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Edwards R, Hamilton C, Keeping Burke L, Goudreau A. Support and services available to at-risk mothers and their children in maternity residences: a scoping review protocol. JBI Evid Synth 2024; 22:1161-1169. [PMID: 38044847 DOI: 10.11124/jbies-23-00186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
OBJECTIVE The objective of this scoping review is to identify, categorize, and map the types of support and services available to at-risk mothers and their children in maternity residences. A secondary objective is to identify and map the measures used to evaluate the efficacy of these types of support and services. INTRODUCTION Pregnant and parenting women and their children experiencing complex challenges related to the social determinants of health, including unstable housing and poverty, are at high risk of long-term negative health and socioeconomic outcomes. Maternity residences may provide support and services that improve this population's outcomes; however, there is little understanding of what services are offered and how efficacious they may be. Therefore, it is necessary to provide a comprehensive overview of support and services in maternity residences, and to identify the measures used to evaluate the efficacy of the support and services. This will provide the foundation to evaluate these services and outcomes and inform the development of future maternity residential programs. INCLUSION CRITERIA Studies including pregnant and parenting women and gender-diverse individuals who are housed in, or accessing the services of, maternity residences in politically stable high-income countries due to challenges rooted in the social determinants of health will be considered for inclusion. We define maternity residences as any agency with a residential component offering support/services to this population. METHODS This review will be conducted in accordance with JBI methodology for scoping reviews. The data will be analyzed using a quantitative descriptive analysis approach. The data analysis and discussion will be informed by the Social Determinants of Health, Reproductive Justice, Harm Reduction, and Health in All Policies frameworks.
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Affiliation(s)
- Rosann Edwards
- Department of Nursing and Health Sciences, University of New Brunswick, Saint John, NB, Canada
- The University of New Brunswick (UNB) Saint John Collaboration for Evidence-Informed Healthcare: A JBI Centre of Excellence, Saint John, NB, Canada
| | - Catherine Hamilton
- Department of Nursing and Health Sciences, University of New Brunswick, Saint John, NB, Canada
- The University of New Brunswick (UNB) Saint John Collaboration for Evidence-Informed Healthcare: A JBI Centre of Excellence, Saint John, NB, Canada
| | - Lisa Keeping Burke
- Department of Nursing and Health Sciences, University of New Brunswick, Saint John, NB, Canada
- The University of New Brunswick (UNB) Saint John Collaboration for Evidence-Informed Healthcare: A JBI Centre of Excellence, Saint John, NB, Canada
| | - Alex Goudreau
- The University of New Brunswick (UNB) Saint John Collaboration for Evidence-Informed Healthcare: A JBI Centre of Excellence, Saint John, NB, Canada
- University of New Brunswick Libraries, University of New Brunswick, Saint John, NB, Canada
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Farrag NH, Haile ZT, Ice G, Berryman D, Ruhil AVS, Fadl N. Association Between Exclusive Breastfeeding and Acute Respiratory Infections Among Infants Under the Age of 6 Months. Breastfeed Med 2024; 19:26-32. [PMID: 38241131 DOI: 10.1089/bfm.2023.0202] [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] [Indexed: 01/21/2024]
Abstract
Introduction: Acute respiratory infection (ARI) is the leading cause of childhood morbidity and mortality. Exclusive breastfeeding is considered the cornerstone of child health; however, the rate of exclusive breastfeeding is suboptimal in low- and middle-income countries (LMICs). This study aimed to assess the association between exclusive breastfeeding and ARI among infants under the age of 6 months in a LMIC. Methods: A secondary analysis of the 2014 Egypt Demographic Health Survey data was conducted. Mothers of infants under the age of 6 months (n = 1,340) were included. The outcome of interest was ARI symptoms among infants, defined by mother's report of a cough accompanied by fast or difficult breathing in the 2 weeks preceding the survey. The exposure variable was exclusive breastfeeding, defined by giving infants only breast milk during the first 6 months of life. Descriptive statistics and multivariate regression were performed. Results: Forty-one percent of the infants were exclusively breastfed and 9% had ARI symptoms. Exclusive breastfeeding reduced the odds of ARI symptoms (adjusted odds ratio [AOR] = 0.450, 95% confidence interval [CI]: 0.243-0.832). Infants of mothers 20-34 years of age (AOR = 0.421, 95% CI: 0.217-0.817) and ≥35 years (AOR = 0.308, 95% CI: 0.123-0.767) at childbirth were less likely to have symptoms of an ARI when compared with adolescent mothers. The likelihood of having ARI symptoms was higher among infants 2-3 months of age (AOR = 2.437, 95% CI: 1.093-5.435), and 4-5 months (AOR = 2.888, 95% CI: 1.193-6.992) compared with infants less than 2 months. Conclusion: Exclusive breastfeeding was protective against ARI symptoms among under-6-month infants, independent of potential confounders.
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Affiliation(s)
- Nada H Farrag
- Clinical Pharmacy, School of Life and Medical Sciences, University of Hertfordshire Hosted by Global Academic Foundation, New Administrative Capital, Egypt
| | - Zelalem T Haile
- Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Dublin, Ohio, USA
| | - Gillian Ice
- Social Medicine and Global Health, Heritage College of Osteopathic Medicine and College of Health Sciences and Professions, Ohio University, Athens, Ohio, USA. Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
| | - Darlene Berryman
- Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
| | - Anirudh V S Ruhil
- The Voinovich School of Leadership and Public Service, Ohio University, Athens, Ohio, USA
| | - Noha Fadl
- Family Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Meherali S, Rehmani AI, Ahmad M, Adewale B, Kauser S, Lebeuf S, Benoit J, Scott SD. Impact of the COVID-19 pandemic on the sexual and reproductive health of adolescents in Alberta, Canada. Reprod Health 2023; 20:172. [PMID: 37990327 PMCID: PMC10664423 DOI: 10.1186/s12978-023-01712-x] [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: 07/20/2023] [Accepted: 11/10/2023] [Indexed: 11/23/2023] Open
Abstract
PURPOSE The COVID-19 pandemic led to major service disruptions in the healthcare sector, especially regarding sexual and reproductive health services. However, the impact of the pandemic on Canadian adolescents is relatively unknown. This study aimed to investigate the impacts of the COVID-19 pandemic and associated public health measures on the sexual and reproductive health (SRH) of adolescents in Alberta, Canada. METHODS A qualitative study using an interpretive description (ID) approach and community-based participatory research principles was conducted to capture the subjective experience and perceptions of adolescents and service providers. With the collaboration of the Adolescent Advisory Group and community partners, 18 adolescents and 15 service providers were recruited for the study through purposive sampling. Findings from the qualitative interviews were analyzed using thematic analysis. RESULTS Three major themes emerged from the analysis: (1) COVID-19 SRH experience, (2) barriers to SRH, and (3) adolescent SRH strategies. Our findings highlight numerous barriers and challenges that prevented adolescents from accessing SRH education, products, and services. CONCLUSION The COVID-19 pandemic had a profound impact on the SRH and the well-being of adolescents. Our study reflects the need for diverse SRH strategies to maintain continued access to SRH resources during disruptive events, such as the pandemic.
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Affiliation(s)
- Salima Meherali
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Amyna Ismail Rehmani
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
| | - Mariam Ahmad
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Bisi Adewale
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Samar Kauser
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Simone Lebeuf
- Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - James Benoit
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Shannon D Scott
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
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What to expect when girls are expecting: psychosocial support challenges and opportunities in the context and aftermath of teenage pregnancy in Kenya. Reprod Health 2022; 19:228. [PMID: 36544207 PMCID: PMC9768923 DOI: 10.1186/s12978-022-01544-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND An understanding of the psychosocial support challenges and opportunities in the context of teenage pregnancy is important for developing appropriate interventions for pregnant and parenting girls. This qualitative study was conducted in Homa Bay County, Kenya, to examine the experience of teenage pregnancy and the resultant psychosocial support needs from the perspectives of both pregnant/parenting girls and their own parents, who are typically expected to provide various forms of support. METHODS The study used a descriptive case study design, drawing on counseling case notes documented by psychologists who held counseling sessions with 20 pregnant or parenting girls and 6 of their parents as part of a psychosocial support intervention. The counseling case notes formed a qualitative data set, which was analyzed thematically. RESULTS Emerging master themes were related to pregnant and parenting girls' experience of sexual violence and adverse childbirth outcomes; psychological trauma confronted by girls and their parents alike; parental need for support in communicating with pregnant/parenting girls about sex and sexuality; and the availability of family support as a resource for teenage mothers. CONCLUSION Pregnant and parenting teenage girls require a range of psychosocial support responses that recognize the realities of sexual violence and other challenges in the lives of the girls themselves, as well as in the lives of their parents and caregivers. While parents and other caregivers can serve as an important resource for supporting affected girls, they often need assistance as well, in order to support pregnant/parenting girls effectively. These realities need to be taken into account to maximize the effectiveness of health and development programs for pregnant and parenting girls. Furthermore, emerging themes from actual counseling sessions with affected girls and parents can provide important insights into the potential psychosocial support needs of the broader population of pregnant and parenting girls.
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Jack SM, Duku E, Whitty H, Van Lieshout RJ, Niccols A, Georgiades K, Lipman EL. Young mothers' use of and experiences with mental health care services in Ontario, Canada: a qualitative descriptive study. BMC Womens Health 2022; 22:214. [PMID: 35672725 PMCID: PMC9172978 DOI: 10.1186/s12905-022-01804-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 05/31/2022] [Indexed: 11/16/2022] Open
Abstract
Background Despite the high prevalence of mental health issues among young mothers, their subsequent needs for mental health care support does not correlate with their access and use of services. The purpose of this study, grounded in the experiences of young mothers living in Ontario, Canada, was to describe their experiences of using mental health services during the perinatal period, and to identify the attributes of services and professionals that influenced their decision to engage with mental health services.
Methods As the qualitative component of a sequential explanatory mixed methods study, the principles of qualitative description informed sampling, data collection, and analysis decisions. In-depth, semi-structured interviews were conducted with a purposeful sample of 29 young mothers (≤ 21 years) who met diagnostic criteria for at least one psychiatric disorder, and who were ≥ 2 months postpartum. Interview data were triangulated with data from ecomaps and a sub-set of demographic data for this purposeful sample from the survey conducted in the quantitative study component. Qualitative data were analyzed using both conventional content analysis and reflexive thematic analysis; the subset of survey data extracted for these 29 participants were analyzed using descriptive statistics. Results Young mothers identified the need to have at least one individual, either an informal social support or formal service provider who they could talk to about their mental health. Among participants deciding to seek professional mental health support, their hesitancy to access services was grounded in past negative experiences or fears of being judged, being medicated, not being seen as an active partner in care decisions or experiencing increased child protection involvement. Participants identified organizational and provider attributes of those delivering mental health care that they perceived influenced their use of or engagement with services. Conclusion Organizations or health/social care professionals providing mental health services to young pregnant or parenting mothers are recommended to implement trauma-and violence-informed care. This approach prioritizes the emotional and physical safety of individuals within the care environment. Applying this lens in service delivery also aligns with the needs of young mothers, including that they are actively listened to, treated with respect, and genuinely engaged as active partners in making decisions about their care and treatment.
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Affiliation(s)
- Susan M Jack
- School of Nursing, McMaster University, HSC 3H48B, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada.
| | - Eric Duku
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Heather Whitty
- Institute for Innovation and Implementation, School of Social Work, University of Maryland Baltimore, Baltimore, USA
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Alison Niccols
- Ron Joyce Children's Health Centre, Hamilton, ON, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Ellen L Lipman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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Goodwin J, Savage E, O’Donovan A. “I Personally Wouldn’t Know Where to Go”: Adolescents’ Perceptions of Mental Health Services. JOURNAL OF ADOLESCENT RESEARCH 2022. [DOI: 10.1177/07435584221076056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to explore perceptions of mental health services from the perspectives of adolescents with no prior service experience. Thirty students in the Transition Year (fourth year) of secondary school participated in this study: 22 females and 8 males, aged 15 to 16. There was equal distribution across rural and urban settings. Participants had no prior experience of accessing mental health services. Data were collected in secondary school settings in the Republic of Ireland. An interpretive description approach guided this study. Data were collected through individual interviews. To complement interviews, participants drew images of mental health care environments and mental health staff members; drawings were not subjected to analysis. Data (participant interviews) were analyzed using qualitative content analysis. Three themes were identified. Participants suggested that “mental health services” differed from “psychiatric services,” with the latter term perceived more negatively. Uncertainty about how to access these services was voiced. Considering the vulnerability of adolescents to the experience of mental distress, education around mental health services is warranted. It is expected that provision of education in this area would enhance service delivery, improve adolescents’ help-seeking behaviors for mental distress, and reduce stigma.
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Millar HC, Lorber S, Vandermorris A, Thompson G, Thompson M, Allen L, Aggarwal A, Spitzer RF. "No, You Need to Explain What You Are Doing": Obstetric Care Experiences and Preferences of Adolescent Mothers With a History of Childhood Trauma. J Pediatr Adolesc Gynecol 2021; 34:538-545. [PMID: 33535100 DOI: 10.1016/j.jpag.2021.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 01/03/2021] [Accepted: 01/09/2021] [Indexed: 11/26/2022]
Abstract
STUDY OBJECTIVE To understand the pregnancy and childbirth experiences and preferences of adolescent mothers with a history of childhood trauma in order to develop trauma-informed care practice recommendations for this unique group. DESIGN Mixed methods convergent parallel design involving completion of the Adverse Childhood Experiences (ACE) questionnaire, a survey of care experiences and preferences during pregnancy and delivery, and a one-on-one interview. SETTING hHospital-based medical home program for pregnant and parenting adolescents. PARTICIPANTS Adolescent and young adult mothers aged 12-22 years, receiving care between June 2018 and June 2019. RESULTS A total of 29 adolescent mothers completed the questionnaire, out of a potential 38 in the program (76.3% participation). Five went on to complete an interview. The average age was 17.9 years (standard deviation 1.8 years). The mean ACE score was 5.1 out of 10, indicating childhood exposure to an average of 5 different types of potential trauma. A total of 19 participants (65.5%) reported being triggered during pregnancy or postpartum. Trauma memories were elicited during vaginal examinations in the clinic (27.6%) and in the hospital (27.6%), abdominal examinations (13.8%), measurement of vital signs (17.2%), and labor (17.2%). Ten participants (34.5%) felt that the providers delivering their baby knew how to help them cope with trauma memories. Themes that emerged included the following: acknowledgment of trauma by provider, avoiding re-telling of story, building a relationship with provider, choice and control in care, and providing coping strategies. CONCLUSION A majority of adolescent mothers in our sample experienced trauma memories during pregnancy and postpartum medical interactions. Priorities for trauma-informed care in this population are described.
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Affiliation(s)
- Heather C Millar
- Department of Paediatrics, Division of Endocrinology, Section of Gynecology, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada.
| | - Sharon Lorber
- Department of Paediatrics, Division of Adolescent Medicine, Hospital for Sick Children, Toronto, Ontario, Canada; Factor-Inwentash Faculty of Social Work, University of Toronto, Ontario, Canada
| | - Ashley Vandermorris
- Department of Paediatrics, Division of Adolescent Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Gillian Thompson
- Department of Paediatrics, Division of Adolescent Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Marysa Thompson
- Department of Paediatrics, Division of Endocrinology, Section of Gynecology, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Paediatrics, Division of Adolescent Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lisa Allen
- Department of Paediatrics, Division of Endocrinology, Section of Gynecology, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada; Department of Obstetrics and Gynaecology, Mount Sinai Health System, Toronto, Ontario, Canada
| | - Anjali Aggarwal
- Department of Paediatrics, Division of Endocrinology, Section of Gynecology, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada; Department of Obstetrics and Gynaecology, Michael Garron Hospital, Toronto, Ontario, Canada
| | - Rachel F Spitzer
- Department of Paediatrics, Division of Endocrinology, Section of Gynecology, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada; Department of Obstetrics and Gynaecology, Mount Sinai Health System, Toronto, Ontario, Canada
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DeMarco N, Twynstra J, Ospina MB, Darrington M, Whippey C, Seabrook JA. Prevalence of Low Birth Weight, Premature Birth, and Stillbirth Among Pregnant Adolescents in Canada: A Systematic Review and Meta-analysis. J Pediatr Adolesc Gynecol 2021; 34:530-537. [PMID: 33727190 DOI: 10.1016/j.jpag.2021.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/04/2021] [Accepted: 03/06/2021] [Indexed: 10/21/2022]
Abstract
Although most studies show that adolescent pregnant women are at a higher risk for adverse birth outcomes, there has been limited research examining this relationship in Canada. This systematic review and meta-analysis investigated the prevalence of low birthweight (LBW), preterm birth (PTB), and stillbirth in Canadian adolescent women compared to adult women. Studies were included if they were primary research and included a sample of adolescent mothers (≤19 years) and adult mothers (≥20 years) who gave birth to singleton infants in Canada. Birth outcomes must have been measured consistently in at least 3 studies for inclusion. Comprehensive electronic literature searches were conducted from database inception until August 2020 in 5 databases. Random effects meta-analysis models were used to estimate pooled odds ratios (pOR) for LBW, PTB, and stillbirth between adolescent and adult pregnant women. Outcomes reported included PTB (8 studies), LBW (6 studies), and stillbirth (3 studies). Compared to adult mothers, adolescent mothers had a 56% increase in the prevalence of LBW (pOR 1.56, 95% confidence interval [CI] 1.24, 1.97), a 23% increase in PTB (pOR 1.23, 95% CI 1.06, 1.42), a 20% increase in stillbirth (pOR 1.20, 95% CI 1.05, 1.37). Heterogeneity, as assessed by I2, was high for LBW and PTB and was low for stillbirth. A subgroup analysis did not remove the high heterogeneity, and some studies did not adjust for confounding variables and were missing information on sociodemographic and behavioral factors. Future research is needed to investigate the mechanisms surrounding these differences by maternal age.
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Affiliation(s)
- Natalie DeMarco
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada
| | - Jasna Twynstra
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Maria B Ospina
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada
| | - Marissa Darrington
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada
| | - Caroline Whippey
- Beryl Ivey Library, Brescia University College, London, Ontario, Canada
| | - Jamie A Seabrook
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada; Department of Paediatrics, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Human Environments Analysis Laboratory, Western University, London, Ontario, Canada.
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The Complexity of the NICU-to-Home Experience for Adolescent Mothers: Meleis' Transitions Theory Applied. ANS Adv Nurs Sci 2020; 43:349-359. [PMID: 33136587 DOI: 10.1097/ans.0000000000000299] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Quality care for individuals and families during periods of transition is one of the major issues facing health care systems and providers today. The transition-home from the neonatal intensive care unit (NICU) as experienced by adolescent mothers is poorly understood-placing young mothers and their infants at risk of poor outcomes following NICU discharge. Meleis' Transitions Theory offers a unique theoretical perspective for understanding this transition experience and also serves to highlight the complexity of the NICU-to-home transition for this population of young mothers that is not currently elucidated in the literature.
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Williams RC, Biscaro A, Clinton J. Relationships matter: How clinicians can support positive parenting in the early years. Paediatr Child Health 2019; 24:340-357. [PMID: 31379438 DOI: 10.1093/pch/pxz063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 02/08/2019] [Indexed: 11/14/2022] Open
Abstract
A secure attachment relationship with at least one healthy adult is essential for a child to develop optimal coping abilities. Primary care providers like paediatricians and family physicians can help by supporting parents in practice settings. Every clinician encounter is an opportunity to ask parents about children's relationships and their behaviour, daily routines, and overall family function. This statement, which focuses on children aged 0 to 6 years, describes basic principles in support of positive parenting and recommends in-office practices to promote secure parent-child relationships, engage families and build trust with parents. Crying, sleep, and difficult behaviours are described as opportunities for clinicians to provide anticipatory, responsive guidance to parents.
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Affiliation(s)
- Robin C Williams
- Canadian Paediatric Society, Early Years Task Force, Ottawa, Ontario
| | - Anne Biscaro
- Canadian Paediatric Society, Early Years Task Force, Ottawa, Ontario
| | - Jean Clinton
- Canadian Paediatric Society, Early Years Task Force, Ottawa, Ontario
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Di Meglio G, Yorke E. Universal access to no-cost contraception for youth in Canada. Paediatr Child Health 2019; 24:160-169. [PMID: 31110456 PMCID: PMC6519616 DOI: 10.1093/pch/pxz033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 11/22/2018] [Indexed: 11/14/2022] Open
Abstract
Timely access to effective contraception reduces the incidence of unintended pregnancy. Cost is a significant barrier to using contraception for youth in Canada. Many must pay out-of-pocket because they have no pharmaceutical insurance, their insurance does not cover the contraceptives they desire, or they wish to obtain contraceptives without their parents' knowledge. To address these barriers and reduce rates of unintended pregnancy, this statement recommends that all youth should have confidential access to contraception, at no cost, until the age of 25. The statement also recommends measures to help achieve this goal across Canada.
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Affiliation(s)
| | - Elisabeth Yorke
- Canadian Paediatric Society, Adolescent Health Committee, Ottawa, Ontario
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12
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Di Meglio G, Yorke E. L’accès universel à la contraception sans frais pour les jeunes du Canada. Paediatr Child Health 2019. [DOI: 10.1093/pch/pxz047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Giuseppina Di Meglio
- Société canadienne de pédiatrie, comité de la santé de l’adolescent, Ottawa (Ontario)
| | - Elisabeth Yorke
- Société canadienne de pédiatrie, comité de la santé de l’adolescent, Ottawa (Ontario)
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13
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Govender D, Naidoo S, Taylor M. Nurses' perception of the multidisciplinary team approach of care for adolescent mothers and their children in Ugu, KwaZulu-Natal. Afr J Prim Health Care Fam Med 2019; 11:e1-e11. [PMID: 31038339 PMCID: PMC6489148 DOI: 10.4102/phcfm.v11i1.1936] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/12/2018] [Accepted: 11/15/2018] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Adolescent childbearing has numerous consequences on maternal health, child health and the well-being of society. Because of the high-risk nature of adolescent pregnancy, a multidisciplinary team (MDT) approach is recommended to achieve satisfactory pregnancy outcomes. AIM The aim of this study was to explore nurses' perceptions of the MDT approach in the continuum of care for adolescent mothers and their children. SETTING The study was conducted in a local district hospital in Ugu, KwaZulu-Natal. METHODS An explorative and descriptive qualitative study design was used. The first author and hospital staff (clinical midwives and the clinical manager of obstetrics and gynaecology) collaborated on the development of the focus group discussion (FGD) guide to explore nurses' perception of the MDT approach of care for adolescent mothers and their children. A total of three FGDs were conducted. Data were analysed using thematic analysis. RESULTS Six overarching themes emerged from the data analysis which included professional benefits of adopting the MDT approach of care for adolescent mothers and their children, barriers to the multidisciplinary collaboration, clinical benefits of adopting the MDT approach of care for parenting adolescent mothers, problems and needs of adolescent mothers, and nurses' reasons regarding their willingness to participate in a multidisciplinary collaboration in the care of parenting adolescent mothers. CONCLUSION In the opinion of nurses, the MDT approach of care for adolescent mothers and their children is an important strategy to improve maternal and child health outcomes. This study has important implications for the design of an intervention.
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Affiliation(s)
- Desiree Govender
- KwaZulu-Natal Department of Health, Ugu District, South Africa; and, School of Nursing and Public Health, Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban.
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Closing the Gap between Need and Uptake: a Case for Proactive Contraception Provision to Adolescents. Asian Bioeth Rev 2019; 11:95-109. [PMID: 33717303 DOI: 10.1007/s41649-019-00082-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 03/14/2019] [Accepted: 03/20/2019] [Indexed: 10/26/2022] Open
Abstract
In New Zealand, there are adolescents who are at risk of pregnancy and who do not want to become pregnant, but are not using contraception. Cost and other barriers limit access to contraception. To address the gap between contraceptive need and contraceptive access, this paper puts forward the concept of proactive contraception provision, where adolescents are offered contraceptives directly. To strengthen the case for proactive contraception provision, this paper addresses a series of potential objections. One is that such a programme would cause harm; another that such a programme would not have sufficient benefit. In rebutting these objections, the conclusion is reached that proactive contraception provision is a model worth pursuing as a means of meeting the needs of the New Zealand adolescent population and may be of interest more widely.
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Reibel T, Wyndow P, Walker R. From Consultation to Application: Practical Solutions for Improving Maternal and Neonatal Outcomes for Adolescent Aboriginal Mothers at a Local Level. Healthcare (Basel) 2016; 4:E90. [PMID: 27929416 PMCID: PMC5198132 DOI: 10.3390/healthcare4040090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 11/16/2016] [Accepted: 11/30/2016] [Indexed: 11/16/2022] Open
Abstract
Adolescent pregnancy has been typically linked to a range of adverse outcomes for mother and child. In Australia, Aboriginal and Torres Strait Islander women have a higher proportion of adolescent births compared with other adolescent Australian women, and are at greater risk of poorer psychosocial and clinical outcomes if they are not well supported during pregnancy and beyond. Drawing on existing literature and consultations with young Aboriginal women and health professionals supporting pregnant Aboriginal women in Western Australia, this paper discusses the importance of creating models of antenatal care using a "social determinants of health" framework. Destigmatizing young parenthood and providing continuity of caregiver in culturally safe services, with culturally competent health professionals provides a means to encourage engagement with the health system and improve health outcomes for young mothers and their babies.
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Affiliation(s)
- Tracy Reibel
- Telethon Kids Institute, University of Western Australia, Nedlands 6009, Australia.
| | - Paula Wyndow
- Telethon Kids Institute, University of Western Australia, Nedlands 6009, Australia.
| | - Roz Walker
- Telethon Kids Institute, University of Western Australia, Nedlands 6009, Australia.
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