Dissertations / Theses: 'Clinical midwife'

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Mettler, Gretchen G. "Growing into a Midwife: A Theory of Graduate Nurse-Midwife Students' Process of Clinical Learning." Kent State University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=kent1271258271.

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Bluff, Rosalind. "Learning and teaching in the context of clinical practice : the midwife as role model." Thesis, Bournemouth University, 2001. http://eprints.bournemouth.ac.uk/339/.

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The purpose of this study was to develop a theory in order to explain the meaning and process of learning the role of the midwife from midwives in the clinical setting. To achieve the depth and detail required in the absence of literature on this topic, the grounded theory approach was adopted. The sample consisted of twenty student midwives and seventeen midwives. Data were collected by means of unstructured interviews which were tape-recorded. Each participant was interviewed on a minimum of two separate occasions. The constant comparative method was used to analyse the data. The findings of the research contribute to knowledge by making explicit how the role of the midwife is interpreted and enacted, the effect this has on what role students learn, how it is learned and hence how the role is transmitted from one generation of midwives to the next. The `emic' perspective facilitated the emergence of a number of theoretical ideas. Central to these are the rules of practice. When midwives rigidly follow written and unwritten rules they prescribe midwifery care which corresponds to the medical model. In doing so they act as obstetric nurses or handmaidens to the doctor. When everything is interpreted as rules to be followed prescriptive midwives appear to be uncaring and detached from the experience of childbirth. The individual needs of women are not met and the relationship between midwife and client is superficial. Midwives who rigidly follow the rules inhibit the growth and development of students providing them with few opportunities to achieve beyond the level of their role model. Midwives are flexible when they interpret the rules for the benefit of women and provide a woman-centred model of care. These midwives therefore act as autonomous practitioners. When rules are interpreted and adapted to meet the needs of women, flexible midwives demonstrate involvement in women's experiences and are empathic, supportive and caring. Midwives who use professional judgement to interpret the rules provide an environment in which senior students can become autonomous practitioners. When midwives demonstrate the role of autonomous practitioner, practise a woman-centred model of care and meet the learning needs of students, they are appropriate role models and teachers. There is conflict in the clinical setting when practitioners who hold opposing attitudes, values and beliefs practice together. Conflict can be avoided when flexible midwives adopt strategies that involve becoming prescriptive or practising by subterfuge. In accordance with Bandura's social learning theory students learn by observing and emulating the example of their role models. Learning is vicarious when students observe the consequences of their role models' actions. When learning the role from a role model is interpreted as a passive process, a behaviourist and pedagogical approach to learning and teaching ensures perpetuation of the obstetric nurse role that is no longer considered acceptable. Role modelling serves as a vehicle for transmitting new behaviour when learning is perceived to be an active process. In this case a humanistic, andragogical and cognitive approach to learning and teaching is adopted giving students the freedom to determine their own role. Practice from a number of role models is emulated. In this way each midwife acquires a unique identity which is derived from an abstract role model rather than a particular person. Students are prepared for the autonomous role of the midwife, and it is this role they wish to emulate.

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Phuma, Ellemes Everret. "Development of neonatal nursing care clinical competency-based assessment tool for Nurse-midwife technicians in CHAM nursing colleges, Malawi." University of the Western Cape, 2015. http://hdl.handle.net/11394/5079.

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Philosophiae Doctor - PhD
Literature has shown that Malawi is experiencing a shortage of qualified healthcare providers, with the greatest burden on maternal and neonatal health. The majority of health service providers are Nurse-Midwife Technicians (NMT), contributing to 87% of the nursing and midwifery workforce. However, research has shown that the NMTs lack the ability to transfer skills into different clinical settings. It was not known what competencies were taught in Christian Health Association of Malawi colleges to equip the NMTs with clinical competence in neonatal nursing practice and how the clinical teachers assisted these NMTs to acquire the competencies. Furthermore, there was no documentation on the availability of a clinical competency-based assessment tool to validate the NMTs’ achievement of clinical competence in neonatal nursing. The purpose of this study was to develop a neonatal nursing care clinical competency-based assessment tool to validate NMTs’ achievement of clinical competence in CHAM nursing colleges. The competency, outcomes and performance assessment (COPA) model and the skills acquisition model were the conceptual frameworks used as the foundation of the study. The study adopted a sequential mixed method approach in which both qualitative and quantitative methods were utilized. Data collection was conducted using focus group discussions, document review and cross-sectional survey. The design and development model developed by Reeves (2006) and steps to development of assessment tools identified by the Department of Training and Workforce Development (2012) guided the study and development of the competency-based assessment tool. The study was conducted in eight CHAM nursing colleges. The researcher employed purposive, convenient and proportional stratified sampling to select the participants. Ethics clearance was obtained from the University of Western Cape and the National Health Sciences Ethical Research Committee in Malawi, prior to data collection. The data collection involved 31 midwifery clinical teachers and 140 third year students for the FGD and 48 midwifery clinical teachers and 195 third year students for the cross section survey. Document analysis was conducted at all the eight nursing colleges. The qualitative data was analysed using content analysis with Atlas.ti 7 and the quantitative data was analysed using descriptive analysis with SPSS 22. The research findings showed that the NMTs were taught basic nursing skills to enable them provide basic care to the health newborn baby. However, there were inadequate clinical assessments done to validate the NMT’s achievement of clinical competence in this setting. In addition, the clinical teachers used skills checklists to evaluate the NMTs clinical performance on specific procedures. The outcome of this study was the establishment of neonatal nursing clinical competencies, and development of a neonatal nursing care clinical competency-based assessment tool for the validation of NMT’s achievement of clinical competence. The tool provides a framework for neonatal nursing clinical teaching and assessments as well as tracking of the NMT’s clinical performance in this setting. It is recommended that training institutions should reinforce mechanisms to track the students’ clinical experience and performance assessments using this tool to ensure quality student outcomes. Furthermore, the clinical teachers should be oriented on the use of the developed assessment tool for familiarisation; thereby enhancing consistency and objectivity in the students’ performance assessments.
ICAP-NEPI Project Malawi

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Ramahlo, Tebogo. "The self-perception of preparedness for midwifery practice of final-year nursing students at a university in the Western Cape, South Africa." University of the Western Cape, 2020. http://hdl.handle.net/11394/8158.

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Magister Curationis
Background: Globally, nurses and midwives are the most important healthcare providers. In most countries, nurses and midwives are often the first point of contact to healthcare, and in many rural areas, they are the only point of contact for patients. Skilled midwives are essential for the care of pregnant women and the safe delivery of their infants. Midwives play an important role in promoting the health and wellbeing of women, newborns and their families. In South Africa, slow progress in reducing maternal mortality can be partially attributed to a lack of appropriately trained health professionals to render some basic maternal care services. Aim & objectives: The aim of this study was to investigate the self-perception of preparedness for midwifery practice of final-year nursing students at a university in the Western Cape, South Africa. The objectives of the study were to: identify midwifery skills final-year nursing students found challenging to perform independently, determine the level of confidence of final-year nursing students for managing patients in the maternity unit, determine the level of comfort/confidence of final-year nursing students in key practice skills performance, and collect baseline evidence of nursing students’ perceptions of self-preparedness to inform the higher education institution of gaps and needs identified by nursing students. Methodology: A quantitative research approach using a descriptive survey design was implemented to gather information. A self-administered questionnaire using the Casey-Fink Readiness for Practice Survey was used. Due to the limited size of the population, an all-inclusive sampling strategy was utilised, with a sample size of N=217. At the time of the survey, only 164 nursing students attended class. Only 112 questionnaires were returned, yielding a response rate of 70.88%. All returned questionnaires had no missing data. SPSS Statistics version 25 was utilised for data analysis. Descriptive statistics, frequencies and tests for association were utilised.

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Ross-Davie, Mary C. "Measuring the quantity and quality of midwifery support of women during labour and childbirth : the development and testing of the 'Supportive Midwifery in Labour Instrument'." Thesis, University of Stirling, 2012. http://hdl.handle.net/1893/9796.

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The thesis describes the development and testing of a new computer based systematic observation instrument designed to facilitate the recording and measurement of the quantity and quality of midwifery intrapartum support. The content of the systematic observation instrument, the ‘SMILI’ (Supportive Midwifery in Labour Instrument), was based on a comprehensive review of the literature. The instrument was found to be valid and reliable in a series of studies. The feasibility and usability of the SMILI was extensively tested in the clinical setting in four maternity units in Scotland, UK. One hundred and five hours of direct observation of forty nine labour episodes were undertaken by four trained midwife observers. The clinical study demonstrated that the study and the instrument were feasible, usable and successful in measuring the quantity and quality of midwifery intrapartum support. The data collected has provided significant new information about the support given by midwives in the National Health Service of Scotland, UK. Continuous one to one support was the norm, with 92% of the observed midwives in the room for more than 80% of the observation period. Emotional support, including rapport building, encouragement and praise, was the most frequently recorded category of support.

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Kleinsmith, Debora Ann. "Student midwives' experiences of the Objective Structured Clinical Examination (OSCE) at a University in the Western Cape." University of the Western Cape, 2017. http://hdl.handle.net/11394/5663.

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Magister Curationis - MCur
The Objective Structured Clinical Examination (OSCE) is a formative and summative assessment method used in several health science disciplines. The primary focus of this research study was to explore and describe the experiences of student midwives of the OSCE as used in a specific university context and determine how effective it is in preparing student midwives for clinical practice. However the researcher acknowledges the value of the OSCA (Objective Structured Clinical Assessment), which was not used in the context where the study was conducted. Due to the scarcity of academic literature in South Africa and internationally regarding the experiences of student midwives of OSCE assessments, this research study attempted to increase evidence of students’ experiences for improving the OSCE as an assessment method at a school of nursing used in this study. Research purpose: The purpose of the study was to explore and describe student midwives’ experiences of the Objective Structured Clinical Examination, at the SoN, at a university in the Western Cape, and ascertain whether it prepared them adequately for clinical practice. Research design: A qualitative approach with an exploratory descriptive design was used for the investigation of the student midwives' experiences of this assessment method. Sample: Purposive sampling was utilised to select third year Bachelor of Nursing students, who completed the OSCE during semester one in 2014, at a University in the Western Cape. Nine participants were interviewed. Data collection: The data collection was obtained through semi-structured interviews. Data analysis: The data analysis was done manually using the Thomas (2003) data analysis process. Saturation was reached after nine interviews, when no new relevant knowledge was being acquired. Findings: OSCE preparation was supported by theory and clinical learning opportunities. The OSCE environment was found to be challenging and stressful. Alignment of OSCE stations to clinical skills, theory, clinical practice and appropriateness of time allocation. Students had differing views about their level of confidence and competence. Recommendations: Although the OSCE is a valued instrument in the summative assessment of midwifery students, attention must be given to the careful planning of the OSCE environment and the use of simulation techniques. Adequate support for students is essential, and adherence to a standard method of facilitation in clinical learning, in the skills laboratory, is crucial to fairness in learning and assessment. The direct input from valuable stakeholders in clinical training, such as educators and clinical supervisors, must be considered in order to identify ways to improve the OSCE.

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Bäck, Lena. "Confidence in Midwifery : Midwifery students and midwives’ perspectives." Licentiate thesis, Mittuniversitetet, Avdelningen för omvårdnad, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-33560.

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A confident midwife has an impact on a pregnant woman’s clinical outcome and birth experience. Knowledge acquisition, competence, and confidence develops over a lifetime and is of great importance in developing and forming personal skills and allowing the personal traits to grow and mature. Previous international studies have shown that midwifery students do not feel confident in many areas in which they are supposed to practice independently. The aim of this thesis was to investigate confidence levels in basic midwifery skills in Swedish midwifery students in their final semester just before entering the midwifery profession. An additional aim was to describe clinical midwives’ reflections about learning and what factors that developes professional competence, and confidence. Study I was a cross-sectional survey with Swedish midwifery students (n=238). They assessed their own confidence in all competencies that a midwife should have and could practice independently. The results of study I confirmed that Swedish midwifery students feel confident in dealing with the most common procedures during normal pregnancy, childbirth, and postpartum and newborn care. However, they do not feel fully confident in cases in which there are deviations from the normal procedures and obstetric emergencies. When comparing groups of midwifery students, the younger group of midwifery students felt more confident in general compared to the older group. Students at a university with a medical faculty were also more confident than the students at a university without a medical faculty. In study II, focus group discussions were held with 14 midwives emphasizing the way in which midwives reflect on learning and the development of competence and confidence. Content analysis was used to analyze the focus group discussions. Four categories were identified as a result of study II: 1.) feelings of professional safety evolve over time; 2.) personal qualities affect professional development; 3.) methods for knowledge and competence expansion; and 4.) competence as developing and demanding. The conclusion of this thesis is that more practical and clinical training during education is desirable. Midwifery students need to have access and the opportunity to practice obstetrical emergencies within a team of obstetricians and pediatricians. Learning takes time, and one improvement is to extend midwifery education to include and increase in clinical training. This would strengthen the students theoretical, scientific, and clinical confidence. Clinical midwives claim that it takes time to feel confident and that there is a need to develop professionalism.
En trygg barnmorska har en positiv inverkan för förlossningsutfall samt förlossningsupplevelse. Kunskap, kompetens och trygghet är ett livslångt lärande och har stor betydelse för att utveckla och forma personliga färdigheter, att låta de personliga egenskaperna växa och mogna. Tidigare internationella studier har påvisat att barnmorskestudenter känner sig otrygga inom områden där förväntas vara självständiga. Syftet med denna avhandling var att undersöka graden av trygghet hos svenska barnmorskstudenter strax innan de var färdigutbildade. Ett annat syfte var att utforska hur kliniskt verksamma barnmorskor reflekterar över lärande och vilka faktorer som bidrar till att utveckla yrkesmässig kompetens och trygghet. Studie I var en tvärsnittsundersökning med svenska barnmorskestudenter (n = 238). De bedömde egen trygghet inom alla kompetenser som en barnmorska förväntas kunna samt utföra självständigt. Resultaten av studie I bekräftade att svenska barnmorskestudenter känner sig trygga att hantera de vanligaste rutinerna vid normal graviditet, förlossning, eftervård samt nyföddhets vård. De känner sig emellertid inte fullt så trygga när något avviker från det normala samt vid obstetriska nödsituationer. Vid jämförelse mellan yngre och äldre barnmorskestudenter samt grad av trygghet, var det den yngre gruppen av barnmorskestudenter som kände sig tryggare i allmänhet jämfört med den äldre gruppen. Studenter vid ett universitet med en medicinsk fakultet var också mer trygga än studenterna vid ett universitet utan en medicinsk fakultet. I studie II hölls fokusgrupper med 14 barnmorskor, de diskuterade och reflekterade över hur barnmorskor utvecklar kompetens. Metod för att analysera var innehållsanalys, i resultatet framkom fyra kategorier 1.) känslor av professionell trygghet utvecklas över tid ; 2.) Personliga kvaliteter påverkar yrkesutveckling. 3.) metoder för kunskap och kompetensutveckling; och 4.) Kompetens som utveckling och krävande. Slutsatsen av denna avhandling är att mer klinisk träning under utbildning är önskvärt. Barnmorskestudenter behöver tillgång och möjlighet att öva obstetriska nödsituationer tillsammans i team bestående av förlossningspersonal och barnläkare. Det tar tid att lära samt att känna trygghet, en möjlighet att underlätta för studenter vore att utöka samt förlänga barnmorskeutbildningen, att inkludera mer klinisk träning. Detta skulle innebära att stärka studenters möjligheter till en utökad klinisk trygghet. Kliniska barnmorskor hävdar att det tar tid att känna sig trygg och att det ett finns behov av att utveckla professionalism.

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Chan, Seung-chuen, and 陳湘銓. "The development of four advanced nursing roles in the United States, the United Kingdom, Australia, and Hong Kong: a comparative analysis of nurse practitioner, clinical nursespecialist, nurse midwife, and nurse anesthetist." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31972809.

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Chan, Seung-chuen. "The development of four advanced nursing roles in the United States, the United Kingdom, Australia, and Hong Kong a comparative analysis of nurse practitioner, clinical nurse specialist, nurse midwife, and nurse anesthetist /." Click to view the E-thesis via HKUTO, 2002. http://sunzi.lib.hku.hk/hkuto/record/B31972809.

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Sohlin, Viktoria, and Karin Kullgren. "Barnmorskestudenters upplevelser av verksamhetsförlagd utbildning på förlossningsavdelning." Thesis, Umeå universitet, Institutionen för omvårdnad, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-184573.

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Bakgrund: Barnmorskans yrkesområde är inom sexuell, reproduktiv och perinatal hälsa. Detövergripande målet i barnmorskeutbildningen är att utveckla självständiga och kompetenta barnmorskor. Den verksamhetsförlagda utbildningen (VFU) motsvarar ungefär halva studietiden och är en viktig del i barnmorskeutbildningen. Förlossningsavdelningen är en viktig miljö för barnmorskestudenter att inhämta kunskaper om graviditet och förlossning. Motiv: VFU på förlossningsavdelning är en känslomässig och intensiv period för barnmorskestudenter. Barnmorskestudenters uppfattningar om vad som främjar utveckling behöver studeras vidare för att kunna optimera framtida verksamhetsförlagda utbildningar. Syfte: Det övergripande syftet var att belysa barnmorskestudenters upplevelser av verksamhetsförlagd utbildning på förlossningsavdelning. Metod: En kvalitativ design med induktiv ansats har använts. Semistrukturerade intervjuer med sju barnmorskestudenter i Sverige genomfördes. Intervjuerna har analyserats genom en kvalitativ innehållsanalys. Resultat: Genom analysprocessen framkom ett tema, VFU på förlossningsavdelning – en känslomässig berg- och dalbana samt tre kategorier; Att både ge och ta emot stöd där en mängd faktorer som kan påverka mötet med kvinnan och stödpersonen beskrevs. Andra kategorin Att hålla ihop hela vägen beskrev hur barnmorskestudenternas hälsa varierade samt svårigheter i att gå från en trygg yrkesroll till en studentroll. Tredje kategorin Hinder i utvecklingsprocessen visade hur Covid-19-pandemin påverkade barnmorskestudenternas VFU, optimeringar inför framtida VFU samt tankar om den framtida yrkesrollen. Åtta subkategorier bildades. Konklusion: Barnmorskestudenterna upplevde sin VFU på förlossningsavdelning som en känslomässig berg- och dalbana. Flertalet faktorer som tidigare erfarenheter, relationen till handledaren och reflektionsmöjligheter påverkade barnmorskestudenters möte med kvinnan och stödpersonen. Att belysa dessa faktorer och inkludera barnmorskestudenter i den kvinnocentrerade vården kan leda till ökat självförtroende och kompetens hos barnmorskestudenter vilket i sin tur kan leda till optimeringar av den kvinnocentrerade vården.
Background: The midwife's profession is within the sexual, reproductive and perinatalhealth. The overall purpose of midwifery education is to develop independent and competent midwives. The clinical internship is an important part of the education. The labour ward is an important environment for midwifery students to acquire knowledge about pregnancy and childbirth. Motive: Clinical internship in the labour ward is an emotional and intense period for midwifery students. Midwifery student’s perceptions of what promotes development needs to be studied further, in order to optimise future clinical internships. Aim: The aim was to investigate midwifery students experiences of clinical internship at labour wards. Methods: A qualitative design with an inductive approach was used. Semi-structured interviews with seven midwifery students in Sweden participated. The interviews were analysed with qualitative content analysis. Result: A theme emerged, Clinical internship at the labour ward - an emotional roller coaster and three categories; To both give and receive support where a number of factors that can affect the meeting with the woman and the support person were described. Second category Holding together all the way described how the midwifery student’s health varies as well as difficulties in the student role. The third category Obstacles in the development process showed how the Covid-19-pandemic affected midwifery student’s clinical internship, optimisations and thoughts about the future professional role. Conclusion: The clinical internship at the labour ward was described as an emotional roller coaster. Previous experiences, the relationship with the supervisor and opportunities for reflection influenced the midwifery student's encounter with the woman and the support person. Elucidating these factors and including midwifery students in women-centered care can lead to increased self-confidence and competence among midwifery students, this couldlead to optimisations of the women-centered care.

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ME, Chokwe, and SCD Wright. "Caring during clinical practice: Midwives’ perspective." Adelaide Tambo School of Nursing Science, Tshwane University of Technology, 2013. http://encore.tut.ac.za/iii/cpro/DigitalItemViewPage.external?sp=1001969.

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Summary Background: Caring forms the core of nursing and midwifery. Despite caring being an important emotional aspect of midwifery and nursing, there are general public complaints about uncaring behaviour in midwifery. Therefore, there is a need to explore caring from midwives’ point of view with the hope of identifying solutions and recommendations for midwifery practice. Furthermore, the study aimed to stimulate debate and discussion about the caring behaviour of midwives. Objective: To explore caring during clinical practice as perceived and experienced by midwives. Method: The study was contextual, exploratory and qualitative. The participants were midwives working in state and private hospitals in Tshwane, South Africa where BTech II and III midwifery learners were allocated for work integrated learning (WIL). Data collection was carried out through self-report using a questionnaire and focus group. Questionnaires were distributed to 40 midwives at private and state hospitals in Tshwane. This was followed by two focus group sessions to ensure that data is enriched. The hermeneutic interpretive approach was used to analyse data, and analysis continued until saturation. Results: Themes of caring and uncaring related to patient care and midwives emerged. The findings illustrated that the midwives had excellent theoretical knowledge of caring, but some of them did not display caring behaviour during clinical practice. Conclusion: Some of the midwives did not display caring behaviour. Implication for practice was provided based on the research findings. Recommendations included measures of improving caring behaviours during midwifery practice.

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Vuso, Virginia Zanyiwe. "Enhancing clinical preparedness of basic midwifery students: perceptions of midwifery educators." Thesis, Nelson Mandela Metropolitan University, 2016. http://hdl.handle.net/10948/13204.

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Since the inception of the student supernumerary status, both globally and in South Africa, nursing and midwifery educators have been concerned about the clinical competencies of their students. Student clinical competency levels in South Africa are critical to midwifery practice, especially as most litigation against the Department of Health in South Africa concerns negligence in midwifery practice. In addition, the litigations mostly involve newly qualified midwives, thus suggesting a link with practice competency levels. Several challenges exist in the academic and practice environments regarding student learning, practice and clinical preparedness. Lack of support during clinical placement and a lack of facilities for use during clinical practice modules are among these challenges. Some students, due to the challenges they face with clinical learning and practice, fail to meet the practical competencies for examination entry requirements. Consequently, some of these students have to repeat the year or exit the programme. The current study sought to identify how to assist midwifery educators in their activities to prepare students for clinical placement readiness. The first objective of the study was to explore and describe the perceptions of midwifery educators regarding the need for additional measures to enhance the clinical preparedness of basic midwifery students before they are allocated to the clinical areas. The second objective sought to make recommendations that would further assist the midwifery educators to clinically prepare midwifery students before being allocated and placed in different clinical areas. A qualitative, explorative, descriptive and contextual research design was used for the study and the study was conducted at a nursing college in the Eastern Cape Province from August 2014 to January 2016. The research population consisted of midwifery educators at a nursing college and a purposive sampling technique was used guided by set criteria. Data were collected using focus group interviews. Four focus groups were used making a total of 17 participants. The principles applied for data analysis were those of Tesch’s method of data analysis, which were used to develop the themes and sub-themes. An independent coder assisted with the coding of the data for the purposes of trustworthiness. In addition, Lincoln and Guba’s model of trustworthiness consisting of the criteria of credibility, transferability, dependability and conformability was used to confirm the validity of the study while the ethical principles adopted were informed consent, justice, non-maleficence, privacy and confidentiality. The study found that the participants perceived numerous challenges that hindered the clinical preparedness of their students. These related to increased workload, lack of support from management and a lack of commitment on the part of students towards their studies. The participants also identified inconsistencies in clinical practice between the clinical midwives and the educators, and even among the educators themselves. This lack of consistency in turn causes confusion among the students and thus impacts negatively on their clinical practice preparedness. Based on these findings recommendations for clinical nursing practice, nursing education and research were made.

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Spiby, Helen. "Clinical trials and their tribulations : a midwife's perspective." Thesis, Sheffield Hallam University, 1998. http://shura.shu.ac.uk/20836/.

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From the late 1970's, there was an increasing criticism of hospital maternity care. Conventional practices were challenged, including that of recumbency for birth. ofessionals responded to these criticisms in a variety of ways: more homelike decoration in labour wards, information for women through birth plans and new equipment to use in labour. Some obstetricians utilised the randomised controlled trial to evaluate new methods of management. Inevitably, midwives attending women in labour came into contact with these trials. This thesis utilises the experiences of one such clinical trial. A case study methodology was used to identify the impact of the trial on the work and experiences of midwives attending women in labour. The effects on midwives' work include changes of philosophy, changes to practice, increased work, exacerbation of existing inter-disciplinary tensions and difficulties with communication. The effect of the presence of a midwife research assistant has been explored. Midwives' contact with research at the time of the trial is also included. This programme of research has added to the body of knowledge by demonstrating the extent of the impact of clinical trials on the work and experiences of midwives attending women in labour. The appropriateness of the case study approach for use by midwifery researchers has also been demonstrated. Issues arising from the case study have been further reviewed in the light of contemporary midwifery practice, education and research and related to the wider research agenda. Recommendations are made for the conduct of clinical trials in the labour ward and for future avenues of enquiry.

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Almoghrabi, Hannoud. "WATER BIRTH: MIDWIVES PERCEPTION, ATTITUDE, KNOWLEDGE, AND CLINICAL PRACTICES." Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1523398858143798.

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Chokwe, M., and S. Wright. "Caring in clinical practice: experiences and perceptions of learner midwives." Evidence Based Midwifery, 2011. http://encore.tut.ac.za/iii/cpro/DigitalItemViewPage.external?sp=1001967.

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Abstract Background. There is a growing concern about the lack of caring in midwifery clinical practice. In addition findings of studies exploring health-seeking behaviours in South Africa indicated the abuse of the pregnant women by midwives as the most important reason causing a delay in seeking health care.Objective. To explore the experiences and perceptions of the learner midwives of caring as exhibited by qualified midwives during midwifery clinical practice.Methods. A qualitative and phenomenological study was done. Ethical clearance was granted by the university and the managers of the hospitals where the Baccalaureus Technologiae II and III learner midwives were placed for work-integrated learning. Three self-report techniques used were diaries, debriefing sessions with reflection and focus group.Findings. Data from 48 diaries and two focus groups were analysed using a qualitative approach. Care of the women and midwife-related themes emerged, each with caring and uncaring as major categories. The findings illustrated that the learner midwives were familiar with and internalised the meaning of caring from the theoretical facilitation, however they did not always experience caring in midwifery clinical practice. Some of the midwives were caring, but the majority did not role model commitment, competence, compassion, confidence and communication.Implication for practice. Managers must be held accountable for setting, implementing and maintaining caring standards in the healthcare institutions. Furthermore, there is a need to emphasise the importance of role modelling and ensure that the affective aspect of caring is communicated to the learner midwives during theoretical facilitation and clinical practice.

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Berg, Amelie, and Karin Striegel. "Värkstimulering med oxytocin : En granskning av PM från Sveriges samtliga förlossningskliniker." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-90953.

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Bakgrund: I Sverige finns 45 förlossningskliniker. Varje klinik har egna PM/riktlinjer för olika tillstånd och omhändertagande. De är framtagna för att underlätta arbetet och främja jämlik vård. Det finns både risker med att ge oxytocin och att avstå från det. Därför är det viktigt att åtgärden används på ett sätt som minimerar riskerna för mor och barn samt ökar sannolikheten för ett positivt förlossningsutfall. Syfte: Att kartlägga svenska förlossningsklinikers riktlinjer för värkstimulering med oxytocin under aktiv förlossning utifrån frågeställningarna: Är förlossningsklinikernas riktlinjer utformade enligt Nationella Mediciniska Indikationer och uppvisar riktlinjerna en god kvalitét enligt bedömningsinstrumentet Apprasial of Guidelines Research and Evaluation II (AGREE II). Metod: En kvantitativ studie med beskrivande och jämförande design. Resultat: Resultatet grundar sig på samtliga förlossningskliniker riktlinjer för värkstimulering med oxytocin under aktiv förlossning. Jämförelsen mot Nationella Medicinska Indikationer visar på stora skillnader vad gäller innehållet i riktlinjerna. I 25 PM (69 %) saknas en eller flera delar av innehållet. Resultatet utifrån AGREE II visade att endast 20 PM (56%) kunde rekommenderas för användning. Slutsats: Kvalitén på riktlinjerna varierar och de förlossningskliniker som följt Nationella Mediciniska Indikationer är också de som uppvisar bäst resultat enligt AGREE II.
Background: In Sweden there are 45 delivery wards. Every ward has their own guidelines for different conditions and their management. They are composed to relieve the work and promote equal care. There are risks of both administering oxytocin and to refrain from it. It is therefore important that the course of action taken is used in a way that minimizes the risk for both the mother and the child at the same time increasing the probability for a positive delivery outcome. Purpose: To map the Swedish delivery wards local guidelines in inducing delivery with oxytocin during active delivery in regards to the following issues: are the delivery wards guidelines formed according to National Medical Indication and do they uphold the high quality standard according to the assessment tool Appraisal of Guidelines Research and Evaluation II (AGREE II). Method: A quantitative study with descriptive and comparable design. Results: The result is based on all delivery wards local guidelines for inducing delivery with oxytocin during active delivery. In comparison to NMI there are large differences in the content of the guidelines. In 25 guidelines (69%) there were one or several parts of content missing. The result according to AGREE II showed that only 20 local guidelines (56%) could be recommended for clinical use. Conclusion: The quality of the local guidelines vary and the delivery wards that have followed National Medical Indication recommendations are also the ones that present the best results according to AGREE II.

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Young, Nicola. "An Exploration of Clinical Decision-Making Amongst Students and Newly Qualified Midwives." Thesis, University of East Anglia, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.490667.

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Although decision-making is an intrinsic part of professional practice there is very little research conducted into how midwifery students in the United Kingdom develop the skill. The principles of ethnography were used to explore how decision-making was learnt amongst direct entry student midwives during training .and after qualification. The overall aims of the research were to explore the factors which influenced decision-making and to . identify the factors that assisted or interfered with learning to make decisions. The 49 participants were a combination of students, midwives who had been qualified for less than a year and midwifery mentors. The data collection methods consisted of: three focus groups conducted with student midwives, 15 observations of practice (combination of student mentor pairs and midwives within the first year of practice), 27 individual interviews (combination of students, midwives within the first year of practice and mentors). Data analysis followed the principles of coding data, category, theme and metatheme formation described by Garner (1991) and Ely et al (1997). The classification of the nature of professional knowledge and typology of non-formal learning created by Eraut (2000) was used to identify where explicit and implicit learning occurred in relation to decision-making. Very little knowledge related to decision-making was gained from formal teaching sessions in the classroom. The personal knowledge or 'know-how' surrounding decision-making was. acquired by the student working alongside the inentor in practice. Consequently learning occurred through the participation in shared practices and was influenced by the quality of social relations and interactions in clinical practice (Wenger 1998). A number of features emerged from the study which appeared to be common amongst students and newly qualified midwives in relation to the way decision-making was learnt. These features include: making an assessment seeing the outcome of care, predicting and anticipating events, pattern recognition, self and group reflection and the use of heuristics. Other factors which helped or hindered decision-making were evident such as: the qualities of the mentor, the quality of mentoring, confidence and emotion management, getting to know the woman and contextual and environmental influences. Vignettes were created to represent composites of the findings; these were presented to study participants in a focus group as a means to achieve respondent validation. This study has led to some insights into the factors that influence and mould decision-making, the findings can be applied to the education of students and newly qualified midwives.

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Strachan, Kathryn Anne. "Discussing risk during pregnancy : the experiences of midwives and women with pre-existing diabetes." Thesis, University of Hull, 2017. http://hydra.hull.ac.uk/resources/hull:15429.

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This portfolio thesis contains three separate parts: a systematic literature review, an empirical study and corresponding appendices. Part one is a systematic literature review, which uses meta-ethnography to synthesise qualitative empirical studies investigating the female experience of living and coping with Type 1 Diabetes mellitus and the impact on identity. A systematic database search identified nine articles which were included. The synthesis of findings resulted in seven subthemes and four super-ordinate themes: ‘Identity shaped by the grip of blood glucose levels’, ‘The influence of others’, ‘Resistance against a ‘diabetic’ identity’ and ‘Creating Stability: integrating diabetes’. The quality of included studies was reviewed and the overall strength of literature considered. Results are discussed in relation to implications for clinical practice in diabetes care and areas for future research. Part two is an empirical study exploring the experience of discussing risk from the perspective of midwives and pregnant women with Type 1 diabetes mellitus. Five midwives and eight women with Type 1 diabetes were interviewed. Data was analysed using Interpretative Phenomenological Analysis. Twelve subthemes and four super-ordinate themes were identified: ‘Understanding and responding to risk’, ‘Talking about risk’, ‘Negotiating choice and control’ and ‘The relationship buffer’. Results are discussed in relation to relevant theory, implications for clinical practice in maternity care and suggestions for future research. Part three includes appendices which support the meta-ethnography and empirical study. This contains an epistemological statement and a reflective statement detailing the research processes and underpinnings.

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Deery, Ruth. "Engaging with clinical supervision in a community midwifery setting : an action research study." Thesis, University of Sheffield, 2004. http://etheses.whiterose.ac.uk/3544/.

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The main aim of this research study was to explore midwives' views and experiences of their support needs in clinical practice and then to identify how they would wish to receive such support. There was much literature to support the existence of stress and burnout in midwifery but no research that addressed ways of alleviating this. Further aims were to redress that imbalance by planning and facilitating a model of clinical supervision devised by the participating midwives. The study took an action research approach that involved working with a group of eight National Health Service (NHS) community midwives in a collaborative, non-hierarchical and democratic way in order to achieve change. This accorded with a woman-centred approach to working with clients that was being encouraged within midwifery. The midwives were typical of many community-based midwives in the United Kingdom (UK) who were working in increasingly stressful, complex and changing environments. Wider organisational and cultural issues are considered that affect working relationships. The nature of the way the midwives worked when they were offered and received support, and how they reacted and coped when their work team and work situation was threatened, was also explored. Each midwife was interviewed twice; before and after the experience of clinical supervision. They also participated in two focus groups before clinical supervision. In- depth individual interviews lasted up to two hours, as did the focus groups. The interviews and the focus groups were taped, transcribed and then analysed using a relational voice-centred methodology. The main findings were that recent and ongoing change plus the organisational demands placed on the midwives by the NHS and their managers were detrimental to working relationships with their colleagues and clients. This also inhibited the process of change. A discourse of denigration became apparent within the interviews and the midwives behaviour and coping strategies revealed some well developed defence mechanisms, as well as an apparent lack of understanding on their part and that of their midwifery managers in relation to emotion work. Resistance to change was a key defence mechanism used by the midwives. Strong messages emerge about certain 'performances' being available to midwives and the use of defence mechanisms as a way of 'getting the work done'. There are also messages about the cultural legacy of midwifery and how this can inhibit autonomous behaviour by midwives. Developing and increasing self awareness is still not viewed as being intrinsic to the work of the midwife and midwives are being asked to undertake a level of work that they have not been adequately prepared for. Neither do there appear to be effective role models for midwives. The bureaucratic pressures of working in a large maternity unit are also addressed where the system is seen as more important than the midwives.

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Ntlokonkulu, Zukiswa Brenda. "The effectiveness of medium-fidelity simulation on the clinical readiness of student midwives." Thesis, University of Fort Hare, 2017. http://hdl.handle.net/10353/4503.

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Simulation affords the student a safe and supportive environment in which to practise skills repeatedly without causing any harm to a real patient. The Department of Nursing Sciences at the University of Fort Hare has a laboratory that offers lowto medium-fidelity simulation in the form of task trainers and mannequins. These task trainers and mannequins are used in general nursing, and in community and midwifery nursing sciences, for the demonstration of skills, the practising of skills by students and for formative assessments. In midwifery, task trainers are used for vaginal examinations, abdominal palpation breech and vaginal deliveries and the management of post-partum haemorrhage (PPH). Given that in a real-life clinical environment limited opportunities exist for students to practise during an obstetrical emergency, medium-fidelity simulation (MFS) in midwifery ideally positions the student in a practical environment without risking the patient’s safety. Despite the availability of MFS at UFH, its benefit on the clinical readiness of student midwives is not known. The present study was designed to assess the effectiveness of MFS in enhancing the clinical readiness of student midwives at the University of Fort Hare. The main research objective of the study was to explore, describe and analyse the effect of medium-fidelity simulation on student midwives’ confidence, critical thinking ability, communication, satisfaction and team work in an obstetrical clinical emergency environment. This was a qualitative, interpretive, phenomenological analysis designed to explore the student midwives’ lived experiences regarding the effectiveness of mediumfidelity simulation and the effect of these experiences on clinical readiness. The target population was fourth-year Bachelor of nursing student midwives at the University of Fort Hare. Purposive sampling was used to select five student midwives who were team leaders during the management of PPH using MFS. Ethical approval was granted by the University of Fort Hare Ethics Committee. Informed consent was obtained from the participants prior to data collection. Trustworthiness was ensured by observing the principles of transferability, credibility, confirmability and dependability. Data was collected through individual face-to-face interviews and a semi-structured interview guide. All fourth-year student midwives had viewed an on-line video entitled Essential Steps in Management of Obstetrical Emergency(ESMOE) Postpartum Haemorrhage, in which the procedure was demonstrated. The video, sent via Backboard, was presented in such a way that student midwives had the opportunity to watch it repeatedly in order to thoroughly comprehend the demonstrated skill. A semi-structured interview guide was used for data collection. Interviews were conducted in the simulation laboratory. A Samsung smartphone was used to record interviews and a notepad was used to make notes of gestures, such as smiles or other facial expressions. Data was analysed using thematic content analysis applicable to interpretative phenomenological analysis (IPA) studies using the six steps: reading and re-reading; initial noting taking; developing emergent themes; searching for connections across the emergent themes; moving to the next case and lastly, looking for patterns across cases. The major findings indicated that the participants had differing views regarding the concept of clinical readiness; some held that clinical readiness meant being ready or prepared to handle any eventuality in the course of work, others opined that it was a state of being conversant with the policies and procedures in the clinical ward. Participants believed that clinical readiness was parallel to being competent and that midwives should always be ready to anticipate complications that might arise with the patient, endeavouring to analyse and interpret such conditions clinically. Participants expressed the need to see the simulation skill demonstrated repeatedly for thorough understanding of the technique, so that they could work independently in an obstetrical emergency situation. During simulation, participants were confident in delegating duties to team members, affirming that in order to ensure that tasks were carried out, team leaders should receive regular updates from team members.

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Nallen, Kathleen. "Midwifery graduates' perceptions of the impact of enquiry based learning on their clinical practice." Thesis, Queen's University Belfast, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.709681.

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In recent years Enquiry Based Learning (EBL) has been embedded in a variety of healthcare related programmes and has become a fundamental component of curricula delivery. EBL research suggests that positive experiences outweigh limitations including enhancing links between theory and practice. Development of transferable skills such as decision making, problem solving and critical thinking is attributed to EBL in some studies. Overall however, very little high quality evidence exists to advocate EBL’s efficacy and subsequently justify widespread curriculum change. Limited research is available on the effectiveness of EBL in midwifery education, additionally there is a paucity of EBL related research with midwifery graduates, an anomaly this evaluation attempts to ameliorate. EBL was recently introduced into Higher Diploma in Midwifery education in the Republic of Ireland. As EBL is frequently credited with being positively influential on clinical practice, it was considered fitting to undertake an evaluation based on this premise. The aim of the study was to elicit perceptions of Higher Diploma in Midwifery graduates regarding the impact of Enquiry Based Learning on their clinical practice. Fourteen graduates took part in a qualitative study which used semi-structured interviews. Findings centred on three major themes: ‘Impact of EBL on the experience of learning’, ‘Impact of EBL on the quality of learning’ and the ‘Impact of EBL on clinical practice’. These three themes incorporated fourteen categories which were then used to provide the framework for discussing the research findings within the context of wider literature. Findings support the assertion that EBL helps relate theory to clinical practice as well as enhancing personal development and the quality of learning. Recommendations are made based on the findings and the implications for stakeholders in midwifery education, practice and management are discussed.

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22

Montgomery, Jacqueline. "Job evaluation : a critical analysis of the clinical grading for nurses midwives and health visitors." Thesis, University of Dundee, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.484436.

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23

Sehume, Gloria Gaogakwe. "Ethical decision-making the experience of nurses in selected clinical settings /." Diss., Pretoria :b [s.n.], 2008. http://upetd.up.ac.za/thesis/available/etd-05132009-125706.

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Rasetshwane, Itumeleng. "Evaluating The Psychometric Properties of the Clinical Assessment Tool Used in The Midwifery Programme In Botswana." Diss., University of Pretoria, 2021. http://hdl.handle.net/2263/78119.

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Background: Clinical assesssment tools play an essential role in clinical practice and assessment. Clinical assessment tools have to be evaluated for pyschometric properties to enhance objectivity and fairness when evaluating students. Reliability and validity are considered the main psychometric properties of clinical assessment tools. However, determining the psychometric properties of clinical assessment tools still remains a major problem. Hence, some tools are designed and used without adequate assessment of their reliability and validity. There is no evidence of the psychometric properties, mainly internal consistency, reliability and content validity of the clinical assessment tool used in Midwifery Programme in Botswana. Aim/Purpose: The aim of the study was to evaluate the internal consistency reliability and content validity psychometric properties of the clinical assessment tool used in the Midwifery Programme in Botswana. Design: A methodological design was used to evaluate the internal consistency reliability and content validity psychometric properties of the clinical assessment tool used in the Midwifery Programme in Botswana. Research process: Data was collected from the completed clinical assessment tools which were used to assess midwifery students registered for intrapartum care (MID 421) in semester 2 and intrapartum care practicum (MID 543) in semester 4 in 2019, from the midwifery training schools, n=114. Data collected from these clinical assessment tools was captured and analyzed using the downloaded IBM® Statistical Package for the Social Sciences (SPSS) software, version 25. Inter-item analysis and the corrected item–total correlation were calculated to determine the internal consistency reliability of the clinical assessment tool used in midifery programme. Cronbach’s alpha was used to determine the reliability of the entire clinical assessment tool. The Subject Matter Expects in midwifery working in the academic field and those working in the Nursing and Midwifery Council in Botswana, were used to evaluate the content validity regarding the relevance and clarity of the competencies in the clinical assessment tool. The Content Validity Index (CVI), Item Content Validity Index (I-CVI), Content Validity Ratio (CVR), the overall scale (S-CVI/Ave) and Scale Content Validity Index using Universal Agreement (S-CVI-UA) were calculated to determine the content validity of the clinical assessment tool used in the Midwifery Programme in Botswana. Results: The results of this study with regard to internal consistency reliability, revealed an overall Cronbach’s alpha of the clinical assessment tool of 0.837. The results of this study, with regard to content validity, revealed an overall CVR of 0.95 and an overall CVI of 0.97. The I-CVI value of the competencies for content validity ranged from 0.8 to 1. The S-CVI/Ave and the S-CVI/UA values of the competencies for content validity were 0.97 and 0.75 respectively. Conclusion: The clinical assessment tool used in the Midwifery Programme in Botswana is reliable and valid. However, there is a need to review some of the competencies to improve its internal consistency reliability and content validity. Keywords: Clinical Assessment, Clinical Assessment Tool, Midwifery Training Institutions, Midwifery Students, Midwifery Programme, Botswana, Reliability, Validity, Psychometric Properties.
Dissertation (MNSc)--University of Pretoria, 2021.
Nursing Science
MNSc
Unrestricted

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25

Manthata, Joyce Maphuti. "Challenges Encountered by 0ne-year Diploma student midwives in acquiring clinical skills at selected hospitals in Limpopo Province." Thesis, University of Limpopo, 2016. http://hdl.handle.net/10386/1697.

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Thesis (MPH.) -- University of Limpopo, 2016.
Introduction and purpose: Midwives are the backbone of maternal and child health—the output of their action affect quality of life of mother and child. The purpose of the study was to describe the challenges encountered by one-year diploma student midwives while acquiring clinical skills at selected hospitals in Limpopo Province. Research design and method: A quantitative, descriptive cross-sectional research method was used in this study. The study population comprised all one-year diploma student midwives in selected hospitals in Limpopo Province, namely, Dilokong Hospital, Jane Furse Memorial Hospital, Mokopane Hospital, Philadelphia Hospital, Siloam Hospital and St Rita’s Hospital. The whole study population was used as the total population was small. Data were collected using a self-administered questionnaire. Informed consent was received from the participants as was ethical approval from the relevant authorities. Data were analyzed using SPSS version 22 with the aid of a statistician. Descriptive statistics were used to analyze and describe the data. Data were presented in tables and bar graphs.Findings: Respondents in this study indicated that they encountered the following challenges during their acquisition of clinical skills at the selected hospitals in the Limpopo Province: inadequate resources; inadequate mentoring. Male participants reported feelings of being more competent than their female counterparts. There was no relationship between acquisition of skills and marital status, and no correlation between age and acquisition of skills.

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26

Kabamba, Beatrice Mubanga. "An inquiry into the feasibility of integration of the advanced midwifery and neonatology clinical nurse specialist in the district health system: the Zambian experience." Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&amp.

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Research has shown that there is a problem in the delivery of quality care in maternal and child health services in Zambia. The 1996 Zambia demographic and health survey estimated maternal mortality rate as high as 649 per 100,000 live birth, with this reason among others, human resource constraints and low number of supervised antenatal clinics, deliveries and postnatal clinics by skilled personnel as some of the reasons for the high maternal mortality. Selected studies identify the role of a clinical nurse specialist in advanced midwifery and neonatology who has acquired the knowledge and practical skills to bring about the desired impact of quality care in safe mother hood in order to bring down the high maternal mortality rates. In order to achieve this, the government needs to integrate the advanced midwifery and neonatology clinical nurse specialist in the health system. It was the purpose of the study to inquire into the feasibility of integration of the advanced midwifery and neonatology clinical nurse specialist in the Ndola District Health system .

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Boltman-Binkowski, Haaritha. "A systematic review of best practices in the acute management of postpartum haemorrhage in primary maternity care settings." University of the Western Cape, 2018. http://hdl.handle.net/11394/6893.

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Magister Curationis - MCur
Background: Postpartum haemorrhage (PPH) is one of the most preventable causes of maternal death, yet it still ranks as one of the main conditions responsible for maternal mortality. PPH occurs at a stage when a mother is the least likely to receive care, and mothers often do not survive to be referred to a more specialised level of care. This is compounded by the patient not being able to warn healthcare providers timeously about their condition and healthcare providers lacking training resulting in a lack of accuracy in diagnosis, lack of resources, and differing methods of treatment. Due to the lack of consensus in available treatment options, and the paucity of research aimed at clinical interventions for midwives at the primary care level, this research report aimed to investigate the evidence in order to establish the best practices and evidence for clinical interventions to manage postpartum haemorrhage for midwives at the primary care level. This is to ensure that the continuing education for midwives in practice is based on evidence to keep their skill set current and expose practitioners to the latest evidence based care. Aim: To systematically review all available published evidence for the acute non-pharmaceutical, non-surgical, management of PPH for use by midwives at a primary maternity care setting.

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Huhta, Jonna, and Katarina Svensson. "Young man, there's a place you can go : Unga män på Ungdomsmottagningen i Uppsala city 2012." Thesis, Uppsala universitet, Institutionen för kvinnors och barns hälsa, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-295699.

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Lindblom, Emilia, and Josefin Jonsson. "Att möta oplanerat gravida unga kvinnor som beslutar sig för att genomgå en abort : En kvalitativ intervjustudie med barnmorskor på ungdomsmottagningar." Thesis, Högskolan Dalarna, Vårdvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:du-24415.

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Bakgrund: Barnmorskeyrket har gått från att främst fokusera på vård under graviditet och förlossning till ett bredare arbetsfält inom sexuell och reproduktiv hälsa som även innefattar arbete på ungdomsmottagning. Barnmorskan på ungdomsmottagningen arbetar förebyggande mot oönskade graviditeter och möter unga kvinnor och män i samtal om graviditet och abort. Att ställas inför ett oväntat graviditetsbesked kan vara omvälvande och barnmorskan är central i att finnas till hands för den unga gravida kvinnan, samt för hennes partner och familj så att hon lättare kan utföra ett informerat beslut. Syfte: Att beskriva barnmorskans erfarenheter av att möta oplanerat gravida unga kvinnor på ungdomsmottagning som beslutar sig för att genomgå en abort. Metod: Semistrukturerade individuella intervjuer användes som insamlingsmetod och analys utfördes med kvalitativ innehållsanalys. Resultat: Två kategorier och sju subkategorier identifierades: Att vara en inlyssnande samtalspartner; Vid graviditetsbeskedet, Inför abortbeslutet och Efter aborten. Individanpassat stöd; Att ge praktiskt och kunskapsmässigt stöd vid den oplanerade graviditeten, Att se till det sociala sammanhanget, Ge stöd för en fortsatt säker sexualitet och Att stödjas för att stödja. Slutsatser och klinisk tillämpbarhet: Barnmorskan fångade in tankar och känslor hos den unga kvinnan och bemötte henne där hon befann sig. Barnmorskan tydliggjorde att abortbeslutet var den unga kvinnans och skyndade inte på beslutet. De betonade vikten av att inte förutsätta abort som det enda handlingsalternativet. Genom att lyssna in individuella behov av stöd kunde barnmorskan tillgodose det stöd som saknades. Att stödja för en fortsatt säker sexualitet såg barnmorskorna som en viktig men utmanande arbetsuppgift som väckte mycket känslor och därför var det viktigt med stöd för barnmorskan i form av kollegor, fortbildning och riktlinjer. Genom att öka kunskapen om barnmorskornas möten med oplanerat gravida unga kvinnor har författarna en förhoppning om ökad förståelse för arbetet och dess utmaningar. Genom fortbildning, hospitering, tydligare riktlinjer och stöttning inom preventivmedelsrådgivning efter aborten kan barnmorskan få mer stöd i sitt arbete och därmed möjlighet att förbättra mötet individanpassat utifrån den unga kvinnans behov.
Background: The midwifery profession has developed from focusing solely on pregnancy and childbirth to a broader field of sexual and reproductive health, including also meeting young people at youth clinics. The midwife at the youth clinic works preventively against unplanned pregnancies and meet young women and men in conversations about pregnancy and abortion. Facing a positive pregnancy notice may be overwhelming and the midwife is central in supporting the young woman, her partner and family in order for her to carry out an informed decision. Objective: To describe the midwife's experiences in meeting unplanned pregnant young women at the youth clinic who decide to have an abortion. Design/Methods: Semi-structured individual interviews were used as the method of data collection and analysis was conducted using qualitative content analysis. Results: Two categories and seven subcategories were identified: Being a listening partner; At the pregnancy announcement, In front of the abortion decision and After the abortion. Individualized support; To provide practical and knowledge based support related to the unplanned pregnancy, To consider the social context, Providing support for a continuing safe sexuality and Achieving support to support. Conclusion and clinical applicability: The midwife captured the thoughts and feelings of the young woman and responded to her where she was. The midwife made it clear that the decision about abortion should be the young woman’s own and not to rush the decision. They stressed the importance of not pre-assume abortion as the only treatment option. By listening to the individual needs of support midwife could meet the support that the young woman was missing. To support the continued safe sexuality were considered important but a challenging aspect of the work evoked emotions, and therefore support to the midwife in the form of colleagues, training and guidelines is important. By increasing the knowledge of the midwives' meetings with unplanned pregnant young women, the authors hope to contribute to a better understanding of Midwifery work and challenges. Through training, field studies, clearer guidelines and support in post abortion contraceptive counseling the midwives can get more support in their work and thus the opportunity to improve person-centered care based on the young woman's needs.

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McIntyre, Helen Rachel. "Factors influencing student midwives' competence and confidence when incorporating UNICEF UK Baby Friendly Initiative (BFI) Education Standards in clinical practice." Thesis, University of Nottingham, 2013. http://eprints.nottingham.ac.uk/27802/.

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Background: Breastfeeding is crucial in providing optimum nutrition and health for babies' to develop into healthy adults and has important emotional, physical and psychological benefits on maternal health. The UK has stubbornly low breastfeeding initiation and continuation rates. To address this, the government has policies targeting maternity and public health services. Furthermore, UNICEF UK introduced Baby Friendly Initiative (BFI) Hospital Standards in 1998 and Midwifery Education Standards in 2002. The University of Nottingham adopted BFI Education Standards in 2005 and have maintained accreditation since 2008. The BFI curriculum changes incorporated a knowledge, skills and attitude framework for teaching, learning and assessing. The embedding of positive attitudinal and skills facilitation of breastfeeding within the curriculum changes was essential. The influence of Trust's organisational culture on student learning was considered critical due to its impact on midwives working practises and pre-registration midwifery curricula having a minimum of 50% clinical practice. There is a lack of information about the efficacy of BFI Education Standards on student learning and application to practice. The aim of this study was to explore factors affecting student midwives competence and confidence when incorporating BFI Education Standards into clinical practice. Methodology and methods: A three year longitudinal multiple educational case study of a Bachelor of Midwifery programme commenced in 2009. Ethical and R&D approval were gained from the University and five Trusts, each at different stages of BFI clinical accreditation. The inclusion criteria were any student in the September 2009 midwifery cohort and their allocated midwife mentors. From a cohort of 32 students, 22 consented and 16 supplied data at each collection point throughout the three years. Students identified 92 midwife mentors, they had worked with, who were then invited to participate; 16 consented and 6 supplied data at each collection point throughout the three years. A total of 92 questionnaires and 70 one hour interviews were conducted. Data collected from students included questionnaire, individual interview and documentary evidence at 6, 18 and 30 months into the programme. Data from midwife mentors was questionnaire and individual interview at each stage. Documentary evidence was obtained from the students' NMC record of clinical skills and second year biology examination question on infant feeding. Data analysis used NVivo for qualitative data management, and PAWS for quantitative data analysis. Verbatim transcription of interviews was followed by thematic analysis. Findings: Findings are presented using BFI 'Ten Steps' Standards with the underpinning knowledge, skills and attitude framework. All students considered themselves to be competent and confident in 'normal' aspects of infant feeding but only competent in 'complex' feeding scenarios. Students self reported the theoretical component was most important to their learning in years 1 and 3 and clinical placements in year 2. Students who were mothers and students working in BFI accredited units had better examination results. Changes in workforce skill mix and reduced community midwife visits were factors in reported gaps of 'complex' breastfeeding learning opportunities. These were addressed by scenario role play. Reductions in Infant Feeding Advisor hours were found to correlate with increased formula supplementation. Mentors praised students' enhanced theoretical knowledge from their first year, and assessment and planning in the third year. They attributed this to the BFI curriculum. More prescriptive and structured organisational documentation facilitated student learning. Theory practice gaps existed at all five case study sites. At BFI accredited sites mothers and babies were statistically more likely to experience skin-to-skin following any mode of birth (n=1462 p<0.001 phi=0.21). At all sites a normal birth statistically increased the opportunity of mother-baby skin-to-skin (n=1462 p<0.001 phi=0.57) and initiation of breastfeeding (n=1462 p<0.001 phi=0.52). Students embraced a 'hands-off' technique to support breastfeeding and hand expression of the breast against prevailing clinical role modelling. Techniques students developed were 'shadowing', use of props, use of feeding cues and increasing the accessibility of their knowledge to women through facilitative communication skills. Use of infant feeding tools provided through the curriculum supported student learning. Detail provided within the postnatal data was poor and mirrored by mentors reporting poor use of relevant organisational documentation. Students had little opportunity to develop constructive formula feeding support, sterilisation of feeding equipment and reconstitution of formula milk. Anxiety was expressed by mentors and students in providing support to formula feeding women within a BFI framework. The use of interactive teaching methods and individual assessment through a workshop in year 3 were identified by students as significant to their learning. Students desire to support women to breastfeed grew over the 3 years. This was independent of personal feeding experiences of students who were mothers and the non-mothers embedded norms. The reinforcement and incremental delivery of the BFI curriculum in each year was identified as essential in this process. Conclusion: A BFI accredited midwifery curriculum positively impacts on student learning in infant feeding, raises the profile of infant feeding within postnatal care and enables students to create positive experiences for women. This study's findings would recommend that all midwifery curricula embrace BFI Education Standards within a knowledge, skills and attitudes framework.

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MacVane, Fiona E. "Midwifery knowledge and the medical student experience. An exploration of the concept of midwifery knowledge and its use in medical students' construction of knowledge during a specialist obstetric rotation." Thesis, University of Bradford, 2010. http://hdl.handle.net/10454/4904.

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The literature concerning what medical students learn from midwives during specialist obstetric rotations is scarce. In the UK, despite a long tradition of providing midwifery attachments for medical students, it is almost non-existent. Working with midwives is arguably the only opportunity medical students have to experience holistic or social models of maternity care, focusing on normality rather than on the medical concept of risk. This study sought to discover how medical students constructed their knowledge about childbirth during a six week specialist rotation in obstetrics in a Northern English teaching hospital (NETH), with particular emphasis on whether participants assimilated any concepts from midwifery knowledge (MK). A Delphi Study, done as the first phase of the research, focused on MK, utilizing an international sample of experienced midwives. Resulting themes were used to develop the data collection tool for the second phase of the research. The research employed a qualitative case study method with students from a single year cohort comprising the case. Data were collected using a tool consisting of three problem based learning (PBL) scenarios. These were presented to the students in consecutive interviews at the beginning, the middle and the end of their obstetric rotation. Following analysis, five main themes were identified which illuminated the medical students' construction of knowledge about maternity care. These were explored and discussed. The thesis concludes with recommendations for increasing opportunities for IPE in the medical and midwifery curricula.

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Gullin, Ann-Sofie, and Tina Magnevall. "Granska och värdera kvaliteten av lokala behandlingsriktlinjer med hjälp av AGREE-instrumentet." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-34938.

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Sammanfattning Bakgrunden beskriver hur barnmorskans arbete ska byggas på vetenskap och beprövad erfarenhet enligt gällande författningar, förordningar, föreskrifter och andra riktlinjer. Det åligger därför barnmorskan att kunna söka, analysera och kritiskt granska relevant kunskap för att kunna delta i utvecklingsarbete eller dess utvärdering. Det finns ett värde i att reflektera över befintliga rutiner och vid behov medverka till en förändring samt implementera ny kunskap. Kliniska riktlinjer har tagits fram för att underlätta det kliniska arbetet och det är därför viktigt att riktlinjerna innehåller evidensbaserad forskning. Syftet med studien var att granska och värdera kvaliteten av lokala behandlingsriktlinjer gällande mödrahälsovårdens basprogram. En kvantitativ metod valdes för att besvara studiens syfte där granskningsinstrumentet AGREE II användes, vilket är framtaget för att kunna bedöma kvalitén angående utvecklingsprocessen av kliniska riktlinjer inom hälso- och sjukvården. Resultatet från aktuell studie visade att avsnittet mål och syfte innehöll stora variationer gällande hur tydligt formulerat syfte de olika kliniska riktlinjerna hade. Inom berörda intressenters delaktighet framkom bristfällig dokumentation angående vilka yrkeskategorier som varit delaktiga i processen även patienters åsikter saknades. Inom stringens i framställningen erhöll alla kliniska riktlinjer låga poäng, beskrivning av litteratursökningen samt val av metod saknades. Samtliga kliniska riktlinjer i avsnittet tydlighet och framställning saknade eller hade otydliga behandlingsalternativ. Däremot kunde huvudrekommendationerna urskiljas med lätthet i sju av 18 kliniska riktlinjer. I avsnittet tillämpbarhet saknade samtliga kliniska riktlinjer resonemang kring hälsoekonomiska frågor eller angående behovet av eventuella organisatoriska förändringar. Redaktionell självständighet lyftes inte fram i någon av de kliniska riktlinjerna. Ingen klinisk riktlinje fick genomgående bra poäng i helhetsbedömningen enligt AGREE II, vilket gör det svårt att rekommendera någon av de kliniska riktlinjerna utifrån dess nuvarande presentation. Med detta resultat i åtanke anser författarna att de kliniska riktlinjer som granskades i aktuell studie inte har någon påvisbar evidensbaserad grund enligt AGREE II-instrumentet och kan således inte rekommenderas att använda som stöd i det kliniska arbetet.
Abstract The work of the midwife should be based on science and knowledge according to statutes, ordinances, regulations and available guidelines. In order to participate in development work and evaluation of it, it is important for the midwife to search, analyze and critically examine the relevant knowledge. To help the nursing staff in their clinical work and to provide quality proof care to the patients, clinical guidelines have been developed. It is therefore important that the content of the clinical guidelines is based on evidence-based research and easy to understand. The aim of the study was to review and evaluate the quality of local clinical guidelines regarding the basic maternity health care program. A quantitative method was used and the clinical guidelines were reviewed using the instrument AGREE II. The findings revealed that the quality of the clinical guidelines evaluated in this study varied. The result from current study showed that the section scope and aim contained big variations regarding how clearly the purpose was formulated in the different clinical guidelines. Within the section stakeholders involvement inadequate documentations revealed, containing the occupational category the professionals who was involved in the process had, also the patients’ options were missing. Within the rigour of development all clinical guidelines gained low credits, the description of the literature search as well as the choice of method were missing. All the clinical guidelines in the section of clarity and presentation were missing or had unclear assessment alternatives. However the main recommendation could easily be distinguished in seven of the eighteen clinical guidelines. In the section of applicability all of the clinical guidelines were missing argument regarding health economics or the need of possible organizationally changes. Editorial independence was not highlighted in any of the clinical guidelines. No clinical guideline had consistently good points according to AGREE II in the overall assessment. Therefore it is hard to recommend any of the clinical guidelines as they currently stands. With these results in mind authors of this study believes that the clinical guidelines that were viewed in this study did not, according to AGREE II, have any evidence-based ground demonstrable and can therefore not be recommended to nursing staff to be used as support in their clinical work.

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MacVane, Fiona Ellen. "Midwifery knowledge and the medical student experience : an exploration of the concept of midwifery knowledge and its use in medical students' construction of knowledge during a specialist obstetric rotation." Thesis, University of Bradford, 2010. http://hdl.handle.net/10454/4904.

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The literature concerning what medical students learn from midwives during specialist obstetric rotations is scarce. In the UK, despite a long tradition of providing midwifery attachments for medical students, it is almost non-existent. Working with midwives is arguably the only opportunity medical students have to experience holistic or social models of maternity care, focusing on normality rather than on the medical concept of risk. This study sought to discover how medical students constructed their knowledge about childbirth during a six week specialist rotation in obstetrics in a Northern English teaching hospital (NETH), with particular emphasis on whether participants assimilated any concepts from midwifery knowledge (MK). A Delphi Study, done as the first phase of the research, focused on MK, utilizing an international sample of experienced midwives. Resulting themes were used to develop the data collection tool for the second phase of the research. The research employed a qualitative case study method with students from a single year cohort comprising the case. Data were collected using a tool consisting of three problem based learning (PBL) scenarios. These were presented to the students in consecutive interviews at the beginning, the middle and the end of their obstetric rotation. Following analysis, five main themes were identified which illuminated the medical students' construction of knowledge about maternity care. These were explored and discussed. The thesis concludes with recommendations for increasing opportunities for IPE in the medical and midwifery curricula.

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Dyeli, Nolwando. "An investigation into the implementation of the basic antenatal care programme by midwives in Mdantsane clinics." Thesis, University of Fort Hare, 2011. http://hdl.handle.net/10353/425.

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Basic Antenatal Care (BANC) is a way of training or upgrading the knowledge and skills of all nurses, midwives and doctors involved in antenatal care at the primary health care level so that the minimum care can be provided effectively. This study was conducted to investigate the implementation of the BANC program by midwives in the Mdantsane clinics during February 2009. Methods: A descriptive study design was undertaken targeting midwives providing antenatal care to pregnant women, in 14 clinics of Mdantsane. Data was collected from 25 midwives in the clinics, and from 140 ANC cards of women attending ANC on the day of their visit to the clinic. Results: The majority of midwives providing BANC in Mdantsane clinics were not trained in BANC. There were 10 trained midwives and 15 not yet trained. A total of twenty five midwives were involved in the study. The number of visits according to the BANC schedule was well known by the midwives in the study. The content of the visits was well known for the first visit, but for subsequent visits, the participating midwives could not state exactly what they do on these visits. They perceived BANC as something beneficial for both midwives and pregnant women with 24 of the participating midwives rating BANC as advantageous. In completing an ANC card, the midwives scored between 48 percent and 100 percent. Under examination, they scored between 52 percent and 100 percent. Lastly on interpretation and decision making, they scored between 0 percent and 92 percent. This could have troubling consequences for the health status of the mother and baby. Weaknesses in providing antenatal care identified in the study included participating midwives failing to fill in the last normal menstrual period (LNMP) and the estimated date of delivery (EDD), which was a worrying observation. Plotting of the gestational age at first visit was also not carried out well as only 47 percent of the midwives in the study did this, meaning that there would be a miscalculation of the gestational age thereafter throughout the pregnancies. The body mass index (BMI) was not calculated as the maternal height and weight were not written on the ANC card. This should be completed in order to check the nutritional status of the pregnant woman to help supplement, if malnourished, and educate on diet, if overweight. Only 17 percent of the midwives in the study plotted the foetal presentation. Failure to plot foetal presentation could lead to complications during delivery because women with abnormal presentations could end up delivering in a clinic instead of the hospital.Conclusion: This study showed that even though midwives are implementing BANC among pregnant women, it is not being carried out correctly. Therefore the programme will not be as beneficial as it would be if put into practice correctly. This is highlighted by the lack of knowledge from the untrained midwives regarding the content of care on subsequent visits. Thus there is an urgent need for BANC training to be conducted and monitored at various sites.

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Shaw, Heather. "Decision-making, uncertainty and risk : a critical exploration of the decision-making processes of supervisors of midwives regarding serious untoward clinical events." Thesis, University of the West of Scotland, 2010. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.748757.

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Yimer, Endris Mekonnen, Firew Ayalew Desta, Kefyalew Muleta Akassa, Tadele Bogale Yitaferu, Mesfin Goji Abebe, Mebit Kebede Tariku, and Hannah Gibson. "Assessment of Midwifery and Nursing Students’ Nutrition Competence in Ethiopia: A Cross Sectional Study." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/ijhse/vol4/iss2/2.

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Background: Malnutrition is a major public health problem in Ethiopia contributing to half of infant and child mortality. The 2014 mini Ethiopian Demographic and Health Survey revealed that four out of ten children under five are stunted, nearly one out of ten are wasted, and a quarter are underweight. One of the factors that contributed to the high stunting rate is the shortage of capable providers who are competent to provide nutrition services. The purpose of this study was to assess graduating midwifery and nursing students’ nutrition competence and explore the factors that influence their competence. Methods: A cross-sectional survey was employed in June 2015. Students’ knowledge was assessed using objective written assessment questions; and their skills were assessed using a five-station objectively structured clinical examination. Students’ perception of the nutrition learning environment and their learning experience was obtained by administering a structured questionnaire using interviews. Bivariate and multivariable analysis, including Chi-square test and independent sample t-test, were used to detect statistically significant associations or differences. Results: A total of 113 students from four public universities in Ethiopia participated in the study. Only 38.1% of students demonstrated adequate competency in nutrition. The mean percentage score for nutrition knowledge and skills were 63.8% and 46.6% respectively. There was no statistically significant difference between midwifery and nursing students’ nutrition competence (P>0.05). Both cadres scored a mean value above 50% in the knowledge assessment, except in the competency areas of nutrition and HIV. However, both showed lesser competence in performing basic nutrition skills such as anthropometry. Midwives scored higher than nurses on counseling mothers on optimal breast feeding (p=0.001). The majority (98.2%) of students reported that they had no access to nutrition skills laboratory when they took the nutrition course. In multivariable analysis, students who perceived the practice sites as conducive for nutrition skills learning achieved higher levels of competence. Conclusions: The target students were deficient in nutrition competencies. The study suggests revision of midwifery and nursing curricula for adequacy and relevance of nutrition contents, learning and assessment techniques. Nutrition skills learning both in skills lab and at clinical and practical settings need to be strengthened.

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Archer, Wendy Kaye. "A sociolinguistic analysis of communication patterns between midwives and mothers in antenatal clinics in Great Britain and Germany." Thesis, Liverpool John Moores University, 2005. http://researchonline.ljmu.ac.uk/5777/.

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Building on the success of previous investigations, the doctoral thesis offers a contribution to the study of communication between health professionals and their clients. Since the overall aim of the investigation was to analyse both the verbal and non-verbal communication strategies used by both midwives and mothers in antenatal clinics in Great Britain and Germany, data was collected in the form of videotaped recordings of consultations during pregnancy. Socio-demographic data was retrieved through the use of questionnaires designed to investigate the participants' perceptions of the consultation. Working within a framework of speech act theory and conversation analysis, data was analysed in order to assess the varying degrees of asymmetry apparent in the communicative patterns of interactants. Typically occurring features such as use of the first person plural pronoun, references to the expected baby, interruptions, requests for information and confirmation, and unrelated responses were examined under the linguistic areas of lexis and pragmatics. The significance of non-verbal behaviour and its relation to verbal requests was investigated through the analysis of listener-oriented and other-oriented head movements. Statistical analysis of the phenomena chosen for observation revealed that the appearance and frequency of certain linguistic features (e.g. the first person plural pronoun) was significantly associated with socio-demographic variables such as age and occupational status. Analysis of request sequences also revealed significant correlation when compared with social variables such as age of participants and occupational status of mothers. Qualitative analysis of detailed transcriptual data appeared to indicate that the functions of particular utterances were positively associated with socio-demographic and cross-cultural features such as age and country of study, respectively. Confirming the hypothesis that both linguistic and sub-linguistic features are subject to influences from social and external factors, the results offer a thorough description of the communicative behaviour of both midwives and mothers in antenatal consultations in Great Britain and Germany. Furthermore, it is suggested that the findings arising from the study will enable professional midwives and members of the public alike to develop greater awareness of the importance of good communication skills in order that consultations may operate effectively and to the benefit of both parties. Linguistically, it is argued that the study contributes to our understanding of the distribution and functions of language according to its particular context.

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Clow, Sheila Elizabeth. "The effect of a training and clinical facilitation programme for registered midwives in primary maternity settings with respect to managing labour: a pragmatic cluster randomised trial." Doctoral thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/13082.

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Includes bibliographical references.
Background: Intrapartum complications contribute to nearly half of all avoidable maternal and perinatal deaths nationally. Inadequate understanding of the labour process by midwives, poor documentation of labour monitoring and inadequate systemlevel support may lead to wrong diagnosis, incorrect management, and the potential for missed opportunities to prevent mortality. Aim: To evaluate the effect of an intervention package of training and clinical facilitation on the quality of clinical management in labour by registered midwives in primary level public sector health facilities in rural South Africa. Methods: Research design : Pragmatic cluster randomised trial with 12 month follow-up. Setting and participants : Seventeen clusters stratified by geo-political region and size of service; 1020 labour records (60 per cluster / site; systematic random sample); and 154 registered midwives employed in the study sites during the study period. Participants were not blinded. Intervention : A package of clinical faclitation training for selected experienced midwife clinicians / managers, and an intrapartum educational update for midwives. Intervention and control sites continued receiving routine communication, all clinical guidelines and scheduled outreach activities. Main outcome measures : Primary outcome - clinical practice measuring partograph utilisation, using a modified partograph checklist, the testing of which is described in this study. Secondary outcome - midwives’ knowledge and skills, measured by written and clinical tests. Outcomes were analysed at the individual level using regression methods that allowed for clustering. The evaluator was blinded to the study allocation. Findings: The mean scores for the total partograph were not statistically significantly different between arms; the mean difference was 1.55 points out of a possible score 47 (95% CI: -1.18 to 4.28) p= 0.27. At a score of 27 the estimated absolute difference was 13.6% (95% CI : 0.16 to 0.25) p = 0.026. The total score for midwives’ knowledge and skills was 7 points (out of a possible 119) higher in the intervention arm (95% CI : 2.1 to 12.3), p=0.006. Conclusions: Although there was no difference in the quality of the overall completion of the partograph, there was a statistically significant difference in those of better quality completions in the intervention arm. Midwives’ knowledge and skills were higher in the intervention arm and those in the control arm deteriorated over time. This difference was statistically significant. Recommendations and implications for practice: This indicates a critical need to provide continuing professional education to midwives and to arrange midwifery staffing that optimises clinical practice in settings where intrapartum care is offered. In addition to regular, sustainable programmes to enhance partograph utilisation and midwife knowledge and skills, barriers to the utilisation of the partograph need to be investigated and addressed.

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Blomqvist, Sara, and Johanna Thor. "Barnmorskans arbete kring kostråd till gravida kvinnor : En deskriptiv tvärsnittsstudie." Thesis, Uppsala University, Uppsala University, Department of Public Health and Caring Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-105101.

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Syftet med denna undersökning var att undersöka barnmorskans syn på kostrådgivning till gravida kvinnor, om och hur de ger information om kost och i så fall vad de informerar om. Vidare undersöktes till vilken grad barnmorskorna på mödravårdscentralerna följer de rekommendationer om kost till gravida kvinnor som Svenska Livsmedelsverket tagit fram. En deskriptiv tvärsnittsstudie genomfördes bland samtliga barnmorskor på mödravårdscentraler i Uppsala län. Det var 36 barnmorskor som deltog i studien (53 % svarsfrekvens) och som besvarade ett webbaserat frågeformulär. Resultatet från undersökningen visar att barnmorskorna ofta ger kostråd till den gravida kvinnan i samarbete med dietisten. Informationen ges då för det mesta både muntligt och skriftligt. Vidare visar resultatet att barnmorskorna anser att det är viktigt att ge kostråd till gravida kvinnor och att de allra flesta kvinnor får kostrådgivning på mödravårdscentralen. Barnmorskorna anser att de och den gravida kvinnan har ett gemensamt ansvar när det gäller information angående kost. Barnmorskorna grundar kostrådgivningen främst på Svenska Livsmedelsverkets rekommendationer och undersökningen visar att de informerar om det mesta som det Svenska Livsmedelsverket tar upp angående kost under graviditeten. Slutsatsen av denna undersökning är att barnmorskorna ger en individuellt anpassad kostrådgivning som följer det Svenska Livsmedelsverkets rekommendationer.

The aim of this study was to examine what view the midwives have on nutritional guidance towards pregnant women, if they give information regarding diets, and if so, how they inform pregnant women, and also what the information consists of. Furthermore, the aim of this study was to determine how the midwives comply with the recommendations given by the Swedish National Food Administration. A descriptive cross-sectional study was carried out among all midwives at the maternity clinics in the county of Uppsala. There were 36 midwives that participated in the study (53 %) which consisted of a web based questionnaire. The result of this study indicated that the midwives frequently give nutritional guidance to the pregnant woman in collaboration with the dietician. The pregnant woman often receives both verbal and written information. The results also indicate that the midwives believe that it is important to give nutritional guidance to pregnant women and that most of them get this guidance at the maternity clinic. The attitude of the midwives is that they, together with the pregnant woman, have a mutual responsibility when it comes to information about nutrition during pregnancy. The midwives nutritional guidance is based on the given recommendations of the Swedish National Food Administration, and the study also shows that the information given by the midwife corresponds with the information that the Swedish National Food Administration emphasise. Therefore the conclusion of this study is that the midwives give an individually adjusted nutritional guidance which corresponds to the recommendations given by the Swedish National Food Administration.

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Paul, Unathi Mecia. "Challenges faced by midwives in implementing the prevention of mother to child transmission programme during the post-natal period at Khayelitsha Community Health Clinic, Western Cape Province." University of the Western Cape, 2016. http://hdl.handle.net/11394/4903.

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Magister Curationis - MCur
Background: In the South Africa, the number of HIV- positive pregnant women is rising and has resulted in more than 70,000 babies being born with HIV infection annually since the year 2000. In response to the escalating number of HIV-positive pregnant women, the Department of Health of South Africa, decided, in 2002, to implement the Prevention of Mother to Child Transmission (PMTCT) programme at 18 pilot sites in the country. An effective PMTCT programme could reduce the incidences of maternal and child mortalities in the country. An evaluation of the effectiveness of the PMTCT programme that was done in 2010 showed that, although the programme was rendered effectively during pregnancy and labour, there were still irregularities that appeared, especially during the postnatal period. Khayelitsha was the first pilot site in South Africa to provide Antiretroviral Therapy and initiate the Nurse Initiated Management of Antiretroviral Therapy (NIMART) at primary care level in the public sector. Midwives are the health professionals who render the PMTCT services to HIV-positive mothers and their babies until six weeks post-delivery. They have managed to test almost 100% of pregnant women during the antenatal period and the HIV-positive women were started on the PMTCT programme during their first visit. Aim: The aim of this study was to explore the challenges that midwives faced in rendering care to postnatal HIV-positive mothers enrolled in the PMTCT programme at the Khayelitsha Community Health Clinic in the Western Province of South Africa. Method: An exploratory design and qualitative approach was followed. The study population consisted of midwives who were rendering PMTCT services to HIV-positive mothers and their infants during the postnatal period. Purposive sampling was conducted until data saturation was reached. Six participants were included in the sample. The participants were informed about the study by means of an Information Sheet, advised that the study was voluntary and reminded that they could withdraw from the study at any time, without prejudice. In-depth, unstructured individual interviews were conducted with each of the participants. With the permission of participants, an audio tape recorder was used during the interviews to collect data, while the researcher took field notes to supplement and verify the voice recordings, after the interviews. The seven steps of Colaizzi were used to analyse the data. Six themes and sixteen sub-themes emerged during the data analysis. Trustworthinesswas maintained by using the criteria of Guba’s model, i.e. credibility, transferability, conformability and dependability. Permission to conduct the study was obtained from the appropriate ethical committees; the Department of Health, the Khayelitsha Community Health Clinic, as well as, the Senate Research Committee of the University of the Western Cape. Participants were asked to sign Informed Consent forms before participating in the study. The ethical principles of privacy, anonymity, withdrawal, confidentiality and consent were strictly adhered to. Findings: The study found several challenges faced by midwives while implementing the PMTCT programme during the postnatal period. These challenges included: the shortage of NIMART-trained staff attending to the high number of clients per day; the lack of manpower with data base systems to trace mothers who did not come back after delivery; and mothers who did not come back for postnatal appointments because of denial, non-disclosed HIV status and socioeconomic reasons. Furthermore, the participants also reported on midwives experiencing ‘burnout’ as a result of the hectic working environment at the Khayelitsha Community Health Clinic. Recommendations: There is an urgent need for all midwives in the MOU’s to be NIMART-trained. NIMART should be standardize and be the part of the curriculum that taught in all the tertiary institutions and be updated in a yearly basis as part of the in-service training or education for all practising midwives. The South African Government should introduce home visits in the PMTCT programme. Data-bases of all MOU’s and facilities that offer PMTCT services need to be synchronized and these MOU’s and facilities should all follow the same PMTCT guidelines. Further research should be done on the same topic at other clinics and MOU’s that render the PMTCT programme in the Western Cape.

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Paulse, Priscilla Jannet. "The support of nurse managers to midwives in implementing HIV testing and counselling within protocol at an antenatal clinic in the Western Cape." University of the Western Cape, 2017. http://hdl.handle.net/11394/6140.

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Magister Curationis - Mcur
Midwives are expected to encourage pregnant women to undertake, continue and adhere to the Prevention of Mother to Child Transmission (PMTCT) of the Human Immunodeficiency Virus (HIV) program.It should be a norm that midwives counsel every pregnant woman about the benefits of knowing her HIV status so that she can make informed decisions about being tested as part of prenatal care. The researcher has however become aware of clients visiting clinics that complain that they receive contradicting information from midwives around HIV testing and counselling. On the other hand, midwives have indicated that seniors do not support them in their work situation, to implement the HIV policy.

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Crouch, Anna. "The perceptions of how dyslexia impacts on nursing and midwifery students and the coping strategies they develop/use to manage difficulties associated with dyslexia in clinical practice : an embedded case study." Thesis, University of Northampton, 2017. http://nectar.northampton.ac.uk/10128/.

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The aims of this research were to explore the perceptions of the impact of dyslexia on nursing and midwifery students in practice, and of the coping strategies they develop and/or use to help them cope. To achieve the above aims, the following questions were set and addressed: 1. What is the perceived impact of dyslexia on the nursing and midwifery student in clinical practice? 2. How are any difficulties associated with dyslexia managed by the nursing or midwifery student? 3i. What strategies can help and support nursing and midwifery students with dyslexia? 3ii. What are students’ and mentors’ perceptions of the poster guidelines (developed following a previous study), which are designed to help and support nursing and midwifery students with dyslexia in clinical practice? A qualitative study underpinned by a constructivist, interpretive ontological perspective was undertaken, based on a grounded theory case study approach. After seeking and gaining research ethics approval and informed written consent from potential participants, a purposive sample of 12 nursing and midwifery students with dyslexia, and 22 mentors was recruited and used for the study. Varied methods including tape recorded semi-structured interviews and content analysis of students’ practice portfolios (n=8) and files (n=12) were used to collect data from the students. Evaluative comments from the mentors were also collected. The data were then analysed using Glasarian grounded theory method. Findings suggest that dyslexia impacts on the student negatively as well as positively. There was expression of strong support with reference to demonstration of empathy and acceptance of students with dyslexia in both academic and practice settings, however, disclosure remained an issue for some students. Apart from already available strategies, the students managed to develop and used simple and effective coping strategies in a non-stressful environment. In a busy environment however, they became stressed and frustrated with cascading effects. Many of the strategies used including the poster guidelines were identified as very useful and or helpful and suggestions made by both students and mentors led to the development of a tool kit to be use used interactively by the students and their mentors in practice.

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Aneblom, Gunilla. "The Emergency Contraceptive Pill – a Second Chance : Knowledge, Attitudes and Experiences Among Users and Providers." Doctoral thesis, Uppsala University, Department of Women's and Children's Health, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3487.

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The overall aim of this thesis was to study knowledge, attitudes and experience of emergency contraceptive pills among women and providers.

Both quantitative and qualitative methods were used. Focus-group interviews were conducted with teenage-girls (I) and with women who had purchased ECP without prescription (IV). Self-administered waiting-room questionnaires were administered to women presenting for induced abortion in three large hospitals (II, III), and after the deregulation of ECP, a postal questionnaire was sent to pharmacy staff and nurse-midwives in three counties in mid-Sweden (V).

Overall, women showed high basic awareness of ECP although specific knowledge such as the level of effectiveness, time-frames and how the method works was lacking. Approval of the method was high and most women were positive to use the method if they needed. Contradictory views as to whether ECP undermines contraceptive behavior were expressed. As many as 43% of women requesting induced abortion had a history of one or more previous abortions. Among the abortion applicants, one out of five, 22%, had previously used ECP and 3% had used it to prevent the current pregnancy. Media and friends were the two most common sources of information on ECP. Half of the women, 52%, were positive to having ECP prescription-free. Those women who had purchased ECP in a pharmacy without prescription, appreciated this possibility, and the major benefits expressed were time saving aspects. No severe side-effects were reported. The women's experiences of interaction with pharmacy staff were both positive and negative. The importance of up-to-date information about ECP and the OTC-availability from the health care providers was emphasized. Both pharmacy staff and nurse-midwives had positive attitudes towards ECP and the OTC availability. Of pharmacy staff, 38% reported that they referred women to nurse-midwives/gynecologists for further counseling and follow-ups. The need for increased communication and collaboration between pharmacies and local family planning clinics was reported by both study groups with suggestions of regular meetings for information and discussions.

The results suggest that ECP is still underused and that more factual information is needed before the method is becoming a known, accepted and integrated back-up method to the existing family planning repertoire. Longitudinal research to assess the long-term effects of ECP is needed.

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Karlström, Frida, and Johan Bergqvist. "Samtal om pornografi med ungdomar : Barnmorskors erfarenheter, en kvalitativ intervjustudie." Thesis, Högskolan i Skövde, Institutionen för hälsovetenskaper, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-19114.

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Bakgrund: Genomsnittsåldern för exponering av pornografi bedöms vara så låg som 10-års ålder. Ungdomar vänder sig till pornografi i brist på adekvat sex- och samlevnadsundervisning och konsumtion av pornografi kan leda till sexuellt riskbeteende. Barnmorskan har en vital roll i att främja sexuell hälsa såväl i enskilda samtal på ungdomsmottagningen som i skolan. Syfte: Att undersöka barnmorskors erfarenheter av att samtala om pornografi med ungdomar. Metod: I studien genomfördes intervjuer med sex barnmorskor verksamma på olika ungdomsmottagningar i sydvästra Sverige. Datamaterialet analyserades med hjälp av kvalitativ innehållsanalys. Resultat: Analysen gav upphov till fyra kategorier; Barnmorskan anpassar sitt förhållningssätt, Effekter av ungdomars konsumtion, Pornografi finns överallt och Barnmorskan berikar sex- och samlevnadsundervisningen. Konklusion: Barnmorskor erfar att samtal om pornografi är utmanande. Pornografiskt material bidrar till komplex kring fysiologiska och kroppsliga attribut hos ungdomar och medför att normer förskjuts och aktioner normaliseras, vilket resulterar i att ungdomar utför saker mot sin vilja. Pornografins förmåga att influera och de potentiella risker som konsumtion medför i samband med att ingen barnmorska per automatik diskuterar pornografi med ungdomar bör ses som ett observandum. Samtalet om pornografi kan därmed vara avgörande för att främja och stärka den sexuella hälsan bland ungdomar.
Background: The average age of exposure of pornography is estimated to be as low as 10 years. Adolescents turn to pornography due to a lack of adequate sex and cohabitation education, and consumption of pornography can lead to a sexual risk behaviour. The midwife has a vital role in promoting sexual health in individual conversations at the youth clinic as well as in school. Aim: To explore midwives’ experiences of talking to adolescents about pornography Method: The study were conducted by interviews with midwives working at various youth centers in southwestern Sweden. The data material was analyzed using qualitative content analysis. Result: The analysis gave rise to four categories; The midwife adapts her approach, The effects of adolescents consumption, Pornography is everywhere and The midwife enriches sex and cohabitation education. Conclusion: Midwives find that talking about pornography is challenging. Pornographic material contributes to the complexity of physiological and physical attributes of adolescents and causes norms to be shifted and actions normalized, resulting in adolescents doing things against their will. Pornography’s ability to influence and the potential risks that consumption entails in connection with the fact that no midwife automatically discusses pornography with adolescents should be seen as an admonition. The conversation can therefore be crucial in promoting and strengthening the sexual health of adolescents.

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Barasinski, Chloé. "Pratiques obstétricales maïeutiques lors de l'accouchement : État des lieux et évaluation des types de poussée." Thesis, Université Clermont Auvergne‎ (2017-2020), 2017. http://www.theses.fr/2017CLFAS009/document.

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Les pratiques obstétricales utilisées lors des accouchements sont nombreuses et certaines peuvent avoir un impact sur son déroulement ainsi que sur les issues maternelles et foetales. Durant le travail, ces pratiques reposent sur l’utilisation de différentes positions ou de techniques antalgiques pharmacologiques (analgésie péridurale, protoxyde d’azote) ou non (déambulation, utilisation de la baignoire, de la douche, du ballon etc.). Au moment de l’accouchement, il existe également différentes techniques de poussée, de maintien de la tête foetale, de soutien périnéal ou encore différentes positions d’accouchement. Cependant, à ce jour, ces pratiques ne sont pas ou très peu étudiées en France et ne répondent à aucune recommandation pour la pratique clinique. Dans le premier volet de cette thèse (n=1496), nous avons réalisé un état des lieux des pratiques déclarées par les sages-femmes et étudié si les pratiques différaient en fonction du lieu d’exercice et de l’ancienneté. Les sages-femmes françaises proposaient largement le recours à l’analgésie péridurale, surtout celles exerçant en maternité de type II ou III. Le décubitus latéral était la position préférée des sages-femmes durant le 1er stade avec analgésie péridurale et durant la phase de descente du 2ème stade. Pour l’accouchement, la plupart des sages-femmes conseillaient des positions en décubitus. La poussée en bloquant était celle la plus conseillée par les sages-femmes et majoritairement par celles ayant ≤ 5 ans d’ancienneté. Ces données ont montré que les pratiques des sages-femmes françaises étaient hétérogènes et variaient selon le niveau des maternités et l’ancienneté des sages-femmes. Notre deuxième volet repose sur un essai randomisé multicentrique (n=250) dont l’objectif principal était d’évaluer l’efficacité de la poussée dirigée à glotte ouverte vs celle à glotte fermée. Le critère de jugement principal était un critère de jugement composite : accouchement spontané, sans lésion du périnée (épisiotomie ou lésion spontanée des 2ème, 3ème ou 4ème degrés). Les femmes éligibles étaient celles ayant suivi intégralement la séance de formation aux types de poussées, avec une grossesse monofoetale en présentation céphalique, un accouchement par voie basse acceptée, admises en maternité entre 37 et 42 semaines d’aménorrhée pour un travail spontané ou induit, à partir d’une dilatation cervicale utérine ≥ 7 cm. Les critères d’exclusion étaient une pathologie contre-indiquant des efforts expulsifs ou un antécédent d’utérus cicatriciel, ou une anomalie du rythme cardiaque foetal avant la randomisation. Nous n’avons pas retrouvé de risques absolus ou bruts statistiquement différents en terme d’efficacité de la poussée, ni sur la morbidité maternelle (déchirures périnéales sévères ou hémorragies du post-partum) et néonatale immédiate (pH défavorable). Après prise en compte des facteurs de confusion et des facteurs pronostiques cliniquement pertinents, l’efficacité de la poussée n’était pas, non plus, statistiquement différente entre les deux types de poussées (RR ajusté : 0,92 [IC95% : 0,74-1,14]). En conclusion, les pratiques maïeutiques différent durant l’accouchement en France et il n’y a pas lieu de conseiller un type de poussée plutôt qu’un autre. Les femmes doivent, toutefois, être informées des différentes positions et des types de poussées lors des préparations à l’accouchement et doivent pouvoir choisir la position et la poussée qui leur conviennent, voir en changer, au cours du travail (Fédération Internationale de Gynécologie Obstétrique, 2012)
Many different obstetric practices are used during delivery, and some of them can affect the course of labor and delivery as well as maternal and fetal outcomes. During labor, these practices mainly concern the use of different positions and of analgesic techniques, both pharmacological (epidural analgesia, nitrous oxide) or not (walking, water immersion in a pool, large tub, or shower, birthing balls, etc.). At delivery, there are also different techniques of pushing, of fetal head management, perineal support, and birthing positions. Nonetheless, until now, the use of these practices in France has been studied little if at all, and there are no Clinical Practice Guidelines to help midwives choose their practices based on scientific evidence.The first component of this dissertation describes our inventory of practices reported by midwives (n=1496) and examines whether these practices differ as a function of either place of practice or experience. French midwives very frequently offer women epidural analgesia, especially those practicing in level II or III maternity units. Lateral decubitus was the position midwives preferred during the first stage for women with epidural analgesia and during the descent phase of the second stage. For delivery, most midwives advised decubitus positions. Pushing with Valsalva breathing was advised most often, mostly by midwives with ≤ 5 years of experience. These data show that French midwives use heterogeneous practices that vary according to the maternity unit level and the midwife's experience.The second component of this dissertation is based on a multicenter randomized trial (n=250) to assess the effectiveness of directed pushing when used with open glottis or closed glottis (Valsalva) breathing. The principal endpoint was a composite criterion: spontaneous delivery without perineal lesion (episiotomy, or spontaneous 2nd, 3rd, or 4th degree lacerations). Women were eligible if they have taken an antenatal class that includes a specific training in the types of pushing, and had a singleton pregnancy in cephalic presentation, planned vaginal delivery, and were admitted to the maternity ward between 37 and 42 weeks of gestation in spontaneous or induced labor when cervical dilation was ≥ 7 cm. The exclusion criteria were a disorder contraindicating expulsive efforts, previous cesarean or other uterine scar, or a fetal heart rate anomaly before randomization. The unadjusted analysis show no difference between the groups in the effectiveness of pushing, in maternal morbidity (severe perineal lacerations or postpartum hemorrhage), or immediate neonatal morbidity (unfavorable pH). After adjustment for confounding factors and clinically relevant prognostic factors, there was still no statistically significant difference in the effectiveness of the type of pushing (RR adjusted: 0.92, 95% CI 0.74-1.14).In conclusion, midwifery practices during delivery in France differ, and there is no evidence to recommend one type of pushing over another. Women must nonetheless be informed about the different positions and types of pushing during their preparation for delivery and must be able to choose the position and type of pushing they prefer, and be able to change it, during labor (International Federation of Gynecology and Obstetrics, 2012)

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Demeester, Anne. "Formation initiale au raisonnement clinique en sciences maïeutiques : Bénéfices, limites et perspectives d'utilisation des cartes conceptuelles." Thesis, Aix-Marseille, 2014. http://www.theses.fr/2014AIXM3112/document.

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Introduction. Le raisonnement clinique (RC) est une compétence médicale clé. Cette thèse soutient que l'organisation et la mise en lien systématique et explicite entre les données d'une patiente ou d'un nouveau-né et les connaissances d'un étudiant améliore sa performance dans la résolution de cas cliniques courants de la pratique sage-femme. Objectifs. Identifier les difficultés de RC d'étudiants en maïeutique et leurs causes explicatives ; identifier l'utilisation des cartes conceptuelles (CC) en lien avec le raisonnement clinique ; solliciter le RC des étudiants par la résolution de cas cliniques courants, identifier leurs perceptions et analyser leurs performances en fonction de leur niveau d'acquisition des CC.Méthodes. Etude exploratoire mixte, revue de la littérature, et expérimentation auprès de 97 étudiants de trois écoles de maïeutique. Analyse de 570 questionnaires et 352 CC. Résultats. Sept causes de difficultés de RC identifiées, parmi lesquelles le défaut de mise en liens entre les connaissances. Le potentiel d'utilisation des CC est confirmé par la littérature. L'expérimentation montre l'acceptabilité des CC et une aide à la résolution dans 50% des cas. Il existe un lien entre la maîtrise des CC, la cohérence du RC et le niveau de performance de résolution des cas. Cette dernière dépend de la représentation initiale du cas (concept de départ) et de la hiérarchisation des concepts, mais pas de la forme de la CC. Les CC permettent également d'identifier les difficultés des étudiants et d'établir un diagnostic pédagogique. Conclusion. La recherche valide l'hypothèse de départ et débouche sur des propositions pour utiliser les CC dans la formation au RC
Introduction. Clinical reasoning (CR) is a key competence that students in health sciences must acquire. This thesis argues that concept mapping improves midwives students' performance in clinical problem solving. Objectives. Identify midwives students CR difficulties and their explanatory causes; identify the use of concept mapping and show compatibility between concept mapping and recommendations for clinical reasoning; introduce concept maps (CMs) in clinical solving learning sessions and observe their effects.Methods. Mixed exploratory study, literature review and experimentation including 97 students nested in three schools of midwifery: 570 questionnaires and 352 CMs were analysed. Results. Seven causes of CR difficulties were identified. Literature confirms CMs may be a relevant tool for clinical reasoning teaching and learning. By making knowledge explicit CM helps one out of two students to improve clinical problem solving performance when CM include a correct core concept and when concepts are hierarchically organized. The best performing students are those who acquire the construction of CMs.Conclusion. The research validates the starting assumption and leads to proposals of using CMs in CR learning. Concept mapping might be an interesting activity to foster CR and identify the difficulties that students may encounter

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Thored, Emelie, and Freja Wikström. "Bidragande faktorer till valet av LARC vid strukturerad preventivmedelsrådgivning på ungdomsmottagning : Klusterrandomiserad kontrollerad interventionsstudie i Stockholms län." Thesis, Högskolan Dalarna, Institutionen för hälsa och välfärd, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:du-38415.

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Bakgrund: Kvinnors behov av modern familjeplanering är inte tillgodosett. Samhällsekonomiska vinster finns att hämta om fler använder långverkande reversibla preventivmedel (LARC), i stället för mindre effektiva kortverkande metoder. Det finns ett behov av förbättrade arbetssätt för att kvinnor genom ett välinformerat beslut ska kunna välja effektiva preventivmedel. Syfte: Att undersöka om reproduktiv anamnes och sociodemografiska faktorer har en inverkan på valet av LARC vid strukturerad respektive sedvanlig preventivmedelsrådgivning, bland ungdomar och unga vuxna (18–24 år) på ungdomsmottagningar i Stockholmsregionen. Metod: Kvantitativ ansats. Klusterrandomiserad studie och substudie av LOWE-studien. Resultat: Planerad användning av LARC innan besöket (OR 45.78, 95% CI 23,54–89,02) och strukturerad preventivmedelsrådgivning (intervention) (OR 3,67, 95% CI 2,24–5,97) var de variabler som visade sig vara påverka valet av LARC. Slutsats: En trolig anledning till att sociodemografiska faktorer och reproduktiv anamnes inte påverkar valet av LARC i denna studie kan vara att preventivmedelsanvändning är ett mer komplext område. Den information som ges vid preventivmedelsrådgivning har en inverkan på majoriteten av alla patienter, men rådande samhällsnormer styr valet av preventivmedel tillsammans med paradigmskiften inom SRHR. Klinisk tillämpbarhet: Resultatet var av klinisk signifikans för vårdpersonal på ungdomsmottagningar och kan kliniskt tillämpas för en fördjupad kunskap kring bidragande faktorer för valet av LARC.
Background: Women’s need for modern family planning is not met. Socioeconomic benefits can be obtained if less-safe methods are replaced by long-acting reversible contraceptives (LARC). There is a need for improvement within the work to enable women to choose effective contraceptives by a well-informed decision. Aim: To investigate if reproductive history and socioeconomic factors have an impact on the choice of LARC under the influence of customary and structured contraceptive counselling, among adolescents and young adults (18-24) at youth clinics in Stockholm, Sweden. Method: Quantitative method. Cluster randomized controlled intervention study, and a substudy of LOWE. Result: Planned use of LARC before the visit (OR 45.78, 95% CI 23,54–89,02) and structured contraceptive counselling (intervention) (OR 3,67, 95% CI 2,24–5,97) was the variables that influenced the choice of LARC. Conclusion: A likely reason why sociodemographic factors and reproductive history did not influence the choice of LARC, could be that contraceptive use is a part of a more complex context. The information provided in contraceptive counselling has an influence on the majority of all patients, but current societal norms control the choice of contraception, as well as paradigm shifts within SRHR. External validity: The result was of clinical significance for staff at youth clinics and can be clinically applied for in-depth knowledge of influencing factors for the choice of LARC.

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Sumari, Ayo Eliaremisa Ndetaulo. "Factors influencing clinical teaching of midwifery students in a selected clinical setting in Tanzania." Diss., 2006. http://hdl.handle.net/10500/2258.

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A quantitative, descriptive non-experimental design was used to identify the factors that influence clinical teaching of midwifery students in selected postnatal clinical settings in Tanzania. Structured questionnaires were used to collect data from midwifery tutors/preceptors. The major findings of the study showed that both the professional and educational qualification of tutors was low; tutors and preceptors were overworked due to shortage of staff; the school skills laboratory and postnatal wards lacked equipment and necessary supplies; there were no clinical accompaniment guidelines, and overcrowding of postnatal patients. Recommendations included developing the clinical teaching guidelines, employing more tutors, preceptors and clinical staff; improving the tutors'/ preceptors' educational and professional qualifications and updating the qualifications of ward supervisors and clinical facilitators.
Health Studies
M.A. (Health Studies)

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Meyer, Rushaan. "The experiences of male nurses in midwifery clinical training at a regional hospital in the Eastern Cape." Diss., 2012. http://hdl.handle.net/10500/10572.

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The purpose of the study was to explore and describe the experiences of male community service officers during midwifery clinical training. A qualitative, explorative, descriptive and contextual design was used in order to achieve the study objectives. Data was collected by means of semi-structured interviews. Data analysis elucidated analogous themes and categories which translated into the overall experiences of the participants. The study found that whilst the experience was described as beneficial, there were overwhelming challenges in providing intimate care to female clients, dealing with ethno-cultural aspects, meeting clinical practice requirements and the right to choose to be part of midwifery clinical training. Recommendations to nurse educators, clinical midwives and midwifery clinical supervisors with regard to better support for male nurses during midwifery clinical training emanated from the study findings
Health Studies
M.A. (Health Studies)

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Masemola, Sizile Rose. "Implementation of clinical guidelines for the management of pre-eclampsia by midwives in uMgungundlovu District of KwaZulu Natal." Diss., 2017. http://hdl.handle.net/10500/25030.

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The purpose of the study is to determine the knowledge of midwives on implementing clinical guidelines for the management of pre-eclampsia with the aim of improving midwifery practice and preventing maternal and neonatal death due to pre-eclampsia. A quantitative, descriptive, cross sectional study design was used for the study. Data was collected using a self-administered questionnaire from 100 midwives working in the maternity section of the clinic referring to the regional hospital in UMgungundlovu District. The Statistical Package for Social Sciences (SPSS) version 23 was used for data analysis. The findings show that respondents to the study have a high mean value (3.6) of knowledge but need support in terms of providing training on the new guidelines. The study also showed that there is need to improve on distribution of guidelines. There was no significant association between demographic factors and the knowledge of midwives on clinical guidelines for the management of pre-eclampsia. A clinical audit of maternity records as well as a quality care project can be developed based on the findings
Health Studies
M.A. (Health Studies)

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Dissertations / Theses on the topic 'Clinical midwife'

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