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EXPLORING PROBLEMATIC SUBSTANCE USE AMONG REGISTERED MIDWIVES – SURVEY

recruitment poster PSU survey

There is a united level of concern for the health and wellbeing of midwives in the United Kingdom (UK), where recent research has shown that many experience work-related stress and burnout. Such experiences may lead to midwives being at particular risk of substance use/misuse. In fact, in a recent review of fitness to practise (FtP) cases, a number of those put before the Nursing and Midwifery Council (NMC) related to alcohol (n=208) and drug misuse (n=131).

Such episodes of addiction, alcohol and drug use are classed as individual health concerns. Yet, whilst they can leave a variety of healthcare professionals depleted, and both workplace safety and the safety of care compromised, relevant literature has thus far been largely dominated by the experiences and care of physicians. Consequently, researchers from Coventry University are now conducting the first nationwide study of registered midwives in relation to this issue.

Project Team:

The aims of this study are:

  • To investigate substance use among midwives registered in the UK
  • To explore the perceptions of midwives registered in the UK in relation to midwifery impairment
  • To explore perceptions of midwives registered in the UK in relation to organisational support
  • To identify incidents of midwifery impairment
  • To explore the help seeking behaviours of midwives registered in the UK with problematic substance use (PSU)
  • To identify health risks among midwives registered in the UK with PSU

If you are happy to take part, you can access the survey via this link: http://bit.ly/MidwivesSubstanceUse

Your insights will help us to better understand the phenomena of substance use in midwifery populations and identify any barriers to support. The survey should take approximately 30 minutes to complete.  Your answers will be treated confidentially and the information you provide will be kept anonymous in any research outputs/publications.  Your data will be held securely on password-protected computers and project folders hosted by Coventry University.  All data will be deleted by the 1st of May 2021.  The project has been reviewed and approved through the formal Research Ethics procedure at Coventry University.

We are very grateful to the Royal College of Midwives for supporting recruitment to this study. We hope that this survey link will be shared widely.

 

For further information, or if you have any queries, please contact me, the lead researcher, Dr Sally Pezaro (sally.pezaro@coventry.ac.uk).

Twitter handle: @SallyPezaro

Please note: We will not be able to track or identify you in any way. As such, there will be no repercussions arise from anything you disclose. We are only interested in understanding, so please help us by keeping your responses anonymous throughout.

If you would like to follow the progress of work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

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How does patient and public involvement work in research? An example exploring midwives’ workplace wellbeing.

Patient and public involvement or #PPI is defined by INVOLVE (part of, and funded by, the National Institute for Health Research) as: 

“Research being carried out ‘with’ or ‘by’ members of the public rather than ‘to’, ‘about’ or ‘for’ them. This includes, for example, working with research funders to prioritise research, offering advice as members of a project steering group, commenting on and developing research materials and undertaking interviews with research participants.”

three person pointing the silver laptop computer

In our latest publication, we explain how patient and public involvement works in maternity service research. Here, we asked childbearing women about their experiences in relation to the workplace wellbeing of midwives. We also asked them how they felt about new research looking to create and test an online intervention designed to support midwives. We did this via a discussion group, where participants were offered refreshments and remuneration for their time. Our aim was to answer the following questions:

  1. What are the perceptions of new mothers in relation to the barriers to receiving high quality maternity care?
  2. What are the perceptions of new mothers in relation to the psychological wellbeing of midwives working in maternity services?
  3. What are the perceptions of new mothers in relation to a research proposal outlining the development and evaluation of an online intervention designed to support midwives in work-related psychological distress?

These PPI activities helped us as researchers to do the following:

  • Better understand this research problem from the perspectives of new mothers
  • Validate the direction of future research plans
  • Explore new areas for data collection based on what really mattered to mothers and their babies
  • Improve upon the design of the proposed online intervention based on what really mattered to mothers and babies.

You can read our full methodology via the linked citation below:

Pezaro, Sally, Gemma Pearce, and Elizabeth Bailey. “Childbearing women’s experiences of midwives’ workplace distress: Patient and public involvement.” British Journal of Midwifery 26.10 (2018): 659-669.

This article was launched in the October edition of the British Journal of Midwifery at the Royal College of Midwives annual conference in 2018 .

white and black Together We Create graffiti wall decor

Put simply, the findings in relation to what participants said were analysed thematically and turned into meaningful insights or ‘PPI coutcomes’. In this sense, we used a co-design approach to inform the direction of new research. How did this work exactly? See figure below.

Figure 1. Overall findings

Initially, we considered that it may have been useful to include midwives in PPI activities, as they were to be the intended recipients of the intervention proposed. However, INVOLVE briefing notes state that:

“When using the term ‘public’ we include patients, potential patients, carers and people who use health and social care services as well as people from organisations that represent people who use services. Whilst all of us are actual, former or indeed potential users of health and social care services, there is an important distinction to be made between the perspectives of the public and the perspectives of people who have a professional role in health and social care services.”

A such, we could not include midwives in these PPI activities due to them having a ‘professional role in health and social care services’. Nevertheless, as midwives were the intended end users and direct beneficiary of the intervention proposed, we argued that they should “not necessarily be excluded from PPI activities simply because they treat patients”. This debate lends itself to further academic discussion and we welcome ideas on this going forward.

two person standing on gray tile paving

Both national and international strategies and frameworks relating to healthcare services tend to focus on putting the care and safety of patients first , yet these findings suggest that to deliver the best care to new mothers effectively, the care of the midwife must equally be prioritised. As such, we now intend to seek further funding to continue this work and secure excellence in maternity care.

If you would like to follow the progress of work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

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19 Things That Show Workplace Compassion for Healthcare Staff

We are all well aware of how the wellbeing of healthcare staff can affect the quality and safety of care. I have also talked at length about the wellbeing of health care staff and the theories surrounding work-related psychological distress. But do we really have any concrete idea of what shows workplace compassion for healthcare staff?

My research published in collaboration with Dr. Wendy Clyne, Dr. Karen Deeny and Dr. Rosie Kneafsey asked Twitter users to contribute their views about what activities, actions, policies, philosophies or approaches demonstrate workplace compassion in healthcare using the hashtag #ShowsWorkplaceCompassion. It can be cited as follows:

Clyne W, Pezaro S, Deeny K, Kneafsey R. Using Social Media to Generate and Collect Primary Data: The #ShowsWorkplaceCompassion Twitter Research Campaign. JMIR Public Health Surveill 2018;4(2):e41. DOI: 10.2196/publichealth.7686. PMID: 29685866

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The results of this study outlined 19 things or ‘Themes’ in relation to what shows workplace compassion for healthcare staff as follows…

  Leadership and Management
1 Embedded organizational culture of caring for one another
2 Speaking openly to learn from mistakes
3 No blame/no bullying management
4 Inspiring leaders and collective leadership
5 Financial investment in staff
6 Recognize humanity and diversity
  Values and Culture
7 Common purpose in a team
8 Feeling valued
9 Being heard
10 Enjoying work
11 Being Engaged at work
12 Use of caring language
  Personalized Policies and Procedures
13 Recognition of the emotional and physical impact of healthcare work
14 Recognition of non-work personal context
15 Work/life balance is respected
16 Respecting the right to breaks
17 Being treated well when unwell
  Activities and Actions
18 Small gestures of kindness
19 Provision of emotional support

How will you implement these things within your healthcare workplace? I would love to hear your thoughts on this…

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

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How to conduct research: A dummy’s guide to conducting research

Image result for quote "I do research because"

Seminars held by the worlds top universities generally present the most up to date and respected ideas in relation to conducting research. Recently, I was lucky enough to attend a conference where several seminars were held over a one week period…How very convenient!…These seminars in combination were able to map out a broad blue print of how to conduct research for their audiences (myself and other chums).

As a result of attending these wonderful seminars, I am now able to translate what was shared into this dummy’s guide to conducting research. I write here not only to refresh my own knowledge in this area, but also in the hope that it may be of use to the readers of this post. Wish me luck!…

research

So why do we do research?…Because we have an idea?, a problem to solve?, or an area where a lack of knowledge resides?..(See ) …These are all valid reasons to conduct research within reason, but…What is research?…

Image result for quote on research is formalised curiosity

OK, so we need to define a research question…What question, need or idea are we trying to answer?..What itch do we have to scratch? We need to formulate a research question….and also formulate a research problem.

How to formulate a research problem

  • Explore the nature of the problem. Why is it a problem?..who does it affect?
  • Explore the context of the research problem. Where does it ‘sit’ among other things?
  • Define your variables. What would vary?…what can’t you control?…what would be the impact of that?
  • Think about what would happen if you didn’t address this problem. What would be the consequences of doing something else?
  • Define your objectives? What are you trying to achieve by doing this research?

How to formulate a research question

Think first…is your research question:

  • Interesting
  • Relevant
  • Focused
  • Answerable

Then…narrow your ideas down to develop a great research question.

Broad topic  Narrowed topic      Focused topic   Research Question
Children’s
health →
 Children and diabetes → School meals and sugar content→ Is there an association between sugar content in school meals and diabetes risk?
Walking → Walking related injury → Walking related injury and
adults→
How does Walking related injury affect
adults?
Bullying → Teenagers and
bullying →
Teen peer
pressure and aggressive behavior→
What role, if any, does
peer pressure play in the development of aggressive behavior
among teens?

                                          Image result for hypothesis

Image result for hypothesis

  1. Non directional hypothesis = Pregnant women will experience some change in their pattern of urination.
  2. Directional hypothesis = Pregnant women will urinate less frequently.
  3. Null hypothesis = A statistical assumption. e.g: There will be no difference in the frequency of urination for pregnant women who swim compared with those who do not swim.

And to test this theory…..(quasi-experimental or experimental study design)..we must ascertain the relationship between variables.

Components

Experimental group = Pregnant women swimming

Expected result = e.g Pregnant women will urinate less frequently

Comparison group = Pregnant women who do not swim

Image result for which research design

 

Image result for methods

Quantitative and qualitative research characteristics….

Characteristic Quantitative research Qualitative research
Philosophical origin Logical positivism Naturalistic/Interpretive
Focus

Reasoning

Concise and objective Broad and objective
Reasoning Logistic and deductive Dialectic and inductive
Basis of knowing Cause and effect relationships Meaning, discovery and understanding
Theoretical focus Tests theory Develops theory
Researcher involvement Control Shared interpretations
Methods of measurement Structured interviews, questionnaires, observations, scales or measurements Unstructured interviews and observations
Data Numbers Words
Analysis Statistical analysis Individual interpretations
Findings Generalisation, accept or reject theoretical propositions Uniqueness, understanding of new phenomena and/or theory

Image source and further reading = Crowe, Michael, and Lorraine Sheppard. “Qualitative and quantitative research designs are more similar than different.” Internet Journal of Allied Health Sciences and Practice 8.4 (2010): 5.

Image result for research designs

Image result for data analysis

Quantitative data analysis methods Qualitative data analysis methods
Involve statistics/number analysis Text analysis
Seek deductive interences Seek inductive inferences
Focus on quantifiable phenomena (comparisons, differences, trends and relationships) Focus on meanings (themes)
Involve data clustering analysis for relationships in non-hypothesis testing Involve data structuring and coding into themes and groups.
Involve systematic predetermined analysis Involve in-depth fluid analysis
Value-free enquiry Considers the impact a researcher may have on others’ values
Objective Subjective
Narrow and specific General and broad

Image result for variables

Variable = Anything that varies

Independent variable = does not depend on that of another. Can be introduced or withdrawn by the researcher

Dependent variable = Depends on the independent variables and it’s out come variable e.g: Trauma, bleeding, symptom changes.

Extraneous variable = Unwanted influence that may interfere with either the dependent and/or independent variables.

Demographic variable = Age, gender, race etc.

Top tips:

  • We can ask..’What is the relationship between two or more variables?’ However, we cannot infer ’cause and effect’.
  • Experimental study designed (hypothesis testing) is considered to be the ‘Gold standard’ for evidence. However, you can gather a multitude of this type of evidence via systematic review and/or meta analysis (See more information on these here or in the image below).
  • Ethical considerations should be revisited throughout the study, as well as before commencement.
  • Take control of any extraneous variables by random sampling (from a larger sample base), random assignment (into either a control or experimental group), selecting a homogeneous (similar on an important variable) sample and by matching the control to the experimental group on important variables.

In conducting a systematic review, you can also arrive at new research problems and questions…meaning that the possibilities of conducting research are endless!..

 

But why do all of this hard work if you are not going to share what you have found, analysed, discussed and then concluded?

Image result for publish

It is important to publish and share your work at both a high and low level, so that new knowledge is available to everyone!…Students and professors alike should publish. It is never too soon or early in your career to get started on this. If you are not confident about writing or publishing your work, contact me and I will be happy to partner with you throughout the process.

Not sure how to do this?…see my post…’Why Midwifery and Nursing Students Should Publish their Work and How’ for further info.

Image result for methods of research data analysis

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

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Highlights from the 31st ICM Triennial Congress in Toronto, Canada #ICM2017 #ICMLive

toronto

My vacation is now over following a visit to the 31st International Confederation of Midwives Triennial Congress in Toronto, Canada (ICM). I think we would all agree that this was an emotional occasion, as thousands of midwives came together from all over the world to both celebrate our wonderful profession and share new research, knowledge and ideas about our exciting future.

I was personally in awe of our midwifery leaders, who certainly inspired a passion for change, strength and future thinking in midwifery practice. I would like to think that my work will go some way towards building a bright future for the profession, and one day I hope to stand beside those on the main stage of midwifery who are ultimately steering the ship. Yet for now, I am learning from a plethora of inspirational midwives about how to thrive and implement change. As I come to the end of my PhD, I reflect on how I might move forward in partnership with the most inspiring midwives I know. It was an honor to spend time with them in Canada….see all of those flags?…What a wealth of knowledge!

Naturally, we were flying the flag for the Brits…

Throughout the conference I naturally gravitated towards all of the midwifery workforce presentations, my favorite and most passionate area of workforce research…Here are some highlights from these sessions below:

I would like to thank all of these wonderful research groups for sharing their insights with me, and for helping my understanding of midwifery workplace wellbeing to grow. I would also like to thank those at Nottingham University and Elsevier for inviting me to their exclusive evening receptions. I felt very honored to be among the best academic midwives in the world!

Thank you also to those of you who came to see me present some of my own research (done in partnership with my wonderful colleagues at Coventry University and NHS England of course). It was really enlightening to hear your thoughts on the staff experience!…The best is yet to come!

Equally, I would like to thank the audience who came to discuss my PhD work following my presentation at this wonderful conference. Indeed, there was much interest in this work going forward, and whilst other interventions were presented for mothers and babies, it was clear that by following the MRC framework for developing complex interventions and by incorporating the Revised Transactional Model (RTM) of Occupational Stress and Coping, this intervention, being deeply rooted within an evidence base, is now ready for co-creation.

It was particularly interesting to hear the audience keen to invest in this project and disseminate it widely across the profession. As an online intervention designed to support midwives in work-related psychological distress, this intervention certainly has the potential to be widely adopted. This was music to the ears of a global midwifery audience, who may often see things developed in other countries, and yet be unavailable in their own area of practice.

Again, the theme arose here that midwives wanted a place to talk and seek help confidentially, away from traditional channels. I see such places growing organically in the online arena, yet none seem to be fit for purpose, evidence based or co-created on a large scale. To me this suggests that the next phase of my research (to build and test an evidence and theory based online intervention designed to support midwives in work-related psychological distress) will be well received by the midwifery community, especially if it has the support of larger healthcare organisations who can champion its implementation, dissemination and testing.

To spread and embed a large and complex intervention such as this across the midwifery profession would indeed be a legacy. Yet this work may also support excellence in maternity care, increase safety and support effective retention and recruitment strategies for maternity services around the world. As such, taking this work forward will indeed be crucial since it has been reported that reducing stress and fatigue among maternity staff is key to reducing baby deaths and brain injuries during childbirth, according to a detailed new analysis published by the Royal College of Obstetricians and Gynecologists. The challenge is to turn the vision for online support into practice.

icm

This was a wonderful, inspiring and thought provoking conference. To see a more detailed day by day summary, please see the wonderful blog by my dear friend @Dianethemidwife ….

Day One

Day two

Day three

Day four

Day five

Last day

It is sad that my time in Toronto is now over, but I have returned home with a new found sense of hope and enthusiasm for doing great things in the midwifery profession….

Until next time..🤚🇨🇦🇬🇧

 

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

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Making Birth better: How research shapes practice #bbresearch17

Indulging in my passion for research, I am today reflecting on my time at  …an intimate conference made into a delightful day thanks to  & …More specifically …    &   …

I personally enjoyed this as a more intimate conference, where deeper conversations could get the brain working on what was really needed in maternity services and health research…Another reflection of the day can be seen on Steller here…

As you can see, we had a great line up for the day, and a fish and chip lunch no less!

Highlights for me include:

Stop sexualising breastfeeding!!!! The great presentation by

Learning about associated with at with

Learning so much about at with Prof. Soo Downe

Getting a wave from miles away from  across the miles sending & midwifery love to us all …..❤️

Powerful words from at …. how do we cope as midwives, & ensure excellence in maternity care?

And of course.. # learning all about making sure that blood goes to baby with  with ❤️

Learning about the barriers to identifying poor shared by prof at  with 🎓

Yet there were a couple of overarching themes that came from the day…including….

 

Thank you to everyone who came to see these wonderful presentations (including those who came to see my own presentation of course – you gave me lots to think about!)!…and thank you all for such an intimate and heartwarming day discussing my favorite topic…Research in Midwifery 😍…

 

And a last word from the Head of Midwifery at Hinchingbrooke  Hospital….(Heather Gallagher)…..

bbresearch

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaro; The Academic Midwife; This blog

Until next time…Look after yourselves and each other 💚💙💜❤