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Objective To test the validity and reliability of the Chichewa Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) in Malawian postpartum women. Methods A cross-sectional study of postnatal women (N= 415) at 1 day after vaginal birth was conducted at a district hospital in Malawi. The W-DEQ, Edinburgh Postnatal Depression Scale and the World Health Organization Quality of Life Scale were used to measure fear of birth (FOB), depressive symptoms and quality of life (QoL). Principal component analysis (PCA) and confirmatory factor analysis (CFA), Cronbach’s alpha, the average variance extracted (AVE) and the composite reliability (CR) and Pearson correlation were used to test the construct validity, reliability, convergent and divergent validity of the Chichewa W-DEQ (CW-DEQ). Results The participants had a mean age of 28.3 ± 6.7 years. A multidimensional structure containing three factors – a lack of positive feelings, fear and concerns about childbirth – with an appropriate model fit was reported for the CW-DEQ version. The Cronbach’s α of the CW-DEQ was 0.87. The AVE and CR values were highly acceptable in lack of positive feelings – 0.17 (0.68), and concerns about childbirth – 0.79 (0.88) factors which proved the convergent validity of each; however, was marginally acceptable in the fear factor – 0.14 (0.53). Low range of correlations between the CW-DEQ constructs (r = 0.27 ∼ 0.42, p

Abstract Background Interprofessional collaborative practice is essential for meeting patients’ needs and improving their health outcomes; thus, the effectiveness of interprofessional education (IPE) should be clearly identified. There is insufficient evidence in the literature to determine the outcomes of IPE compared to traditional single-profession education (SPE). This study aimed to compare the outcomes of IPE and SPE during a simulation training course. Methods The study design was a mixed-methods, incorporated cross-over design and a qualitative survey. A total of 54 students including 18 medical students and 36 nursing students were recruited from March to April 2019. The 4-week simulation course was designed based on Kolb’s experimental learning theory and Bandura’s social learning theory. Participants were evenly divided into group 1 (received IPE-learning followed by SPE-learning), and group 2 (received SPE-learning followed by IPE-learning). Students’ medical task performance, team behavior performance, teamwork attitude, and patient safety attitude were collected at pretest, mid-test, and posttest. Descriptive statistics and repeated measures analysis of variance were used. End-of-study qualitative feedback was collected, and content analysis was performed. Results Both groups demonstrated moderate-to-large within-group improvements for multiple learning outcomes at mid-test. Group 1 students’ medical task performance (F = 97.25; P

Conventional nursing courses have solely adopted lecture-based instruction for knowledge delivery, which tends to lack interaction, rehearsal, and personalized feedback. The development of chatbot technologies and their broad application have provided an opportunity to solve the abovementioned problems. Some knowledge-based chatbot systems have been developed; however, it is still a challenging issue for researchers to determine exactly how to effectively apply these chatbot technologies in nursing training courses. Intending to explore the application mode of chatbot technologies and their effectiveness in nursing education, this study integrated a knowledge-based chatbot system into the teaching activities of a physical examination course, using smartphones as the learning devices, and guiding students to practice their anatomy knowledge in addition to analyzing their learning efficacy and pleasure. A quasi-experiment was conducted by recruiting two classes of university students with nursing majors. One class was the experimental group learning with the knowledge-based chatbot system, while the other class was the control group learning with the traditional instruction. Based on the experimental results, the knowledge-based chatbot system effectively enhanced students’ academic performance, critical thinking, and learning satisfaction. The results indicate that the application of chatbots has great potential in nursing education.

Abstract Secret sharing is a widely-used security protocol and cryptographic primitive in which all people cooperate to restore encrypted information. The characteristics of a quantum field guarantee the security of information; therefore, many researchers are interested in quantum cryptography and quantum secret sharing (QSS) is an important research topic. However, most traditional QSS methods are complex and difficult to implement. In addition, most traditional QSS schemes share classical information, not quantum information which makes them inefficient to transfer and share information. In a weighted threshold QSS method, each participant has each own weight, but assigning weights usually costs multiple quantum states. Quantum state consumption will therefore increase with the weight. It is inefficient and difficult, and therefore not able to successfully build a suitable agreement. The proposed method is the first attempt to build multiparty weighted threshold QSS method using single quantum particles combine with the Chinese remainder theorem (CRT) and phase shift operation. The proposed scheme allows each participant has its own weight and the dealer can encode a quantum state with the phase shift operation. The dividing and recovery characteristics of CRT offer a simple approach to distribute partial keys. The reversibility of phase shift operation can encode and decode the secret. The proposed weighted threshold QSS scheme presents the security analysis of external attacks and internal attacks. Furthermore, the efficiency analysis shows that our method is more efficient, flexible, and simpler to implement than traditional methods.

Abstract Background Fear of childbirth is a common health concern for women during pregnancy. The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) is widely used to measure childbirth fear during pregnancy. However, this instrument is yet to be validated in Malawi, Africa. Our study aimed to assess the psychometric properties of the W-DEQ questionnaire in Malawi. Methods Healthy pregnant women in the third trimester (N = 476) at a district hospital in Malawi were included. Fear of childbirth, depressive symptoms, and quality of life were assessed using the W-DEQ, the Edinburg Postnatal Depression Scale, and the World Health Organization Quality of Life scale, respectively. The construct validity, reliability, and convergent validity of the W-DEQ were examined using exploratory and confirmatory factor analyses, Cronbach’s alpha, and Pearson correlations. Results The mean age of participants was 28.2 (standard deviation = 6.8) years. Exploratory and confirmatory factor analysis of the Malawian version of the W-DEQ indicated a multidimensional structure with three factors: fear, negative appraisal, and a lack of self-efficacy, with acceptable goodness of model fit. The Malawian version of the W-DEQ showed a satisfactory internal consistency (α = 0.84) and was significantly correlated with depressive symptoms (r = 0.23, p

Abstract Background Perceived milk supply is an important modifiable factor for optimal breastfeeding. However, little is known about maternal perception of milk supply or how it impacts breastfeeding practices. The aim of this study was to examine relationships of perceived milk supply, maternal breastfeeding self-efficacy, and skin-to-skin contact with early initiation and exclusive breastfeeding among mothers of infants less than 6 months of age in Indonesia. Methods This was a cross-sectional study conducted in Yogyakarta City, Indonesia between August and October 2015. Maternal perception of milk supply was assessed using the Hill and Humenick Lactation Scale. Data on breastfeeding practices, and maternal and infant factors were collected using a structured questionnaire. Multiple regression and multivariate logistic regression analyses were performed to obtain estimates of associations. Results Thirty four percent of mothers had initiated breastfeeding within an hour after birth, and 62.4% of mothers were exclusively breastfeeding. High levels of perceived breast milk supply were reported in mothers who practiced skin-to-skin contact or rooming-in with their infants, experienced positive infant sucking behavior, or had high breastfeeding self-efficacy (p

Abstract Background Childbirth fear is a health concern in women living in high-income countries; however, little is known about childbirth fear among women living in low-income countries like Malawi. In this study, we explored childbirth fear and associated factors among pregnant and postpartum women in Malawi. Methods A cross-sectional study of 152 pregnant and 153 postpartum women was conducted at a district hospital in Malawi. Participants were assessed for childbirth fear using the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ). Demographic and obstetric variables were collected using a structured questionnaire. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure social support. Using a multinomial logistic regression, factors related to childbirth fears were examined, namely demographic and obstetric characteristics, and social support. Results The mean age of participants was 26 (standard deviation: 6.4) years. During pregnancy, 39% women reported a low level of fear, 41% reported moderate fear, and 20% reported high fear; while after birth, 49, 41, and 10% women reported low, moderate, and high fear, respectively. Pregnant women who were illiterate (odds ratio (OR): 5.0, p