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Hearn F, Brown SJ, Szwarc J, Toke S, Alqas Alias M, Essa M, Hydari S, Baget A, Riggs E. Perceptions and Experiences of Inequity for Women of Refugee Background Having a Baby during the COVID-19 Pandemic in Melbourne, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:481. [PMID: 38673392 PMCID: PMC11049987 DOI: 10.3390/ijerph21040481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024]
Abstract
Listening to What Matters is an exploratory descriptive qualitative study that aimed to (1) understand how women of refugee background in Melbourne, Australia experienced access to health information and maternity and/or early parenting care during the COVID-19 pandemic and (2) whether pandemic health directives had an impact on structural inequities for women of refugee background who received maternity and/or early parenting care during the COVID-19 pandemic. Semi-structured interviews were conducted with 41 participants including 17 women of refugee background, who identified as belonging to the Karen, Assyrian Chaldean, Iraqi, Syrian, Afghan, Sudanese, or South Sudanese communities and 24 health and social care professionals who identified as providing pregnancy or early parenting care during the pandemic in the north western suburbs of Melbourne. Interviews with women were conducted in preferred languages by community researchers. Interviews with professionals were conducted in English by researchers. Reflexive thematic data analysis included constructivist positionality and a trauma and violence informed approach. The results reported in this paper include three themes, with four accompanying subthemes, as follows: theme (1), 'Structural inequities and the toll of the pandemic'; theme (2), 'Supportive infrastructure'; and theme (3), 'Cultural safety during the pandemic'. The results demonstrate that cumulative negative impacts such as unequal access to health information, family separation and isolation, inadequate household income, and mental and social health concerns had the potential to amplify pre-existing structural inequities for women of refugee background. Community engagement facilitated by bicultural workers, interpreters, and trusted care providers facilitated fast-paced, two-way communication that built capacity and health literacy for women who were unable to speak English and unfamiliar with the health care system and, improved experiences of care. More research is needed to understand how the intersectional cumulative impacts of structural inequities have affected maternal and neonatal health outcomes for women of refugee background during the pandemic, as well as any differences in maternal and neonatal health outcomes between Australian-born and refugee background women and babies.
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Affiliation(s)
- Fran Hearn
- Intergenerational Health, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
| | - Stephanie J. Brown
- Intergenerational Health, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
- Department of General Practice, University of Melbourne, Parkville, VIC 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
- South Australian Health and Medical Research Institute, Adelaide, SA 5001, Australia
| | - Josef Szwarc
- The Victorian Foundation for Survivors of Torture Inc., Brunswick, VIC 3056, Australia
| | - Shadow Toke
- Intergenerational Health, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
- Department of General Practice, University of Melbourne, Parkville, VIC 3052, Australia
| | - May Alqas Alias
- Intergenerational Health, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
| | - Maryaan Essa
- Intergenerational Health, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
| | - Shogoufa Hydari
- Intergenerational Health, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
| | - Ashay Baget
- Intergenerational Health, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
| | - Elisha Riggs
- Intergenerational Health, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
- Department of General Practice, University of Melbourne, Parkville, VIC 3052, Australia
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Golden BN, Elrefaay S, McLemore MR, Alspaugh A, Baltzell K, Franck LS. Midwives' experience of telehealth and remote care: a systematic mixed methods review. BMJ Open 2024; 14:e082060. [PMID: 38553065 PMCID: PMC10982796 DOI: 10.1136/bmjopen-2023-082060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/14/2024] [Indexed: 04/02/2024] Open
Abstract
INTRODUCTION Increasing the midwifery workforce has been identified as an evidence-based approach to decrease maternal mortality and reproductive health disparities worldwide. Concurrently, the profession of midwifery, as with all healthcare professions, has undergone a significant shift in practice with acceleration of telehealth use to expand access. We conducted a systematic literature review to identify and synthesize the existing evidence regarding how midwives experience, perceive and accept providing sexual and reproductive healthcare services at a distance with telehealth. METHODS Five databases were searched, PubMed, CINHAL, PsychInfo, Embase and the Web of Science, using search terms related to 'midwives', 'telehealth' and 'experience'. Peer-reviewed studies with quantitative, qualitative or mixed methods designs published in English were retrieved and screened. Studies meeting the inclusion criteria were subjected to full-text data extraction and appraisal of quality. Using a convergent approach, the findings were synthesized into major themes and subthemes. RESULTS After applying the inclusion/exclusion criteria, 10 articles on midwives' experience of telehealth were reviewed. The major themes that emerged were summarized as integrating telehealth into clinical practice; balancing increased connectivity; challenges with building relationships via telehealth; centring some patients while distancing others; and experiences of telehealth by age and professional experience. CONCLUSIONS Most current studies suggest that midwives' experience of telehealth is deeply intertwined with midwives' experience of the response to COVID-19 pandemic in general. More research is needed to understand how sustained use of telehealth or newer hybrid models of telehealth and in-person care are perceived by midwives.
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Affiliation(s)
- Bethany N Golden
- Department of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Shaimaa Elrefaay
- Department of Community Nursing, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Monica R McLemore
- Child, Family, and Population Health Nursing Department, University of Washington, Seattle, Washington, USA
| | - Amy Alspaugh
- The University of Tennessee Knoxville College of Nursing, Knoxville, Tennessee, USA
| | - Kimberly Baltzell
- Department of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Linda S Franck
- Department of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, California, USA
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Chapman M, Evans EC, Long MH. Midwifery Practice Leaders' Experiences of Practice Changes Early in the COVID-19 Pandemic: A Qualitative Exploration. J Midwifery Womens Health 2024; 69:236-242. [PMID: 37986664 DOI: 10.1111/jmwh.13584] [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] [Revised: 09/08/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic generated considerable upheaval in all sectors of the US health care system, including maternity care. We focused this inquiry on midwifery practice leaders' experiences and perspectives on changes that occurred in their practices early in the pandemic. METHODS This was a qualitative descriptive study using thematic analysis. The data were responses to an open-ended question in a survey of pandemic-related employment and clinical practice changes. Findings are presented from a constructivist perspective, describing the experiences and perspectives of a group of US midwifery practice leaders during the initial phase of the COVID-19 pandemic. RESULTS Two main themes emerged from the analysis: demands on midwives and driving forces. Demands on midwives were 3-fold: clients' needs, modification of care, and midwives' needs. These encompassed the psychological, physical, and emotional toll that caring for women during the pandemic placed on midwives. Driving forces were those entities that spurred and directed change and included regulations, institutions, financial logistics, and team dynamics. Survey respondents in community (home and birth center) practices reported substantial increases in inquiries and client volume, and many respondents expressed concern about withdrawal of students from clinical placements. DISCUSSION Midwifery practices experienced profound changes in their work environments during the COVID-19 pandemic, with both positive and negative characteristics. These challenges in providing birth care were similar to those reported in other countries. Results indicated existing guidance for maternity care during emergencies did not meet clients' needs. Coordinated planning for maternity care in future prolonged health emergencies should incorporate best practices and include midwives in the process.
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Affiliation(s)
- Meredith Chapman
- School of Nursing, University of Virginia, Charlottesville, Virginia
| | | | - Maryann H Long
- School of Nursing, University of Virginia, Charlottesville, Virginia
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Collins E, Keedle H, Jackson M, Lequertier B, Schmied V, Boyle J, Kildea S, Dahlen HG. Telehealth use in maternity care during a pandemic: A lot of bad, some good and possibility. Women Birth 2024; 37:419-427. [PMID: 38218652 DOI: 10.1016/j.wombi.2023.12.008] [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: 08/05/2023] [Revised: 11/18/2023] [Accepted: 12/26/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND To reduce transmission risk during the COVID-19 pandemic, 'telehealth' (health care delivered via telephone/video-conferencing) was implemented into Australian maternity services. Whilst some reports on telehealth implementation ensued, there was scant evidence on women and midwives' perspectives regarding telehealth use. METHODS A qualitative study was conducted in Australia during 2020-2021 using two data sources from the Birth in the Time of COVID-19 (BITTOC) study: i) interviews and ii) surveys (open-text responses). Content analysis was utilised to analyse the data and explore telehealth from the perspective of midwives and women accessing maternity care services. In-depth interviews were conducted with 20 women and 16 midwives. Survey responses were provided from 687 midwives and 2525 women who were pregnant or gave birth in 2021, generating 212 and 812 comments respectively. FINDINGS Telehealth delivery was variable nationally and undertaken primarily by telephone/videoconferencing. Perceived benefits included: reduced COVID-19 transmission risk, increased flexibility, convenience and cost efficiency. However, women described inadequate assessment, and negative impacts on communication and rapport development. Midwives had similar concerns and also reported technological challenges. CONCLUSION During the COVID-19 pandemic, telehealth offered flexibility, convenience and cost efficiency whilst reducing COVID-19 transmission, yet benefits came at a cost. Telehealth may particularly suit women in rural and remote areas, however, it also has the potential to further reduce equitable, and appropriate care delivery for those at greatest risk of poor outcomes. Telehealth may play an adjunct role in post-pandemic maternity services, but is not a suitable replacement to traditional face-to-face maternity care.
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Affiliation(s)
- Emma Collins
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith 2751 NSW Australia
| | - Hazel Keedle
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith 2751 NSW Australia
| | - Melanie Jackson
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith 2751 NSW Australia
| | - Belinda Lequertier
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Level 11, East Tower, 410 Ann Street, Brisbane, Qld 4000, Australia
| | - Virginia Schmied
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith 2751 NSW Australia
| | - Jacqueline Boyle
- Monash Centre of Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Locked Bag 29, Clayton, VIC 3168, Australia
| | - Sue Kildea
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, Queensland, Australia
| | - Hannah Grace Dahlen
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith 2751 NSW Australia.
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Matthews RP, Hyde RL, McLachlan HL, Llewelyn F, Forster DA. Midwifery workforce challenges in Victoria, Australia. A cross-sectional study of maternity managers. Women Birth 2024; 37:144-152. [PMID: 37553273 DOI: 10.1016/j.wombi.2023.07.130] [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: 03/21/2023] [Revised: 07/19/2023] [Accepted: 07/19/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND In Australia, there is a lack of accurate data on midwifery workforce staffing and skill mix, which in turn hinders workforce policy and planning. AIM To describe the current staffing levels of the midwifery workforce in Victoria, Australia, explore workforce challenges and assess the impact of COVID-19 pandemic on staffing. DESIGN Cross-sectional. METHODS Midwifery managers in all public and private maternity services in Victoria, Australia were invited to complete a survey exploring midwifery staffing numbers and adequacy. Topics explored included midwifery turnover, recruitment, and skill mix. Descriptive statistics were used. FINDINGS The survey was open March to October 2021, and 56 % (38/68) of managers responded. Of these, 76 % reported inadequate midwifery staff levels, with deficits ranging from one to 19 estimated Full-Time Equivalent (EFT) midwives, with a combined total deficit of 135 EFT. In the 12 months prior to the survey, 73 % of services had found it difficult to recruit midwives, with increased difficulty during the COVID-19 pandemic. Managers were concerned about retaining and recruiting 'experienced' midwives due to an ageing workforce and high turnover due to work/life imbalance and job dissatisfaction. These issues have led to a predominantly early career midwifery workforce and created concern about skill mix. CONCLUSION Victorian maternity services have a midwifery workforce shortage and are experiencing significant skill mix issues. The pandemic has exacerbated these considerable gaps in the workforce. Urgent implementation of retention and recruitment schemes are needed, along with strategies to improve the working conditions for the current workforce.
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Affiliation(s)
- Robyn P Matthews
- Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia; School of Nursing & Midwifery, La Trobe University, Bundoora, VIC 3086, Australia; The Royal Women's Hospital, Locked Bag 300, Cnr Grattan St and Flemington Rd, Parkville, VIC 3052, Australia.
| | - Rebecca L Hyde
- Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia; School of Nursing & Midwifery, La Trobe University, Bundoora, VIC 3086, Australia; The Royal Women's Hospital, Locked Bag 300, Cnr Grattan St and Flemington Rd, Parkville, VIC 3052, Australia
| | - Helen L McLachlan
- Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia; School of Nursing & Midwifery, La Trobe University, Bundoora, VIC 3086, Australia
| | - Fleur Llewelyn
- The Royal Women's Hospital, Locked Bag 300, Cnr Grattan St and Flemington Rd, Parkville, VIC 3052, Australia
| | - Della A Forster
- Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia; School of Nursing & Midwifery, La Trobe University, Bundoora, VIC 3086, Australia; The Royal Women's Hospital, Locked Bag 300, Cnr Grattan St and Flemington Rd, Parkville, VIC 3052, Australia
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Loezar-Hernández M, Briones-Vozmediano E, Gea-Sánchez M, Robledo-Martin J, Otero-García L. Primary health care midwives' perceptions on the use of telemedicine during the COVID-19 pandemic in Spain. ENFERMERIA CLINICA (ENGLISH EDITION) 2023; 33:380-390. [PMID: 37898171 DOI: 10.1016/j.enfcle.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/23/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVE To explore the experiences of primary healthcare (PHC) midwives with the implementation of telemedicine in pregnancy and puerperium care during the Covid-19 pandemic. METHOD Exploratory qualitative study based on an inductive content analysis of 15 semi-structured interviews with intentionally selected PHC midwives in four Spanish Autonomous Regions, during 2021-22. RESULTS Five categories were identified: (1) changes in the modality of care in pregnancy and puerperium: prioritization of pregnant women, unprotected puerperium, an increase of home visits and decline of parental education groups, (2) implementation of telemedicine in a changing scenario: the positive and negative side of telemedicine (3) reaction of women to telemedicine (4) strategies implemented by midwives for a humanized care, (5) learning for the future. CONCLUSIONS The use of telemedicine by primary healthcare midwives enabled the care of pregnant and postpartum women during the pandemic in Spain. The positive aspects of the implementation of this type of care raise possibilities for change towards a hybrid format of healthcare.
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Affiliation(s)
- Mariana Loezar-Hernández
- Departamento de Enfermería y Fisioterapia, Facultad de Enfermería y Fisioterapia, Universidad de Lleida, Lleida, Spain; Grupo de Estudios en Salud, Sociedad, Educación y Cultura de los Cuidados, Universidad de Lleida, Lleida, Spain; Grup de Recerca en Cures en Salut (GRECS), Institut de Recerca Biomèdica (IRB), Lleida, Spain
| | - Erica Briones-Vozmediano
- Departamento de Enfermería y Fisioterapia, Facultad de Enfermería y Fisioterapia, Universidad de Lleida, Lleida, Spain; Grupo de Estudios en Salud, Sociedad, Educación y Cultura de los Cuidados, Universidad de Lleida, Lleida, Spain; Grup de Recerca en Cures en Salut (GRECS), Institut de Recerca Biomèdica (IRB), Lleida, Spain.
| | - Montserrat Gea-Sánchez
- Departamento de Enfermería y Fisioterapia, Facultad de Enfermería y Fisioterapia, Universidad de Lleida, Lleida, Spain; Grupo de Estudios en Salud, Sociedad, Educación y Cultura de los Cuidados, Universidad de Lleida, Lleida, Spain; Grup de Recerca en Cures en Salut (GRECS), Institut de Recerca Biomèdica (IRB), Lleida, Spain; Centro de Investigación Biomédica en Red en Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Juana Robledo-Martin
- Departamento de Enfermería, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañon (IiSGM), Madrid, Spain
| | - Laura Otero-García
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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McKenna K, Bouchoucha S, Redley B, Hutchinson A. "Building the plane while flying it" Reflections on pandemic preparedness and response; an organisational case study. BMC Health Serv Res 2023; 23:940. [PMID: 37658384 PMCID: PMC10472588 DOI: 10.1186/s12913-023-09874-x] [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: 01/30/2023] [Accepted: 08/04/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic provided a unique opportunity to learn about acute health organisations experiences implementing a pandemic response plan in real-time. This study was conducted to explore organisational leader's perspectives and experience activating a COVID-19 pandemic response plan in their health service and the impact of this on service provision, clinicians, and consumers. METHODS This study was conducted at a large metropolitan health service in Australia that provides acute, subacute, and residential aged care services. Semi-structured interviews were conducted with 12 key participants from the COVID-19 leadership team between November-January 2021/2022. A semi-structured interview guide was developed to explore how the health service developed a clinical governance structure, policy and procedures and experience when operationalising each element within the Hierarchy of Controls Framework. Thematic analysis was used to code data and identify themes. A cross-sectional survey of frontline healthcare workers on the impacts and perceptions of infection control practices during the COVID-19 pandemic, was also completed in 2021 with 559 responses. RESULTS Twelve organisational leaders completed the semi-structured interviews. Key themes that emerged were: (1) Building the plane while flying it, (2) A unified communications strategy, (3) Clinicians fear 'my job is going to kill me', (4) Personal Protective Equipment (PPE) supply and demand, and (5) Maintaining a workforce. When surveyed, front-line healthcare workers responded positively overall about the health services pandemic response, in terms of communication, access to PPE, education, training, and availability of resources to provide a safe environment. CONCLUSION Health service organisations were required to respond rapidly to meet service needs, including implementing a pandemic plan, developing a command structure and strategies to communicate and address the workforce needs. This study provides important insights for consideration when health service leaders are responding to future pandemics. Future pandemic plans should include detailed guidance for acute and long-term care providers in relation to organisational responsibilities, supply chain logistics and workforce preparation.
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Affiliation(s)
- Karen McKenna
- Health Services Manager Infection Prevention, Mercy Health, Victoria, Australia.
- Centre for Quality and Patient Safety Research in the Institute for Health Transformation, School of Nursing and Midwifery, Deakin University Geelong, Victoria, Australia.
| | - Stéphane Bouchoucha
- Centre for Quality and Patient Safety Research in the Institute for Health Transformation, School of Nursing and Midwifery, Deakin University Geelong, Victoria, Australia
- Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR), Deakin University, Geelong, VIC, Australia
| | - Bernice Redley
- Centre for Quality and Patient Safety Research in the Institute for Health Transformation, School of Nursing and Midwifery, Deakin University Geelong, Victoria, Australia
| | - Anastasia Hutchinson
- Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR), Deakin University, Geelong, VIC, Australia
- Centre for Quality and Patient Safety Research in the Institute for Health Transformation, School of Nursing and Midwifery Geelong, Epworth Health/Deakin University Partnership, Victoria, Australia
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McGrory S, Neill RD, Gillen P, McFadden P, Manthorpe J, Ravalier J, Mallett J, Schroder H, Currie D, Moriarty J, Nicholl P. Self-Reported Experiences of Midwives Working in the UK across Three Phases during COVID-19: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013000. [PMID: 36293580 PMCID: PMC9603051 DOI: 10.3390/ijerph192013000] [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: 08/17/2022] [Revised: 10/07/2022] [Accepted: 10/09/2022] [Indexed: 06/07/2023]
Abstract
Maternity services cannot be postponed due to the nature of this service, however, the pandemic resulted in wide-ranging and significant changes to working practices and services. This paper aims to describe UK midwives' experiences of working during the COVID-19 pandemic. This study forms part of a larger multiple phase research project using a cross-sectional design based on an online survey. The online survey used validated psychometric tools to measure work-related quality of life, wellbeing, coping, and burnout as well as open-ended questions to further understand the experiences of staff working during the pandemic. This paper reports the qualitative data collected from the open-ended questions. The qualitative data were subjected to thematic analysis and the four main themes that emerged were 'relentless stress/pressure', 'reconfiguration of services', 'protection of self and others', and 'workforce challenges'. The key conclusions were that midwives experienced a reduction in quality of working life and significant stress throughout the pandemic due to a range of factors including staffing shortages, restrictions placed on women's partners, changes to services and management support, all of which compounded workforce pressures that existed prior to the pandemic. This research recommends consultation of front-line midwives in relation to possible changes in practice and workforce planning in preparation for crises such as a pandemic and to ensure equitable and supportive management with access to practical and psychological support.
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Affiliation(s)
- Susan McGrory
- School of Nursing and Paramedic Science, Magee Campus, Ulster University, Londonderry BT48 7JL, UK
| | - Ruth D. Neill
- School of Medicine, Ulster University, Londonderry BT48 7JL, UK
| | - Patricia Gillen
- School of Nursing and Paramedic Science, Belfast Campus, Ulster University, Belfast BT15 1ED, UK
- Southern Health and Social Care Trust, 10 Moyallen Road, Gilford BT63 5JX, UK
| | - Paula McFadden
- School of Applied Social Policy Sciences, Magee Campus, Ulster University, Londonderry BT48 7JL, UK
| | - Jill Manthorpe
- NIHR Policy Research Unit in Health and Social Care Workforce, King’s College London, 22 Kingsway, Holborn, London WC2B 6LE, UK
| | - Jermaine Ravalier
- School of Science, Bath Spa University, Newton Park, Newton St Loe, Bath BA2 9BN, UK
| | - John Mallett
- School of Psychology, Coleraine Campus, Ulster University, Cromore Road, Coleraine BT52 1SA, UK
| | - Heike Schroder
- Queen’s Management School, Queen’s University Belfast, 185 Stranmillis Road, Belfast BT9 5EE, UK
| | - Denise Currie
- Queen’s Management School, Queen’s University Belfast, 185 Stranmillis Road, Belfast BT9 5EE, UK
| | - John Moriarty
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, 69-71 University Street, Belfast BT7 1HL, UK
| | - Patricia Nicholl
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, 69-71 University Street, Belfast BT7 1HL, UK
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Baloushah SR, Abu-Hamad N, Mohammadi N, Alkasseh ASM, Salah MS. Gaza Midwives’ Lived Experience of Providing Maternity Care During COVID-19. Eur J Midwifery 2022; 6:51. [PMID: 35974714 PMCID: PMC9348584 DOI: 10.18332/ejm/150490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The Gaza Strip is densely populated. The COVID-19 pandemic has had a detrimental impact on global healthcare systems, and midwifery practices have transformed in maternity care settings. Our research aimed at understanding the Palestinian midwives’ experiences in providing maternity care in Gaza during the COVID-19 pandemic at Gaza European Hospital which was the only hospital providing care for people diagnosed with COVID-19. METHODS To understand the phenomenon of interest, descriptive phenomenology was used. A purposive sample of eight midwives from the European Gaza Hospital was chosen. Between December 2020 and January 2021, semi-structured interviews were used in the data collection procedure. The collected data were analyzed using the Colaizzi approach. RESULTS The investigation resulted in three main themes: emotionally overwhelmed, work environment challenges, and interpersonal relationship development. CONCLUSIONS Midwives shared both positive and negative experiences from their time working in the European Gaza Hospital during the COVID-19 pandemic. They were confronted with negative emotions such as fear, stress, and anxiety, as well as environmental challenges. Despite this, they created a new interpersonal bond that was positively reflected. To sustain their psychological well-being, COVID-19 care workers require psychological support at work. A strong need exists for equipping the Maternity Department with the essential equipment and supplies to reduce the working environment load, as well as giving the necessary training to staff to be qualified enough to provide such crucial care.
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Affiliation(s)
- Suha R. Baloushah
- Midwifery Department, Faculty of Nursing, Islamic University of Gaza, Gaza City, Palestine
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Science, Tehran, Iran
| | - Nidal Abu-Hamad
- Independent Reproductive Health Researcher, Gaza City, Palestine
| | - Nooredine Mohammadi
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
| | - Areefa S. M. Alkasseh
- Midwifery Department, Faculty of Nursing, Islamic University of Gaza, Gaza City, Palestine
| | - Motasem S. Salah
- Nursing and Health Sciences Department, University College of Applied Sciences, Gaza City, Palestine
- Faculty of Public Health, Al-Quds University, Jerusalem, Palestine
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Henry A, Yang J, Grattan S, Roberts L, Lainchbury A, Shanthosh J, Cullen P, Everitt L. Effects of the COVID-19 Pandemic and Telehealth on Antenatal Screening and Services, Including for Mental Health and Domestic Violence: An Australian Mixed-Methods Study. Front Glob Womens Health 2022; 3:819953. [PMID: 35814835 PMCID: PMC9257034 DOI: 10.3389/fgwh.2022.819953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/04/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Australian antenatal care includes specific screening and service provision for domestic and family violence (DFV) and mental health. However, the COVID-19 pandemic resulted in major care changes, including greatly expanded telehealth. Given difficulties in a safe assessment and management of disclosures via telehealth, DFV and mental health service provision might be substantially impacted. This study therefore aimed to assess COVID-19 effects on DFV and mental health screening, as well as broader service provision from the perspective of local maternity service providers. Methods Mixed-methods study of staff surveys and interviews of staff directly involved in pregnancy care (doctors, midwives, and allied health) in three Sydney (Australia) maternity units, from October 2020 to March 2021. Surveys and interviews interrogated perceived effects of the COVID-19 pandemic on delivery (ensuring required services occurred), timeliness, and quality of (a) overall maternity care and (b) DFV and mental health screening and care; and also advantages and disadvantages of telehealth. Surveys were descriptively analyzed. Interviews were conducted online, recorded, and transcribed verbatim prior to thematic analysis. Results In total, 17 interviews were conducted and 109 survey responses were received. Breakdown of survey respondents was 67% of midwives, 21% of doctors, and 10% of allied health. Over half of survey respondents felt the pandemic had a negative effect on delivery, timeliness, and quality of overall pregnancy care, and DFV and mental health screening and management. Perceived telehealth positives included convenience for women (73%) and reducing women's travel times (69%). Negative features included no physical examination (90%), difficulty regarding non-verbal cues (84%), difficulty if interpreter required (71%), and unsure if safe to ask some questions (62%). About 50% felt telehealth should continue post-pandemic, but for <25% of visits. Those perceived suitable for telehealth were low-risk and multiparous women, whereas those unsuited were high-risk pregnancy, non-English speaking, and/or mental health/psychosocial/DFV concerns. “Change to delivery of care” was the central interview theme, with subthemes of impact on mental health/DFV screening, telehealth (both positive and negative), staff impact (e.g., continuity of care disruption), and perceived impact on women and partners. Discussion While telehealth may have an ongoing, post-pandemic role in Australian maternity care, staff believe that this should be limited in scope, mostly for low-risk pregnancies. Women with high risk due to physical health or mental health, DFV, and/or other social concerns were considered unsuited to telehealth.
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Affiliation(s)
- Amanda Henry
- Discipline of Women's Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales (NSW), Sydney, NSW, Australia
- Department of Women's and Children's Health, St George Hospital, Sydney, NSW, Australia
- The George Institute for Global Health, UNSW Medicine and Health, Sydney, NSW, Australia
- *Correspondence: Amanda Henry
| | - Jennifer Yang
- Discipline of Women's Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales (NSW), Sydney, NSW, Australia
| | - Sarah Grattan
- The George Institute for Global Health, UNSW Medicine and Health, Sydney, NSW, Australia
| | - Lynne Roberts
- Department of Women's and Children's Health, St George Hospital, Sydney, NSW, Australia
- St George and Sutherland Clinical School, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | | | - Janani Shanthosh
- The George Institute for Global Health, UNSW Medicine and Health, Sydney, NSW, Australia
- Australian Human Rights Institute, UNSW Sydney, Kensington, NSW, Australia
| | - Patricia Cullen
- School of Population Health, UNSW Sydney, Kensington, NSW, Australia
- Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Louise Everitt
- Department of Women's and Children's Health, St George Hospital, Sydney, NSW, Australia
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
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