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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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Zhu W, Zhu C, Min H, Li L, Wang X, Wu J, Zhu X, Gu C. Status of the midwifery workforce and childbirth services and the impact of midwife staffing on birth outcomes in China: a multicentre cross-sectional study. BMJ Open 2024; 14:e082527. [PMID: 38692722 PMCID: PMC11086407 DOI: 10.1136/bmjopen-2023-082527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/02/2024] [Indexed: 05/03/2024] Open
Abstract
OBJECTIVE To investigate the status of the midwifery workforce and childbirth services in China and to identify the association between midwife staffing and childbirth outcomes. DESIGN A descriptive, multicentre cross-sectional survey. SETTING Maternity hospitals from the eastern, central and western regions of China. PARTICIPANTS Stratified sampling of maternity hospitals between 1 July and 31 December 2021.The sample hospitals received a package of questionnaires, and the head midwives from the participating hospitals were invited to fill in the questionnaires. RESULTS A total of 180 hospitals were selected and investigated, staffed with 4159 midwives, 412 obstetric nurses and 1007 obstetricians at the labour and delivery units. The average efficiency index of annual midwifery services was 272 deliveries per midwife. In the sample hospitals, 44.9% of women had a caesarean delivery and 21.4% had an episiotomy. Improved midwife staffing was associated with reduced rates of instrumental vaginal delivery (adjusted β -0.032, 95% CI -0.115 to -0.012, p<0.05) and episiotomy (adjusted β -0.171, 95% CI -0.190 to -0.056, p<0.001). CONCLUSION The rates of childbirth interventions including the overall caesarean section in China and the episiotomy rate, especially in the central region, remain relatively high. Improved midwife staffing was associated with reduced rates of instrumental vaginal delivery and episiotomy, indicating that further investments in the midwifery workforce could produce better childbirth outcomes.
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Affiliation(s)
- Wenli Zhu
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- School of Nursing, Fudan University, Shanghai, China
| | - Chunxiang Zhu
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Hui Min
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Lingling Li
- Department of Gynecology and Obstetrics, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Xiaojiao Wang
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Jiangnan Wu
- Clinical Research Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xinli Zhu
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Chunyi Gu
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
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Luo H, Gong H, Luo F, Xing Y, Wang X, Huang J, Ding M, Lin D, Lan Y. Core competence of midwives in township hospitals and its influencing factors-A cross-sectional study. Heliyon 2024; 10:e25475. [PMID: 38327397 PMCID: PMC10848002 DOI: 10.1016/j.heliyon.2024.e25475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/09/2024] Open
Abstract
Objective This study aimed to assess the core competence of midwives in township hospitals through a self-assessment questionnaire. The relationship between professional identity and core competence and the factors influencing midwives' core competence was also investigated. Method Convenience sampling was conducted in 77 township hospitals in Ganzhou, Jiangxi Province, China, with 150 participants. The questionnaires were distributed online in November 2021. We conducted a descriptive data analysis, a correlation analysis of the two variables of professional identity and core competencies, and multivariate linear regression to analyse the influencing factors, including the sociodemographic information, the Midwife Core Competence Scale, and the Nurses' Professional Identity Scale scores. Results The mean score for the core competence was 206.43 (±37.45) out of 270. The highest score was for pregnancy care (3.97 ± 0.70) and the lowest was for newborn care (3.72 ± 0.78). The independent sample t-test results and one-way analysis of variance showed that qualifications, midwifery training situation, and midwifery working years had differential effects on midwives' core competencies (P < 0.05). Multiple linear regression showed that qualifications, midwifery working years, and level of professional identity were influencing factors (P < 0.05). Conclusions The core competencies of midwives in township hospitals were lower than those reported in other studies. Advancements in education, midwifery working years, and professional identity may increase midwives' core competencies.
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Affiliation(s)
- Huiyi Luo
- College of Nursing, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Huping Gong
- College of Nursing, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Feng Luo
- Department of Obstetrics, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Ying Xing
- College of Nursing, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Xin Wang
- College of Nursing, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Jingwen Huang
- College of Nursing, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Mei Ding
- College of Nursing, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Dongmei Lin
- College of Nursing, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Yanli Lan
- College of Nursing, Gannan Medical University, Ganzhou, Jiangxi, China
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Wang Y, Yang Y, Wang X, Tan H, Sun J, Yan X, Liu Y, Ding R, Guo Y, Wang L. Status and influencing factors of undergraduate midwifery students' core competencies: A cross sectional study. NURSE EDUCATION TODAY 2024; 133:106042. [PMID: 37984053 DOI: 10.1016/j.nedt.2023.106042] [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: 04/11/2023] [Revised: 10/27/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Midwifery undergraduate students' core competencies directly affect the quality of midwifery services and overall quality of midwifery teams. However, limited research has explored the core competencies of undergraduate midwifery students in China. OBJECTIVES This study aimed to describe the level of core competencies among undergraduate midwifery students in China and investigated possible associated factors. DESIGN This was a cross-sectional descriptive study. SETTINGS AND PARTICIPANTS The study population comprised third- and fourth-year undergraduate midwifery students at Zunyi Medical University in Guizhou Province in southwest China (n = 207, response rate 94.1 %). METHODS Data were collected using an online survey that included a general information questionnaire, a general self-efficacy scale, and a core competencies self-assessment questionnaire for midwifery undergraduates. Data were statistically analyzed using SPSS 18.0. Pearson's correlation analysis was used to explore the relationship between self-efficacy and the core competencies. Stepwise multiple linear regression was used to explore influencing factors. RESULTS The total score for the core competencies among midwifery undergraduates was 118.46 (8.97). The highest mean score was for professional attitude, 4.21 (0.43), and the lowest was for professional skills, 3.70 (0.30). We found a positive association between self-efficacy and core competencies (r = 0.251, P < 0.01). Grade (β = 0.261, P < 0.01), scholarship (β = -0.231, P < 0.01), work intention (β = -0.135, P < 0.05), and self-efficacy (β = 0.207, P < 0.01) significantly influenced undergraduate midwifery students' core competencies (R2 = 0.189, adjusted R2 = 0.173, F = 11.775, P < 0.001). CONCLUSIONS Undergraduate midwifery students showed moderate core competencies, indicating room for improvement. Fourth-grade midwifery students had higher core competencies than third-grade students. Additionally, scholarship, work intention, and self-efficacy were significant influencing factors. Midwifery educators should examine students' core competencies and explore targeted interventions, particularly for those with low self-efficacy and core competencies.
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Affiliation(s)
- Yousha Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China; Nursing College, Zunyi Medical University, Zunyi, China
| | - Yuan Yang
- Department of Reproductive Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Xueting Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China; Nursing College, Zunyi Medical University, Zunyi, China
| | - Huiwen Tan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China; Nursing College, Zunyi Medical University, Zunyi, China
| | - Jing Sun
- Nursing College, Zunyi Medical University, Zunyi, China
| | - Xin Yan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China; Nursing College, Zunyi Medical University, Zunyi, China
| | - Ying Liu
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China; Nursing College, Zunyi Medical University, Zunyi, China
| | - Rui Ding
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China; Nursing College, Zunyi Medical University, Zunyi, China
| | - Yunmei Guo
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China; Nursing College, Zunyi Medical University, Zunyi, China
| | - Lianhong Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China; Nursing College, Zunyi Medical University, Zunyi, China.
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Shang X, Ye L, Gu X, Zhou A, Xu Y, Zhang Y, Liao Y, Li L. Attitudes and Barriers to Physical Activity and Exercise Self-Efficacy Among Chinese Pregnant Women: A Cross-Sectional Study. J Multidiscip Healthc 2023; 16:3561-3573. [PMID: 38024132 PMCID: PMC10676646 DOI: 10.2147/jmdh.s441210] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023] Open
Abstract
Background Most pregnant women do not reach the recommendation for physical activity (PA). As a subcategory of PA, exercise is also essential. Evidence on pregnant women's attitudes and barriers to PA and exercise self-efficacy in China is scarce. Aim To explore the levels and influencing factors of attitudes and barriers to PA and exercise self-efficacy among pregnant women. Methods A cross-sectional study of 311 pregnant women was conducted from August to December 2022. Individual characteristics, pregnant women's attitudes toward exercise, barriers to prenatal PA and exercise, and exercise self-efficacy were measured using the self-designed demographic questionnaire, pregnant women's attitudes toward exercise questionnaire, barriers to prenatal PA and exercise questionnaire, and the pregnancy exercise self-efficacy scale, respectively. Results More than 90% of pregnant women believed exercise benefits themselves and their babies, and 40.8% of pregnant women did not know how to exercise. Women encounter different types of barriers to PA and exercise. Intrapersonal barriers included the proportion of feelings of tiredness (56.6%), low energy (54.7%), lack of interest or motivation (49.2%), feelings of illness and morning sickness (46.6%), and large body weight (43.7%). Interpersonal barriers included pregnant women being advised to avoid PA and exercise (49.2%), lack of clear advice about the intensity and dose of exercise (41.8%), no one to exercise with (38.9%), and lack of advice from healthcare professionals (38.6%). Weather conditions were the most significant environmental barriers (41.2%). The total score of pregnancy exercise self-efficacy was (38.50±7.33). Education level, parity, and attitudes toward exercise independently predict pregnant women's attitudes toward exercise, barriers to prenatal PA and exercise, and exercise self-efficacy, respectively. Conclusion Pregnant women have a favorable attitude toward exercise and relatively good exercise self-efficacy but lack knowledge of exercise. They face numerous barriers. Medical professionals should encourage pregnant women with lower levels of education to exercise and assist multipara in overcoming obstacles.
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Affiliation(s)
- Xingchen Shang
- School of Nursing, Yangzhou University, Yangzhou, People’s Republic of China
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People’s Republic of China
| | - Linfei Ye
- School of Nursing, Yangzhou University, Yangzhou, People’s Republic of China
| | - Xiaohua Gu
- Delivery Room, Yangzhou Maternal and Child Care Service Centre, Yangzhou, People’s Republic of China
| | - Aihua Zhou
- Delivery Room, Taizhou Second People’s Hospital, Taizhou, People’s Republic of China
| | - Yunmei Xu
- Obstetrics and Gynecology Department, Baoying People’s Hospital, Yangzhou, People’s Republic of China
| | - Yiran Zhang
- School of Nursing, Yangzhou University, Yangzhou, People’s Republic of China
| | - Yuexia Liao
- School of Nursing, Yangzhou University, Yangzhou, People’s Republic of China
| | - Lin Li
- Department of Nursing, The Affiliated Hospital of Yangzhou University, Yangzhou, People’s Republic of China
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Zang Y, Huang J, Zhang H, Sun K, Li X, Wang D, Wei T, Xing L, Fu L, Hou R, Lu H. Implementation of the Practice Programme for Upright Positions in the Second Stage of Labour and the birth experience of Chinese women: A qualitative study. Midwifery 2023; 125:103801. [PMID: 37657132 DOI: 10.1016/j.midw.2023.103801] [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: 02/20/2023] [Revised: 08/08/2023] [Accepted: 08/25/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE Upright positions in the second stage of labour are recommended by many international organizations. However, they have not been widely used worldwide, especially in China. One of the important factors is the absence of a practice programme based on the best available evidence. We thus developed a Practice Programme for Upright Positions in the Second Stage of Labour following the UK Medical Research Council framework. Under the guidance of the programme, whether the use of upright positions can improve the maternal birth experience is a question of great concern. This study aimed to explore the birth experience of Chinese women who adopted upright positions in the second stage of labour. DESIGN This qualitative descriptive study was conducted as part of an implementation study that developed an evidence-based intervention and used strategies to integrate the evidence-based intervention into routine obstetric clinical practice. SETTING The maternity department of a tertiary comprehensive hospital in Hebei Province, China. PARTICIPANTS Semi-structured interviews with twelve eligible women who adopted upright positions in the second stage of labour were conducted between March and April 2022. Qualitative data were analyzed by using conventional content analysis. FINDINGS The average age of included women was 26.5 ± 3.5 years, and ten of them were primiparous women. Eight women adopted epidural analgesia during labour to relieve labour pain. All women gave birth in at least one type of upright position in the passive second stage of labour and adopted the semi-recumbent position in the active second stage of labour. Through conventional content analysis, we found that the use of upright positions in the second stage of labour could possibly promote an overall positive birth experience. Women giving birth in upright positions generally perceived they were more involved in their birthing process, and had greater physical and mental capacity to cope with childbirth. KEY CONCLUSIONS Women have a positive birth experience when using upright positions in the second stage of labour. IMPLICATIONS FOR PRACTICE This study suggests upright positions could improve women's birth experience and have the potential to be widely applied in clinical practice.
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Affiliation(s)
- Yu Zang
- School of Nursing, Hebei Medical University, Shijiazhuang, China
| | - Jing Huang
- School of Nursing, Peking University, Beijing 100191, China
| | - Huixin Zhang
- Department of Obstetrics and Gynaecology, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, China
| | - Kejuan Sun
- Department of Nursing, The First Affiliated Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiaodan Li
- Department of Nursing, Peking University People's Hospital, Beijing, China
| | - Dehui Wang
- Department of Obstetrics, Beijing Hospital, Beijing, China
| | - Tao Wei
- Department of Obstetrics, Beijing Hospital, Beijing, China
| | - Lili Xing
- Department of Obstetrics, Peking University People's Hospital, Beijing, China
| | - Li Fu
- School of Nursing, Peking University, Beijing 100191, China
| | - Rui Hou
- School of Nursing, Peking University, Beijing 100191, China
| | - Hong Lu
- School of Nursing, Peking University, Beijing 100191, China.
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Chen W, Ma Y, Yu C. Unmet chronic care needs and insufficient nurse staffing to achieve universal health coverage in China: Analysis of the Global Burden of Disease Study 2019. Int J Nurs Stud 2023; 144:104520. [PMID: 37295284 DOI: 10.1016/j.ijnurstu.2023.104520] [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: 01/03/2023] [Revised: 02/21/2023] [Accepted: 04/24/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Although China has made impressive progress towards Universal Health Coverage through the health system reform plan since 2009, chronic disease prevention and control implementations are still inadequate to meet the need at large. This study aims to quantify the acute and chronic care needs in China and examine the human resources for health and financial protection for the population to achieve Universal Health Coverage. METHODS The data on disability-adjusted life years, years lived with disability, and years of life lost in China were disaggregated from the Global Burden of Diseases Study 2019 by age and sex based on acute care need or chronic care need. An auto-regressive integrated moving average model was deployed to predict the supply gap of physicians, nurses and midwives from 2020 to 2050. Out-of-pocket health expenditure was compared among China, Russia, Germany, the US, and Singapore to examine the current status of financial protection. RESULTS In 2019, conditions requiring chronic care accounted for 86.4% of all-cause, all-age disability-adjusted life years in China, while acute-care-need conditions accounted for 11.3%. Approximate 25.57% of disability-adjusted life years in communicable diseases and 94.32% in non-communicable diseases were caused by chronic care need conditions. Chronic care-need conditions accounted for more than 80% of both man and woman's disease burden. The proportion of disability-adjusted life years and years of life lost attributable to chronic care was greater than 90% in people aged 25 and up. The nurse and midwife supply will be in absolute shortage and unable to achieve effective universal health coverage effective coverage of 80% or 90% from 2020 to 2050, while the physician supply will be sufficient to maintain effective universal health coverage of 80% and reach 90% from 2036. The out-of-pocket health expenditure decreased with time but was still relatively higher than that of Germany, the US, and Singapore. CONCLUSIONS The present study demonstrates the chronic care needs outweigh those for acute care in China. Nurse supply and the financial protection for the poor were still inadequate to achieve Universal Health Coverage. Better workforce planning and concerted actions on chronic care prevention and control should be taken to meet the population's chronic care needs.
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Affiliation(s)
- Wen Chen
- School of Public Health, Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
| | - Yudiyang Ma
- Department of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chuanhua Yu
- School of Public Health, Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China.
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Guo H, Li T, Zhou R, Li M, Feng C, Cai X, Zhang C. The application of a continuous partnership-based birth plan in China: A randomized controlled trial. Midwifery 2023; 120:103625. [PMID: 36905757 DOI: 10.1016/j.midw.2023.103625] [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: 01/26/2022] [Revised: 11/23/2022] [Accepted: 02/05/2023] [Indexed: 02/13/2023]
Abstract
BACKGROUND The cesarean section rate is as high as 36.7% in China, much higher than the average cesarean section rate of 27% in Asia. With the implementation of the two-children and three-children policy, the primipara with cesarean will also face the choice of repeated or even multiple cesareans, which will increase the risk of maternal perinatal mortality and serious fetal pulmonary morbidity. To reduce the cesarean section rate, a series of midwifery service measures such as the birth plan have been taken in China and it has played a certain role in improving the birth outcome and maternal birth experience. However, the areas carrying out birth plan are often economically developed with advanced medical conditions. the application effect of birth plan in economically underdeveloped areas with limited medical conditions in China is unknown. OBJECTIVE To evaluate the effects of a continuous partnership-based birth plan on local women's birth outcomes and experience in Haikou which is an economically underdeveloped city in China. DESIGN A randomized controlled trial study design was used. PARTICIPANTS 90 primiparous women who received pregnancy service from the obstetrics clinic of one of tertiary hospitals in Haikou city, Hainan Province between July 2020 and December 2020 and planned to give birth in this hospital were recruited. METHODS After eligibility was determined, consents obtained and baseline surveys completed, 90 participants were randomly allocated to study groups with concealed opaque envelopes by a blinded research assistant and each group were 45 participants. Participants in control group received routine obstetric health service and nursing care, while participants in the experimental group received the continuous partnership service of midwives on the basis of routine care. At the same time, the birth plan was formulated and implemented, and the relevant indicators were recorded and analyzed during and after birth, including cesarean section rate, non-medical indication cesarean section rate, oxytocin use rate, perineal lateral resection rate and anxiety degree. RESULTS The cesarean rate in the experiment and control groups were 20.45% and 57.14%, of which the non-medical indication cesarean rate in the experiment and control groups were 22.22% and 50.00%, respectively, whereby the difference of cesarean rate and nonmedically indicated cesarean section rate between the groups was statistically significant (χ2 = 12.231, p < 0.001;χ2 = 9.101, p = 0.003). Besides, the differences in anxiety degree, neonatal NICU transfer rate and satisfaction of birth between the two groups were statistically significant (p < 0.05). While there was no significant difference in oxytocin use rate, perineal lateral resection rate, neonatal 1-min and 5-min Alzheimer's score between the two groups (P > 0.05). CONCLUSION The birth plan based on continuous partnership can reduce medical intervention, improve birth outcomes, reduce anxiety and optimize maternal birth experience of women, which is worthy of promotion in economically underdeveloped areas of China.
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Affiliation(s)
- Honghua Guo
- International Nursing School, Hainan Medical University, 3 Xueyuan Road, Longhua District, Haikou, China
| | - Tong Li
- International Nursing School, Hainan Medical University, 3 Xueyuan Road, Longhua District, Haikou, China
| | - Rong Zhou
- International Nursing School, Hainan Medical University, 3 Xueyuan Road, Longhua District, Haikou, China
| | - Minxiang Li
- Department of Nursing, Second Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Chunling Feng
- Department of Nursing, Second Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Xiaoxia Cai
- International Nursing School, Hainan Medical University, 3 Xueyuan Road, Longhua District, Haikou, China.
| | - Caihong Zhang
- International Nursing School, Hainan Medical University, 3 Xueyuan Road, Longhua District, Haikou, China.
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Exploring Midwifery Students’ Experiences of Professional Identity Development During Clinical Placement: A Qualitative Study. Nurse Educ Pract 2022; 63:103377. [DOI: 10.1016/j.nepr.2022.103377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 05/08/2022] [Accepted: 06/03/2022] [Indexed: 11/22/2022]
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Li Y, Lu H, Zhao Y, Ren L, Cao L, Pang D, Wang A. Core competencies of the midwifery workforce in China: a scoping review. J Nurs Manag 2021; 30:535-558. [PMID: 34894017 DOI: 10.1111/jonm.13531] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/25/2021] [Accepted: 12/01/2021] [Indexed: 12/01/2022]
Abstract
AIM This review aims to demonstrate the current core competencies of the Chinese midwifery workforce, and summarize the influencing factors of core competencies. BACKGROUND Midwifery core competencies are crucial to providing high-quality maternal and newborn health care, but little is known about the overall status of the core competencies of the Chinese midwifery workforce. EVALUATION A scoping review was conducted following the latest JBI scoping review methodology and PRISMA-ScR checklist. KEY ISSUES Forty-one studies were included in this review. Regarding core competency assessment tools, the Midwife Core Competency Scale was used most frequently among 16 identified tools. Generally, the core competencies of the Chinese midwifery workforce were at a moderate or high level, but the competencies in pre-pregnancy, public health care, and integrative competence were relatively inadequate. The main factors influencing the core competencies of the midwifery workforce were their working years, educational level, and training experience. CONCLUSION This review provides a comprehensive overview of the core competencies of the Chinese midwifery workforce at the national level. Future studies are encouraged to use objective instruments to reflect core competencies and explore the intervenable influencing factors of core competencies. IMPLICATIONS FOR NURSING MANAGEMENT Core competency assessment tools can be used to select the qualified midwifery workforce. Targeted core competency enhancement programs should be formulated based on the current core competencies level and the factors influencing core competencies.
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Affiliation(s)
- Yuxuan Li
- School of Nursing, Peking University, Beijing, China
| | - Hong Lu
- School of Nursing, Peking University, Beijing, China
| | - Yang Zhao
- School of Nursing, Peking University, Beijing, China
| | - Lihua Ren
- School of Nursing, Peking University, Beijing, China
| | - Linlin Cao
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Dong Pang
- School of Nursing, Peking University, Beijing, China.,Health Science Center for Evidence-Based Nursing, Peking University, Beijing, China
| | - Aihua Wang
- Health Science Library, Peking University, Beijing, China
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Qin F, Meng G, Luo C, Wei H, Zhang L, Shi L. Comfort With Touch and Influencing Factors Among Chinese Midwives: A Cross-sectional Survey. J Perinat Neonatal Nurs 2021; 34:330-337. [PMID: 33079806 DOI: 10.1097/jpn.0000000000000480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The aim of this study was to identify comfort with touch (CT) and influencing factors among Chinese midwives. Midwives (N = 252) from 7 hospitals in Guangdong, China, were asked to complete a self-report questionnaire between November 2018 and April 2019. The questionnaire included the Nurses' Comfort with Touch Scale (NCTS), the Nurses' Perceived Professional Benefits (NPPB) Scale, the Maslach Burnout Inventory-General Survey (MBI-GS), and a self-designed demographic questionnaire. Multivariate linear regression was used to identify influencing factors for CT. Mean NCTS total score was 88.90 ± 14.40, and the mean item score was 5.23 ± 0.91, which indicated a respectable score. Within the NCTS, CT was highest in the comfort support category (5.32 ± 0.29) whereas CT was lowest in the physical comfort category (4.28 ± 0.28). Multivariate regression analysis demonstrated that CT among Chinese midwives was associated with positive experiences or feelings surrounding the patient-nurse relationship (B = 3.239, P < .001), perceived professional benefit (PPB, positive professional identity) (B = 0.240, P < .001), emotional exhaustion (B = -0.414, P < .001), depersonalization (negative attitude toward the work setting) (B = -0.773, P < .001), and personal accomplishment (evaluation of self-worth) (B = 0.170, P = .015). Touch training and educational programs are recommended for Chinese midwives to enhance awareness and acceptance of touch care. In addition, promoting positive patient-nurse relationships, improving PPB, and reducing burnout are recommended to enhance CT among Chinese midwives. Because of the size and racial homogeneity of the sample, further studies are recommended to identify CT and influencing factors in a larger, more diverse population of midwives worldwide.
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Affiliation(s)
- Fang Qin
- Southern Medical University, Guangzhou, China (Mss Qin and Meng and Drs Luo, Zhang, and Shi); and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (Dr Wei)
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Gu C, Lindgren H, Wang X, Zhang Z, Liang S, Ding Y, Qian X. Developing a midwifery service task list for Chinese midwives in the task-shifting context: a Delphi study. BMJ Open 2021; 11:e044792. [PMID: 34266838 PMCID: PMC8286777 DOI: 10.1136/bmjopen-2020-044792] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 06/16/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To develop and validate a midwifery-led task list in the task-shifting context. DESIGN An extensive literature review followed by a two-iterative Delphi survey. SETTING Twenty university hospitals, three non-university hospitals and four university colleges from nine provincial regions of China. PARTICIPANTS Purposive non-probability sampling of a national panel of experts in maternal healthcare, obstetrics, nursing and midwifery. Experts in the panel were asked to rate each midwifery service item regarding importance, feasibility and advancement on a 5-point scale, in order to determine those best suited for midwifery-led practice in China. RESULTS Two rounds of Delphi surveys were completed before consensus was achieved, with effective response rate ranging from 96.4% (27/28) to 100% (27/27), indicating a high positive coefficient of the experts. The authority coefficient of experts was 0.882, indicating the high reliability of this study. The Kendall harmony coefficient (W) in the two rounds of consultations was 0.196 (p<0.001) and 0.324 (p<0.001), respectively. A detailed, three-level midwifery-led task list was developed, including 3 domains of midwifery practice (first-level indicators), 13 types of task (second-level indicators) and 58 midwifery service items (third-level indicators). The 3 domains of midwifery practice involved the appropriate scope of practice for Chinese midwives, including antenatal care, intrapartum care and postnatal care. The 58 service items embraced core components of caring task in the Chinese midwifery profession. CONCLUSION This study outlines the first midwifery-led task list that defines clearly the Chinese midwives' scope of practice. It will provide a foundational framework for future midwifery practice in China and abroad, and can be used to inform the design of midwifery-led task shifting interventions in various maternity settings.
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Affiliation(s)
- Chunyi Gu
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China
- Global Health Institute, Fudan University, Shanghai, China
| | - Helena Lindgren
- Department of Women's and Children's Health, Reproductive Health, Karolinska Institute, Stockholm, Sweden
| | - Xiaojiao Wang
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Zheng Zhang
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Shuang Liang
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yan Ding
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xu Qian
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China
- Global Health Institute, Fudan University, Shanghai, China
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Liu Y, Li T, Guo N, Jiang H, Li Y, Xu C, Yao X. Women's experience and satisfaction with midwife-led maternity care: a cross-sectional survey in China. BMC Pregnancy Childbirth 2021; 21:151. [PMID: 33607963 PMCID: PMC7893951 DOI: 10.1186/s12884-021-03638-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 02/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low risk pregnancy ending in a vaginal birth is best served and guided by a midwife. Utilizing a midwife in such cases offers many emotional and economic advantages and does not increase the risks for mother or neonate. However, women's experience and satisfaction of midwife-led maternity care is rarely reported in China. The primary objective of this study is to describe the experience of Chinese women receiving midwife-led maternity care, and to report their satisfaction level of the experience. METHODS The study is a cross-sectional survey of 4192 women who had natural birth from March-June 2019 in a maternity care center, Shanghai, China. We used a self-administered questionnaire addressing items related to women's experience during childbirth, as well as their satisfaction with midwife-led maternity care. We also included demographic and perinatal characteristics of each participant. Descriptive statistics and correlations analysis between groups of different experience and satisfaction were used. RESULTS In this sample, 87.7% of women had a Doula and a family member present during childbirth. Epidural anesthesia was used in 75.6% and episiotomy was needed in 23.2%. Free positioning during the first stage of labor and free positioning during the second stage of labor and delivery were adopted in 84.3 and 67.9% of the cases, respectively. Moderate to severe perineal pain and moderate to severe perineal edema were reported in 43.1 and 12.2% of the participants, respectively. High satisfaction level was found when there was midwife-led prenatal counseling and presence of Doula and family member, Lamaze breathing techniques, warm perineal compresses, epidural anesthesia, free positioning during the first stage of labor, and midwifes' postpartum guidance. Negative satisfaction was seen with perineal pain and edema. CONCLUSION Women in this survey generally had high satisfaction with midwife-led maternity care. This satisfaction is probably felt because of the prenatal counseling by the midwife and allowing a Doula and a family member in the room during childbirth. Other intangible factors to improve the satisfaction level were Lamaze breathing techniques, warm perineal compresses, epidural anesthesia, free positioning during first stage of labor, and early skin to skin contact.
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Affiliation(s)
- Ying Liu
- Nursing Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204, China
| | - Tengteng Li
- Nursing Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204, China
| | - Nafei Guo
- Nursing Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204, China
| | - Hui Jiang
- Nursing Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204, China.
| | - Yuehong Li
- Delivery Room, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204, China
| | - Chenying Xu
- Delivery Room, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204, China
| | - Xiao Yao
- Delivery Room, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204, China
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Li T, Wang J, Chen X, Chen L, Cai W. Obstetric Nurses' Knowledge, Attitudes, and Professional Support Related to Actual Care Practices About Urinary Incontinence. Female Pelvic Med Reconstr Surg 2021; 27:e377-e384. [PMID: 32925423 DOI: 10.1097/spv.0000000000000941] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The objective of this study was to evaluate obstetric nurses' knowledge, attitudes, and practices (KAP) toward urinary incontinence (UI) during pregnancy and identify factors associated with their actual specific care practices for recommending pelvic floor muscle training (PFMT). METHODS A cross-sectional study was conducted among obstetric nurses attending an academic conference about perinatal care in China. Data were collected through a self-administered questionnaire, including demographic and professional information, professional supports included clinical protocol and learning experience, knowledge, attitudes, and practices of UI. RESULTS Four hundred and seven obstetric nurses completed the survey (89.8% response rate). The correct answer rates of the vast majority of knowledge items was more than 80%. The majority of participants strongly agreed that antenatal PFMT is effective in UI treatment and prevention (69.5% and 69.0% respectively). Although only less than 30% of participants always recommended PFMT to incontinent or continent pregnant women (29.5% and 25.3%, respectively), obstetric nurses with clinical protocol, learning experience, and positive attitudes were more likely to recommend PFMT for treating UI (odds ratio [OR], 2.165, P < 0.001; OR, 1.759; P = 0.014; OR, 2.326; P < 0.001, respectively). Obstetric nurses with clinical protocol and positive attitudes were more likely to recommend PFMT for preventing UI (OR, 2.252; P < 0.001; OR, 1.693; P = 0.005, respectively). CONCLUSIONS Most obstetric nurses have good knowledge and positive attitudes toward UI during pregnancy, but fail to deliver care for it. Clinical protocol, learning experience, and positive attitudes are facilitators of their actual specific care practices for recommending PFMT. This finding suggests the need for developing clinical protocols and education programs regarding UI during pregnancy.
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Affiliation(s)
- Tiantian Li
- From the Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, and School of Nursing, Southern Medical University, Guangzhou
| | - Jia Wang
- From the Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, and School of Nursing, Southern Medical University, Guangzhou
| | - Xiaomin Chen
- Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Ling Chen
- Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Wenzhi Cai
- From the Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, and School of Nursing, Southern Medical University, Guangzhou
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