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Hughes A, Weckesser A, Denny E, Junaid F, Nelson-Piercy C, Black M, Allotey J, Thangaratinam S, Dyson J. Barriers and facilitators to healthcare practitioners providing care for pregnant women with epilepsy: A systematic review and narrative synthesis. Seizure 2024; 118:38-46. [PMID: 38631244 DOI: 10.1016/j.seizure.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 04/19/2024] Open
Affiliation(s)
- Anita Hughes
- Centre for Social, Health and Related Research, Birmingham City University, Ravensbury Building, Westbourne Road, Edgbaston, Birmingham, B15 3TN, United Kingdom
| | - Annalise Weckesser
- Centre for Social, Health and Related Research, Birmingham City University, Ravensbury Building, Westbourne Road, Edgbaston, Birmingham, B15 3TN, United Kingdom
| | - Elaine Denny
- Centre for Social, Health and Related Research, Birmingham City University, Ravensbury Building, Westbourne Road, Edgbaston, Birmingham, B15 3TN, United Kingdom
| | - Fatima Junaid
- Institute of Metabolism and Systems Research, University of Birmingham, United Kingdom
| | | | - Mairead Black
- Aberdeen Centre for Women's Health Research, University of Aberdeen, Aberdeen, United Kingdom
| | - John Allotey
- Institute of Metabolism and Systems Research, University of Birmingham, United Kingdom
| | - Shakila Thangaratinam
- WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom; NIHR Birmingham Biomedical Centre (BRC), University Hospitals Birmingham, Birmingham, United Kingdom; Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | - Judith Dyson
- Centre for Social, Health and Related Research, Birmingham City University, Ravensbury Building, Westbourne Road, Edgbaston, Birmingham, B15 3TN, United Kingdom.
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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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Bailey C, Medeiros PDB, Ellwood DA, Middleton P, Andrews CJ, Flenady VJ. A systematic review of interventions to increase the use of smoking cessation services for women who smoke during pregnancy. Aust N Z J Obstet Gynaecol 2023; 63:737-745. [PMID: 37621216 PMCID: PMC10952730 DOI: 10.1111/ajo.13745] [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: 04/25/2023] [Accepted: 07/30/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Although many pregnant women accept referrals to stop-smoking support, the uptake of appointments often remains low. AIM The aim was to review the success of interventions to increase the uptake of external stop-smoking appointments following health professional referrals in pregnancy. MATERIALS AND METHODS Embase, PubMed, Cochrane Central Register of Controlled Trials, Scopus and CINAHL were searched in February 2023 for studies with interventions to increase the uptake rates of external stop-smoking appointments among pregnant women who smoke. Eligible studies included randomised, controlled, cluster-randomised, quasi-randomised, before-and-after, interrupted time series, case-control and cohort studies. Cochrane tools assessing for bias and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. RESULTS Two before-and-after studies were included, including a combined total of 1996 women who smoked during pregnancy. Both studies had a serious risk of bias, and meta-analysis was not possible due to heterogeneity. One study testing carbon monoxide monitors and opt-out referrals showed increased uptake of external stop-smoking appointments, health professional referrals and smoking cessation rates compared to self-identified smoking status and opt-in referrals. Results were limited in the second study, which used carbon monoxide monitors, urinary cotinine levels and self-disclosed methods to identify the smoking status with opt-out referrals. Only post-intervention data were available on the uptake of appointments to external stop-smoking services. The number of health professional referrals increased, but change in smoking cessation rates was less clear. CONCLUSIONS There is insufficient evidence to inform practice regarding strategies to increase the uptake of external stop-smoking appointments by women during pregnancy.
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Affiliation(s)
- Cheryl Bailey
- Centre of Research Excellence in Stillbirth, Mater Research InstituteThe University of QueenslandBrisbaneQueenslandAustralia
| | - Poliana de Barros Medeiros
- Centre of Research Excellence in Stillbirth, Mater Research InstituteThe University of QueenslandBrisbaneQueenslandAustralia
- Department of Paediatrics and NeonatologySunshine Coast University HospitalSunshine CoastQueenslandAustralia
| | - David A. Ellwood
- Centre of Research Excellence in Stillbirth, Mater Research InstituteThe University of QueenslandBrisbaneQueenslandAustralia
- School of Medicine & DentistryGriffith University and Gold Coast University HospitalGold CoastQueenslandAustralia
| | - Philippa Middleton
- Centre of Research Excellence in Stillbirth, Mater Research InstituteThe University of QueenslandBrisbaneQueenslandAustralia
- South Australian Health and Medical Research Institute (SAHMRI) : Women and Kids and The University of AdelaideAdelaideSouth AustraliaAustralia
| | - Christine J. Andrews
- Centre of Research Excellence in Stillbirth, Mater Research InstituteThe University of QueenslandBrisbaneQueenslandAustralia
| | - Vicki J. Flenady
- Centre of Research Excellence in Stillbirth, Mater Research InstituteThe University of QueenslandBrisbaneQueenslandAustralia
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Fletcher C, Hoon E, Gialamas A, Dekker G, Lynch J, Smithers L. Isolation, marginalisation and disempowerment - understanding how interactions with health providers can influence smoking cessation in pregnancy. BMC Pregnancy Childbirth 2022; 22:396. [PMID: 35538450 PMCID: PMC9086664 DOI: 10.1186/s12884-022-04720-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/20/2022] [Indexed: 11/26/2022] Open
Abstract
Background Maternal smoking during pregnancy can lead to serious adverse health outcomes for both women and their infants. While smoking in pregnancy has declined over time, it remains consistently higher in women with lower socioeconomic circumstances. Furthermore, fewer women in this group will successfully quit during pregnancy. Aim This study explores the barriers to smoking cessation experienced by socially disadvantaged pregnant women and investigates how interactions with health providers can influence their smoking cessation journey. Methods Women (either pregnant or birthed in the previous 10 years, who smoked or quit smoking in pregnancy) were recruited from a metropolitan public hospital antenatal clinic in South Australia and community organisations in surrounding suburbs. Seventeen women participated in qualitative semi-structured small focus groups or interviews. The focus groups and interviews were recorded, transcribed and thematically analysed. Findings Four interconnected themes were identified: 1) smoking embedded in women’s challenging lives and pregnancies, 2) cyclic isolation and marginalisation, 3) feeling disempowered, and 4) autonomy and self-determination. Themes 3 and 4 are characterised as being two sides of a single coin in that they coexist simultaneously and are inseparable. A key finding is a strong unanimous desire for smoking cessation in pregnancy but women felt they did not have the necessary support from health providers or confidence and self-efficacy to be successful. Conclusion Women would like improvements to antenatal care that increase health practitioners’ understanding of the social and contextual healthcare barriers faced by women who smoke in pregnancy. They seek improved interventions from health providers to make informed choices about smoking cessation and would like women-centred care. Women feel that with greater support, more options for cessation strategies and consistency and encouragement from health providers they could be more successful at antenatal smoking cessation. If such changes were made, then South Australian practice could align more with best practice international guidelines for addressing smoking cessation in pregnancy, and potentially improve outcomes for women and their children. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04720-0.
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Affiliation(s)
- Cherise Fletcher
- School of Public Health, Faculty of Health & Medical Sciences, University of Adelaide, Level 5, 50 Rundle Mall, Rundle Mall Plaza, Adelaide, SA, 5005, Australia.,The Robinson Research Institute, Norwich Centre, Ground Floor, 55 King William Road, North Adelaide, SA, 5006, Australia
| | - Elizabeth Hoon
- School of Public Health, Faculty of Health & Medical Sciences, University of Adelaide, Level 5, 50 Rundle Mall, Rundle Mall Plaza, Adelaide, SA, 5005, Australia.,Discipline of General Practice, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Angela Gialamas
- School of Public Health, Faculty of Health & Medical Sciences, University of Adelaide, Level 5, 50 Rundle Mall, Rundle Mall Plaza, Adelaide, SA, 5005, Australia.,The Robinson Research Institute, Norwich Centre, Ground Floor, 55 King William Road, North Adelaide, SA, 5006, Australia
| | - Gustaaf Dekker
- The Robinson Research Institute, Norwich Centre, Ground Floor, 55 King William Road, North Adelaide, SA, 5006, Australia.,Obstetrics and Gynaecology Department, Lyell McEwin Hospital, University of Adelaide, Adelaide, Australia
| | - John Lynch
- School of Public Health, Faculty of Health & Medical Sciences, University of Adelaide, Level 5, 50 Rundle Mall, Rundle Mall Plaza, Adelaide, SA, 5005, Australia.,The Robinson Research Institute, Norwich Centre, Ground Floor, 55 King William Road, North Adelaide, SA, 5006, Australia.,Population Health Sciences, University of Bristol, Bristol, UK
| | - Lisa Smithers
- School of Public Health, Faculty of Health & Medical Sciences, University of Adelaide, Level 5, 50 Rundle Mall, Rundle Mall Plaza, Adelaide, SA, 5005, Australia. .,The Robinson Research Institute, Norwich Centre, Ground Floor, 55 King William Road, North Adelaide, SA, 5006, Australia. .,School of Health & Society, Faculty of Arts, Social Sciences & Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia. .,The Illawarra Health and Medical Research Institute, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia.
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