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Boyer's framework of scholarship, the basis of many academic models for faculty promotion, is comprised of the components of discovery, teaching, integration, application, and engagement. Yet, the scholarship component of application (containing goal-based clinical practice) is undervalued by many academic models. This study explores the nursing activities currently qualifying as scholarship in several international academic models. Using the Delphi approach, an international nine-member panel from seven countries participated in a six-question, structured brainstorming session to explore the nursing activities qualifying as scholarship by academic models. Follow-up sessions were attended by six panel members. Panel members reported that the nursing activities, which most often were recognized as scholarship, fit the scholarship components of discovery, teaching and integration but few fit the components of application or engagement. Although this project originally focused on clinical practice, far more recommendations for an academic model targeted the scholarship component of engagement. Academic models' lack of appreciation for the scholarship components of application (goal-based clinical practice) and engagement (partnering with community groups) discourages faculty from participating in these activities. Yet, these nursing activities demonstrate scholarship and are essential for the continued development of the nursing profession and discipline. • Academic models consistently focus on research and teaching as scholarship. • Academic models overlook scholarship contributions of praxis and community input. • Nursing science is enriched by scholarship from praxis and patient/community input. [ABSTRACT FROM AUTHOR]

An important aspect of achieving the provision of woman-centred maternity services is to seek women's experiences of maternity care. To explore women's experiences of the care received within the Irish maternity system and to identify aspects of positive care and areas requiring improvement. The Babies Born Better pan-European online survey asked open-ended questions on positive aspects of care and aspects of care that could be improved. Data from women who birthed in Ireland within the previous five years were included. Socio-demographic data were analysed descriptively, and descriptive content analysis was conducted for the qualitative comments. Data from 736 participants were included. Four categories were generated from the analysis: Women's interactions with healthcare professionals included five sub-categories of competence and expertise, continuity and consistency, respectful care, communication, and shared decision-making ; Interventions and procedures included the five sub-categories of medical interventions , breastfeeding support , pain relief , birth partner's presence and involvement , and facilitating mother and baby attachment ; Organisational and infrastructural issues contained three sub-categories of facilities and services , environment and atmosphere , and staffing levels ; and the fourth category, Overall evaluations and specific statements, showed the diversity of women's experiences within the services. Several positive aspects of care within the Irish maternity services were identified, many of which related to interpersonal factors and interactions with healthcare professionals. The findings also revealed what could be changed, some of which would require minimal resources or effort, so that women would experience positive care. [ABSTRACT FROM AUTHOR]

Perinatal mental health care differs around the world. We provide a global perspective on the current status of service provision, barriers and facilitators to access, and strategies to improve access in high-income and low- and middle-income countries across five continents (Asia, Africa, Europe, North America and South America). Many of the countries considered do not have universal healthcare coverage. This poses a challenge to perinatal mental health care access. However, there are other social and structural barriers to access, including stigma and other sources of marginalization and discrimination. Yet there are opportunities discussed herein to learn more about what perinatal mental health services work for what populations* and in what circumstances, by adopting a global lens to examine innovative solutions utilized across geographical settings. [ABSTRACT FROM AUTHOR]

The humanisation of childbirth has been identified as a practice of care focusing on the physical, psychological, and emotional wellbeing of women. Healthcare professionals (HCPs) are expected to understand and embed humanised practice when supporting women in childbirth. The aim of this paper is to present a meta-synthesis of the experiences and perspectives of HCPs who undertake care for women at the time of birth regarding the humanisation of childbirth. A systematic search of the electronic databases CINAHL, Medline, PsycINFO, and SocINDEX were conducted in July 2020. Qualitative studies exploring HCPs' experiences and perspectives of humanisation in childbirth were eligible. Studies were synthesised using a meta-ethnographic approach. Fourteen studies involving 197 participants were included. Two themes were identified: 'Women at the centre' and 'Professional dissonance'. Two line of argument synthesis were identified: 'invisible boundaries' and 'unconscious undermining'. HCPs recognised that women required positive interactions which met both their emotional and physical needs. Human touch supported bonding between HCPs and women. HCPs understood humanisation as the reduction of unnecessary intervention and/or technology but had difficulties enacting this and often used disempowering language when discussing women's choices. The management of pain and the presence of a companion were considered important by HCPs. This synthesis revealed that HCPs do understand the humanisation of childbirth but have difficulties in enacting it in practice. Women classified as high risk were identified as having specific needs such as increased emotional support. Further research is required for women classified as high risk who may require technology and/or interventions to maintain a safe birth. [ABSTRACT FROM AUTHOR]

Stillbirth affects 1:200 pregnancies in high income countries. Most women are pregnant again within 12 months. Little is known about how couples negotiate a subsequent pregnancy. This paper presents findings from a study exploring the experiences of couples' in pregnancy after stillbirth. Qualitative, interpretive phenomenological analysis was used to conduct in-depth interviews with eight heterosexual couples in the immediate pregnancy after stillbirth. Couples were interviewed together to explore their dyadic, lived experiences of stillbirth and the pregnancy that follows. Hoping for a born alive baby was one superordinate theme and Trying to conceive one of its subordinate themes, is presented here. Couples jointly negotiated their decision to get pregnant again, varying upon their individual circumstances, including their experiences of stillbirth. Gender differences were apparent in a couple's agreement to pursue a pregnancy after stillbirth and may be explained by the desire of men to fully parent the baby who died before reaching a decision about a subsequent pregnancy. Sexual intercourse often became less about emotional connection and more about a means to achieve a pregnancy. Couples spoke of the need for each partner to be in agreement with the decision for a pregnancy. The experiences of trying to conceive after stillbirth impacted the couple relationships. Couples who were able to discuss their feelings with one another appeared more cohesive than those who experienced communication challenges in the aftermath of loss. New insights into men's thinking about the decision to get pregnant after stillbirth were revealed. [ABSTRACT FROM AUTHOR]

Fear of childbirth (FOC) can be debilitating, impacting women's lives in pregnancy, the puerperium and beyond. Research investigated various interventions for FOC in the perinatal period, but there been no synthesis of the experiences of women who engaged with these interventions, which would inform clinical practice guidance and the development of future interventions. To conduct a review and synthesis of qualitative studies of interventions for fear of childbirth in the perinatal period and women's experiences of them. A meta-synthesis was performed to examine all relevant qualitative studies describing women's experiences of interventions for FOC, in all languages. A comprehensive search of relevant databases from 1978 to 2019 was conducted. In total, following appraisal, seven qualitative studies were eligible for inclusion. The findings were integrated using thematic synthesis for the final stages in the thematic analysis. One overarching theme "Ownership of Childbirth" and three analytical themes "Facing the fear", "Feeling empowered", "Managing the fear with a sense of security" were generated through the synthesis. There were no studies outside of Scandinavia located. This meta-synthesis provides a new way to describe the process of moving from fear to "Ownership of childbirth". The first step in the process appears to be acknowledging and identifying the individual's fears. Women can be empowered to self-manage FOC but may be influenced by external factors such as the support of partners and staff. These findings provide evidence to inform the development of future interventions for FOC and highlight the need for further qualitative research globally. [ABSTRACT FROM AUTHOR]

• The defining attributes of empowerment of women in pregnancy and childbirth are external and internal to the woman. • External attributes include gender equality, access and control over resources, meaningful interconnectedness and facilitation of a woman's choices and decisions. • Internal attributes include a woman's belief in her own ability to achieve meaningful goals and have control over her situational context and behaviours of herself and those around her. • Empowerment needs to be understood within the socio-cultural-economic-political landscape of the individual woman whose internal belief in herself is key. Empowerment is expected to have a beneficial effect on a woman's well-being during the perinatal period and her readiness to face the challenges of motherhood. In the literature on pregnancy and childbirth, empowerment is used widely in different contexts, with different connotations and often without a definition, thus indicating a lack of clarity of what is actually meant by the concept. To report an analysis of the concept of women's empowerment in the context of the perinatal period. We used the concept analysis framework of Walker and Avant to analyse the concept of women's empowerment during pregnancy and childbirth. In July 2018, we did a systematic search in EBSCOhost, including the database MEDLINE, CINAHL, PsycINFO, PsycARTICLES and SocINDEX, using keywords: empower, women, childbirth and their synonyms. All selected papers were analysed for definitions of empowerment, defining attributes, antecedents and consequences. Ninety-seven scientific papers from all continents were included in the analysis. Defining attributes, antecedents, consequences and empirical referents are discussed, and a model case as well as related and contrary cases are presented. Attributes, external and internal to the woman, were identified. Both types of attributes need to be considered within the broader socio-cultural-economic-political landscape of the individual woman, in conjunction with a woman's belief in herself and her meaningful interconnectedness with carers. This study resulted in an understanding of empowerment in the context of pregnancy and childbirth that can be used in research and for the development of interventions preparing women for childbirth and their subsequent transition to motherhood. [ABSTRACT FROM AUTHOR]

• Father's anxiety increased from the antenatal period to the time of birth. • From the time of birth to the later postnatal period father's anxiety decreased. • Anxiety impacts negatively on fathers physical and mental health. • Lower social support and work- family conflict contribute to perinatal anxiety. fatherhood in the perinatal period can be a time of great excitement, happiness and joy. However, a growing body of literature indicates that fathers are at risk for elevated levels of anxiety symptoms during the perinatal period. the purpose of this systematic review is to determine the prevalence and levels of anxiety in fathers during the perinatal period, identify the risk factors and impact of anxiety, and establish if there are effective interventions that reduce father's anxiety. Systematic review. A systematic review protocol was developed and registered with PROSPERO (reference number: CRD42017073760). The review was guided by the PRISMA reporting process. Electronic databases Medline, CINAHL, Embase, the Cochrane Library, PsycARTICLES, PsycINFO, and Psychology were searched to identify eligible studies. Studies that researched fathers during the perinatal period were included if anxiety was the primary focus of the research or was an outcome or dependent variable. Data were extracted and presented in narrative form including tables and figures. Thirty-four studies met the inclusion criteria. Findings from these studies indicate that fathers experience anxiety in the perinatal period, particularly at the time of birth. Anxiety increased from the antenatal period to the time of birth, with a decrease in anxiety from the time of birth to the later postnatal period. The prevalence of anxiety ranged between 3.4% and 25.0% during the antenatal period and 2.4% and 51.0% during the postnatal period. Factors contributing to anxiety included lower education levels, lower income levels, lower co-parenting support, lower social support, work-family conflict, a partner' anxiety and depression, and being present during a previous birth. Anxiety had a negative impact on fathers' mental health, physical health, social relationships and parenting skills. Anxiety contributed to stress, depression, fatigue and lower paternal self-efficacy. Five studies reported on interventions to reduce anxiety and all the studies found that anxiety significantly decreased following the intervention. Fathers experience increased anxiety from the antenatal period to the time of birth, with a decrease in anxiety from the time of birth to the later postnatal period. Anxiety during the perinatal period that can impact negatively on fathers physical and mental health, and social relationships. [ABSTRACT FROM AUTHOR]

Background despite the evidence that fatherhood has a long-term positive and protective effect on men's health, there is also evidence that fatherhood in the perinatal period can be complex and demanding. Due to the potential increase in stressors in the perinatal period, there is reason to hypothesise that it is a time of increased stress for fathers. However, it is not clear how significant a problem stress is for fathers during this stage of life. This is in part, due to the fact that the available research has not been systematically reviewed. Purpose the purpose of this systematic review was to critically appraise the empirical evidence that examined stress in fathers in the perinatal period. Design systematic review. Methods a systematic review protocol was developed and registered with PROSPERO (Reference number: CRD42016035821). The review was guided by the PRISMA reporting process. Electronic databases Medline, CINAHL, the Cochrane Library, PsycARTICLES, PsycINFO, Psychology and Behavioural Sciences Collections were searched to identify studies that met the inclusion criteria. Studies that researched fathers in the perinatal period were included if stress was the principal focus of the research, if stress was in the title and/or aim of the study or if stress was an outcome or dependent variable. Data were extracted and presented in narrative form including tables and figures. Findings eighteen studies met the inclusion criteria. The findings indicate that fathers experience stress in the perinatal period, particularly at the time of birth. Stress levels were found to increase from the antenatal period to the time of birth, with a decrease in stress levels from the time of birth to the later postnatal period. There are a number of factors that contribute to stress in fathers in the perinatal period and these included negative feelings about the pregnancy, role restrictions related to becoming a father, fear of childbirth and feelings of incompetence related to infant care. The review found that stress has a negative impact on fathers, with higher stress levels contributing to mental health issues such as anxiety, depression, psychological distress and fatigue. Key conclusion during the perinatal period fathers experience stress and face unique stressors that can impact negatively on their health and social relationships. [ABSTRACT FROM AUTHOR]

Objective: to investigate the influence of parental and infant characteristics on exclusive breast feeding from birth to six months of age and breast feeding rates at two, six and 12 months of age in Ireland. Methodology: secondary data analysis from the Cork BASELINE Birth Cohort Study (http://www.baselinestudy. net/). Infants were seen at birth and two, six, and 12 months of age. Maternal and paternal history, neonatal course and feeding data were collected at birth and using parental questionnaires at each time point. Participants: 1094 singleton infants of primiparous women recruited at 20 weeks' gestation who were breastfeeding on discharge from the maternity hospital. Findings: at discharge from the maternity hospital and at two months, neonatal intensive-care unit admission had the strongest influence on exclusive breast feeding status (adjusted OR 0.17, 95% CI 0.07-0.41 at discharge) and at two months (adjusted OR=0.20,95% CI 0.05-0.83). A shorter duration of breast feeding was significantly associated with younger maternal age, non-tertiary education, Irish nationality and neonatal intensive-care unit admission. There was a significant difference in the duration of any breast feeding between infants who were and were not admitted to the neonatal intensive-care unit, 28(10.50, 32) weeks versus 32(27, 40) weeks. Mothers whose maternity leave was between seven and 12 months (adjusted OR=2.76, 95% CI 1.51-5.05) breast fed for a longer duration compared to mothers who had less than six months of maternity leave. Key conclusions: admission to the neonatal intensive care unit negatively influenced both exclusivity and duration of breast feeding. Length of maternity leave, and not employment status, was significantly associated with duration of breast feeding. Implications for practice: additional support may be required to ensure continued breast feeding in infants admitted to the neonatal intensive-care unit. Length of maternity leave is a modifiable influence on breast feeding and offers the opportunity for intervention to improve our rates of breast feeding. [ABSTRACT FROM AUTHOR]

The aim of this research was to identify factors associated with mothers breast feeding and to identify, for those who breast fed, factors associated with breast feeding for as long as planned. Background: breast feeding rates in Ireland are amongst the lowest in Europe. Research evidence indicates that in order for mothers to be successful at breast feeding, multiplicities of supports are necessary for both initiation and duration. The nature of these supports in tandem with other influencing factors requires analysis from an Irish perspective. Design: cross-sectional study involving public health nurses and mothers in Ireland. This paper presents the results of the mothers' evaluation. Method: mothers (n = 1715) with children less than three years were offered a choice of completing the self-report questionnaires online or by mail. Data were analysed and reported using descriptive and inferential statistics. Findings: four in every five participants breast fed their infant and two thirds of them breast fed as long as planned. The multivariate logistic regression analysis identified that third level education, being a first time mother or previously having breast fed, participating online, having more than two public health nurse visits, and having a positive infant feeding attitude were independently and statistically significantly associated with breast feeding. Among mothers who breast fed, being aged at least 35 years, participating online, having a positive infant feeding attitude and high breast feeding self-efficacy were independently and statistically significantly associated with breast feeding for as long as planned. Conclusions: findings from this study reinforce health inequalities therefore there needs to be a renewed commitment to reducing health inequalities in relation to breast feeding. Relevance to clinical practice: this study has identified factors associated with initiation and duration of breast feeding that are potentially modifiable through public health interventions. [ABSTRACT FROM AUTHOR]

Abstract: Objective: to present an integrated literature review on maternal parental self-efficacy (MPSE) in the postpartum period. Data sources: a literature search of CINAHL with full text and MEDLINE and PsycINFO from their start dates to February 2010. Study selection: inclusion criteria were English written research articles which reported the measurement of MPSE in the postpartum period. Data extraction: articles were reviewed based on purpose, theoretical framework, data collection method, sample, main findings and nursing implications for maternal parenting. In addition, data related to the instruments that were used to measure MPSE were included. Data synthesis: data revealed is a statistically significant increase in MPSE over time from baseline; a positive relationship between MPSE and number of children, social support, maternal parenting satisfaction and marital satisfaction; and a negative relationship between MPSE and maternal stress, anxiety and postpartum depression. A variety of instruments to measure MPSE were used but the majority were based on Bandura’s framework. Conclusions: findings from this review may assist women’s health researchers and clinical nurses/midwives in assessing and developing appropriate interventions for increasing risk awareness, enhancing MPSE and subsequent satisfaction with parenting and emotional well-being. Further research is necessary underpinned by theoretical frameworks using domain-specific instruments to identify predictors of MPSE. [Copyright &y& Elsevier]

Postnatal depression (PND) is a significant public health issue, with variable prevalence and a dearth of research on risk and protective factors. This quantitative longitudinal study of 512 first-time mothers identified the prevalence of PND and examined the relationships between functional and structural social support at 6 and 12 weeks postpartum. The prevalence of PND was 13.2% at 6 weeks and 9.8% at 12 weeks. At 6 and 12 weeks, the only social support dimension independently associated with PND was total functional social support. At-birth formal structural support and emotional functional support were independently predictive of PND at 12 weeks. [Copyright &y& Elsevier]

Abstract: Diabetes has reached pandemic proportions worldwide. To address and assist health care professionals in maintaining and updating their knowledge base on diabetes care, a multilateral project within the framework of the Lifelong Learning Programme and the Erasmus Curriculum Development - sub programme was initiated in 2008. Four European countries are involved in the project – Estonia, Finland, Ireland and Lithuania. Across all four countries the prevalence of diabetes is rising rapidly. The project’s (DIPRA - Counselling for Practice – a pilot of improving counselling quality of diabetes) main product will be an on-line study module on patient education and counselling for health care professionals. The management of diabetes demands a broad range of skills which include, communication, leadership, counselling, teaching and research to name but a few. While it is acknowledged that nurses can incorporate these skills into practice and so benefit the care of the patient there is no uniformity across the four countries studied as to what constitutes a specialist diabetes nurse. The study module and all the materials (databank, on-line lectures, and interactive exercises) will be developed in English and translated into partners’ national languages (Estonian, Finnish, Lithuanian) to maximize the accessibility of all professionals in partner countries. [Copyright &y& Elsevier]

The article presents a study conducted to identify support networks, needs and types of support for infant care practices provided to first-time mothers at 6 weeks after delivery in Ireland. The study made used of a 28-item questionnaire that measured the social support needs and formal and informal support networks in the field of infant care. It was found out that most women obtain information in caring for their infants from informal social networks.

This article presents an overview of research on postnatal depression conducted with postnatal women only. Research spanning three areas is reviewed, namely, prevalence, mothers'' experiences ,and treatments. The review shows prevalence rates varying from 4.4% to 73.7%, with the most recent systematic review suggesting a rate of 13%, indicating a serious clinical issue for nurses providing postnatal care to mothers. Mothers'' experiences of living with postnatal depression exemplify such feelings as loneliness, anxiety, hopelessness, and loss of control at a time when expectations of joyousness are anticipated. Results of research on treatment options show limited success with antidepressant medications, some success with psychotherapeutic options, and the importance of social support for mothers with postnatal depression. Comparisons of studies are made from methodological perspectives, drawing on their strengths and limitations. Overall, this review highlights the high prevalence rates of postnatal depression, negative feelings exemplified by mothers'' living with this condition, and the limited success of treatment options available to mothers. Postnatal depression is a significant clinical issue for nurses providing postnatal care for mothers and is underassessed, misunderstood, and very often poorly treated. [Copyright &y& Elsevier]

• Self-harm is an umbrella term used to define any act of deliberate self-injury or self-poisoning carried out by an individual regardless of their intent or motivation (National Institute of Clinical Excellence, NICE, 2013). It is the direct and deliberate damage to a person's own body without the explicit aim of dying as a result of the actions [2] People who engage in self harm are at a greater risk of subsequently dying by suicide [3]. • Patients that presented to ED following self-harm without a life threating physical injury were not seen as requiring urgent intervention regardless of their triage category. Priority was given to their physical symptoms with their mental health needs considered the remit of the mental health team. The physical infrastructure of ED coupled with the dynamic fast pace of the clinical area is an inappropriate environment in caring for patients who have self-harmed. • Nurses in ED struggle in assessing and providing adequate care for patients who have self-harmed. There is a level of uncertainty in dealing with this patient group. A deficit of specific self-harm education and training was highlighted by participants. • This study found that ED nurses were unsure of their practice with self-harm patients but they held an empathic and positive outlook when dealing with these patients. • ED nurses are conscious that self-harm can equate to frequent attendances to ED and they are mindful not to let this influence the care they provide. However, at times, the conduct of patients can result in staff having feelings of frustration towards patients who self-harm. There are a substantial number of self-harm presentations to emergency departments (EDs) yearly throughout Ireland. Nurses often struggle with the psychosocial nursing interventions required when caring for patients who present following self-harm. To explore the experiences of registered general nurses (RGN) who care for patients presenting with self-harm to the ED in Ireland. A qualitative descriptive study design was used to explore experiences of RGNs in caring for patients with self-harm in the emergency department. Data was collected using one to one interviews with a purposive sample of nine RGNs working in ED. Transcripts were analysed using Burnard's thematic content analysis framework. Three themes emerged: 1) waiting for assessment/treatment in an unsuitable environment 2) caring for self-harming patients from a nursing perspective and 3) nurses' perceptions of self-harming patients. Overall ED nurses hold a positive attitude towards patients who self-harm but acknowledge that barriers and challenges do exist when caring for this patient group. This study highlights the need for specific training on caring for patients who present to ED following self-harm. [ABSTRACT FROM AUTHOR]

Tocophobia is a severe fear of pregnancy and childbirth. There is increasing evidence that tocophobia has serious adverse effects on both mother and baby, which can be long term. In this review, the concept of tocophobia is discussed in the context of current maternity practice. Maternity caregivers need to be aware of presentation, symptoms and predisposing characteristics of women with tocophobia so that plans can be put in place to help them. Management of tocophobia is individualized and depends on the cause. Early psychological support is vital. Women need to be involved in developing an appropriate birth plan. For some women, it may be necessary to carry out an elective Caesarean section. Other considerations may be required depending on the cause of the phobia. If tocophobia is not addressed, it may become worse in subsequent pregnancies or women may avoid further pregnancies. The overall aim is to ensure a safe birth outcome for mother and baby. [ABSTRACT FROM AUTHOR]

Background Breastfeeding rates in Ireland are among the lowest in Europe. Breastfeeding groups can provide support, information, and friendship for women. However, there is little research exploring community breastfeeding groups led by Public Health Nurses providing universal maternal and child care to all postnatal mothers in the community in Ireland. Aim The aim of this study was to explore breastfeeding women’s experiences of a Public Health Nurse led support group. Methods A qualitative descriptive design to explore women’s experiences of a community breastfeeding support group was conducted. Data were collected using one to one interviews with breastfeeding women (n = 7) in a primary healthcare setting. Transcripts were analysed using Burnard’s thematic content analysis. Results The overall theme identified was ‘normalising breastfeeding’ which emerged from the subthemes ‘socialising and sharing’, ‘information and support seeking’, ‘building confidence’, ‘overcoming embarrassment’, ‘negative perceptions of others’, and ‘promoting breastfeeding to others’. Discussion Women who attended the PHN led breastfeeding support group found it to be a cocoon of ‘normality’, whereas breastfeeding was considered almost something to be ashamed of in other circumstances. Many women attributed their success with breastfeeding to the support group. Conclusion Facilitating a sense of normalcy for breastfeeding women at individual, community and societal levels was essential in promoting breastfeeding. The community support group was influential in normalising breastfeeding for a sample of women, by minimising the potential for embarrassment, promoting social interaction and sharing, building confidence and knowledge. This buffered the effects of negative attitudes of others and personal feelings of shame. [ABSTRACT FROM AUTHOR]