Dr Rita Pace Parascandalo is currently engaged in several research projects addressing
diverse aspects of midwifery and the childbearing continuum. Her research focuses on
enhancing midwives’ wellbeing and resilience while supporting the provision of high-quality,
compassionate care to women, babies, and their families.

Since its inception in November 2023, Dr Pace Parascandalo has been actively involved in
TREASURE, a COST Action (CA 22114) titled Maternal Perinatal Stress and Adverse
Outcomes in the Offspring: Maximizing Infants’ Development. Within this European research
network, she contributes to Working Groups (WG) 1, 4, and 6.

In WG1, which focuses on conceptualising maternal perinatal stress and identifying its
psychological and biological determinants, Dr Pace Parascandalo is contributing to a scoping
review that explores how couples experience, define, and respond to stress during the
perinatal period. This review aims to synthesise current evidence on definitions, measurement
tools, sources of stress, and ameliorating factors reported by both partners. It will also
identify knowledge gaps to inform future couple-focused interventions and research. In WG4,
Dr Pace Parascandalo serves as the local research lead for the TURTLE Study, part of a
Europe-wide initiative exploring the experiences of expectant mothers during pregnancy and
within the first year after birth. The study seeks to identify social, cultural, and psychological
factors that mitigate perinatal stress. Mothers, partners, and family members across 12
European countries, including Malta, are invited to complete two online questionnaires: the
Birth Mother Survey and the Partners and Family Members Survey. The findings will
contribute to a deeper understanding of how best to support maternal, infant, and family
wellbeing during this critical life stage. Within WG6, Dr Pace Parascandalo contributes to the
dissemination and knowledge translation activities of the TREASURE project. This working
group aims to communicate and transfer research outputs to scientific, clinical, and policy
audiences, as well as to women, partners, and families. The deliverables for this COST
Action are expected to be completed by November 2027.

Another key area of Dr Pace Parascandalo’s research focuses on compassion in midwifery
education and practice. Her recent study, Self-Compassion and Compassion for Others
Among Student Midwives: A Cross-Sectional Survey, explored the relationship between self-
compassion and compassion for others among midwifery students in Malta. Using the
Sussex-Oxford Compassion for Self (SOCS-S) and for Others (SOCS-O) scales (Gu et al.,
2016), the study provided valuable insights into how compassion develops throughout
undergraduate training. Findings indicated that student midwives generally report high levels
of compassion for others and moderate levels of self-compassion, with none indicating low
levels in either domain. While students demonstrated a strong capacity to recognise and
respond to the suffering of others, they were less inclined to extend the same compassion
toward themselves. These findings highlight the need for targeted educational interventions to
foster self-compassion, enhance emotional resilience, and reduce the risk of burnout,
ultimately supporting sustainable and compassionate midwifery practice. Publication of this
study in a peer-reviewed journal is currently in progress.

Building on this work, Dr Pace Parascandalo is currently leading a follow-up study titled
Compassion and Professional Quality of Life Among Midwives: A Cross-Sectional Study.
This research aims to measure levels of self-compassion, compassion for others, and
professional quality of life among practising midwives, and to explore associations between
these constructs. The findings will contribute to a deeper understanding of how compassion
influences midwives’ professional wellbeing and job satisfaction, providing evidence to
inform strategies that promote workforce resilience and retention within the profession.

A Framework of Competencies in Spiritual Care: A Modified Delphi Study
Professor Josephine Attard led this pioneering research project to address the well-recognised
gap between the teaching of spiritual care and its consistent application in nursing and
midwifery practice. Recognising the importance of developing competence in spiritual care at
the point of professional registration, the study aimed to create a rigorous, evidence-based
framework of competencies to guide education and better equip practitioners to meet clients’
spiritual needs.

The study, jointly supervised by the University of Glamorgan (now the University of South
Wales) and the University of Malta, used a Modified Delphi method involving expert panels
and extensive consultation with European nursing and midwifery organisations. This process
established consensus and identified factors influencing the implementation of spiritual care
competencies in pre-registration education.

The resulting framework formed the basis for the Enhancing Nurses’ and Midwives’
Competence in Providing Spiritual Care through Innovative Education and Compassionate
Care (EPICC) project (2016–2019), funded by the Erasmus+ programme. In collaboration
with five European universities, the EPICC project developed a flexible Spiritual Care
Education Standard, a comprehensive educational toolkit and matrix, and a validated set of
core competencies.

These outputs have since been translated, adapted, and psychometrically tested in multiple
languages including Spanish, Turkish, Italian, Dutch, Norwegian, and English demonstrating
strong reliability and cross-cultural applicability. Today, the EPICC framework is
internationally recognised as a benchmark for integrating spiritual care into nursing and
midwifery education, promoting a more holistic, compassionate, and person-centred approach
to care.