PURPOSE: As midwives witness and attend the whole process of childbirth, they have a better understanding of which factors may cause traumatic childbirth. However, because most of the studies paid their attention on mothers, little is known about psychological birth trauma from the perspective of midwives. This study aims to gain a full understanding of which factors may contribute to psychological traumatic childbirth from the perspective of midwives.METHODS: A qualitative research was conducted using in-depth interviews, which involved fourteen midwives from the maternal ward of a tertiary hospital. The interviews were recorded and transcribed, and then, Colaizzi's method was used to analyze the contents of the interviews.RESULTS: We proposed four themes and eight subthemes on the influencing factors of psychological traumatic childbirth from the perspective of midwives: low perceived social support (lack of support from family and lack of support from medical staff), hard times (protracted labor in the first stage and futile efforts during the second stage), poor birth outcomes (poor birth outcomes of the mother and poor birth outcomes of the baby), and excruciating pain (unbearable pain of uterine contraction and labor pain was incongruent with the mother's expectations).CONCLUSION: Medical staff should pay attention to psychological traumatic childbirth and its effects, and emphasis on the screening and assessment of birthing women with negative feelings so that their psychological traumatic childbirth can be prevented and decreased.
Female ; Humans ; Labor Pain ; Mass Screening ; Medical Staff ; Methods ; Midwifery ; Mothers ; Natural Childbirth ; Parturition ; Pregnancy ; Psychological Trauma ; Qualitative Research ; Tertiary Care Centers ; Uterine Contraction

Purpose: Elder self-neglect is a global public health issue and should be taken seriously at large. Nurses,usually working directly with elderly patients, have a better understanding of what factors may causeelder self-neglect. In this qualitative study, we explored the influencing factors of elder self-neglect fromthe perception of nurses in the context of Chinese culture. Methods: Face-to-face, in-depth interviews were conducted from November 2018 to December 2018.Purposive sampling was used. Twenty one participants recruited from eight geriatric wards of a generalhospital located in Wuhan were interviewed. A content analysis of qualitative nature was performed toanalyze the data. Results: Our conceptual model illustrated the findings based on the three themes of the conflict betweenpersonal recognition and social judgment, the choice between current needs and individual beliefs, aswell as the compromise between insufficient abilities and limited resources. Conclusion Nurses together with family members and social workers can help older adults improvetheir awareness of self-neglect to bridge the gap with social judgment, learn to focus on their own needs,as well as seek as much support as possible. Nurses should also respect the autonomy and selfdeterminationof elder self-neglecters because self-neglect is related to older adults' values. Furthermore,larger studies are needed to quantitatively test and refine the model.

Purpose: Elder self-neglect is a global public health issue and should be taken seriously at large. Nurses,usually working directly with elderly patients, have a better understanding of what factors may causeelder self-neglect. In this qualitative study, we explored the influencing factors of elder self-neglect fromthe perception of nurses in the context of Chinese culture. Methods: Face-to-face, in-depth interviews were conducted from November 2018 to December 2018.Purposive sampling was used. Twenty one participants recruited from eight geriatric wards of a generalhospital located in Wuhan were interviewed. A content analysis of qualitative nature was performed toanalyze the data. Results: Our conceptual model illustrated the findings based on the three themes of the conflict betweenpersonal recognition and social judgment, the choice between current needs and individual beliefs, aswell as the compromise between insufficient abilities and limited resources. Conclusion Nurses together with family members and social workers can help older adults improvetheir awareness of self-neglect to bridge the gap with social judgment, learn to focus on their own needs,as well as seek as much support as possible. Nurses should also respect the autonomy and selfdeterminationof elder self-neglecters because self-neglect is related to older adults' values. Furthermore,larger studies are needed to quantitatively test and refine the model.

Objective:To develop a Self-neglect Questionnaire for the aged in China and to test its reliability and validity so as to provide an effective assessment tool for differentiating self-neglect for the aged.Methods:The initial questionnaire was developed based on former results of qualitative research, literature review and the method of Delphi expert consultation. From April to May 2018, a total of 71 elderly inpatients were selected by convenience sampling at a ClassⅢ Grade A hospital in Wuhan to investigation with item analysis. From June to October 2018, by convenience sampling a total of 314 elderly inpatients were investigated formally at a Class Ⅲ Grade A hospital in Wuhan, and the questionnaire was tested in terms of reliability and validity.Results:Finally, the Self-neglect Questionnaire induding 7 common factors and 24 items was formed. The Cronbach's α of the questionnaire was 0.875, the split-half reliability coefficient was 0.709. In content validity, the item-content validity index (I- CVI) ranged from 0.895 to 1, and the average scale-content validity index (S- CVI/Ave) was 0.987. Exploratory factor analysis extracted 7 common factors with 69.391% for the cumulative variance contribution. Conclusions:The Self-neglect Questionnaire for the aged has good reliability and validity which can be an assessment tool for self-neglect of the aged.

Objective:To develop the Perceived Nurse-Patient Relationship Scale and test its reliability and validity.Methods:Based on literature review, qualitative interviews, and expert consultation, a preliminary draft of the Perceived Nurse-Patient Relationship Scale was developed. From June to August 2020, convenience sampling was used to select 2 578 clinical nurses from 49 ClassⅢ hospitals in Hubei Province as research subjects, and reliability and validity testing were conducted on the scale.Results:Exploratory factor analysis extracted three common factors, including 18 items, with a cumulative variance contribution rate of 74.702%. Confirmatory factor analysis showed that the model fitted well. The scale-content validity index was 0.983, and the item-content validity index was 0.900 to 1.000. The Cronbach's α coefficient of the scale was 0.955, with a split-half reliability of 0.883.Conclusions:The Perceived Nurse-Patient Relationship Scale has good reliability and validity, and can be used to measure the nurse-patient relationship perceived by nurses.