The effect on pregnant women's prenatal attachment of a nursing practice using the first and second Leopold's maneuvers

Effects of game-based learning integrated with the self-regulated learning strategy on nursing students' entrustable professional activities: A quasi-experimental study

BACKGROUND

In the field of nursing education, the expertise and knowledge required to perform Leopold's Maneuvers are critical, forming an integral part of Entrustable Professional Activities for nursing students. As a result, mastering Leopold's Maneuvers has become a core component of nursing education. Despite this, the prevailing didactic methods in many nursing courses tend to limit interactive and contextual learning experiences, which can hinder students' ability to engage deeply with the subject matter. This lack of engagement may subsequently affect both the effectiveness of students' learning and students' clinical judgment capacity, essential elements in the competencies of Entrustable Professional Activities.

METHODS

A quasi-experimental design was employed in this study, involving a total of 55 nursing university students, with 28 participants in the experimental group and 27 in the control group. The research incorporated game-based learning integrated with the self-regulated learning strategy, and employed a pretest, posttest, and questionnaires to assess students' learning performance, self-efficacy, and learning motivation. The experimental group participated in game-based learning with the self-regulated learning strategy, whereas the control group experienced game-based learning without the integration of self-regulated learning. Learning performance was analyzed using an independent samples t-test, while Analysis of Covariance was employed to compare the self-efficacy and learning motivation of the two groups.

RESULTS

The findings showed that the integration of game-based learning with the self-regulated learning strategy can significantly improve students' learning performance, self-efficacy, and learning motivation.

CONCLUSION

As an integral part of Entrustable Professional Activities, Leopold's Maneuvers were integrated into an interactive game-based learning environment, coupled with the self-regulated learning strategy in nursing education. This approach aimed at cultivating core competencies among nursing students. This study has demonstrated its efficacy in engaging students effectively, serving as a dynamic resource for immersive learning in Leopold's Maneuvers, aligning well with the design considerations for promoting Entrustable Professional Activities in nursing education.

Does the immigration affect prenatal attachment levels?

Pregnancy is an important period in which mother-infant attachment begins, includes bio-psychological changes, and has physical and psychological effects on the future life of the fetus. This study aims to evaluate the prenatal attachment levels of Syrian refugee and Turkish mothers in Turkey and to determine the variables that affect these. This cross-sectional study conducted in the obstetric outpatient clinics with 397 pregnant women 197 Syrian and 200 native women. Inclusion criteria were a pregnancy of at least 20 weeks, no communication or mental disorders, no chronic diseases, no diagnosis of high-risk pregnancy, literacy in the pregnant Turkish women, Turkish language proficiency in the pregnant Syrian women, and residence in Turkey for at least three years. Data were collected using a Sociodemographic form and The Prenatal Attachment Inventory (PAI). The data were analyzed by conducting independent t-tests, and hierarchical multiple linear regression analysis. The mean prenatal attachment score of Turkish pregnant women (61.79 ± 8.55) was higher than Syrian women (48.38 ± 10.39) (p < .05). Education level, pre-pregnancy counseling, regular checkup, support from spouses, relatives, and friends, and being a refugee of pregnant women were determined as predictors of prenatal attachment. The results showed that 67 percent of the total variance in the prenatal attachment levels could be explained in model 2 (F = 35.524, R2 variation = .673, p = .001). The low prenatal attachment level of Syrian pregnant women was a result of the detrimental impacts of being a refugee on pregnancy. The integration of transcultural knowledge, culture-specific perspectives, and cross-cultural theories into clinical practices is essential for immigrant women.

The role of midwives in supporting the development of the mother-infant relationship: a scoping review

BACKGROUND

The mother-infant relationship is complex and dynamic, informing the psychological development of the infant through bonding and attachment. Positive early interactions influence the quality of this relationship. Midwives are well placed to support the developing relationship between the mother and baby, yet there has been limited research exploring the role of the midwife in this context.

AIM

To explore interventions that have been provided by the midwife which support the development of the maternal-fetal or mother-infant relationship amongst a low-risk population from pregnancy, and up to six weeks postnatal. The review also sought to understand the types of interventions developed, format and delivery, outcomes measured and if cultural considerations had been incorporated.

METHODS

A scoping review of the research literature was undertaken using the Joanna Briggs Institute framework. Five online databases were searched for relevant articles published in English from 2000 to 2021.

FINDINGS

Sixteen articles met the inclusion criteria. Three themes emerged: (1) viewing the fetus as separate from the mother, (2) focused activities on the maternal-infant relationship and (3) targeted educational interventions.

DISCUSSION

Providing focused activities and targeted education during the pre and postnatal periods support the development of the mother-infant relationship. Significantly, there was insufficient research that considered the influence of culture in supporting the mother-infant relationship.

CONCLUSION

Further research is required to develop interventions that include a diverse sample to ensure culturally appropriate activities can be integrated into care during pregnancy and/or the postnatal period provided by midwives.

Systematic Review of the Content Validity of Patient Reported Outcome Measures of Transition to Parenthood

This review aims to identify self-report instruments examining aspects of transition to parenthood for use in practice and research. After performing a literature search in Embase, Medline, Web of Science, Cochrane, PsycINFO and Google Scholar, the Patient Reported Outcome Measures (PROMs) measuring (aspects of) transition to parenthood during pregnancy or up to 1-year postpartum were identified. Following COSMIN guidelines for systematic reviews on PROMs, the quality of the PROM development and PROM content validity was evaluated. From the 129 included studies, 39 PROMs assessed aspects of transition to parenthood. A total of 32 PROMs were included in the evaluation. The development quality of 30/32 PROMS was mostly rated as inadequate and the quality of 15 content validity studies was mostly rated as doubtful. All PROMs received inadequate or doubtful ratings on content validity. Most of the PROMs measuring aspects of the transition to parenthood didn't include parents' points of view when developing them. Many PROMs are being used for a long time without reassessing relevance, comprehensiveness, and comprehensibility among parents and/or practitioners. It is recommended that researchers and healthcare professionals assess content validity of the PROM before use with the target population.

Abdominal examination during pregnancy may enhance relationships between midwife, mother and child: a qualitative study of pregnant women's experiences

BACKGROUND

Abdominal examination is a routine procedure performed by midwives several times during pregnancy to monitor the growth and well-being of the baby. Literature and instructions regarding abdominal examination focus on the technical performance, with limited attention paid to the women's experience of the examination or the bonding-related aspects between the mother and baby. The aim of the study was to explore how pregnant women experience the abdominal examination and how the examination affects maternal-fetal attachment.

METHODS

Participant observation and semi-structured interviews with 10 pregnant women. We used thematic analysis to identify themes across the empirical material.

RESULTS

We identified the following four central themes: an essential examination, the baby becomes real, the importance of being involved and different senses provide different experiences. These themes describe how the women regarded the abdominal examination as an essential part of the midwifery consultation and considered it the occasion when the baby became real and tangible. Being prepared and involved before and during the examination were pivotal for how the examination was experienced by the women. The abdominal examination was crucial to the pregnant women because it provided them with important sensory aspects that were not obtained from ultrasound examination.

CONCLUSION

The abdominal examination is regarded as essential in midwifery consultations and has the potential for supporting a woman's bodily sensation of her baby, which is reinforced by the midwife's manual palpation. Touch can be a way for a pregnant woman to become acquainted with her unborn child, which provides midwives a profound potential to facilitate the process of maternal-fetal attachment.

Educational workshops about bonding with the fetus during pregnancy: a clinical trial

OBJECTIVE

To verify if participation in educational workshops about bonding with the fetus influences the adoption of practices of interaction with the baby by pregnant women.

METHOD

Randomized clinical trial conducted in a health clinic. The experimental group participated in educational workshops designed for the pregnant couple and the control group received usual care. The practices of interaction with the fetus were evaluated before and after the intervention.

RESULTS

19 pregnant women participated in the study. There was a positive correlation between higher gestational age and the interaction with the fetus (p = 0.016), and between younger mothers and the practice of touching or poking the baby (p = 0.019). There was an increase in the interaction with the fetus in the control and experimental groups (p= 0.024).

CONCLUSION

Educational workshops are strategies for sharing knowledge about fetuses' sensory skills and to foster bonding and child development since pregnancy.

The effectiveness of psychoeducation interventions on prenatal attachment: A systematic review

OBJECTIVE

Positive prenatal attachment facilitates parental role adaptation and psychological adjustment during pregnancy, which is a significant predictor of postpartum attachment. The objective of this systematic review was to examine the effect of psychoeducation interventions on prenatal attachment of pregnant women and their partners.

DESIGN

Systematic literature searches of randomized controlled trials (RCTs) were conducted from January 2000 to January 2021, using databases: CINAHL, Embase, Medline, PsycInfo, PubMed, Web of Science and Cochrane Central Register of Controlled Trial and through hand-searching. Studies were independently selected by two reviewers, who also assessed the methodological quality of the included studies using the Cochrane Risk of Bias Tool. Narrative synthesis was conducted due to the significant clinical and methodological heterogeneity.

SETTING/PARTICIPANTS

Fifteen studies met the eligibility criteria for this review, among which 11 studies focused on pregnant women and four studies on their partners.

FINDINGS

The psychoeducation interventions in the included studies showed consistent favorable effects on prenatal attachment. Nine out of the 11 included studies showed statistical significant effects on maternal fetal attachment. Three out of the four studies reported significant effects favoring paternal fetal attachment.

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

The preliminary evidence suggests that psychoeducation interventions have potential favorable effects on maternal fetal attachment and can enhance paternal fetal attachment. However, more studies are needed for investigating the effects of psychoeducation on paternal fetal attachment and for enhancing the validity of the evidence. Our review recommends that healthcare professionals to include psychoeducation as a part of their prenatal care for promoting prenatal attachment. Common characteristics of the interventions could act as references when designing psychoeducation programs for enhancing prenatal attachment.