‘Midwives Overboard!’ Inside their hearts are breaking, their makeup may be flaking but their smile still stays on

PROBLEM: Midwifery practice is emotional and, at times, traumatic work. Cumulative exposure to this, in an unsupportive environment can result in the development of psychological and behavioural symptoms of distress. BACKGROUND: As there is a clear link between the wellbeing of staff and the quality of patient care, the issue of midwife wellbeing is gathering significant attention. Despite this, it can be rare to find a midwife who will publically admit to how much they are struggling. They soldier on, often in silence. AIM: This paper aims to present a narrative review of the literature in relation to work-related psychological distress in midwifery populations. Opportunities for change are presented with the intention of generating further conversations within the academic and healthcare communities. METHODS: A narrative literature review was conducted. FINDINGS: Internationally, midwives experience various types of work-related psychological distress. These include both organisational and occupational sources of stress. DISCUSSION: Dysfunctional working cultures and inadequate support are not conducive to safe patient care or the sustained progressive development of the midwifery profession. New research, revised international strategies and new evidence based interventions of support are required to support midwives in psychological distress. This will in turn maximise patient, public and staff safety. CONCLUSIONS: Ethically, midwives are entitled to a psychologically safe professional journey. This paper offers the principal conclusion that when maternity services invest in the mental health and wellbeing of midwives, they may reap the rewards of improved patient care, improved staff experience and safer maternity services

Internet-delivered psychoeducation for older adolescents and young adults with autism spectrum disorder (SCOPE): An open feasibility study

Background: There is a paucity regarding interventions in general, and especially internet-delivered treatment options, for adolescents and young adults with autism spectrum disorder (ASD), despite the group´s capacity and willingness to utilize computer-mediated communication. This open feasibility study evaluated the new internet-delivered, psychoeducational intervention, SCOPE (Spectrum COmputerized PsychoEducation), for adolescents and young adults aged 16–25 years with ASD in the normative IQ range. Method: The participation in SCOPE was facilitated by weekly contacts with disability service professionals (trained coaches) and the intervention consisted of eight ASD-themed modules. In an open feasibility study we evaluated treatment completion, treatment credibility and satisfaction, as well as preliminary efficacy. We assessed feasibility in an outpatient disability services context, regarding both participants’ and coaches’ experiences. Results: Twenty-three out of the 29 included participants (79%) completed the intervention. The participants’ experience of treatment credibility was increased during the SCOPE web course and the overall satisfaction with the treatment was high. The coaches reported high treatment credibility and good clinical feasibility of the internet-based delivered intervention. The participants’ knowledge of ASD increased significantly from pre-intervention to post-intervention. The increased knowledge of ASD was not associated with negative effects on psychological well-being. Conclusions: Our results suggest that the internet-delivered psychoeducational intervention SCOPE is a feasible intervention and could contribute to youth's sense of empowerment through increased knowledge of ASD and themselves. An ongoing randomized controlled study will generate further evidence concerning the SCOPE intervention