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Sun L, Wang X, Gao H, Li Z, Chen M, Qian X, Gu C. Development and psychometric testing of a Chinese version of the postnatal care experience scale for postpartum women. BMC Pregnancy Childbirth 2023; 23:868. [PMID: 38104121 PMCID: PMC10724998 DOI: 10.1186/s12884-023-06187-z] [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: 09/23/2022] [Accepted: 12/10/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Postnatal period is a critical transitional phase in the lives of mothers and newborn babies. In recent years the importance on promoting a positive experience of care following childbirth is increasingly emphasized. Yet published evidence of the methodological and psychometric quality of instruments to evaluate women's experience of comprehensive postnatal care is still lacking. OBJECTIVE This study aimed to develop and validate a unique scale (the Chinese version of the Postnatal Care Experience Scale, PCES) to measure women's overall experience of care during postnatal periods. METHODS The PCES instrument was developed and validated over three phases, including item development, scale development, and scale evaluation. The item pool of the PCES was generated through existing literature and in-depth semi-structured interviews, followed by assessment of content validity and rating of importance and feasibility of items through two-round Delphi surveys. Psychometric properties were examined in a convenience sample of 736 postpartum women. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to assess the construct validity of the developed PCES. The relationship between the total PCES score and the global item construct was estimated using Pearson product-moment coefficient. Reliability was assessed using Cronbach's alpha and Spearman Brown coefficients. RESULTS The content validity index of the Chinese version PCES was 0.867. Following item reduction analysis, this instrument consisted of 30 five-point Likert items. The Kaiser-Meyer-Olkin statistic was 0.964 and the chi-square value of the Bartlett spherical test was 11665.399 (P < .001). The scale explained 75.797% of the total variance and consisted of three subscales, including self-management, social support, and facility- and community-based care. The Pearson correlation coefficient between the total PCES score and the global item construct was 0.909. The CFA showed that the 3-factor model had suitable fitness for the data. Cronbach's alpha value and Spearman-Brown Split-half reliability for the total scale were 0.979 and 0.941, respectively. CONCLUSIONS The newly developed 30-item PCES is a psychometrically reliable and valid instrument that assesses women's overall experience of postnatal care. Future research should aim to use the PCES in various populations to obtain further evidence for its validity and reliability.
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Affiliation(s)
- Liping Sun
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xiaojiao Wang
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Hua Gao
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Zhaorun Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China
| | - Meiyi Chen
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China
| | - Xu Qian
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China.
- Global Health Institute, Fudan University, Shanghai, China.
| | - Chunyi Gu
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
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Dynes MM, Daniel GA, Mac V, Picho B, Asiimwe A, Nalutaaya A, Opio G, Kamara V, Kaharuza F, Serbanescu F. A qualitative evaluation and conceptual framework on the use of the Birth weight and Age-at-death Boxes for Intervention and Evaluation System (BABIES) matrix for perinatal health in Uganda. BMC Pregnancy Childbirth 2023; 23:86. [PMID: 36726073 PMCID: PMC9890791 DOI: 10.1186/s12884-023-05402-1] [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: 10/10/2022] [Accepted: 01/23/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Perinatal mortality (newborn deaths in the first week of life and stillbirths) continues to be a significant global health threat, particularly in resource-constrained settings. Low-tech, innovative solutions that close the quality-of-care gap may contribute to progress toward the Sustainable Development Goals for health by 2030. From 2012 to 2018, the Saving Mothers, Giving Life Initiative (SMGL) implemented the Birth weight and Age-at-Death Boxes for Intervention and Evaluation System (BABIES) matrix in Western Uganda. The BABIES matrix provides a simple, standardized way to track perinatal health outcomes to inform evidence-based quality improvement strategies. METHODS In November 2017, a facility-based qualitative evaluation was conducted using in-depth interviews with 29 health workers in 16 health facilities implementing BABIES in Uganda. Data were analyzed using directed content analysis across five domains: 1) perceived ease of use, 2) how the matrix was used, 3) changes in behavior or standard operating procedures after introduction, 4) perceived value of the matrix, and 5) program sustainability. RESULTS Values in the matrix were easy to calculate, but training was required to ensure correct data placement and interpretation. Displaying the matrix on a highly visible board in the maternity ward fostered a sense of accountability for health outcomes. BABIES matrix reports were compiled, reviewed, and responded to monthly by interprofessional teams, prompting collaboration across units to fill data gaps and support perinatal death reviews. Respondents reported improved staff communication and performance appraisal, community engagement, and ability to track and link clinical outcomes with actions. Midwives felt empowered to participate in the problem-solving process. Respondents were motivated to continue using BABIES, although sustainability concerns were raised due to funding and staff shortages. CONCLUSIONS District-level health systems can use data compiled from the BABIES matrix to inform policy and guide implementation of community-centered health practices to improve perinatal heath. Future work may consider using the Conceptual Framework on Use of the BABIES Matrix for Perinatal Health as a model to operationalize concepts and test the impact of the tool over time.
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Affiliation(s)
- Michelle M. Dynes
- grid.416738.f0000 0001 2163 0069Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Gaea A. Daniel
- grid.189967.80000 0001 0941 6502Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA USA
| | - Valerie Mac
- grid.189967.80000 0001 0941 6502Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA USA
| | - Brenda Picho
- grid.11194.3c0000 0004 0620 0548Infectious Diseases Institute, Makerere University, Kampala, Uganda
| | - Alice Asiimwe
- grid.423308.e0000 0004 0397 2008Baylor College of Medicine Children’s Foundation, Kampala, Uganda
| | - Agnes Nalutaaya
- grid.11194.3c0000 0004 0620 0548Infectious Diseases Institute, Makerere University, Kampala, Uganda
| | - Gregory Opio
- grid.423308.e0000 0004 0397 2008Baylor College of Medicine Children’s Foundation, Kampala, Uganda
| | | | - Frank Kaharuza
- grid.440478.b0000 0004 0648 1247Kampala International University, Western Campus, Ishaka Bushenyi, Uganda
| | - Florina Serbanescu
- grid.416738.f0000 0001 2163 0069Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA USA
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Lythgoe C, Lowe K, McCauley M, McCauley H. How women's experiences and perceptions of care influence uptake of postnatal care across sub-Saharan Africa: a qualitative systematic review. BMC Pregnancy Childbirth 2021; 21:506. [PMID: 34256727 PMCID: PMC8276494 DOI: 10.1186/s12884-021-03910-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/22/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The burden of maternal and neonatal morbidity and mortality is a global health concern with the highest burden documented after childbirth in women and babies living in sub-Saharan Africa. To date, there is limited information on the quality of postnatal care and/or whether evidence-based interventions to improve postnatal care in a way that meets the specific health needs of each mother and her baby have been lacking. There is also limited data related to how quality of care (respectful or disrespectful) influences women's decision to access postnatal care. OBJECTIVE To systematically review available qualitative evidence for how quality of care (respectful or disrespectful) influences perceptions and experiences of, and decisions to, access postnatal care for women living in sub-Saharan Africa. SEARCH STRATEGY CINAHL plus, Cochrane library, Global Health, Medline, PubMed, Web of Science were searched from 2009-2019. Grey literature was searched on Google Scholar. SELECTION CRITERIA Qualitative literature in English describing women's perceptions and experiences of the quality of care they received after childbirth and how this influenced their perceptions of and decisions to access postnatal care. DATA ANALYSIS Thematic analysis was performed to extract subthemes and themes. Outcomes were themes from the qualitative data used to form a thematic synthesis. RESULTS Fifteen studies were included with data from 985 women interviewed face-to-face across eight countries. Descriptions of respectful care included healthcare providers being kind, supportive and attentive to women's needs. Women described preferring healthcare services where the healthcare providers communicated in a respectful and caring manner. Descriptions of disrespectful care included verbal and/or physical abuse and power imbalances between women and healthcare providers. Some women were denied postnatal care when attending a healthcare facility after giving birth at home. There is evidence to suggest that vulnerable women (adolescents; women with poor socioeconomic status; women who are HIV positive) are more likely to receive disrespectful care. CONCLUSIONS This systematic review describes how aspects of respectful and disrespectful maternity care influence women's perceptions and experiences of, and decisions to access postnatal care services. There is a need for a renewed focus to prioritise respectful maternity care and to sustainably provide good quality postnatal care to all women and their babies in a way that meets their expectations and health needs.
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Affiliation(s)
- Caitlin Lythgoe
- Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Kirsty Lowe
- Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Mary McCauley
- Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
- Liverpool Women's Hospital, Liverpool Women's NHS Foundation Trust, Crown Street, Liverpool, L8 7SS, UK
| | - Hannah McCauley
- Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
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Yaman Sözbir Ş, Erenoğlu R, Ayaz Alkaya S. Birth Experience in Syrian Refugee Women in Turkey: A Descriptive Phenomenological Qualitative Study. Women Health 2021; 61:470-478. [PMID: 33957842 DOI: 10.1080/03630242.2021.1922570] [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: 10/21/2022]
Abstract
A negative birth experience affects the woman's subsequent pregnancy, and delivery processes negatively, decreases patient satisfaction, and the high anxiety/stress experienced during pregnancy/delivery is transferred to the next generations by epigenetic transmission. In this study, women's birth experiences of Syrian refugees in Turkey aimed to describe in-depth. It was designed as a descriptive phenomenological qualitative study. Fifteen refugee women included in the sample gave birth in Turkey, living in Turkey's southern city. In-depth interviews were conducted with women. Six themes were formed in the results: "quantitatively enough but unsatisfactory service," "not providing autonomy," "think that she was neglected," "no respect to privacy," "feeling loneliness/fear in the delivery room," and "prejudice." The factors that negatively affect the pregnancy and birth experiences of Syrian refugee women are language/communication barriers, the provision of care services that are incompatible with their religious and cultural values, and their prejudice regarding discrimination.
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Affiliation(s)
- Şengül Yaman Sözbir
- Faculty of Health Sciences, Nursing Department, Gyneacology and Obstetric Nursing Department, Gazi University, Ankara, Turkey
| | - Rabiye Erenoğlu
- Faculty of Health Sciences, Nursing Department, Gyneacology and Obstetric Nursıng Department, Mustafa Kemal Universtiy, Hatay, Turkey
| | - Sultan Ayaz Alkaya
- Faculty of Health Sciences, Nursing Department, Public Health Nursing Department, Gazi University, Ankara, Turkey
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Navajas-Romero V, Hernández-Rojas RD, Hidalgo-Fernández A, Jimber del Rio JA. Tourist loyalty and mosque tourism: The case of the Mosque-Cathedral in Córdoba (Spain). PLoS One 2020; 15:e0242866. [PMID: 33259515 PMCID: PMC7707557 DOI: 10.1371/journal.pone.0242866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/10/2020] [Indexed: 12/04/2022] Open
Abstract
Loyalty is important in the tourism sector since tourists are the key to returning to a destination or recommending it, which is a determining factor in the management of tourist sites. The tourism of Mosques, is a contextualized tourism within religious and cultural tourism. This research aims to analyze the loyalty of tourists of Islamic origin in the Cathedral Mosque of Cordoba. Unlike previous studies, this research adopts a comprehensive approach by considering cultural factors in the analysis of loyalty of Islamic tourists in mosque tourism. The methodology used in this study was a structural equation model with a partial least squares (PLS) analysis. The sample is made up of 262 tourists of Islamic origin at Cordoba Cathedral Mosque. This model does not correspond to factors identified by the previous literature, which adopts an religious perspective of Islamic tourists in mosque tourism. The methodology used in this study was a structural equation model with a partial least squares (PLS) analysis. The sample is made up of 262 tourists of Islamic origin in Cordoba Cathedral Mosque. This model does not correspond to factors identified by the previous literature, which adopts an religious perspective.
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Affiliation(s)
- Virginia Navajas-Romero
- Department of Statistics, Econometrics, Operational Research, Business Organization and Applied Economics, University of Cordoba, Córdoba, Spain
| | | | - Amalia Hidalgo-Fernández
- Department Agricultural Economics, Finance, and Accounting, University of Cordoba, Córdoba, Spain
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Mazúchová L, Kelčíková S, Štofaníková L, Kopincová J, Malinovská N, Grendár M. Satisfaction of Slovak women with psychosocial aspects of care during childbirth. Midwifery 2020; 86:102711. [DOI: 10.1016/j.midw.2020.102711] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 03/19/2020] [Accepted: 03/27/2020] [Indexed: 11/26/2022]
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Astuti MD, Rachmawati IN, Rahmah H. Intrapartum care satisfaction at three levels of healthcare facilities in Jakarta. ENFERMERIA CLINICA 2019. [DOI: 10.1016/j.enfcli.2019.04.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Women's labour experiences and quality of care in relation to a prolonged latent phase of labour. Midwifery 2019; 77:155-164. [PMID: 31369936 DOI: 10.1016/j.midw.2019.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/04/2019] [Accepted: 07/08/2019] [Indexed: 11/21/2022]
Abstract
AIM To describe primiparous and multiparous women's labour experiences and their perception of quality of intrapartum care, in relation to background characteristics and length of latent phase of labour prior to admittance to labour ward. DESIGN A cross-sectional study. SETTING A middle-sized hospital in a rural county in western part of Sweden. PARTICIPANTS Primiparous and multiparous women, both low-risk and risk, with a spontaneous onset of labour after gestational week 37+0 were included. In total, n = 1193 women were invited, and n = 757 responded the questionnaire, n = 342 primiparous and n = 415 multiparous women. METHODS The Intrapartal-specific Quality from Patient Perspective (QPP-I), with responses on perceived reality and subjective importance, was used for data collection. QPP-I covers ten factors of quality of care. Background characteristics, length of latent phase of labour, global items about labour experience and items regarding feelings during labour and birth were included. Data were analysed with descriptive and analytic statistics. FINDINGS All factors in QPP-I were rated higher for subjective importance than perceived reality, except for information about selfcare, for both primi- and multiparous women. Labour experience, perceived reality of quality of care, and feelings were related to length of the latent phase of labour. Primiparous women with a prolonged latent phase (>18 h) had significantly lower scores regarding six out of ten QPP-I factors (PR); Information procedures, Information self-care, Commitment (midwives), Commitment (enrolled nurses), Midwives present, and Partner/ significant others. They scored lower on Experience birth as normal and Safe during labour and birth. The felt less proud and felt more ignored by professionals. Multiparous women with a prolonged latent phase of labour scored significantly lower on one QPP-I factor, Commitment (midwives). They also scored lower on Control over the situation and felt less safe during labour and birth. KEY CONCLUSION Women's perception of quality of intrapartum care, the birth experience and feelings are related to length of the latent phase of labour. Women perceive quality of intrapartum care as being lower than its subjective importance. IMPLICATIONS FOR PRACTICE A prolonged latent phase of labour can be regarded as a risk factor for a more negative birthing experience.
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