Western Sydney University & Nepean Blue Mountains Local Health District, Centre for Nursing and Midwifery Research, First Floor - Court Building - Nepean Hospital, Nepean Blue Mountains Local Health District, PO Box 63, Penrith, NSW, 2751 Australia.
Midwifery. 2020 Oct;89:102795. doi: 10.1016/j.midw.2020.102795. Epub 2020 Jul 13.
Midwives provide care to women across the childbearing journey from pre-conception to the post-partum period in various clinical settings. Due to the increasing incidence of diabetic pregnancies, midwives are now in a position to support other health professionals, as part of a team, to reduce the stress and / or demand on the health care services.
This integrative review synthesises original research that explores the experiences and perceptions of midwives in the provision of care for women with diabetes.
Integrative review.
Whittemore and Knafl's (2005) systematic approach was used to search for primary literature related to the research question. Studies meeting the following criteria were included: primary qualitative, quantitative and mixed methods research studies published in peer reviewed journals between January 2009 to October 2019. The population of interest being midwives or nurse-midwives and the outcomes of interest included their perceived role in the management of women with diabetes from the pre conceptual to the postpartum period. The methodological quality of the studies was assessed using the appropriate CASP (Critical Appraisal Skills Programmes, 2014) criteria for qualitative and quantitative research studies. A robust search strategy was conducted using the following databases: EBCSO host (all data bases), Embase, Scopus, and Science Direct (see Table 1).
A total of 7275 articles were retrieved and ten papers were included in this review (five qualitative and five quantitative) that fulfilled the inclusion criteria. Two overarching themes were identified: professional and personal impacts on midwifery practice. The professional impact theme included three sub themes: organisational issues, professional development and holistic support. The personal impact theme also included three themes: limited diabetes knowledge, limited clinical practice skills and mental attitude.
The findings indicate that midwives need opportunities to learn and develop skills specific to their role so that each individual's needs can be met. These opportunities include provision of education at a university level, offering work based training and increasing the number of post registration courses targeted at midwives who are willing to upskill to provide appropriate care to women with diabetes. Courses are required to address the knowledge, attitudes to diabetes, appropriate assessment skills and innovative communication skills for midwives.
助产士在各种临床环境中为女性提供从孕前到产后的生育全程护理。由于糖尿病妊娠的发病率不断上升，助产士现在可以作为团队的一部分，与其他卫生专业人员一起支持，以减轻卫生保健服务的压力和/或需求。
本综合评价综合了探索助产士在为糖尿病女性提供护理方面的经验和看法的原始研究。
综合评价。
采用 Whittemore 和 Knafl（2005 年）的系统方法，搜索与研究问题相关的主要文献。符合以下标准的研究被纳入： 2009 年 1 月至 2019 年 10 月期间在同行评议期刊上发表的主要定性、定量和混合方法研究。研究人群为助产士或护士助产士，研究结果包括他们在管理从孕前到产后期间的糖尿病女性方面的感知作用。使用适当的 CASP（批判性评估技能计划，2014 年）标准评估研究的方法学质量，适用于定性和定量研究。使用以下数据库进行了强大的搜索策略： EBCSO 主机（所有数据库）、Embase、Scopus 和 Science Direct（见表 1）。
共检索到 7275 篇文章，10 篇文章符合纳入标准，纳入本综述（5 篇定性和 5 篇定量）。确定了两个总体主题：对助产实践的专业和个人影响。专业影响主题包括三个子主题：组织问题、专业发展和整体支持。个人影响主题也包括三个主题：有限的糖尿病知识、有限的临床实践技能和心态。
研究结果表明，助产士需要有机会学习和发展特定于其角色的技能，以满足每个人的需求。这些机会包括在大学层面提供教育、提供基于工作的培训以及增加针对愿意提高技能以向糖尿病女性提供适当护理的助产士的注册后课程数量。这些课程需要解决助产士的知识、对糖尿病的态度、适当的评估技能和创新沟通技能。
