Asia-Pacific psychiatry : official journal of the Pacific Rim College of PsychiatristsLucy Charlotte Broughton, Natalie Hughes, Jiaxu Zeng, Alesha Smith
PURPOSE: Perinatal mood disorders are associated with adverse maternal and neonatal outcomes and affect 15%-20% of pregnant people. Guidelines recommend SSRIs when non-pharmacological therapies are ineffective, yet antenatal depression remains undertreated. This study aimed to assess the attitudes, knowledge, and practices of general practitioners (GPs) and midwives on SSRI use in pregnancy. METHODS: A knowledge, attitudes, and practice survey was developed in QualtricsXM and distributed to New Zealand-registered GPs and midwives between May 2023 and October 2024 using convenience sampling. RESULTS: Responses from 119 GPs and 62 midwives were analyzed. Discomfort managing antenatal depression was reported by 11% of GPs and 36% of midwives. Knowledge of SSRI risks in pregnancy varied among respondents. Average concern regarding the use of SSRIs in pregnancy and the risk of adverse outcomes was low, but there was considerable variation. In the case vignette, recommended actions differed: 53% advised maintaining treatment, 13% suggested dose reduction, and 24% recommended switching antidepressants. Patient counseling was limited, and appropriate written patient information was rarely provided. CONCLUSIONS: This study highlights variability in knowledge, attitudes, and practices among GP's and midwives regarding SSRIs during pregnancy. Further training, improved access to patient information, and decision aids could enhance patient-centered care and ensure pregnant people receive balanced, evidence-based guidance on SSRI use.
Nursing & health sciencesBirgül Erdoğan, Sümeyra Topal, Sinem Yalnızoğlu Çaka
Disaster response in neonatal intensive care units is particularly complex because care continuity depends on coordinated teamwork, stable infrastructure, and technology-dependent support for highly vulnerable infants. However, qualitative evidence on how nurses experience disaster response in these settings remains limited, especially in the context of the 2023 Türkiye-Syria earthquakes. This study explored how nurses working in neonatal intensive care units experienced disaster response during the earthquakes. Data were collected through semistructured in-depth interviews with 21 nurses and analyzed using descriptive phenomenological analysis. Participants described disaster response not only as a clinical emergency but also as a disruption of the systems supporting coordination, safe neonatal care, and practical preparedness. They reported breakdowns in communication and role clarity, fragility in care when electricity, oxygen delivery, monitoring systems, evacuation planning, and essential supplies became unstable, and a clear gap between general disaster education and unit-specific readiness. Overall, the findings highlight the need for neonatal intensive care-specific disaster preparedness.
International nursing reviewLara Delbene, Sara Mezini, Camilla Cacciabue, Roger Watson, Giuseppe Aleo, Marco Di Nitto, Milko Zanini, Gianluca Catania, Loredana Sasso, Annamaria Bagnasco
AIM: To evaluate the effectiveness of educational programs on disaster preparedness and management for emergency nurses and nursing students, focusing on teaching methods that enhance readiness and competence. BACKGROUND: The increasing frequency and severity of disasters require healthcare systems to be adequately prepared. Nurses, often on the frontline, must receive structured and effective training to respond to critical events with competence and resilience. METHODS: A Rapid Evidence Assessment was conducted to explore and synthesize the available literature on educational interventions in disaster preparedness. Studies were identified through structured searches in international databases and were selected and evaluated using the PRISMA 2020 checklist. The quality of included studies was appraised using the CASP tool. RESULTS: Thirty-six studies met the inclusion criteria. Educational programs incorporating realistic simulations, virtual technologies, and interprofessional exercises were most effective in improving technical skills, confidence, and crisis management. Programs varied in format and intensity but shared common elements such as experiential learning and integration of psychological preparedness. DISCUSSION: Educational interventions must balance theory with practice and adapt to diverse cultural and contextual needs. Simulations and technology-enhanced learning emerge as critical strategies to reinforce emergency competencies. CONCLUSION: Educational programs in disaster preparedness positively influence nurses' readiness, skills, and confidence. Integrating these interventions into nursing education is essential to prepare a responsive and resilient workforce. IMPLICATIONS FOR NURSING: Ongoing and structured education strengthens nurses' ability to respond effectively during disasters, promoting professional growth and emotional resilience. IMPLICATIONS FOR HEALTH POLICY: Policies should support the mandatory inclusion of disaster preparedness training in nursing curricula and continuing education. National frameworks must prioritize standardized educational models to ensure healthcare system resilience and nurse preparedness worldwide.
International nursing reviewMaria João Silva, Lídia Guimarães, Catarina Costa, Marcia Van Riper, Milena Paneque, Maria do Céu Barbieri-Figueiredo
BACKGROUND: Genomics is reshaping healthcare and is increasingly recognized as essential to nursing. Although international organizations call for aligned genomic competencies, integration in undergraduate education remains limited. Curriculum-mapping studies show what is taught, but little is known about how educators interpret genomic relevance or navigate institutional constraints. AIM: To explore how nursing educators in Portuguese higher education institutions understand, value, and operationalize genomics within nursing education programs. METHODOLOGY: A qualitative, exploratory study grounded in interpretivist and reflexive epistemology was conducted through online focus groups with ten nursing educators. Data were generated through dialogic discussions and analyzed using reflexive thematic analysis. RESULTS: Three themes captured shared meanings. Educators viewed genomics as aligned with holistic and person-centered nursing. However, its curricular presence was described as fragmented, implicit, and predominantly taught through biomedical lenses. Structural constraints, such as curriculum saturation, regulatory rigidity, uneven faculty expertise, and reduced contact hours, were perceived as barriers to systematic integration. Participants also constructed feasible pathways to achieve integration, including transversal embedding, case-based pedagogies, flexible initiatives, and interprofessional collaboration. DISCUSSION: Educators' interpretations illustrate how global recommendations are adapted within local realities. They also highlight pragmatic strategies that can support incremental and context-sensitive integration of genomics into nursing education. CONCLUSION: Purposeful integration requires coordinated action across pedagogical design, faculty development, and system-level structures. IMPLICATIONS FOR NURSING: Strengthening faculty preparation and embedding genomic concepts across curricula can enhance genomic literacy. IMPLICATIONS FOR HEALTH POLICY: Aligning educational standards and regulatory frameworks with genomic competencies is key to preparing a genomics-ready nursing workforce.
International nursing reviewBarry McBrien, Frances O' Brien, Shobha Rani Shetty, Sinead Keogh, Jessica Eustace-Cook, Gobnait Byrne
AIM: To map the available evidence on the assessment of migrant nurse and midwife workplace integration in global healthcare settings. BACKGROUND: Globally, migrant nurses and midwives are important resources in mitigating workforce shortages. Existing evidence focuses on the orientation stages of migrant nurse and midwife transition into the healthcare setting rather than their long-term workplace integration. DESIGN/METHODS: The nine databases searched were CINAHL, Medline, Web of Science, Embase, PsycINFO, ASSIA, SicELO, Maternity & Infant Care and Global Index Medicus. An initial search was performed in December 2021 and updated in December 2025. RESULTS: A total of 91 articles were included, comprising qualitative (n = 48), quantitative (n = 13), mixed-methods (n = 6), others (n = 23) and one book chapter. Multiple definitions of workplace integration were found, and 23 tools were identified. CONCLUSIONS: Workplace integration, a multidimensional, time-dependent process, requires collaboration among stakeholders. A standard definition will help to clarify their responsibilities. Key factors ensuring successful integration include promoting effective communication, supporting knowledge advancement, facilitating career development and skill utilisation. The development of standardised interventions with flexibility for local adaptation will support successful workplace integration. IMPLICATIONS FOR NURSING/HEALTH POLICY: Findings highlight the need for policy developers to support migrant nurses and midwives with interventions focused on linguistic challenges, cultural competence and differing care models, that are key to successful integration. Future research must include host stakeholders' perspectives to fully understand the dynamics of workplace integration.
Health expectations : an international journal of public participation in health care and health policyMartin Blanc, Marie-Pierre Gagnon, Daphney St-Germain, Boutheina Mejri, Marie Gagné, Isabel Bean, Gratianne Vaisson
INTRODUCTION: HOPtimise is an organisational innovation in paediatric oncology in the province of Québec (Canada) destined to improve and reinforce best nursing practices through digital training using a serious game and create dashboards focused on indicators sensitive to the quality of care. This complex intervention is led by a quality improvement committee, a joint committee of user partners (former patients and family members) and healthcare providers. The present study aims to demonstrate how innovation and training are co-created with multiple stakeholders. The involvement of patients and their families is at the core of the innovation's design. The aim of this study was to create and elaborate on the components of the logic model of the innovation in order to make it easily understandable for any stakeholder, to set the central roles and activities of the innovative process and to be able to verify the progress of the elaboration and the implementation of the innovation afterwards. The study also intended to generate guidance for future complex interventions in nursing practice improvement. DESIGN: This study has a qualitative, descriptive and participatory design with a mixed data collection destined to create the logic model of the innovation. The qualitative methods used are organised through a three-step timeline: the elaboration of the logic model, the verification phase and validation. Data collection methods involved two focus groups, each one at a different phase of the process (n = 9 and n = 6), semi-structured interviews (n = 4) and verification checklists (n = 9) conducted from June 2022 to June 2024. Data collection guides are based on the Porteus (2009) method for the elaboration of a logic model. Through the process, n = 15 participants took part in at least one data collection (either focus group or interviews). RESULTS: With a 2-year and n = 15 multistakeholder study, the team obtained a logic model of organisational innovation. The HOPtimise logic model is a necessary tool to communicate with all stakeholders from various backgrounds. The study shows that the logic model was clear enough to all the participants (n = 15). As a result, this logic model is a strong base to stabilise the roles and activities of those stakeholders in the elaboration and implementation of the innovation. Indeed, it allowed the building of a stable quality improvement committee. Finally, the logic model became a baseline for the process of identifying barriers and implementation strategies. CONCLUSIONS: The HOPtimise logic model is representative of the complexity of the organisational innovation and the organisational challenges that the project will encounter, and is a necessary tool for evaluation of its implementation in terms of its co-constructive nature. PATIENT AND PUBLIC CONTRIBUTION: This study is a co-creation and is family-centred. It involved the engagement and participation of user partners and organisational members. The research team interacted with them during the three steps of the elaboration of the logic model. They provided opinion and expertise on the content of the innovation, its components, the activities needed to reach the outcomes and implementation strategies.
Health services researchE Brie Thumm, Amy H Goh, Elizabeth G Phillips, Zachary Giano
OBJECTIVE: To understand why advanced practice midwives (certified nurse-midwives and certified midwives) leave the workforce. STUDY SETTING AND DESIGN: A multi-method, multi-source investigation included secondary analysis of certification data of advanced practice midwives and a cross-sectional online survey with closed- and open-ended items. Advanced practice midwives' active certification data were used to compare self-reported demographic characteristics of advanced practice midwives who reported working in the discipline of midwifery to those who did not (n = 9704). A survey was conducted in 2022 with individuals who allowed their certification to lapse between 2017 and 2021 (n = 303) and individuals who maintained certification but reported not working in the discipline of midwifery (n = 1994) to understand why individuals left the workforce and the likelihood of returning. Data were analyzed with ANOVAs, chi-squares, t-tests, and thematic analysis. DATA SOURCES AND ANALYTIC SAMPLE: Administrative data from the American Midwifery Certification Board (n = 9704) and an online survey from a national sample of currently and previously certified nurse-midwives and certified midwives who had left the workforce (n = 646; response rate of 33.8%). PRINCIPAL FINDINGS: The most endorsed reasons for leaving were work-life balance (50.3%, n = 325), unsupportive work environment (34.7%, n = 224), and schedule (32.0%, n = 207). Participants from restrictive regulation states reported lack of opportunities for career advancement, state-level regulation restricting ability to practice, and lack of employment opportunities at higher rates. Respondents of color more frequently reported inadequate compensation, lack of opportunity for advancement, and workplace discrimination at higher rates. Themes included barriers to re-entry to practice and compensation. CONCLUSIONS: Work-life balance and work environment drive midwifery workforce attrition. Individuals of color and those living in states with restrictive regulation face unique challenges. Challenges re-entering the workforce after leaving create barriers to remaining in the workforce, especially with inequitable compensation.
Journal of child and adolescent psychiatric nursing : official publication of the Association of Child and Adolescent Psychiatric Nurses, IncR Colin Blenis
BACKGROUND: Developmental dysgraphia affects 5% to 20% of school-age children and reaches 59% among children with ADHD or autism. The condition produces task avoidance, eroded self-esteem, and behavioral presentations that frequently result in psychiatric referral for anxiety, depression, school refusal, and behavioral disturbance. More than 37% of children with learning disabilities reach clinical thresholds for affective and ADHD problems. Despite this clinical footprint, dysgraphia remains nosologically contested and rarely identified within psychiatric evaluation. OBJECTIVES: This integrative review synthesizes the multidisciplinary evidence on developmental dysgraphia and examines its implications for child and adolescent psychiatric-mental health nursing. DATA SOURCES: Eight databases (PubMed/MEDLINE, CINAHL, PsycINFO, Scopus, ERIC, Cochrane, OTseeker, Web of Science) yielded 8290 records published between January 2000 and March 2026. After deduplication, 6308 records were screened, 1476 were assessed for eligibility, and 56 contributed to synthesis. Synthesis followed Whittemore and Knafl (2005) under PRISMA 2020 reporting conventions. CONCLUSIONS: Findings document definitional disagreement, fragmented assessment, underpowered intervention evidence, and substantial psychosocial burden. Three nursing publications addressed dysgraphia, and none reported original research on the condition. IMPLICATIONS FOR PRACTICE: Dysgraphia screening may be integrated into psychiatric evaluations of children referred for ADHD, anxiety, depression, school refusal, or behavioral disturbance. Handwriting may be monitored as a stimulant medication outcome. On inpatient units, writing-based therapeutic activities require adaptation when dysgraphia is suspected. Pediatric primary care and school health represent upstream identification opportunities.
International journal of mental health nursingSini Jacob, Sebastian Samuel, Greety Antony, Susan Hua, Nisha Antony
Mental health nursing requires specialised training in therapeutic communication and related soft skills. Innovative, digitally enhanced strategies may support competency development, particularly amid clinical placement shortages. This article outlines insights from a scoping review of technology use in undergraduate mental health nursing education. The objectives were to (a) explore the impact of using these technologies in students' experience and (b) develop insights that can contribute to the development of a curriculum that embed innovative educational technology with strong theoretical foundations and pedagogical strategies. This review was guided by the modified Arksey and O'Malley methodological framework. The PCC (Population, Concept, Context) framework was used to formulate the eligibility criteria. A review protocol was registered with the Open Science Framework (OSF). The databases for searching included CINAHL, MEDLINE, Scopus, PsycINFO, Web of Science. The results were reported according to the PRISMA-ScR checklist. The review included 35 studies and the evidence showed that, virtual reality simulations (VRS) with varying immersive abilities were the most popular innovative educational technology used in undergraduate mental health nursing education. Interestingly, no articles were identified that used other innovative educational technologies as outlined in the search strategies. Both immersive and non-immersive VRS were equally effective in improving student learning experiences compared to traditional learning modalities. The main benefits included enhanced learning experiences and comprehension and the development of necessary skills and confidence before entering clinical settings. Advanced technologies offer future-focused benefits for mental health nursing education; however, core therapeutic skills remain essential. Virtual learning should therefore complement, not replace, realistic learning experiences.
International journal of mental health nursingAntony Mullen, Brenda Happell, Bridget Hamilton, Stephanie Skinner
The Safewards model and its ten interventions have been effective in reducing restrictive practices and preventing conflict within acute inpatient mental health units. However, few studies in the current literature explore the consumers' experiences of Safewards. This exploration also needs to consider the views of Mental Health Nurses and the Lived Experience Workforce, who are both important stakeholders in the application of Safewards and how it impacts on consumers' experiences. Despite this, the views of Mental Health Nurses and the Lived Experience Workforce about consumers' experiences of Safewards are limited. This qualitative study explored the views of Lived Experience Workforce leaders about consumers' experiences of Safewards, and Mental Health Nurses' responses to these experiences in acute inpatient mental health units in Australia. Six Lived Experience Workforce leaders participated in individual interviews. Data were analysed using thematic analysis, revealing four themes: (1) consolidating Safewards through understanding consumers' experiences, (2) consumers as leaders in Safewards, (3) acknowledging the realities of acute inpatient mental health units and (4) practice foundations underpinning Safewards. Results highlighted the positive impact of improved consumer involvement in Safewards. Additionally, mechanisms to develop strategic partnerships between Lived Experience Workforce leaders and mental health nurses warrant further investigation. This study highlighted the restrictive nature of acute inpatient mental health units and the need to acknowledge the impact this has on consumers. Further embedding of foundational approaches, such as trauma-informed and recovery-oriented practice within Safewards, is also required to align with consumers' expectations. Greater recognition of consumers' experiences and their agency within the model, and consideration of other Safewards interventions, is also needed. This is required to increase safety, reduce harms associated with restrictive practice, and enhance Safewards effectiveness.
International journal of mental health nursingSuyoun Ahn, Eunmi Hwang
As community mental health services expand in scope and responsibility, mental health nurses are playing a central role in delivering integrated, recovery-oriented care. However, they face substantial challenges in adapting to community practice and sustaining professional development. Clinical supervision can mitigate these demands through its formative, normative, restorative functions. This study explored the supervision experiences of community mental health nurse specialists in South Korea to provide evidence for specifying the effective functions and operational systems of supervision using an exploratory qualitative design. Twelve community mental health nurse specialists participated in three focus group interviews conducted between June 2024 and July 2025. Data were analysed using reflexive thematic analysis. Four themes and 10 subthemes were generated: translating community mental health ideals into professional practice; serving as an anchor in unfamiliar terrain; supervision undermined by superficiality and disrespect; and competency development constrained by structural barriers. Supervision was perceived as a critical space for clarifying clinical direction, regulating emotional involvement and supporting professional adaptation. However, formalistic delivery and structural constraints limited its impact. These findings highlight the need for integrated and systematic supervision approaches aligned with the community mental health paradigm, supported by organisational and policy commitments to protected time, staffing, education and financial resources. Strengthening supervision under such conditions may enhance practitioner development and service user outcomes.
International journal of mental health nursingEsario Iv Daguman, Dane Owen, Jacqui Yoxall, Richard Lakeman, Marie Hutchinson
Interventions aimed at reducing restrictive practices are also designed to enhance the service experience in acute mental health units. However, people with experience of coercive engagement with these services are seldom involved as active contributors in evaluative research on interventions to reduce restrictive practices. With the meaningful involvement of lived experience practitioners, this research was aimed at examining care recipients' service experiences and perspectives on nurses' therapeutic responses during the implementation of a de-escalation intervention in three adult inpatient units within New South Wales, Australia, from March 2024 to April 2025. Nested within a larger study employing a mixed concurrent control design, this research evaluated the effectiveness and process of the Safe Steps for De-escalation through comparisons of unmatched measures of empowerment, dehumanisation, and staff actions on violence prevention across three time points, as well as through a reflective thematic analysis of semi-structured interviews. Safe Steps is a structured approach for therapeutic responding, targeting nurses' relationship-promotion behaviours to increase focus on minimising the use of restrictive practices. Eighty-six inpatients completed the unmatched measures, with nine participating in interviews following discharge. No significant changes were noted in quantitative measures over time. Five themes emerged from the qualitative analysis: (i) Clarity calms; confusion harms, (ii) Control cuts deep, (iii) Systems strain; people break, (iv) Connection is treatment in itself, and (v) Meaning-making outweighs medicine. These findings cast acute inpatient units in a light akin to a power circuit, elevating the need to make inpatient admissions more reflective of everyday life outside the units.
International journal of mental health nursingSophie Isobel
There are increasing guides and expectations for being trauma informed in research practices. This perspective paper builds upon this emerging field of literature to consider what it means to be trauma and violence informed in mental health nursing research and evaluation. Being trauma and violence informed requires all the same in-the-moment application of the principles of trauma informed care when engaging with participants or data, while also contextualising trauma in the context of wider social contexts. This includes recognising the role that structural violence plays in compounding and sustaining trauma for groups and individuals. To be trauma and violence informed in research requires attention to the power that research and evaluation hold and ongoing reflection on the implications of the design, measures, outcomes and findings of research and evaluation, while informing all decisions by awareness of trauma and the forms of violence that cause and sustain it.
Medical education onlineMarisol Angulo-Ramos, César Merino-Soto, Dayana Guillinta-Herrera, Giorgio Aquije-Cardenas, Guillermo M Chans
BACKGROUND: Among Hispanic undergraduate students, the association between research-related coursework and research interest remains largely underexplored. This exploratory study examined differences in research interest among undergraduate nursing students according to their exposure to research-related coursework, drawing on Social Cognitive Career Theory. METHODS: A cross-sectional study was conducted with 106 nursing students from a Peruvian university. Participants completed the Interest in Research Questionnaire (IRQ), which demonstrated excellent internal consistency (α = 0.98). Research interest was compared across four academic-semester groupings reflecting proximal and distal exposure to research-related coursework using rank-based nonparametric methods. RESULTS: Significant differences in research interest were observed across groups (Anderson-Darling test = 9.41, p = 0.001), indicating a curvilinear pattern. Students currently or recently exposed to research-related coursework (levels 2 and 4) reported significantly higher research interest than those with more distal exposure (level 3; p < 0.05; medium effect sizes). First-semester students showed research interest levels comparable to those of the proximally exposed groups. CONCLUSION: Research interest may decline in the absence of sustained engagement in research activities, underscoring the importance of early and continuous integration of research experiences throughout undergraduate nursing curricula. The findings also provide initial evidence supporting the use of the IRQ in Spanish-speaking undergraduate contexts.
International journal of qualitative studies on health and well-beingKumiko Hashiratani, Hiroko Azechi
BACKGROUND: Emergency nurses caring for patients who have attempted suicide face ethical dilemmas and negative emotions that hinder empathetic care. Existing studies have mainly reported emotional burden and mixed attitudes, with limited research examining nurses' internal interest processes. Therefore, this study aimed to clarify the structure and processes underlying nurses' interest in caring for these patients in hospital-based emergency care settings, using a grounded theory approach. METHOD: Data were collected through semi-structured interviews with 25 nurses experienced in emergency care in Japan who had provided care to patients who had attempted suicide. Interviews were conducted from August 2022 to December 2023 and analyzed using constant comparative analysis. RESULTS: Six major categories emerged: "Attention towards care," "Being influenced by one's inner self," "Welling up emotions," "Focusing on attention," "Deciding the direction of care," and "Taking a meta-perspective on oneself within the situation." Nurses' beliefs and values were profoundly challenged by the gravity of suicide attempts, eliciting complex emotional responses combining a sense of moral responsibility, discomfort, and conflicting feelings. CONCLUSIONS: Emergency nurses maintained an interest in patient care despite emotional conflict and a destabilized sense of self. Self-awareness and situational awareness, particularly taking a meta-perspective, supported professional caring and decision-making.
BACKGROUND: Nurses are central to trauma care in both peacetime and conflict, where training and expertise directly affect patient outcomes. Cooperative training between healthcare professionals from opposing communities is rare in regions of ongoing violence, yet may be a powerful mechanism for strengthening regional trauma systems and advancing health diplomacy. Operating Together is a binational initiative that brings Palestinian and Israeli trauma providers together for joint training. This study describes the establishment of a regional Advanced Trauma Care for Nurses (ATCN) program serving both Israeli and Palestinian communities, evaluates course effectiveness, and health‑diplomacy attitudes. METHODS: Between January 1 and December 31, 2025, six ATCN providers and two ATCN instructor courses were conducted. Participants completed anonymous questionnaires assessing satisfaction, perceived clinical relevance, and attitudes toward Palestinian-Israeli health cooperation. Descriptive statistics summarized responses, and comparisons used independent‑samples t tests and Fisher's exact tests (significance p < 0.05). RESULTS: Of 52 participants, 36 completed the study (50% Israeli, 50% Palestinian). Participants reported high course satisfaction (M = 8.44/10) and perceived educational impact (M = 4.39/5). Most (94.4%) expressed interest in maintaining professional contact. The belief that cooperation improves patient care is strongly correlated with positive health‑diplomacy attitudes (rs =.74, p < .001). Palestinian nurses reported significantly higher scores regarding the role of health cooperation in conflict resolution and mutual understanding (both p = .006). Male participants had higher health‑diplomacy index scores than female participants (p = .004). CONCLUSION: In the context of ongoing conflict, joint ATCN courses for Palestinian and Israeli nurses were associated with high educational satisfaction and strong support for continued professional cooperation. Participants perceived binational training as beneficial for trauma care and contributing to a more positive climate. Joint trauma nursing education may provide a promising platform for strengthening trauma systems and advancing health diplomacy in conflict‑affected settings. LEVEL OF EVIDENCE: Prognostic and epidemiological; Level II-III (educational intervention).
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal ObstetriciansYing Guo, ZhiYun Zhang, YanHua Zhang, JiMei Cong, Li Li, Wei Yi, Min Chang
OBJECTIVE: To evaluate the association between integrated midwife-led continuous labor support with postpartum care and maternal and neonatal outcomes, psychological resilience, and labor pain in primiparous women. METHODS: Medical records of 150 nulliparous women who delivered at Beijing Ditan Hospital between October 2023 and July 2025 were retrospectively reviewed. The observation group received continuous midwife-led support during labor with extended postpartum care, while the control group received standard obstetric care. Outcomes were assessed using the Labor and Delivery Efficiency and Quality Index (LBDI), Connor-Davidson Resilience Scale (CD-RISC), Delivery Pain Assessment System (DPAS), and Pain Tolerance-Recovery Response Index (PTRR). Relevant clinical data were analyzed to explore associated factors. Data were analyzed using SPSS 26.0 and AMOS 24.0. RESULTS: Compared with the control group, the observation group showed higher composite LBDI scores (8.43 ± 0.57 vs. 7.77 ± 0.65, p < 0.001, Cohen's d = 1.09), higher spontaneous vaginal delivery rates (95% vs. 76%, p < 0.001), and higher 5-minute Apgar scores (9.4 ± 0.4 vs. 8.8 ± 0.6, p < 0.001), along with reduced postpartum hemorrhage and lower incidence of fetal distress (all p < 0.05). Psychological resilience and labor pain responses were better in the observation group (p < 0.05). CONCLUSION: Integrated midwife-led labor support with postpartum continuity of care was associated with better delivery outcomes and higher psychological resilience scores in primiparous women. Prospective studies are needed to confirm causality.
European journal of obstetrics, gynecology, and reproductive biologyClément Bourdel, Lucie Guilbaud, Violaine Peyronnet, Paul Berveiller, Alexandre J Vivanti, Thomas Schmitz, Jean-Marie Jouannic, Gilles Kayem, Aude Girault, Yoa…
OBJECTIVE: To assess healthcare professionals' opinions, counseling practices, and personal preferences regarding mode of delivery for term breech presentation, and to explore variations according to gender, professional status, experience, and institutional policy. METHODS: We conducted a multicenter cross-sectional survey in six tertiary maternity units in the Paris area between September 2025 and January 2026. Obstetrics residents, senior obstetricians, and midwives were invited to complete an anonymous electronic questionnaire exploring counseling practices, reported neutrality of information, and personal preferences regarding mode of delivery. Comparisons were performed according to gender, professional status, experience, and institutional policy. RESULTS: A total of 242 healthcare professionals responded (response rate, 46.1%). Overall, 81.4% reported a personal preference for planned vaginal breech delivery. Most respondents considered that, in cases of breech presentation, the final decision regarding mode of delivery should belong to the patient (88.8% vs 57.9% for cephalic presentation;p < 0.01). Only 54.1% reported providing neutral counseling. Male professionals were more likely than female professionals to support planned vaginal delivery in nulliparous women (90.9% vs 72.2%;p = 0.01) and in women with a previous uterine scar (69.7% vs 50.2%;p = 0.04). Support for planned vaginal breech delivery differed according to professional status (p = 0.04), with lower rates among midwives with more than 5 years of experience (69.1%). Institutional policy had a major influence: professionals working in centers favoring planned vaginal breech delivery were more likely to support this option than those working in centers with elective cesarean policies (84.9% vs 61.1%;p < 0.01), and counseling was more often oriented toward cesarean delivery in the latter group (47.2% vs 2.4%;p < 0.01). CONCLUSIONS: This study showed that reported counseling practices for term breech presentation are frequently non-neutral and that healthcare professionals' opinions and reported counseling practices vary according to professional characteristics and institutional setting. These findings highlight the heterogeneity of counseling practices and emphasize the importance of promoting balanced information and shared decision-making to support women's informed choice regarding mode of delivery.
Scandinavian journal of primary health careGabriella Caleres, Sarah Thelin, Elisabeth Persson, Veronica Milos Nymberg, Sara Modig
BACKGROUND: To improve care for community-dwelling older individuals, Swedish primary care has implemented nurse-led elderly care units targeting this group. AIM: To explore how primary care nurses working in elderly care units view their role regarding medication safety and gain their perspectives on the work model. METHODS: This was a qualitative focus group study with 14 strategically sampled primary care nurses working at elderly care units. Data were collected through three focus groups and two individual interviews between September 2024 and June 2025, audio-recorded and transcribed verbatim. Content analysis was applied, and the person-centred nursing framework was used to interpret the results. Triangulation and reflexivity were pursued, and an audit trail was maintained to ensure trustworthiness. RESULTS: Five categories emerged (1), diverse conditions for elderly care units (2), preventing and managing drug-related problems (3), bridging the gap - a vital function for medication safety (4), the comprehensive geriatric perspective, and (5) perceptions of the nurse's role. CONCLUSION: This study found that nurses in elderly care units recognize their potentially significant role in medication safety. Their comprehensive geriatric perspective enables them to impede or intervene on drug-related problems, compensate for fragmented care and resolve issues as a central coordinator. However, the absence of guidelines leads to inconsistent and inequitable care, insights important for further development of the work model.
Human vaccines & immunotherapeuticsJihye Choi, Efrat K Gabay, Jeanette Deason, Elizabeth Baumler, Diane Santa Maria, Daisy Mullassery, Lara S Savas, Erika Thompson, Sanghamitra M Misra, Paula M …
Human papillomavirus (HPV) can cause six cancer types but can be prevented with timely vaccination in early adolescence. However, despite the wide availability of the HPV vaccine, uptake remains suboptimal among US adolescents. School nurses are invaluable resources to students and their families regarding adolescent immunization needs. As part of the All for Them vaccination program, we assessed the impact of the continued nurse education (CNE) intervention on school nurses' HPV vaccine communication with parents. Seventy-two school nurses and nurse administrators in Texas participated in the study. Using a single-arm study design, we measured participants' potential barriers to and self-efficacy for recommending the HPV vaccine, and knowledge about HPV and the vaccine. Data were collected between November 2021 and May 2023. We evaluated differences in survey responses using paired t-test and McNemar-Bowker chi-square test. Participants' uncertainty about HPV vaccine efficacy was significantly reduced at follow-up (P < .001). More participants indicated that their HPV knowledge (P = .003) and understanding of the recommended dosing schedule for the vaccine (P = .003) were not barriers at all at follow-up. Participants' confidence to communicate with parents about HPV vaccination significantly increased across six self-efficacy variables at follow-up (P < .001). The CNE intervention appeared to improve nurses' HPV and HPV vaccine-related knowledge and increased their self-efficacy to communicate about HPV vaccination with parents, while lessening their perceived barriers to do so. The CNE can be a key resource to support school nurses' professional practice, facilitating their high-quality HPV vaccine recommendations to adolescents and parents.