Midwives' experiences of high stress levels due to emergency childbirths in Namibia Regional Hospital
- Authors: Ndikwetepo, Monika Ndaudika
- Date: 2015
- Subjects: Midwifery -- Namibia , Medical personnel -- Job stress -- Namibia , Childbirth -- Namibia
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10073 , http://hdl.handle.net/10948/d1021162
- Description: Many midwives throughout the world experienced high stress levels when they deal with emergency childbirths. Midwifery professionals experience certain unique stressors, such as midwives being responsible for the care of women when they are giving birth. Complications of childbirth may occur during labour leading to the life of the baby and the mother being threatened. Situations such as this leave midwives experiencing high levels of stress for which they often do not have effective coping mechanisms. When the stress is not managed, it may lead to burnout. When burnout occurs the midwives present with physical and psychological symptoms of stress, grief for the loss and lack of motivation, which results in staff turnover and a fear of working in a maternity ward. Consequently, patient care may be compromised as some midwives became apathetic and develop unacceptable attitudes toward their patients. Such behavior led to poor work performances, maternity services that are not woman-friendly and women seeing the maternity ward as a place where they are treated in rude and unfriendly manner which increased the chances of adverse childbirth outcomes. The aim of the study was to explore and describe the experiences of midwives who have to cope with stress associated with emergency childbirths. This information was used to develop the guidelines to help midwives to cope with the high stress associated with emergency childbirths. The researcher used a phenomenological, qualitative approach. The study was explorative, as little was known on this topic in the Namibian context and it was also descriptive and contextual. Purposive and convenient sampling was used to select the research sample. The research population was all the midwives working in the maternity ward of a Namibian regional hospital, who met the inclusion criteria. Data gathering was done using semi-structured interviews. Once data saturation occurred, interviewing stopped. The interviews were audio-taped and transcribed verbatim. Tesch’s eight steps of data analysis were followed to create meaning from the data collected. An independent coder assisted with the coding process to ensure the trustworthiness of the findings. Literature control was done after data collection to support and strengthen the study’s findings. Trustworthiness, as suggested by using Lincoln & Guba’s model of trustworthiness, included truth-value/credibility, applicability/transferability, consistency/dependability and neutrality/conformability was implemented. Ethical principles of beneficence, non-maleficence, autonomy and justice were ensured by obtaining permission to conduct the research from relevant authorities and from University structures, obtaining consent from the participants before the interviews, voluntary participation and right to withdraw from the study, privacy, confidentiality and dissemination of the results. Three main themes and sub-themes were identified namely: Midwives experienced significant stressors associated with emergency childbirth situations. Midwives experienced mixed emotions about dealing with emergency childbirth situations Midwives shared their views regarding their support needs associated with emergency childbirth situations. Recommendations for nursing education, clinical midwifery and for further research were made. Four guidelines were developed based on the study findings as well as literature related to these findings, to help the midwives to cope with high stress levels associated with emergency childbirths.
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- Date Issued: 2015
Midwives' experiences regarding the utilization of partographs in a Namibian Regional Hospital
- Authors: Fernandes, Diina
- Date: 2015
- Subjects: Midwifery -- Namibia , Labor (Obstetrics) -- Namibia
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10071 , http://hdl.handle.net/10948/d1021158
- Description: Labour has been characterized as the most dangerous journey a woman undertakes. The reason being, that although it is a natural process, many labouring women suffer complications during labour and childbirth including prolonged or obstructed labour. These complications can result in maternal and infant morbidity and mortality. The partograph is a monitoring tool that can provide a continuous pictorial overview and is essential to monitor and manage labour. It is recommended by the WHO for use universally by midwives while monitoring labour. However partographs are poorly utilized and most parameters on the partograph are not monitored and findings after reviewing a labouring woman are not documented on the partograph. It is unclear how midwives working in Namibian Health services experience and utilize the partograph during the monitoring of a woman in labour. These may be the factors that hinder the effective utilization of the partograph. The objective of this study was to explore and describe the experiences of midwives regarding the utilization of the partograph for monitoring a labouring woman in a Namibian regional hospital in order to develop guidelines based on the findings to improve the use of the partograph by midwives in order to improve the management of labour. The research design was qualitative, descriptive, explorative and contextual in nature. The research population consisted of midwives working in a regional hospital in Namibia. A purposive and convenient sampling method was used to select participants. Specific inclusion criteria were met and consent was obtained from the participants and from the Regional Health Directorate Management of the hospital where the research was conducted. Interviews were conducted by an independent interviewer within the Department of Health to ensure an unbiased viewpoint. Data were collected by means of semi-structured in depth interviews with a guide, using an audio tape recorder. Field notes were used to record non- verbal communication. As soon as data were saturated, the interviews were stopped. They were then transcribed, verbatim and analysed using the Tesch’s approach as described in (Creswell, 2009:186). The service of an independent coder was utilized to ensure trustworthiness. Trustworthiness was further ensured by using the strategies suggested by Lincoln and Guba’s model, namely credibility, transferability, dependability and confirmability. Ethical considerations were honoured throughout by adhering to ethical principles during the study. These included ensuring that the participants` rights were respected, they were not harmed and fairness were ensured. On completion of the data analysis a literature control was conducted and existing literature was compared to the findings in order to identify similarities and differences and to verify whether the literature supported the findings. Four main themes that emerged during data analysis are: Theme 1.Midwives found it a positive experience to use the partograph when caring for a woman in labour. Theme 2. When a midwife experienced problems in using the partograph, it may lead to detrimental outcomes. Theme 3. Utilizing the partograph evoked differing emotions in midwives. Theme 4. Midwives` knowledge and skills in the utilization of the partograph should be updated regularly. By describing the lived experienced of midwives in the maternity ward on the use of the partograph, the midwives had a positive attitude to using the partograph, but they also found it difficult to utilize the instrument as was directed by the (WHO) due to challenges experienced such as: unrealistic staff/patient ratio, shortage of staff, time consuming, insufficient knowledge and skills among midwives and lack of appropriate equipment. There is a specific need to prevent further negative emotions by addressing the challenges experienced. Based on the findings, guidelines for partograph utilization which aimed at improving the midwifery care were developed. Recommendations were made regarding midwifery education, clinical midwifery care and midwifery research.
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- Date Issued: 2015