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Bali AG, Vasilevski V, Sweet L. Barriers and facilitators of access to maternity care for African-born women living in Australia: a meta-synthesis of qualitative evidence. Syst Rev 2024; 13:215. [PMID: 39123244 PMCID: PMC11312702 DOI: 10.1186/s13643-024-02628-8] [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: 10/19/2023] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Adverse perinatal health outcomes are notably high among African-born women living in Australia. This problem is partly attributed to their lower engagement in maternity care services as compared to Australian-born women. Various barriers might limit African-born women's access to and use of services; however, these barriers are not well documented. Therefore, this review aimed to synthesise current qualitative evidence on barriers and facilitators of access to maternity care for African-born women living in Australia. METHODS The search was conducted in MEDLINE, CINAHL, Embase, PsychInfo, and Maternity and Infant Care databases on 16 April 2023. All articles retrieved were meticulously screened for eligibility by two independent reviewers with any disagreements resolved through discussion. The quality of the included articles was evaluated using the Mixed Methods Appraisal Tool. Studies were screened in Covidence and analysed in NVivo. The findings were organised and presented using Levesque's framework of healthcare access. RESULTS Out of 558 identified papers, 11 studies comprising a total of 472 participants met the eligibility criteria. The review highlighted provider-side barriers such as shortage of information, unmet cultural needs, long waiting times, low engagement of women in care, discrimination, and lack of continuity of care. User-side barriers identified include communication issues, difficulty navigating the health system, and lack of trustful relationships with healthcare providers. In contrast, the review pinpointed provider-side facilitators including positive staff attitudes, service availability, and the proximity of facilities to residential homes, while user-side facilitators such as cultural assimilation and feeling valued by healthcare providers were noted. CONCLUSIONS This review identified barriers and facilitators of access to maternity care for African-born women living in Australia. Empirical evidence that would inform potential changes to policy and practice to address African-born women's unique health needs was highlighted. Designing and implementing a culturally safe service delivery model could remove the identified access barriers and improve African-born women's engagement in maternity care. Moreover, reinforcing factors associated with positive healthcare experiences is essential for improving maternity care access for this priority population. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42023405458.
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Affiliation(s)
- Ayele Geleto Bali
- School of Nursing and Midwifery, Deakin University, Burwood, VIC, Australia.
- Centre for Quality and Patient Safety Research, Institute for Health Transformation, Western Health Partnership, Melbourne, VIC, Australia.
| | - Vidanka Vasilevski
- School of Nursing and Midwifery, Deakin University, Burwood, VIC, Australia
- Centre for Quality and Patient Safety Research, Institute for Health Transformation, Western Health Partnership, Melbourne, VIC, Australia
| | - Linda Sweet
- School of Nursing and Midwifery, Deakin University, Burwood, VIC, Australia
- Centre for Quality and Patient Safety Research, Institute for Health Transformation, Western Health Partnership, Melbourne, VIC, Australia
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Sacks E, Brizuela V, Javadi D, Kim Y, Elmi N, Finlayson K, Crossland N, Langlois EV, Ziegler D, Parmar SM, Bonet M. Immigrant women's and families' views and experiences of routine postnatal care: findings from a qualitative evidence synthesis. BMJ Glob Health 2024; 8:e014075. [PMID: 38351019 PMCID: PMC10897958 DOI: 10.1136/bmjgh-2023-014075] [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: 09/26/2023] [Accepted: 01/06/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Uptake of postnatal care (PNC) is low and inequitable in many countries, and immigrant women may experience additional challenges to access and effective use. As part of a larger study examining the views of women, partners, and families on routine PNC, we analysed a subset of data on the specific experiences of immigrant women and families. METHODS This is a subanalysis of a larger qualitative evidence synthesis. We searched MEDLINE, PUBMED, CINAHL, EMBASE, EBM-Reviews and grey literature for studies published until December 2019 with extractable qualitative data with no language restrictions. For this analysis, we focused on papers related to immigrant women and families. Two reviewers screened each study independently; inclusion was agreed by consensus. Data abstraction and quality assessment were carried out using a study-specific extraction form and established quality assessment tools. Study findings were identified using thematic analysis. Findings are presented by confidence in the finding, applying the GRADE-CERQual approach. FINDINGS We included 44 papers, out of 602 full-texts, representing 11 countries where women and families sought PNC after immigrating. All but one included immigrants to high-income countries. Four themes were identified: resources and access, differences from home country, support needs, and experiences of care. High confidence study findings included: language and communication challenges; uncertainty about navigating system supports including transportation; high mental health, emotional, and informational needs; the impact of personal resources and social support; and the quality of interaction with healthcare providers. These findings highlight the importance of care experiences beyond clinical care. More research is also needed on the experiences of families migrating between low-income countries. CONCLUSIONS Immigrant families experience many challenges in getting routine PNC, especially related to language, culture, and communication. Some challenges may be mitigated by improving comprehensive and accessible information on available services, as well as holistic social support. TRIAL REGISTRATION NUMBER CRD42019139183.
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Affiliation(s)
- Emma Sacks
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Vanessa Brizuela
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Dena Javadi
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Yoona Kim
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Nika Elmi
- School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Kenneth Finlayson
- School of Nursing and Midwifery, University of Central Lancashire, Preston, UK
| | - Nicola Crossland
- School of Nursing and Midwifery, University of Central Lancashire, Preston, UK
| | - Etienne V Langlois
- Partnership for Maternal, Newborn, and Child Health, World Health Organization, Geneva, Switzerland
| | - Daniela Ziegler
- Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada
| | | | - Mercedes Bonet
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Sharma E, Tseng PC, Harden A, Li L, Puthussery S. Ethnic minority women's experiences of accessing antenatal care in high income European countries: a systematic review. BMC Health Serv Res 2023; 23:612. [PMID: 37301860 PMCID: PMC10256965 DOI: 10.1186/s12913-023-09536-y] [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: 01/10/2022] [Accepted: 05/10/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Women from ethnic minority backgrounds are at greater risk of adverse maternal outcomes. Antenatal care plays a crucial role in reducing risks of poor outcomes. The aim of this study was to identify, appraise, and synthesise the recent qualitative evidence on ethnic minority women's experiences of accessing antenatal care in high-income European countries, and to develop a novel conceptual framework for access based on women's perspectives. METHODS We conducted a comprehensive search of seven electronic databases in addition to manual searches to identify all qualitative studies published between January 2010 and May 2021. Identified articles were screened in two stages against the inclusion criteria with titles and abstracts screened first followed by full-text screening. Included studies were quality appraised using the Critical Appraisal Skills Programme checklist and extracted data were synthesised using a 'best fit' framework, based on an existing theoretical model of health care access. RESULTS A total of 30 studies were included in this review. Women's experiences covered two overarching themes: 'provision of antenatal care' and 'women's uptake of antenatal care'. The 'provision of antenatal care' theme included five sub-themes: promotion of antenatal care importance, making contact and getting to antenatal care, costs of antenatal care, interactions with antenatal care providers and models of antenatal care provision. The 'women's uptake of antenatal care' theme included seven sub-themes: delaying initiation of antenatal care, seeking antenatal care, help from others in accessing antenatal care, engaging with antenatal care, previous experiences of interacting with maternity services, ability to communicate, and immigration status. A novel conceptual model was developed from these themes. CONCLUSION The findings demonstrated the multifaceted and cyclical nature of initial and ongoing access to antenatal care for ethnic minority women. Structural and organisational factors played a significant role in women's ability to access antenatal care. Participants in majority of the included studies were women newly arrived in the host country, highlighting the need for research to be conducted across different generations of ethnic minority women taking into account the duration of stay in the host country where they accessed antenatal care. PROTOCOL AND REGISTRATION The review protocol was registered on PROSPERO (reference number CRD42021238115).
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Affiliation(s)
- Esther Sharma
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Park Square Rm B201, Luton, Bedfordshire LU1 3JU UK
| | - Pei-Ching Tseng
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Park Square Rm B201, Luton, Bedfordshire LU1 3JU UK
| | - Angela Harden
- School of Health Sciences, Division of Health Services Research and Management, City, University of London, Northampton Square London, EC1V 0HB UK
| | - Leah Li
- Population, Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, London, WC1N 1EH UK
| | - Shuby Puthussery
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Park Square Rm B201, Luton, Bedfordshire LU1 3JU UK
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South-Asian women's experiences of earlier additional, fetal monitoring to reduce stillbirth: An exploratory qualitative study. Women Birth 2023; 36:e213-e218. [PMID: 35902344 DOI: 10.1016/j.wombi.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND In an attempt to reduce the rates of stillbirth at term among South-Asian born women, Victoria's largest maternity service, Monash Health, implemented a new clinical guideline in 2017 that recommended additional earlier, twice weekly monitoring to assess fetal wellbeing from 39 weeks for South-Asian women. In acknowledging the importance of woman centred, culturally responsive care, this study aimed to understand South-Asian women's, experiences, of the additional earlier fetal monitoring. METHODS An exploratory qualitative study was conducted using semi-structured phone interviews six weeks postpartum, across June and July 2021, with South-Asian born women who underwent the earlier monitoring from 39 weeks. Women were asked questions regarding their understanding of the monitoring, their experiences of the monitoring process and any impact the monitoring or results had on their pregnancy, labour and birth. Interviews were recorded and transcribed verbatim. Data were analysed using a thematic approach and an inductive coding strategy. RESULTS Seventeen women from India, Sri Lanka, Pakistan and Afghanistan were interviewed. the main themes were i: gaining peace of mind, need for better communication, did the women really have a choice? and comparisons to maternity care in the country of origin. Women experienced positive reassurance of their baby's well-being from the monitoring and were happy with the earlier, extra care. However, women described receiving variable explanations of the purpose of the monitoring. Ineffective communication and logistical barriers were highlighted to negatively impact women's ability to engage in shared decision making and their overall experience of the earlier monitoring. CONCLUSIONS The additional monitoring is reported by these women to have an overall positive impact on their maternity care. Future work should explore the experiences of non-English speaking South-Asian women and those who declined monitoring.
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Sellevold VL, Hamre LL, Bondas TE. A meta-ethnography of language challenges in midwifery care. Eur J Midwifery 2022; 6:41. [PMID: 35860721 PMCID: PMC9254263 DOI: 10.18332/ejm/147994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 03/17/2022] [Accepted: 04/03/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
| | - Lene L Hamre
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Terese E Bondas
- Childbearing - Qualitative Research Network, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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MacLellan J, Collins S, Myatt M, Pope C, Knighton W, Rai T. Black, Asian and minority ethnic women's experiences of maternity services in the UK: A qualitative evidence synthesis. J Adv Nurs 2022; 78:2175-2190. [PMID: 35332568 PMCID: PMC9314829 DOI: 10.1111/jan.15233] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/24/2022] [Accepted: 02/21/2022] [Indexed: 01/13/2023]
Abstract
AIMS Black, Asian and minority ethnic women are at higher risk of dying during pregnancy, childbirth and postnatally and of experiencing premature birth, stillbirth or neonatal death compared with their White counterparts. Discrimination against women from ethnic minorities is known to negatively impact women's ability to speak up, be heard and their experiences of care. This evidence synthesis analysed Black, Asian and minority ethnic women's experiences of UK maternity services in light of these outcomes. DESIGN We conducted a systematic review and qualitative evidence synthesis using the method of Thomas and Harden. DATA SOURCES A comprehensive search in AMED, Cinahl, Embase, Medline, PubMed and PsycINFO, alongside research reports from UK maternity charities, was undertaken from 2000 until May 2021. Eligible studies included qualitative research about antenatal, intrapartum and postnatal care, with ethnic minority women in maternity settings of the UK NHS. REVIEW METHODS Study quality was graded using the Critical Appraisal Skills Programme tool. RESULTS Twenty-four studies met the inclusion criteria. Our synthesis highlights how discriminatory practices and communication failures in UK NHS maternity services are failing ethnic minority women. CONCLUSION This synthesis finds evidence of mistreatment and poor care for ethnic minority women in the UK maternity system that may contribute to the poor outcomes reported by MBRRACE. Woman-centred midwifery care is reported as positive for all women but is often experienced as an exception by ethnic minority women in the technocratic birthing system. IMPACT Ethnic minority women report positive experiences when in receipt of woman-centred midwifery care. Woman-centred midwifery care is often the exception in the overstretched technocratic UK birthing system. Mistreatment and poor care reported by many ethnic minority women in the UK could inform the inequalities of outcomes identified in the MBRRACE report.
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Affiliation(s)
- Jennifer MacLellan
- Nuffield Department of Primary Care Health SciencesUniversity of Oxford, Radcliffe Observatory QuarterOxfordUK
| | - Sarah Collins
- Nuffield Department of Women's & Reproductive HealthUniversity of Oxford, Level 3, Women's Centre, John Radcliffe HospitalOxfordUK
| | - Margaret Myatt
- University Hospitals Sussex NHS Foundation TrustWorthingUK
| | - Catherine Pope
- Nuffield Department of Primary Care Health SciencesUniversity of Oxford, Radcliffe Observatory QuarterOxfordUK
| | | | - Tanvi Rai
- Nuffield Department of Primary Care Health SciencesUniversity of Oxford, Radcliffe Observatory QuarterOxfordUK
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de Diego-Cordero R, Tarriño-Concejero L, Vargas-Martínez AM, Muñoz MÁGC. Effects of an educational intervention on nursing students' attitudes towards gypsy women: A non-randomized controlled trial. NURSE EDUCATION TODAY 2022; 113:105383. [PMID: 35508084 DOI: 10.1016/j.nedt.2022.105383] [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: 08/04/2021] [Revised: 03/01/2022] [Accepted: 04/24/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The cultural differences between health professionals and patients, together with the ethnocentric opinions that some health professionals sometimes hold, generate prejudice and negatively influence the experiences of these groups, for example, the Gypsy population. METHODS We set up a quasi-experimental study to test the efficacy of an educational intervention among 40 nursing students in Spain based on the use of positive references in order to improve the students' attitude towards gypsy women receiving health care. Analysis of comparison of means and correlation analysis were carried out according to the type of variable compared. RESULTS The score in all the items that make up the Prejudicial Attitude Scale (PAT) decreased after the test, which demonstrated that their attitudes had become less prejudiced. The Stereotype Content Model (SCM), the perception of the outgroup and the stereotypes regarding the Roma population as "trustworthy" all improved showing a statistically significant difference between the periods (pre and post educational intervention). CONCLUSION Nursing educators have the opportunity, through theoretical and practical exposure to positive references, to explore the students' experience and perceptions, analyze interventions and change their perceptions of threat, thus contributing to a more inclusive group identity.
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Affiliation(s)
- Rocio de Diego-Cordero
- Research Group CTS 969 Innovation in HealthCare and Social Determinants of Health, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain.
| | - Lorena Tarriño-Concejero
- Research Group CTS-1050: Complex Care, Cronocity and Health Outcome, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain.
| | - Ana Magdalena Vargas-Martínez
- Research Group CTS 969 Innovation in HealthCare and Social Determinants of Health, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain.
| | - Mª Ángeles García-Carpintero Muñoz
- Research Group CTS-1050: Complex Care, Cronocity and Health Outcome, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain.
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Heinonen K. Strengthening Antenatal Care towards a Salutogenic Approach: A Meta-Ethnography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105168. [PMID: 34068114 PMCID: PMC8152723 DOI: 10.3390/ijerph18105168] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022]
Abstract
The aim was to explore how midwives, public health nurses and nurses view caring in antenatal care (ANC) as provided for mothers and fathers/partners. Based on Noblit and Hare (1988), meta-ethnography was used to address meaning by synthesizing knowledge and understanding inductively through selected qualitative studies (n = 16). Four core themes were identified: (1) supporting the parents to awaken to parenthood and creating a firm foundation for early parenting and their new life situation; (2) guiding parents on the path to parenthood and new responsibility; (3) ensuring normality and the bond between baby and parents while protecting life; and (4) promoting the health and wellbeing of the family today and in the future. The overarching theme can be expressed as "helping the woman and her partner prepare for their new life with the child by providing individualized, shared care, firmly grounded and with a view of the future". Caring in antenatal care (ANC) is being totally present, listening and using multidimensional professional competence but also being open-minded to new aspects and knowledge. The health promotion and positive health aspects should be considered an important part of supporting parents and the whole family now and in the future. A more conscious salutogenic approach to ANC would lead to more favorable results and could be a fruitful research topic in the future. There is a need to provide midwives/nurses with enough time to allow them to concentrate on specific needs and support for different kind of families in ANC but also training for midwives to make them more familiar with online and other options.
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Affiliation(s)
- Kristiina Heinonen
- Health Care and Health Promotion, Metropolia University of Applied Sciences, P.O. Box 4000, FI-00079 Helsinki, Finland;
- Department of Nursing Science, University of Eastern Finland, Yliopistonranta 1, FI-70210 Kuopio, Finland
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Näsman Y. The theory of caritative caring: Katie Eriksson’s theory of caritative caring presented from a human science point of view. Nurs Philos 2020; 21:e12321. [DOI: 10.1111/nup.12321] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 07/01/2020] [Accepted: 07/05/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Yvonne Näsman
- Department of Caring Science Faculty of Education and Welfare Studies Åbo Akademi University Vaasa Finland
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Merry L, Villadsen SF, Sicard V, Lewis-Hibbert N. Transnationalism and care of migrant families during pregnancy, postpartum and early-childhood: an integrative review. BMC Health Serv Res 2020; 20:778. [PMID: 32838781 PMCID: PMC7446052 DOI: 10.1186/s12913-020-05632-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 08/06/2020] [Indexed: 12/05/2022] Open
Abstract
Background Migrant families’ transnational ties (i.e., connections to their countries of origin) may contribute to their hardships and/or may be a source of resiliency. A care approach that addresses these transnational ties may foster a positive identity and give coherence to experiences. We conducted an integrative review to determine what is known about transnational ties and the care of migrant families during pregnancy, postpartum and early childhood. Methods We searched 15 databases to identify literature reporting on a health or social program, service, or care experience of migrant families during pregnancy up to age five in a Western country (i.e., Canada, US, Australia, New Zealand or a European country). Information regarding if and how the service/program/care considered transnational ties, and care-providers’ perceptions of transnational ties, was extracted, analyzed and synthesized according to transnational ‘ways of belonging’ and ‘ways of being’. Results Over 34,000 records were screened; 69 articles were included. Care, programs and services examined included prenatal interventions (a mhealth app, courses, videos, and specialized antenatal care), doula support, maternity care, support groups, primary healthcare and psycho-social early intervention and early childhood programs. The results show that transnational ties in terms of ‘ways of belonging’ (cultural, religious and linguistic identity) are acknowledged and addressed in care, although important gaps remain. Regarding ‘ways of being’, including emotional, social, and economic ties with children and other family members, receipt of advice and support from family, and use of health services abroad, there is very little evidence that these are acknowledged and addressed by care-providers. Perceptions of ‘ways of belonging’ appear to be mixed, with some care-providers being open to and willing to adapt care to accommodate religious, cultural and linguistic differences, while others are not. How care-providers perceive the social, emotional and economic ties and/or the use of services back home, remains relatively unknown. Conclusion Significant knowledge gaps remain regarding care-providers’ perceptions of transnational ‘ways of being’ and whether and how they take them into account, which may affect their relationships with migrant families and/or the effectiveness of their interventions. Continued efforts are needed to ensure care is culturally safe for migrants.
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Affiliation(s)
- Lisa Merry
- Faculty of Nursing, University of Montreal, Montreal, Canada.
| | | | - Veronik Sicard
- School of Kinesiology and Exercise Science, University of Montreal, Montreal, Canada
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Wikberg AM. A theory on intercultural caring in maternity care. Scand J Caring Sci 2020; 35:442-456. [PMID: 32291776 DOI: 10.1111/scs.12856] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 03/17/2020] [Indexed: 11/27/2022]
Abstract
AIM To describe a theory on intercultural caring in maternity care and its development. METHODOLOGY The theory has been developed qualitatively using hermeneutics. MATERIAL Previous studies have been interpreted. FINDINGS Five meaningful interpretation patterns emerged. These are that the experience of caring is related to power; the family is always present; childbearing and migration - a multiple vulnerability; the intercultural encounter changes the mother and the midwife; and conflicts may cause change. These themes are implicit in the theory. The theory consists of the caring relationship between the midwife and the mother. Intercultural caring has four dimensions: universal, cultural, contextual and unique caring. Intercultural caring relieves suffering and promotes health and well-being. Outer circumstances on three levels influence the maternity care. The five patterns and the theory are merged together. CONCLUSION The theory can be used in nursing education to awaken awareness in students of cultural aspects and caring in the maternity care of immigrants. Midwives can apply the theory to maternity care to enable a positive experience of childbearing by immigrant and minority mothers, which in turn can influence the well-being and indirectly the health outcome. The theory connects caring, culture, intercultural and maternity care in a new way, which is important in the care of childbearing immigrant and minority women. It also adds the intercultural and maternity care contexts to the theory of caritative caring.
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Berbyuk Lindström N, Rodríguez Pozo R. Perspectives of Nurses and Doulas on the Use of Information and Communication Technology in Intercultural Pediatric Care: Qualitative Pilot Study. JMIR Pediatr Parent 2020; 3:e16545. [PMID: 32181748 PMCID: PMC7109617 DOI: 10.2196/16545] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/09/2020] [Accepted: 01/27/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Sweden is rapidly becoming an increasingly multicultural and digitalized society. Encounters between pediatric nurses and migrant mothers, who are often primary caregivers, are impeded by language problems and cultural differences. To support mothers, doulas, who are women having the same linguistic and cultural backgrounds, serve as cultural bridges in interactions with health care professionals. In addition, information and communication technology (ICT) can potentially be used to manage interactions owing to its accessibility. OBJECTIVE The objective of this study was to investigate the role of ICT in managing communicative challenges related to language problems and cultural differences in encounters with migrant mothers from the perspectives of Swedish pediatric nurses and doulas. METHODS Deep semistructured interviews with five pediatric nurses and four doulas from a migrant-dense urban area in western Sweden were audio recorded, transcribed, and analyzed using thematic content analysis. RESULTS The results showed that ICT contributes to mitigating communicative challenges in interactions by providing opportunities for nurses and migrant mothers to receive distance interpreting via telephones and to themselves interpret using language translation apps. Using images and films from the internet is especially beneficial while discussing complex and culturally sensitive issues to complement or substitute verbal messages. These findings suggest that ICT helps enable migrant mothers to play a more active role in interactions with health care professionals. This has important implications for their involvement in other areas, such as child care, language learning, and integration in Sweden. CONCLUSIONS The findings of this study suggest that ICT can be a bridging tool between health care professionals and migrants. The advantages and disadvantages of translation tools should be discussed to ensure that quality communication occurs in health care interactions and that health information is accessible. This study also suggests the development of targeted multimodal digital support, including pictorial and video resources, for pediatric care services.
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Fair F, Raben L, Watson H, Vivilaki V, van den Muijsenbergh M, Soltani H. Migrant women's experiences of pregnancy, childbirth and maternity care in European countries: A systematic review. PLoS One 2020; 15:e0228378. [PMID: 32045416 PMCID: PMC7012401 DOI: 10.1371/journal.pone.0228378] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 01/14/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Across Europe there are increasing numbers of migrant women who are of childbearing age. Migrant women are at risk of poorer pregnancy outcomes. Models of maternity care need to be designed to meet the needs of all women in society to ensure equitable access to services and to address health inequalities. OBJECTIVE To provide up-to-date systematic evidence on migrant women's experiences of pregnancy, childbirth and maternity care in their destination European country. SEARCH STRATEGY CINAHL, MEDLINE, PubMed, PsycINFO and Scopus were searched for peer-reviewed articles published between 2007 and 2017. SELECTION CRITERIA Qualitative and mixed-methods studies with a relevant qualitative component were considered for inclusion if they explored any aspect of migrant women's experiences of maternity care in Europe. DATA COLLECTION AND ANALYSIS Qualitative data were extracted and analysed using thematic synthesis. RESULTS The search identified 7472 articles, of which 51 were eligible and included. Studies were conducted in 14 European countries and focused on women described as migrants, refugees or asylum seekers. Four overarching themes emerged: 'Finding the way-the experience of navigating the system in a new place', 'We don't understand each other', 'The way you treat me matters', and 'My needs go beyond being pregnant'. CONCLUSIONS Migrant women need culturally-competent healthcare providers who provide equitable, high quality and trauma-informed maternity care, undergirded by interdisciplinary and cross-agency team-working and continuity of care. New models of maternity care are needed which go beyond clinical care and address migrant women's unique socioeconomic and psychosocial needs.
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Affiliation(s)
- Frankie Fair
- Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield, England, United Kingdom
| | - Liselotte Raben
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Helen Watson
- Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield, England, United Kingdom
| | - Victoria Vivilaki
- Department of Midwifery, Faculty of Health and Caring Sciences, University of West Attica, Athens, Greece
| | - Maria van den Muijsenbergh
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, Netherlands
- Pharos, Centre of Expertise on Health Disparities, Utrecht, Netherlands
| | - Hora Soltani
- Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield, England, United Kingdom
- * E-mail:
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Hemberg JAV, Vilander S. Cultural and communicative competence in the caring relationship with patients from another culture. Scand J Caring Sci 2017; 31:822-829. [DOI: 10.1111/scs.12403] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 09/27/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Jessica Anne Viveka Hemberg
- Department of Caring Sciences; Faculty of Education and Welfare Studies; Åbo Akademi University; Vaasa Finland
| | - Susann Vilander
- Department of Caring Sciences; Faculty of Education and Welfare Studies; Åbo Akademi University; Vaasa Finland
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15
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Degrie L, Gastmans C, Mahieu L, Dierckx de Casterlé B, Denier Y. "How do ethnic minority patients experience the intercultural care encounter in hospitals? a systematic review of qualitative research". BMC Med Ethics 2017; 18:2. [PMID: 28103849 PMCID: PMC5244561 DOI: 10.1186/s12910-016-0163-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 12/27/2016] [Indexed: 11/30/2022] Open
Abstract
Background In our globalizing world, caregivers are increasingly being confronted with the challenges of providing intercultural healthcare, trying to find a dignified answer to the vulnerable situation of ethnic minority patients. Until now, international literature lacks insight in the intercultural care process as experienced by the ethnic minority patients themselves. We aim to fill this gap by analysing qualitative literature on the intercultural care encounter in the hospital setting, as experienced by ethnic minority patients. Methods A systematic search was conducted for papers published between 2000 and 2015. Analysis and synthesis were guided by the critical interpretive synthesis approach. Results Fifty one articles were included. Four dimensions emerged, describing the intercultural care encounter as (1) a meeting of two different cultural contexts of care, (2) in a dynamic and circular process of (3) balancing between the two cultural contexts, which is (4) influenced by mediators as concepts of being human, communication, family members and the hospital’s organizational culture. Conclusions This review provides in-depth insight in the dynamic process of establishing intercultural care relationships in the hospital. We call for a broader perspective towards cultural sensitive care in which patients are cared for in a holistic and dignity-enhancing way. Electronic supplementary material The online version of this article (doi:10.1186/s12910-016-0163-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Liesbet Degrie
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Kapucijnenvoer 35, blok D, box 7001, Leuven, 3000, Belgium.
| | - Chris Gastmans
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Kapucijnenvoer 35, blok D, box 7001, Leuven, 3000, Belgium
| | - Lieslot Mahieu
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Kapucijnenvoer 35, blok D, box 7001, Leuven, 3000, Belgium
| | - Bernadette Dierckx de Casterlé
- Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Kapucijnenvoer 35 blok D, box 7001, Leuven, 3000, Belgium
| | - Yvonne Denier
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Kapucijnenvoer 35, blok D, box 7001, Leuven, 3000, Belgium
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Wikberg A, Eriksson K, Bondas T. Immigrant New Mothers in Finnish Maternity Care: An Ethnographic Study of Caring. INTERNATIONAL JOURNAL OF CHILDBIRTH 2014. [DOI: 10.1891/2156-5287.4.2.86] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE: To illuminate experiences and perceptions of caring in the maternity care culture of immigrant new mothers in Finland.DESIGN: This is a descriptive interpretive ethnography.PARTICIPANTS AND SETTING: Seventeen new mothers from different cultures on a maternity ward in a medium-sized hospital in Finland.METHODS: Focused ethnographic analysis and interpretation of interviews, observations, and field notes were used.FINDINGS: Caring was part of the positive experience of childbearing and beneficial for the health and well-being of the immigrant new mothers. Negative experiences of health care impaired their well-being. The resources of Finnish maternity care and cultural knowledge of the nurses facilitated the caring. The policy and attitude of Finnish society encouraged childbearing. The immigration regulations affected support during childbearing negatively and tended to caused loneliness. The Finnish maternity care was not fully adapted to the mothers’ wishes to understand the organization of Finnish maternity care, to communicate, to breastfeed, and to have family-centered care, a flexible length of stay in the hospital, and extended support after childbirth.CONCLUSION: Caring improves the childbearing experience and the well-being and health of new immigrant mothers; therefore, caring needs to be emphasized in maternity care, health care administration, and nursing education.
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