International Journal of Community Based Nursing and Midwifery
Volume:11 Issue: 2, Apr 2023

Home births with the help of untrained family members continue to be women’spreference in Indonesia. However, the practice has received very little attention. The purpose of thisstudy was to explore women’s reasons for choosing home births with the help of their untrained familymembers. This study used an exploratory-descriptive qualitative research approach and was conductedfrom April 2020 to March 2021 in Riau Province, Indonesia. A total of 22 respondents determined bydata saturation was recruited using purposive and snowball samplings. The respondents consisted of12 women who had at least one planned home birth with the help of their untrained family members,and 10 untrained relatives who had an experience in intentionally assisting their family member’s homebirth. Data were collected through semi-structured telephone interviews. Nvivo version 11 softwarewas used for data analysis using the Graneheim and Lundman’s content analysis. 13 categories and 4 themes emerged. The themes were living with fallacious beliefs inunassisted home childbirths, feeling of socially alienated from the surrounding communities, dealingwith limited access to healthcare services, and escaping from childbirth-related stressors. Home birth with the help of untrained family members takes place because of not onlylimited access to healthcare services, but also women’s personal beliefs, values, and needs. Designingculturally sensitive health education, ensuring culturally competent healthcare workers and services,overcoming healthcare access barriers, and improving the community’s pregnancy and childbirthliteracies are fundamental in reducing unassisted home births and promoting facility childbirths.

One way of dealing with pregnancy-related anxiety is through women’s beliefs. This studyaimed to assess the effect of spiritual self-care blended learning on anxiety in women with preterm labor. A non-blinded and parallel randomized clinical trial was conducted in Kashan, Iran, fromApril to November 2018. In this study, 70 pregnant women with preterm labor were randomized tointervention and control groups (35 each) by flipping a coin. For the intervention group, spiritualself-care training was delivered through two face-to-face sessions and three offline sessions. Thecontrol group received routine mental healthcare. The data were collected using socio-demographicinformation and the Persian Short Form of the Pregnancy-Related Anxiety (PRA) Questionnaires.Participants filled out the questionnaires at baseline, immediately after the intervention, and fourweeks after it. Chi-square, Fisher’s exact test, independent t-tests, and repeated measures ANOVAwere used to analyze the data. SPSS v.22 was used, with a significance level of P<0.05. At baseline, the mean PRA scores in the intervention and control groups were 52.25±29.23and 49.68±21.66, respectively (P=0.67). There were significant differences immediately after theintervention (28.02±12.13 and 51.42±20.99 in the intervention and control groups, respectively)(P<0.001), and four weeks post-intervention (25.45±10.44 and 52.17±21.13 in the intervention andcontrol groups, respectively) (P<0.001); PRA was lower in the intervention group. Our results revealed the positive effect of spiritual self-care intervention on anxiety inwomen with preterm labor, so this intervention could be integrated into prenatal care.Trial Registration Number: IRCT20160808029255N2

Maternal and child health (MCH) services have been affected by the Coronavirusdisease (COVID-19) pandemic in all countries, including Indonesia. Information regarding the impactof COVID-19 on MCH service access and provision is limited, particularly in the context of ruralIndonesian communities. This study aimed to explore the experiences of Indonesian mothers andmidwives from a rural regency regarding MCH services delivery during the pandemic. This study was a sub-study of a pre-existing cohort study conducted in four sub-districtsin Banggai, Indonesia, as the qualitative research. This study was conducted from November 2020to April 2021, involving 21 mothers and six midwives. We selected the participants using snowballsampling. In-depth interviews were conducted in Bahasa. The study used both deductive and inductiveapproaches for analysis. Data analysis was performed using NVivo v.12. The study identified three themes and eight sub-themes from the analysis incorporating the midwives’and mothers’ data. The themes included health service change, perceived barriers to service delivery, andfamily impact. This study highlights health service changes due to the pandemic, such as relocating the MCHservices. Mothers perceived barriers to accessing health services, including distance reasons and fear ofCOVID-19. Only the shortages of staff affected the midwives in providing optimal services. The pandemic triggered health service changes and caused some barriers to servicedelivery. This study recommends that the local government and stakeholders should pay more attentionto the health service changes according to the mothers’ experiences and address barriers to optimizeaccess to MCH services during the pandemic.

Coronavirus disease-19 (COVID-19) is a widespread disease all over the world that has causedmany psychological complications such as health anxiety (HA) and low quality of life (QOL). Mindfulnessbasedapproaches could improve these complications. Therefore, this study aimed to investigate the effect ofInternet-delivered mindfulness stress reduction combined with acceptance and commitment therapy (IMSRACT)on QOL and HA of caregivers of patients infected by COVID-19.

In this randomized clinical trial, 72 people from Golpayegan city, Iran, who had a patient with COVID-19 in their family were selected from March to June 2020. A caregiver with a score above 27 on the Health Anxietyinventory (HAI-18) was selected using simple random sampling. Participants were assigned in the interventionor control group by permuted block random allocation. The intervention group was trained by MSR and ACTtechniques for 9 weeks accomplished via WhatsApp. All participants completed the QOLQuestionnaire-12 (SF-12) items and HAI-18 before and after completing IMSR-ACT sessions. The data were analyzed through SPSS-23 software, using Chi square, independent and paired t-test, and analysis of covariance, and P-value<0.05 wasconsidered as significant.

The results showed that the intervention group compared to the control group had a significantdecrease in all subscales of HAI after the intervention including worry about consequences (5.78±2.66 vs.7.37±1.34, P=0.004) and awareness of bodily sensation or changes (8.90±2.77 vs. 11.75±2.30, P=0.001), worryabout health (10.94±2.38 vs. 13.09±1.92, P=0.001), and total score of HAI (25.62±4.93 vs. 32.25±3.93, P=0.001).Also, the intervention group compared to the control group had better QOL after the intervention in generalhealth perceptions (3.03±0.96 vs. 2.43±0.95, P=0.01), mental health (7.12±2.25 vs. 6.34±1.85 and P=0.01) andmental component summary) 16.78±3.75 vs. 15.43±3.05, P=0.01), physical component summary (16.06±2.66 vs.15.19±2.25, P=0.01), and total score of SF-12 (32.84±5.39 vs. 30.62±4.34, P=0.004).

Internet-delivered MSR combined with ACT could improve the HA and QOL of caregivers withpatients infected by COVID-19. Thus, it can used in other similar situations for now and future. Also, it seemsto be a useful approach for caregivers of the other illnesses.Trial Registration Number: IRCT20180909040974N5

A high-risk pregnancy (HRP) is adversely affects the health of the mother, baby, or both.Most prenatal care research, rather than quality concepts, focuses on the adequacy of prenatal careand describes the emotional-psychological experiences of women with HRP. The main purpose of thisstudy was to explore the perspectives of healthcare professionals regarding the quality of prenatal carefor women with HRP. This qualitative study was conducted in three university hospitals and 12 comprehensivehealth centers in Ahvaz (Iran) from December 2020 to May 2021. In the present study, 10 midwives,2 executive directors, and 7 specialists were purposefully selected with maximum diversity. In-depthsemi-structured individual interviews were used to collect the data. Data were analyzed concurrentlyusing Elo and Kinga’s content analysis. The MAXQDA software version 10 was used for data analysis. During data analysis, the 6 main categories “infrastructure for care provision”, “optimalclinical care”, “organizing referrals”, “preconception care”, “risk assessment”, and “family-centeredcare” and 14 subcategories were identified. Our findings showed that professional groups focused on the technical aspects of caring.The findings from this study highlight several conditions that can affect the quality of prenatal carefor women with HRP. Healthcare providers can use these factors to effectively manage HRPs, therebyimproving pregnancy outcomes among women with HRPs.

In Iran, the Natural Childbirth Promotion Program (NCPP) has been implemented as acomponent of the Health Transformation Plan (HTP) since 2014 and as an attempt to encourage naturalchildbirth practices and reduce cesarean section rates. The purpose of this qualitative study was toexplore the perceptions of midwives about conditions influencing the implementation of NCPP. In this qualitative study, data were collected through 21 in-depth semi-structured individualinterviews with expert midwives who were selected using purposive sampling mainly from one medicaluniversity in Eastern Iran from October 2019 to February 2020. Based on the framework method asa thematic analysis approach, the data were analyzed manually. To enhance the rigor of the study, wefollowed Lincoln and Guba’s criteria. Data analysis yielded 546 open codes. After the codes were reviewed and similar codeswere removed, there remained 195 codes. Further analysis led to extraction of 81 sub-sub themes,19 sub-themes, and eight main themes. These themes included: Responsive staff; Characteristicsof the parturient; Recognition of midwifery role; Teamwork; The birthing environment; Effectivemanagement; Institutional and social context; and Social education. Based on the perceptions of the studied midwives, the success of the NCPP is guaranteedby a set of conditions identified in this study. In practice, these conditions are complementary andinterrelated, and they cover a wide range of staff and parturient characteristics to the social context. Itseems that effective implementation of the NCPP also calls for the accountability of all stakeholders,from policymakers to maternity care providers.

Clustered care has been recommended as one of the essential developmental care interventions for promoting sleep in preterm infants, which can improve the neurodevelopment of the preterm infant during the neonatal intensive care unit (NICU) hospitalization period.1 Clustered care means clustering or grouping several nursing care procedures performed together instead of spacing them out over time. The main goal of clustering care is to allow the premature infants to rest for longer periods and avoid handling and disturbing their sleep pattern. It has been suggested that clustered care should be considered as a main care method.2