Nursing Midwifery Commons^™

Caesarean Section Rates In South Asian Cities: Can Midwifery Help Stem The Rise?, Sulochana Dhakal Rai, Amudha Poobalan, Rafat Jan, Malin Bogren, Juliet Wood, Ganesh Dangal, Pramod Regmi, Edwin Van Teijlingen, Keshar Bahadur Dhakal, Sahib Jan Badar, Farhana Shahid

Journal of Asian Midwives (JAM)

Introduction: Caesarean section (CS) is a life-saving surgical intervention for delivering a baby when complications arisein childbirth. World Health Organization recommends a rate of CS from 10% to 15%. However, CS rates increased steadily in recent decades and have almost doubled from 12.1% in 2000 to 21.1% in 2015. Therefore, this has become a global public health problem. The main purpose of the scoping review article is to give an overview and analysis of the rising CS use in four South Asian countries: Bangladesh, India, Nepal and Pakistan.
Methods: A scoping review was carried-out using several bibliographic electronic databases (MEDLINE, …

Enhancing Patient Well-Being: Apply Positive Psychology In Nursing Practice, Farida Bibi Mughal

School of Nursing & Midwifery

Objective: Positive psychology is the emerging concept in the medical field and has shown the positive effects on one’s well-being. This paper highlights the application of PERMA model in nursing practice.
Method: The model applied in the clinical area to access improvement in patient’s well-being. The concept of positive psychology’s applicability is discussed with the real life examples.
Result: The PERMA model when applied yields a positive impact on patient’s health and overall well-being.
Conclusion: The learning outcomes of this research will help the people in health care to understand the relationship between positive psychology and nursing practices for the …

Perception Of Nursing Students Regarding Blended Learning Implementation At University Of Lahore, Pakistan, Muhammad Afzal, Tazeen Saeed Ali, Syed Amir Gilani

School of Nursing & Midwifery

Background and objectives: Blended learning (BL) is positive development in education. This method provoke the learner’s critical thinking and given different ways for implementation of their knowledge in real life. There are several advantages of blended learning to the faculty, students and institutions as well.
Methods: The Cross-sectional study design was used to collect data from nursing students. The study was carried out at Lahore School of Nursing, The University of Lahore, Pakistan. All nursing undergraduates students enrolled at elective practicum blended learning course at Lahore School of Nursing, The University of Lahore, Pakistan academic year 2016-2017 were included in …

Knowledge And Practices Among Nurses Regarding Patients’ Care Following Cardiac Catheterization At A Tertiary Care Hospital In Karachi, Pakistan, Adnan Yaqoob, Rubina Barolia, Ahmed Noor, Afshan Nazar

School of Nursing & Midwifery

Aims: The purpose of this study was to assess the knowledge and practices among nurses regarding patient care, following cardiac catheterization, at a tertiary care hospital in Karachi, Pakistan.
Background: Cardiovascular diseases (CVDs) are the major cause of morbidity and mortality, globally. Nurses are the largest body of health care professionals who attempt to reduce the burden of cardiovascular diseases. Design: This study employed a descriptive analytical cross-sectional study design to answer the research questions.
Methodology: The data were collected from 70 participants using two instruments. Knowledge was assessed through a 50-multiple-choice questions-based questionnaire, whereas, to assess the practices, an …

Sociodemographic Factors Associated With Mothers’ Experiences Of Psychosocial Care And Communication By Midwives During Childbirth In Nairobi, Kenya, Jane Kabo, Eleanor Holroyd, Grace Edwards, Ahmed Sarki

School of Nursing & Midwifery, East Africa

Purpose: To clarify sociodemographic and socioeconomic factors associated with mothers’ experiences of psychosocial care and communication by midwives during childbirth in Nairobi, Kenya.

Design: A descriptive cross-sectional study conducted in a government national referral hospital. Respondents were 109 systematically sampled mothers who delivered in the study hospital. Mothers’ experiences of intrapartum care were assessed using three subscales from the Experience of Psychosocial Care and Communication during Childbirth Questionnaire (effective communication; emotional support; and respect, care and dignity). Simple and multivariable logistic regression analyses were used to assess associations between sociodemographic factors, socioeconomic factors and mothers’ experiences of intrapartum care.

Findings: …

Male Involvement In Family Planning Among Squatter Settlement Residents Of Karachi, Fahmida Khowaja, Mehak Pervaiz, Naushaba Khatoon

Journal of Asian Midwives (JAM)

Background: Worldwide, the Contraceptive Prevalence Rate (CPR) increased from 54.8% to 63.3%. However, Pakistan’s current CPR is estimated to be 35%. Men can play an important role in increasing CPR by providing support to their partners, yet their role has been overlooked in targeted reproductive health strategies. The aim of this study was to assess the awareness and practices of married men regarding Family Planning (FP).
Material and Method: This cross-sectional study was conducted among 419 married men, residing in an urban squatter settlement of Karachi. Participants were selected through non-probability convenience sampling and a structured questionnaire was used to …

Higher Education In Midwifery In Pakistan: A Proposed Framework, Rafat Jan, Arusa Lakhani, Karyn Kaufman

Journal of Asian Midwives (JAM)

Access to a skilled professional midwife is the right of each woman. Research evidence shows that midwives prepared to international standards decrease rates of morbidity and mortality and promote health of both mothers and infants. At present, in Pakistan, there are several midwifery cadres, with different formal education levels, who provide maternal and child health services. There are currently three types of diploma programs each serving a different cadre. Until 2012, there was no opportunity to obtain higher education in midwifery in the country. This absence contributed to non-acceptance and invisibility of midwifery as a profession. As a result, midwives …

Cultural Assessment: A Study Of Midwives’ Knowledge, Attitude And Self-Reported Practice In Uganda, Mercy Muwema, Karen Drake, Pamela Friesen, Grace Edwards

Journal of Asian Midwives (JAM)

Background: Cultural assessment is critical due to the increased movement and resettlement of people across the globe, and diverse cultural groups in Uganda. This is putting the health care delivery systems serving the communities under pressure to recognize the different attitudes of people towards health and to develop care systems that are effective in meeting diverse needs. However, despite the importance of cultural assessment in nursing literature, little is known about the cultural assessment competence of Ugandan midwives. This study assessed the knowledge, attitude, and practice of midwives in this assessment process.

Methods: A descriptive correlational design was used to …

Asian Midwifery In 2019, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

Examining Clinical Indications For Cesarean Section In A University Hospital In Karachi, Pakistan, Zehra Kanji, Shannon D. Simonovich, Nida Najmi, Jessica Bishop-Royse

Journal of Asian Midwives (JAM)

Background and objectives: Current research reports that Pakistan exceeds the recommended percent of deliveries via cesarean sections, including both emergent and non-emergent. In order to better understand the high rate of cesarean sections in Pakistan we examined the medical and non-medical indications of these surgeries at a private university hospital in Karachi.

Methods: A retrospective analysis of patient medical record data was conducted from January 1st, 2018 to March 31st, 2018. The data collected was analyzed using SPSS 25.

Results: The total number of deliveries during the period was n= 1,211, out of which n=602 (49.70%) were CS. The top …

Silence In Violence: A Curse Or A Goodwill, Afsheen Hirani, Nasreen Rafiq, Shyrose Sultan, Zainish Hajani, Samreen Siraj

School of Nursing & Midwifery

Healthcare professionals face dilemmas regarding maintaining and breaching confidentiality while dealing with victims of sexual violence. The sensitivity of the cases of violence and the aim to prevent harm generates ambiguity for sound ethical and legal decision making. In Pakistan, maintaining silence is often preferred over breaking the silence. Thus, it is essential to view the risks and benefits of the conflicting positions keeping in mind the diverse perspectives and the bigger picture. Organizations, community and government can plan different strategies to put an end to this obscene game of “silence in violence”.

Developing A Rubric To Assess Critical Thinking In A Multidisciplinary Context In Higher Education, Sadia Muzaffar Bhutta, Sahreen Chauhan, Syeda Kauser Ali, Raisa B. Gul, Shanaz Hussein Cassum, Tashmin Khamis

School of Nursing & Midwifery

Critical thinking (CT) is a generic attribute that is greatly valued across academic disciplines in higher education, and around the globe. It is also defined as one of the graduate attributes of higher education for the sample private university where this research was conducted, as it is perceived that CT helps the graduate to become ‘engaged citizens’ in the twenty-first century. Despite the well-documented importance of CT, its assessment remains a challenge. This study addresses this challenge through the systematic development and field-testing of a rubric for assessing critical thinking in a multidisciplinary context in higher education. A multidisciplinary group …

Students’ Perspectives Regarding Clinical Preceptors (Cps) In The Baccalaureate Undergraduate Nursing Programme In Karachi, Pakistan, Amina Aijaz Khowaja Ap, Jacqueline Maria Dias

School of Nursing & Midwifery

Introduction: Clinical practice is considered an integral part of nursing education. It is in the clinical area that the students integrate the theory learnt in the classroom into practice. An enabling clinical environment with the assistance of a clinical preceptor (CP) ensuresthat student nurses become independent practitioners and competent in their roles and responsibilities.
Design : A comprehensive study was undertaken to explore the emerging role of CPs in Pakistan. This research has been reported in the literature. This paper will deal exclusively with the perceptions of nursing students when working with CPs in the four-year undergraduate baccalaureate program at …

Factors Associated With Postoperative Pain Among Patients After Cardiac Surgery In The Tertiary Care Teaching Hospital Of Karachi, Pakistan, Sineer Micah, Rubina Barolia, Yasmin Parpio, Santosh Kumar, Hasanat Sharif

School of Nursing & Midwifery

Background: Pain is the subjective feeling of an individual, which affects the overall recovery of patients after cardiac surgery. Postoperative pain is the most inadequately managed symptom of cardiac surgery. Subsequently, there are many factors that can either hinder or facilitate pain management, including patients' beliefs, cultural values, physiological features, hospital policies, and healthcare providers' knowledge and beliefs. The purpose of this research was to identify factors associated with postoperative pain and its management, after cardiac surgery, among patients in a tertiary care hospital in Karachi, Pakistan.
Methods: Quantitative correlational study design was employed to attain the study purpose. Data …

A Race Inside The Body: Decision Of The Fate Of Newborn, Shyrose Sultan, Samreen Siraj, Zainish Zafarullah Hajani, Afsheen Hirani, Nasreen Rafiq

School of Nursing & Midwifery

Sex-selective abortion is the killing of a girl fetus merely due to its gender. It has become an emerging problem in developing countries mainly due to lack of resources and cultural stereotypes. Illegal abortions have increased and are jeopardizing not only the gender ratio but also the health of the mother by exposing them to complications and violating their rights. The aim of this paper is to evaluate a case scenario based on many ethical dilemmas and questions that arise form it. The paper presents the problem in light of major ethical principles and theories by counteracting each argument with …

Exploring Lived Experiences Of Married Pakistani Women Post-Mastectomy, Laila Hussain, Zeenatkhanu Kanji, Sharifa Bashir Lalani, Shabnam Moledina, Abida K. Sattar

School of Nursing & Midwifery

Objective: This qualitative descriptive exploratory study aimed to explore the lived experiences of married Pakistani women, 2 years post-mastectomy.
Methods: Twelve participants were recruited through purposive sampling from outpatient oncology clinic from a tertiary care hospital in Pakistan. Interviews were audio-taped and transcribed, and then themes and sub-themes were identified.
Results: Women verbalized a range of their experiences throughout the span from diagnosis to mastectomy. One over arching theme, quality of life and four main themes and their subthemes emerged from the data. Following are the themes; from history to diagnosis, worries, coping strategies, and recommendations.
Conclusions: The study findings …

Improving Nursing Documentation Via Reducing The Written Work Load, Anaiz Ahmed Khowaja, Nasreen Rafiq

School of Nursing & Midwifery

With the growth in the health care industry around the world and introduction to new technologies in the system, the uses of traditional methods in nursing practices are reducing. These modern work practices are meant to reduce human effort without compromising on the quality. Where as dealing with documentation whereas always has been a major challenge in providing the better health care. The project thus outlines the improving nursing documentation via reducing the written work load to increase work efficiency.

Turnover Propensity Among Nurses In Pakistan: Overview And Management, Anaiz Ahmed Khowaja, Nasreen Rafiq, Fazal Rabi, Nazia Merchant, Neelam Rafiq, Sanam Zulfiqar

School of Nursing & Midwifery

Human resource management is an important stake of health care systems. Today, the increase in the burden of diseases has increased the demands of health care professionals in particular Nurses who are the key assets to these agencies. Unfortunately, there is a huge difference between the numbers of nurses between developed and developing countries. Various databases were used to identify this gap, rationales behind its existence and recommendations to improve it.

Growing Evidence For The Impact Of Air Pollution On Depression, Naureen Akber Ali, Adeel Khoja

School of Nursing & Midwifery

No abstract provided.

Acquiring Knowledge About The Use Of A Newly Developed Electronic Fetal Heart Rate Monitor: A Qualitative Study Among Birth Attendants In Tanzania, Sara Rivenes Lafontan, Johanne Sundby, Hussein Kidanto, Columba Mbekenga, Hege L. Ersdal

School of Nursing & Midwifery, East Africa

In an effort to reduce newborn mortality, a newly developed strap-on electronic fetal heart rate monitor was introduced at several health facilities in Tanzania in 2015. Training sessions were organized to teach staff how to use the device in clinical settings. This study explores skilled birth attendants’ perceptions and experiences acquiring and transferring knowledge about the use of the monitor, also called Moyo. Knowledge about this learning process is crucial to further improve training programs and ensure correct, long-term use. Five Focus group discussions (FGDs) were carried out with doctors and nurse-midwives, who were using the monitor in the labor …

The Politics Of Abortion And Maternal Health: A Discussion Paper, Ihsan Ullah, Ayaz Ayub, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

Abortion should be legally allowed for women because it can save mothers from childbirth-related complications and death. Legal abortion is one of the safest methods to terminate a pregnancy when there is a risk to the mother’s health by childbirth or severe deformity of the fetus or it is unwanted. Unfortunately, approximately half of all abortions worldwide mostly in nations where abortion is severely restricted and are performed in dangerous settings. These risky abortions are a significant contributor to maternal morbidity and disability. Limiting a woman's access to an abortion does not stop abortion; rather, it just encourages more risky …

Routine Episiotomies Without Consent, Komal Abdul Rahim, Nasreen Rafiq

School of Nursing & Midwifery

No abstract provided.

Effect Of Psychological Distress On The Emerging Cause Of Infertility, Faiza Kausar

Journal of Asian Midwives (JAM)

Background: Infertility is a growing issue of the recent era, and it represents significant crises for most couples. Psychological distress has often been suggested as a cause of unexplained infertility. Male infertility accounts for 40% of all infertility problems, while female infertility accounts for 40% of all infertility problems; others are unexplained. Previous studies have indicated that stress and depression negatively impact various infertility parameters in both partners. To determine the relationship between infertility and psychological distress and the level of different types of stress among infertile couples, and to relate the significant stressors responsible for worsening infertility or …

Labor Companionship: A Concept Of Doula Care, Arisha Amin, Rabab Vadivala

Journal of Asian Midwives (JAM)

A labor companion is a person who offers consistent individualized support to laboring women. Doula care is defined as the care which an individual provides of physical, social, and emotional support during pregnancy, labor, birth, and the postnatal period (1). Doulas help women ease their anxiety, and pain and address their concerns with comfort, care, and respect. Doulas help in cherishing a mother and child bonding helps in initiate breastfeeding and provide an emotional bond throughout the birthing time. It helps in reducing cesarean sections, and high-risk pregnancies and minimizes infant and maternal mortalities. The purpose of the study is …

Nursing And #Metoo, Nasreen Rafiq, Shyrose Sultan, Afsheen Hirani, Samreen Verasiya, Zainish Hajani, Neelam Rafiq

School of Nursing & Midwifery

The year 2018 revealed a number of sexual harassment stories into public conversation as part of the #MeToo movement. The campaign has relatively spread across all professions and work industries. Today, the society is already hypersensitive towards sexual talks, and the campaigns such as #MeeToo make it even more difficult to overlook these stories; it has challenged the demarcation of important and superfluous accusations which gives rise to various ethical dilemmas. Therefore, the #MeToo movement becomes significant to evaluate both sides of a coin, and assess a situation from various ethical paradigms in order to reach an ethically acceptable solution.

The Intersection Of School Corporal Punishment And Associated Factors: Baseline Results From A Randomized Controlled Trial In Pakistan, Hussain Maqbool Ahmed Khuwaja, Rozina Karmaliani Professor, Judith Mcfarlane, Rozina Somani, Saleema Gulzar, Tazeen S. Ali, Zahra Shaheen Premani, Esnat D. Chirwa, Rachel Jewkes

School of Nursing & Midwifery

Violence against youth is a global issue; one form of youth victimization is school corporal punishment. We use baseline assessments from a cluster randomized controlled trial to examine the prevalence of school corporal punishment, by gender, and the relationship to levels of peer violence at school, parent corporal punishment, youth food security and youth academic performance and school attendance in Pakistan. Forty homogenous public schools in the urban city of Hyderabad, Pakistan were chosen for randomization into the trial evaluating a youth violence prevention intervention. 1752 6th graders, age 11-14 years, were selected as the target population. Since schools are …

Comparison Of Undergraduate Educational Environment In Medical And Nursing Program Using The Dreem Tool, Salima Farooq, Rehana Rehman, Mehwish Hussain, Jacqueline Maria Dias

School of Nursing & Midwifery

Introduction: Educational environment (EE) in a health educational institute can bring about an enduring impact on the students' motivation, knowledge, critical thinking along with their social life. Therefore, identifying strengths and the need for change in the education environment is vital for the enhancement of the students' learning.
Objective: This study aimed to compare the perceptions of nursing and medical students about their EE in a private university, Karachi Pakistan.
Methodology: Data from two cross-sectional studies of 884 students from both medical and nursing schools of Aga Khan University was acquired and analyzed. EE was measured by …

A Pilot Study Exploring Nursing Knowledge Of Depression And Suicidal Ideation In Kenya, Timothy Muga, Gladys Mbuthia, Samwel Gatimu, Rachel Rossiter

School of Nursing & Midwifery, East Africa

Nurses play key roles in recognizing, diagnosing, managing, and referring persons with mental disorders. This cross-sectional study assessed mental health literacy (depression and suicidal ideation) among nurses in a private urban referral hospital in Kenya. Nurses read a vignette and answered questions regarding diagnosis, treatment/interventions, and related attitudes and beliefs. Thirty-seven nurses (12 males) completed the questionnaire. Three correctly identified the diagnosis and 23 identified depression only. Although 75% noted the symptoms were extremely distressing, fear, and stigma were common reactions. This highlights challenges in mental health promotion/prevention in Kenya, and suggests continuous nursing education and curriculum enhancement is needed.

Health In Surroundings: Application Of The Theory Of Environment In Nursing Practice, Nasreen Rafiq

School of Nursing & Midwifery

Nursing practices are guided by theoretical frameworks which provide functional basis to nursing care. This paper discusses the application of Nightingale’s theory of environment in nursing practices. The theory highlights and explains 13 environmental cannons which include ventilation, cleanliness of walls/rooms, light, noise, personal cleanliness, bed and bedding, and taking food. Florence exquisitely explains the influence of environmental health on patients wellbeing. The application of the theory in nursing practices will help to understand and reflect the direct relation of environment on patients health.

Physicians’ And Nurses’ Perspectives On The Importance Of Advance Directives In Tertiary Care Hospitals, Nasreen Panjwani, Raisa B. Gul, Fauziya Ali, Robyna Irshad Khan

School of Nursing & Midwifery

Objective: This study aimed to explore and identify the nurses’ and physicians’ views about Advance Directives and identified their perspectives on its importance, in the context of Pakistan.
Methodology: Using a purposive sample, six physicians and seven nurses from two tertiary care hospitals in Karachi participated in the study. Data was collected using semi structured interviews that were transcribed verbatim. The interviews were coded and categorized manually. Analysis of the data drew four categories: roles of physicians and nurses in the End of life care, challenges they faced while taking end of life care decisions; their perspectives about Advance Directives, …