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Validity of instruments for measuring the satisfaction of a woman and her partner with care received during labour and childbirth: Systematic review. Midwifery 2017; 55:103-112. [DOI: 10.1016/j.midw.2017.09.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 09/12/2017] [Accepted: 09/17/2017] [Indexed: 12/21/2022]
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Crawford A, Hayes D, Johnstone ED, Heazell AE. Women's experiences of continuous fetal monitoring - a mixed-methods systematic review. Acta Obstet Gynecol Scand 2017; 96:1404-1413. [DOI: 10.1111/aogs.13231] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 09/02/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Alexandra Crawford
- Maternal and Fetal Health Research Center; Division of Developmental Biology and Medicine; School of Medical Sciences; Faculty of Biology, Medicine and Health; University of Manchester; St Mary's Hospital; Manchester UK
| | - Dexter Hayes
- Maternal and Fetal Health Research Center; Division of Developmental Biology and Medicine; School of Medical Sciences; Faculty of Biology, Medicine and Health; University of Manchester; St Mary's Hospital; Manchester UK
| | - Edward D Johnstone
- Maternal and Fetal Health Research Center; Division of Developmental Biology and Medicine; School of Medical Sciences; Faculty of Biology, Medicine and Health; University of Manchester; St Mary's Hospital; Manchester UK
- Central Manchester University Hospitals NHS Foundation Trust; St Mary's Hospital; Manchester UK
| | - Alexander E.P. Heazell
- Maternal and Fetal Health Research Center; Division of Developmental Biology and Medicine; School of Medical Sciences; Faculty of Biology, Medicine and Health; University of Manchester; St Mary's Hospital; Manchester UK
- Central Manchester University Hospitals NHS Foundation Trust; St Mary's Hospital; Manchester UK
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Kabakian-Khasholian T, Bashour H, El-Nemer A, Kharouf M, Sheikha S, El Lakany N, Barakat R, Elsheikh O, Nameh N, Chahine R, Portela A. Women’s satisfaction and perception of control in childbirth in three Arab countries. REPRODUCTIVE HEALTH MATTERS 2017; 25:16-26. [DOI: 10.1080/09688080.2017.1381533] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Tamar Kabakian-Khasholian
- Associate Professor, Health Promotion and Community Health Department, Faculty of Health Sciences, American University of Beirut, P.O. Box 11-0236, Riad El-Solh/Beirut 1107 2020, Lebanon
| | - Hyam Bashour
- Professor, Department of Family and Community Medicine, Faculty of Medicine, Damascus University, Damascus, Syria
| | - Amina El-Nemer
- Professor, Faculty of Nursing, Mansoura University, El Gomhouria St, Mit Khamis WA Kafr Al Mougi, Mansoura, Dakahlia Governorate 35516, Egypt
| | - Mayada Kharouf
- Lecturer, Department of Family and Community Medicine, Faculty of Medicine, Damascus University, Damascus, Syria
| | - Salah Sheikha
- Professor and Dean, Department of Family and Community Medicine, Faculty of Medicine, Damascus University, Damascus, Syria
| | - Nasser El Lakany
- Obstetrician & Gynecologist, Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, El Gomhouria St, Mansoura Qism 2, Mansoura, Dakahlia Governorate, Egypt
| | - Rafik Barakat
- Obstetrician & Gynecologist, Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, El Gomhouria St, Mansoura Qism 2, Mansoura, Dakahlia Governorate, Egypt
| | - Ohoud Elsheikh
- Assistant Professor, Faculty of Nursing, Mansoura University, El Gomhouria St, Mit Khamis WA Kafr Al Mougi, Mansoura, Dakahlia Governorate 35516, Egypt
| | - Nadia Nameh
- Research Assistant, Health Promotion and Community Health Department, Faculty of Health Sciences, American University of Beirut, P.O. Box 11-0236, Riad El-Solh/Beirut 1107 2020, Lebanon
| | - Rabih Chahine
- Obstetrician & Gynecologist, Obstetrics and Gynecology Department, Rafik Hariri University Hospital, Beirut, Lebanon
| | - Anayda Portela
- Technical Officer, Department of Maternal, Newborn, Child and Adolescent Health, The World Health Organization, Avenue Appia 20, 1202 Geneva, Switzerland
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van der Kooy J, Birnie E, Valentine NB, de Graaf JP, Denktas S, Steegers EAP, Bonsel GJ. Quality of perinatal care services from the user's perspective: a Dutch study applies the World Health Organization's responsiveness concept. BMC Pregnancy Childbirth 2017; 17:327. [PMID: 28962611 PMCID: PMC5622418 DOI: 10.1186/s12884-017-1464-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 08/22/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The concept of responsiveness was introduced by the World Health Organization (WHO) to address non-clinical aspects of service quality in an internationally comparable way. Responsiveness is defined as aspects of the way individuals are treated and the environment in which they are treated during health system interactions. The aim of this study is to assess responsiveness outcomes, their importance and factors influencing responsiveness outcomes during the antenatal and delivery phases of perinatal care. METHOD The Responsiveness in Perinatal and Obstetric Health Care Questionnaire was developed in 2009/10 based on the eight-domain WHO concept and the World Health Survey questionnaire. After ethical approval, a total of 171 women, who were 2 weeks postpartum, were recruited from three primary care midwifery practices in Rotterdam, the Netherlands, using face-to-face interviews. We dichotomized the original five ordinal response categories for responsiveness attainment as 'poor' and good responsiveness and analyzed the ranking of the domain performance and importance according to frequency scores. We used a series of independent variables related to health services and users' personal background characteristics in multiple logistic regression analyses to explain responsiveness. RESULTS Poor responsiveness outcomes ranged from 5.9% to 31.7% for the antenatal phase and from 9.7% to 27.1% for the delivery phase. Overall for both phases, 'respect for persons' (Autonomy, Dignity, Communication and Confidentiality) domains performed better and were judged to be more important than 'client orientation' domains (Choice and Continuity, Prompt Attention, Quality of Basic Amenities, Social Consideration). On the whole, responsiveness was explained more by health-care and health related issues than personal characteristics. CONCLUSION To improve responsiveness outcomes caregivers should focus on domains in the category 'client orientation'.
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Affiliation(s)
- Jacoba van der Kooy
- Division of Obstetrics & Prenatal Medicine, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Erwin Birnie
- Division of Obstetrics & Prenatal Medicine, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department Obstetrics & Gynaecology, Academic Collaboration Maternity Care Services, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, the Netherlands
| | - Nicole B Valentine
- World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland.,Department of Public Health, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Johanna P de Graaf
- Division of Obstetrics & Prenatal Medicine, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Semiha Denktas
- Division of Obstetrics & Prenatal Medicine, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Eric A P Steegers
- Division of Obstetrics & Prenatal Medicine, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Gouke J Bonsel
- Division of Obstetrics & Prenatal Medicine, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department Obstetrics & Gynaecology, Academic Collaboration Maternity Care Services, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, the Netherlands.,Rotterdam Midwifery Academic (Verloskunde Academie Rotterdam), Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.,Department of Public Health, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
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55
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Satisfaction with caregivers during labour among low risk women in the Netherlands: the association with planned place of birth and transfer of care during labour. BMC Pregnancy Childbirth 2017; 17:229. [PMID: 28705146 PMCID: PMC5513372 DOI: 10.1186/s12884-017-1410-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 07/05/2017] [Indexed: 11/23/2022] Open
Abstract
Background The caregiver has an important influence on women’s birth experiences. When transfer of care during labour is necessary, care is handed over from one caregiver to the other, and this might influence satisfaction with care. It is speculated that satisfaction with care is affected in particular for women who need to be transferred from home to hospital. We examined the level of satisfaction with the caregiver among women with planned home versus planned hospital birth in midwife-led care. Methods We used data from the prospective multicentre DELIVER (Data EersteLIjns VERloskunde) cohort-study, conducted in 2009 and 2010 in the Netherlands. Women filled in a postpartum questionnaire which contained elements of the Consumer Quality index. This instrument measures 'general rate of satisfaction with the caregiver’ (scale from 1 to 10, with cut-off of below 9) and ‘quality of treatment by the caregiver’ (containing 7 items on a 4 point Likert scale, with cut-off of mean of 4 or lower). Results Women who planned a home birth (n = 1372) significantly more often rated 'quality of treatment by caregiver' high than women who planned a hospital birth (n = 829). Primiparous women who planned a home birth significantly more often had a high rate (9 or 10) for ‘general satisfaction with caregiver’ (adj.OR 1.48; 95% CI 1.1, 2.0). Also, primiparous women who planned a home birth and had care transferred during labour (331/553; 60%) significantly more often had a high rate (9 or 10) for ‘general satisfaction’ compared to those who planned a hospital birth and who had care transferred (1.44; 1.0–2.1). Furthermore, they significantly more often rated ‘quality of treatment by caregiver’ high, than 276/414 (67%) primiparous women who planned a hospital birth and who had care transferred (1.65; 1.2–2.3). No differences were observed for multiparous women who had planned home or hospital birth and who had care transferred. Conclusions Planning home birth is associated to a good experience of quality of care by the caregiver. Transferred planned home birth compared to a transferred planned hospital birth does not lead to a more negative experience of care received from the caregiver. Electronic supplementary material The online version of this article (doi:10.1186/s12884-017-1410-9) contains supplementary material, which is available to authorized users.
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56
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First-time fathers experiences of their prenatal preparation in relation to challenges met in the early parenthood period: Implications for early parenthood preparation. Midwifery 2017; 50:86-92. [DOI: 10.1016/j.midw.2017.03.021] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 03/24/2017] [Accepted: 03/29/2017] [Indexed: 11/22/2022]
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57
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Alderdice F, McNeill J, Gargan P, Perra O. Preliminary evaluation of the Well-being in Pregnancy (WiP) questionnaire. J Psychosom Obstet Gynaecol 2017; 38:133-142. [PMID: 28376697 DOI: 10.1080/0167482x.2017.1285898] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND The concept of well-being is multi-faceted by encompassing both positive and negative emotions and satisfaction with life. Measuring both positive and negative thoughts and emotions is highly relevant in maternity care that aims to optimise a woman's experience of pregnancy and childbirth, focussing on positive aspects of health and well-being, not just the prevention of ill health. Yet our understanding of well-being in pregnancy and childbirth is limited as research to date has focussed on negative aspects such as stress, anxiety or depression. The primary aim of this study is to describe the psychometric properties of a newly developed Well-being in Pregnancy (WiP) questionnaire. METHODS A cohort study of 318 women attending hospital antenatal clinics in Belfast completed a questionnaire including three general well-being measures (not pregnancy specific) and the newly developed WiP questionnaire. The psychometric properties of the questionnaire were analysed using correlations to explore the relationship between the WiP questionnaire with the generic well-being measures administered at the same time and exploratory factor analysis was conducted. RESULTS The overall Cronbach's alpha of the WiP was 0.73. Principal factor analysis was run on the WiP items and two factors were identified, one reflecting positive affect and satisfaction (Cronbach's alpha = 0.718) and the other concerns (Cronbach's alpha = 0.702). Both the overall WiP score and WiP sub-scale scores displayed significant correlations with the other well-being scales (r = 0.235-0.527). CONCLUSIONS Measuring well-being in pregnancy is an important step in understanding the potential physical, psychological and social benefits of pregnancy and in understanding how well-being can be enhanced for women and their families at this important life stage. The initial psychometric data presented for the WiP questionnaire are encouraging. Most importantly, the measure provides an opportunity for women to express positive and negative emotions and thoughts about their pregnancy thus reflecting the whole spectrum of well-being.
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Affiliation(s)
- Fiona Alderdice
- a School of Nursing and Midwifery , Queens University Belfast, Medical Biology Centre , Belfast , Northern Ireland
| | - Jenny McNeill
- a School of Nursing and Midwifery , Queens University Belfast, Medical Biology Centre , Belfast , Northern Ireland
| | - Phyl Gargan
- a School of Nursing and Midwifery , Queens University Belfast, Medical Biology Centre , Belfast , Northern Ireland
| | - Oliver Perra
- a School of Nursing and Midwifery , Queens University Belfast, Medical Biology Centre , Belfast , Northern Ireland
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A Framework for Describing the Influence of Service Organisation and Delivery on Participation in Fetal Anomaly Screening in England. J Pregnancy 2017; 2017:4975091. [PMID: 28421145 PMCID: PMC5380857 DOI: 10.1155/2017/4975091] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 02/14/2017] [Accepted: 02/22/2017] [Indexed: 11/17/2022] Open
Abstract
Objective. The aim of this research was to explore the influence of service organisation and delivery on providers and users' interactions and decision-making in the context of Down's syndrome screening. Methods. A qualitative descriptive study involving online interviews conducted with a purposive sample of 34 community midwives, 35 pregnant women, and 15 partners from two maternity services in different health districts in England. Data were analysed using a combination of grounded theory principles and content analysis and a framework was developed. Results. The main emerging concepts were organisational constraints, power, routinisation, and tensions. Providers were concerned about being time-limited that encouraged routine, minimal information-giving and lacked skills to check users' understanding. Users reported their participation was influenced by providers' attitudes, the ambience of the environment, asymmetric power relations, and the offer and perception of screening as a routine test. Discordance between the national programme's policy of nondirective informed choice and providers' actions of recommending and arranging screening appointments was unexpected. Additionally, providers and users differing perceptions of emotional effects of information, beliefs, and expectations created tensions within them, between them, and in the antenatal environment. Conclusions. A move towards a social model of care may be beneficial to empower service users and create less tension for providers and users.
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Todd AL, Ampt AJ, Roberts CL. "Very Good" Ratings in a Survey of Maternity Care: Kindness and Understanding Matter to Australian Women. Birth 2017; 44:48-57. [PMID: 27859548 DOI: 10.1111/birt.12264] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/18/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND Surveys have shown that women are highly satisfied with their maternity care. Their satisfaction has been associated with various demographic, personal, and care factors. Isolating the factors that most matter to women about their care can guide quality improvement efforts. This study aimed to identify the most significant factors associated with high ratings of care by women in the three maternity periods (antenatal, birth, and postnatal). METHODS A survey was sent to 2,048 women who gave birth at seven public hospitals in New South Wales, Australia, exploring their expectations of, and experiences with maternity care. Women's overall ratings of care for the antenatal, birth, and postnatal periods were analyzed, and a number of maternal characteristics and care factors examined as potential predictors of "Very good" ratings of care. RESULTS Among 886 women with a completed survey, 65 percent assigned a "Very good" rating for antenatal care, 74 percent for birth care, 58 percent for postnatal care, and 44 percent for all three periods. One factor was strongly associated with care ratings in all three maternity periods: women who were "always or almost always" treated with kindness and understanding were 1.8-2.8 times more likely to rate their antenatal, birth, and postnatal care as "Very good." A limited number of other factors were significantly associated with high care ratings for one or two of the maternity periods. CONCLUSIONS Women's perceptions about the quality of their interpersonal interactions with health caregivers have a significant bearing on women's views about their maternity care journey.
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Affiliation(s)
- Angela L Todd
- Clinical and Population Perinatal Health Research, The Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW, Australia.,Sydney Medical School Northern, University of Sydney, St Leonards, NSW, Australia
| | - Amanda J Ampt
- Clinical and Population Perinatal Health Research, The Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW, Australia.,Sydney Medical School Northern, University of Sydney, St Leonards, NSW, Australia
| | - Christine L Roberts
- Clinical and Population Perinatal Health Research, The Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW, Australia.,Sydney Medical School Northern, University of Sydney, St Leonards, NSW, Australia
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60
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Larkin P, Begley CM, Devane D. Women's preferences for childbirth experiences in the Republic of Ireland; a mixed methods study. BMC Pregnancy Childbirth 2017; 17:19. [PMID: 28068948 PMCID: PMC5223453 DOI: 10.1186/s12884-016-1196-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 12/13/2016] [Indexed: 11/24/2022] Open
Abstract
Background How women experience childbirth is acknowledged as critical to the postnatal wellbeing of mother and baby. However there is a knowledge deficit in identifying the important elements of these experiences in order to enhance care. This study elicits women’s preferences for the most important elements of their childbirth experiences. Methods A mixed methods design was used. An initial qualitative phase (reported previously) was followed by a second quantitative one using a discrete choice experiment (DCE), which is reported on here. Participants who had experienced labour, were over 18 and had a healthy baby were recruited from four randomly selected and one pilot hospital in the Republic of Ireland. Data were collected by means of a DCE survey instrument. Questions were piloted, refined, and then arranged in eight pair-wise scenarios. Women identified their preferences by choosing one scenario over another. Nine hundred and five women were sent the DCE three months after childbirth, with a response rate of 59.3% (N =531). Results Women clearly identified priorities for their childbirth experiences as: the availability of pain relief, partnership with the midwife, and individualised care being the most important attributes. In the context of other choices, women rated decision-making, presence of a consultant, and interventions as less important elements. Comments from open questions provided contextual information about their choices. Conclusions Most women did not want to be typified as wanting the dichotomy of ‘all natural’ or ‘all technology’ births but wanted ‘the best of both worlds’. The results suggest that availability of pain relief was the most important element of women’s childbirth experiences, and superseded all other elements including partnership with the midwife which was the second most important attribute. The preferences identified might reflect the busy medicalised hospital environments, in which the vast majority of women had given birth, and may differ in settings such as midwifery led care or home births.
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Affiliation(s)
- Patricia Larkin
- School of Health and Science, Scoil na Sláinte agus na hEolaíochta, Dundalk Institute of Technology, Dublin Road, Dundalk, Co. Louth, Ireland.
| | - Cecily M Begley
- School of Nursing and Midwifery, Trinity College Dublin, Dublin 2, Ireland
| | - Declan Devane
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
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Lewis L, Hauck YL, Crichton C, Pemberton A, Spence M, Kelly G. An overview of the first ‘no exit’ midwifery group practice in a tertiary maternity hospital in Western Australia: Outcomes, satisfaction and perceptions of care. Women Birth 2016; 29:494-502. [DOI: 10.1016/j.wombi.2016.04.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 04/21/2016] [Accepted: 04/22/2016] [Indexed: 10/21/2022]
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Burcher P, Cheyney MJ, Li KN, Hushmendy S, Kiley KC. Cesarean Birth Regret and Dissatisfaction: A Qualitative Approach. Birth 2016; 43:346-352. [PMID: 27411933 DOI: 10.1111/birt.12240] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND The most consistently noted difference between unplanned cesarean and vaginal births is patient dissatisfaction or regret. This has been explored in multiple quantitative studies. However, the causes of this dissatisfaction remain elusive as a result of the limitations of survey instruments that restrict possible choices. METHODS Using open-ended, semi-structured interviews (n = 14), the purpose of this study was to identify potentially alterable factors that contribute to cesarean section regret when the surgery is performed during labor. In interviews that took place between 2 and 6 weeks postpartum, patients who had undergone an unscheduled cesarean birth during labor and had volunteered for the study were asked to share the story of their birth. Each participant was prompted to describe her understanding of the indication for her cesarean, and reflect on what felt positive and negative about her experience. Using consensus coding, three investigators independently evaluated the transcribed interviews, identifying recurring themes that were then discussed until consensus on the major themes was achieved. RESULTS Four key themes emerged from patients' unplanned cesarean narratives: poor communication, fear of the operating room, distrust of the medical team, and loss of control. Lack of or incomplete trust in care providers was a new factor not previously recognized as a cause of distress or dissatisfaction in the literature to date. CONCLUSION The four factors identified in this study are all potentially ameliorable, suggesting that changes in physician behavior may reduce patient dissatisfaction with unplanned cesarean birth.
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Shaping the midwifery profession in Nepal – Uncovering actors' connections using a Complex Adaptive Systems framework. SEXUAL & REPRODUCTIVE HEALTHCARE 2016; 10:48-55. [DOI: 10.1016/j.srhc.2016.09.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 09/28/2016] [Accepted: 09/29/2016] [Indexed: 11/19/2022]
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64
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Larsson Å, Wärnå-Furu C, Näsman Y. The meaning of caring in prenatal care from Swedish women's perspectives. Scand J Caring Sci 2016; 31:702-709. [PMID: 27859526 DOI: 10.1111/scs.12383] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 07/19/2016] [Indexed: 11/30/2022]
Abstract
AIM To deepen understanding of the meaning of caring in prenatal care from Swedish women's perspectives. METHOD Ten women, who had given birth between 1 and 2 months previously, were interviewed. The women have taken part in the routine programme that constitutes maternity care Sweden. A hermeneutic approach inspired by Gadamer was used to analyse the data and gain a deeper understanding of the women's experiences. FINDINGS Three themes were identified in the hermeneutical analysis. The themes highlight an existential and ontological aspect for caring as experienced of the women in the study: invitation and caring promise, witnessing and confirmation, and caring emerges in vulnerability. CONCLUSION The life-changing gravidity and vulnerability motivates caritative care during pregnancy. Reception of caring is not just a superficial feeling, but gives a new understanding of life on an ontological level. In a genuine caring relationship, the pregnant woman not only receives something but also a power and an opportunity to go further and find her own inner strength.
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Affiliation(s)
- Åsa Larsson
- Faculty of Education and Welfare Studies, Åbo Akademi University, Vasa, Finland
| | - Carola Wärnå-Furu
- Faculty of Education and Welfare Studies, Åbo Akademi University, Vasa, Finland
| | - Yvonne Näsman
- Faculty of Education and Welfare Studies, Åbo Akademi University, Vasa, Finland
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65
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Baldisserotto ML, Theme Filha MM, da Gama SGN. Good practices according to WHO's recommendation for normal labor and birth and women's assessment of the care received: the "birth in Brazil" national research study, 2011/2012. Reprod Health 2016; 13:124. [PMID: 27766979 PMCID: PMC5073993 DOI: 10.1186/s12978-016-0233-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The World Health Organization recommends good practices for the conduct of uncomplicated labor and birth, with the aim of improving the quality of and assessment by women of childbirth care. The aim of this study was to evaluate the association between adoption of good practices according to WHO's recommendation for normal labor and birth and assessment by women of the care received. METHODS Birth in Brazil is a national hospital-based study with countrywide representation consisting of 23,894 mothers and their newborns, conducted between February 2011 and October 2012. The present study analysed a subsample of this national survey. Postpartum women classified as low risk during pregnancy who had experienced either spontaneous or induced labor were included in this study, totalling 4102 mothers. To estimate the association between assessment by women of the childbirth care received (dependent variable) and good practices according to WHO's recommendation during normal labor and birth (independent variables), a multinomial logistic regression analysis was used and crude and adjusted odds ratios calculated with their 95 % confidence intervals. RESULTS The good practices associated with positive assessment of the care received by women during labor and birth included the partner's presence, privacy in the birthing place, time available to ask questions, clarity of information received, and empathic support from caregivers during labor and birth. Freedom of movement, free nutrition offered, choice of companions, nonpharmacological analgesia, skin-to-skin contact and breastfeeding in the childbirth room were not associated with the assessment by women of the care received. CONCLUSIONS Our findings reveal the importance to mothers of their relationship with the team of caregivers during labor and birth. Therefore, caregiver teams must be qualified within a more humanistic vision of childbirth health care.
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Conesa Ferrer MB, Canteras Jordana M, Ballesteros Meseguer C, Carrillo García C, Martínez Roche ME. Comparative study analysing women's childbirth satisfaction and obstetric outcomes across two different models of maternity care. BMJ Open 2016; 6:e011362. [PMID: 27566632 PMCID: PMC5013466 DOI: 10.1136/bmjopen-2016-011362] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 05/30/2016] [Accepted: 06/01/2016] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To describe the differences in obstetrical results and women's childbirth satisfaction across 2 different models of maternity care (biomedical model and humanised birth). SETTING 2 university hospitals in south-eastern Spain from April to October 2013. DESIGN A correlational descriptive study. PARTICIPANTS A convenience sample of 406 women participated in the study, 204 of the biomedical model and 202 of the humanised model. RESULTS The differences in obstetrical results were (biomedical model/humanised model): onset of labour (spontaneous 66/137, augmentation 70/1, p=0.0005), pain relief (epidural 172/132, no pain relief 9/40, p=0.0005), mode of delivery (normal vaginal 140/165, instrumental 48/23, p=0.004), length of labour (0-4 hours 69/93, >4 hours 133/108, p=0.011), condition of perineum (intact perineum or tear 94/178, episiotomy 100/24, p=0.0005). The total questionnaire score (100) gave a mean (M) of 78.33 and SD of 8.46 in the biomedical model of care and an M of 82.01 and SD of 7.97 in the humanised model of care (p=0.0005). In the analysis of the results per items, statistical differences were found in 8 of the 9 subscales. The highest scores were reached in the humanised model of maternity care. CONCLUSIONS The humanised model of maternity care offers better obstetrical outcomes and women's satisfaction scores during the labour, birth and immediate postnatal period than does the biomedical model.
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Affiliation(s)
- Ma Belén Conesa Ferrer
- Department of Nursing at the University of Murcia, Midwife in the University Hospital of Torrevieja, Murcia, Spain
| | | | - Carmen Ballesteros Meseguer
- Department of Nursing at the University of Murcia, Midwife in the University Hospital Virgen de la Arrixaca, Murcia, Spain
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Weeks F, Pantoja L, Ortiz J, Foster J, Cavada G, Binfa L. Labor and Birth Care Satisfaction Associated With Medical Interventions and Accompaniment During Labor Among Chilean Women. J Midwifery Womens Health 2016; 62:196-203. [DOI: 10.1111/jmwh.12499] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 04/22/2016] [Accepted: 04/25/2016] [Indexed: 11/28/2022]
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Rahman MM, Ngadan DP, Arif MT. Factors affecting satisfaction on antenatal care services in Sarawak, Malaysia: evidence from a cross sectional study. SPRINGERPLUS 2016; 5:725. [PMID: 27375994 PMCID: PMC4909660 DOI: 10.1186/s40064-016-2447-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 05/27/2016] [Indexed: 11/29/2022]
Abstract
Background High levels of satisfaction among women with the antenatal care services will increase the compliance of antenatal visits during pregnancy. Thus, this study was done to assess the level of satisfaction among women on the quality of antenatal care received and the factors influencing thereof. Methods This was a cross-sectional study conducted in the three zones of Sarawak. Women aged 18 years and above, irrespective of ethnic groups, having children aged 3 years and below were included in the study. Data was collected by face-to-face interview using interview schedule. A validated Patient Satisfaction Questionnaire (PSQ-18) was used to assess the satisfaction with antenatal care. A total of 1236 data was analysed using IBM SPSS version 22.0. A p value <0.05 was considered as statistically significant. Results A multinomial logistic regression analysis revealed that Bidayuh 17.4 % was less likely to be highly satisfied with antenatal care. Similarly, respondents with secondary level of education 29.9 % were less likely to be highly satisfied, whereas, respondents having primary level of education, 1.6 % were less likely to be highly satisfied. However, those who did not spend any money as out of pocket expenses were 1.935 times more likely to be highly satisfied with antenatal care. Conclusion Overall the studied women were satisfied with the antenatal care services. Ethnicity, level of education and out of pocket expenses appeared to be important predictors of satisfaction with antenatal care. The finding recommends the community-based and language-specific interventions should be implemented to sustain the satisfaction of maternal care.
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Affiliation(s)
- Md Mizanur Rahman
- Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300 Kota Samarahan, Sarawak Malaysia
| | - Deburra Peak Ngadan
- Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300 Kota Samarahan, Sarawak Malaysia
| | - Mohammad Taha Arif
- Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300 Kota Samarahan, Sarawak Malaysia
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Quality of delivery care in Assiut University Hospital, Egypt: mothers' satisfaction. J Egypt Public Health Assoc 2016; 90:64-71. [PMID: 26154833 DOI: 10.1097/01.epx.0000466380.29269.4b] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Client satisfaction is an important parameter of quality assessment, as patient's preferences and demands influence health status and medical outcomes. OBJECTIVE The aim of this study was to assess mothers' satisfaction with the quality of healthcare during hospital delivery and its determinants. PARTICIPANTS AND METHODS A cross-sectional design was used. Women who gave birth at Women Health Center of Assiut University Hospital during a 2-month period in 2012 (n=435) were interviewed using a semistructured questionnaire to examine various dimensions of care. RESULTS Nearly two-third of interviewed mothers (63%) were satisfied with the quality of delivery care they received at the hospital. They would deliver again in the hospital and would recommend the hospital to others. Younger women, primipara, and highly educated were more likely to be satisfied than their counterparts. Pregnancy intendedness was associated with the satisfaction (P=0.000). Mothers' satisfaction with the way health provider treated them varied among nurses, doctors, and workers (77.7, 69.2, and 56.1%, respectively). Only 11.7% of mothers reported that they were satisfied with the health advices from the health providers, whereas 92.0% were satisfied with the competence of care providers. High satisfaction with the physical environment of the hospital was reported (>90%). CONCLUSION AND RECOMMENDATIONS Although mothers' satisfaction with provider competence was high, satisfaction with the interpersonal aspects of the quality of care and health information given during delivery care was low. Training the physicians about the communication and interpersonal skills and emphasizing the value of providing mothers with health information are highly recommended.
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Lefèvre Å, Lundqvist P, Drevenhorn E, Hallström I. Parents' experiences of parental groups in Swedish child health-care: Do they get what they want? J Child Health Care 2016; 20:46-54. [PMID: 25171811 DOI: 10.1177/1367493514544344] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Almost all parents in Sweden are invited to parental groups organized by the child health service (CHS) during their child's first year, but only 40% chose to attend. The aim of this study was to describe parents' experiences of participating in these parental groups. A total of 143 parents from 71 different parental groups at 27 child health-care (CHC) centres in one Swedish county completed an online questionnaire. A majority of the parents found the parental groups to be meaningful and more than 60% met someone in the group who they socialized with outside the meetings. Parents wanted a greater focus on child-related community information, existential questions, relationships and parenting in general. Group leadership seems to be of significance to how parents in a group connect and whether the parental role is affected. Making CHC nurses more aware of the topics parents desire could help them meet parents' needs. Education and training in group dynamics and group leadership could be of value in further improving the high-quality service CHC nurses already offer parents. More knowledge is needed about what would attract those parents who do not participate.
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Lewis L, Hauck YL, Ronchi F, Crichton C, Waller L. Gaining insight into how women conceptualize satisfaction: Western Australian women's perception of their maternity care experiences. BMC Pregnancy Childbirth 2016; 16:29. [PMID: 26846257 PMCID: PMC4743199 DOI: 10.1186/s12884-015-0759-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 11/23/2015] [Indexed: 11/16/2022] Open
Abstract
Background The concept of maternal satisfaction is challenging, as women’s and clinicians’ expectations and experiences can differ. Our aim was to investigate women’s experiences of maternity care in an urban tertiary obstetric setting, to gain insight into conceptualization of satisfaction across the childbirth continuum. Methods This mixed method study was conducted at a public maternity hospital in Western Australia. A questionnaire was sent to 733 women two weeks post birth, which included an invitation for an audio-recorded, telephone interview. Frequency distributions and univariate comparisons were employed for quantitative data. Thematic analysis of interview transcripts was undertaken to extract common themes. Results A total of 54 % (399 of 733) returned the questionnaire. Quantitative results indicated that women were less likely to feel: involved if they did not have a spontaneous vaginal birth (P = 0.020); supported by a midwife if they had a caesarean (P = <0.001); or supported by an obstetrician if they had a spontaneous vaginal birth (P = <0.001). Qualitative findings emerged from 63 interviews which highlighted the influence that organization of care, resources and facilities had on women’s satisfaction. These paradigms unfolded as three broad themes constructed by four sub-themes, each illustrating a dichotomy of experiences. The first theme ‘how care was provided’ encompassed: familiar faces versus a different one every time and the best place to be as opposed to so disappointed. The second theme ‘attributes of staff’ included: above and beyond versus caring without caring and in good hands as opposed to handled incorrectly. The third theme ‘engaged in care’ incorporated: explained everything versus did not know why and had a choice as opposed to did not listen to my needs. Conclusions Quantitative analysis confirmed that the majority of women surveyed were satisfied. Mode of birth influenced women’s perception of being involved with their birth. Being able to explore the diversity of women’s experiences in relation to satisfaction with their maternity care in an urban, tertiary obstetric setting has offered greater insight into what women value: a sensitive, respectful, shared relationship with competent clinicians who recognise and strive to provide woman focused care across the childbirth continuum.
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Affiliation(s)
- Lucy Lewis
- School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, Perth, 6102, Western Australia, Australia. .,Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, 6008, Western Australia, Australia.
| | - Yvonne L Hauck
- School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, Perth, 6102, Western Australia, Australia. .,Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, 6008, Western Australia, Australia.
| | - Fiona Ronchi
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, 6008, Western Australia, Australia.
| | - Caroline Crichton
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, 6008, Western Australia, Australia.
| | - Liana Waller
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, 6008, Western Australia, Australia.
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Baas CI, Erwich JJHM, Wiegers TA, de Cock TP, Hutton EK. Women's Suggestions for Improving Midwifery Care in The Netherlands. Birth 2015; 42:369-78. [PMID: 26467657 DOI: 10.1111/birt.12185] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/02/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND The experience of the care a woman receives during pregnancy and childbirth has an immediate and long-lasting effect on her well being. The involvement of patients and clients in health care has increased over the last decades. The Dutch maternity care system offers an excellent opportunity to explore and involve women's suggestions for the improvement of midwifery care in the current maternity care model. METHODS This qualitative study is part of the "DELIVER" study. Clients were recruited from 20 midwifery practices. Purposive sampling was used to select the practices. The clients received up to three questionnaires, in which they could respond to the question; "Do you have any suggestions on how your midwife could improve his/her provision of care?" The answers were analyzed with a qualitative thematic content analysis, using the software program MAXQDA. RESULTS Altogether, 3,499 answers were provided. One overarching concept emerged: clients' desire for individualized care. Within this concept, suggestions could be clustered around 1) provider characteristics: interpersonal skills, communication, and competence, and 2) service characteristics: content and quantity of care, guidance and support, continuity of care provider, continuity of care, information, and coordination of care. CONCLUSIONS Informed by the suggestions of women, care to women and their families could be improved by the following: 1) more continuity of the care provider during the prenatal, natal, and postnatal periods, 2) more information and information specifically tailored for the person, 3) client-centered communication, and 4) a personal approach with 5) enough time spent per client.
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Affiliation(s)
- Carien I Baas
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Jan Jaap H M Erwich
- Department of Obstetrics and Gynecology, Staff-Specialist Maternal and Fetal medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Therese A Wiegers
- Netherlands institute for health services research (NIVEL), Utrecht, The Netherlands
| | - T Paul de Cock
- Department of Midwifery Science, EMGO+VUMc, Amsterdam, The Netherlands
| | - Eileen K Hutton
- Department of Midwifery Science, EMGO+VUMc, Amsterdam, The Netherlands
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Hildingsson I, Karlström A, Haines H, Johansson M. Swedish women's interest in models of midwifery care - Time to consider the system? A prospective longitudinal survey. SEXUAL & REPRODUCTIVE HEALTHCARE 2015; 7:27-32. [PMID: 26826042 DOI: 10.1016/j.srhc.2015.11.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 10/10/2015] [Accepted: 11/05/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Sweden has an international reputation for offering high quality maternity care, although models that provide continuity of care are rare. The aim was to explore women's interest in models of care such as continuity with the same midwife, homebirth and birth center care. METHODS A prospective longitudinal survey where 758 women's interest in models such as having the same midwife throughout antenatal, intrapartum and postpartum care, homebirth with a known midwife, and birth center care were investigated. RESULTS Approximately 50% wanted continuity of care with the same midwife throughout pregnancy, birth and the postpartum period. Few participants were interested in birth center care or home birth. Fear of giving birth was associated with a preference for continuity with midwife. CONCLUSIONS Continuity with the same midwife could be of certain importance to women with childbirth fear. Models that offer continuity of care with one or two midwives are safe, cost-effective and enhance the chance of having a normal birth, a positive birth experience and possibly reduce fear of birth. The evidence is now overwhelming that all women should have maternity care delivered in this way.
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Affiliation(s)
- Ingegerd Hildingsson
- Department of Nursing, Mid Sweden University, Sundsvall, Sweden; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | | | - Helen Haines
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Northeast Health Wangaratta, Education and Research Unit, Melbourne Medical School, Rural Health Academic Centre, The University of Melbourne, Melbourne, Australia
| | - Margareta Johansson
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
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Escuriet R, White J, Beeckman K, Frith L, Leon-Larios F, Loytved C, Luyben A, Sinclair M, van Teijlingen E. Assessing the performance of maternity care in Europe: a critical exploration of tools and indicators. BMC Health Serv Res 2015; 15:491. [PMID: 26525577 PMCID: PMC4631101 DOI: 10.1186/s12913-015-1151-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 10/22/2015] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND This paper critically reviews published tools and indicators currently used to measure maternity care performance within Europe, focusing particularly on whether and how current approaches enable systematic appraisal of processes of minimal (or non-) intervention in support of physiological or "normal birth". The work formed part of COST Actions IS0907: "Childbirth Cultures, Concerns, and Consequences: Creating a dynamic EU framework for optimal maternity care" (2011-2014) and IS1405: Building Intrapartum Research Through Health - an interdisciplinary whole system approach to understanding and contextualising physiological labour and birth (BIRTH) (2014-). The Actions included the sharing of country experiences with the aim of promoting salutogenic approaches to maternity care. METHODS A structured literature search was conducted of material published between 2005 and 2013, incorporating research databases, published documents in english in peer-reviewed international journals and indicator databases which measured aspects of health care at a national and pan-national level. Given its emergence from two COST Actions the work, inevitably, focused on Europe, but findings may be relevant to other countries and regions. RESULTS A total of 388 indicators were identified, as well as seven tools specifically designed for capturing aspects of maternity care. Intrapartum care was the most frequently measured feature, through the application of process and outcome indicators. Postnatal and neonatal care of mother and baby were the least appraised areas. An over-riding focus on the quantification of technical intervention and adverse or undesirable outcomes was identified. Vaginal birth (no instruments) was occasionally cited as an indicator; besides this measurement few of the 388 indicators were found to be assessing non-intervention or "good" or positive outcomes more generally. CONCLUSIONS The tools and indicators identified largely enable measurement of technical interventions and undesirable health (or pathological medical) outcomes. A physiological birth generally necessitates few, or no, interventions, yet most of the indicators presently applied fail to capture (a) this phenomenon, and (b) the relationship between different forms and processes of care, mode of birth and good or positive outcomes. A need was identified for indicators which capture non-intervention, reflecting the reality that most births are low-risk, requiring few, if any, technical medical procedures.
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Affiliation(s)
- Ramón Escuriet
- Directorate-General for Health Planning and Research, Ministry of Health of the Government of Catalonia, Barcelona, Spain.
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
| | - Joanna White
- Centre for Research in Anthropology/Centro em Rede de Investigação em Antropologia (CRIA-IUL, Lisbon, Portugal.
- Department of Health and Social Sciences, University of the West of England, Bristol, UK.
| | - Katrien Beeckman
- Nursing and Midwifery research unit, University hospital Brussels, Vrije universiteit Brussel, Brussel, Belgium.
| | - Lucy Frith
- Department of Health Services Research, The University of Liverpool, Liverpool, UK.
| | - Fatima Leon-Larios
- Departamento de Enfermería. Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain.
| | - Christine Loytved
- Zurich University of Applied Sciences, School of Health Professions, Institute of Midwifery, Zurich, Switzerland.
| | - Ans Luyben
- Women's Clinic, Spital STS AG, Thun, Switzerland.
| | - Marlene Sinclair
- Maternal Fetal and Infant Research Centre, University of Ulster, Coleraine, UK.
| | - Edwin van Teijlingen
- Centre for Midwifery, Maternal & Perinatal Health Bournemouth University, Bournemouth, UK.
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Coxon K, Sandall J, Fulop NJ. How do pregnancy and birth experiences influence planned place of birth in future pregnancies? Findings from a longitudinal, narrative study. Birth 2015; 42:141-8. [PMID: 25676885 PMCID: PMC5024040 DOI: 10.1111/birt.12149] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/23/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND A perception that first birth is more risky than subsequent births has led to women planning births in obstetric units (OU) and to care providers supporting these choices. This study explored the influence of pregnancy and birth experiences on women's intended place of birth in current and future pregnancies. METHODS Prospective, longitudinal narrative interviews (n = 122) were conducted with 41 women in three English National Health Service sites. During postnatal interviews, women reflected on their recent births and discussed where they might plan to give birth in a future pregnancy. Longitudinal narrative analysis methods were used to explore these data. RESULTS Women's experience of care in their eventual place of birth had more influence on decisions about the (hypothetical) next pregnancy than planned place of birth during pregnancy did. Women with complex pregnancies usually planned hospital (OU) births, but healthy women with straightforward pregnancies also chose an OU and would often plan the same for the future, particularly if they experienced giving birth in an OU setting during recent births. DISCUSSION The experience of giving birth in a hospital OU reinforced women's perceptions that birth is risky and uncertain, and that hospital OUs are best equipped to keep women and babies safe. The assumption that women will opt for lower acuity settings for second or subsequent births was not supported by these data, which may mean that multiparous women who best fit criteria for non-OU births are reluctant to plan births in these settings. This highlights the importance of providing balanced information about risks and benefits of different birth settings to all women during pregnancy.
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Affiliation(s)
- Kirstie Coxon
- Division of Women's HealthWomen's Health Academic CentreKing's College LondonLondonUK
| | - Jane Sandall
- Women's Health Academic CentreKing's College LondonLondonUK
| | - Naomi J. Fulop
- UCL Department of Applied Health ResearchUniversity College LondonLondonUK
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Hildingsson I. Women's birth expectations, are they fulfilled? Findings from a longitudinal Swedish cohort study. Women Birth 2015; 28:e7-13. [DOI: 10.1016/j.wombi.2015.01.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 12/28/2014] [Accepted: 01/31/2015] [Indexed: 11/28/2022]
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Chalmers BE, Dzakpasu S. Interventions in labour and birth and satisfaction with care: The Canadian Maternity Experiences Survey Findings. J Reprod Infant Psychol 2015. [DOI: 10.1080/02646838.2015.1042964] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Clark K, Beatty S, Reibel T. ‘What women want’: Using image theory to develop expectations of maternity care framework. Midwifery 2015; 31:505-11. [DOI: 10.1016/j.midw.2014.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 11/06/2014] [Accepted: 12/31/2014] [Indexed: 11/27/2022]
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Ford JB, Hindmarsh DM, Browne KM, Todd AL. Are women birthing in New South Wales hospitals satisfied with their care? BMC Res Notes 2015; 8:106. [PMID: 25890303 PMCID: PMC4378554 DOI: 10.1186/s13104-015-1067-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 03/18/2015] [Indexed: 11/26/2022] Open
Abstract
Background Surveys of satisfaction with maternity care have been conducted using overnight inpatient surveys and dedicated maternity surveys in a number of Australian settings, however none have been used to report on satisfaction with maternity care among women in New South Wales. The aims of this study were to investigate the association between: 1) parity (first and subsequent births) and patient experience of hospital care at birth, and 2) other patient, birth and hospital characteristics and experience of hospital care at birth. Methods Data were from the New South Wales (NSW) Ministry of Health surveys of overnight hospital inpatients, including maternity patients, between 2007 and 2011. Questionnaires were mailed to a sample of patients three months after receiving inpatient services involving at least 1 night in a public hospital. Experience of care included 12 items grouped into: satisfaction with care, staff and information. Results were weighted to overall hospital facility populations and age-standardised. Frequencies and chi-square tests were used. Results Analysis of responses from 5,367 obstetric patients revealed three quarters of women were satisfied with care provided in hospital. Compared with women who had previously given birth, first-time mothers were more likely to recommend their birth hospital to friends and family (60.5% versus 56.4%; P < 0.05), less likely to have experienced differing messages from staff (44.8% vs 59.4%; P < 0.001), and less likely to feel they had received sufficient information about feeding (58.8% vs 65.0%; P < 0.001) and caring for their babies (52.4% vs 65.2%; P < 0.001). While metropolitan women were more likely to rate their birth hospital positively (76.0% vs. 71.3%; P < 0.05) than their rural counterparts, rural women tended to rate the care they received (68.1% vs. 63.4%; P < 0.05), and doctors (70.7% vs 61.1%; P < 0.05) and nurses (73.5% vs. 66.9%; P < 0.001) more highly than metropolitan women. Conclusions The overall picture of maternity care satisfaction in New South Wales is a positive one, with three quarters of women satisfied with care. Further resources could be dedicated to ensuring consistency and amount of information provided, particularly to first-time mothers. Electronic supplementary material The online version of this article (doi:10.1186/s13104-015-1067-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jane B Ford
- C/- University Department of Obstetrics and Gynaecology, Kolling Institute, University of Sydney, Building 52, Royal North Shore Hospital, St Leonards, Sydney, NSW, 2065, Australia.
| | - Diane M Hindmarsh
- Bureau of Health Information, PO Box 1770, Chatswood, Sydney, NSW, 2057, Australia.
| | - Kim M Browne
- Bureau of Health Information, PO Box 1770, Chatswood, Sydney, NSW, 2057, Australia.
| | - Angela L Todd
- C/- University Department of Obstetrics and Gynaecology, Kolling Institute, University of Sydney, Building 52, Royal North Shore Hospital, St Leonards, Sydney, NSW, 2065, Australia.
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Miani C, Ball S, Pitchforth E, Exley J, King S, Roland M, Fuld J, Nolte E. Organisational interventions to reduce length of stay in hospital: a rapid evidence assessment. HEALTH SERVICES AND DELIVERY RESEARCH 2014. [DOI: 10.3310/hsdr02520] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundAvailable evidence on effective interventions to reduce length of stay in hospital is wide-ranging and complex, with underlying factors including those acting at the health system, organisational and patient levels, and the interface between these. There is a need to better understand the diverse literature on reducing the length of hospital stay.ObjectivesThis study sought to (i) describe the nature of interventions that have been used to reduce length of stay in acute care hospitals; (ii) identify the factors that are known to influence length of stay; and (iii) assess the impact of interventions on patient outcomes, service outcomes and costs.Data sourcesWe searched MEDLINE (Ovid), EMBASE, the Health Management Information Consortium and System for Information on Grey Literature in Europe for the period January 1995 to January 2013 with no limitation of publication type.MethodsWe conducted a rapid evidence synthesis of the peer-reviewed literature on organisational interventions set in or initiated from acute hospitals. We considered evidence published between 2003 and 2013. Data were analysed drawing on the principles of narrative synthesis. We also carried out interviews with eight NHS managers and clinical leads in four sites in England.ResultsA total of 53 studies met our inclusion criteria, including 19 systematic reviews and 34 primary studies. Although the overall evidence base was varied and frequently lacked a robust study design, we identified a range of interventions that showed potential to reduce length of stay. These were multidisciplinary team working, for example some forms of organised stroke care; improved discharge planning; early supported discharge programmes; and care pathways. Nursing-led inpatient units were associated with improved outcomes but, if anything, increased length of stay. Factors influencing the impact of interventions on length of stay included contextual factors and the population targeted. The evidence was mixed with regard to the extent to which interventions seeking to reduce length of stay were associated with cost savings.LimitationsWe only considered assessments of interventions which provided a quantitative estimate of the impact of the given organisational intervention on length of hospital stay. There was a general lack of robust evidence and poor reporting, weakening the conclusions that can be drawn from the review.ConclusionsThe design and implementation of an intervention seeking to reduce (directly or indirectly) the length of stay in hospital should be informed by local context and needs. This involves understanding how the intervention is seeking to change processes and behaviours that are anticipated, based on the available evidence, to achieve desired outcomes (‘theory of change’). It will also involve assessing the organisational structures and processes that will need to be put in place to ensure that staff who are expected to deliver the intervention are appropriately prepared and supported. With regard to future research, greater attention should be given to the theoretical underpinning of the design, implementation and evaluation of interventions or programmes. There is a need for further research using appropriate methodology to assess the effectiveness of different types of interventions in different settings. Different evaluation approaches may be useful, and closer relationships between researchers and NHS organisations would enable more formative evaluation. Full economic costing should be undertaken where possible, including considering the cost implications for the wider local health economy.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
| | | | | | | | | | - Martin Roland
- Cambridge Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | | | - Ellen Nolte
- European Observatory on Health Systems and Policies, London School of Economics and Political Science and the London School of Hygiene & Tropical Medicine, London, UK
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81
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Floyd L, Coulter N, Asamoah S, Agyare-Asante R. Women's views and experience of their maternity care at a referral hospital in Ghana. ACTA ACUST UNITED AC 2014. [DOI: 10.12968/ajmw.2014.8.4.168] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Liz Floyd
- Midwife South Tees NHS Trust, UK, Kybele Core Team Member, Ghana
| | - Nicole Coulter
- Midwife South Tees NHS Trust, UK, Kybele Team Volunteer, Ghana
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82
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Russell G, Sawyer A, Rabe H, Abbott J, Gyte G, Duley L, Ayers S. Parents' views on care of their very premature babies in neonatal intensive care units: a qualitative study. BMC Pediatr 2014; 14:230. [PMID: 25216714 PMCID: PMC4190336 DOI: 10.1186/1471-2431-14-230] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 09/10/2014] [Indexed: 11/10/2022] Open
Abstract
Background The admission of a very premature infant to the neonatal intensive care unit (NICU) is often a difficult time for parents. This paper explores parents’ views and experiences of the care for their very premature baby on NICU. Methods Parents were eligible if they had a baby born before 32 weeks gestation and cared for in a NICU, and spoke English well. 32 mothers and 7 fathers were interviewed to explore their experiences of preterm birth. Although parents’ evaluation of care in the NICU was not the aim of these interviews, all parents spoke spontaneously and at length on this topic. Results were analysed using thematic analysis. Results Overall, parents were satisfied with the care on the neonatal unit. Three major themes determining satisfaction with neonatal care emerged: 1) parents’ involvement; including looking after their own baby, the challenges of expressing breast milk, and easy access to their baby; 2) staff competence and efficiency; including communication, experience and confidence, information and explanation; and 3) interpersonal relationships with staff; including sensitive and emotional support, reassurance and encouragement, feeling like an individual. Conclusions Determinants of positive experiences of care were generally consistent with previous research. Specifically, provision of information, support for parents and increasing their involvement in the care of their baby were highlighted by parents as important in their experience of care.
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Affiliation(s)
| | | | | | | | | | | | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City University London, London EC1R 1UW, UK.
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83
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Macfarlane AJ, Rocca-Ihenacho L, Turner LR, Roth C. Survey of women's experiences of care in a new freestanding midwifery unit in an inner city area of London, England. 1: Methods and women's overall ratings of care. Midwifery 2014; 30:998-1008. [PMID: 24820003 PMCID: PMC4157326 DOI: 10.1016/j.midw.2014.03.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Revised: 03/07/2014] [Accepted: 03/22/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE to describe and compare women's choices and experiences of maternity care before and after the opening of the Barkantine Birth Centre, a new freestanding midwifery unit in an inner city area. DESIGN telephone surveys undertaken in late pregnancy and about six weeks after birth in two separate time periods, Phase 1 before the birth centre opened and Phase 2 after it had opened. SETTING Tower Hamlets, a deprived inner city borough in east London, England, 2007-2010. PARTICIPANTS 620 women who were resident in Tower Hamlets and who satisfied the Barts and the London NHS Trust's eligibility criteria for using the birth centre. Of these, 259 women were recruited to Phase 1 and 361 to Phase 2. MEASUREMENTS AND FINDINGS women who satisfied the criteria for birth centre care and who booked antenatally for care at the birth centre were significantly more likely to rate their care as good or very good overall than corresponding women who also satisfied these criteria but booked initially at the hospital. Women who started labour care in spontaneous labour at the birth centre were significantly more likely to be cared for by a midwife they had already met, have one to one care in labour and have the same midwife with them throughout their labour. They were also significantly more likely to report that the staff were kind and understanding, that they were treated with respect and dignity and that their privacy was respected. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE this survey in an inner city area showed that women who chose the freestanding midwifery unit care had positive experiences to report. Taken together with the findings of the Birthplace Programme, it adds further weight to the evidence in support of freestanding midwifery unit care for women without obstetric complications.
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84
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Jenkins MG, Ford JB, Morris JM, Roberts CL. Women's expectations and experiences of maternity care in NSW – What women highlight as most important. Women Birth 2014; 27:214-9. [DOI: 10.1016/j.wombi.2014.03.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 02/26/2014] [Accepted: 03/03/2014] [Indexed: 11/26/2022]
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85
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Sawyer A, Rabe H, Abbott J, Gyte G, Duley L, Ayers S. Measuring parents' experiences and satisfaction with care during very preterm birth: a questionnaire development study. BJOG 2014; 121:1294-301. [PMID: 24953082 PMCID: PMC4282037 DOI: 10.1111/1471-0528.12925] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2014] [Indexed: 11/27/2022]
Abstract
Objective To develop a questionnaire to assess parents' experiences and satisfaction with care during very preterm birth. Design Questionnaire development. Setting Parents whose babies had been cared for at five tertiary neonatal units in England. Population A total of 145 women who gave birth before 32 weeks of gestation, and 85 of their partners. Methods A 30-item questionnaire was developed on the basis of qualitative interviews with parents of very preterm babies, a literature review and discussion with relevant experts. The questionnaire was posted to a second group of parents, and its reliability and validity were explored. Main outcome measures The Preterm Birth Experience and Satisfaction Scale (P-BESS) was correlated with two global questions measuring satisfaction with care during the birth. Internal consistency was measured using Cronbach's α. Results Parents of 458 babies were invited to take part and 147 (32%) responded. Two women and 22 partners were excluded or ineligible, leaving 145 women and 85 partners. Factor analysis produced three clear dimensions: Staff professionalism and empathy, Information and explanations, and Confidence in staff. The total scale and three subscales showed high reliability. Strong positive correlations were found between the questionnaire scales and the two global questions, indicating convergent validity. For women whose partners were present at the birth, a fourth factor was identified ‘Partner Involvement’. Conclusions The P-BESS appears to be a valid measure of satisfaction with care during very preterm birth.
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Affiliation(s)
- A Sawyer
- Centre for Maternal and Child Health Research, School of Health Sciences, City University London, London, UK
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86
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Hildingsson I, Andersson E, Christensson K. Swedish women’s expectations about antenatal care and change over time – A comparative study of two cohorts of women. SEXUAL & REPRODUCTIVE HEALTHCARE 2014; 5:51-7. [DOI: 10.1016/j.srhc.2014.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 01/07/2014] [Accepted: 01/13/2014] [Indexed: 11/26/2022]
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87
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Pregnancy termination due to fetal anomaly: Women's reactions, satisfaction and experiences of care. Midwifery 2014; 30:620-7. [DOI: 10.1016/j.midw.2013.10.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 10/03/2013] [Accepted: 10/13/2013] [Indexed: 11/17/2022]
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88
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van Haaren-ten Haken T, Pavlova M, Hendrix M, Nieuwenhuijze M, de Vries R, Nijhuis J. Eliciting preferences for key attributes of intrapartum care in the Netherlands. Birth 2014; 41:185-94. [PMID: 24702440 DOI: 10.1111/birt.12081] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/01/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND As part of the move toward "patient-centered care," women's preferences with regard to maternity services have become increasingly important to policy makers. To realize optimal patient-centered care, knowledge of patients' preferences is essential. The aim of our study was to assess the strength and relative importance of women's preferences for different aspects of intrapartum care in The Netherlands, where women have easy access to both home and hospital birth. METHODS A discrete choice experiment was conducted at 16 weeks of gestation as part of a Dutch multicenter, prospective cohort study from 2007 to 2011 of low-risk, nulliparous women. Responses were analyzed per intended place of birth group: midwifery-led home (n = 191) and hospital birth (n = 152) and obstetric-led hospital birth (n = 188). RESULTS We analyzed 562 questionnaires. Women in all groups preferred the possibility of influencing decision making and pain-relief treatment during birth and no co-payment for childbirth. Women with an intended home birth preferred a home-like birth setting with the assistance of a midwife and transport during birth in case of complications. Type of birth setting and transport during birth were not considered important to women with an intended midwifery- or obstetric-led hospital birth. CONCLUSION Policies aimed at the improvement of maternity care must take into account women's preferences for the possibility of pain-relief treatment and the fact that all women desire a high level of involvement in decision making. Furthermore, efforts to change maternity care systems must consider how to counter the culturally embedded nature of women's preferences.
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Affiliation(s)
- Tamar van Haaren-ten Haken
- Department midwifery science of Midwifery Education & Studies Maastricht-ZUYD, Maastricht, The Netherlands
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89
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Jönsson L, Lundqvist P, Tiberg I, Hallström I. Type 1 diabetes - impact on children and parents at diagnosis and 1 year subsequent to the child's diagnosis. Scand J Caring Sci 2014; 29:126-35. [DOI: 10.1111/scs.12140] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 03/16/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Lisbeth Jönsson
- Department of Health Sciences; Faculty of Medicine; Lund University; Lund Sweden
| | - Pia Lundqvist
- Department of Health Sciences; Faculty of Medicine; Lund University; Lund Sweden
| | - Irén Tiberg
- Department of Health Sciences; Faculty of Medicine; Lund University; Lund Sweden
| | - Inger Hallström
- Department of Health Sciences; Faculty of Medicine; Lund University; Lund Sweden
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90
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Harding AJE, Sanders F, Lara AM, van Teijlingen ER, Wood C, Galpin D, Baron S, Crowe S, Sharma S. Patient choice for older people in english NHS primary care: theory and practice. ISRN FAMILY MEDICINE 2014; 2014:742676. [PMID: 24967329 PMCID: PMC4041268 DOI: 10.1155/2014/742676] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 01/20/2014] [Indexed: 11/21/2022]
Abstract
In the English National Health Service (NHS), patients are now expected to choose the time and place of treatment and even choose the actual treatment. However, the theory on which patient choice is based and the implementation of patient choice are controversial. There is evidence to indicate that attitudes and abilities to make choices are relatively sophisticated and not as straightforward as policy developments suggest. In addition, and surprisingly, there is little research on whether making individual choices about care is regarded as a priority by the largest NHS patient group and the single largest group for most GPs-older people. This conceptual paper examines the theory of patient choice concerning accessing and engaging with healthcare provision and reviews existing evidence on older people and patient choice in primary care.
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Affiliation(s)
- Andrew J. E. Harding
- School of Health & Social Care, Bournemouth University, Bournemouth House, 19 Christchurch Road, Bournemouth, Dorset BH1 3LH, UK
| | - Frances Sanders
- Westbourne Medical Centre, Milburn Road, Bournemouth, Dorset BH4 9HJ, UK
| | - Antonieta Medina Lara
- Health Economics Group, University of Exeter Medical School, Veysey Building, Salmon Pool Lane, Exeter EX2 4SG, UK
| | - Edwin R. van Teijlingen
- School of Health & Social Care, Bournemouth University, Bournemouth House, 19 Christchurch Road, Bournemouth, Dorset BH1 3LH, UK
| | - Cate Wood
- School of Health & Social Care, Bournemouth University, Bournemouth House, 19 Christchurch Road, Bournemouth, Dorset BH1 3LH, UK
| | - Di Galpin
- Plymouth University, Drake Circus, Plymouth, Devon PL4 8AA, UK
| | - Sue Baron
- School of Health & Social Care, Bournemouth University, Bournemouth House, 19 Christchurch Road, Bournemouth, Dorset BH1 3LH, UK
| | - Sam Crowe
- Dorset County Council, Vespasian House, Bridport Road, Dorchester DT1 1TS, UK
| | - Sheetal Sharma
- School of Health & Social Care, Bournemouth University, Bournemouth House, 19 Christchurch Road, Bournemouth, Dorset BH1 3LH, UK
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91
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Thompson R, Miller YD. Birth control: to what extent do women report being informed and involved in decisions about pregnancy and birth procedures? BMC Pregnancy Childbirth 2014; 14:62. [PMID: 24507621 PMCID: PMC3923734 DOI: 10.1186/1471-2393-14-62] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 02/05/2014] [Indexed: 11/11/2022] Open
Abstract
Background Health policy, guidelines, and standards advocate giving patients comprehensive information and facilitating their involvement in health-related decision-making. Routine assessment of patient reports of these processes is needed. Our objective was to examine decision-making processes, specifically information provision and consumer involvement in decision-making, for nine pregnancy, labour, and birth procedures, as reported by maternity care consumers in Queensland, Australia. Methods Participants were women who had a live birth in Queensland in a specified time period and were not found to have had a baby that died since birth, who completed the extended Having a Baby in Queensland Survey, 2010 about their maternity care experiences, and who reported at least one of the nine procedures of interest. For each procedure, women answered two questions that measured perceived (i) receipt of information about the benefits and risks of the procedure and (ii) role in decision-making about the procedure. Results In all, 3,542 eligible women (34.2%) completed the survey. Between 4% (for pre-labour caesarean section) and 60% (for vaginal examination) of women reported not being informed of the benefits and risks of the procedure they experienced. Between 2% (epidural) and 34% (episiotomy) of women reported being unconsulted in decision-making. Over one quarter (26%) of the women who experienced episiotomy reported being neither informed nor consulted. Conclusions There is an urgent need for interventions that facilitate information provision and consumer involvement in decision-making about several perinatal procedures, especially those performed within the time-limited intrapartum care episode.
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Affiliation(s)
| | - Yvette D Miller
- School of Psychology, The University of Queensland, Brisbane, QLD 4072, Australia.
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92
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Murphy A, Wells J, Chesser-Smyth P, Sheahan L, Foley M. An Exploratory Survey of Low-Risk Pregnant Women’s Perceptions of Antenatal Care and Services in Southern Ireland. INTERNATIONAL JOURNAL OF CHILDBIRTH 2014. [DOI: 10.1891/2156-5287.4.3.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Ireland currently has the highest birthrate of the 27 European Union countries which has led to an increase in demand for maternity services. In the Irish Republic, most maternity units have traditionally followed the medical-led model of care, which, as a result, has limited women’s choice for maternity care. Although various different midwifery-led schemes are available, concerns exist regarding the knowledge and accessibility of these schemes.The aim of this descriptive, exploratory survey was to explore and determine the views of “low-risk” pregnant women (n= 394) regarding their antenatal care and services. A purposive homogeneous sample comprised the first phase of a mixed methods study and data were analyzed using Predictive Analytics Software. The findings identified a lack of awareness and understanding of the concept of a low-risk pregnancy. Consequently, women identified an overall lack of information and an inability to access available options for their care.
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93
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Andersson E, Christensson K, Hildingsson I. Mothers’ satisfaction with group antenatal care versus individual antenatal care – A clinical trial. SEXUAL & REPRODUCTIVE HEALTHCARE 2013; 4:113-20. [DOI: 10.1016/j.srhc.2013.08.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 07/07/2013] [Accepted: 08/12/2013] [Indexed: 10/26/2022]
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94
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McNelis M. Women's experiences of care during labour in a midwifery-led unit in the Republic of Ireland. ACTA ACUST UNITED AC 2013. [DOI: 10.12968/bjom.2013.21.9.622] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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95
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Bell SA, Seng J. Childhood maltreatment history, posttraumatic relational sequelae, and prenatal care utilization. J Obstet Gynecol Neonatal Nurs 2013; 42:404-15. [PMID: 23772546 PMCID: PMC4331183 DOI: 10.1111/1552-6909.12223] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To test the hypothesis that childhood maltreatment history would be associated with inadequate prenatal care utilization. DESIGN A post-hoc analysis of a prospective cohort study of the effects of post traumatic stress disorder (PTSD) on pregnancy outcomes. SETTING Recruitment took place via prenatal clinics from three academic health systems in southeast Michigan. PARTICIPANTS This analysis included 467 diverse, nulliparous, English-speaking adult women expecting their first infants. METHODS Data were gathered from structured telephone interviews at two time points in pregnancy and from prenatal medical records. RESULTS Contrary to our hypothesis, history of childhood maltreatment was associated with better likelihood of using adequate prenatal care. Risk for inadequate prenatal care occurred in association with the posttraumatic stress and interpersonal sensitivity that can result from maltreatment, with low alliance with the maternity care provider, and with public insurance coverage. Prior mental health treatment was associated with using adequate prenatal care. CONCLUSION When childhood maltreatment survivors were resilient or had used mental health treatment, they were more likely to utilize adequate prenatal care. The maternity care relationship or service delivery model (e.g., no continuity of care) as well as structural factors may adversely affect utilization among PTSD-affected survivors. Since inadequate care was associated with adverse outcomes, further studies of these modifiable factors are warranted.
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Affiliation(s)
- Sue Anne Bell
- University of Michigan School of Nursing. Her research focuses on the intersection of reproductive health and mental health
| | - Julia Seng
- University of Michigan School of Nursing where she studies the effects of posttraumatic stress disorder on women's health and childbearing outcomes. 204 South State Street G120 Lane Hall Ann Arbor, MI 48109 734-647-4291
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Haines HM, Hildingsson I, Pallant JF, Rubertsson C. The role of women's attitudinal profiles in satisfaction with the quality of their antenatal and intrapartum care. J Obstet Gynecol Neonatal Nurs 2013; 42:428-41. [PMID: 23773005 DOI: 10.1111/1552-6909.12221] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To compare perceptions of antenatal and intrapartum care in women categorized into three profiles based on attitudes and fear. DESIGN Prospective longitudinal cohort study using self-report questionnaires. Profiles were constructed from responses to the Birth Attitudes Profile Scale and the Fear of Birth Scale at pregnancy weeks 18 to 20. Perception of the quality of care was measured using the Quality from Patient's Perspective index at 34 to 36 weeks pregnancy and 2 months after birth. SETTING Two hospitals in Sweden and Australia. PARTICIPANTS Five hundred and five (505) pregnant women from one hospital in Västernorrland, Sweden (n = 386) and one in northeast Victoria, Australia (n = 123). RESULTS Women were categorized into three profiles: self-determiners, take it as it comes, and fearful. The self-determiners reported the best outcomes, whereas the fearful were most likely to perceive deficient care. Antenatally the fearful were more likely to indicate deficiencies in medical care, emotional care, support received from nurse-midwives or doctors and nurse-midwives'/doctors' understanding of the woman's situation. They also reported deficiencies in two aspects of intrapartum care: support during birth and control during birth. CONCLUSIONS Attitudinal profiling of women during pregnancy may assist clinicians to deliver the style and content of antenatal and intrapartum care to match what women value and need. An awareness of a woman's fear of birth provides an opportunity to offer comprehensive emotional support with the aim of promoting a positive birth experience.
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Affiliation(s)
- Helen M Haines
- Department of Women's and Children's Health, Obstetrics and Gynaecology, Uppsala University, Akademiskasjukhuset, Uppsala, Sweden.
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Regardless of where they give birth, women living in non-metropolitan areas are less likely to have an epidural than their metropolitan counterparts. Women Birth 2013; 26:e77-81. [DOI: 10.1016/j.wombi.2012.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 11/29/2012] [Accepted: 12/02/2012] [Indexed: 11/21/2022]
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98
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Michels A, Kruske S, Thompson R. Women’s postnatal psychological functioning: the role of satisfaction with intrapartum care and the birth experience. J Reprod Infant Psychol 2013. [DOI: 10.1080/02646838.2013.791921] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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99
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Women's satisfaction with antenatal care: Comparing women in Sweden and Australia. Women Birth 2013; 26:e9-e14. [DOI: 10.1016/j.wombi.2012.06.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 06/22/2012] [Indexed: 11/20/2022]
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100
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Sawyer A, Rabe H, Abbott J, Gyte G, Duley L, Ayers S. Parents' experiences and satisfaction with care during the birth of their very preterm baby: a qualitative study. BJOG 2013; 120:637-43. [PMID: 23289929 PMCID: PMC3613739 DOI: 10.1111/1471-0528.12104] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2012] [Indexed: 11/29/2022]
Abstract
Objective To assess parents' experiences and satisfaction with care during very preterm birth and to identify domains associated with positive and negative experiences of care. Design Qualitative study using semi-structured interviews. Setting Three neonatal units in tertiary care hospitals in South-East England. Population Thirty-two mothers and seven fathers who had a baby born before 32 weeks of gestation and spoke English well. Methods Semi-structured interviews were conducted. Results were analysed using thematic analysis. Main outcome measures Participants' experiences and satisfaction with care during the birth of their preterm baby. Results Overall, 80% of participants were extremely satisfied with the care during the birth of their preterm baby, seven were generally satisfied but felt some things could be improved and one was dissatisfied. Four key determinants of experiences of care were identified: staff professionalism, which included information and explanation, being calm in a crisis, appearing confident and in control, and conversely not listening to the woman; staff empathy, which included caring and emotional support, and encouragement and reassurance; involvement of the father; and birth environment. Conclusions Although the determinants of experiences of care are generally consistent with previous research on term births, unique factors to preterm birth were identified. These were the importance of the staff appearing calm during the birth, and the staff portraying confidence and taking control during the birth. Women valued being listened to, and both they and their partners valued staff helping fathers to feel involved during the birth.
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Affiliation(s)
- A Sawyer
- School of Psychology, University of Sussex, Brighton, UK
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