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Qian J, Wu G, Jevitt C, Sun S, Wang M, Sun X, Yu X. Psychological pathway to emotional exhaustion among nurses and midwives who provide perinatal bereavement care in China: a path analysis. BMC Psychiatry 2024; 24:90. [PMID: 38297253 PMCID: PMC10832229 DOI: 10.1186/s12888-024-05534-4] [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: 05/16/2023] [Accepted: 01/18/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND A lack of confidence in perinatal bereavement care (PBC) and the psychological trauma experienced by nurses and midwives during bereavement care leads to their strong need for sufficient organisational support. The current study intended to test a hypothesised model of the specific impact paths among organisational support, confidence in PBC, secondary traumatic stress, and emotional exhaustion among nurses and midwives. METHODS A descriptive, cross-sectional survey was conducted in sixteen maternity hospitals in Zhejiang Province, China, from August to October 2021. The sample (n = 779) consisted of obstetric nurses and midwives. A path analysis was used to test the relationships among study variables and assess model fit. RESULTS Organisational support directly and positively predicted confidence in PBC and demonstrated a direct, negative, and significant association with secondary traumatic stress and emotional exhaustion. Confidence in PBC had a positive direct effect on secondary traumatic stress and a positive indirect effect on emotional exhaustion via secondary traumatic stress. Secondary traumatic stress exhibited a significant, direct effect on emotional exhaustion. CONCLUSIONS This study shows that nurses' and midwives' confidence in PBC and mental health were leadingly influenced by organisational support in perinatal bereavement practice. It is worth noting that higher confidence in PBC may lead to more serious psychological trauma symptoms in nurses and midwives. Secondary traumatic stress plays an essential role in contributing to emotional exhaustion. The findings suggest that support from organisations and self-care interventions were required to improve confidence in PBC and reduce negative psychological outcomes among those providing PBC. The development of objective measures for assessing competence in PBC and organizational support are essential.
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Affiliation(s)
- Jialu Qian
- Zhejiang University School of Medicine, Hangzhou, China
- Midwifery Division, Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Gaoyan Wu
- Surgery Department of Thyroid and Breast, Huashan Hospital Fudan University, Shanghai, China
| | - Cecilia Jevitt
- Midwifery Division, Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Shiwen Sun
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China, 1st Xueshi Road, Zhejiang Province, 310006
| | - Man Wang
- Zhejiang University School of Medicine, Hangzhou, China
| | - Xiangyu Sun
- Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoyan Yu
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China, 1st Xueshi Road, Zhejiang Province, 310006.
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Wu JL, Pang SQ, Jiang XM, Lin Y, Zheng QX. The mothers' breastfeeding behaviour within six weeks postpartum: new scale development and psychometric validation study. BMC Pregnancy Childbirth 2023; 23:138. [PMID: 36864400 PMCID: PMC9979542 DOI: 10.1186/s12884-023-05439-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 02/09/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND The evaluation of mothers' breastfeeding behaviour within 6 weeks postpartum could help health workers comprehensively identify maternal breastfeeding shortcomings, clarify nursing problems, and provide targeted interventions. However, no prior study was found, therefore this study aimed to develop and validate the reliability and validity of the mothers' breastfeeding behaviour scale within 6 weeks postpartum. METHODS A main two-step approach was used: (1) a qualitative pilot study using the purposive sampling method was adopted to test the fitness, simplicity, and clarity of items with 30 mothers; (2) a cross-sectional survey using the convenient sampling method was conducted for item analysis and psychometric validation with 600 mothers. RESULTS The final version of the scale consisted of 36 items with seven dimensions, explaining 68.852% of the total variance. The Cronbach's α, split-half, and retest coefficients were 0.958, 0.843, and 0.753, respectively. The validity of the scale: (1) Content validity: content validity index (CVI) range of items was between 0.882 and 1.000. The scale-level-CVI was 0.990. (2) Structure validity: The fitting indices were as follows: χ2/ⅆf =2.239, RMR = 0.049, RMSEA = 0.069, TLI = 0.893, CFI = 0.903, IFI = 0.904, PGFI = 0.674, and PNFI = 0.763. (3) Convergent validity: The composite reliability and average variance extracted (AVE) of the seven dimensions were between 0.876 and 0.920 and between 0.594 and 0.696. (4) Distinguish validity: The correlation coefficients were less than the square root of the AVE, except for self-decision behaviour, self-coping behaviour, and self-control behaviour. However, the fit index of the original three-factor model was better than that of the other new models, with significant differences (P < 0.001). (5) Calibration validity: The area under the curve was 0.860 or 0.898 when the scale was used to predict exclusive or any breastfeeding at 42 days. The correlation coefficients of the maternal breasting feeding evaluation scale, breastfeeding self-efficacy short-form scale, and the scale were 0.569 and 0.674, respectively. CONCLUSION The newly developed mothers' breastfeeding behaviour scale within 6 weeks postpartum consists of 36 items belonging to seven dimensions with good reliability and validity and is a reliable and valid instrument to be used in future maternal breastfeeding behaviour assessments and interventions.
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Affiliation(s)
- Jing-Ling Wu
- grid.411504.50000 0004 1790 1622School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian China ,grid.256112.30000 0004 1797 9307Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian China
| | - Shu-Qin Pang
- grid.411504.50000 0004 1790 1622School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian China
| | - Xiu-Min Jiang
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China.
| | - Yan Lin
- grid.256112.30000 0004 1797 9307Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian China
| | - Qing-Xiang Zheng
- grid.256112.30000 0004 1797 9307Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian China
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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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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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Qian J, Wang W, Sun S, Wu M, Liu L, Sun Y, Yu X. Exploring interactions between women who have experienced pregnancy loss and obstetric nursing staff: a descriptive qualitative study in China. BMC Pregnancy Childbirth 2022; 22:450. [PMID: 35637436 PMCID: PMC9153172 DOI: 10.1186/s12884-022-04787-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 05/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Contradictory interactions between bereaved women who have experienced pregnancy loss and obstetric nursing staff are becoming increasingly prominent. The aim of the present study was to gain an understanding of how women who have experienced pregnancy loss and obstetric nursing staff perceive their interactions, what influencing factors impacted their experiences. METHODS A qualitative, exploratory study was conducted in a delivery room and six maternity wards of a tertiary hospital. Semi-structured interviews were performed with six nurses, 13 midwives and seven women who experienced pregnancy loss to collect rich information about how they make sense of their interactions. Thematic analysis was adopted to analyse the data. RESULTS Five overarching themes were identified: (1) interaction characteristics, (2) interactive contradiction, (3) influencing factors of the interaction, (4) training needs and (5) suggestions for benign interactions. CONCLUSIONS Healthcare providers should be instructed in adopting a respectful and sympathetic attitude in communication, strengthening information support and offering patient-centred care for benign interactions. Ignoring women's needs and using disrespectful words should be avoided. Training for preparing nurses and midwives in perinatal bereavement care and addressing heavy emotional burden is necessary. Additional efforts are needed to improve medical services and to facilitate benign interactions in induced abortion care.
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Affiliation(s)
- Jialu Qian
- Zhejiang University School of Medicine, NO. 268 Kaixuan Road, Hanghzhou, 310016, Zhejiang, China
| | - Weihong Wang
- Department of Obstetrics, Ninghai Maternal and Child Health Hospital, NO. 365 Xinghai Road, Ningbo, 315600, Zhejiang, China
| | - Shiwen Sun
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang Province, China
| | - Mengwei Wu
- Zhejiang University School of Medicine, NO. 268 Kaixuan Road, Hanghzhou, 310016, Zhejiang, China
| | - Lu Liu
- Zhejiang University School of Medicine, NO. 268 Kaixuan Road, Hanghzhou, 310016, Zhejiang, China
| | - Yaping Sun
- Zhejiang University School of Medicine, NO. 268 Kaixuan Road, Hanghzhou, 310016, Zhejiang, China
| | - Xiaoyan Yu
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang Province, China.
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