Nursing Midwifery Commons^™

Development Of Mentorship Module And Its Feasibility For Community Midwives In Sindh, Pakistan: A Pilot Study, Amber Hussain Sayani, Rafat Jan, Susan Lennox, Yasmeen Jan Mohammad

Journal of Asian Midwives (JAM)

Numerous articles describe the concept of mentorship for providing professional support in midwifery settings in different countries; however, in Pakistan the concept is under developed. Before implementing the concept in the Pakistani context, it was important to first develop a mentorship module and pilot test the idea. Therefore, the aim of the present study was to develop and test a mentorship module to determine its feasibility for educating community midwives about providing mentoring, so that a formal mentorship program could be established in the future. The training aimed to provide skill focused mentorship training to experienced midwives, so that they …

I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam

Master's Projects and Capstones

The title of the clinical nurse leader project is “I’m a Big Kid Now: Enhancing Transition RN Residents’ Confidence During Pediatric Patient Care”. The project aims to improve the support components for Transition RN residents during their Transition RN Residency at Children’s Hospital Los Angeles. The clinical leadership theme that correlates to this project is communication. The clinical nurse leader’s role is to act as an educator and a facilitator throughout this project. In examining the clinical nurse leader competencies, competencies “use performance measures to assess and improve the delivery of evidence-based practices and promote outcomes that demonstrate delivery of …

Implementing An Evidence-Based Education Program For Labor And Delivery Nurses In A Community Hospital Setting, Sara E. Humphrey

Graduate Theses, Dissertations, and Capstones

Many factors contribute to the success of an organization. The nursing workforce is the guiding strength behind the delivery of safe patient care resulting in quality outcomes. Preparing the nursing staff to deliver safe care begins with the introduction of evidence based practice as a viable partner to clinical expertise and knowledge. Implementing an evidence based education program is a critical step in the process of integrating evidence into clinical practice. This paper focuses on the implementation of an evidence based education program or Labor and Delivery nurses in a community hospital setting. Evidence based education can promote competency development, …

The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey

Scholarly and Creative Works Conference (2015 - 2021)

Type 1 Diabetes Mellitus accounts for approximately 5% of the diabetic population (CDC, 2015). Numerous complications must be avoided when a diabetic is insulin dependent. Women who are diabetic who are planning to conceive a family have special considerations. Little research has been focused into how to best manage Type 1 diabetics during pregnancy. Since Type 1 diabetes is predominantly diagnosed between birth and 30 years of age, many Type 1 diabetics have potential to become pregnant without knowing how to best manage their diabetes. Poor glycemic control in diabetics has been related to miscarriages, stillbirths, malformations, and macrosomia (Lapolla, …

The Relationship Between Promoting Self-Efficacy And Informed Decision-Making In Pregnant Nulliparous Women And Method Of Delivery, Crystal Hunter

Scholarly and Creative Works Conference (2015 - 2021)

This presentation will cover the relationship between the concepts of decreased self-efficacy in pregnant women’s abilities to deliver their babies vaginally, fear of the pain and duration of labor process, and the acceptance of medical intervention without sufficient intrapartum education surrounding delivery methods. These interrelated variables impede the concept of informed choice. The current state of the problem surrounds women with low self-efficacy who are predicted to have negative childbirth experiences such as, consenting to an astronomically high rate of cesarean sections. The focus for nursing is that low-risk, healthy women who elect cesarean sections without the knowledge that permanent …

Palliative Care: An Alien Concept In Pakistan, Nadia Pyarali Mulji, Sumaira Sachwani

School of Nursing & Midwifery

Every living being has to die. Respecting a dying individual’s personal values and preferences is a challenge. We live in a culture where family decisions are given priority over individual’s wish. To address this challenge, a concept of palliative or comfort care is newly introduced in Pakistan. Palliative care is a multidisciplinary specialty that emphases on prevention and relieving suffering as well as supporting the optimal quality of life of patients and their families (Bailey, Harman, Bruera, Arnold, & Savarese,2014). In Pakistan, the concept of palliative care is like a newborn baby who needs a lot of ethical attention in …

Practices Of Faculty Members Regarding Teaching And Learning Strategies In Nursing Education, Shams Ul Huda, Tazeen Saeed Ali, Kashmira Nanji, Shanaz Hussein Cassum

School of Nursing & Midwifery

Objective: To determine the different teaching learning strategies utilized, percentage of faculty members utilizing these teaching strategies and faculty perceptions regarding effectiveness of these in undergraduate nursing degree programs in Khyber Pakhtunkhwa (KPK), Pakistan.
Methodology: Cross sectional descriptive design was used to conduct this study. The sample size was 42. The faculty members were recruited from different nursing institutes offering degree programs in KPK, Pakistan. Statistical analysis was done using SPSS & STAT.
Results:Discussion, lecture, group discussion, and PPT were used by 78.6%, 73.8%, 73.8%, and 69% of the faculty members, respectively. However, other learning strategies like debate, PBL, …

Quality Of Life And Its Determinants In Adult Cancer Patients Undergoing Chemotherapy Treatment In Pakistan., Parveen Chagani, Yasmin Parpio, Raisa B. Gul, Adnan Jabbar

School of Nursing & Midwifery

Objective:

Cancer is a leading cause of death worldwide. Likewise, in Pakistan, it is a major health problem, with an approximate increase each year. Cancer treatment, particularly chemotherapy, produces a detrimental effect on individuals' well-being. Since the past few years, quality of life (QOL) is considered as the primary goal of cancer treatment in patients' survival. This study aimed to assess the QOL and its determinants in adult cancer patients undergoing chemotherapy treatment.

Methods:

An analytical cross-sectional design was employed to achieve the study objectives, utilizing consecutive sampling technique. A total of 150 adult (>19 years) cancer patients were …

The Benefits Of Breastfeeding, Annagrace E. Anderson

Senior Honors Theses

Breast milk is the gold standard for infant nutrition. In the past, infant formula was promoted as equal or superior to breast milk. However, research has shown that breastfeeding is the superior form of infant nutrition except in rare circumstances. Breast milk provides for all of a newborn’s caloric needs and has the correct balance of nutrients to promote proper development. In addition, breast milk provides protection against illnesses, supports an infant’s immune system, and promotes life-long health for the newborn. Mothers also experience personal benefits by breastfeeding such as decreased cancer risks, bonding with their babies, and faster postpartum …

Nurse Teachers’ Conceptions And Practices Of Written Feedback In Karachi., Sobia Idrees, Raisa B. Gul, Ambreen Tharani, Syeda Kauser Ali

School of Nursing & Midwifery

Background:

Written Feedback (WFB) plays a significant role in student’s learning in terms of improvement of their academic writing skills. However, the quality of WFB may be affected by various personal and contextual factors. This study aimed to identify nurse teachers’ conceptions and practices of WFB on written assignments in nursing degree offering institutions in Karachi, Pakistan.

Methods:

A cross-sectional descriptive study design was used to answer the study questions. The study was conducted at 11 nursing schools in Karachi by recruiting those teachers who were teaching in nursing degree programs. The sample size of the study consists of 80 …

Opening Up About Birth: An Autoethnographic Account Of Prolonged Labour, Petra B. Elias

The Qualitative Report

A woman’s first pregnancy can be both emotionally exciting and daunting. There are many changes to make, but there is little emotional support to adjust to the role, the focus being on the physical process which is most often managed medically (Spear, 2008; Zasloff, Schytt, & Waldenström, 2007) though warnings about what could occur are not routinely told (Kaitz, 2007, pp. 720-721). This paper presents an autoethnographic story of first time pregnancy and the unfolding labour. The methodology of autoethnography is a useful tool for conveying stories of lived experience at a level of detail often previously unrecorded, evoking for …

Infection Control In Labor And Delivery Room, Learning From The Small Hospital Based Project, Savera Aziz Ali, Sumera Aziz Ali

School of Nursing & Midwifery

Background: It has been estimated that around 36% of the neonatal deaths occur due to infection in the lower and middle income countries. Infection control is a more substantial area of concern, particularly in Labor and delivery room. Multiple factors can cause infection in the labor room, therefore it is important to assess various factors of maternal and neonatal infection. Hence we explored multiple factors through this project and developed the action plan to address those factors effectively.
Methods: During our Leadership and Management course, we conducted a project in Labor room pertaining to a prevalent issue. The whole process …

Creating Enabling Environment For Student Engagement: Faculty Practices Of Critical Thinking, Shanaz Hussein Cassum, Raisa B. Gul

School of Nursing & Midwifery

Critical thinking (CT) is considered an important attribute in practice disciplines and faculty members in nursing, medicine, and education are expected to facilitate the development of CT in their graduates so that these individuals can be critical, reflective, competent, and caring professionals and service providers (Distler, 2007; Shiau & Chen, 2008; Worell & Profetto-McGrath, 2007). When students are actively engaged in their learning, and classrooms have an enabling environment, critical thinking is promoted. Teachers must reflect upon their teaching pedagogy when students do not participate in stimulating discussions, or asks questions in class. Research suggests that lack of understanding of …

Non-Pharmacologic Measures To Prevent And Treat Gestational Diabetes, Dikshya Aryal

All Electronic Theses and Dissertations

Background: Gestational Diabetes (GDM) can have adverse effects on the health of both mother and baby during pregnancy and for a lifetime thereafter. While insulin is the mainstay of treatment, metformin and glyburide may be considered as alternatives (Carroll & Kelley, 2014). Pregnant mothers, however, may be hesitant to use pharmaceutical therapies, preferring natural alternatives (Zaki & Albarraq, 2014). Purpose: The purpose of this paper is to identify and examine effective non-pharmacological interventions for the prevention and the management of GDM. Results: Twenty-one articles were included in this review and thirteen studies support the use of certain diets (Mediterranean or …

Midwife Provider Education And Screening Can Prevent And Decrease The Prevalence Of Perinatal And Postpartum Depression: A Critical Review Of The Literature, Suzanne M. Chatters

All Electronic Theses and Dissertations

Background: Perinatal and postpartum depression (PPD) has a diagnosed prevalence of 10-20%. Experts theorize that up to 60% of women experiencing PPD do not seek help. Mental depression carries a negative stigma in western culture and medicine. It is however, both a natural occurrence and physiologic disorder. If unaddressed, depression can become a severe and dangerous condition for both women and their children. The transition to motherhood presents with multifactorial influences such as hormonal, physical, and mental changes. Pregnant women in particular, who are experiencing a change in hormonal status, sleep pattern disruption, and personal role identity are at risk …

Routine Screening For Thyroid Peroxidase Antibodies During Pregnancy: Universal Versus Targeted, Megan M. Gross

All Electronic Theses and Dissertations

Background: There are currently no guidelines for screening for thyroid peroxidase antibodies (TPOAb) during pregnancy. Currently, there is some debate as to whether pregnant women should be screened for TPOAb, universally, or using a risk-based approach. In addition, there is conflicting evidence suggesting the implications of positive TPOAb testing during pregnancy and their effect on not only the pregnancy, but also the postpartum period and the fetus. Purpose: To determine whether TPOAb should be screened for during the first trimester of pregnancy; and if so, to determine if a risk-based approach or universal screening method is more appropriate. Results: Twenty-four …

Better Together: Group Prenatal Care Improves Outcomes, Rachel Hanus

All Electronic Theses and Dissertations

Background: Neonatal outcomes have not improved over the past 30 years in spite of increases in funding and utilization. New models of prenatal care, such as Centering Pregnancy, need to be evaluated for effectiveness. This critical review of the literature focuses on comparing birth outcomes, maternal weight gain, and adequacy of prenatal care between group and traditional care models. Results: Newborns with mothers in group care were more likely to be born at later gestational ages and with higher birth weights. Mothers in group care were more likely to use contraception postpartum and have better prenatal attendance. Women in at-risk …

Culturally Sensitive And Holistic Care For Women Who Have Undergone Female Genital Circumcision, Maria Fernanda Honebrink

All Electronic Theses and Dissertations

Background: Around the world, immigration is part of many people’s lives. In that context, obstetric healthcare providers must be ready to deliver culturally sensitive care to women of different backgrounds. Some of these women have undergone female genital circumcision (FGC). As a result, they have unique healthcare needs. Purpose: Conduct a critical literature review designed to discover and evaluate culturally holistic care guidelines being used to provide healthcare to women who have undergone FGC. Results: There is a lack of clinical guidelines for healthcare providers as they care for circumcised women. Randomized controlled trials are not being done due to …

Variations To Birth Outcomes With Labor And Delivery Doula Support, Nicole I. Hunter-Severson

All Electronic Theses and Dissertations

Background/Purpose: The purpose of this critical appraisal of the literature is to discern if there are variations to birth outcomes as a result of having a doula present as a continuous support during labor and delivery. Theoretical/Conceptual Framework: Watson’s (2010) Theory of Human Caring will be the framework for this literature appraisal. Dr. Watson’s theory is founded on holistic care that involves putting a heart-centered caring process into action based upon Watson’s 10 carative factors. Methods: Thirty research articles that were relevant to the scope of variations to birth outcomes as a result of having a doula present as a …

Reducing Perineum Injuries And Trauma During Vaginal Delivery, Joyce Elaine Pepple

All Electronic Theses and Dissertations

Background: Perineal trauma and injury is extremely common during vaginal birth. Nurse-midwives and other obstetric providers should explore the most current literature for possible ways that perineal trauma and injury during vaginal birth can be avoided in patients. Purpose: To determine if hands-on perineum care, given by healthcare providers during labor and delivery, decreases perineal trauma and injury in women giving birth vaginally, compared with as opposed to women delivering vaginally who do not receive any hands-on perineum care. Results: Some hands-on techniques may improve perineal outcomes, but the hands-on techniques vary in effectiveness. The majority of providers currently prefer/use …

Implications For Delayed Versus Immediate Umbilical Cord Clamping, Laura Ann Shaver

All Electronic Theses and Dissertations

Purpose: The purpose of the critical review of literature was to identify and analyze benefits of delayed umbilical cord clamping in full term and preterm infants with a focus on iron stores, hemoglobin, hematocrit, and hyperbilirubinemia. Methods: Twenty-two articles were included in the critical literature review with the purpose of determining whether delayed umbilical cord clamping caused increases in iron stores, hemoglobin and hematocrit, or had no clinical significant increases in hyperbilirubinemia causing neonatal jaundice and the need for phototherapy treatment. Results/Conclusion: Delayed umbilical cord clamping is a low risk, cost effective intervention that is safe and has many benefits …

Nitrous Oxide: Revival Of An Antiquated Pain Modality Helps To Empower Women, April Shuneson

All Electronic Theses and Dissertations

Background: Options for pharmacological pain management in labor are limited. The use of nitrous oxide during labor and gynecological procedures is supported by the American College of Nurse-Midwives (2016); they group suggested that different forms of coping with labor and pain should be made available for women. Purpose: The purpose of this critical review of the literature is to examine the factors contributing to availability, efficacy, safety, and patient outcomes of nitrous oxide when used during labor and gynecological procedures. Results: Twenty-four articles were selected for review and were appraised using the John Hopkins Research Evidence Appraisal Tool (Dearholt & …

Adult Qdts, Chinese, Marianne E. Weiss, Binghua Wang

Quality of Discharge Teaching Scale

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …

Attitude Towards Gender Roles And Violence Against Women And Girls (Vawg): Baseline Findings From An Rct Of 1752 Youths In Pakistan, Tazeen S. Ali, Rozina Karmaliani, Judith Mcfarlane, Hussain M. A. Khuwaja, Yasmeen Somani, Esnat D. Chirwa, Rachel Jewkes

School of Nursing & Midwifery

Background: Violence against women is driven by gender norms that normalize and justify gender inequality and violence. Gender norms are substantially shaped during adolescence. Programs offered through schools offer an opportunity to influence gender attitudes toward gender equity if we understand these to be partly shaped by peers and the school environment.
Objective: We present an analysis of the baseline research conducted for a randomized controlled trial with 1752 grade 6 boys and girls and their attitudes toward gender roles, VAWG, and associated factors.
Methods: We used baseline data from a cluster randomised control study. Interviews were …

Cultural Practices Of Rearing Preterm Infants: A Qualitative Study In A Tertiary Care Hospital, Karachi, Pakistan, Salima Sulaiman Gulamani, Ambreen Tharani, Sharifa Bashir Lalani, Kiran Shaikh

School of Nursing & Midwifery

The research work explores the cultural practices of feeding and hygiene of preterm infants in the Pakistani context. A Qualitative descriptive-exploratory design has been used. Purposive sampling was utilized to recruit 17 mothers, who met inclusion criteria from a largest government tertiary care hospital in Karachi, Pakistan. The semi-structured interview was used to collect the data, which lasted for approximately 45-60 minutes. Thematic analysis was conducted to analyze the key findings of the study. Welcoming newborn with 'honey' and herbal remedies were reported as a common ritual among mothers. Findings revealed differences in the time period of initial bath given …

Association Of Awareness About Hepatitis C Infection With Patterns Of Health Seeking Behavior Among Hepatitis C Patients In Karachi, Pakistan, Shahina S. Pirani, Saleema Allana, Tazeen S. Ali, Faisal Wasim Ismail

School of Nursing & Midwifery

Background: Hepatitis C infection is one of the significant causes of morbidity and mortality throughout the world. In Pakistan, hepatitis C infection rate is 4.8%, which is the second highest prevalence rate among all developing countries. This study aimed to identify the association between awareness about hepatitis C infection and pattern of health seeking behavior among patients living with hepatitis C in Karachi, Pakistan.
Methods: A descriptive, cross-sectional study was conducted among 250 hepatitis C patients who were recruited from the Aga Khan University Hospital and the Civil Hospital Karachi, Pakistan between March and May 2013. Data were …

Exploring The Impact Of Gender Inequities On The Promotion Of Cardiovascular Health Of Women In Pakistan, Rubina Barolia, Alexander M. Clark, Gina M. Higginbottom

School of Nursing & Midwifery

Cardiovascular disease exerts an enormous burden on women's health. The intake of a healthy diet may reduce this burden. However, social norms and economic constraints are often factors that restrain women from paying attention to their diet. Underpinned by critical realism, this study explores how gender/sex influences decision-making regarding food consumption among women of low socioeconomic status (SES). The study was carried out at two cardiac facilities in Karachi, Pakistan, on 24 participants (male and female from different ethnic backgrounds), who had received health education. Using an interpretive descriptive approach, the study identified major barriers to a healthy diet: proscribed …

The Lived Experience Of The Western Australian Graduate Registered Nurse Who Is Male, Dianne Juliff

Theses

Nursing professionals are ageing and alternate career opportunities for females threatens nursing workforce sustainability. Largely untapped human resource and underrepresented within nursing in Australia are men. Therefore, the attraction and retention of men into nursing is imperative for the profession to support a sustainable workforce.

A qualitative longitudinal phenomenological study, explored the lived experience of nine newly graduated registered nurses who are male during their first year in their professional-practice environment. The methodological approach that guided this study was Interpretive Phenomenological Analysis (IPA). The IPA enhanced the exploration of the lived experiences of these participants by investigating the meaning of …

Honoring Motherhood: The Meaning Of Childbirth For Tongan Women, Shelly J. Reed, Lynn Clark Callister, 'Ana Kavaefiafi, Cheryl A. Corbett, Debra Edmunds

Faculty Publications

Purpose: The purpose of this ethnographic study was to describe the meaning of childbirth for Tongan women.

Study Design and Methods: In this qualitative descriptive study, 38 Tongan women, 18 from Tonga and 20 from the United States, who had given birth in the past year were invited to share their perceptions of childbirth. Themes were generated collaboratively by the research team.

Findings: The overarching theme was honoring motherhood; other themes include using strength to facilitate an unmedicated vaginal birth, describing the spiritual dimensions of birth, adhering to cultural practices associated with childbearing, and the influence of the concept of …

‘Fighting A Losing Battle’: A Glaserian Grounded Theory Of Midwives’ Workplace Stress, Sadie Margaret Geraghty

Theses: Doctorates and Masters

The development of the midwifery profession and the culture of childbirth are inevitably entwined from an historical perspective through to current day practice. Early written accounts describe the fifteenth century midwife as dealing with high maternal and child mortality rates, the invention of forceps, the rise of male obstetric practitioners, and the complex social and cultural changes of that era. The twenty-first century midwife faces challenges in Australia and worldwide, which are not dissimilar to our midwifery predecessors.

Midwifery clinical practice has become more complex due to the medicalisation of childbirth and 21st century lifestyles, which have contributed to a …