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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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Toll K, Sharp T, Reynolds K, Bradfield Z. Advanced midwifery practice: A scoping review. Women Birth 2024; 37:106-117. [PMID: 37845089 DOI: 10.1016/j.wombi.2023.10.001] [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: 07/26/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/18/2023]
Abstract
PROBLEM There is no international standard for advanced midwifery scope of practice. BACKGROUND Globally, there is variance in how scope of midwifery practice is determined and regulated, with no consensus on extended or advanced scope. This can lead to under-utilised staff potential, un-met consumer need, and loss of professional skill. AIMS The aim of this scoping review was to synthesise and map what is reported in the international literature on the advanced scope of midwifery practice. METHODS A systematic scoping review methodology was adopted utilising Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A full search was conducted of databases including MEDLINE, CINAHL, Scopus, Google. Publications from 2019 to August 2022 that met criteria were included. Reported skills were mapped to the International Confederation of Midwives (ICM) competencies of pre-conception, antenatal, labour and birth, postnatal plus globally identified areas for midwifery investment. FINDINGS 28 articles met inclusion criteria. Reported skills included abortion care (n = 6), prescribing (n = 7), ultrasound (n = 2), advanced practice skills (n = 7), midwifery-led skills, primary health, post-graduate education, HIV/AIDS testing, advocacy, and acupressure (all n = 1). DISCUSSION This review presents a synopsis of publications describing what has been defined as advanced midwifery scope of practice in international contexts. CONCLUSION Establishing evidence of midwives working to the peak of professional scope is important to continue to develop professional capacity and support contemporary practice, regulation, governance, and policy while improving consumer access to equitable care. Findings aid service development, provision, and professional planning.
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Affiliation(s)
- Kaylie Toll
- School of Population Health, Curtin University, Perth, Western Australia, Australia.
| | - Tarryn Sharp
- WA Country Health Service, Western Australia, Australia
| | - Kate Reynolds
- WA Country Health Service, Western Australia, Australia
| | - Zoe Bradfield
- School of Nursing, Curtin University, Perth, Western Australia, Australia; King Edward Memorial Hospital, Bagot Rd, Subiaco, Perth, Western Australia, Australia
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Maga G, Arrigoni C, Brigante L, Cappadona R, Caruso R, Daniele MAS, Del Bo E, Ogliari C, Magon A. Developmental Strategy and Validation of the Midwifery Interventions Classification (MIC): A Delphi Study Protocol and Results from the Developmental Phase. Healthcare (Basel) 2023; 11:healthcare11060919. [PMID: 36981576 PMCID: PMC10048446 DOI: 10.3390/healthcare11060919] [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: 01/19/2023] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
This study protocol aims to describe the rationale and developmental strategy of the first study in the Italian context which aimed to define a Midwifery Interventions Classification, an evidence-based, standardized taxonomy and classification of midwifery interventions. Midwifery interventions require a specific definition, developed through a consensus-building process by stakeholders to develop the Italian taxonomy of the Midwifery Interventions Classification with the potential for international transferability, implementation, and scaling up. A multi-round Delphi study was designed between June and September 2022, and data collection is planned between February 2023 and February 2024. The developmental phase of the study is based on a literature review to select meaningful midwifery interventions from the international literature, aiming to identify an evidence-based list of midwifery interventions. This phase led to including 16 articles derived from a systematic search performed on PubMed, CINAHL, and Scopus; 164 midwifery interventions were selected from the data extraction performed on the 16 included articles. Healthcare professionals, researchers, and service users will be eligible panelists for the Delphi surveys. The protocol designed a dynamic number of consultation rounds based on the ratings and interim analysis. A nine-point Likert scoring system is designed to evaluate midwifery interventions. Attrition and attrition bias will be evaluated. The results from the study designed in this protocol will inform the development of the Italian taxonomy of the Midwifery Interventions Classification. A shared classification of midwifery interventions will support audit and quality improvement, education, and comparable data collections for research, sustaining public recognition of midwifery interventions to promote optimal maternal and newborn health.
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Affiliation(s)
- Giulia Maga
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, 27100 Pavia, Italy
| | - Lia Brigante
- Department of Women's and Children's Health, Faculty of Life Sciences and Medicine, King's College London, London WC2R 2LS, UK
| | - Rosaria Cappadona
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milano, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
| | - Marina Alice Sylvia Daniele
- Department of Midwifery and Radiography, School of Health and Psychological Sciences, University of London, London EC1V 0HB, UK
| | - Elsa Del Bo
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Chiara Ogliari
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Arianna Magon
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milano, Italy
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Jin Y, Wu Y, Li J. Midwife empathy and its association with the childbirth experience: a cross-sectional study. BMC Pregnancy Childbirth 2022; 22:960. [PMID: 36550461 PMCID: PMC9774080 DOI: 10.1186/s12884-022-05309-3] [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: 09/05/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Although pregnancy and childbirth comprise a life-course that most midwives experience, whether their own experiences of childbirth resonate with other women during childbirth remains to be determined. In this study, we therefore characterized midwives' empathic capabilities and defined their underlying factors. METHOD We conducted a cross-sectional study with data from 464 midwives in Guangdong, China, that were collected through the "Chinese version of the Jefferson Scale of Empathy for Health Professionals (JSE-HP)." This questionnaire contains sections related to midwife demographics and delivery characteristics. We then implemented multivariate logistic regression analysis to identify empathy-related factors. RESULTS Our analysis revealed 303 (65.3%) participants in the high-empathy group while 161 (34.7%) were in the middle-empathy group. Compared with the reference groups, these results indicated that higher empathy was associated with an elevated educational level (OR, 1.83; 95% CI, 1.04-3.25), high monthly salary (OR, 2.30; 95% CI, 1.11-4.80), and no shift work (OR, 2.89; 95% CI, 1.09-7.63). The odds of a high empathy score were higher for midwives who experienced two childbirths (2.27, 1.11-4.66) and for those who had children under the age of 3 years (2.81, 1.34-5.92). CONCLUSION Midwives possess a moderate-to-high level of empathy, and the greater the number of childbirths they experienced and the younger their children, the higher their reported empathy score. This study contributes novel information regarding the empathic behavior of midwives toward women who give birth in China.
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Affiliation(s)
- Yuhua Jin
- Department of Obstetrics and Gynecology, Shenzhen Samii Medical Center, Shenzhen, 518118 Guangdong Province China
| | - Yanpeng Wu
- grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, Shanghai, 200433 China
| | - Jing Li
- grid.488521.2Department of Obstetrics and Gynecology, Shenzhen Hospital, Southern Medical University, Shenzhen, 518100 Guangdong Province China ,grid.443187.d0000 0001 2292 2442School of Nursing, Philippine Women’s University, 1743 Taft Avenue, 1004 Malate, Manila, Philippines
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Liu C, Yue C, Liu L, Liu T, Wang X, Hou Y, Gao S. Mediating role of perceived social support in the relationship between perceived stress and job burnout among midwives in the post-COVID-19 era. Nurs Open 2022; 10:479-487. [PMID: 35964290 PMCID: PMC9834135 DOI: 10.1002/nop2.1313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 06/18/2022] [Accepted: 07/29/2022] [Indexed: 01/16/2023] Open
Abstract
AIM The aim of this study was to explore the mediating role of perceived social support in the association between perceived stress and job burnout in midwives. DESIGN A descriptive, cross-sectional online survey. METHODS Using the stratified cluster sampling method, 329 midwives in 20 hospitals in China were selected as the participants. They completed self-report assessment measures of job burnout, perceived stress and perceived social support. RESULTS 63.5% of the participants had job burnout. Perceived stress was negatively associated with social support (r = -.350, p < .01), while it was positively associated with job burnout (r = -.382, p < .01). Social support was negatively correlated with job burnout (r = -.569, p < .01). The total effect of perceived stress on job burnout was 0.474 (95% CI: 0.367 ~ 0.596, p < .01), the direct effect was 0.242 (95% CI: 0.142 ~ 0.355, p < .01), and the indirect effect was 0.232 (95% CI: 0.160 ~ 0.316, p < .01). Social support programmes for midwives should be implemented to control the impact of perceived stress on job burnout.
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Affiliation(s)
- Cuiping Liu
- School of NursingShandong First Medical University & Shandong Academy of Medical SciencesTaianChina
| | - Chongyu Yue
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Lei Liu
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Ting Liu
- School of NursingQingdao UniversityQingdaoChina
| | - Xuelei Wang
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Yan Hou
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Shaobo Gao
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
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Stollenwerk MM, Gustafsson A, Edgren G, Gudmundsson P, Lindqvist M, Eriksson T. Core competencies for a biomedical laboratory scientist - a Delphi study. BMC MEDICAL EDUCATION 2022; 22:476. [PMID: 35725406 PMCID: PMC9208704 DOI: 10.1186/s12909-022-03509-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND After completing university education, biomedical laboratory scientists work in clinical laboratories, in biomedical research laboratories, in biotech, and in pharmaceutical companies. Laboratory diagnostics have undergone rapid development over the recent years, with the pace showing no signs of abatement. This rapid development challenges the competence of the staff and will most certainly influence the education of future staff. This study aimed to examine what was considered the necessary competencies needed to pursue a career as a biomedical laboratory scientist. METHODS A modified Delphi technique was used, with the panel of experts expressing their views in a series of three questionnaire. Consensus was defined as the point which 75 % or more of the panel participants agreed that a particular competency was necessary. RESULTS The study highlights the perceived importance of mostly generic competencies that relate to quality, quality assurance, and accuracy, as well as different aspects of safety, respect, trustworthiness (towards patients/clients and colleagues), and communication skills. The results also stress the significance of self-awareness and professionality. CONCLUSIONS We identified important competencies for biomedical laboratory scientists. Together with complementary information from other sources, i.e., guidelines, laws, and scientific publications, the competencies identified can be used as learning outcomes in a competency-based education to provide students with all the competencies needed to work as professional biomedical laboratory scientists.
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Affiliation(s)
- Maria M Stollenwerk
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Biofilms Research Center for Biointerfaces, Malmö University, Malmö, Sweden
| | - Anna Gustafsson
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, Malmö, Sweden.
- Biofilms Research Center for Biointerfaces, Malmö University, Malmö, Sweden.
| | - Gudrun Edgren
- Center for Teaching and Learning, Faculty of Medicine, Lund University, Lund, Sweden
| | - Petri Gudmundsson
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Biofilms Research Center for Biointerfaces, Malmö University, Malmö, Sweden
| | | | - Tommy Eriksson
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Biofilms Research Center for Biointerfaces, Malmö University, Malmö, Sweden
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Liu S, Li Y, Fu S, Liu X, Liu T, Fan H, Cao C. Establishing a Multidisciplinary Framework for an Emergency Food Supply System Using a Modified Delphi Approach. Foods 2022; 11:foods11071054. [PMID: 35407141 PMCID: PMC8997876 DOI: 10.3390/foods11071054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 02/01/2023] Open
Abstract
A scientific food emergency supply system is helpful for assuring food supplies continuity, improving response efficiency, and reducing disaster losses. However, the framework for a food emergency supply system is currently an understudied area in emergency management post-disaster. In this study, a comprehensive literature review of major databases was performed to identify potential indicators for the emergency food supply system, followed by a two-round modified Delphi with a multidisciplinary expert panel (n = 17) to verify the proposed framework. The effective response rate of questionnaires ranged from 94.4% (17/18) to 100% (17/17) and the authority coefficient of experts was 0.88, indicating high positivity and reliability of the experts. Furthermore, the p-values of Kendall’s W were < 0.01 and the Cronbach’s α were > 0.7 for all domains and indicators, indicating a high reliability and validity for the proposed framework. Finally, a consensus was reached on all eight domains and 81 indicators. In conclusion, this study introduced and verified a multidisciplinary framework for the food emergency supply system, which could provide a theoretical basis for emergency responders to make corresponding commands and decisions post-disaster.
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Affiliation(s)
- Shuyu Liu
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; (S.L.); (Y.L.); (X.L.); (T.L.); (H.F.)
| | - Yue Li
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; (S.L.); (Y.L.); (X.L.); (T.L.); (H.F.)
| | - Shaobo Fu
- General Courses Department, Army Military Transportation University of PLA, Tianjin 300161, China;
| | - Xin Liu
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; (S.L.); (Y.L.); (X.L.); (T.L.); (H.F.)
| | - Tao Liu
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; (S.L.); (Y.L.); (X.L.); (T.L.); (H.F.)
| | - Haojun Fan
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; (S.L.); (Y.L.); (X.L.); (T.L.); (H.F.)
| | - Chunxia Cao
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; (S.L.); (Y.L.); (X.L.); (T.L.); (H.F.)
- Correspondence:
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