Self-management Behaviours among Nurses and Midwives during Pregnancy and Associated Factors: A Cross-sectional Study

Authors

  • Marie Hino MW Graduate School of Health Sciences, Hokkaido University, Hokkaido, Japan.
  • Rika Yano Faculty of Health Sciences, Hokkaido University, Hokkaido, Japan.

DOI:

https://doi.org/10.60099/prijnr.2024.268970

Keywords:

Midwives, Nurses, Pregnancy, Self–management, Work environment

Abstract

The high rate of perinatal abnormality among pregnant nurses and midwives attributable to their working environment is a serious international occupational health concern. Self-management behaviours can prevent abnormalities, but nurses and midwives have difficulty carrying out these behaviours during pregnancy. This cross-sectional study aimed to examine self-management behaviours and associated factors during pregnancy among nurses and midwives. The partic­ipants were 232 pregnant or postpartum registered nurses and midwives from four Japanese general hospitals. Participant recruitment and questionnaire distribution were undertaken through hospital management. Data were collected from July to November 2022. Instruments included the Personal Demographic and Obstetric Conditions Questionnaire, the Self-Management Behaviours Questionnaire, the Working Conditions during Pregnancy Questionnaire, the Social and Workplace Support Scale, the Sense of Coherence Scale, and Self-Management Difficulties Scale. Data analysis used univariate and multiple classification analysis.

Results indicated that participants demonstrated good compliance with contraindications among self-management behaviours but scored lower in knowledge and self-monitoring, abnormalities prevention, and avoiding burden movements. Multiple classification analyses revealed that parity, profession, overtime, acquisition of maternity protection provisions, managers support, family support, and prioritising the foetus were significantly associated with self-management behaviors. Nursing administrators must provide adequate information and adjust the work of pregnant staff. Policymakers need to propose measures to reinforce maternity protection provisions for pregnant nurses and midwives. Pregnant nurses and midwives need to be proactively educated on occupational health and safety. Learning the importance of acquiring maternity protection provisions, receiving support and prioritising the foetus will contribute to effective self-management practices in them. Further research is needed to promote self-management behaviours among pregnant nurses and midwives.

References

World Health Organization. Promoting healthy pregnancy. WHO [Internet]. 2024 [cited 2024 Apr 25]. Available from: https://www.who.int/activities/promoting-healthy-pregnancy

World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. WHO [Internet]. 2016 Nov 28 [cited 2024 Apr 25]. Available from: https://www.who.int/publications/i/item/9789241549912

National Institute for Health and Care Excellence. Antenatal care NICE guideline. NICE [Internet]. 2021 Aug 19 [cited 2024 Apr 25]. Available from: https://www.nice.org.uk/guidance

Odendaal H, Dukes KA, Elliott AJ, Willinger M, Sullivan LM, Tripp T, et al. Association of prenatal exposure to maternal drinking and smoking with the risk of stillbirth. JAMA Netw Open. 2021;4(8):e2121726. doi: 10.1001/jamanetworkopen.2021.21726.

Quenby S, Gallos ID, Dhillon-Smith RK, Podesek M, Stephenson MD, Fisher J, et al. Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss. Lancet. 2021;397(10285): 1658-67. doi: 10.1016/S0140-6736(21)00682-6.

Vogel JP, Chawanpaiboon S, Moller AB, Watananirun K, Bonet M, Lumbiganon P. The global epidemiology of preterm birth. Best Pract Res Clin Obstet Gynaecol. 2018;52:3-12. doi: 10.1016/j.bpobgyn.2018.04.003.

Chia AR, Chen LW, Lai JS, Wong CH, Neelakantan N, Van Dam RM, et al. Maternal dietary patterns and birth outcomes: a systematic review and meta-analysis. Adv Nutr. 2019;10(4):685-95. doi: 10.1093/advances/nmy123.

Hamułka J, Zielińska AM, Chądzyńska K. The combined effects of alcohol and tobacco use during pregnancy on birth outcomes. Rocz Panstw Zakl Hig. 2018, 69(1):45-54. PMID: 29517191.

Wang J, Yang W, Xiao W, Cao S. The association between smoking during pregnancy and hypertensive disorders of pregnancy: a systematic review and meta-analysis. Int J Gynaecol Obstet. 2022;157(1):31-41. doi: 10.1002/ijgo.13709.

Ministry of Health, Labour and Welfare. Maternal health care for women workers. [Internet]. 2024 [cited 2024 Apr 25]. Available from: https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/koyou_roudou/koyoukintou/seisaku05/index.html

The American College of Obstetricians and Gynecologists. Employment considerations during pregnancy and the postpartum period. ACOG [Internet]. 2018 Apr [cited 2024 Apr 25]. Available from: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/04/employment-considerations-during-pregnancy-and-the-postpartum-period

Cai C, Vandermeer B, Khurana R, Nerenberg K, Featherstone R, Sebastianski M, et al. The impact of occupational shift work and working hours during pregnancy on health outcomes: a systematic review and meta-analysis. Am J Obstet Gynecol. 2019;221(6):563-76. doi: 10.1016/j.ajog.2019.06.051.

Cai C, Vandermeer B, Khurana R, Nerenberg K, Featherstone R, Sebastianski M, et al. The impact of occupational activities during pregnancy on pregnancy outcomes: a systematic review and meta-analysis. Am J Obstet Gynecol. 2020;222(3): 224-38. doi: 10.1016/j.ajog.2019.08.059.

Evrenos AN, Cakir Gungor AN, Gulerman C, Cosar E. Obstetric outcomes of patients with abortus imminens in the first trimester. Arch Gynecol Obstet. 2014;289(3): 499-504. doi: 10.1007/s00404-013-2979-5.

Hino M, Takashima R, Yano R. Health management of working pregnant nurses: a grounded theory study. Nursing Open. 2024;11(4):e2158. doi: 10.1002/nop2.2158.

Rainbow JG, Dolan HR, Farland L. Nurses’ experiences of working while pregnant: a qualitative descriptive study. Int J Nurs Stud. 2021;124:104092. doi: 10.1016/j.ijnurstu.2021.104092.

Japan Federation of Medical Worker’s Unions. Working conditions of nursing staff report on survey results (2017) [Internet]. 2017 [cited 2024 Apr 25]. Available from: http://irouren.or.jp/

Lee H, Chang HE, Ha J. Nurses’ clinical work experience during pregnancy. Healthcare (Basel). 2020;9(1):16. doi: 10.3390/healthcare9010016.

Quinn P. A grounded theory study of how nurses integrate pregnancy and full-time employment: becoming someone different. Nurs Res. 2016;65(3):170-8. doi: 10.1097/NNR.0000000000000157.

Ryan P, Sawin KJ. The individual and family self-management theory: background and perspectives on context, process, and outcomes. Nurs Outlook. 2009; 57(4):217-25.e6. doi: 10.1016/j.outlook.2008.10.004.

Antonovsky A. Unraveling the mystery of health:how people manage stress and stay well. San Francisco: Jossey-Bass; 1987.

Ferguson S, Davis D, Browne J, Taylor J. Sense of coherence and childbearing: a scoping review of the literature. Int J Childbirth. 2014;4(3):134-50. doi: 10.1891/2156-5287.4.3.134.

Sekizuka-Kagami N, Shimada K, Tabuchi N, Nakamura H. Association between the sense of coherence 13-item version scale score of pregnant women in the second trimester of pregnancy and threatened premature birth. Environ Health Prev Med. 2015;20(2):90-6. doi: 10.1007/s12199-014-0436-0.

Masjoudi M, Khazaeian S, Malekzadeh S, Fathnezhad- Kazemi A. Health-promoting behaviors and intermediary social determinants of health in low and high-risk pregnant women: an unmatched case-control study. BMC Pregnancy Childbirth. 2022;22(1):445. doi: 10.1186/s12884-022-04784-y.

von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007;147(8):573-7. doi: 10.7326/0003-4819-147-8-200710160-00010.

Ramos AM, Marceau K, Neiderhiser JM, De Araujo- Greecher M, Natsuaki MN, Leve LD. Maternal consistency in recalling prenatal experiences at 6 months and 8 years postnatal. J Dev Behav Pediatr. 2020;41(9):698-705. doi: 10.1097/DBP.0000000000000841.

World Medical Association. WMA declaration of Helsinki – ethical principles for medical research involving human subjects (64th WMA General Assembly, Fortaleza, Brazill, 2013) [Internet]. 2022 Sept 6 [cited 2024 Apr 25]. Available from: https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/

Guidelines Committee of the Japan Academy of Midwifery. 2020 Evidence-based guidelines for midwifery care. J Jpn Acad Midwif. 2019;33:1-183. doi: 10.3418/jjam.33s.

Itakura A, Satoh S, Aoki S, Fukushima K, Hasegawa J, Hyodo H, et al. Guidelines for obstetrical practice in Japan: Japan Society of Obstetrics and Gynecology and Japan Association of Obstetricians and Gynecologists 2020 edition. J Obstet Gynaecol Res. 2023;49(1):5-53. doi: 10.1111/jog.15438.

Yamazaki Y. A new view of health provided by salutogenesis and a sense of coherence (SOC). Qual Nurs. 1999;5:825-32 (in Japanese).

Iwasa H, Gondo Y, Masui Y, Inagaki H, Kawaai C, Otsuka R, et al. Reliability and validity of the Japanese version of the Multidimensional Scale of Perceived Social Support among middle-aged and elderly people living in a Japanese community. J Health Welfare Stats. 2007;54(6):26-33 (in Japanese).

Zimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the Multidimensional Scale of Perceived Social Support. J Pers Assess. 1990;55(3-4):610-7. doi:10.1080/00223891.1990.9674095.

House JS. Work stress and social support. Reading (MA): Addison-Wesley; 1981.

Korukcu O. Psycho-adaptive changes and psychological growth after childbirth in primiparous women. Perspect Psychiatr Care. 2020;56(1):213-21. doi:10.1111/ppc.12413.

Shakarami A, Mirghafourvand M, Abdolalipour S, Jafarabadi MA, Iravani M. Comparison of fear, anxiety and self-efficacy of childbirth among primiparous and multiparous women. BMC Preg Childbirth. 2021;21(1):642. doi:10.1186/s12884-021-04114-8.

Christian LM, Carroll JE, Porter K, Hall MH. Sleep quality across pregnancy and postpartum: effects of parity and race. Sleep Health. 2019;5(4):327-34. doi: 10.1016/j.sleh.2019.03.005.

Sekizuka H, Miyake H. Overtime work is related to nonrestorative sleep independently of short sleep time among a Japanese occupational population. Int Arch Occup Environ Health. 2024;97(1):75-80. doi: 10.1007/ s00420-023-02027-x.

Delgado A, Louis JM. Sleep deficiency in pregnancy. Sleep Med Clin. 2023;18(4):559-71. doi: 10.1016/j.jsmc.2023.06.011.

Downloads

Published

2024-08-31

How to Cite

1.
Hino MW M, Yano R. Self-management Behaviours among Nurses and Midwives during Pregnancy and Associated Factors: A Cross-sectional Study. PRIJNR [Internet]. 2024 Aug. 31 [cited 2024 Nov. 21];28(4):795-811. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/268970