Search Results (132)

Background: Sexual assault victims involving penetration are at risk of contracting human immunodeficiency virus (HIV). Post-exposure prophylaxis (PEP) can effectively prevent HIV infection if initiated promptly within 72 h following exposure and adhered to for 28 days. Nonetheless, therapeutic adherence amongst sexual assault victims is low. Victim-centered care, provided by specially trained forensic nurses and midwives, may increase adherence. Methods: We conducted a retrospective case–control study to evaluate the impact of sexual assault center (SAC)—centered care on adherence to PEP compared to care received in the emergency department (ED). Data from January 2011 to February 2022 were reviewed. Multivariable logistic regression analysis was employed to determine the association between centralized specific care for sexual assault victims and completion of the 28-day PEP regimen. The secondary outcome assessed was provision of psychological support within 5 days following the assault. Results: We analyzed 856 patients of whom 403 (47.1%) received care at a specialized center for sexual assault victims. Attendance at the SAC, relative to the ED, was not associated with greater probability of PEP completion both in the unadjusted (52% vs. 50.6%; odds ratio [OR]: 1.06, 95% CI: 0.81 to 1.39; p = 0.666) and adjusted (OR: 0.81, 95%CI 0.58–1.11; p = 0.193) analysis. The care provided at the SAC was associated with improved early (42.7% vs. 21.5%; p < 0.001) and delayed (67.3% vs. 33.7%; p < 0.001) psychological support. Conclusions: SAC-centered care is not associated with an increase in PEP completion rates in sexual assault victims beyond the increase associated with improved access to early and delayed psychological support. Other measures to improve PEP completion rates should be developed. What is already known on this topic—Completion rates for HIV post-exposure prophylaxis (PEP) among victims of sexual assault are low. Specialized sexual assault centers, which provide comprehensive care and are distinct from emergency departments, have been suggested as a potential means of improving treatment adherence and completion rates. However, their actual impact on treatment completion remains unclear. What this study adds—This study found that HIV PEP completion rates in sexual assault victims were not significantly improved by centralized care in a specialized sexual assault center when compared to care initiated in the emergency department and continued within a sexually transmitted infection clinic. However, linkage to urgent psychological and psychiatric care was better in the specialized sexual assault center. How this study might affect research, practice or policy—Healthcare providers in sexual assault centers should be more aware of their critical role in promoting PEP adherence and improving completion rates. Policymakers should ensure that measures aimed at improving HIV PEP outcomes are implemented at all points of patient contact in these centers. Further research is needed to assess the cost-effectiveness of specialized sexual assault centers. Full article

Background/Objectives: Nursing staff face mentally and physically demanding work environments in the obstetrics and gynecology departments in hospitals. This study elucidated the working hours of midwives and nurses in these departments and the background factors influencing them. Methods: This study employed a quantitative, descriptive, and correlational cross-sectional design. A questionnaire-based survey targeting nursing personnel working in the obstetrics and gynecology departments in hospitals across Japan was conducted. The respondents’ attributes, working hours, number of night shifts, and other employment conditions were described. To identify the background factors of long working hours, multivariate logistic regression analysis was performed using working hours ≥50 h per week as dependent variables and respondents’ attributes and employment conditions as explanatory variables. Results: Questionnaires were sent to 1170 hospitals, and valid responses were obtained from 2043 nursing personnel in 474 hospitals. Working ≥50 and ≥60 h per week were observed in 15.5% and 3.6% of the respondents, respectively, and 54.2% reported working night shifts ≥5 times monthly. Background factors strongly correlated with working ≥50 h per week among nursing staff included being in their 40s, licensed practical nurses, or a head nurse; having 5–8 night shifts per month; and working in hospitals with a total bed count of 200–400, 400–600, or 600–800, as well as ≥10 full-time physicians, ≥10 or an unknown number of advanced practice midwives, and >400 inpatient midwifery delivery cases annually. Conclusions: Urgent interventions are needed to reduce the workload of nursing staff in the obstetrics and gynecology departments of Japanese hospitals. Full article

Objectives: To identify the factors influencing the job satisfaction of midwives working in birthing rooms with a medium to high level of obstetric intervention. Methods: A qualitative phenomenological–hermeneutic design based on Heideggerian philosophy was implemented. A study involving 25 participants, midwives, and resident nurses (RINs) was conducted. Residents were included to enrich the analysis with their critical perspectives with regard to interventional procedures and exposure to acts of obstetric violence. Convenience sampling was used. Data were collected from four focus groups in three hospitals in the region and one in-depth interview between 30 September 2022 and 23 June 2023. The testimonies were recorded and transcribed verbatim, and data analysis was carried out using an inductive–deductive approach. The triangulation of data and researchers was used to minimise potential bias. Results: The participants highlighted the following key dimensions or areas that contribute to midwives’ job satisfaction in the labour and birthing room: maternal satisfaction, professional competencies, multidisciplinary team, working conditions, and interventions during childbirth. Conclusions: These findings may inform healthcare management strategies to reduce burnout and improve working conditions in maternity care settings. Full article

Artificial intelligence, the simulation of human intelligence by computers and machines, has found its way into healthcare, helping surgeons, doctors, radiologists, and many more. However, over 80% of healthcare professionals consists of people working in allied health professions such as nurses, physiotherapists, and midwives. Considering the aging of the general population around the world, the workforce shortages in these occupations are especially crucial. As the COVID-19 pandemic demonstrated, globally, most healthcare systems are strained, and there is a consensus that current healthcare systems are not sustainable with the increasing challenges. AI is often viewed as one of the potential solutions for not only reducing the strain on the healthcare workforce, but also to sustain the current workforce. Still, most AI applications are being developed for the medical community and often allied health is overlooked or not even considered despite comprising a large proportion of the total workforce. In addition, the interest of the private sector to invest specifically in the allied health workforce is low since the financial incentive is low. This paper provides examples of AI solutions for seven important allied health professions. To increase the uptake of AI solutions in allied healthcare, AI companies need to connect more with professional associations and be as patient-oriented as many claim to be. There also needs to be more AI schooling for allied healthcare professionals to increase adoption of these AI solutions. Full article

Background: Nursing leadership is associated with a host of benefits for patient outcomes and health services. Pressures relating to the COVID-19 pandemic saw many relatively inexperienced nurses thrust into leadership roles, often with little notice. In response to this situation, The Tasmanian Health Service—Hospitals South created the Leadership Excellence in Practice Program (L-EPP) as a way of developing the leadership skills of its nurses and midwives. This study aimed to describe the development of the L-EPP and to evaluate it from the perspective of its participants and their peers. Methods: A longitudinal mixed-methods study was conducted using data from the first two offerings of the L-EPP. The L-EPP employs a blended learning model comprised of e-learning, work-integrated learning and face-to-face workshops. Surveys targeting the participants’ leadership abilities were completed at numerous time points by participants themselves, their peers, and their managers. Results: A total of 57 participants completed the program. Workshop surveys indicated that these sessions were generally well-received by participants. Significant improvements were observed in several domains of leadership, from the perspective of the participants themselves and their peers and managers. Conclusions: The program was well-received by its participants, and would serve as a useful template for other organisations seeking to build the leadership capacity of their nurses and midwives. This may be particularly useful to organisations seeking to upskill their existing staff and prevent further attrition of nurses and midwives in the wake of the pandemic. Full article

Background: Nursing and midwifery expertise exceeds the realms of clinical and biomedical knowledge. With the healthcare system transforming towards the Fourth Industrial Revolution (4IR), midwives are expected to broaden their knowledge and skills to provide quality care through the use of digital health technologies. However, there is a paucity of studies that look at the perceptions of midwives towards these digital health technologies. Objective: Hence, in this case, the authors sought to investigate the perceptions of the midwives towards the adoption of digitalized triage system in their maternity units, prior to designing and implementing the digitalized system. This was undertaken to avoid imposing a huge change upon the midwives which will consequently affect the widespread implementation of the proposed system. Methods: A sequential exploratory research design within a pragmatic paradigm underpinned this study to gain a comprehensive understanding of the midwives’ perceptions on the adoption of a digitalized triage system in the maternity units. The qualitative phase embraced purposive sampling to select participants, and data saturation was reached at 20th midwife. Meanwhile, the quantitative phase embraced a stratified sampling technique and the sample size was 155. The mixed methodological analysis was conducted using a case-comparison analytical strategy. Results: The study revealed that the midwives perceived that the adoption of a digitalized triage system would improve their skills and enhance positive health outcomes for the patients. However, they were concerned with implementation challenges such as the availability of resources and network connectivity. Conclusions: The findings suggested that midwives in this modern era are accepting of digital health interventions as they perceive them to be useful. However, the digital health intervention was also perceived to possibly be affected by external factors such as digital illiteracy, lack of resources and internet connectivity failures. Therefore, there is a need for the development of guidelines and a conceptual framework dedicated to facilitating the widespread implementation of digital triaging in maternity units in South Africa. Full article

This paper presents a newly developed online learning program currently designed to meet the learning objectives of nurses and midwives and rare and undiagnosed disease. Background/Objectives: This paper will also introduce the Global Nursing Network for Rare Disease and its role and commitment in supporting nurses and midwives in the identification of rare disease and the delivery of appropriate care and interventions to care for people living with rare and undiagnosed disease. Globally, nurses and midwives are often the first healthcare provider a patient will engage with. Combined with the estimated 300 million living with a rare disease across the globe, nurses and midwives are well positioned when assessing patients to have adequate awareness and suspicion to consider the presence and impact of rare disease. To enable this awareness and knowledge to ensure timely assessment and referrals, specific knowledge is required. There is a current paucity of learning programs about rare and undiagnosed disease specifically for nurses and midwives. Methods: The proposed learning program comprises seven modules designed to address the learning needs of novice to expert nurses and midwives from across the globe. Increased knowledge will in turn increase awareness and confidence to inform decision-making for patients presenting with undiagnosed signs and symptoms by ‘thinking rare’. Results: The proposed learning program comprises seven modules and a number of individual lessons which will be suitable for the needs of novice to expert nurses and midwives from across the globe. Full article

Background/Objectives: Measles is a vaccine-preventable disease with a high level of transmissibility. Outbreaks of measles continue globally, with gaps in healthcare and immunisation resulting in pockets of susceptible individuals. Measles outbreaks have been proposed as a “canary in the coal mine” of under-resourced health systems, uncovering broader system weaknesses. We aim to understand whether under-resourced health systems are associated with increased odds of large measles outbreaks in low- and middle-income countries (LMICs). Methods: We used an ecological study design to identify measles outbreaks that occurred in LMICs between 2010 and 2020. Health systems were represented using a set of health system indicators for the corresponding outbreak country, guided by the World Health Organization’s building blocks of health systems framework. These indicators were: the proportion of births delivered in a health facility, the number of nurses and midwives per 10,000 population, and domestic general government health expenditure per capita in USD. We analysed the associations using a predictive model and assessed the accuracy of this model. Results: The analysis included 78 outbreaks. We found an absence of any association between the included health system indicators and large measles outbreaks. When testing predictive accuracy, the model obtained a Brier score of 0.21, which indicates that the model is not informative in predicting large measles outbreaks. We found that missing data did not affect the results of the model. Conclusions: Large measles outbreaks were not able to be used to identify under-resourced health systems in LMICs. However, further research is required to understand whether this association may exist when taking other factors, including smaller outbreaks, into account. Full article

Background: The traditional presentation of results of cognitive test and surveys using simple percentages or average score obscures topics failed or mastered by test takers. However, the Rasch technique revolutionises the presentation of a test result by connecting respondent latent knowledge (or ability) with the test items using Wright maps. Aim: To assess nurses and midwives’ knowledge of managing primary postpartum haemorrhage using a Wright map Methods: A twelve-item dichotomous (YES/NO) computer-based test developed from the recently updated WHO’s treatment bundle was presented to the respondents for fifteen minutes. A nine-member panel reviewed the test to ensure clarity and relevance to Nigeria’s public maternity setting. All the respondents were nurses and midwives with previous experience of responding to primary postpartum haemorrhage. Ethical approval was provided by the University of Huddersfield and the nurses’ association. After eight weeks of data collection, both descriptive and inferential analyses were conducted using a Wright map. Results: The 180 responses analysed on a Wright map showed that the lowest, average and highest measures to be 476.3 logits, 495.9 logits and 521.7 logits respectively. Also, 178 (98%) respondents incorrectly answered the question on the source of treatment evidence but correctly answered that uterine atony is the main cause of postpartum haemorrhage. However, all the respondents who scored below average (495.6 logits) incorrectly answered the question on oxytocin as the best uterotonic. Conclusions: Wright map analysis confirms the problem of the inadequate knowledge of maternity staff as a major barrier to the effective treatment of maternal bleeding. A significant difference was found in the knowledge of the treatment among the three levels of maternity settings, implying the need for effective educational intervention strategies. Full article

Background: The Work Ability Index (WAI) measures how well employees’ abilities match their job demands. This study assessed the WAI among health workers and explored how age, gender, and job roles affected it. The research was conducted in a central Italian hospital, with a focus on health workers undergoing health surveillance between September 2020 and April 2021. Methods: Data were collected using validated questionnaires that assessed the WAI and risk factors for metabolic syndrome among participants. Demographic information, including age, gender, and occupation, was also obtained. The study involved 1847 health workers, with an average age of 43 years, predominantly women (67.6%). Occupational categories included administrative staff, nurses/healthcare workers (HCWs)/midwives, physicians, and healthcare technicians. Statistical analyses, such as t-tests, ANOVA, and chi-squared tests, were performed to explore the relationships between WAI scores and demographic/occupational variables. Results: The study suggested a relationship between WAI scores and gender, age, and occupation. Men workers exhibited higher mean WAI scores than women workers, while older workers (>55 years) had lower WAI scores compared with their younger counterparts. WAI scores varied by job role, with physicians scoring the highest. Conclusions: The findings suggested that demographic and occupational factors were associated with variations in work ability among health workers. These findings can help improve workforce management, occupational health, and research on aging workers. However, it is important to acknowledge the limitations of this study. Given its cross-sectional design, causal inferences cannot be established, and further longitudinal research is needed to confirm these findings and explore potential causal relationships. Full article

Introduction: Nurses and midwives caring for newborns with lethal defects experience significant emotional stress. Understanding coping strategies and the factors influencing stress is crucial for improving their well-being and ensuring high-quality care. Objectives: The aim of this study was to identify the coping strategies used by nurses and midwives in stressful situations and to analyse the relationship between stress levels and selected sociodemographic and professional factors. Methods: A cross-sectional study was conducted in the second quarter of 2023 among 307 nurses and midwives working in neonatal and obstetric wards in the Silesian metropolitan area, Poland. A diagnostic survey method was applied using a standardised questionnaire. The Perceived Stress Scale (PSS-10) and the MINI-COPE Inventory were used to assess stress levels and coping mechanisms. A stratified random sampling method was employed to ensure representation from various professional backgrounds. Data analysis was conducted using descriptive statistics, chi-square tests, Spearman’s correlation, and Cohen’s d coefficient, with statistical significance set at p < 0.05. Results: High stress levels were associated with shorter professional experience, frequent exposure to lethal defects, and emotional discomfort in interactions with grieving families. The most commonly used coping strategies were active coping (M = 2.06, SD = 0.635) and planning (M = 1.95, SD = 0.590), whereas self-blame (M = 1.20, SD = 0.714, p < 0.001) and denial (M = 0.88, SD = 0.751, p < 0.001) were linked to higher stress levels. Positive reinterpretation (r = −0.211, p < 0.001) and seeking emotional support (r = −0.129, p = 0.024) correlated with lower stress levels. Nurses and midwives with secondary education reported higher stress levels compared to those with higher education (χ²(10) = 30.651, p = 0.001). Work experience played a role, with moderate stress levels most frequently observed among those with 2–5 years of professional experience (χ²(14) = 24.023, p = 0.046). Emotional involvement, particularly supporting parents during their farewell to the child (69.1%), was identified as the most stressful aspect of their work. Conclusions: Promoting adaptive coping strategies, such as positive reinterpretation and emotional support, can help reduce stress and improve the well-being of nurses and midwives. Implementing psychological support programmes and stress management training is essential for maintaining high-quality neonatal care. Full article

Background/Objectives: This study examines the transformation of Turkey’s hospital sector from 2002 to 2022, focusing on physical capacity, service utilization, and workforce distribution in the public and private sectors. Methods: Longitudinal data from the Ministry of Health were analyzed using trend and breakpoint methods to evaluate hospital beds, qualified beds, intensive care beds, service volumes (outpatient visits, inpatient admissions, surgeries, and hospitalization days), and staffing (physicians, nurses, and midwives). Results: Findings reveal a marked shift in the balance between public and private providers. Due to public regulations effectively controlling resource allocation, the private sector’s share expanded to around one-fourth of the system. Private capacity in total beds rose from 7.53% to 21.00%, outpatient visits from 4.58% to 15.07%, and inpatient admissions from 10.10% to 30.63%. Breakpoint analyses indicate crucial turning points around 2005, 2008, and 2011, when policy changes restricted public capacity but facilitated private investment. Although the public sector’s share in total beds declined, its proportion of qualified and intensive care beds, as well as dialysis machines, increased, suggesting a strategic shift toward complex, high-quality services. Conclusions: Over the past 20 years, Turkey’s hospital sector exemplifies privatization without ownership transfer. Although delayed, private hospital expansion aligned with global neoliberal trends. Policy regulations played a key role in both promoting and limiting sector growth. A constant conflict exists between market-driven resource allocation and public health needs, which must be considered in restructuring efforts alongside private sector motivations. Full article

Introduction: Uterine transplantation is currently the only treatment that allows women with absolute uterine factor infertility (AUFI) to gestate and give birth. Objective: This systematic review aims to analyze the available evidence on uterine transplantation, focusing on the medical process, associated complications, ethical dilemmas, and the psychological and social impact on recipients. Methods: A systematic review of PubMed, Medline, MedNar, and Cinahl databases was conducted. The inclusion criteria included articles related to uterine transplantation published in English or Spanish between 2019 and 2024, excluding animal studies or other uterine procedures. Results: A total of 46 articles were analyzed. The review describes ethical considerations and recipients’ perceptions, two variables that have received limited attention in recent studies. Additionally, the transplant and gestation processes, along with associated complications, were detailed. Discussion: The limited availability of studies on ethical aspects and recipient perceptions presented challenges in the research. Moreover, the role of nurses and midwives, despite their importance in the process, is scarcely discussed in the literature. Conclusions: Although uterine transplantation remains an emerging treatment, its development suggests that the benefits may outweigh the risks, offering new hope for women with AUFI. Full article

Background/Objectives: Postpartum hemorrhage (PPH) is the most prevalent complication of childbirth and the most preventable cause of maternal mortality worldwide. Maternity nurses and midwives are often the first-line providers responding to PPH. As a result, maternity nurses have the potential to save the lives of women who are clinically deteriorating because of PPH. Simulation-based training is an effective way to develop maternity nurses’ knowledge, skills, and experience to save a woman’s life after PPH. Aim: to investigate the effect of simulation-based training on nurses’ knowledge and performance about primary postpartum hemorrhage management. Design: an experimental design (pre-test/post-test control group). Setting: the study was conducted in the labor and delivery room at KAUH in Jeddah, Saudi Arabia. Sample: A convenient sample of 54 nurses and midwives who were working in the labor and delivery room and the postnatal unit was randomly divided into two equal groups, the control group and study group. Tools: A structured tool was used for data collection and consisted of four parts: I—sociodemographic data, II—assessment of nurse’s/midwives’ knowledge about prevention and management of primary PPH, III—nurse’s/midwives’ performance observational checklist for primary PPH management, and IV—nurse’s/midwife’s satisfaction of the simulation-based training session. Results: The study group had a significantly higher knowledge level immediately after training (X² = 9.39, p = 0.002) and one month after training (X² = 5.51, p = 0.02). Regarding the performance level and total practice level immediately after the intervention, the study group had statistically significantly better practices (X² = 50.143, p = 0.000 *) and this continued one month later (X² = 50.143, p = 0.000 *). Conclusions: The nurses’ knowledge and performance skills related to primary postpartum hemorrhage care improved after receiving simulation-based training. We recommend that all the maternity nurses and midwives participate in an ongoing in-service simulation training program to enable nurses to demonstrate an active role in PPH prevention and management. Full article