搜索结果：midwifery

Objective structured clinical examinations (OSCEs) are a common assessment tool used to evaluate the application of clinical knowledge, clinical reasoning, competency-based performance, and professional behavior in health care education. Their development and facilitation are often included under the broader umbrella of simulation pedagogies. Despite their widespread adoption and the availability of guidelines, variability exists in approaches specific to OSCE development, implementation, and evaluation. The purpose of this scoping review is to explore and describe the variability and similarities in OSCE development, implementation, and evaluation in nursing, midwifery, and medical education in the context of existing guidelines to inform future directive work in this area. This review will follow the JBI methodology for scoping reviews, with searches conducted by a librarian familiar with the scoping review process. Records retrieved will be reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Two reviewers will independently assess the records for inclusion against the defined criteria and extract data using an adapted JBI extraction form. The data will be charted using narrative summary text, tables, and figures. As of July 2026, a search for existing reviews in the PubMed, PROSPERO, Cochrane Database of Systematic Reviews, and JBI Evidence Synthesis databases has been conducted, yielding no current or in-progress reviews on our specific topic. An initial search feasibility assessment has been conducted to ensure sufficient articles for a robust review. Data collection, extraction, and analysis will be conducted over the 12 months following the literature search. The completed scoping review is anticipated to be submitted for publication in summer 2027. This review will provide a comprehensive overview of how OSCEs are operationalized across nursing, midwifery, and medical programs. It will highlight emerging themes, key differences between guidelines and practice, and underresearched areas, informing future research and educational practice.

To evaluate how the documentation process was impacted by the implementation of the PACE Framework and its influence on the development of person-centred practice. A research evaluation was conducted using a two-phase sequential approach, underpinned by the Person-centred Nursing Framework. The study was conducted in two phases. Phase one generated mainly quantitative data using the person-centred nursing KPIs. Phase two generated qualitative data using one-to-one interviews. The study was conducted in a region within the United Kingdom and involved a range of clinical practice settings within acute care, across five healthcare organisations. The study findings indicate that PACE provides a vehicle for registered nurses to engage in effective person-centred processes. The PACE documentation was also viewed as a means of promoting a holistic approach, shifting the attention of registered nurses from a primary focus on clinical care and associated tasks towards an appreciation of understanding other perspectives of the patient as a person. Additionally, within the PACE initiative, education sessions, follow-up support and resource materials, delivered by local facilitators, all contributed towards involving registered nurses in the process and reducing perceived barriers to implementation. This study's findings confirm that the implementation of PACE has had a positive impact on the development of person-centred practice and on the experience of care for patients, their significant others and for registered nursing staff. The findings also reflected the complex blending of the art and science of nursing, placing nurses in an ideal position to deliver person-centred care. This research evaluation provides evidence that effective person-centred care planning has an impact on the quality of nursing care provided to patients. This study adhered to the GRAMMS guidelines, which are relevant to the reporting of mixed method studies. The Research Team sought valued contributions from a Service User and Carer Group based in the School of Nursing and Midwifery Queen's University Belfast at various stages.

Postpartum depression (PPD) and impaired bonding are critical biopsychosocial challenges affecting maternal&#x2011;neonatal health and infant development. This study evaluated the effectiveness of a Watson's Theory of Human Caring (WTHC)-based psychoeducational intervention on PPD symptoms and mother-infant bonding. This randomized controlled trial was conducted between July 2025 and January 2026 with 99 women (intervention: 49, control: 50). Data were collected using the Edinburgh Postnatal Depression Scale (EPDS), Prenatal Attachment Inventory (PAI), and Mother-Infant Bonding Scale (MIBS). Statistical analyses included t-tests, chi-square, and logistic/linear regression. Post-intervention, the risk of PPD in the intervention group was significantly lower than in the control group (p&#xa0;=&#xa0;.015). Risk analysis demonstrated that mothers in the control group were 3.14 times more likely to develop PPD compared to the intervention group (OR&#xa0;=&#xa0;3.141; 95% CI: 1.216-8.111). EPDS and bonding difficulty MIBS scores were significantly lower in the intervention group than in the control group (p&#xa0;<&#xa0;.01). Regression analysis revealed that bonding levels accounted for 27.9% of the variance in PPD in the intervention group (R2&#xa0;=&#xa0;0.279, p&#xa0;<&#xa0;.001). Furthermore, as bonding difficulty decreased, depressive symptoms significantly decreased (Beta&#xa0;=&#xa0;0.542; p&#xa0;<&#xa0;.001). WTHC-based psychoeducation effectively reduces PPD risk and strengthens the maternal-infant bond. Addressing the biopsychosocial needs of the dyad creates a healthier primary environment, which is vital for infant mental health. Nurses and midwives providing maternal-child health care should integrate WTHC-based psychoeducational assessments into routine infant follow-ups. Strengthening the biopsychosocial bond is a vital nursing and midwifery role in promoting long-term infant development and holistic family well-being.

A growing body of literature suggests that patient-provider communication in perinatal care is a key factor in addressing inequities in pregnancy outcomes. The purpose of this study was to explore how a sample of midwives who provide perinatal care perceive their communication practices about racism-related risks with Black women who are pregnant during clinical encounters. Fourteen midwives from a national mixed-methods study completed semistructured interviews about communication practices regarding pregnancy risks during prenatal care. Interviews were analyzed using thematic analysis. Three themes developed. Evolving Communication describes the multitude of ways participants engaged in patient-centered communication over time, tailored to the needs of individual patients and circumstances. Tension describes the internal conflict midwives experience when they want to address racism in conversations but fear causing offense, harm, or misunderstanding. Room for Growth was defined as the lack of formal training and the desire to learn more about incorporating discussions about structural racism into communication with Black women when discussing risks or complications during pregnancy. Midwives in this study deployed adaptive communication strategies while experiencing tension between wanting to convey accurate information effectively and being considerate of how their communication might be received. Education and training in best practices for communicating with patients who are diverse may help reduce clinicians' reticence to raise potentially charged topics and support open, frank dialogue. Midwives have a clear commitment to ensuring Black patients are seen, heard, and receive excellent care, and there is a need for midwifery education to include training on communicating about how structural racism and contextual factors drive health care.

Sudden cardiac arrest (SCA) remains a significant cause of in-hospital mortality and morbidity in Ghana, with increasing incidence in the Central Region of Ghana. Although nurses are continuously present at patients' bedsides, their ability to recognize and manage cardiac arrest using basic life support (BLS) is under scrutiny. The study evaluated the impact of a structured BLS training programme on nurses' knowledge and practical application of BLS. A one-group pretest-posttest quasi-experimental design was used. Using a simple random sampling technique (lottery method), 101 nurses were selected. A seven-point Likert scale questionnaire adapted from the American Heart Association (AHA) 2020 guidelines was used to assess BLS knowledge, while practical skills were evaluated using the BLS task checklist from the Nursing and Midwifery Council of Ghana. Data were analyzed using Wilcoxon signed-rank test and linear regression. Significant post-training increases were observed in BLS knowledge (W = 4753, p < .001; 95% CI: 1.25 to 1.59) and BLS practice (W = 5151, p < .001; 95% CI: 63.50 to 65.50). In the regression analyses, pretest knowledge was positively associated with posttest knowledge (&#x3b2; = 0.74, p < .001). However, pretest practice and posttest knowledge showed negative regression coefficients in models predicting posttest practice. These regression findings were interpreted cautiously because of restricted variability and possible ceiling effects in posttest scores. In-service BLS training significantly enhanced both the knowledge and practical skills of nurses. Routine implementation of such programme should be organized at regular interval.

gestational hypertension (GH) is a common complication that affects approximately 5% of pregnancies worldwide. presenting a model-based cost description of managing severe GH in inward setting following the Italian National Health Service (INHS) perspective. Epidemiological data on pregnancies and severe GH were obtained from Lombardy region and extrapolated to national level for 2024 (last available year). Health care resources for managing severe GH patients aged 20-49&#x2009;years with severe GH, identified and quantified according to literature and expert' opinion, were valued through INHS tariffs (2025 values). One-way and scenario sensitivity analyses tested the robustness of the baseline findings. 375,553 pregnancies and 1928 episodes of severe GH needing hospitalization (0.51% of all pregnancies) were estimated for Italy in 2024. The overall average cost of managing a severe GH episode reaches &#x20ac;752.64. Inward hospitalization (&#x20ac;454.23) is the main cost-driver (60.04% of the total), as confirmed by one-way and scenario sensitivity analyses. as reported in research conducted in other countries, inward hospitalization is both essential and the main cost-driver for the optimal management of severe GH. Outpatient programmes aimed at identifying and following-up GH patients before the disease requires hospitalization should be considered by INHS policymakers.

Nursing theory has long treated "person" and "human being" as interchangeable, reflecting philosophical traditions that prioritize autonomy and individualism. Thinkers such as John Locke distinguish the biological human organism from the person, defining personhood through inward-looking psychological capacities. This cognitive, individualistic model has shaped conventional nursing theories that frame the person as a self-contained unit. In contrast, African relational ontologies conceptualize personhood as a moral, communal, and developmental achievement. Traditions such as Ubuntu, Ukama, and Consciencism, and the writings of Mbiti, Menkiti, Gyekye, Imafidon, and Wiredu, emphasize that personhood is constituted through relationships, communal belonging, and progressive moral maturation. A human being is born with ontological potential, but personhood is conferred through participation in communal life and alignment with shared values. This paper introduces the Theory of Communal-Relational Person-Becoming, a nursing theory that integrates African relational ontologies to reinterpret the metaparadigm concepts. The theory reframes personhood as dynamic becoming, health as holistic harmony, and nursing as a communal, relational, and moral act. Its novelty lies in offering a nursing framework that explicitly contrasts Western psychological individualism with African relational personhood and systematically integrates African philosophies into nursing theory, thereby expanding the discipline's conceptual repertoire and addressing epistemic exclusions.

暂无摘要（点击查看详情）

Climate change is a significant threat to global health. While its psychological impacts are documented, research exploring the link between climate change anxiety and premenstrual disorders is scarce. This study investigated the relationship between climate change anxiety and premenstrual syndrome (PMS) severity among young women. A cross-sectional study was conducted with 1035 young women (mean age: 20.83&#x2009;&#xb1;&#x2009;1.76) in T&#xfc;rkiye. Data were collected using the Climate Change Anxiety Scale (CCAS) and the Premenstrual Syndrome Scale (PMSS). Data were analyzed using Pearson's correlation and linear regression. PMS prevalence was 60.8%. A significant positive correlation was found between total CCAS and PMSS scores (r&#x2009;=&#x2009;0.188, p&#x2009;<&#x2009;0.001). Higher levels of overall climate change anxiety were significantly correlated with increased PMS severity (r&#x2009;=&#x2009;0.188, p&#x2009;<&#x2009;0.001). Regression analysis revealed that climate change anxiety is significantly associated with PMS symptoms, explaining 3.5% of the variance (R2&#x2009;=&#x2009;0.035, p&#x2009;<&#x2009;0.001). Age and menstruation-related daily life interference were also associated with higher climate anxiety. Climate change anxiety acts as a modern psychosomatic stressor contributing to premenstrual symptoms. Healthcare professionals should adopt holistic approaches, considering environmental distress a potential factor in menstrual health management for young populations.

To explore the associations between sociodemographic and cultural predictors of health service use among Aboriginal and Torres Strait Islander communities (respectfully referred to as Indigenous Australians) in Southeast Queensland with mental health concerns. Queensland Urban Indigenous Mental Health Survey data was analysed to investigate predictors of health service use within an adult sample of Indigenous Australians who experienced (a) elevated psychological distress or (b) a mental disorder or harmful substance use. Sociodemographic, cultural, and mental health predictors were quantified. A series of logistic regression models were used to explore the association between predictors and health service use. For those with elevated psychological distress, male sex, greater self-perceived physical health, and larger social support networks were associated with decreased likelihood of health service access, while greater comorbidity and frequent experiences of racism were associated with increased likelihood. For those experiencing a mental disorder or harmful substance use, greater self-perceived physical health was associated with decreased likelihood of service access, while greater comorbidity was associated with increased likelihood. Age approached significance as a predictor of increased access. Service preference was not a statistically significant predictor in either group. Differences in predictors between those with elevated psychological distress and those with mental disorders or harmful substance use underscore the importance of recognising the heterogeneity within Indigenous Australian populations and tailoring health service planning and delivery approaches accordingly for issues related to mental health.

Background"Impaired Gas Exchange" (NANDA-I 00030) is a prevalent respiratory nursing diagnosis, yet individual validation studies report conflicting findings regarding the frequency and diagnostic accuracy of its defining characteristics (DCs).ObjectiveTo synthesize evidence on the frequency and diagnostic accuracy of the DCs of the nursing diagnosis "Impaired Gas Exchange".MethodsA systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines. A systematic search was performed across six databases, including PubMed, CINAHL, Scopus, Web of Science, Embase, and ProQuest, from each database's start date through December 14, 2025, to find relevant studies. Keywords covered "Impaired Gas Exchange," "Pulmonary Gas Exchange," "Nursing Terminologies," "NANDA-International," and "Nursing Diagnosis." Methodological quality was assessed using QUADAS-2. Diagnostic accuracy parameters were pooled using bivariate random-effects models in Meta-DiSc 1.4.ResultsThirteen studies (n&#x2009;=&#x2009;2,346) were included. Pooled frequencies were calculable for 12 of 19 NANDA-I DCs; the most prevalent were hypoxia (96%; 95% CI: 94-98%), tachypnea (48%; 95% CI: 43-53%), hypercapnia (44%; 95% CI: 15-100%), and tachycardia (42%; 95% CI: 4-80%). Three studies were eligible for diagnostic accuracy meta-analysis across seven DCs. Hypoxemia had the highest sensitivity (0.94). Irritable mood had the highest specificity (0.95). Dyspnea performed poorly (DOR&#x2009;=&#x2009;0.46).ConclusionObjective physiological indicators, particularly hypoxemia, hypoxia, and hypercapnia, were the most frequent and diagnostically accurate DCs. Future multicentre studies using standardized definitions and objective reference standards are needed to refine the diagnostic profile of "Impaired Gas Exchange".

Amid healthcare workforce shortages and an aging population, families are increasingly performing informal caregiving tasks, equipping them with skills unique to their older relative's medications. Yet, despite high rates of medication errors during transitions of care, family members' expertise is rarely solicited by healthcare professionals in hospital. To understand how families are engaged in older adults' medication management, and to explore strategies for improving medication management during transitions of care. A qualitative exploratory study was conducted between October 2024 and January 2025. Semi-structured interviews were audio-recorded, transcribed verbatim, and analyzed using the Framework Method. Inductive themes were conceptualized from the data and deductively mapped to the Patient and Family Engagement Framework. In total, 66 semi-structured interviews were conducted. Eight inductive themes were generated from the data and deductively mapped to three levels of engagement comprising consultation, involvement, and partnership and shared leadership. Four themes mapped onto consultation, with family members mainly receiving and transferring medication information between healthcare professionals. Three themes reflected involvement, where healthcare professionals considered family members' preferences when determining the treatment options. At this level of engagement, responsibility for managing medications was delegated between families and healthcare professionals. The last theme aligned with partnership and shared leadership, where families initiated medication changes and negotiated treatment plans with healthcare professionals. An application or QR code was proposed as a strategy to improve medication information transfer. Family members also believed that being offered alternative treatments and a list of possible medication questions to ask would enhance collaborative decision-making. Families rarely received an invitation to participate in medication decision-making, highlighting how preferences for active engagement are difficult to address under current practices. Policymakers should consider strategies that promote shared decision-making, such as mandating that alternative treatment options are provided where clinically appropriate. Registered in ANZCTR (ACTRN12624000901505) on the 24th of July 2024.

Acute pain in hospitalised patients is common, yet African data are scarce. We conducted a prospective point-prevalence study of hospitalised adult patients across Africa to determine acute pain prevalence and severity and investigate associations of pain with critical illness and 7-day mortality. On a single day, investigators assessed patients' worst pain in the preceding 24 hours using a 0 to 10 visual-numerical scale and recorded vital signs. Critical illness was defined as &#x2265;1 vital sign out of range, in line with an international consensus definition. In-hospital mortality was assessed at day 7. Data are presented as median [interquartile range], n (%), and odds ratios with 95% confidence intervals. Between September and December 2023, 19,438 patients from 180 hospitals in 22 African nations were included (age 40 [29; 59] years; 10,874 [56%] female). Pain prevalence [95% CI] was 67.9% [67.9-68.5], with 2795 (14.4%) patients reporting severe pain (&#x2265;7/10). Pain was more common among patients admitted for emergency or trauma care and in surgical and high-care wards. Pain severity did not differ meaningfully between sexes. There was no evidence of an association between pain severity and critical illness; however, increasing pain severity was associated with a higher likelihood of 7-day mortality. These findings are comparable to data from high-income countries despite substantial differences in healthcare resources, suggesting that acute pain remains a persistent and underaddressed problem globally. This study provides the first large-scale evidence of acute pain burden in African hospitals and lays a foundation for future research aimed at comprehensively characterising in-hospital pain.

Trials of behavioural interventions aimed at preventing an Alcohol-Exposed Pregnancy (AEP) before conception report variable effectiveness. Understanding which intervention components, such as Behaviour Change Techniques (BCTs), are effective is essential when adapting for real-world implementation. This review describes the intervention models, the BCTs utilised, and the BCT combinations in effective interventions. An earlier systematic review of studies published from 1970 to 2018 was updated using the same search strategy to identify additional articles published subsequently. Searches were conducted on CINAHL, PsycINFO, Embase and PubMed to identify studies published between 2019 and 2025. Eligible study designs were randomised controlled trials (RCTs), non-randomised comparative studies, cohort studies and before-and-after studies. Studies were included if they were in English, included non-pregnant women of reproductive age or their social networks and aimed to prevent AEP. Outcomes reviewed were measures of knowledge of guidelines and attitudes towards alcohol consumption in pregnancy or when planning a pregnancy, changes in alcohol consumption and changes in behaviours to prevent unplanned pregnancies, such as effective contraception use at every sexual encounter that could lead to pregnancy. Narrative synthesis was used to describe intervention models and annotate BCTs guided by the BCT Ontology (BCTO) and alcohol-specific taxonomy. Risk of bias was assessed using the ROB 2 tool and the Modified Downs and Black Checklist. Twenty-five studies, comprising 18 studies from the previous systematic review and seven published between 2019 and 2025, were identified with 6,020 participants. Three intervention models were identified: (i) alcohol-only educational, (ii) alcohol-only screening and brief interventions (SBIs), and (iii) dual-focused (alcohol and contraception) interventions. Models included single- and multiple-session interventions, which were delivered face-to-face, remotely or digitally. Fifty-one BCTs were coded across all studies. Within the alcohol-only SBIs and dual-focused (alcohol and contraception) models, multi-session interventions generally demonstrated greater effects in intervention groups than controls and utilised more BCTs from the goal-directed and monitoring BCTO groups compared to single-session interventions. These findings deepen our understanding of why some interventions are more effective than others and suggest that tailored interactions with certain goal-directed and monitoring BCTs may enhance their effectiveness. Future research can explore greater incorporation of BCT combinations from these groups into single-session interventions and pathways to identify women who need more intense interventions for referral or support.

The period of transfer from hospital to home is challenging for patients with coronary artery disease (CAD). Transitional care is an effective approach to bridge this gap, reduce readmission risk and improve secondary prevention. Components necessary for optimal models of transitional care in CAD are unknown. To synthesise evidence describing nurse-led transitional care model (TCM) for patients with CAD. The specific review objectives are: (1) To identify the components and characteristics of TCM for patients with CAD and (2) To evaluate the effectiveness of the TCM interventions compared with usual care. A systematic review (&#xb1; meta-analysis) of randomised controlled trials. Multiple databases including the Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online, Cochrane Central Register of Controlled Trials, the Excerpta Medica Database, PyscINFO and Emcare will be searched. Independent screening in Covidence, data extraction and quality assessment will be undertaken by two reviewers with a third available for arbitration of disagreements. Two reviewers will use the Consolidated Standards of Reporting Trials (CONSORT) checklist to assess methodological quality, and the Cochrane Risk of Bias 2 (RoB 2) tool to assess risk of bias in included trials. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework will be used to determine certainty in the evidence. Narrative synthesis will be used to describe model components. Approaches to meta-analyses to assess effectiveness of transitional care models will be determined by type and frequency of reported outcome measures. Identifying key model components and characteristics in the context of CAD management should reveal gaps in evidence for best practice, providing opportunities to improve outcomes associated with care transitions.Registration: PROSPERO International Prospective Register of Systematic Reviews, registration number CRD420251182328.

The aim of this research was to investigate the effect of coffee and warm water consumption on gastrointestinal system functions after cesarean section performed under general anesthesia. The research employed randomized controlled experimental design. The study sample consisted of 25 participants in the coffee group, 26 in the warm water group and 27 in the control group. In the 4th, 8th, and 12th hours following the cesarean section, the first intervention group was given coffee, the second intervention group was given warm water, and the third group was not intervened except for routine practices. The time of first bowel sound, flatus passage and defecation were determined in all groups. The study was registered in ClinicalTrials.gov (NCT05980975). It was found that the average occurrence of the first bowel sounds of women in Group 1 was 3.285&#x2009;&#xb1;&#x2009;2.472&#x2009;h, while it was 5.480&#x2009;&#xb1;&#x2009;2.945&#x2009;h in Group 2 and 8.148&#x2009;&#xb1;&#x2009;3.591&#x2009;h in Group 3, and it was noted that bowel sounds were heard statistically significantly earlier in Group 1. When the time of flatus passage in the first 12&#x2009;h was examined, there was no significant difference between the groups. There was no defecation in any group in the first 12&#x2009;h. The current results show that coffee intake supports the first steps of the digestive process.

Digital professionalism has become increasingly relevant to nursing education as students engage with social media, generative artificial intelligence, and online platforms. However, the relationship between digital professionalism and professional identity formation among undergraduate nursing students remains conceptually fragmented and has not been comprehensively mapped. To map and synthesize the existing evidence on the relationship between digital professionalism and professional identity formation among undergraduate nursing students within nursing education settings. A scoping review guided by the Joanna Briggs Institute (JBI) methodology, reported according to the PRISMA-ScR guidelines. MEDLINE (PubMed), CINAHL (EBSCO), EMBASE, Scopus, Web of Science, Google Scholar, and ProQuest Dissertations and Theses Global were searched for studies published between January 2016 and March 2026. Two reviewers independently screened and extracted data using the Population, Concept, Context framework. Findings were synthesized using thematic analysis. Eighteen studies were included. Two themes were identified. Challenges included foundational structural gaps, blurred personal-professional boundaries, and intensifying issues related to Generation Z learners, influencer culture, and generative artificial intelligence. Opportunities demonstrated that guided digital engagement through social media initiatives, targeted digital pedagogy, virtual simulation, and critically informed influencer interactions can foster professional socialization, advocacy, belonging, and accountability. Digital professionalism poses both challenges and opportunities for the professional identity formation of undergraduate nursing students. Without structured guidance and governance, digital engagement can fragment identity development. However, when embedded in intentional pedagogical frameworks and adaptive institutional policies, digital environments become active sites for professional socialization and identity growth. Nursing education must treat digital professionalism as a core, evolving competency integrated throughout the curriculum.

During the COVID-19 pandemic, pregnant women experienced increased psychological distress, while access to routine mental health care was often disrupted. Psychological interventions may provide an effective strategy to support maternal mental health under these circumstances. This systematic review aimed to provide an overview of psychological interventions for pregnant women during the COVID-19 pandemic and to evaluate their effectiveness in reducing distress and enhancing resilience. A systematic search of four databases was conducted up to 3 September 2025. Randomised and non-randomised studies evaluating psychological interventions during pregnancy were included. Sixteen studies met the inclusion criteria. Interventions included cognitive behavioural therapy, mindfulness-based interventions, psychoeducation, and other psychological approaches delivered through individual, group, digital, or hybrid formats. Most studies reported reductions in depression, anxiety, or stress, and some found improvements in resilience-related factors. However, the methodological quality was modest; with heterogeneous outcome measures and limited follow-up. Overall, psychological interventions adapted for digital or hybrid delivery show promise for improving maternal emotional well-being in times of crises. The findings suggest that accessible and scalable psychological interventions may support maternal mental health during crisis situations when routine care is disrupted. Future research should prioritize larger, methodologically rigorous trials with standardized outcomes, and longer follow-up periods.