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Sposato MF, Miller WR. Concept Analysis of Woman-Centered Care: Implications for Postpartum Care. MCN Am J Matern Child Nurs 2024:00005721-990000000-00061. [PMID: 39012337 DOI: 10.1097/nmc.0000000000001045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/17/2024]
Abstract
ABSTRACT Approximately two-thirds of pregnancy-related deaths in the United States occur during the postpartum period, yet there is minimal research focusing on the postpartum hospital stay, a critical point of contact between women and the health care system and an important opportunity for intervention. A new approach to postpartum care is needed. "Woman-centered" postpartum care is recommended to improve maternal outcomes, but the concept of woman-centered care is not well-defined. Using Walker & Avant's method of concept analysis, we identified four defining attributes of woman-centered care in the literature: 1) choice, control, and involvement in decision-making; 2) communication and collaboration in the caregiver-woman relationship; 3) individualized and holistic care; and 4) continuity of care. Using these findings, we offer a conceptual definition of woman-centered care and apply the attributes to the postpartum hospitalization in the model and contrary cases. We discuss the potential of the concept to improve maternal health care during this critical period.
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Talbot H, Peters S, Furber C, Smith DM. Midwives' experiences of discussing health behaviour change within routine maternity care: A qualitative systematic review and meta-synthesis. Women Birth 2024; 37:303-316. [PMID: 38195300 DOI: 10.1016/j.wombi.2024.01.002] [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: 09/06/2023] [Revised: 12/22/2023] [Accepted: 01/02/2024] [Indexed: 01/11/2024]
Abstract
PROBLEM Behaviours, such as smoking, alcohol use, unhealthy diet, lack of physical activity and vaccination non-adherence may lead to adverse pregnancy outcomes. BACKGROUND Pregnancy has been identified as an opportune time for midwives to support women to make health behaviour changes. AIM To synthesise existing qualitative research exploring midwives' experiences of discussing health behaviour change with women within routine care. METHODS A systematic search was conducted across: Maternity and Infant Care, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Applied Social Sciences Index and Abstracts. Thematic analysis was used to synthesise the data. A professional and public advisory group provided feedback during the synthesis stage. FINDINGS Twenty-two studies, published between 2005 and 2023, which represented findings from eight countries, were included in the review. The meta-synthesis revealed three themes: The midwife-woman relationship; Reflective and tailored behaviour change communication; Practical barriers to behaviour change conversations. This led to one overarching theme: Although midwives recognised the importance of behaviour change discussions, these conversations were not prioritised in clinical practice. CONCLUSION Health behaviour change discussions were de-prioritised in midwives' clinical practice. Future research should explore intervention development to support midwives with their health behaviour change communication.
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Affiliation(s)
- Hannah Talbot
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK.
| | - Sarah Peters
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK
| | - Christine Furber
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, UK
| | - Debbie M Smith
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK
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Roddy J, McGowan L. What are the childbearing experiences of women with type 1 diabetes? A scoping review of qualitative literature. Midwifery 2024; 128:103884. [PMID: 37984081 DOI: 10.1016/j.midw.2023.103884] [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: 08/01/2023] [Revised: 10/31/2023] [Accepted: 11/13/2023] [Indexed: 11/22/2023]
Abstract
PROBLEM Type 1 diabetes is associated with the risk of adverse outcomes for mother and baby. BACKGROUND How pregnant people adapt to the challenges of type 1 diabetes and engage with healthcare professionals can affect how likely they will be to maintain good glycaemic control. Therefore, it is important to understand the childbearing and care experiences of women with type 1 diabetes. AIM To examine contemporary literature describing the childbearing experiences of women with type 1 diabetes over the last decade. METHOD The review follows 5 stages of Arksey and O'Malley's scoping review framework. Four databases were searched for English language publications 2012-2023 using indexed terms and Boolean operators. 64 studies were retrieved, 10 included in the review. Braun and Clarke's thematic synthesis process was used to collate findings. FINDINGS Five key themes emerged: 1. Glycaemic control dominates the childbearing journey, 2. Emphasis on risk, 3. Importance of social and peer support, 4. Care organisation, systems, and communication, 5. The impact of technology on the childbearing experience. CONCLUSION Based on lived experiences, women with type 1 diabetes value being treated as partners in their care by health professionals providing medical and midwifery services. Peer and social support from family, friends and the diabetes community can bring comfort and reassurance in a perceived 'medicalised' childbearing journey. Further research is needed on the impact of the use of type 1 diabetes technologies on childbearing experiences and how peer support can be incorporated into current care provision.
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Affiliation(s)
- Jenny Roddy
- Consultant Midwife Health Equity, Leeds Teaching Hospitals NHS Trust, England, UK.
| | - Linda McGowan
- Professor of Applied Health Research, School of Healthcare, University of Leeds, England, UK
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Pelak H, Dahlen HG, Keedle H. A content analysis of women's experiences of different models of maternity care: the Birth Experience Study (BESt). BMC Pregnancy Childbirth 2023; 23:864. [PMID: 38102547 PMCID: PMC10722666 DOI: 10.1186/s12884-023-06130-2] [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: 06/04/2023] [Accepted: 11/15/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Pregnancy, birth, and early parenthood are significant life experiences impacting women and their families. Growing evidence suggests models of maternity care impact clinical outcomes and birth experiences. The aim of this study was to explore the strengths and limitations of different maternity models of care accessed by women in Australia who had given birth in the past 5 years. METHODS The data analysed and presented in this paper is from the Australian Birth Experience Study (BESt), an online national survey of 133 questions that received 8,804 completed responses. There were 2,909 open-ended comments in response to the question on health care provider/s. The data was analysed using content analysis and descriptive statistics. RESULTS In models of fragmented care, including standard public hospital care (SC), high-risk care (HRC), and GP Shared care (GPS), women reported feelings of frustration in being unknown and unheard by their health care providers (HCP) that included themes of exhaustion in having to repeat personal history and the difficulty in navigating conflicting medical advice. Women in continuity of care (CoC) models, including Midwifery Group Practice (MGP), Private Obstetric (POB), and Privately Practising Midwifery (PPM), reported positive experiences of healing past birth trauma and care extending for multiple births. Compared across models of care in private and public settings, comments in HRC contained the lowest percentage of strengths (11.94%) and the highest percentage of limitations (88.06%) while comments in PPM revealed the highest percentage of strengths (95.93%) and the lowest percentage of limitations (4.07%). CONCLUSIONS Women across models of care in public and private settings desire relational maternity care founded on their unique needs, wishes, and values. The strengths of continuity of care, specifically private midwifery, should be recognised and the limitations for women in high risk maternity care investigated and prioritised by policy makers and managers in health services. TRIAL REGISTRATION The study is part of a larger project that has been retrospectively registered with OSF Registries Registration DOI https://doi.org/10.17605/OSF.IO/4KQXP .
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Affiliation(s)
- Helen Pelak
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, 167 Great Western Highway, Blackheath, Penrith, NSW, 2751, Australia
| | - Hannah G Dahlen
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, 167 Great Western Highway, Blackheath, Penrith, NSW, 2751, Australia
| | - Hazel Keedle
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, 167 Great Western Highway, Blackheath, Penrith, NSW, 2751, Australia.
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Psaila KM, Schmied V, Heath S. Exploring continuity of care for women with prenatal diagnosis of congenital anomaly: A mixed method study. J Clin Nurs 2023; 32:7147-7161. [PMID: 37409420 DOI: 10.1111/jocn.16777] [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: 08/09/2022] [Revised: 03/04/2023] [Accepted: 05/15/2023] [Indexed: 07/07/2023]
Abstract
AIMS To map the pathway and service provision for pregnant women whose newborns require admission into the surgical neonatal intensive care unit at or soon after birth, and to examine the nature of continuity of care (COC) provided and the facilitators and barriers to woman- and family-centred care from the perspective of women/parents and health professionals. BACKGROUND Limited research exists on current service and care pathways for families whose babies are diagnosed with congenital abnormality requiring surgery. DESIGN A mixed method sequential design adhering to EQUATOR guidelines for Good Reporting of a Mixed Methods Study. METHODS Data collection methods included: (1) a workshop with health professionals (n = 15), (2) retrospective maternal record review (n = 20), prospective maternal record review (17), (3) interviews with pregnant women given a prenatal diagnosis of congenital anomaly (n = 17) and (4) interviews with key health professionals (n = 7). RESULTS/FINDINGS Participants perceived care delivered by state-based services as problematic prior to admission into the high-risk midwifery COC model. Once admitted to the high-risk maternity team women described care 'like a breath of fresh air' with a 'contrast in support', where they felt supported in their decisions. CONCLUSION This study highlights provision of COC, in particular relational continuity between health providers and women as essential to achieve optimal outcomes. RELEVANCE TO CLINICAL PRACTICE Provision of individualised COC offers an opportunity for perinatal services to reduce the negative consequences of pregnancy-related stress associated with diagnosis of foetal anomaly. PATIENT OR PUBLIC CONTRIBUTION No patient or public was involved in the design, analysis, preparation or writing of this review.
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Affiliation(s)
- Kim M Psaila
- School of Nursing and Midwifery, University of Western, Sydney, New South Wales, Australia
| | - Virginia Schmied
- School of Nursing and Midwifery, University of Western, Sydney, New South Wales, Australia
| | - Susan Heath
- PEARLS Team, Westmead Hospital, Sydney, New South Wales, Australia
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O'Brien C, Newport M. Prioritizing women's choices, consent, and bodily autonomy: From a continuum of violence to women-centric reproductive care. Soc Sci Med 2023; 333:116110. [PMID: 37567015 DOI: 10.1016/j.socscimed.2023.116110] [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: 02/03/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/13/2023]
Abstract
Obstetric violence is a product of medical institutions' failure to prioritize women-centric reproductive care. Through interviews with local activists and leaders in Oaxaca, Mexico, as well as analysis of primary and secondary sources, we find that women-centric reproductive care is hindered by three barriers that are a part of a continuum of violence. These barriers include the cultural and religious norms surrounding reproductive care, the medical community and medical profiteers' opposition to combatting obstetric violence, and the state's resistance to women's human rights policy changes. Shifting to a women-centric reproductive care model requires: the life of the woman to be prioritized in reproductive care, the criminalization of obstetric violence, improved training for the medical community, reduced monetary incentives for unnecessary cesarean sections, and the respectful inclusion of indigenous and midwife knowledge and practices. Our study's theoretical and empirical contributions add to the scholarly research regarding the systemic causes of obstetric violence and the care ethic required for transformative change. Our recommendations can be applied across contexts with locally developed and culturally inclusive models of women-centric reproductive care.
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Affiliation(s)
- Cheryl O'Brien
- Department of Political Science, San Diego State University, San Diego, 5500 Campanile Dr, San Diego, CA, 92182-4427, USA.
| | - Morgan Newport
- Department of Political Science, San Diego State University, San Diego, 5500 Campanile Dr, San Diego, CA, 92182-4427, USA
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Anolak H, Lau F, Davis D, Browne J, Watt B. Creative arts intervention in support of women experiencing a high-risk pregnancy: A qualitative descriptive thematic analysis. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 36:100830. [PMID: 36898309 DOI: 10.1016/j.srhc.2023.100830] [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: 11/27/2022] [Revised: 02/09/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Mental illness can have negative effects on both the pregnant woman and her unborn child. Studies that use the creative arts as interventions have proven to be beneficial to women's antenatal mental health and wellbeing, however, these studies are limited and emergent. Music, drawing and narrative (MDN) is an established music therapy intervention, stemming from guided imagery and music (GIM), that has the potential to support positive mental health and wellbeing. Yet, to date, there have been limited studies on the use of this form of therapy with inpatient antenatal women. AIM To describe antenatal inpatient women's experiences of participating in a MDN session. METHODS Qualitative data were collected from a sample of 12 inpatient pregnant women who participated in MDN group sessions of drawing to music. Post intervention interviews explored the mental and emotional health of participants. A thematic analysis of the transcribed interview data was performed. FINDINGS Through reflection women were supported to acknowledge both the positives and difficulties of pregnancy as well as establish meaningful connections through shared experience. These thematic findings highlighted that MDN enabled this group of pregnant women to better communicate their feelings, validate emotions, engage in positive distractions, develop greater connections, improve optimism, experience calmness, and learn from others. CONCLUSION This project demonstrates that MDN may offer a viable method for supporting women experiencing high risk pregnancies.
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Affiliation(s)
- Helena Anolak
- Federation University, Mt Helen, PO Box 663, Ballarat, VIC 3353, Australia.
| | - Farrah Lau
- Flinders University, Sturt Rd, Bedford Park, S.A 5042, Australia.
| | - Deborah Davis
- University of Canberra, 11 Kirinari St, Bruce, ACT 2617, Australia.
| | - Jenny Browne
- University of Canberra, 11 Kirinari St, Bruce, ACT 2617, Australia.
| | - Bec Watt
- Flinders University, Sturt Rd, Bedford Park, S.A 5042, Australia.
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O'Rourke K, Yelland J, Newton M, Shafiei T. Matching of woman and doula, and the generation of trust in an Australian volunteer doula program: Findings from a realist evaluation. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5423-e5433. [PMID: 35924682 PMCID: PMC10087570 DOI: 10.1111/hsc.13965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 05/31/2022] [Accepted: 07/25/2022] [Indexed: 05/15/2023]
Abstract
How women are cared for while pregnant and having a new baby can have profound and lasting effects on their health and well-being. While mainstream maternity care systems aspire to provide care that is woman-centred, women with fewest social and economic resources often have reduced access. Community-based doula support programs offer complementary care for these women and are known to, on average, have positive outcomes. Less understood is how, when and why these programs work. A realist evaluation of an Australian volunteer doula program provided for women experiencing socioeconomic adversity explored these questions. The program provides free non-medical, social, emotional, and practical support by trained doulas during pregnancy, birth and new parenting. This paper reports the testing and refinement of one program theory from the larger study. The theory, previously developed from key informant interviews and rapid realist review of literature, hypothesised that the cultural matching of woman (client) and doula led to best outcomes. This was tested in realist interviews with women and focus groups with doulas, in January-February 2020. Seven English speaking, and six Arabic speaking clients were interviewed. Two focus groups were conducted with a total of eight doulas from diverse cultural and professional backgrounds. Data were analysed in NVivo. The study found cultural matching to be valued by some but not all women, and only when the doula was also genuinely interested, kind, timely and reliable. These approaches (with or without cultural matching) generate trust between the doula and woman. Trust theory, reflexivity theory and social relations theory supported explanatory understanding of the causal contribution of a doula knowing what it takes to build trust, to a woman deciding to trust her doula.
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Affiliation(s)
- Kerryn O'Rourke
- Judith Lumley CentreLa Trobe UniversityBundooraVictoriaAustralia
- Realist Research Evaluation and Learning InitiativeNorthern Institute Charles Darwin UniversityCasuarina, DarwinNorthern TerritoryAustralia
| | - Jane Yelland
- Murdoch Children's Research InstituteParkvilleVictoriaAustralia
- Department General PracticeUniversity of MelbourneParkvilleAustralia
| | - Michelle Newton
- Judith Lumley CentreLa Trobe UniversityBundooraVictoriaAustralia
- School of Nursing and MidwiferyLa Trobe UniversityBundooraVictoriaAustralia
| | - Touran Shafiei
- Judith Lumley CentreLa Trobe UniversityBundooraVictoriaAustralia
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Simpson N, Steen M, Vernon R, Briley A, Wepa D. Developing conflict resolution strategies and building resilient midwifery students: A mixed methods research protocol. JMIR Res Protoc 2021; 11:e35558. [PMID: 34995202 PMCID: PMC8900901 DOI: 10.2196/35558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/18/2021] [Indexed: 11/30/2022] Open
Abstract
Background Workplace bullying and violence (WBV) are well-documented issues in the midwifery profession. Negative workplace culture, conflict, and bullying are the most common forms of workplace violence experienced by midwives. Workplace violence increases the risk of midwives experiencing burnout, compassion fatigue, psychological trauma, poor mental health, absenteeism, loss of passion for the midwifery profession, job dissatisfaction, and poor job retention. Midwifery students describe workplace violence in the form of physical, emotional, or verbal abuse, and bullying. Therefore, there is a justification to develop conflict resolution strategies and resilience in midwifery students prior to graduation. Objective Our aim is to develop and facilitate a bespoke education program for South Australian midwifery students to enable them to develop skills in conflict resolution, build resilience, and identify self-care strategies. Methods This study will undertake a preparatory phase summarizing the body of literature on midwifery students’ knowledge, understanding, and experiences of WBV. Following this, a 3-phase sequential mixed methods research design study will be undertaken. In Phase 1, quantitative data will be collected via a semistructured questionnaire and a validated conflict measurement tool, before and after attending an education workshop, and will be analyzed using descriptive and inferential statistics. Results from Phase 1 will inform and guide the development of an interview schedule for Phase 2. In Phase 2, qualitative data will be gathered by facilitating one-to-one interviews and a thematic analysis will be undertaken to gain a deeper understanding of midwifery students’ experiences of WBV. In Phase 3, data integration using triangulation will be undertaken and meta-inferences will be developed via the integration of results and findings from Phases 1 and 2. Results The preparatory phase will commence in October 2021. Phase 1 will commence in 2022 with analysis of pre- and posteducation results anticipated to be completed by December 2022. Phase 2 will be developed from findings of the preparatory phase and results of Phase 1. An interpretation of verbatim interview transcripts is estimated to be undertaken by April 2023. Phase 3 of the study is expected to commence in May 2023, and this will involve the analysis of collective evidence gathered from Phases 1 and 2. The anticipated completion date for the study is December 2023. Conclusions The outcomes of this research will provide insights into the prevalence and impact of WBV experienced by midwifery students. The findings of the research will report on levels of knowledge, skills, and confidence, and will assess the impact of a bespoke conflict resolution and resilience education workshop for midwifery students in managing WBV. International Registered Report Identifier (IRRID) PRR1-10.2196/35558
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Affiliation(s)
- Naomi Simpson
- University of South Australia, Crn Frome Road & North Terrace, Adelaide, AU
| | | | - Rachael Vernon
- University of South Australia, Crn Frome Road & North Terrace, Adelaide, AU
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