A conceptual framework was developed based on Fawcett’s conceptual framework and Stufflebeam’s Decision Making Model. The merging of the concepts of the framework and the model gave rise to the concepts of the research model, viz. environment, registered midwife, curriculum and outcome. These concepts were researched. Donabedian’s Quality Assurance Model and Parlett and Hamilton’s Illuminative Evaluation guided the research methodology. The methodology adopts a triangulated approach, making use of both quantitative and qualitative data collection procedures. In order to study the concept “environment” 250 women were interviewed post-natally in order to determine their perceptions and expectations of care during pregnancy, labour and the puerperium. The findings show that women are not empowered in terms of their expectations of care. Caring appears to be viewed at a very low level and to be taskfocused. Furthermore, caring around the birth process appears to be seen as best when it is hospital-based. Attention needs to be given to health information and health promotion. This concept was also studied through four focus groups held with women in the community. These data were analysed qualitatively. The findings revealed women’s dissatisfaction with the role and function of the nurse. Women’s lack of empowerment was evident in their encounters with health care professionals. Women related more negative than positive experiences of relationships with nurses. Perceptions of lack of trust and lack of concern, inter alia, in and from nurses were highlighted in the interviews. The concept “registered midwife” was studied by requesting registered midwives in a la. e academic hospital’s maternity unit to complete a questionnaire. The questionnaire aimed to obtam the midwives perceptions of the needs of women during pregnancy, labour and the puerperium. It also probed midwives perceptions of their roles and functions. The findings reveal that midwives recognise their teaching responsibility, but appear to have difficulty in meeting this responsibility. Her own education has prepared her for hospitalv based practice. Administration, research and policy-making are not priority roles for the majority of the respondents. “Curriculum” was studied through two questionnaires given to students in the B.Nursing programme. The findings revealed a need to increase curriculum content which relates to primary health care and a need to restructure practical learning opportunities as students do not feel compete,nt to practise in rural hospitals and community settings. The concept “outcome” was studied through two sets of focus groups. One with graduands who were currently in midwifery practice and the other with supervisors of these practitioners. The findings from the graduands’ groups highlighted the need for greater emphasis on culture, health information and promotion and holistic care in their learning experiences. The groups held with the nursing supervisors highlighted their perceptions of student needs and the inadequacy of the hospital as a learning environment. The findings from the four concepts have been used to develop a curriculum for Women’s Health. The curriculum model encapsulates Stufflebeam’s model and the concepts of the conceptual framework. The curriculum process utilizes problem-based learning and community-based education as the means to learning.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Thesis--Ed. D. Columbia University, Teachers College, 1974.

Thesis--Ed. D. Columbia University, Teachers College, 1974.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Este estudo buscou identificar os critérios utilizados pelas enfermeiras obstétricas para empregar as tecnologias não-invasivas de cuidado no suporte físico à parturiente e quais são seus efeitos esperados. Para tanto, se realizou uma pesquisa quantitativa exploratória do tipo survey, que abordou as práticas/cuidados fornecidas pelas enfermeiras obstétrica durante a assistência ás parturientes que tinham relação com o suporte físico. Estas foram agrupadas em: suporte relacionado ao ambiente; suporte ao posicionamento (livre movimentação e adoção de posturas verticais, deambulação, movimentos pélvicos, posição de cócoras, e posição de quatro apoios); suporte aos estímulos táteis (massagens, compressas frias/mornas, banho morno de aspersão e imersão); e suporte energético (oferta de alimento). Para tanto, utilizou-se um questionário, que foi disponibilizado via internet, após a criação de um domínio e web site próprio para tal finalidade. A população-alvo constituiu-se de enfermeiras obstétricas que atuam no cuidado da parturiente em território nacional, sendo que estas foram convidadas a participar, entre os meses de julho e setembro de 2009, através de e-mails survey individuais ou coletivos. Participaram do estudo120 profissionais, sendo que 45,8% foram excluídos automaticamente pelo sistema, pois não possuíam os critérios de inclusão. Dos participantes elegíveis (65), 33,8% responderam somente o teste de elegibilidade, 4,6% responderam parcialmente e 61,6% responderam completamente o questionário. Os resultados demonstraram que alguns aspectos relacionados ao conceito ainda encontram-se pouco compreendidos pelas profissionais da área, entretanto este não é um entrave para que práticas/cuidados relacionados a esta nova terminologia sejam utilizadas durante a assistência à parturiente. De acordo com os objetivos propostos, conseguiu-se determinar os critérios e efeitos esperados pelas enfermeiras obstétricas ao utilizarem as tecnologias não-invasivas de cuidado estudadas, entretanto também se evidenciou brechas no conhecimento científico. Assim conclui-se que as enfermeiras obstétricas utilizam práticas/cuidados relacionadas as tecnologias não-invasivas de cuidado de enfermagem obstétrica no suporte físico à parturiente, pautadas em critérios e efeitos esperados que em sua maioria possuem bases científicas que os comprove. Considera-se que a utilização destas são uma ferramenta importante para a desmedicalização do processo de parto e consequentemente, para a diminuição dos índices de morbimortalidade materna e neonatall. Portanto, é necessário estimular à assistência ao parto por enfermeiras obstétricas, de modo a suplantar o modelo de assistência tecnocrático, ainda hegemônico no país. / This study sought to identify the criteria used by midwives to use the non-invasive technologies of care in physical support for women during childbirth and what are its effects. Therefore, conduced a exploratory quantitative research type survey, which dealt with the practice/care provided by obstetric nurses for assistance to pregnant women who were related to physical support. These were grouped into: the environment support, the position support (free movement and adoption of vertical posture, walking, pelvic movements, squatting, and the fours position), tactile support (massage, cold/warm compresses, warm bath spray and warm bath immersion), and energy support (food supply). We used a questionnaire, which was made available by Internet, after the creation of a domain and web site suitable for this purpose. The target population consisted of nurse-midwives who work in the care of the parturient in Brazil, and these were invited to participate between July and September 2009, by individuals or collective e-mails survey. Participated of this research 120 professionals, but 45.8% were deleted automatically by the system, because they did not have the criteria for inclusion. Of the eligible participants (65), 33.8% responded only the eligibility test, 4.6% responded partially and 61.6% answered the questionnaire completely. The results showed that some aspects of the concept are still poorly understood by professionals, however this is not a barrier to practice/care related to this new terminology be used during assisting the mother. According to the proposed objectives, we were able to determine the criteria and expected effects of nurse-midwives to use the non-invasive technologies of care, however also highlighted gaps in scientific knowledge. It was concluded that midwives use practices/cares related the non-invasive technologies of obstetric nursing care in physical support to laboring women guided criteria and expected effects most of which have the scientific proof. It is considered that the use of these are an important tool for the desmedicalization of the birthing process and consequently to reduce the rates of maternal morbidity and neonatall. Therefore, it is necessary to stimulate the delivery care by nurses-midwives in order to overcome the technocratic model of care, even hegemonic in the country.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / O presente estudo teve como objetivo construir e validar uma tecnologia educativa de enfermagem (manual) direcionada para acompanhantes durante o trabalho de parto e parto. Pesquisa metodolÃgica desenvolvida em onze etapas, sendo as cinco primeiras correspondentes à construÃÃo do manual, as cinco seguintes referentes ao processo de validaÃÃo e, a Ãltima, referente à disponibilizaÃÃo do manual. A primeira etapa correspondeu ao levantamento de conteÃdo. Na segunda etapa, houve a seleÃÃo e fichamento do conteÃdo levantado, de acordo com as demandas dos acompanhantes. Na terceira etapa, iniciou-se a elaboraÃÃo textual. Na quarta etapa, houve a captaÃÃo de modelos, seleÃÃo e elaboraÃÃo de 38 ilustraÃÃes. A quinta etapa correspondeu à diagramaÃÃo do manual, a qual foi realizada de acordo com as recomendaÃÃes da NBR6029 e desenvolvida atravÃs do programa CorelDraw 15.0. Realizadas as cinco etapas de construÃÃo do manual educativo, passou-se para o processo de validaÃÃo da tecnologia educativa produzida. Na sexta etapa, foram convidados, de acordo com critÃrios prÃ-estabelecidos, nove especialistas na Ãrea de interesse (saÃde da mulher; obstetrÃcia; tecnologia em saÃde; e validaÃÃo de instrumentos), os quais avaliaram objetivos, estrutura, apresentaÃÃo e relevÃncia do manual. Um determinado item foi considerado validado quando o mesmo obteve a classificaÃÃo de âTotalmente Adequadoâ por pelo menos metade mais um do nÃmero de especialistas e Ãndice de Validade de ConteÃdo (IVC) maior ou igual a 0,78. Alguns itens foram satisfatoriamente avaliados e outros necessitaram de modificaÃÃes. Quantos aos objetivos do manual, os especialistas consideraram validados todos os itens questionados, tendo o IVC variado entre 0,88 e 1,0. Quanto a estrutura e apresentaÃÃo do manual, trÃs itens necessitaram adequar-se as sugestÃes dos especialistas: clareza e objetividade das mensagens; sequÃncia lÃgica do conteÃdo e correspondÃncias do estilo da redaÃÃo ao nÃvel de conhecimento do pÃblico-alvo. O IVC dos itens pertencentes a este tÃpico variou entre 0,66 e 1,0. Todos os itens referentes à relevÃncia do manual foram considerados validados, tendo o IVC variado entre 0,88 e 1,0. O IVC Global do manual educativo foi de 0,94. Na sÃtima etapa, o manual educativo foi aplicado junto a onze representantes do pÃblico-alvo, os quais tiveram nÃvel de concordÃncia acima de 75% nos itens referentes à organizaÃÃo, estilo da escrita, aparÃncia e motivaÃÃo do manual. Na oitava etapa, foram realizadas as alteraÃÃes sugeridas por especialistas e representantes do pÃblico-alvo: reformulaÃÃo de frases; substituiÃÃo de palavras ou expressÃes; inclusÃo, substituiÃÃo ou realocaÃÃo de informaÃÃes e ilustraÃÃes. A nona etapa correspondeu à revisÃo de portuguÃs por profissional especializado. Na dÃcima etapa, foi verificado o Ãndice de Legibilidade de Flesch (ILF). Os tÃpicos do manual tiveram ILF entre 50 e 94, o que corresponde a uma leitura âMuito FÃcilâ ou âFÃcilâ, adequada a um pÃblico com atà nove anos de estudo. A Ãltima etapa correspondeu ao encaminhamento para impressÃo. Por fim, considera-se o manual educativo validado por especialistas e representantes do pÃblico-alvo quanto à sua aparÃncia e conteÃdo, sendo necessÃrio estudo posterior para a avaliaÃÃo do impacto desta tecnologia sobre a postura do acompanhante em sala de parto. / The present study aimed to build and validate a nursing educative technology (manual) directed for companions during labor and delivery. Methodological research developed in eleven stages. Begin, the five first regarding the construction of the manual, the following five referring to the validation process and, the last one, referring to the availability of the manual. The first stage corresponded to the content survey. In the second stage, there was a selection and written report of the raised content, in accordance with the demands of the companions. In the third stage, it was initiated textual elaboration. In the fourth stage, there was a raise of models, election and creation of 38 illustrations. The fifth stage corresponded to the layout of the manual, which was carried through according with the recommendations of the NBR6029 and developed through the program CorelDraw 15.0. After the five stages of construction of the educative manual, it was initiated the process of validation of the produced technology. In the sixth stage, nine specialists of the interest area were invited criteria in accordance with preset criteria (womenâs health; obstetrics; technology in health; e instrument validation), which evaluated aims, structure and presentation, and relevance of the manual. A certain item was considered validated when it obtained a âCompletely Adquetaeâ classification from at least half plus one of the number of specialists and Content Validity Index (CVI) higher or equal to 0,78. Some items were evaluated as satisfactory and others still need to suffer changes. As for the manualâs aim, specialists considered validated all questioned items, with an CVI between 0,88 and 1,0. As for structure and presentation of the manual, three items needed to adjust to the specialists suggestions: clarity and objectiveness of the messages; logic sequence of the content and match between writing and level of understanding of the target group. The CVI of the items that belong to this topic varied from 0,66 to 1,0. All items regarding the relevance of the manual were considered validated, with a CVI between 0,88 and 1,0. The global CVI of the educative manual was 0,94.. In the seventh stage, the educative manual was applied with eleven representatives of the target group obtained a level of conformity higher than 75% for the items evaluated such as organization, style of the writing, appearance and motivation of the manual. In the eighth stage, the alterations suggested from the specialists and representatives of the target group were accomplished: reformulating phrases, substitution of words or expressions; inclusion, substitution or relocation of information and illustration. The ninth stage corresponded to the review of the Portuguese by a specialized professional. In the tenth stage, the Fleschâs Index of Legibility was verified (FIL). The topics of the manual obtained a FIL between 50 and 94, which corresponds to an âEasyâ or âVery Easyâ reading, sufficient to a public with up to nine years of study. The last stage corresponded to printing of the manual. Finally, the educative manual validated by specialists and representatives of the target group is considered, regarding its appearance and content. Thus, further studies are necessary for the evaluation of the impact of this educative technology on the companionâs attitude in the labor room.

Thesis (M.S.)--University of Michigan, 1986. / "A research report submitted in partial fulfillment of the requirements for the degree ..." T.p.

Thesis (M.S.)--University of Michigan, 1986. / "A research report submitted in partial fulfillment of the requirements for the degree ..." T.p.