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DeMaria AL, Meier S, King H, Sidorowicz H, Seigfried-Spellar KC, Schwab-Reese LM. The role of community healthcare professionals in discussing sexual assault experiences during obstetrics and gynecological healthcare appointments. BMC Womens Health 2023; 23:263. [PMID: 37189119 PMCID: PMC10184971 DOI: 10.1186/s12905-023-02401-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 04/28/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Nearly half of adult women in the US report experiencing sexual assault, with almost one-fifth reporting rape. For many sexual assault survivors, healthcare professionals are the first point of contact and disclosure. This study aimed to understand how healthcare professionals working in community settings perceived their role in discussing sexual violence experiences with women during obstetrical and gynecological healthcare appointments. The secondary purpose was to compare healthcare professionals' perspectives with the patients' to determine how sexual violence conversations should occur in these environments. METHODS Data were collected in two phases. Phase 1 consisted of 6 focus groups (Sept-Dec, 2019) with women aged 18-45 (n = 22) living in Indiana who sought community-based or private healthcare for women's reproductive healthcare needs. Phase 2 included 20 key-informant interviews with non-physician healthcare professionals (i.e., NP, RN, CNM, doula, pharmacist, chiropractor) living in Indiana (September 2019-May 2020) who provided community-based women's reproductive healthcare. Focus groups and interviews were audio-recorded, transcribed, and analyzed using thematic analyses. HyperRESEARCH assisted in data management and organization. RESULTS There were three resulting themes: (1) healthcare professionals' approaches to screening for a history of sexual violence varied depending on how they ask, what setting they work in, and type of professional asking; (2) healthcare experiences can compound traumatic experiences and create distrust with survivors; and (3) sexual violence impacts patient healthcare experiences through what services they seek, how professionals may interact with them, and what professionals they are willing to utilize. CONCLUSIONS Findings offered insight into actionable and practical strategies for enhancing sexual violence screening and discussions in community-based women's reproductive health settings. The findings offer strategies to address barriers and facilitators among community healthcare professionals and the people they serve. Incorporating healthcare professional and patient experiences and preferences for violence-related discussions during obstetrical and gynecological healthcare appointments can assist in violence prevention efforts, improve patient-professional rapport, and yield better health outcomes.
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Affiliation(s)
- Andrea L DeMaria
- Department of Public Health, College of Health and Human Sciences, Purdue University, 812 West State Street, 47907, West Lafayette, IN, USA.
- Division of Consumer Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA.
| | - Stephanie Meier
- Division of Consumer Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
| | - Hannah King
- Department of Public Health, College of Health and Human Sciences, Purdue University, 812 West State Street, 47907, West Lafayette, IN, USA
| | - Haley Sidorowicz
- Department of Biological Sciences, College of Science, Purdue University, West Lafayette, IN, USA
| | - Kathryn C Seigfried-Spellar
- Department of Computer and Information Technology, Polytechnic Institute, Purdue University, West Lafayette, IN, USA
| | - Laura M Schwab-Reese
- Department of Public Health, College of Health and Human Sciences, Purdue University, 812 West State Street, 47907, West Lafayette, IN, USA
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Borghei NS, Ebady T, Bayrami R, Nikbakht R. Determining the status of preconception care model in pregnant woman of Gorgan city (North of Iran) using structural equation modeling (SEM). JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:240. [PMID: 36177427 PMCID: PMC9514249 DOI: 10.4103/jehp.jehp_1284_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/30/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Preconception reduces unplanned pregnancies and plays an important role in reducing maternal and infant mortality. Considering the importance of these care services, this study was conducted to determine the status of preconception care (PCC) model with Structural Equation Modeling (SEM). MATERIALS AND METHODS This cross-sectional descriptive study was conducted on 394 pregnant women referring to Gorgan's health centers. Samples were selected by multi-stage stratified sampling method. The instrument used in this research was a researcher-made questionnaire by Bayrami. Data were analyzed using R software version 4.1.4. Structural equation modeling (SEM) with weighted least square mean and variance method was used to fit the conceptual model and the significance level of the tests was considered 0.05. RESULTS The results showed that PCC model was deemed appropriate as optimum conditions indicators of goodness of fit; knowledge with a coefficient of 0.182 leads to self-efficacy (SE), and SE affects the accessibility of facilities with a coefficient of 0.465 and the expected outcome with a coefficient of 0.500. After facility structure with a coefficient of 0.500, SE construct with a coefficient of 0.215 had the most effect on performing PCC behavior. CONCLUSIONS Facilities and SE as a key element of empowerment have an important role in promoting PCC. Identifying the factors associated with this care appears to help health policymakers to planning for these caregivers more precise and sensitive.
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Affiliation(s)
- Narjes Sadat Borghei
- Department of Midwifery, School of Nursing and Midwifery, Counseling and Reproductive Health Research Centre, Golestan University of Medical Sciences, Gorgan, Iran
| | - Tayebeh Ebady
- Department of Midwifery, School of Nursing and Midwifery, Counseling and Reproductive Health Research Centre, Golestan University of Medical Sciences, Gorgan, Iran
| | - Roghaieh Bayrami
- Department of Midwifery, School of Nursing and Midwifery, Patient Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Roya Nikbakht
- Department of Biostatistics and Epidemiology, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
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Ebadi T, Narjes Sadat B, Bayrami R, Mehrbakhsh Z. Preconception Care Patterns and Some Related Factors in Pregnant Women in Gorgan in 2017. JOURNAL OF RESEARCH DEVELOPMENT IN NURSING AND MIDWIFERY 2019. [DOI: 10.29252/jgbfnm.16.2.30] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Boutain DM, Foreman SW, Hitti JE. Interconception Challenges of Women Who Had Prior Preterm Births. J Obstet Gynecol Neonatal Nurs 2017; 46:209-219. [PMID: 28108231 DOI: 10.1016/j.jogn.2016.11.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2016] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To describe the interconception challenges of women who had prior preterm births. DESIGN We used a cross-sectional design and collected data via survey. SETTING King County, Washington. PARTICIPANTS Ninety-two women who had prior early preterm births (20-33 weeks gestation) were included. METHODS Women were recruited from a larger study focused on exploring the infectious pathways for early preterm birth. Participants were interviewed once using open-ended and close-ended surveys. The primary open-ended survey question was What are the five greatest challenges you experience now? We analyzed data using inductive and summative content analysis and descriptive statistics. RESULTS Ninety-one participants described challenges. One participant had no challenge. We categorized 11 challenges during the interconception period: Mothering (n = 70, 76%), Self-Care Desires (n = 35, 38%), Finances (n = 31, 34%), Employment (n = 31, 34%), Partner Relationships (n = 29, 32%), Individualized Concerns (n = 25, 27%), Mental Health (n = 23, 25%), Balance (n = 22, 24%), Physical Health (n = 19, 21%), Housing (n = 18, 20%), and Family (n = 17, 19%). CONCLUSION Participants described an array of challenges that often related to their roles as mothers, employees, and partners. Our research advances knowledge by describing contemporary challenges of women during the interconception period.
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Rosener SE, Barr WB, Frayne DJ, Barash JH, Gross ME, Bennett IM. Interconception Care for Mothers During Well-Child Visits With Family Physicians: An IMPLICIT Network Study. Ann Fam Med 2016; 14:350-5. [PMID: 27401423 PMCID: PMC4940465 DOI: 10.1370/afm.1933] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 01/04/2016] [Indexed: 12/17/2022] Open
Abstract
PURPOSE Interconception care (ICC) is recommended to improve birth outcomes by targeting maternal risk factors, but little is known about its implementation. We evaluated the frequency and nature of ICC delivered to mothers at well-child visits and maternal receptivity to these practices. METHODS We surveyed a convenience sample of mothers accompanying their child to well-child visits at family medicine academic practices in the IMPLICIT (Interventions to Minimize Preterm and Low Birth Weight Infants Through Continuous Improvement Techniques) Network. Health history, behaviors, and the frequency of the child's physician addressing maternal depression, tobacco use, family planning, and folic acid supplementation were assessed, along with maternal receptivity to advice. RESULTS Three-quarters of the 658 respondents shared a medical home with their child. Overall, 17% of respondents reported a previous preterm birth, 19% reported a history of depression, 25% were smoking, 26% were not using contraception, and 58% were not taking folic acid. Regarding advice, 80% of mothers who smoked were counseled to quit, 59% reported depression screening, 71% discussed contraception, and 44% discussed folic acid. Screening for depression and family planning was more likely when the mother and child shared a medical home (P <.05). Most mothers, nearly 95%, were willing to accept health advice from their child's physician regardless of whether a medical home was shared (P >.05). CONCLUSIONS Family physicians provide key elements of ICC at well-child visits, and mothers are highly receptive to advice from their child's physician even if they receive primary care elsewhere. Routine integration of ICC at these visits may provide an opportunity to reduce maternal risk factors for adverse subsequent birth outcomes.
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Affiliation(s)
- Stephanie E Rosener
- Middlesex Hospital Family Medicine Residency Program, Middletown, Connecticut
| | - Wendy B Barr
- Lawrence Family Medicine Residency Program, Lawrence, Massachusetts
| | - Daniel J Frayne
- MAHEC Family Medicine Residency Program, Asheville, North Carolina
| | - Joshua H Barash
- Department of Family & Community Medicine, Jefferson Medical College, Philadelphia, Pennsylvania
| | | | - Ian M Bennett
- Department of Family Medicine, University of Washington, Seattle, Washington
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Abstract
The aim of interconception care is to provide women who have had a prior adverse pregnancy outcome with optimal care in order to reduce risks that may affect the woman׳s health and any future birth she may choose to have. National recommendations call for action, and evidence supports specific clinical interventions. The need for interconception care is documented in national and state survey and surveillance data. Chronic diseases and behavioral risks affect the health of millions of U.S. women of childbearing age. Interconception care demonstration projects have used a "disease management" approach that includes medical care and case management. The increasing use of postpartum visits, as a gateway to interconception interventions, is essential. The Affordable Care Act emphasis on preventive services and expanded health coverage for women offers new opportunities to finance interconception care. Improved and enhanced clinical practices, along with the engagement of women, in interconception care have the potential to improve birth outcomes and reduce disparities.
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Affiliation(s)
- Kay A Johnson
- Department of Pediatrics, Geisel Medical School at Dartmouth, Lebanon, NH
| | - Rebekah E Gee
- Departments of Health Policy and Management, Schools of Public Health and Medicine, Louisiana State University, 2020 Gravier St, New Orleans, LA; Departments of Obstetrics and Gynecology, Schools of Public Health and Medicine, Louisiana State University, New Orleans, LA.
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Abstract
OBJECTIVE A comprehensive treatment program for schizophrenia needs to include services to women of childbearing age that address contraception, pregnancy, and postpartum issues, as well as safe and effective parenting. To update knowledge in these areas, a summary of the recent qualitative and quantitative literature was undertaken. METHOD The search terms 'sexuality,''contraception,''pregnancy,''postpartum,''custody,' and 'parenting' were entered into PubMed, PsycINFO, and SOCINDEX along with the terms 'schizophrenia' and 'antipsychotic.' Publications in English for all years subsequent to 2000 were retrieved and their reference lists further searched in an attempt to arrive at a distillation of useful clinical recommendations. RESULTS The main recommendations to care providers are as follows: take a sexual history and initiate discussion about intimate relationships and contraception with all women diagnosed with schizophrenia. During pregnancy, adjust antipsychotic dose to clinical status, link the patient with prenatal care services, and help her prepare for childbirth. There are pros and cons to breastfeeding while on medication, and these need thorough discussion. During the postpartum period, mental health home visits should be provided. Parenting support is critical. CONCLUSION The comprehensive treatment of schizophrenia in women means remembering that all women of childbearing age are potential new mothers.
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Affiliation(s)
- M V Seeman
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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Rowley DL, Hogan V. Disparities in infant mortality and effective, equitable care: are infants suffering from benign neglect? Annu Rev Public Health 2012; 33:75-87. [PMID: 22224890 DOI: 10.1146/annurev-publhealth-031811-124542] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Quality care for infant mortality disparity elimination requires services that improve health status at both the individual and the population level. We examine disparity reduction due to effective care and ask the following question: Has clinical care ameliorated factors that make some populations more likely to have higher rates of infant mortality compared with other populations? Disparities in postneonatal mortality due to birth defects have emerged for non-Hispanic black and Hispanic infants. Surfactant and antenatal steroid therapy have been accompanied by growing disparities in respiratory distress syndrome mortality for black infants. Progesterone therapy has not reduced early preterm birth, the major contributor to mortality disparities among non-Hispanic black and Puerto Rican infants. The Back to Sleep campaign has minimally reduced SIDS disparities among American Indian/Alaska Native infants, but it has not reduced disparities among non-Hispanic black infants. In general, clinical care is not equitable and contributes to increasing disparities.
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Affiliation(s)
- Diane L Rowley
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599-7445, USA.
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Malnory ME, Johnson TS. The reproductive life plan as a strategy to decrease poor birth outcomes. J Obstet Gynecol Neonatal Nurs 2011; 40:109-19; quiz 120-1. [PMID: 21309093 DOI: 10.1111/j.1552-6909.2010.01203.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The purpose of this article is to discuss the importance of implementing a life course perspective model that includes a reproductive life plan to improve health outcomes, especially in populations at risk for adverse outcomes. A reproductive life plan is a comprehensive strategy that can be incorporated into nursing practice at all levels to improve birth outcomes. Health care providers, especially nurses, should incorporate reproductive life planning into their daily encounters with patients.
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Affiliation(s)
- Margaret E Malnory
- Wheaton Franciscan Healthcare-All Saints, 3821 Spring Street, Racine, WI 53405, USA
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Park YC, Park SC, Park MI. The preconception stress and mental health of couples. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2011. [DOI: 10.5124/jkma.2011.54.8.832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Yong Chon Park
- Department of Neuropsychiatry, Hanyang University College of Medicine, Seoul, Korea
| | - Seon-Cheol Park
- Department of Neuropsychiatry, Hanyang University College of Medicine, Seoul, Korea
| | - Moon-Il Park
- Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Korea
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Kelley M, Rubens CE. Global report on preterm birth and stillbirth (6 of 7): ethical considerations. BMC Pregnancy Childbirth 2010; 10 Suppl 1:S6. [PMID: 20233387 PMCID: PMC2841776 DOI: 10.1186/1471-2393-10-s1-s6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Despite the substantial global burden of preterm and stillbirth, little attention has been given to the ethical considerations related to research and interventions in the global context. Ethical dilemmas surrounding reproductive decisions and the care of preterm newborns impact the delivery of interventions, and are not well understood in low-resource settings. Issues such as how to address the moral and cultural attitudes surrounding stillbirths, have cross-cutting implications for global visibility of the disease burden. This analysis identifies ethical issues impacting definitions, discovery, development, and delivery of effective interventions to decrease the global burden of preterm birth and stillbirth. METHODS This review is based on a comprehensive literature review; an ethical analysis of other articles within this global report; and discussions with GAPPS's Scientific Advisory Council, team of international investigators, and a community of international experts on maternal, newborn, and child health and bioethics from the 2009 International Conference on Prematurity and Stillbirth. The literature review includes articles in PubMed, Academic Search Complete (EBSCO), and Philosopher's Index with a range of 1995-2008. RESULTS Advancements in discovery science relating to preterm birth and stillbirth require careful consideration in the design and use of repositories containing maternal specimens and data. Equally important is the need to improve clinical translation from basic science research to delivery of interventions, and to ensure global needs inform discovery science agenda-setting. Ethical issues in the development of interventions include a need to balance immediate versus long-term impacts--such as caring for preterm newborns rather than preventing preterm births. The delivery of interventions must address: women's health disparities as determinants of preterm birth and stillbirth; improving measurements of impact on equity in coverage; balancing maternal and newborn outcomes in choosing interventions; and understanding the personal and cross-cultural experiences of preterm birth and stillbirth among women, families and communities. CONCLUSION Efforts to improve visibility, funding, research and the successful delivery of interventions for preterm birth and stillbirth face a number of ethical concerns. Thoughtful input from those in health policy, bioethics and international research ethics helped shape an interdisciplinary global action agenda to prevent preterm birth and stillbirth.
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Affiliation(s)
- Maureen Kelley
- Department of Pediatrics, Bioethics Division, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington, USA.
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