Arja Häggman-Laitila

Views of midwives about ethical aspects of participation in placental perfusion studies

BACKGROUND Little is known regarding the role of the midwife in recruiting mothers to participate in scientific research. OBJECTIVE To describe ethical aspects of participation of midwives in placental perfusion studies. DESIGN Qualitative study involving thematic interviews and thematic content analysis. SETTING Two university hospitals in Finland in 2008-2009. PARTICIPANTS Midwives (n=20) who had been involved in recruiting mothers for a placental perfusion study. FINDINGS Midwives felt that the situation, when inviting the mothers to donate their placentas, was restless and hasty because of the considerable number of tasks required during a birth. For recruitment, they explained how they tried their best to find a quiet opportunity to provide information about the placental perfusion study, so that the mother could take her time reading the written information. During a birth, it was difficult to give information to the mother in such a way that she would truly understand. Information for the mother was planned to be provided in an equal, dialogic conversation, with the subject of research introduced by the midwife. Placental perfusion studies as carried out in this setting were not seen to have any risks for the mothers, and midwives were under less strain in this study than in other medical research projects. The midwives considered it normal to use placentas in scientific research, and did not see any associated ethical problems. In their opinion, the use of placentas was acceptable and even desirable, provided that the mother was informed about the research and gave voluntary informed consent. CONCLUSIONS AND IMPLICATIONS FOR PRACTISE Recruitment must be taken into account in management of the ward, and should be planned so that no recruitment is undertaken during medical procedures. Midwives need more education about the research including the important aspects of the creation of general knowledge about substances which may harm the fetus. Dialogue is needed between the mother and the midwife to ensure genuine informed consent.

A systematic review on educational interventions for learning and implementing evidence-based practice in nursing education: The state of evidence

The aim of this systematic review was to gather, assess and synthesize evidence on educational interventions promoting learning and implementation of evidence-based practice in nursing education and their outcomes. Literature was sought from the Cochrane, CINAHL and PubMed databases. The data (10 articles) were analysed by applying qualitative content analysis. The analysis of the interventions produced five main categories: Theoretical foundations, Teachers and partnerships, Learning contents, Learning/teaching methods, and Learning tools. Outcomes of the evaluations were divided into three categories. A Web-based EBP learning module supplemented by help sessions, a program including the Self-Directed Learning Process for EBP Basics and a Workshop for Critical Appraisal of Literature, and an Evidence-Based Practice Project as a group work were interventions that had gained ‘excellent’ outcomes. When supporting nurse students’ learning of EBP, it is recommended to use a combination of self-directed learning and a consultation by a teacher when needed, different learning tools, as well as partnerships in planning and conducting interventions.

Outcomes of partnership between higher education and health care

The aim of this study was to describe partnership activities between a university of applied sciences and a nursing care unit for the elderly, the competences that staff members working across these organizations needed and the outcomes gained. Staff of the organizations took part in nine focus group interviews (n = 39) and completed self-evaluations based on diaries (n = 13) and essays (n = 24). The data were analyzed using qualitative content analysis. The staff planned, coordinated, implemented and surveyed change processes based on a joint development target and developed student supervision. Staff needed competence to analyze their expertise and the organizations’ operations, as well as to manage development work, negotiations, communication and networking. The outcomes included identifying possibilities for cooperation and establishing new partnerships, developing good practices and new expertise, boosting student recruitment and supervision, as well as recruiting staff, mentoring and advancing their career development.

Small groups for parents: motives and practical issues boosting attendance

Small groups offer families support on parenting, interaction between parents and children, parents’ own relationship, children’s upbringing and development, parents’ self-esteem and the family’s immediate community. There is some research on the impact of group activities intended for families, but little is known about the factors that make families seek support. Reports on experiences describing parents’ group processes are also scarce, and particularly little is known about fathers’ participation. The aim of this study is to describe small group attendance from the perspective of mothers and fathers with small children. Data were collected by 13 videotaped group interviews. Qualitative content analysis of latent content was used as the method of analysis. Altogether 77 parents participated in the study. Participants’ motives for group attendance were classified as curious, knowledge seekers, variety seekers, socializers and pleasers. Each group included both fathers and mothers. The practical issues boosting parental attendance were babysitting services, suitable working hours, low costs and convenient meeting times. Since the parental experiences of group attendance were expressed at a very concrete level, they can easily be taken into account in family-oriented small group programmes. The study produces concepts that can be used in identifying the motives of families seeking to attend the groups and issues promoting their decision to attend. Focusing on Finnish parents, research complements previous qualitative studies in Spain and Norway. Further research should be directed at families with fewer resources, dysfunctional families and families discontinuing the group.