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Chronic fatigue syndrome (CFS) is a severe, systemic, acquired illness which presents with overpowering tiredness that cannot be relieved by rest and is deteriorated through physical and mental activity. Due to the window of prevalence (20-40 years), some women diagnosed with CFS become pregnant. Given that CFS targets women in their reproductive years, responsibility is placed upon midwives to educate, support and provide families with advice. To equip midwives with knowledge about CFS, the objectives of this paper are to provide an overview of: how CFS impacts on reproductive health; the effects of pregnancy on CFS symptoms; CFS-related pregnancy complications; intrapartum management of women with CFS, and postpartum recovery of women with CFS. To date, only a handful of studies have explored the relationships between CFS and childbearing, and associated complications. A greater understandings of CSF interactions with physical, psychological and social reproductive processes are required. [ABSTRACT FROM AUTHOR]

Quality of life measures can be used by health professionals to assess effectiveness of nutritional interventions administered to palliative care patients. Stabilizing, maintaining and attempting to increase weight in palliative care patients through the support of oral feeding, and provision of artificial feeding, has been shown to mediate the metabolic and physical wasting effects of the disease process and improve general comfort. A quality of life instrument is a multi-dimensional questionnaire that health professionals can use to measure domains relating to physical, psychological and social aspects of living, and health and disease outcomes. There are three instruments specifically designed to assess quality of life in patients receiving palliative care. These are: The Palliative Care Quality of life Instrument, The Assessment of Quality of Life at the End of Life (AQEL), and The Spitzer Quality of Life Index (SQLI). General use quality of life measures are multifaceted; however, for use with palliative care patients, they have added dimensions of spirituality, existential issues (purpose and meaning of life), family members' perceptions of quality of care, symptom control and family support. Use of quality of life scales provides health professionals and organizations with an ideal measure for planning, targeting and evaluating health interventions. [ABSTRACT FROM AUTHOR]

On occasion midwives may be required to construct a research proposal. In the current climate of evidence-based practice. Such activity is considered an elemental skill for career progression in both education and service. Examples of where writing a research proposal may be required include: writing an assessment for under and post graduate research modules or designing a dissertation, MPhil, Prof Doc or PhD. Within clinical practice there are also audit and evaluation of practice responsibilities. With these factors at the forefront, this article provides a template specifically designed to direct midwives through the procedures of constructing a research proposal. The purpose of a research proposal is to produce a template of common understanding from which tasks are allocated, divided and discussed by researchers, clinical staff and in some cases participants. The finished product is then used to communicate intent to the ethics committees and grant funding bodies before authorization and money are awarded. [ABSTRACT FROM AUTHOR]

If women are to be empowered to make choices for childbirth, it is important that midwives explore and discuss their wishes and feelings about the delivery options available. Providing practical and sensible information should facilitate women with constructing a more accurate picture from which realistic hopes, fears and expectations can be formulated about impending labour. To facilitate midwives with this process, a flexible framework for a birth plan has been proposed. This easy to complete template can be used to assist childbearing women with assimilating their ambitions and desires regarding labour. Birth planning is important, since studies that compare women's expectations of childbirth with actual experience present contrasting accounts, with disappointment, guilt and failure compared with delight, pride and success. Since experiences differ it is recommended that midwives audit birth satisfaction against women's birth plans. Results would inform auditors of whether there is satisfaction with a woman's birth experience and the quality of care that she perceived she received. Women's articulated wishes about birth would facilitate understanding of why satisfaction/dissatisfaction occurs. [ABSTRACT FROM AUTHOR]

This study analyzes the psychological processes involved when a midwife accepts directions from a senior person. A representative sample of 20 midwives were recruited from 7 maternity units in North Yorkshire. An inductive thematic analysis was used to interpret interview data. Results showed that midwives respond to social influence from senior people using two processes: obedience and/or conformity. Thirteen (65%) excerpts informed that participants' interpreted direction from the senior person as instructions they were expected to follow (obedience) and seven (35%) showed that others voluntarily changed their viewpoint to agree with the one offered by the senior person (conformity). Participants' behaviour has been explained in terms of ‘legitimacy’, ‘perceived obligation to the organization’ and ‘social identification’. These pressures create conflict between the midwives' knowledge of how they would prefer to behave and concern to please authority or fit into the social group. Consequently, it may be difficult for midwives to support safe requests from women that conflict with what a senior person [ABSTRACT FROM AUTHOR]

The aim was to develop a scale—the Birth Participation Scale (BPS)—which midwives can use to measure fathers' attitudes and needs in relation to birth participation. The objectives were to use the BPS to: detect whether fathers genuinely want to be present at the birth; identify localized perceptions and fears fathers may have about birth participation; and ascertain whether being present at the birth was a rewarding experience. A quantitative survey was carried out with data collected from York District Hospital Maternity Unit (UK). The participants were a stratified sample of first-time (n= 42) and second-time fathers (n= 36). Measurements and findings: the BPS was issued at two observation points: prior to birth participation and post birth participation. Difference in scores between conditions assessed the fathers' attitudes towards birth participation in a positive or negative direction. Scores post birth showed a small shift in attitude in a positive direction for first-time (p= 0.01) and second-time fathers (p= 0.02) with only 4% finding birth partnering more difficult than they had anticipated. Key conclusions are that midwives are facilitating the majority of fathers towards a positive birth experience. Implications for practice are that the BPS may prove useful for: identifying whether fathers genuinely want to be present at the birth; ascertaining fathers' personal concerns in relation to birth participation; and tailoring birth preparation to meet fathers individualized needs. [ABSTRACT FROM AUTHOR]

In some Instances midwives find It difficult to Implement research into practice (Aibers, 2001). For example, evidence informs of the benefits of providing continuous support during labour (Hodnett et al, 2003), yet one midwife to one woman is not compulsory in every maternity unit in the UK. Olsen (1997) meta-analyzed research that relates to the relative safety of home birth compared to hospital birth. Results found no difference In survival rates between babies born at home and those born In hospital. Amniotomy is still a common procedure, yet contra-indicated since fetal heart abnormalities are more likely in the healthy term fetus (Fraser et al, 1993). Such examples serve to sharpen awareness that some research is being overlooked. Consequently Ideas about how to narrow the theory-practice gap become salient. With this In mind a model Is proposed to help midwives implement change into practice. Changing behaviour is possible when logical structured approaches are taken at a number of levels. [ABSTRACT FROM AUTHOR]