1
|
Moser A, Korstjens I. Series: Practical guidance to qualitative research. Part 5: Co-creative qualitative approaches for emerging themes in primary care research: Experience-based co-design, user-centred design and community-based participatory research. Eur J Gen Pract 2022; 28:1-12. [PMID: 35037811 PMCID: PMC8765256 DOI: 10.1080/13814788.2021.2010700] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 11/07/2021] [Accepted: 11/16/2021] [Indexed: 11/03/2022] Open
Abstract
This article, the fifth in a series aiming to provide practical guidance for qualitative research in primary care, introduces three qualitative approaches with co-creative characteristics for addressing emerging themes in primary care research: experience-based co-design, user-centred design and community-based participatory research. Co-creation aims to define the (research) problem, develop and implement interventions and evaluate and define (research and practice) outcomes in partnership with patients, family carers, researchers, care professionals and other relevant stakeholders. Experience-based co-design seeks to understand how people experience a health care process or service. User-centred design is an approach to assess, design and develop technological and organisational systems, for example, eHealth, involving end-users in the design and decision-making processes. Community-based participatory research is a collaborative approach addressing a locally relevant health issue. It is often directed at hard-to-reach and vulnerable people. We address the context, what, why, when and how of these co-creative approaches, and their main practical and methodological challenges. We provide examples of empirical studies using these approaches and sources for further reading.
Collapse
Affiliation(s)
- Albine Moser
- Research Centre Autonomy and Participation of Chronically Ill People, Zuyd University of Applied Sciences, Heerlen, The Netherlands
- Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
| | - Irene Korstjens
- Research Centre for Midwifery Science, Zuyd University of Applied Sciences, Maastricht, The Netherlands
| |
Collapse
|
2
|
Zondag DC, van Haaren-Ten Haken TM, Offerhaus PM, Maas VYF, Nieuwenhuijze MJ. Knowledge and skills used for clinical decision-making on childbirth interventions: A qualitative study among midwives in the Netherlands. Eur J Midwifery 2022; 6:56. [PMID: 36119405 PMCID: PMC9434498 DOI: 10.18332/ejm/151653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/23/2022] [Accepted: 06/27/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Appropriate use of interventions in maternity care is a worldwide issue. Midwifery-led models of care are associated with more efficient use of resources, fewer medical interventions, and improved outcomes. However, the use of interventions varies considerably between midwives. The aim of this study was to explore how knowledge and skills influence clinical decision-making of midwives on the appropriate use of childbirth interventions. METHODS A qualitative study using in-depth interviews with 20 primary care midwives was performed in June 2019. Participants’ clinical experience varied in the use of interventions. The interviews combined a narrative approach with a semi-structured question route. Data were analyzed using deductive content analysis. RESULTS ‘Knowledge’, ‘Critical thinking skills’, and ‘Communication skills’ influenced midwives’ clinical decision-making towards childbirth interventions. Midwives obtained their knowledge through the formal education program and extended their knowledge by reflecting on experiences and evidence. Midwives with a low use of interventions seem to have a higher level of reflective skills, including reflection-in-action. These midwives used a more balanced communication style with instrumental and affective communication skills in interaction with women, and have more skills to engage in discussions during collaboration with other professionals, and thus personalizing their care. CONCLUSIONS Midwives with a low use of interventions seemed to have the knowledge and skills of a reflective practitioner, leading to more personalized care compared to standardized care as defined in protocols. Learning through reflectivity, critical thinking skills, and instrumental and affective communication skills, need to be stimulated and trained to pursue appropriate, personalized use of interventions.
Collapse
Affiliation(s)
- Dirkje C. Zondag
- Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC), Maastricht University, Maastricht, Netherlands
| | | | - Pien M. Offerhaus
- Research Centre for Midwifery Science, Zuyd University, Maastricht, Netherlands
| | - Veronique Y. F. Maas
- Department of Obstetrics and Gynaecology, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Marianne J. Nieuwenhuijze
- Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC), Maastricht University, Maastricht, Netherlands
- Research Centre for Midwifery Science, Zuyd University, Maastricht, Netherlands
| |
Collapse
|
3
|
Weldegiorgis SK, Feyisa M. Why Women in Ethiopia Give Birth at Home? A Systematic Review of Literature. Int J Womens Health 2021; 13:1065-1079. [PMID: 34785958 PMCID: PMC8590518 DOI: 10.2147/ijwh.s326293] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 10/12/2021] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed at reviewing identifying reasons for home delivery preference, determining the status of homebirth in Ethiopia, and identifying socio-demographic factors predicting home delivery in Ethiopia. Methods A systematic literature review regarding the status of homebirth, reasons why women preferred homebirth and socio-demographic determinants of home deliveries was performed using CINAHL, MEDLINE, Google Scholar and Maternity and Infant Care. Keywords and phrases such as home birth, home delivery, childbirth, prevalence, determinants, predictors, women and Ethiopia were included in the search. Results A total of 10 studies were included in this review. The mean proportion of homebirth was 73.5%. Maternal age, ANC visits, maternal level of education, distance to facilities, and previous facility birth were significantly associated with homebirth. Perceived poor quality of service, distant location of facilities, homebirth as customary in the society and perceived normalness of labour were identified as reasons for choosing homebirth. Conclusion Despite the significance of skilled birth attendants in reducing maternal and newborn morbidity and mortality, unattended homebirth remains high. By identifying and addressing socio-demographic enablers of home deliveries, maternal health service uptake can be improved.
Collapse
|
4
|
González-Mesa E, Rengel-Díaz C, Riklikiene O, Thomson G, Cazorla-Granados O, Abreu W, Morgado-Neves D, Gökçe Isbir G, Jonsdottir SS, Karlsdóttir SI, Lalor J. Assessment of the attitude towards childbirth in health sciences students - development and validation of the questionnaire Cave-St. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01892-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AbstractThe purpose of this study is to report on the validation process of a questionnaire that explores health science students’ attitudes towards women’s childbirth experiences. This questionnaire can help inform education programs to enhance the quality of woman-professional interactions, and to improve women’s experiences of childbirth. A standardized procedure for the development and validation of the questionnaire included: item development and psychometric pre-validation, Cronbach’s Alpha coefficient calculation, test–retest and item-total correlation for the reliability analysis. Content validity was undertaken by Delphi method with sixteen panelists over two rounds. We determined the factor structure and refined and validated the questionnaire according to the responses of a cohort of 560 students using principal components factor analysis with varimax rotation. Confirmatory factor analysis was undertaken. A 52-items questionnaire CAVE-st: (acronym for cuestionario de actitudes sobre vivencias y experiencias en el parto) was developed and validated. The results of the factor analysis finally revealed four latent dimensions. The questionnaire CAVE-st is a valid and reliable tool to assess health science students’ attitude towards women’s childbirth experiences. Further work to translate and adapt the instrument in other cultures and languages will be undertaken.
Collapse
|
5
|
González-Mesa E, Cazorla-Granados O, Blasco-Alonso M, Sabonet L, Jiménez-López JS, Rengel-Díaz C. Educating future professionals in perinatal medicine: the attitude of medical and nursing students towards childbirth. J Perinat Med 2021; 49:485-495. [PMID: 33554590 DOI: 10.1515/jpm-2020-0395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/02/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The main objective of the present study was to evaluate what educational needs were being neglected in current perinatal educational program in the University of Malaga. METHODS We performed a cross-sectional study using the Students' questionnaire on attitudes towards childbirth (CAVE-st) in a sample of 378 students who were finishing their undergraduate or postgraduate academic perinatal program, including medical and nursing students. RESULTS The Cronbach's alpha reliability coefficient was 0.895. The mean score of CAVE-st in the sample was 200.34 (DT 21.0). The scores were below the median value in more than 53% of the students, especially in medical students. Female students scored systematically higher in the overall scale and its subscales, even after adjusting for study groups. On the other hand, the students with children scored significantly lower in the subscale that explored their attitudes towards unexpected results. A huge margin for improvement was recognizable in those subscales related with childbirth medicalization, respect to women decisions, and health-care prioritization. CONCLUSIONS Students' attitude towards childbirth need to be improved as a means to improve women's childbirth experience and prevent birth-related trauma. The current undergraduate and postgraduate training in perinatal care lacks a comprehensive and biopsychosocial perspective that would improve the quality of clinical practice during childbirth.
Collapse
Affiliation(s)
- Ernesto González-Mesa
- Obstetrics and Gynecology Department, School of Medicine, University of Malaga, Malaga, Spain.,Obstetrics and Gynecology Department, Malaga Regional University Hospital, Malaga, Spain.,IBIMA Research Group in Maternal-Fetal Medicine, Epigenetics, Women's Diseases and Reproductive Health, Malaga, Spain
| | - Olga Cazorla-Granados
- Obstetrics and Gynecology Department, School of Medicine, University of Malaga, Malaga, Spain
| | - Marta Blasco-Alonso
- Obstetrics and Gynecology Department, School of Medicine, University of Malaga, Malaga, Spain.,Obstetrics and Gynecology Department, Malaga Regional University Hospital, Malaga, Spain.,IBIMA Research Group in Maternal-Fetal Medicine, Epigenetics, Women's Diseases and Reproductive Health, Malaga, Spain
| | - Lorena Sabonet
- Obstetrics and Gynecology Department, Malaga Regional University Hospital, Malaga, Spain.,IBIMA Research Group in Maternal-Fetal Medicine, Epigenetics, Women's Diseases and Reproductive Health, Malaga, Spain
| | - Jesús S Jiménez-López
- Obstetrics and Gynecology Department, School of Medicine, University of Malaga, Malaga, Spain.,Obstetrics and Gynecology Department, Malaga Regional University Hospital, Malaga, Spain.,IBIMA Research Group in Maternal-Fetal Medicine, Epigenetics, Women's Diseases and Reproductive Health, Malaga, Spain
| | - Cristóbal Rengel-Díaz
- IBIMA Research Group in Maternal-Fetal Medicine, Epigenetics, Women's Diseases and Reproductive Health, Malaga, Spain.,Obstetrics and Gynecology Department, Ntra Sra de la Victoria University Hospital, Malaga, Spain.,Nursing Department, School of Health Sciences, University of Malaga, Malaga, Spain
| |
Collapse
|
6
|
Thompson SM, Low LK, Budé L, de Vries R, Nieuwenhuijze M. Evaluating the effect of an educational intervention on student midwife self-efficacy for their role as physiological childbirth advocates. NURSE EDUCATION TODAY 2021; 96:104628. [PMID: 33160156 DOI: 10.1016/j.nedt.2020.104628] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 09/25/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Midwifery education that strengthens self-efficacy can support student midwives in their role as advocates for a physiological approach to childbirth. METHODS To assess the effect of an educational intervention on self-efficacy, a pre- and post-intervention survey was administered to a control group and an intervention group of third year student midwives. The General Self-Efficacy Scale (GSES) was supplemented with midwifery-related self-efficacy questions related to behaviour in home and hospital settings, the communication of evidence, and ability to challenge practice. RESULTS Student midwives exposed to midwifery education designed to strengthen self-efficacy demonstrated significantly higher levels of general self-efficacy (p = .001) when contrasted to a control cohort. These students also showed significantly higher levels of self-efficacy in advocating for physiological childbirth (p = .029). There was a non-significant increase in self-efficacy in the hospital setting in the intervention group, a finding that suggests that education may ameliorate the effect of hospital settings on midwifery practice. DISCUSSION In spite of the small size of the study population, education that focuses on strengthening student midwife self-efficacy shows promise.
Collapse
Affiliation(s)
- Suzanne M Thompson
- Midwifery Science, Zuyd University of Applied Sciences, Maastricht, the Netherlands; Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
| | - Lisa Kane Low
- School of Nursing, University of Michigan, Ann Arbor, United States
| | - Luc Budé
- Midwifery Science, Zuyd University of Applied Sciences, Maastricht, the Netherlands
| | - Raymond de Vries
- Midwifery Science, Zuyd University of Applied Sciences, Maastricht, the Netherlands; Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, United States
| | | |
Collapse
|
7
|
Kuliukas L, Bayes S, Geraghty S, Bradfield Z, Davison C. Graduating midwifery students' preferred model of practice and first job decisions: A qualitative study. Women Birth 2020; 34:61-68. [PMID: 32814673 DOI: 10.1016/j.wombi.2020.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/30/2020] [Accepted: 07/19/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To explore and describe the preferred model of practice and first job decisions of final stage midwifery students from three Western Australian universities. DESIGN Qualitative descriptive. SETTING Three Western Australian (WA) universities offering courses leading to registration as a midwife. PARTICIPANTS Twenty-seven midwifery students from undergraduate and postgraduate (pre-registration) courses. METHODS Data were collected from recorded interviews and focus groups. Thematic analysis of interview transcripts was used to identify commonalities. Data saturation guided when recruitment ceased and final sample size was achieved. FINDINGS Participants' preferred model of maternity care was influenced by learning about and witnessing both autonomous midwifery practice and collaborative care during their studies. The greatest influence was clinical experience, with most preferring a continuity of midwifery model (CoM) but first consolidating their practice in a public hospital. Most students reported that they would not choose a private hospital as their first option. Work/life balance was also considered, with some accepting that family commitments and a need to work close to home may prevent them from choosing a CoM model. CONCLUSION AND IMPLICATIONS Although many Australian midwifery students start their midwifery course with preconceived ideology of their eventual workplace, the influences of their educators, clinical placement environment, preceptors and continuity of care experience relationships with women helped determine their final direction. To provide students with the experiences to become woman-centred autonomous practitioners it is important for universities and all maternity care providers to carefully consider their responsibility in how they influence midwifery students in education and practice.
Collapse
Affiliation(s)
- Lesley Kuliukas
- Curtin University School of Nursing, Midwifery & Paramedicine, GPO Box U1987, Perth, Western Australia 6845, Australia.
| | - Sara Bayes
- Edith Cowan University, School of Nursing & Midwifery, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.
| | - Sadie Geraghty
- Edith Cowan University, School of Nursing & Midwifery, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.
| | - Zoe Bradfield
- Curtin University School of Nursing, Midwifery & Paramedicine, GPO Box U1987, Perth, Western Australia 6845, Australia.
| | - Clare Davison
- Edith Cowan University, School of Nursing & Midwifery, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.
| |
Collapse
|