Objective:To determine the most common mistakes made during the use of a metered-dose inhaler(MDI),and the effect of the repeated trainings performed with demonstration method by providing one-to-one feedback on these...Objective:To determine the most common mistakes made during the use of a metered-dose inhaler(MDI),and the effect of the repeated trainings performed with demonstration method by providing one-to-one feedback on these mistakes.Methods:This is a quasi-experimental study with a control group.A total of 100 chronic obstructive pulmonary disease(COPD)patients(50 in the control group and 50 in the experimental group)were included in the research.“Patient Information Form(PIF)”(to determine the descriptive characteristics of patients)through the face-to-face interview method,using“MDI Skill Assessment Form”(MDISAF)(it is composed of 10 skill steps about the use of MDI)through observation method was used.Patients in both the groups were asked to use MDI and their abilities regarding use of MDI were assessed.Then in the intervention group,usage of MDI was explained by a nurse via demonstration and placebo MDI.Trainings were repeated on days 1,3,and 5 as from hospitalization of the patient.In the intervention group,three methods were used in this study:“face-to-face training,”“one-to-one,”and“with feedbacks and repeated.”Routine training regarding use of MDI was given by the nurses in the clinic to patients in the control group.The use of an MDI was assessed using MDISAF before training and after the training on the first,third and fifth days of hospitalization.On the seventh day,the last measurement was performed.Percentage,chi square,and mean were used to assess the data.Results:After repetitive training with one-to-one feedback,several differences between the groups in favor of the experimental group were found in 7 of the 10 skill levels of the MDI.There was a significant difference after“training”between the groups in the third,fourth,fifth,sixth,seventh,eighth and ninth MDI steps in posttest measurement(P<0.05).Evaluating the skills of the groups to use MDI from pretest to posttest,it was determined that while the intervention group made less mistakes in steps in which mistakes were made mostly,the control group continued to make mistakes.Conclusions:Inhaler technique intervention with repeated,face to face,and one-to-one feedback trainings can significantly enhance the MDI techniques in COPD patients.The patients in the intervention group made less mistakes during MDI application and their application skills improved.It may be asser ted that the training provided to the intervention group was effective for using the device correctly,while the training provided in the clinic for the control group was inadequate.展开更多
Introduction: Ultrasound is an essential component of antenatal care. Midwives provide most of the antenatal care but they do not perform ultrasound as it has been beyond their scope of practice. This leaves many wome...Introduction: Ultrasound is an essential component of antenatal care. Midwives provide most of the antenatal care but they do not perform ultrasound as it has been beyond their scope of practice. This leaves many women in Low and Middle-Income Countries without access to ultrasound scanning. The aim of this study was to identify competencies in ultrasound scanning in midwifery education. Methods: A desk review and needs assessment were conducted between July and October 2023. Articles and curricula on the internet, Google scholar and PubMed were searched for content on ultrasound scanning competencies. A Google form consisting of 20 questions was administered via email and WhatsApp to 135 participants. Descriptive statistics were used to analyse data. Results: The desk review showed that it is feasible to train midwives in ultrasound scanning. The training programs for midwives in obstetric ultrasound were conducted for 1 week to 3 months with most of them running for 4 weeks. Content included introduction to general principles of ultrasound, physics, basic knowledge in embryology, obstetrics, anatomy, measuring foetal biometry, estimating amniotic fluid and gestational age. Experts like sonographers trained midwives. Theory and hands on were the teaching methods used. Written and practical assessments were conducted. Needs assessment revealed that majority of participants 71 (53%) knew about basic ultrasound training for midwives. All participants (100%) said it is necessary to train midwives in basic ultrasound scan in Zambia. Some content should include, anatomy, measuring foetal biometry, assessing amniotic fluid level, and gestational age determination. Most participants 91 (67%) suggested that the appropriate duration of training is 4 - 6 weeks. Conclusion: Empowering every midwife with ultrasound scanning skills will enable early detection of any abnormality among pregnant women and prompt intervention to save lives.展开更多
BACKGROUND Diabetes is a common chronic disease,and its global incidence is on the rise.The disease is directly attributed to insufficient insulin efficacy/secretion,and patients are often accompanied by multiple comp...BACKGROUND Diabetes is a common chronic disease,and its global incidence is on the rise.The disease is directly attributed to insufficient insulin efficacy/secretion,and patients are often accompanied by multiple complications.Diabetic foot is one of the most common complications of diabetes.Diabetic feet have ulcers and infections,which can eventually lead to amputation.Basic nursing care,such as lowering blood pressure and preventing foot skin infections in clinical nursing work,has positive significance for the prevention and control of diabetic feet.AIM To explore the positive significance of one-to-one education in high-risk cases of diabetic foot.METHODS This observation included 98 high-risk cases of diabetic foot in our hospital during the period from August 2017 to October 2019,and these patients were randomly divided into the basic nursing group and the one-to-one education group with 49 patients per group.The basic nursing group only received routine basic nursing,while the one-to-one education group gave patients one-to-one education on the basis of basic nursing.After nursing,the self-care ability and compliance behavior of the two groups were evaluated and compared between these two groups.The knowledge mastery of the patient and the satisfaction of nursing were accounted.RESULTS The assessment results of patients(self-care responsibility,self-care skills,selfconcept and self-care knowledge)were significantly higher in the one-to-one education group than in the basic nursing group.The scores of compliance behaviors(foot bathing,shoes and socks selection,sports health care)in the oneto-one education group were significantly higher than those in the basic nursing group.Patients in the one-to-one education group had a significantly higher level of knowledge mastery and satisfaction of nursing than the basic nursing group.CONCLUSION One-to-one education for high-risk cases of diabetic foot is helpful to improve the cognition and self-care ability of patients with diabetic foot,to ensure that patients follow the doctor’s advice of self-care and to improve their nursing satisfaction.展开更多
LDL-factorization is an efficient way of solving Ax = b for a large symmetric positive definite sparse matrix A. This paper presents a new method that further improves the efficiency of LDL-factorization. It is based ...LDL-factorization is an efficient way of solving Ax = b for a large symmetric positive definite sparse matrix A. This paper presents a new method that further improves the efficiency of LDL-factorization. It is based on the theory of elimination trees for the factorization factor. It breaks the computations involved in LDL-factorization down into two stages： 1） the pattern of nonzero entries of the factor is predicted, and 2） the numerical values of the nonzero entries of the factor are computed. The factor is stored using the form of an elimination tree so as to reduce memory usage and avoid unnecessary numerical operations. The calculation results for some typical numerical examples demonstrate that this method provides a significantly higher calculation efficiency for the one-to-one marketing optimization algorithm.展开更多
BACKGROUND There are many drawbacks to the traditional midwifery service management model,which can no longer meet the needs of the new era.The Internet+continuous midwifery service management model extends maternal m...BACKGROUND There are many drawbacks to the traditional midwifery service management model,which can no longer meet the needs of the new era.The Internet+continuous midwifery service management model extends maternal management from prenatal to postpartum,in-hospital to out-of-hospital,and offline to online,thereby improving maternal and infant outcomes.Applying the Internet+continuous midwifery service management model to manage women with highrisk pregnancies(HRP)can improve their psycho-emotional opinion and,in turn,minimize the risk of adverse maternal and/or fetal outcomes.AIM To explore the effectiveness of a midwife-led Internet+continuous midwifery service model for women with HRP.METHODS We retrospectively analyzed the clinical data of 439 women with HRP who underwent prenatal examination and delivered at Shanghai Sixth People's Hospital(affiliated to the Shanghai Jiao Tong University School of Medicine)from April to December 2022.Among them,239 pregnant women underwent routine obstetric management,and 200 pregnant women underwent Internet+continuous midwifery service mode management.We used the State-Trait Anxiety Inventory,Edinburgh Postnatal Depression Scale,and analysis of delivery outcomes to compare psychological mood and the incidence of adverse delivery outcomes between the two groups.RESULTS The data showed that in early pregnancy,the anxiety and depression levels of the two groups were similar;the levels gradually decreased as pregnancy progressed,and the decrease in the continuous group was more significant[31.00(29.00,34.00)vs 34.00(32.00,37.00),8.00(6.00,9.00)vs 12.00(10.00,13.00),P<0.05].The maternal self-efficacy level and strategy for weight gain management were better in the continuous group than in the traditional group,and the effective rate of midwifery service intervention in the continuous group was significantly higher than in the control group[267.50(242.25,284.75)vs 256.00(233.00,278.00),74.00(69.00,78.00)vs 71.00(63.00,78.00),P<0.05].The incidence of adverse delivery outcomes in pregnant women and newborns and fear of maternal childbirth were lower in the continuous group than in the traditional group,and nursing satisfaction was higher[10.50%vs 18.83%,8.50%vs 15.90%,24.00%vs 42.68%,89.50%vs 76.15%,P<0.05].CONCLUSION The Internet+continuous midwifery service model promotes innovation through integration and is of great significance for improving and promoting maternal and child health in HRP.展开更多
BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventio...BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventions are necessary to improve maternal and fetal outcomes and alleviate primiparas’negative emotions(NEs).AIM To discusses the impact of nursing responsibility in midwifery and postural and psychological interventions on maternal and fetal outcomes as well as primiparas’NEs.METHODS As participants,115 primiparas admitted to Quanzhou Maternity and Child Healthcare Hospital between May 2020 and May 2022 were selected.Among them,56 primiparas(control group,Con)were subjected to conventional midwifery and routine nursing.The remaining 59(research group,Res)were subjected to the nursing model of midwifery and postural and psychological interventions.Both groups were comparatively analyzed from the perspectives of delivery mode(cesarean,natural,or forceps-assisted),maternal and fetal outcomes(uterine inertia,postpartum hemorrhage,placental abruption,neonatal pulmonary injury,and neonatal asphyxia),NEs(Hamilton Anxiety/Depressionrating Scale,HAMA/HAMD),labor duration,and nursing satisfaction.RESULTS The Res exhibited a markedly higher natural delivery rate and nursing satisfaction than the Con.Additionally,the Res indicated a lower incidence of adverse events(e.g.,uterine inertia,postpartum hemorrhage,placental abruption,neonatal lung injury,and neonatal asphyxia)and shortened duration of various stages of labor.It also showed statistically lower post-interventional HAMA and HAMD scores than the Con and pre-interventional values.CONCLUSION The nursing model of midwifery and postural and psychological interventions increase the natural delivery rate and reduce the duration of each labor stage.These are also conducive to improving maternal and fetal outcomes and mitigating primiparas’NEs and thus deserve popularity in clinical practice.展开更多
Introduction: International migration has always existed, primarily as a means to find economic opportunity. Recently, the number of health care professionals seeking to work outside Albania is growing rapidly. In 202...Introduction: International migration has always existed, primarily as a means to find economic opportunity. Recently, the number of health care professionals seeking to work outside Albania is growing rapidly. In 2021 alone, 1073 nurses left Albania. The departure of health care professionals is reflected in education where it can be observed that a good part of the students who finished the bachelor’s level program did not enroll to continue the second level of study in the master’s. The student’s decision not to continue further levels of education has brought consequences from programs shutting down due to lack of students and forcing the university to spread out the few remaining students to other programs. Objective: The purpose of the study was to explore the opinions of Midwifery Students studying at the Bachelor level, regarding their professional future and continuing education. Methodology: This is a cross-sectional study. In this study are included the students of the bachelor level of education. Student participating are studying Midwifery in the 2022-2023 academic year, at the Faculty of Technical Medical Sciences at the University of Medicine, Albania. Results: The students on average believe they can find a job as a midwife. The career is relatively safe and the profession of midwifery will ensure economic well-being for them. Most of the students hope to emigrate and develop their professional career outside of Albania. This was a surprise given that most frequent answers given by the students for not continuing their Master’s level education was the fact that the program was not accredited, their Bachelor’s diploma was also not accredited and so not recognized by other countries, the cost of continuing their studies was too high and their desire for a better economic and social status which they cannot get in Albania. The majority of students participating in the study identified emigration as the main way they plan to further their studies. Conclusions and Recommendations: Although the students had willingly chosen to continue the midwifery diploma, as they thought it would provide them with a proper future, this dignified professional future was seen as unattainable in Albania so they are seeking it out in more developed countries. A significant number of health professionals prefer to continue their second cycle studies in another country. The professional security within their home country does not satisfy the students. As the market demand for nurses around the globe escalates, the changes and consequences associated with nurse migration are increasingly in need of policy solutions that will address the needs of all parties involved. .展开更多
Background: Many countries across the world are facing an ongoing shortage of midwife practitioners due to several reasons such as increased workload, working overtime, poor-quality midwifery care, low staff morale, s...Background: Many countries across the world are facing an ongoing shortage of midwife practitioners due to several reasons such as increased workload, working overtime, poor-quality midwifery care, low staff morale, stress and burnout, lack of opportunity for training, lack of management support, financial issues and lack of recognition and compromised autonomy. Purpose: To explore the reasons behind nurses’ hesitance to apply for midwifery specialization. The objectives of this study were to understand the challenges that lie in front of Omani nurses and the motivational factors to apply for a midwifery programme. Method: Exploratory qualitative study was conducted at the largest tertiary hospital in Oman. Purposive sampling was applied for participant recruitment. Face-to-face interviews and focus group discussions were used as data collection methods. The study included general nurses, nurses in charge working in the maternity unit as well as nurses whose applications were accepted for midwifery education. Qualified midwives were excluded. The data collection process yielded twenty-five nurses. The interview protocol highlighted the impact and perception of the midwifery specialization on nurses’ careers. Thematic analysis was employed for data analysis. Results: Three over-arching major themes were identified. These are 1) nurses’ perceptions about the nature of work in maternity wards, the nurses have positive perception toward working in maternity wards and labor room because of working exclusively with female patients and their babies 2) factors influencing the decision to study midwifery specialization, work overload, stress, lack of support from administration were the most common reason behind the nurses not to apply for midwifery specialization and 3) support and recommendations required for midwives, the nurses mentioned that their identity, promotions and support from the administration will encourage them to apply for midwifery specialization. Conclusion: One of the main reasons that hindered nurses from applying to midwifery specialization is the false belief that midwives cannot work outside the delivery suite (DS). The second reason was the stress that midwives encounter at DS, and this was perceived by general nurses who did not work at DS. These challenges could be mitigated by leadership support, midwifery profession identity, as well as financial recognition for the midwives.展开更多
文摘Objective:To determine the most common mistakes made during the use of a metered-dose inhaler(MDI),and the effect of the repeated trainings performed with demonstration method by providing one-to-one feedback on these mistakes.Methods:This is a quasi-experimental study with a control group.A total of 100 chronic obstructive pulmonary disease(COPD)patients(50 in the control group and 50 in the experimental group)were included in the research.“Patient Information Form(PIF)”(to determine the descriptive characteristics of patients)through the face-to-face interview method,using“MDI Skill Assessment Form”(MDISAF)(it is composed of 10 skill steps about the use of MDI)through observation method was used.Patients in both the groups were asked to use MDI and their abilities regarding use of MDI were assessed.Then in the intervention group,usage of MDI was explained by a nurse via demonstration and placebo MDI.Trainings were repeated on days 1,3,and 5 as from hospitalization of the patient.In the intervention group,three methods were used in this study:“face-to-face training,”“one-to-one,”and“with feedbacks and repeated.”Routine training regarding use of MDI was given by the nurses in the clinic to patients in the control group.The use of an MDI was assessed using MDISAF before training and after the training on the first,third and fifth days of hospitalization.On the seventh day,the last measurement was performed.Percentage,chi square,and mean were used to assess the data.Results:After repetitive training with one-to-one feedback,several differences between the groups in favor of the experimental group were found in 7 of the 10 skill levels of the MDI.There was a significant difference after“training”between the groups in the third,fourth,fifth,sixth,seventh,eighth and ninth MDI steps in posttest measurement(P<0.05).Evaluating the skills of the groups to use MDI from pretest to posttest,it was determined that while the intervention group made less mistakes in steps in which mistakes were made mostly,the control group continued to make mistakes.Conclusions:Inhaler technique intervention with repeated,face to face,and one-to-one feedback trainings can significantly enhance the MDI techniques in COPD patients.The patients in the intervention group made less mistakes during MDI application and their application skills improved.It may be asser ted that the training provided to the intervention group was effective for using the device correctly,while the training provided in the clinic for the control group was inadequate.
文摘Introduction: Ultrasound is an essential component of antenatal care. Midwives provide most of the antenatal care but they do not perform ultrasound as it has been beyond their scope of practice. This leaves many women in Low and Middle-Income Countries without access to ultrasound scanning. The aim of this study was to identify competencies in ultrasound scanning in midwifery education. Methods: A desk review and needs assessment were conducted between July and October 2023. Articles and curricula on the internet, Google scholar and PubMed were searched for content on ultrasound scanning competencies. A Google form consisting of 20 questions was administered via email and WhatsApp to 135 participants. Descriptive statistics were used to analyse data. Results: The desk review showed that it is feasible to train midwives in ultrasound scanning. The training programs for midwives in obstetric ultrasound were conducted for 1 week to 3 months with most of them running for 4 weeks. Content included introduction to general principles of ultrasound, physics, basic knowledge in embryology, obstetrics, anatomy, measuring foetal biometry, estimating amniotic fluid and gestational age. Experts like sonographers trained midwives. Theory and hands on were the teaching methods used. Written and practical assessments were conducted. Needs assessment revealed that majority of participants 71 (53%) knew about basic ultrasound training for midwives. All participants (100%) said it is necessary to train midwives in basic ultrasound scan in Zambia. Some content should include, anatomy, measuring foetal biometry, assessing amniotic fluid level, and gestational age determination. Most participants 91 (67%) suggested that the appropriate duration of training is 4 - 6 weeks. Conclusion: Empowering every midwife with ultrasound scanning skills will enable early detection of any abnormality among pregnant women and prompt intervention to save lives.
基金Supported by Medical Science and Technology Research Foundation of Guangdong Province,No.A2018461.
文摘BACKGROUND Diabetes is a common chronic disease,and its global incidence is on the rise.The disease is directly attributed to insufficient insulin efficacy/secretion,and patients are often accompanied by multiple complications.Diabetic foot is one of the most common complications of diabetes.Diabetic feet have ulcers and infections,which can eventually lead to amputation.Basic nursing care,such as lowering blood pressure and preventing foot skin infections in clinical nursing work,has positive significance for the prevention and control of diabetic feet.AIM To explore the positive significance of one-to-one education in high-risk cases of diabetic foot.METHODS This observation included 98 high-risk cases of diabetic foot in our hospital during the period from August 2017 to October 2019,and these patients were randomly divided into the basic nursing group and the one-to-one education group with 49 patients per group.The basic nursing group only received routine basic nursing,while the one-to-one education group gave patients one-to-one education on the basis of basic nursing.After nursing,the self-care ability and compliance behavior of the two groups were evaluated and compared between these two groups.The knowledge mastery of the patient and the satisfaction of nursing were accounted.RESULTS The assessment results of patients(self-care responsibility,self-care skills,selfconcept and self-care knowledge)were significantly higher in the one-to-one education group than in the basic nursing group.The scores of compliance behaviors(foot bathing,shoes and socks selection,sports health care)in the oneto-one education group were significantly higher than those in the basic nursing group.Patients in the one-to-one education group had a significantly higher level of knowledge mastery and satisfaction of nursing than the basic nursing group.CONCLUSION One-to-one education for high-risk cases of diabetic foot is helpful to improve the cognition and self-care ability of patients with diabetic foot,to ensure that patients follow the doctor’s advice of self-care and to improve their nursing satisfaction.
基金This work was supported in part by the National Natural Science Foundation of PRC (No.60425310)the Teaching and Research Award Program for Outstanding Young Teachers in Higher Education Institutions of MOE,PRC.
文摘LDL-factorization is an efficient way of solving Ax = b for a large symmetric positive definite sparse matrix A. This paper presents a new method that further improves the efficiency of LDL-factorization. It is based on the theory of elimination trees for the factorization factor. It breaks the computations involved in LDL-factorization down into two stages： 1） the pattern of nonzero entries of the factor is predicted, and 2） the numerical values of the nonzero entries of the factor are computed. The factor is stored using the form of an elimination tree so as to reduce memory usage and avoid unnecessary numerical operations. The calculation results for some typical numerical examples demonstrate that this method provides a significantly higher calculation efficiency for the one-to-one marketing optimization algorithm.
文摘BACKGROUND There are many drawbacks to the traditional midwifery service management model,which can no longer meet the needs of the new era.The Internet+continuous midwifery service management model extends maternal management from prenatal to postpartum,in-hospital to out-of-hospital,and offline to online,thereby improving maternal and infant outcomes.Applying the Internet+continuous midwifery service management model to manage women with highrisk pregnancies(HRP)can improve their psycho-emotional opinion and,in turn,minimize the risk of adverse maternal and/or fetal outcomes.AIM To explore the effectiveness of a midwife-led Internet+continuous midwifery service model for women with HRP.METHODS We retrospectively analyzed the clinical data of 439 women with HRP who underwent prenatal examination and delivered at Shanghai Sixth People's Hospital(affiliated to the Shanghai Jiao Tong University School of Medicine)from April to December 2022.Among them,239 pregnant women underwent routine obstetric management,and 200 pregnant women underwent Internet+continuous midwifery service mode management.We used the State-Trait Anxiety Inventory,Edinburgh Postnatal Depression Scale,and analysis of delivery outcomes to compare psychological mood and the incidence of adverse delivery outcomes between the two groups.RESULTS The data showed that in early pregnancy,the anxiety and depression levels of the two groups were similar;the levels gradually decreased as pregnancy progressed,and the decrease in the continuous group was more significant[31.00(29.00,34.00)vs 34.00(32.00,37.00),8.00(6.00,9.00)vs 12.00(10.00,13.00),P<0.05].The maternal self-efficacy level and strategy for weight gain management were better in the continuous group than in the traditional group,and the effective rate of midwifery service intervention in the continuous group was significantly higher than in the control group[267.50(242.25,284.75)vs 256.00(233.00,278.00),74.00(69.00,78.00)vs 71.00(63.00,78.00),P<0.05].The incidence of adverse delivery outcomes in pregnant women and newborns and fear of maternal childbirth were lower in the continuous group than in the traditional group,and nursing satisfaction was higher[10.50%vs 18.83%,8.50%vs 15.90%,24.00%vs 42.68%,89.50%vs 76.15%,P<0.05].CONCLUSION The Internet+continuous midwifery service model promotes innovation through integration and is of great significance for improving and promoting maternal and child health in HRP.
文摘BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventions are necessary to improve maternal and fetal outcomes and alleviate primiparas’negative emotions(NEs).AIM To discusses the impact of nursing responsibility in midwifery and postural and psychological interventions on maternal and fetal outcomes as well as primiparas’NEs.METHODS As participants,115 primiparas admitted to Quanzhou Maternity and Child Healthcare Hospital between May 2020 and May 2022 were selected.Among them,56 primiparas(control group,Con)were subjected to conventional midwifery and routine nursing.The remaining 59(research group,Res)were subjected to the nursing model of midwifery and postural and psychological interventions.Both groups were comparatively analyzed from the perspectives of delivery mode(cesarean,natural,or forceps-assisted),maternal and fetal outcomes(uterine inertia,postpartum hemorrhage,placental abruption,neonatal pulmonary injury,and neonatal asphyxia),NEs(Hamilton Anxiety/Depressionrating Scale,HAMA/HAMD),labor duration,and nursing satisfaction.RESULTS The Res exhibited a markedly higher natural delivery rate and nursing satisfaction than the Con.Additionally,the Res indicated a lower incidence of adverse events(e.g.,uterine inertia,postpartum hemorrhage,placental abruption,neonatal lung injury,and neonatal asphyxia)and shortened duration of various stages of labor.It also showed statistically lower post-interventional HAMA and HAMD scores than the Con and pre-interventional values.CONCLUSION The nursing model of midwifery and postural and psychological interventions increase the natural delivery rate and reduce the duration of each labor stage.These are also conducive to improving maternal and fetal outcomes and mitigating primiparas’NEs and thus deserve popularity in clinical practice.
文摘Introduction: International migration has always existed, primarily as a means to find economic opportunity. Recently, the number of health care professionals seeking to work outside Albania is growing rapidly. In 2021 alone, 1073 nurses left Albania. The departure of health care professionals is reflected in education where it can be observed that a good part of the students who finished the bachelor’s level program did not enroll to continue the second level of study in the master’s. The student’s decision not to continue further levels of education has brought consequences from programs shutting down due to lack of students and forcing the university to spread out the few remaining students to other programs. Objective: The purpose of the study was to explore the opinions of Midwifery Students studying at the Bachelor level, regarding their professional future and continuing education. Methodology: This is a cross-sectional study. In this study are included the students of the bachelor level of education. Student participating are studying Midwifery in the 2022-2023 academic year, at the Faculty of Technical Medical Sciences at the University of Medicine, Albania. Results: The students on average believe they can find a job as a midwife. The career is relatively safe and the profession of midwifery will ensure economic well-being for them. Most of the students hope to emigrate and develop their professional career outside of Albania. This was a surprise given that most frequent answers given by the students for not continuing their Master’s level education was the fact that the program was not accredited, their Bachelor’s diploma was also not accredited and so not recognized by other countries, the cost of continuing their studies was too high and their desire for a better economic and social status which they cannot get in Albania. The majority of students participating in the study identified emigration as the main way they plan to further their studies. Conclusions and Recommendations: Although the students had willingly chosen to continue the midwifery diploma, as they thought it would provide them with a proper future, this dignified professional future was seen as unattainable in Albania so they are seeking it out in more developed countries. A significant number of health professionals prefer to continue their second cycle studies in another country. The professional security within their home country does not satisfy the students. As the market demand for nurses around the globe escalates, the changes and consequences associated with nurse migration are increasingly in need of policy solutions that will address the needs of all parties involved. .
文摘Background: Many countries across the world are facing an ongoing shortage of midwife practitioners due to several reasons such as increased workload, working overtime, poor-quality midwifery care, low staff morale, stress and burnout, lack of opportunity for training, lack of management support, financial issues and lack of recognition and compromised autonomy. Purpose: To explore the reasons behind nurses’ hesitance to apply for midwifery specialization. The objectives of this study were to understand the challenges that lie in front of Omani nurses and the motivational factors to apply for a midwifery programme. Method: Exploratory qualitative study was conducted at the largest tertiary hospital in Oman. Purposive sampling was applied for participant recruitment. Face-to-face interviews and focus group discussions were used as data collection methods. The study included general nurses, nurses in charge working in the maternity unit as well as nurses whose applications were accepted for midwifery education. Qualified midwives were excluded. The data collection process yielded twenty-five nurses. The interview protocol highlighted the impact and perception of the midwifery specialization on nurses’ careers. Thematic analysis was employed for data analysis. Results: Three over-arching major themes were identified. These are 1) nurses’ perceptions about the nature of work in maternity wards, the nurses have positive perception toward working in maternity wards and labor room because of working exclusively with female patients and their babies 2) factors influencing the decision to study midwifery specialization, work overload, stress, lack of support from administration were the most common reason behind the nurses not to apply for midwifery specialization and 3) support and recommendations required for midwives, the nurses mentioned that their identity, promotions and support from the administration will encourage them to apply for midwifery specialization. Conclusion: One of the main reasons that hindered nurses from applying to midwifery specialization is the false belief that midwives cannot work outside the delivery suite (DS). The second reason was the stress that midwives encounter at DS, and this was perceived by general nurses who did not work at DS. These challenges could be mitigated by leadership support, midwifery profession identity, as well as financial recognition for the midwives.
