Midwifery Research Research Articles

Opportunities for nursing and midwifery research in Bulgaria

Abstract Background The training of nurses and midwives today is at university level and follows established standards. The 2009 Global Standards for the basic nursing and midwifery education of the World Health Organization requires that the curricula should include basic knowledge and skills for scientific research to implement evidence-based health care. In Bulgaria, scientific research among nurses and midwives began in 2000 and has seen more serious development in the last 5 years. Methods A content analysis of normative documents was carried out, to regulate the conduct of scientific studies and the curricula for the two specialties. Results In all documents on the activities of graduate nurses and midwives, activities related to conducting scientific studies are regulated. No mandatory discipline for these competencies is included in the basic education. In Bulgaria, there is a bachelor’s and master’s program only in Health Care Management, in which sociology, statistics, and research methodology are studied. From 2000 to 2016 nurses and midwives defended doctoral dissertations in a program for medical doctors. The first doctoral program for nurses and midwives is from 2016. There are no legal norms for stimulating and provide conducting clinical research, and to ensure evidence-based practice by nurses and midwives. Conclusions The normative regulation of scientific activity among nurses and midwives in Bulgaria corresponds to international and European requirements, but the opportunities for training are limited. The responsibility of nurses and midwives to modern society is to ensure high quality in health care provided by: a. providing opportunities for clinical studies; b. implementation of evidence-based health care and practice; c. developing programs for training for research in health care. Key messages • In Bulgaria, there is a legal norms for conducting nursing research, but not for evidence-based practice. • There is a need for more opportunities to train and encourage clinical nursing research.

Transforming researchers into writers through a series of semi-structured writing retreats: a mixed methods study

AimTo evaluate the experience and effectiveness of six semi-structured writing retreats on research publication quantity and quality for nursing and midwifery academics and research students.BackgroundResearch publications are necessary to develop a track record to gain competitive funding and for promotion. Publications also improve the standing of universities because their performance is measured in-part by research outputs. However, there are challenges to writing for publication, especially for new nursing and midwifery academics and research students. Therefore, four of the authors initiated semi-structured writing retreats to support nursing and midwifery academics and research students to overcome these challenges.MethodsA mixed methods exploratory sequential design consisting of two distinct phases and data collection methods. In phase one, an online evaluation was administered to collect participant experiences which were then analysed using content analysis. In phase two, data about the quantity and quality of publications arising from each retreat was collected, and descriptive statistics performed.ResultsA total of 70 participants responded to the online evaluation. Qualitative analysis of their responses demonstrated that the writing retreats were highly valued as they offered a collaborative environment with dedicated time to focus on writing for publication. Quantitative analysis identified 81 publications were planned over the six writing retreats. Of these, 60 have been published, 5 are under review, 5 have not yet been submitted, and 11 were abandoned.ConclusionsFindings demonstrated that our six semi-structured writing retreats enabled and developed nursing and midwifery academics and research students writing for publication. Semi-structured writing retreats are a research investment that enabled preparation of high-quality publications by offering protected time to write, expert peer review and collaboration and networking opportunities.

Scientific Research in Midwifery and Health Adolescent Reproduction

The research method applied is qualitative with a phenomenological approach. Thematic analysis technique was used to analyze the data obtained. The results showed that adolescents' knowledge about reproductive health is still limited and diverse. The majority of adolescents get information from peers and social media, while sources of information from family and school are still lacking. Factors that contribute to risky behavior include lack of comprehensive sexual education, peer pressure, and limited access to reproductive health services. The conclusion of this study highlights the importance of improving comprehensive reproductive health education at school and within the family. In addition, easier and more youth-friendly access to reproductive health services is needed. These effects are expected to reduce risky behaviors and improve overall adolescent reproductive health.

Assessing the success of a research leadership programme for senior nurses and midwives: A mixed methods programme evaluation.

In 2018 the National Institute of Health and Care Research, United Kingdom, launched a 3-year Senior Nurse and Midwife Research Leader Programme to support nurse and midwifery research leaders to develop research capacity and capability within NHS organisations. We report the results of a service evaluation of the programme strengths, areas for improvement and achievement of programme aims. Partially mixed, concurrent mixed methods programme evaluation, including: (a) meeting evaluation (survey), (b) annual evaluation (survey) and (c) qualitative stakeholder interviews. Survey results were quantitatively analysed using descriptive statistics. Interviews were audio-recorded, transcribed, deductively coded using elements within the logic model and analysed using the seven-stage framework analysis method. Satisfaction with the programme was high (75%). The main perceived benefit of the programme was being part of a network. Challenges included accessing learning resources, lack of opportunity to network and lack of clarity about the programme aims. Meetings were evaluated as relevant and helpful (mean 93%), thought-provoking (92%), inspiring (91%), at the appropriate level (91%) and aligned with the programme aims (90%). All meetings were ranked as highly beneficial by attendees (92%). Stakeholder feedback on the programme success reflected the importance of leadership, the programme design and content, 'connection and community' and communication with and about the cohort. Overall, the anticipated programme aims were met, evaluating well from both the perspective of those on the programme and the wider stakeholder group. There has been a lack of investment in schemes to support research leadership development for nurses/midwives. A novel programme to support nursing/midwifery research leadership was positively evaluated. The programme is a useful model to support future capacity and capability building for nurses/midwives. The work is reported with reference to the SQUIRE 2 and SRQR checklists. No patient or public contribution.

Methodological Triangulation in Midwifery Research

Midwifery researchers form an eclectic interdisciplinary group, and utilize a variety of research methods and data analysis approaches. Because of the interdisciplinary nature of midwifery research, there are many opportunities for using mixed-method research designs to enhance theory and knowledge development in this area of inquiry. The benefits of including both quantitative and qualitative research components in the same study are extensive, yet many researchers are uncertain about how to design and interpret mixed methods studies. This paper was written as an introduction to mixed methods study designs in midwifery research. Different approaches to methodological triangulation and its respective strengths are discussed as well as threats to validity in mixed-methods studies. Examples from midwifery research are used to illustrate core concepts.

Toward Equity in Access to Midwifery in Saskatchewan: Key Informants’ Perspectives

In this article, we report on the second phase of our exploratory research into issues related to equity in access to midwifery in Saskatchewan. This phase of the research project aimed to explore equity in access to midwifery as understood and experienced by key stakeholders involved in the early stages of midwifery implementation in Saskatchewan. A total of 19 interviews were conducted with participants from Saskatchewan Health, the Midwifery Transitional Council, and Saskatoon’s Regional Midwifery Operations Committee, as well as practitioners, primary health care managers, directors from select regional health authorities, and Saskatchewan midwives. Additionally, all available midwifery policy documents and relevant Primary Health Care and Health Human Resource documents complemented the qualitative analysis. Initial thematic analysis led to five policy recommendations: (1) develop a provincial definition of “priority population” for midwifery clients, (2) establish a midwifery health human resource plan, (3) identify provincial midwifery research priorities, (4) facilitate growth in interprofessional relationships, and (5) develop a provincial “road map” for implementation. A secondary analysis of participants’ responses revealed concern over the poor public education about midwifery services and lack of provincial government prioritization, as well as varied perceptions of the concept of “equity.” We conclude that although general commitments to equity in midwifery service and access are enshrined in Saskatchewan’s health care policies and midwifery regulations, insider perspectives suggest that significant yet modifiable barriers to equity in access to care currently exist. This article has been peer reviewed

Japanese midwifery preservice professionals’ journal reflections on practicum experiences working with mothers and infants

Abstract The purpose of the current study was to examine Japanese preservice professionals’ socialization experiences while working with mothers and infants during midwifery practicum experiences. This study utilized an interpretive case study research design (Merriam, Sharan B. 1998. Qualitative research and case study applications in education. San Francisco, CA: Jossey-Bass). Data were collected from reflective journals (Janesick, Valerie. 1999. A journal about journaling: Writing as a qualitative research technique history issues and reflections. Qualitative Inquiry 5(4). 505–524) and electric portfolios. Participants were ten female students enrolled in a midwifery certification program at one private university located in central Tokyo in Japan. A constant comparative analysis method was used to interpret the data, with four themes emerging from the data: (a) struggling to make decisions related to lesson procedures, (b) adjusting lesson content to meet mothers’ and infants’ unique needs, (c) paying less attention to partners’ roles and responsibilities, and (d) applying knowledge and skills to future midwifery settings. Results indicated that the preservice professionals struggled to prepare and plan lessons and activities in a timely manner, and had the challenge of modifying activities based on the infant’s unexpected and unpredictable behaviors. However, the preservice professionals believed that the practicum course was beneficial for their professional learning and development, and applicable to various educational and professional settings. In order to advance the quality of practicum experiences in the midwifery program, instructors, department chairs, and researchers need clear and focused goals related to the status, quality, and relevance of the midwifery program mission and curricula. Due to the paucity of research in this area, it is essential to further explore these issues in Japan.

Over twenty years of pedagogical research from Nurse Education in Practice: A bibliometric analysis from 2001 to 2023

AimTo present a bibliometric overview of pedagogical research from Nurse Education in Practice from its inception in 2001 up until 2023. BackgroundBibliometric methods are useful in analysing and understanding the characteristics of scientific publications in a particular field and the influence of specific journals. However, no bibliometric analysis of a nurse education journal has been undertaken to date which would highlight important research trends in this area of nursing and midwifery. MethodsA total of 2231 publications (articles and reviews only) from Nursing Education in Practice were retrieved from the Scopus database between 2001 and 2023. Several software applications including Microsoft Excel and VOSviewer were used to undertake bibliometric analysis on this dataset. Publication trends such as country analysis, author analysis, keywords analyses (cluster, content and trend analysis) were generated to help understand the volume and scope of pedagogical nursing and midwifery research in this journal. ResultsThere has been a steady increase in pedagogical research from Nurse Education in Practice since its launch in 2001 up until 2018, with a dip in publications in 2022 most likely due to the impact of restrictions during the coronavirus pandemic. The most prolific institutions publishing in the journal are mainly from the United Kingdom, Australia and the United States, with over eighty countries represented demonstrating its global reach and impact. Nursing students, nursing education, simulation and learning are some of the most frequent author keywords. ConclusionThe diversity of pedagogies in nursing and midwifery education, clinical learning and supervision in practice environments, and competence and confidence when transitioning to practice are the most popular research areas in Nurse Education in Practice. This study informs nurse and midwife educators and scholars about the volume and scope of pedagogical research in nursing and midwifery. It also makes recommendations on how to improve aspects of scholarship in education and areas for future pedagogical research.

Defining woman-centred care: A concept analysis

ProblemIn midwifery a shared definition of woman-centred care is lacking, and this remains an identified gap in the evidence underpinning midwifery practice. BackgroundWoman-centred care is an underpinning philosophy used in midwifery practice both nationally and internationally. AimTo analyse the practice of woman-centred care to clarify its meaning and comprehension and subsequently advance an evidence-based definition of the concept. MethodsUsing an adapted theoretical and colloquial evolutionary model a three-stage concept analysis was conducted to identify attributes, antecedents, and consequences of woman-centred care and subsequently construct an evidence-based, internationally informed definition. FindingsAntecedents of woman-centred care are education, models of care and midwife characteristics. Attributes are choice and control, empowerment, and relationships. Consequences are shared and informed decision making which supports the woman in navigating complex health systems, and improved health outcomes. Whilst important to midwifery practice and midwifery-led models of care, continuity of care is not a core essential element of woman-centred care. DiscussionAnalysis, synthesis, and re-examination of the data on woman-centred care facilitated deep immersion, exploration and clarification of this concept that underpins midwifery philosophy and practice. The constructed definition can be used to inform health policy, midwifery research, education, and clinical practice. ConclusionAn evidence-based definition of woman-centred care is necessary for conversion of this essential concept to practice. Regardless of model of care all women should receive woman-centre care improving the health outcomes of both the woman and neonate.

Bibliometric Analysis of Research Trends and Novelty of Midwifery Policy

Midwifery policy is important in regulating services, and its significance cannot be overstated. Despite the ongoing efforts in formulating policy, there remains a need for further analysis. This is because evidence-based research in midwifery serves as a foundation for enhancing the professionalism of the service practices. Bibliometric analysis of publications pertaining to midwifery policy is absent, leaving a gap in understanding trends and concepts. Therefore, this research aimed to determine trends in the number of publications, and visualisation of the relationship on the topic of midwifery policy through bibliometric analysis. The method used systematic reviews with the stages following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagram. Scientific publication data related to midwifery policy was retrieved through dimensions.ai from 2010 to 2022 and the data was analysed using VOSviewer. The results showed that first, there was an annual exponential growth in the number of publications and citations on the topic. Second, there were 224 items, 8 clusters, and 10047 links with a strength of 63352 on the topic of midwifery policy. Third, trends of research related to the topic were focused on hospitals, behaviour, and framework. Fourth, the research related to policy were topics with a low-density category, namely professional development, registration, and public health. Research results could identify trends and novelty in midwifery policy and recommend directions for further analysis.

Study Protocol on “A study to assess the effectiveness of an Evidence-Based Practice educational program on clinical nurses’ EBP & Critical Thinking Skill competencies” at HMC, Qatar-Pre-post Design.

Introduction: The relationship between EBP and Critical Thinking skills is desired in almost every discipline and plays a major role in decision-making and daily judgments. Promoting critical thinking through an evidence-based skills fair intervention (Gonzalez, H. C., et al,2020). The study aims to determine the effectiveness of an Evidence-Based Practice educational program that targets clinical nurses by assessing clinical nurses’ competencies in EBP & Critical Thinking. Research Methodology: A one-group pre-posttest design will be adopted to evaluate the effectiveness of the Evidence-Based Practice educational program. subjects will be selected by simple random sampling. A baseline pretest will be conducted using a demographic tool, the EBP Competencies Scale Gallagher-Ford & Melnyk- 2022, and the Nursing Critical Thinking in Practice Questionnaire. Educational intervention Results: Data analysis will be done using appropriate descriptive and inferential statistical methods. The anticipated outcome is to promote EBP & CT knowledge and practice among clinical nurses. Also, this study supports the development of educational programs and implements Evidence-based practice and critical thinking competencies at the Corporate Nursing and Midwifery Research Department level. Discussion: The primary outcome will be to enhance the increase of 10% (EBP) Evidence-Based Practice competencies among clinical nurses from pretest and post-test scores as assessed by the EBP Competencies Scale Gallagher-Ford & Melnyk (2022). The secondary outcome will be enhancing the increase by 10% (CT) Critical Thinking competencies among clinical nurses from the pretest and posttest mean scores as assessed by the Nursing Critical Thinking in Practice Questionnaire (2000).

Interview with Professor Edwin van Teijlingen

Edwin van Teijlingen is Dutch by birth and a Professor of Reproductive Health at Bournemouth University in the south of England. He has achieved a PhD in Medical Sociology at the University of Aberdeen, UK. Prof. Edwin van Teijlingen connected with Nepal while supervising Nepali PhD scholars in UK, and he has been a frequent visitor to Nepal since 2006. He has supervised more than 35 PhDs, among which 13 are Nepali. He has examined more than 50 PhDs. He has published around 300 academic papers and book chapters in health promotion, midwifery, and health services research. He serves as a peer reviewer for worldwide famous health journals such as PLOS One and BMC Pregnancy and Childbirth. He delivered a speech to the Members of Parliamentarians in Kathmandu in 2016 as part of a workshop to promote evidence-based policymaking. He is a committee member on various grant-awarding bodies in the UK, Belgium, the Netherlands, Norway, Switzerland, and the USA. He is a visiting Professor at the Centre for Disability Studies, Mahatma Gandhi University, Kerala in India (2020-present); the School of Health Sciences at the University of Nottingham in England (2017-2026); Nobel College, affiliated with Pokhara University, Nepal (2012-present); and Manmohan Memorial Institute of Health Sciences affiliated with Tribhuvan University (2009-present). We would like to express our gratitude for his acceptance to share personal and academic lives, which can inspire young and energetic scholars in Nepal and elsewhere.

Asuhan Kebidanan Komprehensif Pada Ny N Umur 22 Tahun Dengan Kekurangan Energi Kronik Di Puskesmas Bumiayu Tahun 2023

Background: KEK is one of the risk factors for pregnancy causes complications and maternal death. The global maternal mortality rate due to CED is 37%, maternal deaths in Central Java Province in 2020 were 530 cases. The maternal mortality rate in Brebes district is 62 cases. At the Bumiayu Health Center, the maternal mortality rate in 2020 was 2 cases. The aim is to be able to carry out Comprehensive Midwifery Care for Mrs N aged 22 years with Chronic Energy Deficiency at the Bumiayu Community Health Center using Varney's seven-step midwifery management and SOAP Research Method: this research is a qualitative descriptive research with a case study approach. The results: of Comprehensive Midwifery Care for Mrs N were that during pregnancy KEK was found. Delivery was normal and the newborn was found to be underweight. In neonates, boils were found on the legs and the baby's body temperature was high, then appropriate management was carried out so that the problem was resolved. During the postpartum period, the stitched wound was found to be still wet, then ointment was given to solve the problem. Mother uses birth control implant. Conclusion: care has been carried out in accordance with midwifery service standards.

The importance of reflexivity in data collection methods for qualitative midwifery research

Interviews remain a crucial component of data collection for qualitative studies. Semi-structured interviews, in which the researcher asks preset questions and follows up while the subject responds, can reveal a participant's experiences, beliefs and opinions. Unfortunately, as qualitative researchers, it can be challenging to collect data when a mother and infant require flexible hours, rather than defined. This paper aims to explore a midwife's reflections on the difficulties of collecting data in qualitative research with mothers of very young babies. It will also discuss some important considerations before conducting interviews among mothers with young babies. Timing considerations and internet connections must be prepared properly. Through early identification of alternate solutions for potential difficulties that may arise throughout the data collection process, such reflexivity can influence future planning of effective data gathering.

Phenomenography: A useful methodology for midwifery research.

To outline the theoretical, philosophical, and major assumptions associated with phenomenography and then address the application of a phenomenographical approach within the context of midwifery research. Phenemonography is a little-known qualitative research approach amongst the main design traditions of phenomenology, grounded theory, case study, and ethnography more typically used within midwifery research. Phenomenography aims to describe the qualitatively different ways that people perceive, conceptualize, or experience a phenomenon. Phenemonography has a distinctly different approach from other qualitative methods as it places emphasis on the 'collective' meaning over individual experience. Phenomenography, as an approach, rests within the interpretivist paradigm recognizing that there are multiple interpretations of reality. Phenomenography emphasizes the various ways that people experience the same phenomenon, including both the similarities and differences. The second-order perspective embraced by phenomenography suggests that the researcher directs themselves towards people's understanding of the world; essentially the world is described as it is understood rather than as it is. It is the reporting about how these different realities appear at a collective level that is the output of phenomenographic research. A framework for conducting phenomenographic research is illustrated by outlining the steps within the methodological approach required to undertake a research study using phenemonography. Phenomenography is a qualitative research approach that can usefully be applied in many midwifery contexts where a collective understanding of a phenomena is required. Using a phenomenographic approach can provide the midwifery profession with knowledge about variations in how women and midwives think, and how aspects of different phenomena are experienced in within a midwifery setting.

Increasing nursing and midwifery research leadership: impact evaluation of the National Institute for Health and Care Research Senior Nurse and Midwife Research Leader Programme at 1 year.

Although nurses and midwives make up the largest sector of the National Health Service (NHS) workforce, studies have identified a lack of knowledge, skills and confidence to engage and lead research. In 2018, the National Institute for Health and Care Research (NIHR) invested in the development of a 3-year Senior Nurse Midwife Research Leader (SNMRL) Programme aimed at developing nursing and midwifery research capacity and capability. This review was conducted at the end of year one as part of an ongoing impact evaluation of the programme. To evaluate the impact of activities undertaken by NIHR SNMRL at the end of year one of the programme. The content of anonymised end-of-year one activity, self-reported by SNMRL, was coded independently and deductively analysed by a project team using the modified Visible ImpaCT Of Research framework (VICTOR). Exemplar case studies were selected by the team to illustrate activity within domains. Working group members coded two reports independently then compared them in pairs to increase inter-rater reliability and the quality and consistency of coding. Reports from 63 of 66 SNMRL were submitted and included for analysis. Reporting reflected progress towards NIHR programme objectives. These included acting as a programme ambassador, creating a vibrant research culture, supporting staff recruitment and retention, enhancing organisational reputation and clinical academic outputs. Networking and collaboration locally, regionally and nationally were widely reported. The SNMRL cohort reported initiating multiple initiatives aimed at influencing organisational research culture, service provision and supporting nursing/midwifery engagement with research. Evaluation indicated progress to address barriers to research engagement within NHS Trusts.

Commentary: Increasing nursing and midwifery research leadership: impact evaluation of the National Institute for Health and Care Research Senior Nurse and Midwife Research Leader Programme at 1 year.

Commentary: Increasing nursing and midwifery research leadership: impact evaluation of the National Institute for Health and Care Research Senior Nurse and Midwife Research Leader Programme at 1 year.

Midwives on Tour – Reflections from a Trip to Norway

In modern midwifery research, we are very quick to say ‘in the developed world’, but have you ever considered that this includes a huge range of countries with differing cultures, languages, people and even midwives? This article reflects on the experience of two UK midwives who attended a postgraduate course at OsloMet University. The experience showed that the passion for midwifery as a vocation, an art, or even a calling, is transnational.

Nursing and midwifery research priorities for Kenya: Results from a national Delphi survey.

The International Council of Nurses and the World Health Organization have prioritized evidence-based nursing and midwifery practice derived from nurse-led research. However, in a low-resource country like Kenya, there is a need to identify research priorities to optimize utilization of limited existing research infrastructure and funding. Kenya lacks a nursing and midwifery research strategy to guide research prioritization. The goal of this study was to identify and describe nursing and midwifery research priorities for Kenya. A cross-sectional Delphi survey using two iterative rounds of electronic data collection was used to reach a consensus about priorities for nursing and midwifery research in Kenya. NVivo-12 was used to analyze the qualitative data to identify categories, sub-themes, and themes; descriptive statistics were used to analyze quantitative data. Participants included 159 nurse managers, administrators, and educators representing regional, county, and national referral, private, and faith-based hospitals, nurse training schools, research institutions, and nursing organizations in Kenya. Staffing challenges, motivation, remuneration, and funding for higher education were ranked as the top critically important issues using a cutoff point of≥70% agreement. There is a need for the development of a National Framework for Nursing and Midwifery Research Priorities in Kenya to guide research that builds excellence in meeting nursing and midwifery human resource concerns and ultimately improves patient care practices and outcomes. The objective of Kenya's health goals delineated within three key national health documents cannot be attained without adequate numbers of nursing and midwifery professionals and policies that address nursing and midwifery staffing challenges, remuneration for employment, and improved funding for higher education.

Investment in the peace of mind? How private services change the landscape of maternity care in Poland

For over two decades midwifery research advocated for the continuity of care and the ability to establish a relationship between care providers and care users as an important features of quality maternity services. In many countries, while unavailable through public services, continuity of care became commercialized and can be access as a private service. In Poland, private prenatal consultations and dedicated midwifery care allow women to access continuity and establish personal relationships with care providers. In this study, we explore, how accessing these private services, impact the rates of medical interventions and type of care women receive during labour and birth. We analyse data collected through an online questionnaire from 4402 first-time mothers in healthy pregnancy who had given birth in Poland between 2020 and 2021. We show that while private consultation did not translate into any significant differences in care, women who accessed private dedicated midwifery services experienced more attentive and less medicalized care, namely were more likely to give birth in vertical position, move freely during labour and less likely to experience emergency caesarean section. However, private dedicated midwifery care did not shield them from negative experience. While private care offers benefits for women who can afford it, it also contributes to inequalities in access to quality care and puts women with less social and financial resources in a vulnerable position. Efforts should be made to develop a more universal and equitable model of care that allows for building personal relationships between maternity care providers and women.