Search results

This study aims to understand how midwifery students view ethical rights concerning the usage of reproductive technologies.

A series of focus groups were conducted with midwifery students who were asked to discuss four novel scenarios highlighting some of the most controversial issues on the ethics of assisted reproductive technologies. The sample consisted of third-year students studying at the Department of Midwifery of a university in the fall semester of the 2020–2021 academic year. In total, 60 students aged between 20 and 23 participated in the study (mean age 21.5 years).

Four scenarios that may be encountered in the use of assisted reproductive techniques were presented to the students. These scenarios were about IVF treatment, using the preimplantation gender identification technique, surrogate mother and using frozen zygotes. Four themes were identified from the analysis of the focus group data related to all four scenarios. These themes were: female reproduction, sex selection, surrogacy and reproductive cloning.

This study reveals what midwifery students consider essential components of assisted reproduction techniques, focusing on the professional attributes of shared decision-making. The results suggest that student midwives are sensitive to the range of ethical dilemmas associated with the increased use of technology in human reproduction, and construct distinct bound arise in relation to what is considered of benefit or good to the mother, parents, the child and to society. They also expressed their opposition to the excessive use of technological intervention, preferring instead to maintain a more naturalistic approach to reproduction.

Servicescape is well recognized by marketing scholars as a key influence in transformative service outcomes. However, the concept of enabling transformative health outcomes through physical servicescape design is often overlooked. The purpose of this study is to integrate marketing's servicescape research with birth territory theory and the enabling places framework, conceptualizing a Co-Curated Transformative Place (CCTP) framework.

This cross-disciplinary conceptual paper uses three places of birth (POB) servicescapes for low-risk birthing women to ground the CCTP framework.

Positioned within transformative service research, this study shows how POB servicescapes are CCTPs. The organizing framework of CCTP comprises four key steps founded on agile and adaptive co-curation of physical place resources.

This study extends the servicescape conceptualization to incorporate the continuum of terrain, introducing adaptive and agile co-curation of places.

The materiality of place and physical resources in CCTP are usefully understood in terms of co-curated substantive staging according to service actor needs. The CCTP servicescape maximizes desired value outcomes and quality experience by adaptive response to service demands and service actors’ needs.

Theoretical discourse of health servicescapes is expanded to focus on the material components of place and their foundational role in generating resources and capabilities that facilitate the realization of service value. In the CCTP, service actors flexibly select, present and adapt physical artifacts and material resources of the service terrain according to dynamic actor needs and service responsibilities, enabling transformative outcomes. Co-curation facilitates reciprocal synergy between other dimensions of place and servicescape.

The purpose of this paper is to evaluate the impact of leadership development programmes, underpinned by Transformational Learning Theory (TLT).

A corpus-informed analysis was conducted using survey data from 690 participants. Data were collected from participants’ responses to the question “please tell us about the impact of your overall experience”, which culminated in a combined corpus of 75,053 words.

Findings identified patterns of language clustered around the following frequently used word types, namely, confidence; influence; self-awareness; insight; and impact.

This in-depth qualitative evaluation of participants’ feedback has provided insight into how TLT can be applied to develop future health-care leaders. The extent to which learning has had a transformational impact at the individual level, in relation to their perceived ability to influence, holds promise for the wider impact of this group in relation to policy, practice and the promotion of clinical excellence in the future. However, the latter can only be ascertained by undertaking further realist evaluation and longitudinal study to understand the mechanisms by which transformational learning occurs and is successfully translated to influence in practice.

Previous research has expounded traditional leadership theories to guide the practice of health-care leadership development. The paper goes some way to demonstrate the impact of using the principles of TLT within health-care leadership development programmes. The approach taken by The Florence Nightingale Foundation has the potential to generate confident leaders who may be instrumental in creating positive changes across various clinical environments.

Decree Law No. 663 introduced a decentralized organizational structure and administration pertaining to Turkish public hospitals in November 2011. This study aims to explore the effects of the public hospital unions (PHUs), which were a result of Decree Law No. 663, on the efficiency and productivity of public hospitals.

Data envelopment analysis (DEA) and DEA-based Malmquist total factor productivity (TFP) index were used from 2011 to 2016. Raw materials and supply expenses, salaries and fringe benefits, other service costs, general administrative expenses, total number of beds, number of specialists, number of residents, number of general practitioners, number of nurses and midwives and other medical officials were used as input variables. Working capital turnover, number of inpatients, number of outpatients and number of surgical operations for Groups A, B and C were used as output variables.

According to the DEA scores, the percentage of efficient hospitals showed a declining trend from 2011 to 2016. The TFP results also showed a decreasing trend from 2011 to 2016.

Providing administrative and financial autonomy to public hospital managers may cause efficiency and productivity losses, which is contrary to expectations.

This study is the first to reveal the impact of decentralization of public healthcare providers on their performance levels in Turkey.

The response of the receiver to a voiced patient safety concern is frequently cited as a barrier to health professionals speaking up. The authors describe a novel Receiver Mindset Framework (RMF) to help health professionals understand the importance of their response when spoken up to.

The framework draws on the broader receiver-focussed literature and integrates innovative findings from a series of empirical studies. These studies examined different receiver behaviour within vignettes, retrospective descriptions of real interactions and behaviour in a simulated interaction.

The authors' findings indicated that speaking up is an intergroup interaction where social identities, context and speaker stance intersect, directly influencing both perceptions of and responses to the message. The authors' studies demonstrated that when spoken up to, health professionals poorly manage their emotions and ineffectively clarify the speaker's concerns. Currently, targeted training for receivers is overwhelmingly absent from speaking-up programmes. The receiver mindset framework provides an evidence-based, healthcare specific, receiver-focussed framework to inform programmes.

Grounded in communication accommodation theory (CAT), the resulting framework shifts speaking up training from being only speaker skill focussed, to training that recognises speaking up as a mutual negotiation between the healthcare speaker and receiver. This framework provides healthcare professionals with a novel approach to use in response to speaking up that enhances their ability to listen, understand and engage in point-of-care negotiations to ensure the physical and psychological safety of patients and staff.

With global migration, the number of ethnic minority and migrant women receiving maternity health care in dominantly Anglo-European societies has increased significantly but they consistently have among the worst pregnancy and maternal outcomes. This paper aims to analyse gaps in structural (migration-related inequalities) and cultural (responsiveness to ethno-cultural practices) competencies among maternal health practitioners in Aotearoa New Zealand (NZ).

Using a semi-structured interview guide, in-depth interviews were conducted with 13 maternal health practitioners in NZ. Data were analysed using a thematic analysis framework.

The results highlight significant barriers around language and communication, cultural stereotyping by professionals, ethnic women’s own constraints around family and cultural expectations and their lack of knowledge about reproductive health. In addition, practitioners’ own ethnic differences are inseparable from their approach to structural and cultural competencies; there were instances of ‘over-’ or ‘under-’ reading of culture, practitioner constructions of ideal pregnancies and anti-racism concerns that shaped maternal care practices that were sensitive to, but also marginalised, ethnic migrant women who attended maternity services.

To the best of the authors’ knowledge, this is the only study in NZ that examines the impact of complex dynamics of migration and culture on knowledge, beliefs and values of practitioners, in context of their own personal biographies. Identifying strategies to improve the way diversity is practiced in hospital settings can be transformational in improving maternal outcomes for ethnic migrant women in NZ.

The purpose of this systematic review was to explore the benefits and challenges in the implementation of simulation-based education (SBE) in the classroom and clinical settings in sub-Saharan Africa. The objectives of this systematic review were to identify the benefits of utilising SBE in the classroom and clinical practice in sub-Saharan Africa and to assess the challenges in the implementation of SBE in the classroom and clinical practice in sub-Saharan Africa.

Five databases were searched for existing English literature (Medline, CINAHL and Science Direct), including grey literature on the subject. Out of 26 eligible studies conducted in sub-Saharan Africa between 2014 and 2021, six studies that used mixed-methods design were included. Hawker et al.’s framework was used to assess the quality of the studies. Quantitative data were presented using descriptive and inferential statistics in the form of means and standard deviations while qualitative data were analysed and presented thematically.

Quantitative findings showed that participants rated SBE highly in terms of teaching (93.2%), learning (91.4%) and skill acquisition (88.6%). SBE improved the clinical skill competency from 30% at baseline to 75% at the end. On the other hand, qualitative findings yielded themes namely: improved confidence and competence; knowledge acquisition and critical thinking; motivation and supervision; independent, self-paced learning; simulation equipment and work schedules; and planning and delivery of simulation activity. Pedagogical skills, competence and confidence are some of the elements that determine the feasibility of implementing SBE in the classroom and clinical settings.

SBE could help to bridge the gap between theory and practice and improve the quality of care provided by nurses. Simulation-based training is effective in improving the clinical skills of midwives and increasing their confidence in providing care. However, SBE trainees require motivation and close supervision in classroom settings if simulation is to be successfully implemented in sub-Saharan Africa. Furthermore, careful planning of scenarios, students briefing and reading of content prior to implementation facilitate effective simulation.

While there may be a lack of literature on the use of SBE for training nurses and midwives in the developing world, there is growing evidence that it can be an effective way to improve clinical skills and quality of care. However, there are also significant challenges to implementing simulation-based training in resource-limited settings, and more research is needed to understand how best to address these challenges. This study fills this gap in the literature.

To research involvement of healthcare staff in the UK and identify practical organisational and policy solutions to improve and boost capacity of the existing workforce to conduct research.

A mixed-method study presenting three work packages here: secondary analysis of levels of staff research activity, funding, academic outputs and workforce among healthcare organisations in the United Kingdom; 39 Research and Development lead and funder interviews; an online survey of 11 healthcare organisations across the UK, with 1,016 responses from healthcare staff included for analysis; and 51 interviews of healthcare staff in different roles from six UK healthcare organisations.

Interest in research involvement is strong and widespread but hampered by a lack of systematic organisational support despite national policies and strategies to increase staff engagement in research. While useful, these external strategies have limited universal success due to lack of organisational support. Healthcare organisations should embed research within organisational and human resources policies and increase the visibility of research through strategic organisational goals and governance processes. A systems-based approach is needed.

The research gathered data from a limited number of NHS trusts but these were purposively sampled to provide a range of different acute/community health service organisations in different areas. But data was therefore more detailed and nuanced due to a more in-depth approach.

The findings are relevant for developing policies and practice within healthcare organisations to support research engagement. The findings also set out key policy and strategic recommendations that will support greater research engagement.

Increased research activity and engagement in healthcare providers improves healthcare outcomes for patients.

This is a large scale (UK-wide) study involving a broad range of healthcare staff, with good engagement of nurses, midwives and Allied Healthcare Professionals who have not been previously achieved. This allowed valuable analysis of under-researched groups and comparisons by professional groups. The findings highlight the need for tailored action to embed research reporting, skills, professional development and infrastructure into organisational policies, strategies and systems, along with broader system-wide development.

Obstetric violence is the mistreatment of women in the setting of obstetric care, which includes preconception, medically assisted reproduction, pregnancy, childbirth and postpartum. Obstetric violence follows and perpetuates the devaluation and subjugation of women in patriarchal societies, where socio-cultural conceptions contribute to a view of the female body as faulty and deviating from the male prototype. These shape the perception that female reproductive processes require technological corrections. The medicalisation of reproductive processes and the mechanisation of a normal life event, with the threat of death and other life-changing consequences, disempower women and objectify the body and its functions.

The entrance of women into the workforce and the specialised fields, feminising care professions, failed to shift this paradigm. Female health workers are trained in the procedures instituted by dominant patriarchal structures, expressing values encoded in the professional culture and the institutions where they work. As women conform to the models they are exposed to during their training, perpetuating corporate hierarchies and practices, they act as agents and perpetrators of obstetric violence. Thus, obstetric violence also constitutes a specific type of violence against women at the hands of other women.