Normal Life Event Research Articles

Facilitators and barriers of midwife-led model of care at public health institutions of dire Dawa city, Eastern Ethiopia, 2022: a qualitative study

BackgroundThe midwife-led model of care is woman-centered and based on the premise that pregnancy and childbirth are normal life events, and the midwife plays a fundamental role in coordinating care for women and linking with other health care professionals as required. Worldwide, this model of care has made a great contribution to the reduction of maternal and child mortality. For example, the global under-5 mortality rate fell from 42 deaths per 1,000 live births in 2015 to 39 in 2018. The neonatal mortality rate fell from 31 deaths per 1,000 live births in 2000 to 18 deaths per 1,000 in 2018. Even if this model of care has a pivotal role in the reduction of maternal and newborn mortality, in recent years it has faced many challenges.ObjectiveTo explore facilitators and barriers to a midwife-led model of care at a public health institution in Dire Dawa, Eastern Ethiopia, in 2021.Methodology: A qualitative approach was conducted at Dire Dawa public health institution from March 1–April 30, 2022. Data was collected using a semi-structured, in-depth interview tool guide, focused group discussions, and key informant interviews. A convenience sampling method was implemented to select study participants, and the data were analyzed thematically using computer-assisted qualitative data analysis software Atlas.ti7. The thematic analysis with an inductive approach goes through six steps: familiarization, coding, generating themes, reviewing themes, defining and naming themes, and writing up.ResultTwo major themes were driven from facilitators of the midwife-led model of care (professional pride and good team spirit), and seven major themes were driven from barriers to the midwife-led model of care (lack of professional development, shortage of resources, unfair risk or hazard payment, limited organizational power of midwives, feeling of demoralization absence of recognition from superiors, lack of work-related security).ConclusionThe midwifery-led model of care is facing considerable challenges, both pertaining to the management of the healthcare service locally and nationally. A multidisciplinary and collaborative effort is needed to solve those challenges.

Driving Forces of Impunity in South Asia: A Human Rights Framework

This paper is the outcome of a research on impunity in South Asia. Undertaken by Forum Asia in 2021, the research collected cases from Afghanistan, Bangladesh, India, Maldives, Nepal, Pakistan and Sri Lanka. The cases related to impunity were collected by the country researchers deputed in these countries. The lead author and co-author of this paper were the main contributors in compiling the country reports, processing the data, editing them and publishing them as country reports and South Asia regional report. Out of the huge compilation, this paper mainly sketches the debates over the constructs on impunity prevailing in these countries. The paper highlights how these countries are combating impunity with respect to the drivers and to what extent this effort is compatible in the realm of global human rights framework. Impunity is found deeply rooted in South Asia both in the cognitive, productive, economic, and political lives of the victims as well as on the psychosocial mindset of society. Individual victims of gross violations of human rights have been denied access to justice at large. This develops post-traumatic stress disorder (PTSD) along with loss of memory, nightmares, excessive fear, loss of attention, loss of self-esteem, self-isolation, distrust, withdrawal from normal life events as well as a refusal to participate in civil, cultural and social interactions. The paper concludes that most South Asian states follow democratic norms and values as they hold periodic elections and form governments. These states, however, severely lack concrete plans and tools to combat impunity. The paper suggests the vibrant role of the legislation penal codes in these countries to make accountable to the stakeholders involved in impunity matters both as perpetrators and those acting against the perpetrators.

The Relationship between Knowledge Level and Mother’s Readiness for Menopause

Introduction: Menopause is the permanent cessation of menstruation. Menopause is a normal life event, not a disease. This period is characterised by the cessation of menstruation as estrogen is not produced. This condition is a very ageing process in every woman. Women experiencing menopause need support from close people such as husbands, friends, and family. The readiness of mothers in facing menopause is influenced by several factors, such as education level, knowledge about menopause, socioeconomic factors that affect the body and health. Objective: To determine the relationship between knowledge and mothers' readiness to face menopause at Posyandu Sukasari Dahlia 2, Ciamis District. Method: This research is a study that uses quantitative methods, which wants to prove whether or not there is a relationship between the level of knowledge and the readiness of mothers in facing menopause at Posyandu Sukasari Dahlia 2, Ciamis District. The research was conducted in July 2023. This study included quantitative research using a cross-sectional analytic design. The population in this study were all mothers in Posyandu Sukasari Dahlia 2 Ciamis District. The population in this study amounted to 45 respondents, with total sampling technique. Result: The results showed that 40 respondents (88.9%) had sufficient knowledge, and the readiness of mothers to face menopause was 37 people (82.2%). Conclusion: Based on the research conducted, it can be concluded; the level of knowledge in the category is sufficient with a total of 40 respondents. Mother's readiness in facing menopause is categorised as ready, namely 37 respondents. There is no relationship between mother’s readiness in facing menopause at Posyandu Sukasari Dahlia 2 Ciamis District with a p value = 0.083 (p <0.05).

Delivery site preferences and associated factors among married women of Panauti Municipality, Kavrepalanchok district, Nepal

Introduction: Maternal mortality is a top global developmental agenda. The main cause of being underutilization of available delivery services especially in a developing country like Nepal. Various socio-demographic, socio-cultural and health service-related factors affect the utilization of these services. Thus, the study aims to identify the delivery site preferences and its associated factors among the married women of Panauti municipality of Kavrepalanchok district.
 Method: A cross-sectional study was conducted among the married women between the ages of 15-49 y residing in Panauti municipality. The face-to-face interviews were conducted using semi-structured questionnaires. The statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 21.
 Result: A total of 106 women of 15-49 y were included in the study. The proportion of institutional delivery among the participants was 68%. 90.6% of total participants would prefer health facility for their future deliveries; 7.5% were not sure about their preferences and very few (1.9%) preferred to deliver at home. The factors like knowledge regarding safe-motherhood program and age at marriage were found to be significantly associated with their delivery site preference (p<0.05).
 Conclusion: In a country like Nepal, home delivery is still in practice and pregnancy and childbirth are regarded as normal life events. Thus, efforts should be made to change that perception, increasing utilization of available services and improving maternal and child health. This in turn will help to achieve the Sustainable Development Goal target in reducing the Maternal Mortality Rate.

What will you do with all that time? Changes in leisure activities after retirement are determined by age-related self-views and preparation

Retirement is a normative life transition that liberates the individual from the external obligations of employment, being a catalyzer of leisure activity engagement. However, the individual's motivations to engage in leisure activities in the time that is gained after retirement may depend on their future self-views (i.e., views of their own ageing) as well as on their levels of preparation for age-related changes. In this study, therefore, we aim to examine longitudinal changes in levels of engagement in leisure activities that occur around the age of retirement as being influenced by views on ageing and preparation for old age. The sample consisted of 451 persons aged 50–65 years at baseline who participated in the Ageing as Future study at two time points 5 years apart. Participants were split in three age-matched groups: recently retired (in between baseline and follow-up), already retired (at baseline), and individuals who were still working (at follow-up). Findings indicated that changes in levels of leisure differed between groups. Compared to both already retired and still working participants, recently retired participants increased their levels of engagement in leisure activities. Positive views on ageing in the leisure domain (at baseline) predicted subsequent increases in activity levels but group and levels of preparation qualified this effect. A combination of positive views on ageing and preparation for age-related changes is needed for one to make use of the time that is gained with retirement, highlighting their role as determinants of behavior in response to normative life events in later life.

Prevalence and Correlates of Embitterment in a National Representative Sample

Introduction: Embitterment may occur after stressful but normal life events, such as job loss, divorce, or unjust events. Embitterment is a normal affect, but it may become clinically relevant in case it becomes very strong and long-lasting, and impairs daily functioning. Objective: Until now, no epidemiological data on the frequency of high embitterment in the general population have been available. Methods: A national representative survey of 2,531 people was carried out in Germany in 2019. The participants gave ratings for their embitterment due to perceived events (Posttraumatic Embitterment Scale), their psychological capacity profile (Mini-ICF-APP-S), sick leave duration, and sociodemographics. Results: About 11.7% of the investigated representative population report moderate embitterment, and another 3.8% high embitterment. Embitterment was only low correlated with other psychopathology, here work anxiety (r = 0.281**). There are no differences between embittered and nonembittered in respect to age, sex, household members, and professional distribution. Those with the highest embitterment have been unemployed more often and have lower income. At least 7.2% of those with high embitterment have a severe psychological capacity impairment and are in need of support by thirds to fulfill daily duties. In 55% of the 802 who reported a stressful event, injustice by an important person has been reported. Injustice by an institution (14%) or societal injustice (12%) was least often reported as a relevant stressful event. Conclusion: Physicians, therapists, and public health must be aware of embitterment as a specific mental health problem which occurs frequently and may become chronic with work and life participation problems.

To Assess the Effectiveness of Planned Teaching on Knowledge Regarding Mid-Wife Led Continuity of Care Model (MLCC) on Final Year Nursing Students

Background: In many parts of the world, midwives are the primary providers of care for childbearing women. There are considerable variations in the organisation of midwifery services and in the education and role of midwives. Childbearing women are often faced with different opinions as to which option might be best for them. The midwife‐led continuity model of care is based on the premise that pregnancy and birth are normal life events. Pregnancy and birth are significant life events for women and their families and midwife supports a woman throughout pregnancy, birth, and the postnatal period. So, the demand for services that are family friendly, women focused, safe and accessible is increasing.
 Objectives: 1) To assess the existing knowledge regarding mid-wife led continuity of care model on final year nursing students. 2) To evaluate the effectiveness of planned teaching on knowledge regarding mid-wife led continuity of care model (MLCC) on final year nursing students. 3) To find out the association between knowledge regarding mid-wife led continuity of care model (MLCC) with selected demographic variables.
 Materials and Methods: In this study, evaluatory research approach and one group pre-test post-test research design was used. The study was conducted at a Selected Nursing College. The sample was collected from final year nursing students (120) by using non-probability convenient sampling technique.
 Results: In this study the study of the findings shows that 10.83% had good level of knowledge score in pre-test. While in post-test, out of 120 subjects the majority of the subjects and 92.50% had good level of knowledge score. This statistically shows that there is profound level of improvement on knowledge.
 Conclusion: Hence, this implies that the planned teaching was effective. Also, the study shows that the knowledge scores of final year nursing students is associated with the age in year and course of study. Hence, this means that greater the number of age in years and the course, greater level of knowledge scores. However, gender was not found to be associated.

Awareness, Perceptions, and Desirability of Epidural Analgesia Among Pregnant Women in King Fahad University Hospital, Al Khobar.

Background: Childbirth is a normal life event that is considered to have the most severe pain faced by women in their lifetime. However, this pain can be managed in many ways such as using epidural analgesia (EDA). Objective: This study focuses on assessing the awareness, perceptions, and desirability of EDA among pregnant women at King Fahad University Hospital (KFUH), Al Khobar.Methods: A cross-sectional study was conducted at KFUH in Al Khobar, Eastern Province of Saudi Arabia. The study took place from November to December 2020 by using a pre-designed questionnaire developed by the researchers based on a thorough literature review of prior studies. A total of 209 pregnant females participated in the study. The study included all pregnant women attending antenatal clinics and the emergency room at KFUH and we excluded postpartum women from the study.Results: A total of 209 pregnant women participated in this two-month study and completed the questionnaire. The majority of women were between the age of 30-35 years old (33%), while a few (16%) were less than 24 years. The patient’s perception was found to be significantly influenced by age and household income. On the other hand, awareness of EDA complications and desirability was seen to be associated with income.Conclusion: Study results demonstrate that the majority of pregnant women were aware, as well as had a positive perception and desirability toward using EDA for labor pain. On the other hand, pregnant women who had a lack of awareness and perception toward EDA may suffer more from labor pain, which will negatively affect their birth experience and may make it less enjoyable. Therefore, education about different types of analgesia, especially EDA, should be included in an antenatal care program.

Widowed Young: The Role of Stressors and Protective Factors for Resilience in Coping with Spousal Loss.

While distressing, late life spousal loss is considered a normative life event and most demonstrate resilient recovery from grief. However, for 5-7% of the population spousal loss comes early, before the age of 50, and little is known about the factors that influence adjustment in this population. We used the DPM integrative framework to examine correlates and predictors of mental wellbeing and grief intensity in an international sample of 603 young widows and widowers. Contrary to existing bereavement research, loss-orientated stressors (e.g., expectedness and cause of death) did not predict bereavement outcomes. Employment and financial wellbeing were the only statistically significant restoration-orientated stressors associated with coping, mental wellbeing and grief intensity. We found no significant associations between parental status and coping or bereavement outcomes. Loss-orientated coping, followed by inter and intrapersonal protective factors for resilience and financial wellbeing were the greatest predictors of grief intensity. Loss-orientated coping was highest in early bereavement, the greatest predictor of grief intensity and associated with being unemployed, financial insecurity and decreased protective factors for resilience. Restoration-orientated coping was highest in later bereavement, was a weak predictor of grief intensity and associated with being employed, increased financial wellbeing and protective factors for resilience. Overall, we found the young-widowed population is at heightened risk of poor adjustment. Almost two-thirds reported decreased functioning, probable depression with high rates of psychological distress. Nearly half met diagnostic criteria for prolonged grief disorder. We discuss implications for research and clinical practice.

Level of Stress and Coping Strategies used during third trimester of pregnancy among Primi Antenatal mothers

Pregnancy is the privilege of experiencing God’s miracles on the earth. Childbirth is a new experience to the primigravida women. It is a time when a woman’s power and strength emerge full force, but it is also a vulnerable time and a time of many changes presenting opportunities for personal growth. Pregnancy and childbirth is a normal life event, yet women are exposed to significant amount of stress. It’s just as important to look after your mental health and wellbeing during pregnancy as your physical health. If you are mentally healthy, you will be in the best position to manage the challenges of pregnancy and life with a new baby. Aim of study: To assess the level of stress and coping strategies during third trimester of pregnancy among primi antenatal mothers with a view to recommend stress relieving strategies to be under taken during the antenatal period. Methodology: A quantitative approach non-experimental prospective correlational research design was chosen for the study. The study was conducted in selected hospital in Kottakkal, Kerala, India. The sample size of 30 primi antenatal mothers admitted in gynaec wards by non-probability purposive sampling technique. After taking the consent, data were collected using socio-demographic performa, structured stress scale, structured coping strategy scale. Data were analyzed and interpreted by descriptive and inferential statistics. Results and Conclusion: The analysis revealed that 70% of primi antenatal mothers experience mild stress and 30% experience moderate stress, 80% of the primi antenatal mothers have good coping strategy and remaining 20% have excellent coping strategy. There is a significant association exists between the level of stress of primi antenatal mothers during their third trimester of pregnancy with selected socio demographic variable gestational diabetes and there is a significant correlation exists between the level of stress and coping strategies among primi antenatal mothers during their third trimester of pregnancy (p value<0.05).

Longitudinal study of individual, environmental and contextual factors predicting adaptation to the transition to lower secondary education

Transitions into higher educational levels are normative life events that challenge students' academic and socio-emotional development. This longitudinal study aims to examine outcomes of and determinants of students' adaptation to the transition from classroom (4th grade) to subject teaching (5th grade). The outcomes of adaptation were assessed by changes in students' GPA and learning self-efficacy from 4th to 5th grade as well as by the self-perceived adaptation. In addition, a number of individual, environmental and contextual determinants of the three adaptation outcomes were examined. Participants were 860 students aged 10–11 years from Zagreb, Croatia. They participated in data collection at the end of 4th grade, at the mid-term of 5th grade and at the end of 5th grade. The results showed that students' GPA and learning self-efficacy declined following transition, although they generally perceived their academic adaptation as successful. Several individual, environmental and contextual variables explained academic adaptation to transition operationalized as self-perceived adaptation, learning self-efficacy and GPA in 5th grade. The stage-environment fit model of educational transition was supported even when transition takes place within the same school building and class.

Protein Fibrils Formed by Rationally Designed α-Helical Peptides.

Fibrillar structures of proteins play essential roles in normal life events as well as diseases. It is of great importance to understand the principles by which proteins organize into fibrils. Here, we report a rationally designed α-helical peptide that can aggregate into fibrils. Mutation studies indicate that the helicity of the peptide is crucial for fibril formation. Multiscale molecular dynamics simulations demonstrated that the peptide may assemble in a quasiregular pattern, which is different from both the coiled coil and cross-α structures reported before. Our study provides a new helical peptide design that produces a fibrillar structure and contributes to the understanding of fibrillar structures formed by α-helices.

Individual life events and blood giving

PurposeImbedded in the life course paradigm, the purpose of this paper is to investigate which individual life events impact blood donations and to study their underlying mechanisms.Design/methodology/approachBy applying logistic regression, moderation and mediation analysis, this paper uses a large sample ofN= 5,640 individuals.FindingsExperiencing normative life events and stressful life events reduce the likelihood of donating blood, whereas human capital life events enhance the likelihood of donating blood. Specifically, having a child and death of a mother decrease and finishing education increases the probability of blood donations. Locus of control and satisfaction with income are significant underlying mechanisms.Practical implicationsSocial marketing campaigns can use individual life events to focus on similarities between potential blood donors and individuals in need of blood. Blood centers can adopt their services to cater to the changing needs after experiencing individual life events by running mobile blood collecting drives and providing guidance.Social implicationsBlood centers take an important role in sustaining a healthy society. As the need for blood will increase in the future, a better understanding of blood donation behavior and social marketing contributes to increased donations.Originality/valueWhile previous research looked at collective life events, there is a dearth in marketing and blood literature on the effects of individual life events.

Provision and uptake of routine antenatal services: a qualitative evidence synthesis.

Provision and uptake of routine antenatal services: a qualitative evidence synthesis.

Survey demonstrates suboptimal menopause care in UK despite NICE guidelines

The menopause is a normal life event for women, not an illness or medical condition. However, it can negatively impact a woman's wellbeing and quality of life. By 2025, over one billion women will be menopausal.

Effectiveness of transdermal oestradiol and natural micronised progesterone for menopausal symptoms.

This article discusses the role of hormone replacement therapy (HRT) in the management of menopausal symptoms, and specifically considers the advantages of different types and preparations of HRT, based on the current medical evidence. The menopause is a normal life event for women, not an illness or a medical condition. However, the effects of the menopause often have a negative impact on women’s wellbeing and quality of life. Furthermore, the low oestrogen levels and other biological changes that occur in these women are also associated with an increased risk of cardiovascular disease, osteoporosis, diabetes, and dementia. In addition to hot flushes and sweats, symptoms include mood changes, memory loss, urogenital atrophy, reduced libido, sleep disturbances, joint pains, and muscle stiffness.1 These symptoms can be non-existent, or can last for a few years or even decades. Much of the negative publicity surrounding HRT stems from misinterpretation by the media of the findings from the Women’s Health Initiative (WHI) study,2 published more than a decade ago. Many women and healthcare professionals are still unnecessarily concerned about the perceived risks of HRT, resulting in a significant proportion of women currently being refused HRT and often being inappropriately offered antidepressants. There is clear evidence to support that, …

Applying Theory: How Salutogenesis Can Support a Woman-Centred Approach to Midwifery Research

Salutogenesis offers a theory to guide midwifery research that is congruent with the midwifery ethos of supporting normality and health. In contrast to the traditional medical model, midwifery research requires an underpinning theory that supports the concept of pregnancy and birth as a normal life event. This article follows the application of salutogenesis through the research pathway, and uses the research topic of kangaroo mother care (KMC) to illustrate the use of salutogenesis in research. By applying Antonovsky’s theory of salutogenesis, midwives can design and carry out research that is woman-centred, and promotes health and wellbeing.

Barriers and facilitators to institutional delivery in rural areas of Chitwan district, Nepal: a qualitative study

BackgroundGiving birth assisted by skilled care in a health facility plays a vital role in preventing maternal deaths. In Nepal, delivery services are free and a cash incentive is provided to women giving birth at a health facility. Nevertheless, about half of women still deliver at home. This study explores socio-cultural and health service-related barriers to and facilitators of institutional delivery.MethodsSix village development committees in hill and plain areas were selected in Chitwan district. We conducted a total of 10 focus group discussions and 12 in-depth-interviews with relevant stakeholder groups, including mothers, husbands, mothers-in-law, traditional birth attendants, female community health volunteers, health service providers and district health managers. Data were analyzed inductively using thematic analysis.ResultsThree main themes played a role in deciding the place of delivery, i.e. socio-cultural norms and values; access to birthing facilities; and perceptions regarding the quality of health services. Factors encouraging an institutional delivery included complications during labour, supportive husbands and mothers-in-law, the availability of an ambulance, having birthing centres nearby, locally sufficient financial incentives and/or material incentives, the 24-h availability of midwives and friendly health service providers. Socio-cultural barriers to institutional deliveries were deeply held beliefs about childbirth being a normal life event, the wish to be cared for by family members, greater freedom of movement at home, a warm environment, the possibility to obtain appropriate “hot” foods, and shyness of young women and their position in the family hierarchy. Accessibility and quality of health services also presented barriers, including lack of road and transportation, insufficient financial incentives, poor infrastructure and equipment at birthing centres and the young age and perceived incompetence of midwives.ConclusionDespite much progress in recent years, this study revealed some important barriers to the utilization of health services. It suggests that a combination of upgrading birthing centres and strengthening the competencies of health personnel while embracing and addressing deeply rooted family values and traditions can improve existing programmes and further increase institutional delivery rates.

Managing common problems in the menopause

The menopause is a normal life event for women and not an illness or medical condition. Despite this, menopause can predispose vulnerable women to distressing symptoms that impact adversely on their quality of life and to long term medical conditions such as osteoporosis, cardiovascular disease and dementia. Many healthcare professionals are uncertain about the management of the menopause, and this leads to many women not receiving treatment which is often beneficial to them. This article will cover the diagnosis of the menopause including premature ovarian insufficiency. Some of the health risks of the menopause will be discussed and treatment of the menopause, with a particular focus on hormone replacement therapy, will be covered in detail.

Crianças em acolhimento residencial: Conteúdo temático das suas narrativas de vida

A narrativa é a forma privilegiada pelo ser humano para organizar a sua vida (Bruner, 2002), dando sentido a uma experiência que de outra forma seria caótica (Gonçalves, Korman & Angus, 2000). Entre o final da infância e início da adolescência surge a importância de construir sentido para a sua história de vida de forma a construir coerência pessoal (Pasupathi, Mansour & Brubaker, 2007). As crianças a viver em acolhimento residencial veem nesta tarefa o desafio adicional de construírem sentido em percursos de adversidade precoce, pautados por traumas e ruturas. Assim afigura-se pertinente estudar a forma como estas organizam as suas narrativas, nomeadamente os temas que incluem. A amostra foi constituída por 16 participantes com idades compreendidas entre os 7 e os 12 anos de idade (M=9.19; DP=1.68), em situação de acolhimento residencial. Foi realizada a Entrevista de Narrativa de Vida com Crianças (Henriques, Ribeiro & Saraiva, 2009), para a recolha das histórias. A análise temática das narrativas de vida permitiu identificar 27 temas, que se destacaram pela frequência com que surgiram no discurso das crianças. As narrativas apresentam uma multiplicidade temática, incluindo acontecimentos de vida normativos e, também, acontecimentos relacionados com a especificidade do seu percurso, remetendo para competência narrativa globalmente funcional. O conteúdo temático diversificado das narrativas salienta, ainda, a importância de se criarem espaços de conversação com as crianças em acolhimento residencial sem limitação de temas.