Evelyn Hermansson

A national survey of how acupuncture is currently used in midwifery care at Swedish maternity units

OBJECTIVE it is not known how acupuncture is used in midwifery care in Sweden and what kind of requirements health-care providers have for midwives and acupuncture training programmes. The aims of this study were to survey indications for the use of acupuncture in midwifery care in Sweden, and to examine the criteria and requirements used for purchase of acupuncture education programmes. DESIGN a postal survey using a structured questionnaire. SETTING 45 maternity units in Sweden. PARTICIPANTS the midwife-in-charge of the units. MEASUREMENTS AND FINDINGS the most common indications for the use of acupuncture were relaxation, pain relief, retained placenta, after pains, milk stasis during lactation, hyperemesis and pelvic instability. Specific requirement for acupuncture education were provision of a short course during weekdays including a follow-up course. KEY CONCLUSION acupuncture is widely used for many indications in Swedish maternity units despite weak or no evidence to support effectiveness in midwifery care. Requirements for acupuncture education did not seem to be in accordance with what might be expected for this type of qualified intervention. IMPLICATIONS FOR PRACTICE the use of acupuncture in midwifery care should not persist until systematic evaluation of the effect of this method is carried through.

National survey of how acupuncture education is organised for Swedish midwives.

OBJECTIVE in Sweden, acupuncture education is required before midwives can use the method in clinical practice. Courses in acupuncture are usually organised by private individuals or companies, and each health facility decides on the adequacy of the educational package. Therefore, there is no overall standard or quality control for free-standing courses of acupuncture education for midwives. The aim of this study was to survey the education given to Swedish midwives in the use of acupuncture treatment in the obstetric area. DESIGN a postal survey using a structured questionnaire. SETTING organisers of acupuncture education. PARTICIPANTS 18 acupuncture instructors. MEASUREMENTS AND FINDINGS acupuncture courses were usually organised outside universities and colleges. The courses were similar in terms of extent and content, and were mainly based on a Western medical approach. The recommended indications were extensive despite a lack of scientific evidence. The most common instructor profile was a midwife without any academic degree. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE courses differed considerably in the extent to which they were research based. Continuing professional education for midwives should be given at the same academic level, at least, as basic midwifery education.

Patients' experiences of supportive conversation as long-term treatment in a Swedish psychiatric outpatient care context: a phenomenological study.

This study aims to describe patients’ experiences of supportive conversation as long-term treatment in a psychiatric outpatient context. A focus group interview was conducted with six female patients (aged 40–60 years). Five key constituents captured the essence of the general structure of supportive conversation: being treated as a responsible person, sensing intimate contact and togetherness, perceiving stability in the relationship, learning to manage daily living, and growing as a person. Supportive conversations have a positive influence on the patients state of mind and enhance self-confidence, thereby giving the inner strength to grow as a person.