STUDENT ATTITUDES TО COUNSELLING MEN AND WOMEN POSTPONING PARENTING

Introduction: Postponement of parenthood in recent years is a problem not only at national but also at European level. A number of statistical analyzes in the field of demography show that the number of infertile families in the world can reach 15%. The etiology of late parenting is diverse, often combining different factors. This in turn leads to a number of personal and public problems, including reproductive, psychological, demographic and others. To overcome this problem it is necessary to work in many directions with the competent intervention of institutions and specialists. To some extent, this is also the task of medical universities, where future health professionals are trained. In response to modern educational requirements, they face the challenge of provoking attitudes and building competencies in future midwives to work with women and men with reproductive problems. The good stimulus provokes young people to generate modern ideas and approaches to reduce reproductive problems and overcome the demographic crisis in the country.Aim: The aim of this study is to establish the attitude of midwifery students about counseling men and women of childbearing age who delay parenthood.Materials and methods: An anonymous survey was conducted among students majoring in Midwifery, who study at the Shumen Affiliate of the Medical University of Varna. Their number is a total of 40 students, distributed as follows: 20 first and second year students and 20 third and fourth year students. The study was conducted in February 2022. The method on the basis of which the study was developed is based on comparative analysis.Results and discussion: To establish the attitude of future midwives to work with men and women who postpone parenthood, the key question was to find out if they are willing to work with such families. The results we received are encouraging with the predominant number of students who indicated thattheir professional activity, they associate with women and men who postpone parenthood (I and II course - 80%; III and IV course - 90%). None of the respondents gave a negative answer, and those who did not think whether they would work in this direction are approximately ¼ (1st and 2nd year - 20%) and significantly less (III and IV) course 10%).Conclusion: The attitude of future midwives is to apply their knowledge and skills in all areas of obstetrics and gynecology. Students who are at an advanced stage of their education have confidence and would consciously apply what they have learned to improve reproductive health. The answers make it clear that in the initial stage of their training, future health professionals are still not well aware ofthe directions in which their competencies would be effectively applied. The surveyed students from the 3rd and 4th year, as expected, show greater confidence and a relatively small share are those who are not yet oriented in which direction of obstetrics and gynecology would find their place. The education and training of future midwives is a chain structured of many elements - personality traits; high professionalism of the trainers; good training conditions; constructive and effective clinical practice; continuity from graduate colleagues, etc. Consistency and unity between each of the elements is needed

Need of Obstetric Family Consultation Activities for Patients from Marginal Groups

The research on the problem concerning the health of women during pregnancy, childbirth and the postnatal period arose from the fact that the lack of involvement of a midwife in consultation activity leads to failure to satisfy the needs of promotive and preventive activities focused on the health and welfare of mothers and children. This problem has a pronounced medico-social aspect among marginalized groups of the society.AIM: The aim of this paper is to analyze the needs of family consultation of obstetric patients from marginal groups.MATERIALS AND METHODS:We have used the following methods:• Documentary method - an analysis of existing at the time legal and normative documents regulating the activities of the midwife.• Sociological method - a survey through direct anonymous poll among 416 patients hospitalized at the Maternity Ward of the St. Anna University Hospital, SHOGAT - Varna, MHAT - Shumen, Sliven, and Rousse in the period May 2014 - April 2015.• Statistical method - the analysis of the data from our own study used non-parametric analysis of the results with statistical package SPSS for Windows version 19.0.0.RESULTS AND CONCLUSIONS: The expanding functions of the midwife focus on the deficits in healthcare, which are mainly in the volume and quality of obstetric care during pregnancy, childbirth and the postpartum period. The deficits in health care are associated with some of the characteristics of the respondents. Such dependence is established at an educational level. Women with higher and secondary education are more likely to visit regularly women`s consultation centers (5-6 or more visits) when pregnant (75÷80%), while 28% to 37% of less educated patients (P<0.001) do this. The need for more information about pregnancy and childbirth increases with the increase in education level - in women with low education it is 48 to 57 percent, while those with higher education - 75%. The mother tongue can also be considered a factor playing a role in the increased medical and social risk. Half of the respondents (50%) speak a language other than Bulgarian. This is very likely to cause difficulties in understanding the recommendations given to them by the midwife.The identification of such communities is relevant in public health in order to take appropriate steps leading to cover their health needs

A STUDY OF THE HEALTH AWARENESS OF PATIENTS OF CHILDBEARING AGE REGARDING REPRODUCTIVE HEALTH

Introduction: A number of medical publications and studies on the level of health culture among the population and health education in early childhood indicate that there is a deficit in these areas. In recent decades, the health of the population has been at the forefront of negative statistics for cardiovascular diseases, oncological diseases, use of tobacco products in early adolescence, etc.Objective: The objective is to establish the level of health awareness among people of childbearing age regarding reproductive health.Materials and methods: An anonymous survey was conducted among men and women registered for treatment in reproductive medicine centers, as well as female patients hospitalized in the maternity ward and pathological pregnancy ward. Obstetricians - gynecologists, embryologists, senior midwives and midwives - were also included in the study. nurses, midwives and nurses. The structure of the examined medical facilities are of the MBAL type; UMBAL; MK and MC from the cities of Sofia, Plovdiv, Varna, Shumen, Veliko Tarnovo and Tutrakan.Results and discussion: We tried to find out if there is a relationship between the  evel of awareness about the appropriate age for having a first child and the religion they practice. For respondents who profess Islam, the most suitable age for having a first child is 20-25 (23.1%), because the younger thewoman, the easier pregnancy and childbirth are (33.3%). The expressed opinion of patients professing Orthodox Christianity about the appropriate age for giving birth to a first child is in a relatively wide range: from 25-30 years (84.6%) to 30-35 years (88.9%).Conclusion: The obtained results have a direct relationship with the religious dogmas preached by Islam. A key feature of marriage in the Muslim community is that the ideal model recommends marriage at a fertile age

OBSTETRIC CARE IN THE HOME ENVIRONMENT FOR WOMEN WITH ONCOGYNECOLOGICAL DISEASE

Introduction: Every year, about 12 million patients with malignant tumors are diagnosed in the world, and every day about 20,000 people die from cancer. Although modern medical oncology has the means for early diagnosis and successful definitive treatment, this diagnosis causes panic and a sense ofdoom in the patient.Objective: To explore the opinion of women with oncological-gynecological diseases, regarding obstetric care in the home environment.Materials and methods: An anonymous survey was conducted for the period April 2022 - May 2023. 74 women with oncological and gynecological diseases hospitalized in the GynecologyDepartments of the Complex Oncology Center and MBAL - Shumen AD were surveyed.Results and discussion: Midwifery care in a home environment can provide greater patient comfort. They can be treated and cared for in their own home where they feel more relaxed and comfortable.Conclusions: Home obstetric care can be an effective way to manage onco-gynecological diseases and improve patients' quality of life. To ensure that patients' medical needs are met and that they receive appropriate midwifery support care

Obstetric center for family counseling - an innovative model for family counseling work among marginalized groups

The socio-economic changes influence negatively the most vulnerable groups of society and deteriorate their so­cial and health status. These groups are with the greatest need of being provided with integrated medical care for the family and the community. In order to increase the quality of care for maternal and child health in margin­alized groups, innovative practices should be applied, the core of which is the holistic approach of the midwife­ry model of care.AIM: To develop and propose a model for an Obstetric Center for Family Counseling (OCFC) and define the role of the midwife in the process of family counseling.MATERIALS AND METHODS: We have used:• literature related to best practices in the implementation of the Midwives Model of Care;• a sociological method - direct anonymous survey of 4th year trainee midwives in the Bachelor Midwife program at: Medical University of Varna, Medical University of Pleven, Rousse University `St. Kliment Ohridski` and the Higher Medical School in Bitola, Macedonia. We have also included graduates from the academic years 2014 and 2015 and experts, professors at the medical universities in Varna, Plovdiv, Pleven, and Sofia and the Rousse Uni­versity, conducting specialized training in the period March - April 2016;• a statistical method - we have used a non-parametric analysis of the results with statistical package SPSS for Windows version 19.0.0 for the analysis of the data from our own study.RESULTS AND CONCLUSIONS: The idea of creating OCFC developed on the basis of opinion surveys of trainee midwives and experts on the attitudes and abilities of the midwife to conduct independent counselling ac­tivities. The creation of an Obstetric Center for Family Counseling is associated with the development of consul­tative work as promotion and prevention method regarding pregnancy and safe motherhood, support in solving medical and social and psychological problems in families from marginalized groups - unemployed, poor, unin­sured with reduced social adaptation and more. The advisory activity will be related to the provision of health in­formation, learning and developing skills associated with normal pregnancy, childbirth and newborn care, psy­chological, social and legal advice

Информираност относно рисковете при сънна апнея – здравно образование (опит на Филиал Шумен)

Да се проучи мнението на студенти от специалностите „Медицинска сестра“ и „Акушерка“ във филиал Шумен относно информираността за идентифициране на рисковите фактори на синдрома на обструктивната сънна апнея

Мултидисциплинарен подход при откриване на пациенти със сънна апнея – ролята на здравните професионалисти (опит на Филиал Шумен)

Изясняване ролята на здравните професионалисти при прилагане на мултидисциплинарен подход чрез участие на студенти от специалностите „Медицинска сестра“ и „Акушерка“ - филиал Шумен, при откриване на пациенти със сънна апнея

Online Education – Advantages and Disadvantages for the Nurse and Midwife Programs

The COVID-19 pandemic and the relevant anti-epidemic measures led to suspending all forms of onsite learning at higher education institutions in March 2020. The educational process was reorganized and transformed into online education. The organization and realization of this form of education are related to innovative approaches and suitable educational resources.The process of training for the regulated Nurse and Midwife programs has specific characteristics. The students need to gain theoretical knowledge and master medical manipulations to the level of automatism before being applied to a real patient. The results of the surveyed opinion of the students from the Nurse and Midwife programs at the Shumen Affiliate about the advantages and disadvantages of online education enabled us to focus on the development of innovative practices, integrating technology in the process of teaching and learning, and the use of digital technology in onsite learning. The respondents rated the availability of electronic resources for the development of hybrid forms of education combining onsite and online learning, as relatively high.Synchronous education, which is the backbone of online education at the Medical University of Varna, creates conditions to maintain the so-called “social presence”, which is a prerequisite for involvement in the learning process and suppresses the feeling of isolation and stress among students. All these dimensions have a significant relevance to the effectiveness of learning

Challenges and Solutions for Nurses and Midwives in the Context of Digitalization

The nurses and midwives trained in Bulgaria are part of modern nursing. As a member state of the EU, Bulgaria has fulfilled the requirements of Directive 2013/55/EU. Successful steps have been taken for the prosperity of the professions but there are also a number of unresolved issues and challenges for healthcare professionals—leadership development, autonomous practice in favor of the society. The results represent the surveyed opinion of the students from the specialties at Shumen Affiliate (third- and fourth-year students), about their attitude to the implementation of digital technology in the care for patients in their home environment. The results outline the trends towards the demand for a balanced approach, considering the specifics in the provision of healthcare as well as the barriers hindering the application of new ideas and practices due to the complex interweaving of social, economic, ethical and psychological factors. Digital transformation is undoubtedly a global trend that affects social life including healthcare. That trend is a great source of optimism with regard to enhancing the quality of medical care, its accessibility and economic effectiveness. However, the euphoria from the first steps of “the digital revolution” is replaced by the realistic analyses of the conditions and ethical aspects under which the colossal potential of the digital transformation in healthcare can be realized