Objective: Reflect on how the new coronavirus pandemic triggered or accentuated the fear of childbirth in pregnant women and affected childbirth care practices. Methods: Reflective analysis of women's pregnancy and childbirth experiences during the current pandemic, supported by the latest scientific evidence and recommendations on the topic. Results: Pregnancy and childbirth are life-changing events for women, but during the new coronavirus pandemic, fear and uncertainty have taken on an unprecedented dimension in the negative way that many pregnant women have anticipated and experienced childbirth. Final considerations: The current period has accentuated a chronic problem: a paternalistic system of health institutions in the approach to childbirth, dense with additional levels of fear in pregnant women. In this context, addressing the fear of childbirth means not giving up the promotion of safe and positive birth experiences for women.
Background Decision-making tools represent a paradigm shift in the relationship between the clinician and the user/patient. Some of their advantages include patient commitment, the promotion of preferences and values, and increased treatment adherence. This study protocol aims to assess the effectiveness of a decision-making tool in contraception (SHARECONTRACEPT) concerning: a) Improvement in counselling on hormonal contraception at the medical consultation, measured in terms of decreasing decisional conflict and improving knowledge of available contraceptive options; b) Improvement in adherence to treatment measured in terms of: persistence in the chosen treatment, compliance with dose or procedure of use, and ability to deal with incidents related to the use of the contraceptive method; and decreasing unwanted pregnancies and voluntary interruption of pregnancy. The SHARECONTRACEPT tool, developed by previous phases of this project, is available at: http://decisionscompartides.gencat.cat/en/decidir-sobre/anticoncepcio_hormonal/ Methods/design A longitudinal, prospective-type, randomized, controlled community clinical trial, carried out in the clinical contraceptive counselling units of 6 autonomous regions in Spain, with an experimental group and a control group. Description of the intervention: The health professionals participating will be randomly assigned to one of the two groups. Clinicians assigned to the experimental group will perform contraceptive counselling assisted by SHARECONTRACEPT, and those of the control group will follow the conventional contraceptive counselling provided in their clinical unit. It is planned to study 1708 users (control group n = 854 and intervention group n = 854), recruited from women who attend the consultations of the health professionals. The selected users will be followed up for one year. The data will be collected through ad-hoc questionnaires, and validated instruments for measuring decisional conflict and adherence to treatment. Discussion The results of this study protocol will offer evidence of the effectiveness of a shared decision-making tool, SHARECONTRACEPT, which may prove a useful tool for users and professionals to promote adherence to contraceptive methods. Trial registration Clinical Register number ISRCTN5827994 . Date: 15/04/2019 (Retrospectively registered)
Objectives: to analyze the perception and conflict management strategies used by nurses in the management of people in Portuguese health services. Methods: descriptive, correlational study, carried out in Portuguese health services, with an intentional non-probabilistic sample, totaling 95 nurse managers. A questionnaire and Conflict Management Scale were used, analyzing the variables of managerial activities and conflict management, with the aid of software. Results: it was identified that 60% of the managers, report having to mediate conflicts daily, and the majority report adopting dialogue in conduct. However, through the Kruskal-Wallis test, it was shown that enforcement strategies in conflict management prevail (p = 0.008), with collaborative ones being more restricted to monthly intervals (p = 0.049). Conclusions: managers perceive the importance of collaboration in the mediation of conflicts, however, in their daily lives; they tend to maintain imposing behaviors, signaling for a little transformational leadership style.
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