associated with compassion satisfaction, explaining 48.7% of the total variance. Always considering giving up a midwifery career, lower social support, working a day-night shift, poor health condition, more exposure to traumatic birth events per month on average in recent years, and lower job satisfaction as a midwife were negative factors for burnout, explaining 35.3% of the total variance. Four factors, including more exposure to traumatic birth events per month on average in recent years, always considering giving up a midwifery career, working a day-night shift and poor sleep quality, were negatively related to secondary traumatic stress, explaining 14.2% of the variance. CONCLUSIONS In this study, midwives showed moderate levels of compassion satisfaction and burnout and low levels of secondary traumatic stress which should attract the attention of health institutions. A healthy and supportive work environment is crucial to midwives' health, well-being and job satisfaction. Tailored strategies such as trauma management, emotional literacy, peer and social support networks should be implemented to support midwives' compassion satisfaction, while prevent and lower midwives' burnout and secondary traumatic stress.
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Affiliation(s)
- Lixia Qu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Jinling Gao
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China.
| | - Li Liu
- Delivery room, Henan Provincial people's hospital, Zhengzhou, China
| | - Bing Lun
- Delivery room, Maternal and Child Health Hospital of Henan Province, Zhengzhou, China
| | - Dongsun Chen
- Delivery room, Maternal and Child Health Hospital of Henan Province, Zhengzhou, China
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Mohd Kamaruzaman AZ, Ibrahim MI, Mokhtar AM, Mohd Zain M, Satiman SN, Yaacob NM. The Effect of Second-Victim-Related Distress and Support on Work-Related Outcomes in Tertiary Care Hospitals in Kelantan, Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6454. [PMID: 35682042 PMCID: PMC9180130 DOI: 10.3390/ijerph19116454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/12/2022] [Accepted: 05/24/2022] [Indexed: 02/01/2023]
Abstract
After a patient safety incident, the involved healthcare providers may experience sustained second-victim distress and reduced professional efficacy, with subsequent negative work-related outcomes and the cultivation of resilience. This study aims to investigate the factors affecting negative work-related outcomes and resilience with a hypothetical triad of support as the mediators: colleague, supervisor, and institutional support. This cross-sectional study recruited 733 healthcare providers from three tertiary care hospitals in Kelantan, Malaysia. Three steps of hierarchical linear regression were developed for both outcomes (negative work-related outcomes and resilience). Four multiple mediator models of the support triad were analyzed. Second-victim distress, professional efficacy, and the support triad contributed significantly in all the regression models. Colleague support partially mediated the relationship defining the effects of professional efficacy on negative work-related outcomes and resilience, whereas colleague and supervisor support partially mediated the effects of second-victim distress on negative work-related outcomes. Similar results were found regarding resilience, with all support triads producing similar results. As mediators, the support triads ameliorated the effect of second-victim distress on negative work-related outcomes and resilience, suggesting an important role of having good support, especially after encountering patient safety incidents.
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Affiliation(s)
- Ahmad Zulfahmi Mohd Kamaruzaman
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia;
| | - Mohd Ismail Ibrahim
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia;
| | - Ariffin Marzuki Mokhtar
- Department of Anesthesiology and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia;
| | - Maizun Mohd Zain
- Public Health Unit, Hospital Raja Perempuan Zainab II, Kota Bharu 16150, Kelantan, Malaysia;
| | - Saiful Nazri Satiman
- Medical Division, Kelantan State Health Department, Kota Bharu 16150, Kelantan, Malaysia;
| | - Najib Majdi Yaacob
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia;
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Borovich A, Handelzalts JE, Levy S, Rafenberg K, Borovich L, Dollinger S, Peled Y, Nassie DI, Krissi H. The effect of stillbirth and late termination of pregnancy on the emergence of post-traumatic symptoms among attending medical personnel. J OBSTET GYNAECOL 2022; 42:1841-1846. [PMID: 35468036 DOI: 10.1080/01443615.2022.2042796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The purpose of this paper was to assess the impact and the post-traumatic potential of late termination of pregnancy (TOP) and stillbirth on medical staff and characterise personal attributes that modulate these possible outcomes. Fifty-one participants involved in the treatment of women undergoing late TOPs and stillbirths answered questionnaires including demographics, Neuroticism subscale of the Big Five Inventory (BFI), Life Orientation Test-Revised (LOT-R), Posttraumatic Diagnostic Scale (PDS), Brief Symptom Inventory (BSI-18) and questions regarding exposure to stillbirths and late TOPs. None of the participants met the full post-traumatic stress disorder (PTSD) criteria. A correlation with a marginal significance was found between the number of TOP's/stillbirths attended during the past year and traumatic symptoms. Neuroticism moderated the association between presence in TOP's/stillbirths and post-traumatic symptoms among those who attended this event over the past month. According to our results, medical personnel do not appear to develop long-term and lingering posttraumatic symptoms following attending TOP's/stillbirths. Impact StatementWhat is already known on this subject? There is a very little research on the ways in which medical personnel respond to Stillbirths, late miscarriages and terminations of pregnancy (TOP) of their patients and on the possible effect of their personality traits in this response.What do the results of this study add? According to our results, medical personnel do not appear to develop long-term and lingering posttraumatic symptoms following attending TOP's/stillbirths.What are the implications of these findings for clinical practice and/or further research? Further studies are warranted to better assess the impact of exposure to traumatic events in general and on the effect of late TOP and stillbirths in particular, on medical personnel and to identify interventions that may prevent posttraumatic symptoms among staff members when they happen.
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Affiliation(s)
- Adi Borovich
- Department of Obstetrics & Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jonathan E Handelzalts
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel.,Psychiatry Department, University of Michigan, Ann Arbor, MI, USA
| | - Sigal Levy
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
| | - Karin Rafenberg
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
| | - Liat Borovich
- Department of Obstetrics & Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel
| | - Sarah Dollinger
- Department of Obstetrics & Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yoav Peled
- Department of Obstetrics & Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel I Nassie
- Department of Obstetrics & Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Haim Krissi
- Department of Obstetrics & Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Translation and Validation of the Malay Revised Second Victim Experience and Support Tool (M-SVEST-R) among Healthcare Workers in Kelantan, Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042045. [PMID: 35206235 PMCID: PMC8872429 DOI: 10.3390/ijerph19042045] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/08/2022] [Accepted: 02/08/2022] [Indexed: 02/05/2023]
Abstract
“Second victims” are defined as healthcare professionals who are traumatized physically, psychologically, or emotionally as a result of encountering any patient safety incidents. The Revised Second Victim Experience and Support Tool (SVEST-R) is a crucial instrument acknowledged worldwide for the assessment of the second victim phenomenon in healthcare facilities. Hence, the aim of this study was to evaluate the psychometric properties of the Malay version of the SVEST-R. This was a cross-sectional study that recruited 350 healthcare professionals from a teaching hospital in Kelantan, Malaysia. After obtaining permission from the original author, the instrument underwent 10 steps of established translation process guidelines. Pretesting of 30 respondents was performed before embarking on the confirmatory factor analysis (CFA) to evaluate internal consistency and construct validity. The analysis was conducted using the R software environment. The final model agreed for 7 factors and 32 items per the CFA’s guidelines for good model fit. The internal consistency was determined using Raykov’s rho and showed good results, ranging from 0.77 to 0.93, with a total rho of 0.83. The M-SVEST-R demonstrated excellent psychometric properties and adequate validity and reliability. This instrument can be used by Malaysian healthcare organizations to assess second victim experiences among healthcare professionals and later accommodate their needs with the desired support programs.
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A qualitative study of early career Australian midwives' encounters with perinatal grief, loss and trauma. Women Birth 2022; 35:e539-e548. [PMID: 35115245 DOI: 10.1016/j.wombi.2022.01.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 11/21/2022]
Abstract
PROBLEM The health of women is dependent on midwifery workforce stability. Retaining new midwives is paramount, however without support, the early career can be a vulnerable time for midwives. BACKGROUND Midwives care for women who experience poor perinatal outcomes like stillbirth and neonatal death. Midwifery care in these sentinel events is complex. There is limited understanding of early career midwives' experiences within these encounters. AIM To understand the experiences of Australian early career midwives' clinical encounters with perinatal grief, loss and trauma. METHODS A qualitative descriptive/exploratory study using in-depth interviews. FINDINGS Four themes were identified from interview data: (1) all eyes on the skills; (2) support is of the essence; (3) enduring an emotional toll; (4) at all times, the woman. Most participants had minimal exposure to perinatal loss as a student. As a result, most felt unskilled and unprepared for this as a new midwife. DISCUSSION Types and degrees of support varied in these encounters. Early career midwives who were well supported reflected positively on working with grief and loss. In contrast, inadequate or absent support had detrimental effects on participant wellbeing. Poorly supported encounters with death (intrapartum fetal, early neonatal, and maternal) in the early career period were significantly distressful, giving rise to mental and emotional distress. CONCLUSION Pre-registration perinatal loss skill development and supported experiences are necessary for preparedness. Continued education, formalised debriefing and mentoring, institutional philosophies which promote collegial ethics of care, and the expansion of continuity of midwifery care models will improve new midwives' experiences.
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Rivera-Chiauzzi EY, Smith HA, Moore-Murray T, Lee C, Goffman D, Bernstein PS, Chazotte C. Healing Our Own: A Randomized Trial to Assess Benefits of Peer Support. J Patient Saf 2022; 18:e308-e314. [PMID: 32925571 DOI: 10.1097/pts.0000000000000771] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study aimed to develop and evaluate a structured peer support program to address the needs of providers involved in obstetric adverse outcomes. METHODS In this pilot randomized controlled trial, participants were providers who experienced an obstetric-related adverse outcome. Providers were randomly assigned to routine support (no further follow-up) or enhanced support (follow-up with a trained peer supporter). Participants completed surveys at baseline, 3 months, and 6 months. The primary outcome was the use of resources and the perception of their helpfulness. Secondary outcomes were the effect on the recovery stages and the duration of use of peer support. RESULTS Fifty participants were enrolled and randomly assigned 1:1 to each group; 42 completed the program (enhanced, 23; routine, 19). The 2 groups were not significantly different with respect to event type, demographics, or baseline stage; in both groups, most participants started at the stage 6 thriving path. Most participants required less than 3 months of support: 65.2% did not need follow-up after the first contact, and 91.3% did not need follow-up after the second contact. Participants who transitioned from an early stage of recovery (stages 1-3) to the stage 6 thriving path reported that they most often sought support from peers (P = 0.02) and departmental leadership (P = 0.07). Those in the enhanced support group were significantly more likely to consider departmental leadership as one of the most helpful resources (P = 0.02). CONCLUSIONS For supporting health care providers involved in adverse outcomes, structured peer support is a practicable intervention that can be initiated with limited resources.
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Affiliation(s)
| | | | | | | | | | - Peter S Bernstein
- From the Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Cynthia Chazotte
- From the Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
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Long T, Aggar C, Grace S, Thomas T. Trauma informed care education for midwives: An integrative review. Midwifery 2021; 104:103197. [PMID: 34788724 DOI: 10.1016/j.midw.2021.103197] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Nearly half of new mothers describe their childbirth as traumatic. Perinatal trauma impacts both short and long-term biopsychosocial outcomes for mother and child. Midwife trauma-informed care education and practice is essential to mitigate this risk. OBJECTIVE This review aimed to identify and describe the nature and extent of trauma informed care education provided for midwives and midwifery students. DESIGN An integrative review. METHODS Five databases (Medline, Embase, CINAHL, Psycinfo, and Emcare) were searched to identify primary research regarding trauma informed care education for midwives and midwifery students. Quality appraisal was conducted using the Mixed Methods Appraisal Tool. RESULTS Three papers were identified. None of the papers were midwifery focused, with midwives representing a small proportion of the participants. Most midwives reported receiving no previous trauma informed care education and lacked confidence to provide quality care to women with lived trauma. Midwives reported trauma informed care education as essential and relevant for providing quality practice. Improvements in knowledge, skills and attitudes was demonstrated following trauma informed care education. More in-depth content and content delivered in multiple ways were recommended. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Midwives are well placed to deliver trauma informed care. Trauma informed care education for midwives is limited. Given the impact of perinatal trauma, further trauma informed care education and research is paramount.
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Affiliation(s)
- Trish Long
- Northern New South Wales Local Health District, 89 Tamar St, Ballina NSW 2478 Australia.
| | - Christina Aggar
- Northern New South Wales Local Health District, 89 Tamar St, Ballina NSW 2478 Australia; Southern Cross University, School of Health & Human Sciences, School of Health & Human Sciences, Southern Cross Drive, Bilinga QLD 4225 Australia
| | - Sandra Grace
- Southern Cross University, School of Health & Human Sciences, School of Health & Human Sciences, Southern Cross Drive, Bilinga QLD 4225 Australia
| | - Tamsin Thomas
- Southern Cross University, School of Health & Human Sciences, School of Health & Human Sciences, Southern Cross Drive, Bilinga QLD 4225 Australia
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Smallwood N, Karimi L, Bismark M, Putland M, Johnson D, Dharmage SC, Barson E, Atkin N, Long C, Ng I, Holland A, Munro JE, Thevarajan I, Moore C, McGillion A, Sandford D, Willis K. High levels of psychosocial distress among Australian frontline healthcare workers during the COVID-19 pandemic: a cross-sectional survey. Gen Psychiatr 2021; 34:e100577. [PMID: 34514332 PMCID: PMC8423519 DOI: 10.1136/gpsych-2021-100577] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/03/2021] [Indexed: 12/17/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has had a profound and prolonged impact on healthcare services and healthcare workers. Aims The Australian COVID-19 Frontline Healthcare Workers Study aimed to investigate the severity and prevalence of mental health issues, as well as the social, workplace and financial disruptions experienced by Australian healthcare workers during the COVID-19 pandemic. Methods A nationwide, voluntary, anonymous, single timepoint, online survey was conducted between 27 August and 23 October 2020. Individuals self-identifying as frontline healthcare workers in secondary or primary care were invited to participate. Participants were recruited through health organisations, professional associations or colleges, universities, government contacts and national media. Demographics, home and work situation, health and psychological well-being data were collected. Results A total of 9518 survey responses were received; of the 9518 participants, 7846 (82.4%) participants reported complete data. With regard to age, 4110 (52.4%) participants were younger than 40 years; 6344 (80.9%) participants were women. Participants were nurses (n=3088, 39.4%), doctors (n=2436, 31.1%), allied health staff (n=1314, 16.7%) or in other roles (n=523, 6.7%). In addition, 1250 (15.9%) participants worked in primary care. Objectively measured mental health symptoms were common: mild to severe anxiety (n=4694, 59.8%), moderate to severe burnout (n=5458, 70.9%) and mild to severe depression (n=4495, 57.3%). Participants were highly resilient (mean (SD)=3.2 (0.66)). Predictors for worse outcomes on all scales included female gender; younger age; pre-existing psychiatric condition; experiencing relationship problems; nursing, allied health or other roles; frontline area; being worried about being blamed by colleagues and working with patients with COVID-19. Conclusions The COVID-19 pandemic is associated with significant mental health symptoms in frontline healthcare workers. Crisis preparedness together with policies and practices addressing psychological well-being are needed.
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Affiliation(s)
- Natasha Smallwood
- Department of Respiratory Medicine, Alfred Hospital, Prahran, Victoria, Australia.,Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
| | - Leila Karimi
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.,School of Medicine and Healthcare Management, Caucasus University, Tbilisi, Georgia
| | - Marie Bismark
- Department of Psychiatry, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Public Health Law, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Mark Putland
- Department of Emergency Services, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Critical Care, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Douglas Johnson
- Departments of General Medicine and Infectious Diseases, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Shyamali Chandrika Dharmage
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Elizabeth Barson
- Department of Allied Health, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Nicola Atkin
- Parkville Integrated Palliative Care Service, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Claire Long
- Department of Geriatric Medicine, Western Health, Footscray, Victoria, Australia
| | - Irene Ng
- Department of Anaesthesia and Pain Management, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Centre for Integrated Critical Care, Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia
| | - Anne Holland
- Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia.,Department of Physiotherapy, Alfred Health, Melbourne, Victoria, Australia
| | - Jane E Munro
- Rheumatology Unit, Royal Children's Hospital, Parkville, Victoria, Australia.,Arthritis and Rheumatology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Irani Thevarajan
- Department of Infectious Diseases, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Cara Moore
- Department of Intensive Care Medicine, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Anthony McGillion
- School of Nursing and Midwifery, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Debra Sandford
- Royal Adelaide Hospital, University of South Australia, Adelaide, South Australia, Australia
| | - Karen Willis
- College of Health and Biomedicine, Victoria University, Footscray, Victoria, Australia.,Division of Critical Care and Investigative Services, The Royal Melbourne Hospital, Parkville, Victoria, Australia
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Smallwood N, Pascoe A, Karimi L, Bismark M, Willis K. Occupational Disruptions during the COVID-19 Pandemic and Their Association with Healthcare Workers' Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179263. [PMID: 34501854 PMCID: PMC8431156 DOI: 10.3390/ijerph18179263] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/23/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022]
Abstract
Background: The COVID-19 crisis has caused prolonged and extreme demands on healthcare services. This study investigates the types and prevalence of occupational disruptions, and associated symptoms of mental illness, among Australian frontline healthcare workers during the COVID-19 pandemic. Methods: A national cross-sectional online survey was conducted between 27 August and 23 October 2020. Frontline healthcare workers were invited to participate via dissemination from major health organisations, professional associations or colleges, universities, government contacts, and national media. Data were collected on demographics, home and work situations, and validated scales of anxiety, depression, PTSD, and burnout. Results: Complete responses were received from 7846 healthcare workers (82.4%). Most respondents were female (80.9%) and resided in the Australian state of Victoria (85.2%). Changes to working conditions were common, with 48.5% reporting altered paid or unpaid hours, and many redeployed (16.8%) or changing work roles (27.3%). Nearly a third (30.8%) had experienced a reduction in household income during the pandemic. Symptoms of mental illness were common, being present in 62.1% of participants. Many respondents felt well supported by their workplaces (68.3%) and believed that workplace communication was timely and useful (74.4%). Participants who felt well supported by their organisation had approximately half the risk of experiencing moderate to severe anxiety, depression, burnout, and PTSD. Half (50.4%) of respondents indicated a need for additional training in using personal protective equipment and/or caring for patients with COVID-19. Conclusions: Occupational disruptions during the COVID-19 pandemic occurred commonly in health organisations and were associated with worse mental health outcomes in the Australian health workforce. Feeling well supported was associated with significantly fewer adverse mental health outcomes. Crisis preparedness focusing on the provision of timely and useful communication and support is essential in current and future crises.
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Affiliation(s)
- Natasha Smallwood
- Department of Respiratory Medicine, The Alfred Hospital, 55 Commercial Road, Prahran, VIC 3004, Australia
- Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, The Alfred Hospital, Monash University, Melbourne, VIC 3004, Australia;
- Correspondence: ; Tel.: +61-3-9903-8735
| | - Amy Pascoe
- Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, The Alfred Hospital, Monash University, Melbourne, VIC 3004, Australia;
| | - Leila Karimi
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3083, Australia;
- School of Medicine and Healthcare Management, Caucasus University, Tbilisi 0102, Georgia
| | - Marie Bismark
- Department of Psychiatry, Royal Melbourne Hospital, Grattan St, Parkville, VIC 3050, Australia;
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3050, Australia
| | - Karen Willis
- College of Health and Biomedicine, Victoria University, Footscray, Melbourne, VIC 3011, Australia;
- Division of Critical Care and Investigative Services, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3050, Australia
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Charmer L, Jefford E, Jomeen J. A scoping review of maternity care providers experience of primary trauma within their childbirthing journey. Midwifery 2021; 102:103127. [PMID: 34425458 DOI: 10.1016/j.midw.2021.103127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/21/2021] [Accepted: 08/03/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine and summarise available literature on maternity care practitioners having experienced primary trauma during their childbirthing journey and whether this impacts their mental well-being and/or care provision when subsequently caring for childbearing women. BACKGROUND Birth trauma affects 1 in 3 women; 1 in 20 women show post-traumatic stress disorder symptoms by 12 weeks after birth. However, what is not known is what percentage of these women are maternity care providers experiencing or having experienced personal trauma during their child birthing journey. This scoping review aims to examine and summarise available literature on maternity care practitioners having experienced primary trauma during their childbirthing journey and whether this impacts their mental well-being and/or care provision when subsequently caring for childbearing women. METHODS Arksey and O'Malley (2005) six-stage scoping review framework was revised and utilised. A search of the relevant databases (MEDLINE Embase, CINAHL, APA PsycInfo, Scopus) was undertaken with several keywords related to trauma and personal experience. Reference lists were also searched of studies identified for reading the full text. FINDINGS The search strategy identified 2983 articles. The studies excluded were considered to be unrelated to the topic directly. A total of 352 articles were reviewed by abstract, and 29 additional studies were identified from reference lists; 32 were reviewed by full text. A total of 0 studies met the inclusion criteria for the scoping review. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The scoping review identified a gap in the literature as maternity care practitioners personal experience of trauma during the child birthing journey has not been researched. Research is needed to explore and conceptualise the experiences of maternity care practitioners having experienced trauma and the ongoing implications this may have on their personal and professional lives.
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Affiliation(s)
- Lisa Charmer
- Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia.
| | - Elaine Jefford
- Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia
| | - Julie Jomeen
- Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia
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Aslantekin-Özçoban F, Türkmen H, Yalnız-Dilcen H. Factors that affect the traumatic childbirth perceptions of midwifery and nursing students: The case of Turkey. Eur J Midwifery 2021; 5:34. [PMID: 34414367 PMCID: PMC8336657 DOI: 10.18332/ejm/138596] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/22/2020] [Accepted: 06/06/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Birth is a natural and joyful situation as well as a process that contains surprise situations that do not go well. Caregivers at birth are affected by this process. Especially when faced with difficult births, it can have an intense psychological effect and a perception of traumatic birth can occur. Although there is research about midwives on this subject, there are very few studies about students who are becoming midwives. The aim of this study was to determine the factors that affect the traumatic childbirth perceptions of midwifery and nursing students. METHODS The study was carried out with 480 students of midwifery and nursing. The data were collected by using a Personal Information Form, the Rosenberg Self-Esteem Scale, Self-Efficacy Scale, Traumatic Childbirth Perception Scale, and State-Trait Anxiety Inventory. RESULTS The traumatic childbirth perception levels were very low in 7.3% of the participants, low in 26.9%, moderate in 37.9%, high in 21.5% and very high in 6.9%. The regression analysis revealed a significant relationship between traumatic childbirth perceptions and the parameters of satisfaction with the department studied, fear of childbirth, defining childbirth as a difficult and painful process, and history of complicated birth in the family. There was also a significant relationship between traumatic childbirth perceptions and the parameters of trait anxiety and general self-esteem. CONCLUSIONS Traumatic childbirth perceptions increased as the state and trait anxiety levels and self-esteem levels increased, while they decreased as the self-efficacy levels increased.
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Affiliation(s)
- Filiz Aslantekin-Özçoban
- Department of Midwifery, Faculty of Health Sciences, Balikesir University, Balikesir, Turkey.,Anatolian Midwives Association, Ankara, Turkey
| | - Hülya Türkmen
- Department of Midwifery, Faculty of Health Sciences, Balikesir University, Balikesir, Turkey
| | - Hacer Yalnız-Dilcen
- Department of Midwifery, Faculty of Health Sciences, Balikesir University, Balikesir, Turkey.,Anatolian Midwives Association, Ankara, Turkey
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Cankaya S, Erkal Aksoy Y, Dereli Yılmaz S. Midwives' experiences of witnessing traumatic hospital birth events: A qualitative study. J Eval Clin Pract 2021; 27:847-857. [PMID: 33006235 DOI: 10.1111/jep.13487] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/01/2020] [Accepted: 09/04/2020] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study was to investigate in detail the traumatic birth experiences of midwives in the delivery rooms, and their attitudes, reactions, and coping strategies. METHODS The design of the study is descriptive and the purposive sampling method was used. This approach is ideal for a preliminary exploration of the nature of a phenomenon. Between October 2018 and January 2019, semi-structured interviews were conducted with a purposeful sample of midwives. The research was carried out with the participation of 29 midwives, who work in labour and birth room. They were asked to describe a particular stressful situation they had experienced during the birth process, their emotions about the event, and their coping strategies and support systems. All interviews were digitally recorded, stored in a database, and transferred to MAX Qualitative Data Analysis 18.1.0 for analysis. FINDINGS As a result of the content analysis, three main themes emerged: psychological impact, defensive practice, and expectations in terms of support from the hospital. It was revealed that, after the traumatic birth, midwives experienced highly emotional exhaustion in the form of sadness, flashbacks, guilt, fear, and empathy, and they performed an increasingly defensive practice. During the interviews, we observed that 19 midwives needed psychological support. Besides, midwives explicitly stated that they were not prepared enough for traumatic events and that most traumatic births were simply ignored in their workplace. Eventually, it was determined that midwives received support mostly from their colleagues in case of a traumatic birth. CONCLUSION(S) Midwives need to feel valued and be supported by their institutions in coping with emotional stress. Therefore, performing clinical inspections by experienced or specialist midwives may serve as a supporting framework for reducing defensive interventions.
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Affiliation(s)
- Seyhan Cankaya
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey
| | - Yasemin Erkal Aksoy
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey
| | - Sema Dereli Yılmaz
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey
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Bayri Bingol F, Demirgoz Bal M, Aygun M, Bilgic E. Secondary traumatic stress among midwifery students. Perspect Psychiatr Care 2021; 57:1195-1201. [PMID: 33135155 DOI: 10.1111/ppc.12674] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/13/2020] [Accepted: 10/16/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE This study aimed to examine the factors affecting secondary traumatic stress on midwifery students. DESIGN AND METHODS This descriptive study was conducted between November and December 2018. Data were collected using information form and the Secondary Traumatic Stress Scale. FINDINGS The study found that 22.2% of midwifery students met all the trauma criteria for posttraumatic stress disorder according to the Secondary Traumatic Stress Scale. Midwifery students who were unhappy to continue their education and those who wished to switch to another profession after graduation respectively showed a 2.8- and a 4-fold higher risk of meeting the trauma criteria (p < 0.05). CONCLUSION The secondary traumatic stress rate in midwifery students is particularly high considering the fact that one in five students fulfills all of the Secondary Traumatic Stress criteria. However, to reduce their secondary traumatic stress rate, students should be thoroughly assessed by the educators who could provide the support necessary. IMPLICATIONS FOR NURSING PRACTICE Before graduation from the midwifery departments, students traumatic stress symptoms could be assessed mental health nursing courses, which might enable to change their attitudes towards to cope with this situation. Especially after traumatic childbirths, midwifery students should be supported by mental health nurses to cope with traumatic stress. Midwifery students should be encouraged each and every possible moment to express their feelings when they experience traumatic stress and thus their skills for effective coping can be reinforced.
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Affiliation(s)
- Fadime Bayri Bingol
- Midwifery Department, Health Sciences Faculty, Marmara University, Basıbuyuk Campus, Maltepe, Istanbul, Turkey
| | - Meltem Demirgoz Bal
- Midwifery Department, Health Sciences Faculty, Marmara University, Basıbuyuk Campus, Maltepe, Istanbul, Turkey
| | - Merve Aygun
- Midwifery Department, Health Sciences Faculty, Marmara University, Basıbuyuk Campus, Maltepe, Istanbul, Turkey
| | - Edanur Bilgic
- Midwifery Department, Health Sciences Faculty, Marmara University, Basıbuyuk Campus, Maltepe, Istanbul, Turkey
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Akın B, Erkal Aksoy Y, Yılmaz S. Spiritual care, compassion and associated factors of midwives working in delivery rooms. Int J Nurs Pract 2021; 27:e12980. [PMID: 34085744 DOI: 10.1111/ijn.12980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 03/30/2021] [Accepted: 05/16/2021] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to determine the level of spiritual care and compassion among midwives working in delivery rooms and associated factors. METHODS A descriptive design was utilized to collect data using self-report questionnaires from 181 midwives working in delivery rooms in Turkey. Data were collected between 1 February 2020 and 20 March 2020. RESULTS The mean Spiritual Care-Giving Scale (SCGS) (min: 25- max: 175) and Compassion Scale (CS) (min: 24- max: 120) scores were 147.88 ± 17.84 and 96.37 ± 12.84. It was determined that there was a significant difference between the SCGS and CS scores of the midwives based on age, working year, work schedule, job satisfaction and traumatic birth experiences. Furthermore, there were positive correlations between scores on certain SCGS and CS subdimensions. CONCLUSION Midwifery is a continuously evolving profession based on helping others. However, long working hours and their exposure to traumatic birth events negatively affect both spiritual caregiving and compassion levels of midwives. Working conditions of midwives need to improve and this would contribute to the quality of maternal healthcare. Also, studies should be conducted in different contexts, societies and cultures to identify barriers to compassionate and spiritual care during childbirth.
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Affiliation(s)
- Bihter Akın
- Faculty of Health Sciences, Midwifery Department, Selcuk University, Konya, Turkey
| | - Yasemin Erkal Aksoy
- Faculty of Health Sciences, Midwifery Department, Selcuk University, Konya, Turkey
| | - Sema Yılmaz
- Faculty of Health Sciences, Midwifery Department, Selcuk University, Konya, Turkey
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Minooee S, Cummins A, Foureur M, Travaglia J. Shoulder dystocia: A panic station or an opportunity for post-traumatic growth? Midwifery 2021; 101:103044. [PMID: 34098223 DOI: 10.1016/j.midw.2021.103044] [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: 04/08/2020] [Revised: 05/07/2021] [Accepted: 05/13/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Traumatic births are considered as challenging events in the professional life of midwives. Negative emotional and psychological consequences of these births on midwives are well-established. However, evidence suggests that in the aftermath of challenging events, such as birth traumas, positive outcomes may emerge as well. Based on the literature, shoulder dystocia (SD) is known as one of the most traumatic birth experiences for midwives. In this study we aimed to explore the impact of experiencing SD complicated births on clinical practice of midwives. METHODS A qualitative descriptive study was undertaken. Midwives who had an experience of at least one case of SD were invited to the study through the Australian College of Midwives. In-depth interviews were conducted with 25 midwives. Data were analysed using an inductive thematic approach. RESULTS Three themes were identified 1) Putting on a brave face 2) Towards the growth zone 3) I am resilient enough to recover, because of …. Experience of SD was described as a dreadful event in midwives' career. However, on reflection, this experience was considered as a benefit which developed midwives' clinical expertise and contributed to their professional empowerment. Having faith in birth normality, support from workplace, seniority/ years of experience and self-confidence were among the factors which helped midwives in overcoming the stress after SD. CONCLUSION There needs to be greater awareness about the consequences of traumatic births such as SD for midwives. Collegial support has a critical role in helping midwives to have a positive outlook on their traumatic experience and to ease their pathway of professional growth.
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Affiliation(s)
- Sonia Minooee
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
| | - Allison Cummins
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
| | - Maralyn Foureur
- Hunter New England Nursing and Midwifery Research Centre & University of Newcastle, Newcastle, NSW, Australia.
| | - Joanne Travaglia
- Centre for Health Services Management, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
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McCarthy C, Meaney S, Rochford M, O’Donoghue K. Risk perception on the labour ward: A mixed methods study. JOURNAL OF PATIENT SAFETY AND RISK MANAGEMENT 2021. [DOI: 10.1177/25160435211002428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Healthcare providers commonly experience risky situations in the provision of maternity care, and there has been increased focus on the lived experience in recent years. We aimed to assess opinions on, understanding of and behaviours of risk on the LW by conducting a mixed methods study. Staff working in a LW setting completed a descriptive questionnaire-based study, followed by qualitative structured interviews. Statistical analysis was performed with SPSS on quantitative data and thematic analysis performed on qualitative data. Nearly two thirds of staff (64%; 73/114) completed the questionnaire, with 56.2% (n = 47) experiencing risk on a daily basis. Experiencing risk evoked feelings of apprehension (68.4%; n = 50) and worry (60.2%; n = 44) which was echoed in the qualitative work. Structured clinical assessment was utilised in risky situations, and staff described “ going on autopilot” to manage these situations. A large number of respondents reflected on their provision of care following an adverse event (87.7%; n = 64). Debriefing was mentioned as an important practice following such events by all respondents. This study describes the negative terminology prevailing in emergency obstetric care. These experiences can have a profound impact on staff. Risk reduction strategies and the provision of increased staff support and training are crucial to improve staff wellbeing in stressful scenarios.
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Affiliation(s)
| | - Sarah Meaney
- National Perinatal Epidemiology Centre, University College Cork, Cork, Ireland
| | - Marie Rochford
- Cork University Maternity Hospital, Wilton, Cork, Ireland
| | - Keelin O’Donoghue
- Cork University Maternity Hospital, Wilton, Cork, Ireland and The Irish Centre for Fetal and Neonatal Translational, Research (INFANT), University College Cork, Cork, Ireland
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BİNGÖL F, DEMİRGÖZ BAL M, AYGÜN M, BİLGİÇ E. Effect of midwifery students’ negative clinical experiences on their emotional labor behaviors. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2020. [DOI: 10.33808/clinexphealthsci.679565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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47
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Minooee S, Cummins A, Foureur M, Travaglia J. Catastrophic thinking: Is it the legacy of traumatic births? Midwives' experiences of shoulder dystocia complicated births. Women Birth 2020; 34:e38-e46. [PMID: 32891557 DOI: 10.1016/j.wombi.2020.08.008] [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: 07/07/2020] [Revised: 08/23/2020] [Accepted: 08/24/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Shoulder dystocia (SD) is considered one of the most traumatic birth experiences not only for women, but for clinicians involved as well. Adverse effects of birth trauma on the emotions and psyche of midwives have been well established. AIM To explore the impact of SD, as a birth trauma, on midwives' orientation towards normal births and on their clinical practice and the factors which may deteriorate or improve the experience of SD. METHODS In a qualitative descriptive study design, 25 in-depth interviews were undertaken with Australian midwives who had experienced at least one case of SD. Data were analysed thematically. FINDINGS A total of four themes emerged: 1) an unforgettable birth; a wake-up call, 2) from passion to caution, 3) factors worsening the experience, and 4) factors soothing the experience. Fear, anxiety and doubt about their professional competence were the most common feelings experienced by midwives after SD. For many, the first exposure to SD left them contemplating their previous attitude towards normal birth. Disturbed orientation of normal birth shifted midwives towards hypervigilance in practice. Not having effective relationships with women and receiving poor support from colleagues were perceived to worsen the traumatic experience, whereas working in a midwifery continuity of care model and the sense of being appreciated improved midwives' experience after the trauma. CONCLUSION Shoulder dystocia is a birth emergency that midwives will inevitably experience. Involvement in such births can potentially direct midwives towards a 'worst case scenario' mentality and affect the way they provide care for women in future.
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Affiliation(s)
- Sonia Minooee
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
| | - Allison Cummins
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
| | - Maralyn Foureur
- Hunter New England Nursing and Midwifery Research Centre & University of Newcastle, Newcastle, NSW, Australia.
| | - Joanne Travaglia
- Centre for Health Services Management, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
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Toohill J, Chadha Y, Nowlan S. An interactive decision-making framework (i-DMF) to scale up maternity continuity of carer models. J Res Nurs 2020; 25:561-576. [PMID: 34394674 PMCID: PMC7932297 DOI: 10.1177/1744987119887424] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Low numbers of women in Queensland receive continuity of care across their maternity episode. The Office of the Chief Nursing and Midwifery Officer was tasked with strengthening maternity service delivery by reviewing and improving Maternity Models of Care and Workforce. AIM Develop a decision-making framework (DMF) to increase maternity continuity of carer models. METHOD A literature review of models, specific to the public health maternity system, including suitability to rural areas and culturally appropriate to Aboriginal and Torres Strait Islander women was undertaken. Stakeholders informed development of the framework and toolkit. A prototype was built, tested and refined following input from rural, regional and metropolitan facilities. RESULTS 42 questions guide services to contextualise delivery of continuity of carer to local circumstances. Three rural sites have applied the i-DMF and toolkit. One used the tool for quality assurance of their existing midwifery continuity model, another has developed a midwifery continuity-of-carer model for Aboriginal and Torres Strait Islander women, the other is looking to establish a local rural birth service. CONCLUSION The i-DMF has potential to grow and sustain best practice maternity care, and particularly enable more women to receive relationship-based care with a known midwife.
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Affiliation(s)
- Jocelyn Toohill
- Chief Nursing and Midwifery Officer, Office of the Chief Nursing and Midwifery Officer, Clinical Excellence Division, Department of Health, Queensland, Australia, Adjunct Professor SONM University of Queensland and School of Medicine Griffith University
| | - Yogesh Chadha
- Chief Nursing and Midwifery Officer, Office of the Chief Nursing and Midwifery Officer, Clinical Excellence Division, Department of Health, Queensland, Australia, Adjunct Professor SONM University of Queensland and School of Medicine Griffith University
| | - Shelley Nowlan
- Chief Nursing and Midwifery Officer, Office of the Chief Nursing and Midwifery Officer, Clinical Excellence Division, Department of Health, Queensland, Australia, Adjunct Professor SONM University of Queensland and School of Medicine Griffith University
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Çankaya S, Dikmen HA. The relationship between posttraumatic stress symptoms of maternity professionals and quality of work life, cognitive status, and traumatic perinatal experiences. Arch Psychiatr Nurs 2020; 34:251-260. [PMID: 32828357 DOI: 10.1016/j.apnu.2020.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 04/09/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of this study was to determine the relationship between posttraumatic stress symptoms of maternity nursing/midwife and their quality of work life, cognitive distortions, and traumatic perinatal experiences. METHODS A descriptive, cross-sectional survey design was used. Two hundred and sixty-six maternity nurses/midwives employed in maternity units of hospitals in a province located in the Central Anatolia Region of Turkey were included in the study. RESULTS 37.2% of the maternity nurses/midwives met the criteria for posttraumatic stress disorder (% 95 CI [31.6, 43.2]). Previous birth-related traumatic experiences, transferring to another unit, and negative cognitions about the self-increase the risk of development of posttraumatic stress disorder by 63% (F = 7.638, P < 0.001). A positive correlation was found between the outcome variable PTS total score and the following predictors: the number of years in the profession, the number of traumatizing events, quality of work life, burnout symptoms, compassion fatigue, posttraumatic cognition, negative cognition about the world, and negative cognition about the self. It was found that those maternity nurses/midwives who were not happy with their profession, who witnessed a traumatic incident, who transferred to another unit, who considered to quit the profession, who had a history of a psychological disorder, and those lacked social life were more sensitive to posttraumatic stress symptoms. CONCLUSION These outcomes have significant consequences for both personal and professional well-being of the maternity nurses/midwives and the welfare of the workforce. To prepare maternity nurses/midwives for such exposures, to support maternity nurses/midwives following traumatic perinatal events, and to provide effective intervention for those with significant symptoms, organizational strategies are necessary.
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Affiliation(s)
- Seyhan Çankaya
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey.
| | - Hacer Alan Dikmen
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey
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Minooee S, Cummins A, Sims DJ, Foureur M, Travaglia J. Scoping review of the impact of birth trauma on clinical decisions of midwives. J Eval Clin Pract 2020; 26:1270-1279. [PMID: 31823445 DOI: 10.1111/jep.13335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/27/2019] [Accepted: 11/29/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The psychological and emotional impact of a traumatic birth experience on clinicians is well-established. It is also known that emotions can generally influence decisions. However, it is not clear whether experiencing a birth trauma can affect the professional behaviour and decision-making of clinicians. This study explores the impact of birth trauma on clinical decision-making of midwives. DATA SOURCES Four databases (Medline, Scopus, CINAHL and ProQuest) were searched to identify English language studies published from 1990 to 2018. Due to the lack of studies with specific focus on clinical decision-making after birth trauma, we defined two main domains for our literature search. To be included, studies had to focus on either traumatic birth experience or clinical decision-making in midwifery. The findings of the two domains were then integrated. STUDY SELECTION Of a total 2104 studies identified, 70 received full-text screening with 40 included in the review. Twenty-two articles were about traumatic birth events and 18 examined decision-making in midwifery. DATA EXTRACTION Information were extracted on each article's purpose, study design, data collection, participants, definitions of birth trauma and the context in which clinical decisions were made. RESULTS Thematic analysis was conducted. The impact of birth trauma on midwives could be categorized into the following themes: psychological issues; professional concerns; changes in practice and positive impact. Review of literature indicated that clinical decision-making could be influenced through all these themes. CONCLUSION Decision-making can be impacted by the midwife's affective state related to previous experience of birth trauma. The continuum of impact may vary from increased defensiveness to increased personal and professional growth. Being aware of this impact can help midwives to better manage their emotions while making decision after traumatic birth experiences.
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Affiliation(s)
- Sonia Minooee
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Allison Cummins
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Deborah J Sims
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Maralyn Foureur
- Hunter New England Nursing and Midwifery Research Centre & University of Newcastle, Newcastle, New South Wales, Australia
| | - Joanne Travaglia
- Centre for Health Services Management, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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