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Paxino J, Molloy E, Denniston C, Abdelmotaleb R, Woodward-Kron R. The work performed through interprofessional meeting discourse: an observational study. J Interprof Care 2024; 38:652-663. [PMID: 38678369 DOI: 10.1080/13561820.2024.2343833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 04/09/2024] [Indexed: 04/29/2024]
Abstract
The effectiveness of work performed through interprofessional practice is contingent on the nature and extent of communication between professionals. To date, there is little research exploring how the patterns of communication may impact interprofessional work. This study focused on communication during interprofessional meetings to better understand the interprofessional work performed through these encounters. Specifically, it examined how interactional discourse, that is, the patterns of language, influenced work performed during interprofessional meetings. A series of four interprofessional meetings in a rehabilitation unit were observed. Twenty-one participants were observed, including medical, nursing, allied health clinicians, and health professions students. Follow-up stimulated-recall interviews were conducted with five meeting participants. The data collection consisted of video and audio recordings and detailed field notes. Data were analyzed using a combination of genre analysis, a form of discourse analysis, and activity system analysis, drawing on Cultural Historical Activity Theory. This facilitated an in-depth examination of the structure of discourse and its influence on meeting outcomes. The meeting structure was defined and predictable. Two distinct forms of discourse were identified and labeled scripted and unscripted. Scripted discourse was prompted by standardized documents and facilitated the completion of organizational work. In contrast, unscripted discourse was spontaneous dialogue used to co-construct knowledge and contributed to collaboration. There was constant shifting between scripted and unscripted discourse throughout meetings which was orchestrated by experienced clinicians. Rather than fragmenting the discussion, this shifting enabled shared decision making. This research provides further insights into the interprofessional work performed during interprofessional meetings. The scripted discourse was highly influenced by artifacts (communication tools) in meetings, and these were used to ensure organizational imperatives were met. Unscripted discourse facilitated not only new insights and decisions but also social cohesion that may influence work within and outside the meeting.
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Affiliation(s)
- Julia Paxino
- Department of Medical Education, Melbourne Medical School, The University of Melbourne, Parkville, Australia
- Department of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia
| | - Elizabeth Molloy
- Department of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia
| | - Charlotte Denniston
- Department of Medical Education, Melbourne Medical School, The University of Melbourne, Parkville, Australia
| | | | - Robyn Woodward-Kron
- Department of Medical Education, Melbourne Medical School, The University of Melbourne, Parkville, Australia
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2
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Leyland A, Choucri L. Student midwives' lived experiences of caring for bereaved parents following perinatal loss using actor-based simulation: A phenomenological study. Midwifery 2024; 130:103913. [PMID: 38241799 DOI: 10.1016/j.midw.2023.103913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 11/30/2023] [Accepted: 12/21/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND Student midwives frequently encounter bereaved parents in clinical practice; however, the experience of caring for bereaved parents can be a significant source of traumatic stress. Although the use of simulation to teach bereavement care is considered a powerful experiential form of learning, evidence for its effectiveness as a transformative learning strategy is limited. AIM To explore student midwives' lived experience of caring for bereaved parents experiencing perinatal loss using high-fidelity simulation. DESIGN Students midwives participated in an actor-based bereavement simulated scenario. Data was collected using semi-structured interviews. Interpretative Phenomenological Analysis was conducted to gain a deep understanding of the meaning of the experience. Mezirow's Transformative Learning Theory was applied as an analytical framework to illustrate how the student midwives made sense of and learned from the experience of caring for bereaved parents experiencing perinatal loss. SETTING One BSc (Hons), 156-week undergraduate midwifery programme within a university in the Northwest of England. PARTICIPANTS A purposeful sample of nine first-and second-year student midwives volunteered to participate in the study. FINDINGS One of the superordinate themes that emerged from the analysis (1) 'trying to console and making things easier' and the related subthemes (1a)'what words can I say', (1b)'my instinct was to console the mum', (1c)'left to sort of pick up the pieces' captured the deep sense of powerlessness and the professional dilemmas experienced as students struggled to emotionally console and communicate the right words to say to the grieving parents. CONCLUSION The study highlights the vital role of simulation as a defined model of bereavement education that equips students with the necessary knowledge, skills, and confidence to provide compassionate care to bereaved parents experiencing perinatal loss. IMPLICATIONS FOR PRACTICE The emotional toll of caring for bereaved parents is significant, and higher education institutions should adopt experiential forms of learning using actor-based simulation scenarios to emotionally prepare students to care holistically for parents affected by perinatal loss.
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Affiliation(s)
- Anne Leyland
- University of Salford, School of Health & Society, Frederick Road, Salford M6 6PU, UK.
| | - Lesley Choucri
- University of Salford, School of Health & Society, Frederick Road, Salford M6 6PU, UK
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3
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Khaw SML, Homer CSE, Dearnley R, O'Rourke K, Akter S, Bohren MA. Collaborative relationships between doulas and maternity care providers when supporting migrant women during labour and birth. Midwifery 2023; 125:103791. [PMID: 37611332 DOI: 10.1016/j.midw.2023.103791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 06/30/2023] [Accepted: 08/08/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVE To explore the perspectives and experiences of community-based doulas and maternity care providers working with each other in Australia; and to identify the facilitators and barriers to working relationships when supporting migrant women during labour and birth. DESIGN AND METHODS A qualitative interpretive phenomenological study using in-depth semi-structured interviews. An inductive thematic approach and Capability, Opportunity, and Motivation (COM-B) framework were used in data analysis. SETTING AND PARTICIPANTS 10 doulas from Birth for Humankind (a community-based doula service), and 13 maternity care providers from a tertiary maternity hospital in Melbourne, Australia were included. FINDINGS We identified how collaborative working relationships between community-based doulas and maternity care providers may be enhanced by adopting facilitators across all three COM-B domains and by removing identified barriers. Factors facilitating collaborative working relationships included: knowledge and value of doula roles, establishment of rapport and trust between doulas and providers; doulas enhancing respectful care, communication and relationships between migrant women and providers; and community-based doulas differentiated from private practising doulas. Barriers included: limited understanding of doula roles and service; limiting behaviours impacting collaborative relationships; and limited opportunities for doulas and providers to establish rapport. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Findings are relevant to other models of doula care including private practice doulas and hospital-based doula services. Positive, collaborative doula-provider working relationships are integral for ensuring that the benefits of doula care continue to reach underserved populations such as migrant women and improve their maternity care experiences and outcomes within hospitals settings.
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Affiliation(s)
- Sarah Min-Lee Khaw
- Gender and Women's Health Unit, Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 2, 32 Lincoln Square North, Carlton, VIC 3053, Australia.
| | - Caroline S E Homer
- Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC 3004, Australia. https://twitter.com/https://twitter.com/CarolineHomer
| | - Red Dearnley
- Birth for Humankind, 552 Victoria Street, North Melbourne, VIC 3051, Australia. https://twitter.com/https://twitter.com/saidruth
| | - Kerryn O'Rourke
- Realist Research Evaluation and Learning Initiative, Northern Institute, Faculty of Arts and Society, Charles Darwin University, Ellengowan Drive, Brinkin, NT 0909, Australia. https://twitter.com/https://twitter.com/kerrynorourke
| | - Shahinoor Akter
- Gender and Women's Health Unit, Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 2, 32 Lincoln Square North, Carlton, VIC 3053, Australia. https://twitter.com/https://twitter.com/Dr_Shahinoor_A
| | - Meghan A Bohren
- Gender and Women's Health Unit, Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 2, 32 Lincoln Square North, Carlton, VIC 3053, Australia. https://twitter.com/https://twitter.com/meghanbohren
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Keedle H, Tomczak K, Lequertier B, Dahlen HG. Feeling anxious'- women's experiences of having a baby in Australia during the COVID-19 pandemic using the Voqual real time app. BMC Pregnancy Childbirth 2023; 23:670. [PMID: 37726659 PMCID: PMC10507989 DOI: 10.1186/s12884-023-05993-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 09/12/2023] [Indexed: 09/21/2023] Open
Abstract
PURPOSE Internationally, the COVID-19 pandemic impacted maternity services. In Australia, this included changes to antenatal appointments and the reduction of support people during labour and birth. For women pregnant during the pandemic there were increased stressors of infection in the community and in hospitals along with increased periods of isolation from friends and families during lockdown periods. The aim of this study was to explore the real-time experiences of women who were pregnant and had a baby during the first wave of the COVID-19 pandemic in Australia. METHODS This study followed seven women throughout their pregnancy and early parenthood. Women created audio or video recordings in real time using the Voqual app and were followed up by in-depth interviews after they gave birth. RESULTS Using narrative analysis their individual stories were compared and an overarching theme of 'feeling anxious' was found which was underpinned by the two themes 'model of care' and 'environment'. CONCLUSIONS These findings highlight the protective impact midwifery continuity of care has on reducing anxiety in women during the pandemic, and that the home environment can either be secure and safe or a place of isolation.
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Affiliation(s)
- Hazel Keedle
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Kimberley Tomczak
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Belinda Lequertier
- Molly Wardaguga Research Centre, School of Nursing and Midwifery, Charles Darwin University, Level 11, 410 Ann Street, Brisbane, QLD, 4000, Australia
| | - Hannah G Dahlen
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
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Tafe A, Cummins A, Catling C. Exploring women's experiences in a midwifery continuity of care model following a traumatic birth. Women Birth 2023:S1871-5192(23)00019-7. [PMID: 36774286 DOI: 10.1016/j.wombi.2023.01.006] [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: 08/20/2022] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 02/12/2023]
Abstract
PROBLEM Over one third of women report their birth experience as psychologically traumatic. Psychological birth trauma has been associated with perinatal mental illness and post-traumatic stress disorder. BACKGROUND Midwifery continuity of care provides improved outcomes for mothers and babies as well as increased birth satisfaction. Some women who have experienced psychological birth trauma will seek out midwifery continuity of care in their next pregnancy. The aim of this study was to explore women's experiences of midwifery continuity of care following a previous traumatic birth experience in Australia. METHODS A qualitative descriptive approach was undertaken. Eight multiparous women who self-identified as having psychological birth trauma were interviewed. Data were analysed using thematic analysis to discover how participants subsequently experienced care in a midwifery continuity of care model. FINDINGS Seven out of eight participants had care from a private midwife following birth trauma. Four themes were discovered. The nightmare lives on: despite a positive and/or healing experience in midwifery continuity of care, women still carry their traumatic birth experiences with them. Determination to find better care: Women sought midwifery continuity of care following a previous traumatic birth in their desire to prevent a similar experience. A broken maternity system: women described difficulties accessing these models including financial barriers and lack of availability. The power of continuity: All reported a positive experience birthing in a midwifery continuity of care model and some reported that this had a healing effect. CONCLUSION Offering midwifery continuity of care models to women with a history of psychological birth trauma can be beneficial. More research is necessary to confirm the findings of this small study, and on ways women who have psychological birth trauma can be prioritised for midwifery continuity of care models in Australia.
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Affiliation(s)
- Annabel Tafe
- Collaborative of Midwifery, Child and Family Health, School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Australia.
| | - Allison Cummins
- School of Nursing and Midwifery, College of Health Medicine and Wellbeing, University of Newcastle, Australia
| | - Christine Catling
- Collaborative of Midwifery, Child and Family Health, School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Australia
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6
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Coddington R, Fox D, Scarf V, Catling C. Getting kicked off the program: Women's experiences of antenatal exclusion from publicly-funded homebirth in Australia. Women Birth 2023; 36:e179-e185. [PMID: 35764492 DOI: 10.1016/j.wombi.2022.06.008] [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: 12/16/2021] [Revised: 06/09/2022] [Accepted: 06/20/2022] [Indexed: 01/25/2023]
Abstract
PROBLEM Eligibility criteria for publicly-funded homebirth models are strict and, as such, many women who initially plan a homebirth later become excluded. BACKGROUND Fifteen publicly-funded homebirth programs are operating in Australia, offering eligible women the opportunity to give birth at home at no cost, with the care of a hospital-employed midwife. AIM To explore the experiences of women who planned a publicly-funded homebirth and were later excluded due to pregnancy complications or risk factors. METHODS A qualitative descriptive approach was taken. Recruitment was via social media sites specifically related to homebirth in Australia. Data collection involved semi-structured telephone interviews. Transcripts were thematically analysed. FINDINGS Thirteen women participated. They were anxious about 'Jumping through hoops' to maintain their low-risk status. After being 'Kicked off the program', women carefully 'negotiated the system' in order to get the birth they wanted in hospital. Some women felt bullied and coerced into complying with hospital protocols that did not account for their individual needs. Maintaining the midwife-woman relationship was a protective factor, decreasing negative experiences. DISCUSSION Women plan a homebirth to avoid the medicalised hospital environment and to gain access to continuity of midwifery care. To provide maternity care that is acceptable to women, hospital institutions need to design services that enable continuity of the midwife-woman relationship and assess risk on an individual basis. CONCLUSION Exclusion from publicly-funded homebirth has the potential to negatively impact women who may feel a sense of loss, uncertainty or emotional distress related to their planned place of birth.
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Affiliation(s)
- Rebecca Coddington
- Centre for Midwifery, Child and Family Health, University of Technology Sydney, Australia.
| | - Deborah Fox
- Centre for Midwifery, Child and Family Health, University of Technology Sydney, Australia. https://twitter.com/@debjfox
| | - Vanessa Scarf
- Centre for Midwifery, Child and Family Health, University of Technology Sydney, Australia. https://twitter.com/@VScarf
| | - Christine Catling
- Centre for Midwifery, Child and Family Health, University of Technology Sydney, Australia. https://twitter.com/@ChristineCatli1
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Brigante L, Coxon K, Fernandez Turienzo C, Sandall J. "She was there all the time". A qualitative study exploring how women at higher risk for preterm birth experience midwifery continuity of care. Women Birth 2023:S1871-5192(23)00016-1. [PMID: 36682950 DOI: 10.1016/j.wombi.2023.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023]
Abstract
PROBLEM There is a paucity of research on experiences and views of women at higher risk of preterm birth of midwifery continuity of care. BACKGROUND Midwifery continuity of care (MCoC) has been associated with improved maternal outcomes and with lower levels of preterm births and stillbirths. The majority of MCoC studies have focused on women without risk factors and little has been published on women with obstetric complexities. The aim of this study is to explore the views and experiences of women identified as a higher risk of preterm birth who have had continuity of care from midwives. DESIGN Face-to-face, semi-structured interviews with 16 women identified as at increased risk of preterm birth and experienced continuity of midwifery care across pregnancy, birth and the postnatal period. Care had been provided by the pilot intervention group for the pilot study of midwifery practice in preterm birth including women's experiences (POPPIE) trial. FINDINGS Women valued continuity of midwifery care across the care pathway and described the reassurance provided by having 24 h a day, seven days a week access to known midwives. Consistency of care, advocacy and accessibility to the team were described as the main factors contributing to their feelings of safety and control. KEY CONCLUSIONS Recognising that known midwives were 'there all the time' made women feel listened to and actively involved in clinical decision making, which contributed to women feeling less stressed and anxious during their pregnancy, birth and early parenthood. When developing MCoC models for women with obstetric complexities: access, advocacy and time should be embedded to ensure women can build trusting relationships and reduce anxiety levels.
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Affiliation(s)
- L Brigante
- Department of Women and Children's Health, Faculty of Life Science and Medicine, King's College London, London, United Kingdom; The Royal College of Midwives, London, United Kingdom.
| | - K Coxon
- School of Education, Midwifery and Social Work. Faculty of Health, Science, Social Care and Education. Kingston University, London, United Kingdom
| | - C Fernandez Turienzo
- Department of Women and Children's Health, Faculty of Life Science and Medicine, King's College London, London, United Kingdom
| | - J Sandall
- Department of Women and Children's Health, Faculty of Life Science and Medicine, King's College London, London, United Kingdom
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8
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Webster L, Amador S, Rapaport P, Mukadam N, Sommerlad A, James T, Javed S, Roche M, Lord K, Bharadia T, Rahman-Amin M, Lang I, Livingston G. Tailoring STrAtegies for RelaTives for Black and South Asian dementia family carers in the United Kingdom: A mixed methods study. Int J Geriatr Psychiatry 2023; 38:e5868. [PMID: 36642866 PMCID: PMC10107806 DOI: 10.1002/gps.5868] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 01/06/2023] [Indexed: 01/12/2023]
Abstract
OBJECTIVES We culturally adapted STrAtegies for RelaTives (START), a clinically and cost-effective intervention for dementia family carers, for Black and South Asian families. It had previously been delivered to family carers around the time of diagnosis, when most people with dementia had very mild, mild or moderate dementia. METHODS We interviewed a maximum variation sample of family carers (phase one; n = 15 South Asian; n = 11 Black) about what aspect of START, required cultural adaptation, then analysed it thematically using the Cultural Treatment Adaptation Framework then adapted it in English and into Urdu. Facilitators then delivered START individually to carers (phase two; n = 13 South Asian; n = 8 Black). We assessed acceptability and feasibility through the number of sessions attended, score for fidelity to the intervention and interviewing family carers about their experiences. We used the Hospital Anxiety and Depression Scale. to examine whether immediate changes in family carers' mental health were in line with previous studies. RESULTS In phase one we made adaptations to peripheral elements of START, clarifying language, increasing illustrative vignettes numbers, emphasising privacy and the facilitator's cultural competence and making images ethnically diverse. In phase two 21 family carers consented to receive the adapted intervention; 12 completed ≥5/8 sessions; four completed fewer sessions and five never started. Baseline HADS score (n = 21) was 14.4 (SD = 9.8) but for those who we were able to follow up was 12.3 (SD 8.1) and immediately post-intervention was 11.3 (n = 10; SD = 6.1). Family carers were positive about the adapted START and continued to use elements after the intervention. CONCLUSIONS Culturally adapted START was acceptable and feasible in South Asian and Black UK-based family carers and changes in mental health were in line with those in the original clinical trial. Our study shows that culturally inclusive START was also acceptable. Changes made in adaptations were relevant to all populations. We now use the adapted version for all family carers irrespective of ethnicity.
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Affiliation(s)
- Lucy Webster
- Division of Psychiatry, UCL, London, UK.,Centre for Health Services Studies, University of Kent, Canterbury, UK
| | | | - Penny Rapaport
- Division of Psychiatry, UCL, London, UK.,Camden and Islington NHS Foundation Trust, London, UK
| | - Naaheed Mukadam
- Division of Psychiatry, UCL, London, UK.,Camden and Islington NHS Foundation Trust, London, UK
| | - Andrew Sommerlad
- Division of Psychiatry, UCL, London, UK.,Camden and Islington NHS Foundation Trust, London, UK
| | | | | | | | - Kathryn Lord
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| | - Trishna Bharadia
- Patient and Public Representative & Patient Author, Buckinghamshire, UK
| | | | - Iain Lang
- Exeter Medical School, University of Exeter, Exeter, UK
| | - Gill Livingston
- Division of Psychiatry, UCL, London, UK.,Camden and Islington NHS Foundation Trust, London, UK
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9
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Brewster DJ, Butt WW, Gordon LJ, Sarkar MA, Begley JL, Rees CE. Leadership during airway management in the intensive care unit: A video-reflexive ethnography study. Front Med (Lausanne) 2023; 10:1043041. [PMID: 36873881 PMCID: PMC9980339 DOI: 10.3389/fmed.2023.1043041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/25/2023] [Indexed: 02/18/2023] Open
Abstract
Effective leadership is crucial to team performance within the intensive care unit. This novel study aimed to explore how staff members from an intensive care unit conceptualize leadership and what facilitators and barriers to leadership exist within a simulated workplace. It also aimed to identify factors that intersect with their perceptions of leadership. This study was underpinned by interpretivism, and video-reflexive ethnography was chosen as the methodology for the study. The use of both video recording (to capture the complex interactions occurring in the ICU) and team reflexivity allowed repeated analysis of those interactions by the research team. Purposive sampling was used to recruit participants from an ICU in a large tertiary and private hospital in Australia. Simulation groups were designed to replicate the typical clinical teams involved in airway management within the intensive care unit. Twenty staff participated in the four simulation activities (five staff per simulation group). Each group simulated the intubations of three patients with hypoxia and respiratory distress due to severe COVID-19. All 20 participants who completed the study simulations were invited to attend video-reflexivity sessions with their respective group. Twelve of the 20 participants (60%) from the simulations took part in the reflexive sessions. Video-reflexivity sessions (142 min) were transcribed verbatim. Transcripts were then imported into NVivo software for analysis. The five stages of framework analysis were used to conduct thematic analysis of the video-reflexivity focus group sessions, including the development of a coding framework. All transcripts were coded in NVivo. NVivo queries were conducted to explore patterns in the coding. The following key themes regarding participants' conceptualizations of leadership within the intensive care were identified: (1) leadership is both a group/shared process and individualistic/hierarchical; (2) leadership is communication; and (3) gender is a key leadership dimension. Key facilitators identified were: (1) role allocation; (2) trust, respect and staff familiarity; and (3) the use of checklists. Key barriers identified were: (1) noise and (2) personal protective equipment. The impact of socio-materiality on leadership within the intensive care unit is also identified.
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Affiliation(s)
- David J Brewster
- Intensive Care Unit, Cabrini Hospital, Melbourne, VIC, Australia.,Monash Centre for Scholarship in Health Education, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia.,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Warwick W Butt
- Intensive Care Unit, Cabrini Hospital, Melbourne, VIC, Australia.,Royal Children's Hospital, Melbourne, VIC, Australia
| | - Lisi J Gordon
- Centre for Medical Education, School of Medicine, University of Dundee, Dundee, Scotland, United Kingdom
| | - Mahbub A Sarkar
- Monash Centre for Scholarship in Health Education, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Jonathan L Begley
- Intensive Care Unit, Cabrini Hospital, Melbourne, VIC, Australia.,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Charlotte E Rees
- Monash Centre for Scholarship in Health Education, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia.,School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
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10
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Atchan M, Graham K, Hartney N, Martis R, Kearney L, Davey K, Daellenbach R, Hall H, Sweet L. Either 'a blessing in disguise', or 'I couldn't get help,': Australian and Aotearoa NZ women's experiences of early infant feeding during COVID-19. Women Birth 2022; 36:e305-e313. [PMID: 36443218 PMCID: PMC9699799 DOI: 10.1016/j.wombi.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND To manage the COVID-19 pandemic, public health restrictions and a rapid pivot to telehealth occurred. Peripartum services were significantly affected by a strained infrastructure. Decreased face to face access to health services and support affected maternal experiences and confidence internationally, yet little was reported with the Australian and Aotearoa New Zealand context. AIM To explore the early parenting and infant feeding experiences of new mothers from Australia and Aotearoa New Zealand in the context of a pandemic. METHODS An interpretive qualitative approach and thematic analysis obtained an in-depth understanding of the experiences of 27 mothers who gave birth during the first wave of the COVID-19 pandemic in 2020. FINDINGS Australian and Aotearoa New Zealand women reported similar experiences, which varied contextually. Restrictions and requirements impacted favourably and unfavourably. Many women found the peace and space of social distancing an unexpected benefit and were proud of their achievements, whilst others shared feelings of isolation and distress. Some women felt they instinctively did what they needed to do. Experiences correlated with differing levels of self-efficacy. DISCUSSION While many women relished the freedom from social obligations when faced with feeding challenges, there was general dissatisfaction with the level of support available. Care was fragmented, and health care needs were unmet, impacting feeding and parenting decisions and mental health. CONCLUSION Access to timely and appropriate professional support is an important factor in establishing breastfeeding and developing parenting confidence, particularly in the context of a pandemic and should be a health policy priority.
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Affiliation(s)
- Marjorie Atchan
- School of Nursing, Midwifery and Public Health, University of Canberra, Locked Bag 1, Canberra, ACT 2617 Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia,Corresponding author at: School of Nursing, Midwifery and Public Health, University of Canberra, Locked Bag 1, Canberra, ACT 2617, Australia
| | - Kristen Graham
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Nicki Hartney
- Deakin University, School of Nursing and Midwifery, 1 Gheringhap St., Geelong, Vic. 3227 Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Ruth Martis
- Liggins Institute, The University of Auckland, Aotearoa, New Zealand,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Lauren Kearney
- The University of Queensland, School of Nursing, Midwifery & Social Work, Brisbane, QLD 4072 Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Kym Davey
- School of Nursing and Midwifery, Monash University, Peninsula campus, McMahons Rd, Frankston, VIC 3199 Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Rea Daellenbach
- Department of Health Practice, Ara Institute of Canterbury, New Zealand,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Helen Hall
- Institute of Health and Wellbeing, Federation University, Mt Helen Campus, Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Linda Sweet
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia,Institute of Health and Wellbeing, Federation University, Mt Helen Campus, Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
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Paxino J, Molloy E, Denniston C, Woodward-Kron R. Dynamic and distributed exchanges: an interview study of interprofessional communication in rehabilitation. Disabil Rehabil 2022:1-11. [PMID: 35802465 DOI: 10.1080/09638288.2022.2096125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Interprofessional communication (IPC) in rehabilitation is important for patient care yet it has been shown to be variable and challenging. Existing research does not address the complexity of IPC in this setting. Understanding the influence of contextual factors on IPC may guide improvements to increase the effectiveness of communication within interprofessional teams. METHODS From July 2020 to February 2021 semi-structured interviews were conducted with 24 healthcare professionals across Australia and New Zealand. Cultural Historical Activity Theory provided a guiding theoretical and analytical framework for this qualitative study. RESULTS Participants described engaging in IPC through evolving interactions, piecing together information that underpinned patient care. Meetings occurred frequently, however communication extended well beyond formalised interactions, often requiring individuals to balance clinical workload with communication tasks. IPC reportedly relied on communication tools, however navigating information from multiple sources was demanding. CONCLUSIONS Our results indicate that IPC contributes significantly to the workload of healthcare professionals in rehabilitation. IPC was integral in the provision of cohesive patient care, however it proved time consuming, effortful and at times frustrating and potentially erroneous. Our findings promote the need for rigorous examination of communication practices to ensure they are meeting the needs of an increasingly interprofessional workforce. IMPLICATIONS FOR REHABILITATIONHealthcare professionals should recognise that time spent communicating within their team is a legitimate and important part of patient care.Rehabilitation teams should consider how they allocate resources for communication tasks.Teams should reconsider how they can use communication more effectively to save time by reducing repetition and errors.
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Affiliation(s)
- Julia Paxino
- Department of Medical Education, The University of Melbourne, Melbourne, Australia
| | - Elizabeth Molloy
- Department of Medical Education, The University of Melbourne, Melbourne, Australia
| | - Charlotte Denniston
- Department of Medical Education, The University of Melbourne, Melbourne, Australia
| | - Robyn Woodward-Kron
- Department of Medical Education, The University of Melbourne, Melbourne, Australia
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Roth H, Morcos V, Roberts LM, Hanley L, Homer CSE, Henry A. Preferences of Australian healthcare providers regarding education on long-term health after hypertensive disorders of pregnancy: a qualitative study. BMJ Open 2022; 12:e055674. [PMID: 35618327 PMCID: PMC9137339 DOI: 10.1136/bmjopen-2021-055674] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore Australian healthcare providers' (HCPs') preferred content, format and access to education regarding long-term health after hypertensive disorder of pregnancy (HDP), in order to guide the development of education programmes. DESIGN AND SETTING A qualitative study using a framework analysis was undertaken. Registered HCP who were practising in Australia and previously completed a survey about long-term health after HDP were invited to participate. PARTICIPANTS Twenty HCP were interviewed, including midwives, specialist obstetrician/gynaecologists, general practitioners with a diploma in obstetrics and gynaecology, and cardiologists. PRIMARY AND SECONDARY OUTCOME MEASURES Exploration of preferred content, format and distribution of educational material post-HDP. RESULTS Twenty HCP were interviewed in April to May 2020. Four main categories were identified. 'Obtaining evidence-based information for own learning' addressing own learning with preference for multi-disciplinary education, preferably endorsed or facilitated by professional organisations. 'Optimising the referral process from hospital to community health services' was about the need for structured long-term follow-up to transition from hospital to community health and align with HDP guidelines. 'Facilitating women's health literacy' addressed the need for evidence-based, print or web-based material to assist risk discussions with women. 'Seizing educational opportunities' addressed the responsibility of all HCP to identify education opportunities to initiate key health discussions with women. CONCLUSIONS HCP provided ideas on content, format and access of education regarding long-term health post-HDP within the parameters of the Australian healthcare context. This evidence will guide educational developments for HCP on post-HDP health to ensure they can better care for women and families.
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Affiliation(s)
- Heike Roth
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- Discipline of Women's Health, University of New South Wales Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Centre for Midwifery, Child and Family Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Veronica Morcos
- Discipline of Women's Health, University of New South Wales Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Lynne M Roberts
- Discipline of Women's Health, University of New South Wales Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Women's and Children's Health, Saint George Hospital, Kogarah, New South Wales, Australia
| | - Lisa Hanley
- Maternity Consumer, Saint George Hospital, Kogarah, New South Wales, Australia
| | - Caroline S E Homer
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- Centre for Midwifery, Child and Family Health, University of Technology Sydney, Sydney, New South Wales, Australia
- Maternal, Child and Adolescent Health, Burnet Institute, Melbourne, Victoria, Australia
| | - Amanda Henry
- Discipline of Women's Health, University of New South Wales Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Women's Health, The George Institute for Global Health, Newtown, New South Wales, Australia
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Olmos-Vega FM, Stalmeijer RE, Varpio L, Kahlke R. A practical guide to reflexivity in qualitative research: AMEE Guide No. 149. MEDICAL TEACHER 2022; 45:1-11. [PMID: 35389310 DOI: 10.1080/0142159x.2022.2057287] [Citation(s) in RCA: 175] [Impact Index Per Article: 87.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Qualitative research relies on nuanced judgements that require researcher reflexivity, yet reflexivity is often addressed superficially or overlooked completely during the research process. In this AMEE Guide, we define reflexivity as a set of continuous, collaborative, and multifaceted practices through which researchers self-consciously critique, appraise, and evaluate how their subjectivity and context influence the research processes. We frame reflexivity as a way to embrace and value researchers' subjectivity. We also describe the purposes that reflexivity can have depending on different paradigmatic choices. We then address how researchers can account for the significance of the intertwined personal, interpersonal, methodological, and contextual factors that bring research into being and offer specific strategies for communicating reflexivity in research dissemination. With the growth of qualitative research in health professions education, it is essential that qualitative researchers carefully consider their paradigmatic stance and use reflexive practices to align their decisions at all stages of their research. We hope this Guide will illuminate such a path, demonstrating how reflexivity can be used to develop and communicate rigorous qualitative research.
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Affiliation(s)
| | - Renée E Stalmeijer
- Department of Educational Development and Research, School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Lara Varpio
- Department of Medicine and Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Renate Kahlke
- Division of Education and Innovation, Department of Medicine and Scientist, McMaster University, Hamilton, Canada
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Markey K, Noonan M, Doody O, Tuohy T, Daly T, Regan C, O’Donnell C. Fostering Collective Approaches in Supporting Perinatal Mental Healthcare Access for Migrant Women: A Participatory Health Research Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031124. [PMID: 35162147 PMCID: PMC8834132 DOI: 10.3390/ijerph19031124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/07/2022] [Accepted: 01/13/2022] [Indexed: 11/16/2022]
Abstract
Perinatal mental health is a growing public health concern. The mounting evidence examining the prevalence of perinatal mental illness identifies specific vulnerabilities and risk factors among migrant women. We know that migrant women experience persistent and systematic barriers in accessing healthcare and that healthcare services do not always respond appropriately to migrant women's needs, highlighting the need for targeted interventions in supporting positive perinatal mental health among migrant women. The purpose of this participatory health research study was to explore perinatal mental healthcare for migrant women in Ireland, from the perspectives of a diverse range of stakeholders (healthcare service providers, community organisations/networks/associations and migrant women). A key focus of this study was to collaboratively explore solution-focused approaches to improving access to supports and healthcare services for migrant women experiencing perinatal mental illness. Following ethical approval, data were collected during three key convenings, utilising the design principles of world café philosophies. Thematic analysis led to the generation of the following two themes: Building Capability and Capacity and Empowering Migrant Women. The main conclusions lie in the provision of whole-system approaches in collectively, collaboratively and proactively planning strategies that address the many factors that affect access to healthcare services for migrant women experiencing perinatal mental illness. Drawing on the collective perspectives of a wide range of stakeholders, our innovative solution focused on providing recommendations aimed at strengthening supports and healthcare services for migrant women.
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Affiliation(s)
- Kathleen Markey
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland; (M.N.); (O.D.); (T.T.); (C.O.)
- Correspondence:
| | - Maria Noonan
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland; (M.N.); (O.D.); (T.T.); (C.O.)
| | - Owen Doody
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland; (M.N.); (O.D.); (T.T.); (C.O.)
| | - Teresa Tuohy
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland; (M.N.); (O.D.); (T.T.); (C.O.)
| | - Tony Daly
- 80:20 Educating and Acting for a Better World, St. Cronan’s National School, A98 NW42 Wicklow, Ireland; (T.D.); (C.R.)
| | - Ciara Regan
- 80:20 Educating and Acting for a Better World, St. Cronan’s National School, A98 NW42 Wicklow, Ireland; (T.D.); (C.R.)
| | - Claire O’Donnell
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland; (M.N.); (O.D.); (T.T.); (C.O.)
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"It Makes My Skin Crawl": Women's experience of breastfeeding aversion response (BAR). Women Birth 2022; 35:582-592. [PMID: 35012885 DOI: 10.1016/j.wombi.2022.01.001] [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: 10/03/2021] [Revised: 12/01/2021] [Accepted: 01/03/2022] [Indexed: 11/23/2022]
Abstract
PROBLEM Some women who intend to breastfeed experience a breastfeeding aversion response (BAR) while breastfeeding. BACKGROUND Little is known about the experience of those who have feelings of aversion while breastfeeding. AIM This study aimed to investigate the experiences of women who have an aversion response to breastfeeding while their infant is latched at the breast. This is the first study that aims to understand this breastfeeding aversion response (BAR) as described by women who experience this phenomenon. METHODS Interpretative phenomenological analysis (IPA) was used to conduct and analyse ten semi-structured in-depth interviews with women who self-identified as experiencing BAR. FINDINGS Four overarching themes were identified: (1) Involuntary, strong sensations of aversion in response to the act of breastfeeding, (2) Internal conflict and effects on maternal identity, (3) The connection between BAR and relationships with others, and (4) Reflections on coping with BAR and building resilience. DISCUSSION Some women who intend to breastfeed can experience BAR, and this negative sensation conflicts with their desire to breastfeed. BAR can impact on maternal wellbeing. Those who experience BAR may benefit from person-centred support that directly addresses the challenges associated with BAR to achieve their personal breastfeeding goals. CONCLUSION The experience of BAR is unexpected and difficult for mothers. If support is not available, BAR can have detrimental effects on maternal identity, mother-child bonds, and intimate family relationships.
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Cassidy CE, Shin HD, Ramage E, Conway A, Mrklas K, Laur C, Beck A, Varin MD, Steinwender S, Nguyen T, Langley J, Dorey R, Donnelly L, Ormel I. Trainee-led research using an integrated knowledge translation or other research partnership approaches: a scoping reviews. Health Res Policy Syst 2021; 19:135. [PMID: 34727926 PMCID: PMC8561363 DOI: 10.1186/s12961-021-00784-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/12/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND There are increasing expectations for researchers and knowledge users in the health system to use a research partnership approach, such as integrated knowledge translation, to increase the relevance and use of research findings in health practice, programmes and policies. However, little is known about how health research trainees engage in research partnership approaches such as IKT. In response, the purpose of this scoping review was to map and characterize the evidence related to using an IKT or other research partnership approach from the perspective of health research trainees in thesis and/or postdoctoral work. METHODS We conducted this scoping review following the Joanna Briggs Institute methodology and Arksey and O'Malley's framework. We searched the following databases in June 2020: MEDLINE, Embase, CINAHL and PsycINFO. We also searched sources of unpublished studies and grey literature. We reported our findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. RESULTS We included 74 records that described trainees' experiences using an IKT or other research partnership approach to health research. The majority of studies involved collaboration with knowledge users in the research question development, recruitment and data collection stages of the research process. Intersecting barriers to IKT or other research partnerships at the individual, interpersonal and organizational levels were reported, including lack of skills in partnership research, competing priorities and trainees' "outsider" status. We also identified studies that evaluated their IKT approach and reported impacts on partnership formation, such as valuing different perspectives, and enhanced relevance of research. CONCLUSION Our review provides insights for trainees interested in IKT or other research partnership approaches and offers guidance on how to apply an IKT approach to their research. The review findings can serve as a basis for future reviews and primary research focused on IKT principles, strategies and evaluation. The findings can also inform IKT training efforts such as guideline development and academic programme development.
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Affiliation(s)
| | | | - Emily Ramage
- School of Health Sciences, University of Newcastle, Callaghan, Australia
| | - Aislinn Conway
- Better Outcomes and Registry Network (BORN), Ottawa, ON Canada
| | - Kelly Mrklas
- Alberta Health Services Foothills Medical Centre, Calgary, AB Canada
| | - Celia Laur
- Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, Canada
| | - Amy Beck
- Faculty of Nursing, University of Calgary, Calgary, AB Canada
| | | | | | - Tram Nguyen
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON Canada
| | - Jodi Langley
- School of Health and Human Performance, Dalhousie University, Halifax, NS Canada
| | | | | | - Ilja Ormel
- Department of Family Medicine, McGill University, Montreal, QC Canada
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Roth H, Henry A, Roberts L, Hanley L, Homer CSE. Exploring education preferences of Australian women regarding long-term health after hypertensive disorders of pregnancy: a qualitative perspective. BMC Womens Health 2021; 21:384. [PMID: 34724948 PMCID: PMC8561910 DOI: 10.1186/s12905-021-01524-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 10/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hypertensive disorders of pregnancy (HDP) affect 5-10% of pregnant women. Long-term health issues for these women include 2-3 times the risk of heart attacks, stroke and diabetes, starting within 10 years after pregnancy, making long-term health after HDP of major public health importance. Recent studies suggest this knowledge is not being transferred sufficiently to women and how best to transmit this information is not known. This study explored women's preferred content, format and access to education regarding long-term health after HDP. METHODS This was a qualitative study and framework analysis was undertaken. Women with a history of HDP who had participated in a survey on long-term health after HDP were invited to participate in this study. During telephone interviews women were asked about preferences and priorities concerning knowledge acquisition around long-term health after HDP. RESULTS Thirteen women were interviewed. They indicated that they wanted more detailed information about long-term and modifiable risk factors. Their preference was to receive risk counselling from their healthcare provider (HCP) early after giving birth along with evidence-based, print or web-based information to take home. All women suggested more structured postnatal follow-up, with automated reminders for key appointments. Automated reminders should detail rationale for follow-up, recommended tests and discussion topics to be addressed at the appointment. CONCLUSION Our findings show that most participants wanted information soon after birth with all women wanting information within 12 months post birth, complemented with detailed take-home evidence. Participants indicated preference for structured follow-up via their HCP with automated alerts about the appointment and recommended tests. This evidence can be used to guide the development of education programs for women on health after HDP which may enhance knowledge, preventive health management and more generally improve women's health trajectories.
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Affiliation(s)
- Heike Roth
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
| | - Amanda Henry
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
- Department Women's and Children's Health, St George Hospital, Kogarah, Sydney, NSW, 2217, Australia
| | - Lynne Roberts
- School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
- Department Women's and Children's Health, St George Hospital, Kogarah, Sydney, NSW, 2217, Australia
| | | | - Caroline S E Homer
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- Burnet Institute, Maternal, Child and Adolescent Health, Melbourne, VIC, Australia
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Coates D, Catling C. The Use of Ethnography in Maternity Care. Glob Qual Nurs Res 2021; 8:23333936211028187. [PMID: 34263014 PMCID: PMC8243125 DOI: 10.1177/23333936211028187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 06/05/2021] [Accepted: 06/07/2021] [Indexed: 11/15/2022] Open
Abstract
While the value of ethnography in health research is recognized, the extent to which it is used is unclear. The aim of this review was to map the use of ethnography in maternity care, and identify the extent to which the key principles of ethnographies were used or reported. We systematically searched the literature over a 10-year period. Following exclusions we analyzed 39 studies. Results showed the level of detail between studies varied greatly, highlighting the inconsistencies, and poor reporting of ethnographies in maternity care. Over half provided no justification as to why ethnography was used. Only one study described the ethnographic approach used in detail, and covered the key features of ethnography. Only three studies made reference to the underpinning theoretical framework of ethnography as seeking to understand and capture social meanings. There is a need to develop reporting guidelines to guide researchers undertaking and reporting on ethnographic research.
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From hopelessness to some hope: A qualitative interpretive research project to improve birthing experiences in Jordan. SEXUAL & REPRODUCTIVE HEALTHCARE 2020; 27:100580. [PMID: 33279817 DOI: 10.1016/j.srhc.2020.100580] [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: 05/09/2020] [Revised: 10/16/2020] [Accepted: 11/03/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Many women living in Middle Eastern countries report negative, dehumanising experiences of childbirth. Finding effective ways of changing maternity care to improve women's experience is needed but is challenging. AIM This paper explores the potential strategies to improve birthing experiences of women in Jordan and identifies the facilitators and obstacles to change. METHOD A qualitative interpretive research design underpinned by a feminist approach was used. Seventeen community women, 14 midwives and midwifery leaders were engaged in workshops and face-to-face semi-structured interviews. Data were transcribed verbatim and thematic analysis undertaken. RESULTS An overarching theme "From hopelessness to some hope" emerged from data analysis and comprised of two themes: 'It's hopeless-there are so many obstacles'; and 'Finding some hope for the way forward'. The community women were unhappy with the current maternity services but accepted the situation. Midwives offered explanations for the way women are treated, including that women have no voice. For these participants, the obstacles seemed almost insurmountable; however, there was some hope expressed about potential for small changes to occur. CONCLUSIONS This study highlights the value of women and midwives sharing experiences and listening to the stories of women. Listening to women's birth stories may also be an important element of undergraduate and continuing education in Jordan. Small changes, such as promoting women's dignity by ensuring they are covered during birth are possible, but real change needs to be generated at a professional and societal level.
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Whitley R, Zhou J. Clueless: An ethnographic study of young men who participate in the seduction community with a focus on their psychosocial well-being and mental health. PLoS One 2020; 15:e0229719. [PMID: 32101571 PMCID: PMC7043806 DOI: 10.1371/journal.pone.0229719] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 02/11/2020] [Indexed: 11/19/2022] Open
Abstract
In the last decade, a cross-national community of like-minded young men has emerged, commonly known as ‘the seduction community’. This community is led by professional ‘pick-up artists’ who teach these young men a variety of techniques and mindsets with the stated aim of improving their success with women, or ‘game’. There has been little research on the men who participate in this community, and none from a mental health angle. As such, this study is propelled by two specific objectives, namely documenting and understanding (i) the reasons why young men join the seduction community; and (ii) the impacts of community involvement on participants’ lives. To meet these aims, we used an inductive qualitative methodology giving ample scope for bottom-up understandings to emerge. Specifically, we recruited young men participating in the seduction community for an in-depth qualitative interview (N = 34) to explore self-reported motives and impacts. Interviews were augmented by lengthy participant observation, and data was analyzed by content analysis techniques. The results reveal that men often join the community to address a range of psychosocial deficits, and that community involvement successfully equips participants with numerous valued social and communication skills. The community appears to fill a void in providing a place of hope, fellowship and learning for young (often immigrant) men. The findings are summarized in five themes (i) loneliness and social inclusion; (ii) lack of male role models and need for guidance; (iii) mental health and well-being issues; (iv) skill acquisition and personal development; and (v) the dark side of pick-up. Interestingly, some of the practices commonly taught and utilized within the community resemble aspects of Cognitive Behavioral Therapy and mental health peer support. This may explain its evident appeal. We conclude by reflecting on the implications of the findings for official mental health service provision for young men.
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Affiliation(s)
- Rob Whitley
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- * E-mail:
| | - JunWei Zhou
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
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Javid N, Hyett JA, Homer CS. The experience of vasa praevia for Australian midwives: A qualitative study. Women Birth 2019; 32:185-192. [DOI: 10.1016/j.wombi.2018.06.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 06/26/2018] [Accepted: 06/28/2018] [Indexed: 11/29/2022]
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Anderson NE. Unlocking intuition and expertise: using interpretative phenomenological analysis to explore clinical decision making. J Res Nurs 2019; 24:88-101. [PMID: 34394511 PMCID: PMC7932448 DOI: 10.1177/1744987118809528] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Clinical decision making is a complex, but important, research area. Decision-making theories have evolved to recognise that, although heuristics and biases can lead to error, expert clinician decision makers can also use intuition to good effect. More research is needed to understand how nurses and other clinicians make sense of complexity and uncertainty. AIM This paper discusses the utility of interpretative phenomenological analysis to elucidate clinical decision making, expertise and intuition. METHODS A narrative review of published interpretative phenomenological analysis studies exploring clinical decision-making, and discussion of an exemplar study. RESULTS A limited number of interpretative phenomenological analysis studies have been published in this area. By seeking out descriptions of real-world decision making, interpretative phenomenological analysis research provides ecologically valid insights into what it is like to make time-critical, high-stakes decisions with limited information. CONCLUSION Contributing to the study of complex clinical decision making in combination with other research approaches, interpretative phenomenological analysis research has significant unrealised potential to inform education, assessment and support interventions and the development of clinical guidelines. Future applications could enhance understanding of multi-disciplinary decision-making and the development of expertise and intuition, over time.
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Affiliation(s)
- Natalie Elizabeth Anderson
- Professional Teaching Fellow and Doctoral Candidate,
School of Nursing, University of Auckland, New Zealand; Registered Nurse,
Auckland Adult Emergency Department, Auckland District Health Board, New
Zealand
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Lor M, Bowers BJ. Hmong Older Adults' Perceptions of Insider and Outsider Researchers: Does It Matter for Research Participation? Nurs Res 2019; 67:222-230. [PMID: 29698328 DOI: 10.1097/nnr.0000000000000277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Recruiting racial/ethnic minorities into health research is challenging. Although researchers affiliated with members of the study population (seen as insiders) may increase research participation of racial/ethnic minorities, little is known about who participants see as insiders and how they respond to insider versus outsider researchers. OBJECTIVES The aim of the study was to examine perceptions of Hmong older adults toward insider versus outsider researchers and the influence of these perceptions on their willingness to participate in research. METHODS Participants in a study evaluating use of a culturally and linguistically adapted audio computer-assisted self-interviewing system with helper assistance (ACASI-H) provided information about what they thought would encourage others in their community to participate in research. ACASI-H was used for collection of health data with 30 Hmong older adults. Participants rated the likelihood of participation if the researcher was Hmong and answered open-ended questions about participation when the researcher was not Hmong. Conventional content analysis was used to analyze open-ended questions. RESULTS Sixteen (53%) participants reported that they would be "likely" to participate in the research if the researcher was Hmong. Fourteen (47%) participants reported that they would participate in research if the researcher was not Hmong. In addition to ethnic affiliation, trust in the researcher could shift the perception of the researcher toward insider status, thereby increasing willingness of Hmong adults to participate in research. Trust in the researcher and movement toward insider status could be increased by calling out a connection between the researcher and the participant or creating reciprocity. DISCUSSION Findings suggest that increasing research participation of Hmong (and possibly other) participants, particularly when researchers do not share ethnic membership, can be achieved by building trust. This study also suggests a more nuanced perception of insider status, as a continuum, rather than a dichotomy, may be a more accurate reflection of the relationship between participants and researchers.
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Affiliation(s)
- Maichou Lor
- Maichou Lor, PhD, RN, is Postdoctoral Research Fellow, School of Nursing, Columbia University, New York, New York. Barbara J. Bowers, PhD, RN, FAAN, is Associate Dean for Research and Professor, School of Nursing, University of Wisconsin-Madison
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Javid N, Hyett JA, Homer CS. Providing quality care for women with vasa praevia: Challenges and barriers faced by Australian midwives. Midwifery 2018; 68:91-98. [PMID: 30396003 DOI: 10.1016/j.midw.2018.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 10/15/2018] [Accepted: 10/22/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To explore the barriers to providing quality maternity care for women with vasa praevia as identified by Australian midwives. DESIGN A qualitative descriptive study using semi-structured in-depth telephone interviews. SETTING Australian maternity system. METHODS Midwives were recruited from across Australia. Interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis. PARTICIPANTS Twenty midwives from five Australian states practising in 15 different public or private hospitals who had cared for at least one woman with vasa praevia during 2010-2016 were interviewed. More than half of the participants held senior positions. Twelve were involved in a neonatal death or 'near-miss' due to vasa praevia. FINDINGS Two categories and five themes were identified in relation to barriers to the provision of quality care. Practitioner-level barriers included two themes: identifying lack of midwifery education and lack of knowledge. System-level barriers included lack of a local policy to guide practice, limited information for women, and paucity of research about vasa praevia. CONCLUSION Midwives experienced a number of barriers in caring for women with vasa praevia. Offering more comprehensive pre-registration and continuing professional education to midwives, developing local protocols, and providing clear written information for women may improve the provision of quality care. IMPLICATIONS FOR PRACTICE Midwives have a critical role in caring for and supporting women with vasa praevia. Improving midwives' knowledge with contemporary evidence and clinical guidelines could enable them to deliver safer maternity care and improve a women's journey through this potentially catastrophic condition.
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Affiliation(s)
- Nasrin Javid
- Centre for Midwifery, Child and Family Health, University of Technology Sydney, Building 10, Jones Street, Broadway, Sydney, NSW 2007, Australia.
| | - Jon A Hyett
- RPA Women and Babies, Royal Prince Alfred Hospital, Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Sydney, 50 Missenden Rd, Camperdown, NSW 2050, Australia.
| | - Caroline Se Homer
- Centre for Midwifery, Child and Family Health, University of Technology Sydney, Building 10, Jones Street, Broadway, Sydney, NSW 2007, Australia.
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Nicol JW, Gordon LJ. Preparing for leadership in General Practice: a qualitative exploration of how GP trainees learn about leadership. EDUCATION FOR PRIMARY CARE 2018; 29:327-335. [PMID: 30346250 DOI: 10.1080/14739879.2018.1528896] [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] [Indexed: 10/28/2022]
Abstract
The recent rise to prominence of healthcare leadership worldwide has prompted those involved in medical education to consider how to facilitate learning to lead effectively. Research has focused on formal curriculum activities. Curricular theory suggests that trainee doctors may also learn through the informal curriculum but there is a lack of medical education literature on this. We aimed to explore how GP trainees learn about leadership in their GP training practices. Epistemologically grounded in social constructionism, this research involved 15 semi-structured interviews with GP trainees about to complete their training. Interviews were conducted using an online video conferencing method, audio-taped, transcribed and analysed using thematic framework analysis. We identified three learning processes contributing to leadership development; evaluating leadership, formulating views on leadership and constructing a personal leadership identity. Other factors operating within the informal curriculum included leadership terminology, and the quality of relationships and networks. Paradoxically, a role model's fallibility could positively influence leadership learning. Based on our findings, we present a model for the informal leadership learning process. This may enhance the facilitation of leadership learning by trainers and the wider clinical team, and positively influence the delivery and content of formal leadership courses.
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Affiliation(s)
- John W Nicol
- a Maryhill Practice , Elgin Health Centre , Elgin , UK
| | - Lisi J Gordon
- b School of Management , University of St Andrews , St Andrews , UK
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An instrumental case study examining the introduction and dissemination of the Baby Friendly Health Initiative in Australia: Participants’ perspectives. Women Birth 2018; 31:210-219. [DOI: 10.1016/j.wombi.2017.08.130] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 07/29/2017] [Accepted: 08/18/2017] [Indexed: 11/21/2022]
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McGilloway C, Smith D, Galvin R. Barriers faced by adults with intellectual disabilities who experience sexual assault: A systematic review and meta‐synthesis. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018. [DOI: 10.1111/jar.12445] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Connie McGilloway
- Donegal Sexual Assault Treatment Unit Letterkenny University Hospital Donegal Ireland
| | - David Smith
- Department of General Practice Royal College of Surgeons in Ireland Dublin Ireland
| | - Rose Galvin
- Faculty of Education and Health Sciences School of Allied Health Health Research Institute University of Limerick Limerick Ireland
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Urquhart LM, Ker JS, Rees CE. Exploring the influence of context on feedback at medical school: a video-ethnography study. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2018; 23:159-186. [PMID: 28667549 DOI: 10.1007/s10459-017-9781-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 06/06/2017] [Indexed: 05/27/2023]
Abstract
Feedback in medical education is complicated by the multiple contexts within which learning occurs. However, feedback research in medical education has typically focused on information provided by tutors to students with limited exploration of the influence of context. This research seeks to address this gap by exploring the influence of multiple contexts upon feedback processes. Employing video-ethnography methodology we explored feedback in two common contexts for medical student learning: the simulated clinical environment and the medical workplace. Learning and teaching sessions were filmed in each of these contexts, capturing diverse feedback processes. Data were analysed for key themes using a Framework Analysis approach and similarities and differences between the two contexts identified. In total 239 distinct feedback episodes across 28 different teaching and learning sessions were captured, with feedback processes relating to the patient, practice, educational and institutional contexts observed. In this paper, we concentrate on key similarities and differences in feedback processes between the two contexts with respect to six themes: feedback interlocutors, interlocutor positioning, feedback types, feedback foci, feedback styles and feedback milieu. We argue that feedback is inextricably linked to the multiple contexts in which feedback is enacted. It is only by exploring these contextual influences that feedback can be understood more fully. With such understanding we should be better placed to develop interventions capable of improving the long elusive experience of successful feedback.
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Affiliation(s)
| | - J S Ker
- NHS Education for Scotland, East Deanery, Ninewells Hospital, Dundee, Scotland, UK
| | - C E Rees
- Monash Centre for Scholarship in Health Education, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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Chodzaza E, Haycock-Stuart E, Holloway A, Mander R. Cue acquisition: A feature of Malawian midwives decision making process to support normality during the first stage of labour. Midwifery 2017; 58:56-63. [PMID: 29306097 DOI: 10.1016/j.midw.2017.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 08/14/2017] [Accepted: 11/29/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE to explore Malawian midwives decision making when caring for women during the first stage of labour in the hospital setting. DESIGN AND METHODS this focused ethnographic study examined the decision making process of 9 nurse-midwives with varying years of clinical experience in the real world setting of an urban and semi urban hospital from October 2013 to May 2014.This was done using 27 participant observations and 27 post-observation in-depth interviews over a period of six months. Qualitative data analysis software, NVivo 10, was used to assist with data management for the analysis. All data was analysed using the principle of theme and category formation. FINDINGS analysis revealed a six-stage process of decision making that include a baseline for labour, deciding to admit a woman to labour ward, ascertaining the normal physiological progress of labour, supporting the normal physiological progress of labour, embracing uncertainty: the midwives' construction of unusual labour as normal, dealing with uncertainty and deciding to intervene in unusual labour. This six-stage process of decision making is conceptualised as the 'role of cue acquisition', illustrating the ways in which midwives utilise their assessment of labouring women to reason and make decisions on how to care for them in labour. Cue acquisition involved the midwives piecing together segments of information they obtained from the women to formulate an understanding of the woman's birthing progress and inform the midwives decision making process. This understanding of cue acquisition by midwives is significant for supporting safe care in the labour setting. When there was uncertainty in a woman's progress of labour, midwives used deductive reasoning, for example, by cross-checking and analysing the information obtained during the span of labour. Supporting normal labour physiological processes was identified as an underlying principle that shaped the midwives clinical judgement and decision making when they cared for women in labour. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE the significance of this study is in the new understanding and insight into the process of midwifery decision making. Whilst the approach to decision making by the midwives requires further testing and refinement in order to explore implications for practice, the findings here provide new conceptual and practical clarity of midwifery decision making. The work contributes to the identified lack of knowledge of how midwives working clinically, in the 'real world setting. These findings therefore, contribute to this body of knowledge with regards to our understanding of decision making of midwives.
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Affiliation(s)
- Elizabeth Chodzaza
- University of Malawi, Kamuzu College of Nursing, Private Bag 1, Lilongwe, Malawi.
| | - Elaine Haycock-Stuart
- Nursing Studies, School of Health in Social Science, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK
| | - Aisha Holloway
- Nursing Studies, School of Health in Social Science, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK
| | - Rosemary Mander
- Nursing Studies, School of Health in Social Science, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK
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Gordon L, Rees C, Ker J, Cleland J. Using video-reflexive ethnography to capture the complexity of leadership enactment in the healthcare workplace. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2017; 22:1101-1121. [PMID: 28039588 PMCID: PMC5663839 DOI: 10.1007/s10459-016-9744-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 12/20/2016] [Indexed: 06/01/2023]
Abstract
Current theoretical thinking asserts that leadership should be distributed across many levels of healthcare organisations to improve the patient experience and staff morale. However, much healthcare leadership education focusses on the training and competence of individuals and little attention is paid to the interprofessional workplace and how its inherent complexities might contribute to the emergence of leadership. Underpinned by complexity theory, this research aimed to explore how interprofessional healthcare teams enact leadership at a micro-level through influential acts of organising. A whole (interprofessional) team workplace-based study utilising video-reflexive ethnography occurred in two UK clinical sites. Thematic framework analyses of the video data (video-observation and video-reflexivity sessions) were undertaken, followed by in-depth analyses of human-human and human-material interactions. Data analysis revealed a complex interprofessional environment where leadership is a dynamic process, negotiated and renegotiated in various ways throughout interactions (both formal and informal). Being able to "see" themselves at work gave participants the opportunity to discuss and analyse their everyday leadership practices and challenge some of their sometimes deeply entrenched values, beliefs, practices and assumptions about healthcare leadership. These study findings therefore indicate a need to redefine the way that medical and healthcare educators facilitate leadership development and argue for new approaches to research which shifts the focus from leaders to leadership.
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Affiliation(s)
- Lisi Gordon
- School of Management, University of St Andrews, The Gateway, North Haugh, St Andrews, KY16 9RJ, Scotland, UK.
| | - Charlotte Rees
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Jean Ker
- NHS Education for Scotland, East Region Ninewells Hospital, Dundee, Scotland, UK
| | - Jennifer Cleland
- Institute of Education in Medical and Dental Sciences, University of Aberdeen, Aberdeen, UK
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Davy C, Kite E, Sivak L, Brown A, Ahmat T, Brahim G, Dowling A, Jacobson S, Kelly T, Kemp K, Mitchell F, Newman T, O'Brien M, Pitt J, Roesch K, Saddler C, Stewart M, Thomas T. Towards the development of a wellbeing model for aboriginal and Torres Strait islander peoples living with chronic disease. BMC Health Serv Res 2017; 17:659. [PMID: 28915842 PMCID: PMC5602951 DOI: 10.1186/s12913-017-2584-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 08/30/2017] [Indexed: 11/22/2022] Open
Abstract
Background Re-defining the way in which care is delivered, to reflect Aboriginal and Torres Strait Islander peoples’ needs and values, is essential for improving the accessibility of primary healthcare. This study focused on developing a Framework to support the quality of care and quality of life of, as well as treatment for, Aboriginal and Torres Strait Islander peoples living with chronic disease. Methods A team of researchers, including thirteen experienced Aboriginal healthcare professionals, came together to undertake this important work. Using a Participatory Action Approach, this study actively engaged people with local knowledge to ensure that the Framework was developed by and for Aboriginal people. Results The final Wellbeing Framework consists of two core values and four elements, each supported by four principles. Importantly, the Framework also includes practical examples of how the principles could be applied. National Reference Group members, including community representatives, policy makers and healthcare providers, reviewed and approved the final Framework. Conclusion The outcome of this collaborative effort is a Framework to guide primary healthcare services to develop locally relevant, flexible approaches to care which can respond to communities’ and individuals’ varied understandings of wellbeing.
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Affiliation(s)
- Carol Davy
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia.
| | - Elaine Kite
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia
| | - Leda Sivak
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia
| | - Alex Brown
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia
| | - Timena Ahmat
- Wuchopperen Health Service, 22C Evans St, Atherton, QLD, 4883, Australia
| | - Gary Brahim
- Wirraka Maya Health Service Aboriginal Corporation, 17 Hamilton Road, South Hedland, WA, 6722, Australia
| | - Anna Dowling
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia
| | - Shaun Jacobson
- Nunkuwarrin Yunti Inc, 182-190 Wakefield Street, Adelaide, South Australia, 5000, Australia
| | - Tania Kelly
- Wirraka Maya Health Service Aboriginal Corporation, 17 Hamilton Road, South Hedland, WA, 6722, Australia
| | - Kaylene Kemp
- Maari Ma Health Aboriginal Corporation, 428 Argent St, Broken Hill, NSW, 2880, Australia
| | - Fiona Mitchell
- Maari Ma Health Aboriginal Corporation, 428 Argent St, Broken Hill, NSW, 2880, Australia
| | - Tina Newman
- Tharawal Aboriginal Corporation, 187 Riverside Dr, Airds, NSW, 2560, Australia
| | - Margaret O'Brien
- Danila Dilba Health Service, 1/26 Knuckey St, Darwin, Northern Territory, 0800, Australia
| | - Jason Pitt
- Tharawal Aboriginal Corporation, 187 Riverside Dr, Airds, NSW, 2560, Australia
| | - Kesha Roesch
- Nunkuwarrin Yunti Inc, 182-190 Wakefield Street, Adelaide, South Australia, 5000, Australia
| | - Christine Saddler
- Winnunga Nimmityjah Aboriginal Health Service, 63 Boolimba Cres, Narrabundah, ACT, 2604, Australia
| | - Maida Stewart
- Danila Dilba Health Service, 1/26 Knuckey St, Darwin, Northern Territory, 0800, Australia
| | - Tiana Thomas
- Wuchopperen Health Service, 22C Evans St, Atherton, QLD, 4883, Australia
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Hughes-Morris D, Roberts D. Transition to SCPHN: The effects of returning to student status on autonomous practitioners. ACTA ACUST UNITED AC 2017. [DOI: 10.12968/bjsn.2017.12.5.234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Debbie Roberts
- Professor of practice learning, School of Healthcare Sciences, Bangor University, Bangor
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A research note on the benefit of patient and public involvement in research: The experience of prostate cancer patients regarding information in radiotherapy. Radiography (Lond) 2017; 23:167-170. [PMID: 28390550 DOI: 10.1016/j.radi.2017.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 02/06/2017] [Accepted: 02/07/2017] [Indexed: 11/24/2022]
Abstract
AIM To explore the inclusion of patient and public involvement (PPI) in a qualitative study on the experiences of men with prostate cancer regarding information in radiotherapy. METHOD The application of PPI to one doctoral research study is explored with respect to two perspectives: firstly, involvement of a patient reference group who informed the research design and materials, and secondly, the involvement of a public involvement in research group (PIRg) in advising the researcher during the design process. DISCUSSION PPI is recognised as an important component of contemporary health research. PPI is becoming a common and essential requirement for high quality research projects and yet literature exploring or reporting the involvement and influence of PPI is sparse. Consideration is given to the national PPI landscape that has shaped public involvement in health research. CONCLUSION The contribution of PPI to this study appears to have been beneficial to the development and evaluation of the study design, the self-worth of the reference group participants and demonstrates that the value of PPI in health research should not be underestimated.
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Stevens J, Schmied V, Burns E, Dahlen HG. Video ethnography during and after caesarean sections: methodological challenges. J Clin Nurs 2017; 26:2083-2092. [DOI: 10.1111/jocn.13677] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Jeni Stevens
- School of Nursing and Midwifery; Western Sydney University; Penrith NSW Australia
| | - Virginia Schmied
- School of Nursing and Midwifery; Western Sydney University; Penrith NSW Australia
| | - Elaine Burns
- School of Nursing and Midwifery; Western Sydney University; Penrith NSW Australia
| | - Hannah G Dahlen
- School of Nursing and Midwifery; Western Sydney University; Penrith NSW Australia (Affiliate of the Ingham Institute)
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Experiences of neonatal nurses and parents working collaboratively to enhance family centred care: The destiny phase of an appreciative inquiry project. Collegian 2016. [DOI: 10.1016/j.colegn.2015.05.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Hay-Smith EJC, Brown M, Anderson L, Treharne GJ. Once a clinician, always a clinician: a systematic review to develop a typology of clinician-researcher dual-role experiences in health research with patient-participants. BMC Med Res Methodol 2016; 16:95. [PMID: 27506386 PMCID: PMC4977678 DOI: 10.1186/s12874-016-0203-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 07/30/2016] [Indexed: 11/29/2022] Open
Abstract
Background Many health researchers are clinicians. Dual-role experiences are common for clinician-researchers in research involving patient-participants, even if not their own patients. To extend the existing body of literature on why dual-role is experienced, we aimed to develop a typology of common catalysts for dual-role experiences to help clinician-researchers plan and implement methodologically and ethically sound research. Methods Systematic searching of Medline, CINAHL, PsycINFO, Embase and Scopus (inception to 28.07.2014) for primary studies or first-person reflexive reports of clinician-researchers’ dual-role experiences, supplemented by reference list checking and Google Scholar scoping searches. Included articles were loaded in NVivo for analysis. The coding was focused on how dual-role was evidenced for the clinician-researchers in research involving patients. Procedures were completed by one researcher (MB) and independently cross-checked by another (JHS). All authors contributed to extensive discussions to resolve all disagreements about initial coding and verify the final themes. Results Database searching located 7135 records, resulting in 29 included studies, with the addition of 7 studies through reference checks and scoping searches. Two overarching themes described the most common catalysts for dual-role experiences – ways a research role can involve patterns of behaviour typical of a clinical role, and the developing connection that starts to resemble a clinician-patient relationship. Five subthemes encapsulated the clinical patterns commonly repeated in research settings (clinical queries, perceived agenda, helping hands, uninvited clinical expert, and research or therapy) and five subthemes described concerns about the researcher-participant relationship (clinical assumptions, suspicion and holding back, revelations, over-identification, and manipulation). Clinician-researchers use their clinical skills in health research in ways that set up a relationship resembling that of clinician-patient. Clinicians’ ingrained orientation to patients’ needs can be in tension with their research role, and can set up ethical and methodological challenges. Conclusion The typology we developed outlines the common ways dual-role is experienced in research involving clinician-researchers and patient-participants, and perhaps the inevitability of the experience given the primacy accorded to patient well-being. The typology offers clinician-researchers a framework for grappling with the ethical and methodological implications of dual-role throughout the research process, including planning, implementation, monitoring and reporting.
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Affiliation(s)
- E Jean C Hay-Smith
- Department of Medicine, University of Otago, Wellington, PO Box 7343, Wellington, 6242, New Zealand.
| | - Melanie Brown
- Department of Medicine, University of Otago, Wellington, PO Box 7343, Wellington, 6242, New Zealand
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Abstract
BACKGROUND Conducting video-research in birth settings raises challenges for ethics review boards to view birthing women and research-midwives as capable, autonomous decision-makers. AIM This study aimed to gain an understanding of how the ethical approval process was experienced and to chronicle the perceived risks and benefits. RESEARCH DESIGN The Birth Unit Design project was a 2012 Australian ethnographic study that used video recording to investigate the physical design features in the hospital birthing space that might influence both verbal and non-verbal communication and the experiences of childbearing women, midwives and supporters. Participants and research context: Six women, 11 midwives and 11 childbirth supporters were filmed during the women's labours in hospital birth units and interviewed 6 weeks later. Ethical considerations: The study was approved by an Australian Health Research Ethics Committee after a protracted process of negotiation. FINDINGS The ethics committee was influenced by a traditional view of research as based on scientific experiments resulting in a poor understanding of video-ethnographic research, a paradigmatic view of the politics and practicalities of modern childbirth processes, a desire to protect institutions from litigation, and what we perceived as a paternalistic approach towards protecting participants, one that was at odds with our aim to facilitate situations in which women could make flexible, autonomous decisions about how they might engage with the research process. DISCUSSION The perceived need for protection was overly burdensome and against the wishes of the participants themselves; ultimately, this limited the capacity of the study to improve care for women and babies. CONCLUSION Recommendations are offered for those involved in ethical approval processes for qualitative research in childbirth settings. The complexity of issues within childbirth settings, as in most modern healthcare settings, should be analysed using a variety of research approaches, beyond efficacy-style randomised controlled trials, to expand and improve practice-based results.
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Affiliation(s)
| | | | | | - Nicky Leap
- University of Technology, Sydney, Australia
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Råheim M, Magnussen LH, Sekse RJT, Lunde Å, Jacobsen T, Blystad A. Researcher-researched relationship in qualitative research: Shifts in positions and researcher vulnerability. Int J Qual Stud Health Well-being 2016; 11:30996. [PMID: 27307132 PMCID: PMC4910304 DOI: 10.3402/qhw.v11.30996] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/20/2016] [Indexed: 11/14/2022] Open
Abstract
Background The researcher role is highly debated in qualitative research. This article concerns the researcher-researched relationship. Methods A group of health science researchers anchored in various qualitative research traditions gathered in reflective group discussions over a period of two years. Results Efforts to establish an anti-authoritarian relationship between researcher and researched, negotiation of who actually “rules” the research agenda, and experiences of shifts in “inferior” and “superior” knowledge positions emerged as central and intertwined themes throughout the discussions. The dual role as both insider and outsider, characteristic of qualitative approaches, seemed to lead to power relations and researcher vulnerability which manifested in tangible ways. Conclusion Shifting positions and vulnerability surfaced in various ways in the projects. They nonetheless indicated a number of similar experiences which can shed light on the researcher-researched relationship. These issues could benefit from further discussion in the qualitative health research literature.
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Affiliation(s)
- Målfrid Råheim
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway;
| | - Liv Heide Magnussen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Occupational Therapy, Physiotherapy and Radiography, Bergen University College, Bergen, Norway
| | - Ragnhild Johanne Tveit Sekse
- Department of Obstetrics and Gynecology, Haukaland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway.,Haraldsplass Deaconess University College, Bergen, Norway
| | - Åshild Lunde
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | - Astrid Blystad
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Wigginton B, Setchell J. Researching stigma as an outsider: considerations for qualitative outsider research. QUALITATIVE RESEARCH IN PSYCHOLOGY 2016. [DOI: 10.1080/14780887.2016.1183065] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Malpass A, Sales K, Feder G. Reducing symbolic-violence in the research encounter: collaborating with a survivor of domestic abuse in a qualitative study in UK primary care. SOCIOLOGY OF HEALTH & ILLNESS 2016; 38:442-458. [PMID: 26403218 DOI: 10.1111/1467-9566.12352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This paper explores ideas of symbolic violence inherent in the research encounter (Bourdieu 1999). After defining symbolic violence and how the concept enters into domestic violence and abuse (DVA) research, we discuss the challenges arising from a (DVA) survivor taking on the role of interviewer in a qualitative study nested within a UK primary care based trial: IRIS (Identification and Referral to Improve Safety). KS, a survivor of DVA, conducted interviews with 12 women who had been referred to a domestic violence agency by primary care clinicians taking part in the IRIS trial in two UK cities (Bristol and east London) during 2009. Field notes were kept during all of the research meetings with KS and these were included in analysis. Our analysis maps the research pathway of 'non-violent communication' and discusses the role of social symmetry and proximity in the research encounter. We conclude that while a welcoming disposition, empathy and active listening are all generic skills to qualitative research; if a researcher can enter fieldwork with a claim of social proximity and symmetry, their use of these generic skills is enhanced through a process of shared objectification and empowerment talk. We explore the limitations of social proximity, its relationship to feminist and anthropological theories of 'insider' research and its relevance to primary care research.
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Affiliation(s)
- Alice Malpass
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, UK
| | | | - Gene Feder
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, UK
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Cummins AM, Denney-Wilson E, Homer CSE. The challenge of employing and managing new graduate midwives in midwifery group practices in hospitals. J Nurs Manag 2016; 24:614-23. [PMID: 26923939 DOI: 10.1111/jonm.12364] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2016] [Indexed: 11/26/2022]
Abstract
AIM(S) This study explores the views of midwifery managers and key stakeholders, regarding the facilitators and barriers to employing new graduate midwives in midwifery continuity of care models. BACKGROUND Maternity services in Australia are shifting towards midwifery continuity of care models, where midwives work in small group practices, requiring a change to the management of staff. Public policy in Australia supports maternity services to be reconfigured in this way. Historically, experienced midwives work in these models, as demand grows; new graduates are employed to staff the models. METHOD(S) A qualitative descriptive approach exploring the manager's experience of employing new graduate's in the models. Managers, clinical educators and hospital midwifery consultants (n = 15) were recruited by purposeful sampling. RESULTS Drivers, enablers, facilitators and barriers to employing new graduates in the models were identified. Visionary leadership enabled the managers to employ new graduates in the models through initial and ongoing support. Managing the myths stemming from fear of employing new graduates to work in midwifery continuity of care models was challenging. CONCLUSION Managers and other key stakeholders provide initial and ongoing support through orientation and providing a reduced workload. IMPLICATIONS FOR NURSING MANAGEMENT Visionary leadership can be seen as critical to supporting new graduates into midwifery continuity of care models. The challenges for management to overcome include managing the myths stemming from fear of employing new graduates to work in a flexible way around the needs of the women within an organisation culture.
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Affiliation(s)
- Allison M Cummins
- Faculty of Health, University of Technology, Broadway, NSW, Australia
| | - E Denney-Wilson
- Faculty of Health, University of Technology, Broadway, NSW, Australia
| | - C S E Homer
- International and Development, Faculty of Health, University of Technology, Broadway, NSW, Australia
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Atchan M, Davis D, Foureur M. A methodological review of qualitative case study methodology in midwifery research. J Adv Nurs 2016; 72:2259-71. [PMID: 26909766 DOI: 10.1111/jan.12946] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2015] [Indexed: 11/29/2022]
Abstract
AIM To explore the use and application of case study research in midwifery. BACKGROUND Case study research provides rich data for the analysis of complex issues and interventions in the healthcare disciplines; however, a gap in the midwifery research literature was identified. DESIGN A methodological review of midwifery case study research using recognized templates, frameworks and reporting guidelines facilitated comprehensive analysis. DATA SOURCES An electronic database search using the date range January 2005-December 2014: Maternal and Infant Care, CINAHL Plus, Academic Search Complete, Web of Knowledge, SCOPUS, Medline, Health Collection (Informit), Cochrane Library Health Source: Nursing/Academic Edition, Wiley online and ProQuest Central. REVIEW METHODS Narrative evaluation was undertaken. Clearly worded questions reflected the problem and purpose. The application, strengths and limitations of case study methods were identified through a quality appraisal process. RESULTS The review identified both case study research's applicability to midwifery and its low uptake, especially in clinical studies. Many papers included the necessary criteria to achieve rigour. The included measures of authenticity and methodology were varied. A high standard of authenticity was observed, suggesting authors considered these elements to be routine inclusions. Technical aspects were lacking in many papers, namely a lack of reflexivity and incomplete transparency of processes. CONCLUSION This review raises the profile of case study research in midwifery. Midwives will be encouraged to explore if case study research is suitable for their investigation. The raised profile will demonstrate further applicability; encourage support and wider adoption in the midwifery setting.
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Affiliation(s)
- Marjorie Atchan
- Centre for Midwifery, Child and Family Health, University of Technology Sydney, New South Wales, Australia
| | - Deborah Davis
- Faculty of Health, ACT Health Directorate and University of Canberra, University of Canberra, Australian Capital Territory, Australia
| | - Maralyn Foureur
- Centre for Midwifery, Child and Family Health, University of Technology Sydney, New South Wales, Australia
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A qualitative study exploring how the aims, language and actions of yoga for pregnancy teachers may impact upon women's self-efficacy for labour and birth. Women Birth 2016; 29:3-11. [DOI: 10.1016/j.wombi.2015.04.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Revised: 04/26/2015] [Accepted: 04/28/2015] [Indexed: 11/23/2022]
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Boyle S, Thomas H, Brooks F. Women׳s views on partnership working with midwives during pregnancy and childbirth. Midwifery 2016; 32:21-9. [DOI: 10.1016/j.midw.2015.09.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 05/23/2015] [Accepted: 09/01/2015] [Indexed: 10/23/2022]
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Priddis HS. Autoethnography and severe perineal trauma--an unexpected journey from disembodiment to embodiment. BMC Womens Health 2015; 15:88. [PMID: 26490564 PMCID: PMC4618600 DOI: 10.1186/s12905-015-0249-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 10/08/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There is a lack of research reporting on the physical and emotional experiences of women who sustain severe perineal trauma (third and fourth degree tears). When the researcher identifies with the group being researched, autoethnography can allow an insight into the experiences of the marginalised group through the telling of a personal story. The aim of this paper is to share the journey travelled by an autoethnographer who on examining the issue of severe perineal trauma came to understand the challenges and rewards she experienced through this reflective and analytic process. METHODS A transformative emancipatory approach guided the design, data collection and analysis of findings from this study. For this paper, a multivocal narrative approach was taken in presenting the findings, which incorporated the words of both the autoethnographer and the twelve women who were interviewed as a component of the study, all of whom had sustained severe perineal trauma. RESULTS As an autoethnographer, being a member of the group being researched, can be confronting as the necessary reflection upon one's personal journey may lead to feelings of vulnerability, sadness, and emotional pain. The transformation from disembodied to embodied self, resulted in a physical and emotional breakdown that occurred for this autoethnographer. CONCLUSION Autoethnographers may experience unexpected emotional and physical challenges as they reflect upon their experiences and research the experiences of others. When incorporating a transformative emancipatory framework, the hardships are somewhat balanced by the rewards of witnessing 'self-transformation' as a result of the research.
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Affiliation(s)
- Holly S Priddis
- School of Nursing and Midwifery, College of Health and Science, University of Western Sydney, Building EB, Parramatta Campus, Locked Bag 1797, Penrith South, DC NSW, 2751, Australia.
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Byrne E, Brugha R, Clarke E, Lavelle A, McGarvey A. Peer interviewing in medical education research: experiences and perceptions of student interviewers and interviewees. BMC Res Notes 2015; 8:513. [PMID: 26423420 PMCID: PMC4588247 DOI: 10.1186/s13104-015-1484-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 09/21/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Interviewing is one of the main methods used for data collection in qualitative research. This paper explores the use of semi-structured interviews that were conducted by students with other students in a research study looking at cultural diversity in an international medical school. Specifically this paper documents and gives 'voice' to the opinions and experiences of interviewees and interviewers (the peers and the communities) on the value of peer interviewing in the study and outlines (1) the preparation made to address some of the foreseen challenges, (2) the challenges still faced, and (3) the benefits of using peer interviews with respect to the research study, the individual and the institution. METHODS Peer interviewing was used as part of a two-year phased-study, 2012-2013, which explored and then measured the impact of cultural diversity on undergraduate students in a medical higher education institution in Ireland. In phase one 16 peer interviewers were recruited to conduct 29 semi-structured interviews with fellow students. In order to evaluate the peer interviewing process two focus group discussions were he ld and an online survey conducted. RESULTS Key findings were that substantial preparations in relation to training, informed consent processes and addressing positionality are needed if peer-interviewing is to be used. Challenges still faced included were related to power, familiarity, trust and practical problems. However many benefits accrued to the research, the individual interviewer and to the university. CONCLUSIONS A more nuanced approach to peer interviewing, that recognises commonalities and differences across a range of attributes, is needed. While peer interviewing has many benefits and can help reduce power differentials it does not eliminate all challenges. As part of a larger research project and as a way in which to get 'buy-in' from the student body and improve a collaborative research partnership peer interviewing was extremely useful.
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Affiliation(s)
- Elaine Byrne
- Division of Population and Health Sciences, Royal College of Surgeons in Ireland, Beaux Lane House, Lr Mercer Street, Dublin 2, Ireland.
| | - Ruairi Brugha
- Division of Population and Health Sciences, Royal College of Surgeons in Ireland, Beaux Lane House, Lr Mercer Street, Dublin 2, Ireland.
| | - Eric Clarke
- Health Professions Education Centre, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland.
| | - Aisling Lavelle
- Faculty of Medicine and Health Sciences, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland.
| | - Alice McGarvey
- Anatomy Department, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland.
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Women's reasons for, and experiences of, choosing a homebirth following a caesarean section. BMC Pregnancy Childbirth 2015; 15:206. [PMID: 26337330 PMCID: PMC4560080 DOI: 10.1186/s12884-015-0639-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 08/26/2015] [Indexed: 11/29/2022] Open
Abstract
Background Caesarean section is rising in the developed world and vaginal birth after caesarean (VBAC) is declining. There are increased reports of women seeking a homebirth following a caesarean section (HBAC) in Australia but little is known about the reasons for this study aimed to explore women's reasons for and experiences of choosing a HBAC. Methods Twelve women participated in a semi-structured one-to-one interview. The interviews were digitally recorded, then transcribed verbatim. These data were analysed using thematic analysis. Results The overarching theme that emerged was ‘It’s never happening again’. Women clearly articulated why it [caesarean section] was never happening again under the following sub themes: ‘treated like a piece of meat’, ‘I was traumatised by it for years’, ‘you can smell the fear in the room’, ‘re-traumatised by the system’. They also described how it [caesarean section] was never happening again under the sub themes: ‘getting informed and gaining confidence’, ‘avoiding judgment through selective telling’, ‘preparing for birth’, ‘gathering support’ and ‘all about safety but I came first’. The women then identified the impact of their HBAC under the subthemes ‘I felt like superwoman’ and ‘there is just no comparison’. Conclusions Birth intervention may cause physical and emotional trauma that can have a significant impact on some women. Inflexible hospital systems and inflexible attitudes around policy and care led some women to seek other options. Women report that achieving a HBAC has benefits for the relationship with their baby. VBAC policies and practices in hospitals need to be flexible to enable women to negotiate the care that they wish to have.
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Burns E, Fenwick J, Sheehan A, Schmied V. 'This little piranha': a qualitative analysis of the language used by health professionals and mothers to describe infant behaviour during breastfeeding. MATERNAL AND CHILD NUTRITION 2015; 12:111-24. [PMID: 26059182 DOI: 10.1111/mcn.12179] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Exclusive breastfeeding for the first 6 months of life offers the recommended best start in the life for a newborn baby. Yet, in Australia only a small number of babies receive breast milk exclusively for the first 6 months. Reasons for the introduction of formula milk are multi-factorial including access to appropriate support and the woman's experience of breastfeeding. The language and practices of health professionals can impact upon how a woman feels about breastfeeding and her breastfeeding body. One aspect of breastfeeding support that has had scarce attention in the literature is the language used by health professionals to describe the behaviour of the breastfeeding infant during the early establishment phase of breastfeeding. This paper reveals some of the ways in which midwives, lactation consultants and breastfeeding women describe the newborn baby during the first week after birth. The study was conducted at two maternity units in New South Wales. Interactions between midwives and breastfeeding women were observed and audio recorded on the post-natal ward and in women's homes, in the first week after birth. The transcribed data were analysed using discourse analysis searching for recurring words, themes and metaphors used in descriptions of the breastfeeding baby. Repeated negative references to infant personality and unfavourable interpretations of infant behaviour influenced how women perceived their infant. The findings revealed that positive language and interpretations of infant breastfeeding behaviour emerged from more relationship-based communication.
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Affiliation(s)
- Elaine Burns
- School of Nursing and Midwifery, University of Western Sydney, Penrith, New South Wales, Australia
| | - Jenny Fenwick
- School of Nursing and Midwifery, Maternity and Family, Research Centre for Clinical and Community Practice Innovation, Griffith Health, Griffith University, Meadowbrook, Queensland, Australia
| | - Athena Sheehan
- School of Nursing and Midwifery, University of Western Sydney, Penrith, New South Wales, Australia
| | - Virginia Schmied
- School of Nursing and Midwifery, University of Western Sydney, Penrith, New South Wales, Australia
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Trajkovski S, Schmied V, Vickers M, Jackson D. Using appreciative inquiry to bring neonatal nurses and parents together to enhance family-centred care: A collaborative workshop. J Child Health Care 2015; 19:239-53. [PMID: 24270986 DOI: 10.1177/1367493513508059] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Family-centred care (FCC) has been well recognised, accepted and reported in the literature as an optimised way of caring for hospitalised children. While neonatal units strive to adopt this philosophy, published research suggests there are difficulties implementing FCC principles in daily practice. Appreciative inquiry (AI) is a philosophy and methodology that offers a unique, strength-based approach to promoting organisational learning and positive organisational change. As a participatory approach, AI facilitates change from the ground up and lends itself to building effective partnerships or collaborations. This article reports the findings of a one-day workshop using an AI methodology to bring neonatal nurses and parents together to enhance the FCC within a neonatal intensive care unit in Sydney, Australia. Participants (n = 15) developed collaborative insights of optimal FCC that can be built upon to support neonates and their families in the future. Shared visions were formed, strategies identified and a development plan made for ongoing collaborations and partnerships. AI provides a flexible framework that enables the mandatory collaboration needed to develop action plans that can form the catalyst for organizational change in health-care research and practice.
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50
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Cummins AM, Denney-Wilson E, Homer C. The experiences of new graduate midwives working in midwifery continuity of care models in Australia. Midwifery 2015; 31:438-44. [DOI: 10.1016/j.midw.2014.12.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 11/18/2014] [Accepted: 12/31/2014] [Indexed: 01/26/2023]
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