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Schobinger E, Vanetti M, Ramelet AS, Horsch A. First-time parents' perception of midwives' and other healthcare professionals' support behaviours: A qualitative study. Midwifery 2024; 135:104028. [PMID: 38795667 DOI: 10.1016/j.midw.2024.104028] [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: 06/05/2023] [Revised: 05/13/2024] [Accepted: 05/15/2024] [Indexed: 05/28/2024]
Abstract
PROBLEM Parents often report not being satisfied with the support received from midwives and nurses during their postpartum hospital stay. BACKGROUND Social support is an important protective factor during the transition to parenthood. However, little is known on how first-time parents perceived the behaviours demonstrated by healthcare professionals to support them. OBJECTIVE To describe social support behaviours of midwives and nurses as perceived by first-time parents during the early postpartum period. METHODS This qualitative study used individual semi-structured interviews to collect data. A purposeful sample of first-time parents staying on the postpartum ward of a Swiss university hospital were included. Thematic analysis was performed to identify themes and sub-themes. FINDINGS A total of 26 parents (15 mothers and 11 fathers) were interviewed. Parents reported behaviours perceived either as positive or negative. These behaviours were summarized into five themes: "Welcoming parents on the postpartum ward", "Establishing a partnership with parents", "Guiding parents in acquiring their new parenting role", "Caring for parent's emotions", and "Creating a peaceful environment". DISCUSSION AND CONCLUSION This study reported a wide variety of professional support behaviours. Behaviours promoting individualised care and related to empowering parents in their infant care were perceived as helpful by parents. Midwives and nurses should be aware of the way they provide support, as this shapes the early postpartum experience of first-time parents. Being sufficiently staffed and being well-trained, especially in providing interpersonal support, could help midwives and nurses provide better sensitive individualised care.
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Affiliation(s)
- Elisabeth Schobinger
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
| | - Mélanie Vanetti
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
| | - Anne-Sylvie Ramelet
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland; Department Woman-Mother-Child, University Hospital, Lausanne, Switzerland.
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Shorey S, Ng JQX, Liu VC, Chee CYI. Cradling disparities: A descriptive qualitative study of maternal experiences of mothers from low-socioeconomic status in the first month postpartum. J Adv Nurs 2024. [PMID: 38733069 DOI: 10.1111/jan.16225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024]
Abstract
AIM To explore the experiences, expectations and needs of mothers from low-socioeconomic status at 1 month postpartum. DESIGN Descriptive qualitative. METHODS Mothers from low-socioeconomic status and irrespective of their parity were invited to participate in one-to-one interviews at 1 month postpartum. Semi-structured interviews were conducted until data saturation. Interviews were audio recorded, transcribed verbatim and analysed thematically. Written informed consent was obtained. RESULTS Twenty mothers participated and six themes were identified: (1) No choice but to find meaning; (2) Father as a major pillar of support; (3) 'Kampung' Spirit; (4) Trials and Tribulations of Transition to Motherhood; (5) Shame, guilt and internalized stigma and (6) Reclaiming the power. CONCLUSION This study reflected the unique struggles of mothers from low-socioeconomic status with pregnancy, childbirth and early postpartum and the wider health inequities within Singapore's maternal health system. To provide much-needed support and improved care, the stakeholders within government, healthcare providers and social organizations should consider the niche needs of this community. IMPLICATIONS FOR PATIENT CARE Nurses need to reflect on their own biases and ensure consistent care delivery regardless of socioeconomic status. When delivering patient education, patient-centred and sincere advice rooted in personal experience can help to establish rapport. IMPACT This study is the first to explore the experiences of mothers from low-socioeconomic status in the Singapore context. Low-socioeconomic status mothers experienced less autonomy over their health, the care they received and their childcare options. As mothers adjusted to their new roles, they struggled to cope. However, as they were wary of the stigma surrounding poverty and their guilt of not being a 'good mother', they preferred to seek informal support from their family, friends and self-help through learning from social media, as compared to formal, external help. REPORTING METHOD COREQ checklist. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jamie Qiao Xin Ng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Verity Chandelle Liu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cornelia Yin Ing Chee
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
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Ozcan S, Eryilmaz G. Using Levine's conservation model in postpartum care: a randomized controlled trial. Health Care Women Int 2020; 42:794-814. [PMID: 32744924 DOI: 10.1080/07399332.2020.1797038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This randomized controlled trial was conducted with 117 puerperae who were assigned into 2 groups: the intervention group and the control group. While the participants in the intervention group participated in a full program based on the module trainings, the participants in the control group received routine care. There was a significant difference between the women in the intervention and control groups in terms of the variables such as fatigue, sleep, and quality of life. The women in the intervention group experienced less fatigue, and their quality of sleep and quality of life improved considerably. Levine's conservation model enables the provision of the integrative care to women in their postpartum period.
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Affiliation(s)
- Sadiye Ozcan
- Faculty of Health Science, Yalova University, Yalova, Turkey
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Sunny SH, Malhotra R, Ang SB, Lim CSD, Tan YSA, Soh YMB, Ho XYC, Gostelow M, Tsang LPM, Lock SHS, Kwek SY, Lim YTJ, Vijakumar K, Tan NC. Facilitators and Barriers to Post-partum Diabetes Screening Among Mothers With a History of Gestational Diabetes Mellitus-A Qualitative Study From Singapore. Front Endocrinol (Lausanne) 2020; 11:602. [PMID: 32982985 PMCID: PMC7484739 DOI: 10.3389/fendo.2020.00602] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/23/2020] [Indexed: 12/15/2022] Open
Abstract
Introduction: Gestational Diabetes Mellitus (GDM) affects one in six births worldwide. Mothers with GDM have an increased risk of developing post-partum Type-2 Diabetes Mellitus (T2DM). However, their uptake of post-partum diabetes screening is suboptimal, including those in Singapore. Literature reports that the patient-doctor relationship, mothers' concerns about diabetes, and family-related practicalities are key factors influencing the uptake of such screening. However, we postulate additional factors related to local society, healthcare system, and policies in influencing post-partum diabetes screening among mothers with GDM. Aim: The qualitative research study aimed to explore the facilitators and barriers to post-partum diabetes screening among mothers with GDM in an Asian community. Methods: In-depth interviews were carried out on mothers with GDM at a public primary care clinic in Singapore. Mothers were recruited from those who brought their child for vaccination appointments and their informed consent was obtained. Both mothers who completed post-partum diabetes screening within 12 weeks after childbirth and those who did not were purposively recruited. The social ecological model (SEM) provides the theoretical framework to identify facilitators and barriers at the individual, interpersonal, organizational, and policy levels. Results: Twenty multi-ethnic Asian mothers with GDM were interviewed. At the individual and interpersonal level, self-perceived risk of developing T2DM, understanding the need for screening and the benefits of early diagnosis, availability of confinement nanny in Chinese family, alternate caregivers, emotional, and peer support facilitated post-partum diabetes screening. Barriers included fear of the diagnosis and its consequences, preference for personal attention and care to child, failure to find trusted caregiver, competing priorities, and unpleasant experiences with the oral glucose tolerance test. At the organizational and public policy level, bundling of scheduled appointments, and standardization of procedure eased screening but uptake was hindered by inconvenient testing locations, variable post-partum care practices and advice in the recommendations for diabetes screening. Conclusion: Based on the SEM, facilitators and barriers towards post-partum diabetes screening exist at multiple levels, with some contextualized to local factors. Interventions to improve its uptake should be multi-pronged, targeting not only at personal but also familial, health system, and policy factors to ensure higher level of success.
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Affiliation(s)
| | | | - Seng Bin Ang
- Family Medicine Service, Kandang-Kerbau Women and Children Hospital, Singapore, Singapore
- SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore, Singapore
| | | | | | | | | | | | - L. P. Marianne Tsang
- SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore, Singapore
| | | | | | | | | | - Ngiap Chuan Tan
- SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore, Singapore
- SingHealth Polyclinics, Singapore, Singapore
- *Correspondence: Ngiap Chuan Tan
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Rouhi M, Stirling CM, Crisp EP. Mothers' views of health problems in the 12 months after childbirth: A concept mapping study. J Adv Nurs 2019; 75:3702-3714. [PMID: 31452233 DOI: 10.1111/jan.14187] [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: 03/06/2019] [Revised: 07/22/2019] [Accepted: 08/10/2019] [Indexed: 01/03/2023]
Abstract
AIMS To identify the health problems that women feel require help and subsequent help-seeking behaviour during the 12 months period after childbirth. BACKGROUND Many women experience physical and mental health problems after childbirth, but there is a gap in understanding how they perceive their health after childbirth. Studies suggested they are inhibited in expressing their needs and so seek informal rather than professional help for their health problems. DESIGN A mixed method concept mapping study. METHOD Two groups of Australian women were recruited by an online platform and purposive sampling (N = 81) in 2017-2018, based on an established concept mapping methodology. A first group created 83 brainstorm statements about post-childbirth health problems and help-seeking and a second group sorted and rated the statements based on their perception of the prevalence of the issues and the help-seeking advice they would offer to others. Bradshaw`s Taxonomy of Needs was used to theoretically underpins the explanation of the results of women's felt need after childbirth. RESULTS Multidimensional scaling resulted in six clusters of issues which were categorized into three domains: 'health issues and care', 'support' and 'fitness'. Despite being directly asked, about two-thirds of the women did not report experiencing any health problems. CONCLUSION Our findings showed women had a broader perception of healthcare needs which included support and fitness. There is a potential gap in services for women who do not have good social support. IMPACT Family and friends were a key source of help-seeking. Post-childbirth routine care was focused on infant care and limited to the first 6 weeks after childbirth. The content of current post-childbirth care must be reviewed.
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Affiliation(s)
- Maryam Rouhi
- School of Nursing, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Christine M Stirling
- School of Nursing, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Elaine P Crisp
- School of Nursing, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
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Rouhi M, Stirling C, Ayton J, Crisp EP. Women's help-seeking behaviours within the first twelve months after childbirth: A systematic qualitative meta-aggregation review✰. Midwifery 2019; 72:39-49. [PMID: 30772692 DOI: 10.1016/j.midw.2019.02.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/11/2019] [Accepted: 02/06/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Women within the first 12 months after birth often do not seek professional help for post-childbirth morbidities. This systematic review uses the Behavioural Model of Health Services Use (BMSHU) to assess the barriers and facilitators to women's help-seeking from health professionals during the first twelve months after childbirth. METHOD A qualitative meta-aggregation was used for the review. Systematic searching of Medline via Ovid, CINAHL, EMBASE and Web of Science revealed an initial 691 papers, of which 48 were reviewed. Nine qualitative papers, peer-reviewed, English papers and published from 2000 to 2017, were identified. Studies selected according to the pre-defined protocol were assessed using The Joanna Briggs Institute Critical Appraisal Tools (JBIQARI). RESULTS Seventy-five findings were identified from the approved articles and aggregated into seven categories. Key themes that emerged were that women did not seek help because they accepted problems as a part of the motherhood role or because they feared being judged negatively. Women shared their issues with family and friends as trusted people. Low health literacy was a barrier to seeking help, as was lack of access to proper care and poor advice from families. The women's cultural context was an essential influence in whether or not they sought help. According to BMSHU, a model of key influences on women's help-seeking for maternal morbidities introduced.
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Affiliation(s)
- Maryam Rouhi
- School of Nursing, College of Health and Medicine, University of Tasmania, Advocate House, 9 Liverpool St, Hobart TAS 7001, Australia.
| | - Christine Stirling
- School of Nursing, College of Health and Medicine, University of Tasmania, Private Bag 135, Hobart TAS 7001, Australia.
| | - Jenifer Ayton
- Lecturer in Public Health School of Medicine, College of Health and Medicine, University of Tasmania, Private Bag 34, Hobart, TAS 7001, Australia.
| | - Elaine Peta Crisp
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Launceston 7250, Australia.
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Shorey S, Chee C, Chong YS, Ng ED, Lau Y, Dennis CL. Evaluation of Technology-Based Peer Support Intervention Program for Preventing Postnatal Depression: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2018; 7:e81. [PMID: 29540338 PMCID: PMC5874437 DOI: 10.2196/resprot.9416] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/05/2018] [Accepted: 01/23/2018] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Multiple international agencies, including the World Health Organization and the International Monetary Fund, have emphasized the importance of maternal mental health for optimal child health and development. Adequate social support is vital for the most vulnerable to postpartum mood disorders. Hence, an urgent need for sustainable social support programs to aid mothers ease into their new parenting role exists. OBJECTIVE This study protocol aims to examine the effectiveness of a technology-based peer support intervention program among mothers at risk for postnatal depression in the early postpartum period. METHODS A randomized controlled 2-group pretest and repeated posttest experimental design will be used. The study will recruit 118 mothers from the postnatal wards of a tertiary public hospital in Singapore. Eligible mothers will be randomly allocated to receive either the peer support intervention program or routine perinatal care from the hospital. Peer volunteers will be mothers who have experienced self-reported depression and will be receiving face-to-face training to support new mothers at risk of depression. Outcome measures include postnatal depression, anxiety, loneliness, and social support. Data will be collected at immediate postnatal period (day of discharge from the hospital), at fourth week and twelfth week post childbirth. RESULTS The recruitment and training of peer support volunteers (N=20) ended in June 2017, whereas recruitment of study participants commenced in July 2017 and is still ongoing. The current recruitment for new mothers stands at 73, with 36 in the control group and 37 in the intervention group. Data collection is projected to be completed by May 2018. CONCLUSIONS This study will identify a potentially effective and clinically useful method to prevent postnatal depression in new mothers, which is the top cause of maternal morbidity. Receiving social support from others who share similar experiences may enhance the positive parenting experiences of mothers, which in turn can improve the psychosocial well-being of the mothers, tighten mother-child bond, and enhance overall family dynamics for mothers and infants. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number ISRCTN14864807; http://www.isrctn.com/ISRCTN14864807 (Archived by WebCite at http://www.webcitation.org/6xtBNvBTX).
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Affiliation(s)
| | | | | | | | - Ying Lau
- National University of Singapore, Singapore, Singapore
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Hajimiri K, Shakibazadeh E, Mehrizi AAH, Shabbidar S, Sadeghi R. The impact of general health and social support on health promoting lifestyle in the first year postpartum: the structural equation modelling. Electron Physician 2018; 10:6231-6239. [PMID: 29588825 PMCID: PMC5853999 DOI: 10.19082/6231] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 07/28/2017] [Indexed: 01/19/2023] Open
Abstract
Background and aim Postpartum is a critical period for mothers which often leads to neglect of their own health. Mothers’ new responsibilities may affect their health promoting lifestyle (HPL). The aim of this study was to determine the impact of both general health and social support on health-promoting lifestyle. Methods A cross-sectional survey was conducted on 310 women who gave birth over a one-year period in Zanjan (Iran), 2016. A proportionate stratified random sampling technique was used to select respondents from each stratum. Health-promoting lifestyle was assessed using the health-promoting lifestyle profile II (HPLP II) scale. A structure equation model (SEM) was used to determine the relationship between observed and latent variables. Data were analysed using SPSS version 22 and LISREL 8.5 software. Results The age of 42.6% of the participants was more than 30 years and 40.3% of them had an academic education. The mean score of the health-promoting lifestyle was 131.28 (15.37). The structural equation model fitted well with RMSEA =0.07, CFI=0.92, and GFI=0.94. Among the latent factors, general health, with a factor load of −0.68, had greater impact on health-promoting lifestyle than social support. Moreover, there was a significant correlation (−0.63) between general health and perceived social support in the postpartum period. Conclusion health-promoting lifestyle was not at appropriate levels among women in the first year after delivery. These findings suggest that strengthening general health and social support would improve a health-promoting lifestyle in Iranian postpartum women.
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Affiliation(s)
- Khadijeh Hajimiri
- Ph.D. Candidate of Health Education and Promotion, Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Ph.D. of Health Education, Associate Professor, Department of Health Education and Health Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Asghar Haeri Mehrizi
- M.Sc. of Statistics, Faculty Member, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Sakineh Shabbidar
- Ph.D. of Nutritional Sciences, Assistant Professor, Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sadeghi
- Ph.D. of Health Education, Associate Professor, Department of Health Education and Health Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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