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Maternity Nurses' Work Instability, Job Satisfaction, and Perinatal Missed Care During Labor and Birth: The Mediating Roles of Practice Environment and Burnout

ABSTRACT

Background

Nurses' burnout, work instability (WI), and job satisfaction (JS) in their practice environment (PE) are well established in the literature. However, perinatal missed care (PMC), a subset of missed nursing care, remains underreported among maternity nurses.

Aim

To examine the mediating role of PE and burnout in the associations of WI, JS, and PMC among maternity nurses.

Methods

A cross-sectional and correlational study employed consecutive sampling to recruit maternity nurses (n = 312) from five hospitals in Saudi Arabia (three government and two private hospitals in Hail and Makkah regions, respectively). Maternity staff nurses, regardless of their sex, years of professional nursing experience, or nationality, who met inclusion criteria were included in this study. Data was collected from July to September 2024 using four standardized self-report scales. Structural equation modeling was utilized for statistical analyses.

Results

Maternity nurses' WI negatively influenced PE (β = −0.23, p = 0.014), while positively affected PMC (β = 0.15, p = 0.031). The PE positively affected JS (β = 0.24, p = 0.034) but had a negative effect on burnout (β = −0.24, p = 0.007) and PMC (β = −0.21, p = 0.038). Burnout negatively affected JS (β = −0.25, p = 0.028), while positively associated with PMC (β = 0.20, p = 0.022). PE mediated the associations between WI and burnout (β = 0.05, p = 0.019), JS (β = −0.07, p = 0.020), and PMC (β = −0.06, p = 0.008). Meanwhile, burnout mediated between PE and JS (β = 0.05, p = 0.030) and PMC (β = −0.04, p = 0.023).

Linking Evidence to Action

Understanding the relationships among maternity nurses' burnout, JS, PE, and PMC is key to improving the quality of perinatal care and ensuring the patients' well-being. By focusing on strategies to enhance the PE (e.g., adequate staffing and resources, improved nurse–patient ratio), reduce burnout (e.g., meditation and mindfulness programs, coping intervention programs), and improve JS (e.g., work schedule flexibility, facilitate work-life balance, staff professional development), healthcare organizations can mitigate the occurrence of PMC.

Trends in cardiometabolic conditions and pregnancy outcomes: a retrospective cohort study in South-Eastern Melbourne

Por: Belsti · Y. · Palmer · K. R. · Moran · L. J. · Rolnik · D. L. · Goldstein · R. · Mousa · A. · Enticott · J. · Teede · H. J.
Objectives

To examine trends in preconception and pregnancy cardiometabolic risk factors and conditions, pregnancy and birth complications, obstetric interventions, and the impact of COVID-19, and to forecast future disease burden.

Design

A multi-centre retrospective cohort study.

Setting

A large hospital network with three maternity hospitals serving ethnically diverse populations in Melbourne, Australia.

Participants

Pregnant women who gave birth between 2016 and 2022.

Outcome measures

Trends in cardiometabolic conditions, birth complications and obstetric interventions.

Results

Over 7 years, 63 232 women were included, of whom 40% were nulliparous, and 60.9% were born overseas from 167 countries. From 2016–2022, maternal age (30.2–31.3 years), obesity (21.0%–26.2%), gestational diabetes mellitus (GDM) (15.9%–28.1%) and caesarean delivery (28.5%–37.6%) increased, while average gestational weight gain, premature births and special care admissions declined from 12.6–11.6 kg, 6.3%–4.9% and 24.2%–14.1%, respectively; and was statistically significant (p

Conclusions

Prepregnancy and pregnancy cardiometabolic risk factors and conditions, pregnancy and birth complications, and obstetric interventions increased markedly over 7 years. Despite this, offspring complications, including special care admissions, stillbirths and prematurity, decreased, while pregnancy complications peaked during COVID-19. GDM is forecasted to increase to 43.0% by 2028, posing an unsustainable health and economic burden that necessitates urgent public health initiatives.

Effect of curcumin on fatigue and musculoskeletal health in postmenopausal women: a double-blind randomised controlled trial

Por: Shabani · F. · Mashayekh-Amiri · S. · Mousavi · Z. · Shaseb · E. · Mirghafourvand · M.
Objectives

Considering the proven anti-inflammatory effects of curcumin, we aimed to investigate the effect of curcumin supplementation on fatigue and musculoskeletal health (primary outcomes) and depression and its side effects (secondary outcomes) in postmenopausal women.

Design

This was a parallel-group, double-blind, randomised placebo-controlled superiority trial.

Setting

The trial was conducted at two general clinics in Tabriz, Iran, in 2023.

Participants

A total of 74 postmenopausal women were enrolled. The participants were women aged between 40 years and 60 years with normal menopause and at least 1 year after amenorrhoea.

Intervention

They were randomly assigned (1:1 allocation ratio) using a block randomisation method to receive either 500 mg curcumin capsules (intervention group, n=37) or identical placebo capsules (control group, n=37) twice daily for 8 weeks. Both participants and researchers were blinded to the group assignments.

Primary and secondary outcome measures

Data were collected using the questionnaires of demographic characteristics, short form of the perimenopausal fatigue scale, musculoskeletal health, Beck Depression Inventory (BDI-13) and the side effects checklist. Independent t, ANCOVA and Mann-Whitney U tests were used to compare the results between the two groups.

Results

A total of 74 women were randomised, with 33 in the curcumin group and 31 in the placebo group completing the study and being included in the final analysis. After the 8-week intervention, ANCOVA adjusting for baseline values revealed that the curcumin group showed a statistically significant improvement in musculoskeletal health (mean difference (MD): 5.3; 95% CI: 3.3 to 7.4; p

Conclusion

In this trial, an 8-week supplementation with curcumin was more effective than placebo at improving musculoskeletal health and reducing fatigue score in postmenopausal women. The study was not able to demonstrate a significant effect on depression.

Trial registration number

Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N72. Last updated version: 18 October 2022. Actual start of recruitment: 23 January 2023.

Association between anti-Mullerian hormone levels and age in women with endometriosis: insights from a population-based study

Por: Ramezani Tehrani · F. · Mousavi · M. · Noori Ardebili · S. · Saei Ghare Naz · M. · Azizi · F. · Behboudi-Gandevani · S.
Background

While previous studies have shown an association between anti-Mullerian hormone (AMH) levels and endometriosis, there are limited data on the relationship between AMH levels and age among women with endometriosis.

Objectives

The present study aimed to investigate the associations between age and AMH levels in women with and without endometriosis.

Design and setting

A cross-sectional, population-based study using data from the ongoing Tehran Lipid and Glucose Study.

Participants

A total of 1005 eligible reproductive-age women were selected. These participants were categorised into two groups: women with confirmed endometriosis (n=305) and controls (n=700).

Interventions

None.

Outcome measures

Association between AMH levels and age among women with endometriosis and healthy controls, using linear, quadratic and segmented regression analyses.

Results

A total of 1005 women aged 18–48 years participated in the study, including 305 (30.3%) with endometriosis and 700 (69.7%) healthy controls. Women with endometriosis had significantly lower AMH levels compared with healthy controls (1.99±1.42 vs 2.30±1.61 ng/mL; p=0.029). In healthy controls, an increase of 1 year was associated with –0.15 ng/mL of AMH (95% CI: –0.17 to –0.14). Segmented regression identified a threshold at 27 years (1.92), with a sharper decline below this age (slope: –0.35, 95% CI: –0.47 to –0.23; p

Conclusion

Our study showed that women with endometriosis had significantly lower AMH levels compared with healthy controls and did not demonstrate the age-related threshold observed in the control group, where AMH levels declined more sharply before 27 years of age. These findings suggest that endometriosis may alter the typical pattern of AMH, indicating that clinicians should interpret AMH levels with caution in this population. Further research is needed to validate these results in other populations and explore alternative biomarkers or strategies for more accurately assessing ovarian reserve in women with endometriosis.

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