Cross-cultural adaptation and psychometric properties of the Brazilian-Portuguese version of the Quality of Prenatal Care Questionnaire (QPCQ)

Women's experiences with Centering-Based Group Care in Zhejiang China: A pilot study

BACKGROUND

The group prenatal care model, which caters to women with low medical needs but high support needs, has become a highly prevalent and innovative approach implemented globally. For Centering-Based Group Care (CBGC) to remain effective, women's evaluations of the quality of care and perspectives about the model are crucial.

AIM

This study aimed to describe women's appraisal of CBGC quality and explore the experiences of women in the mixed-methods pilot study conducted in Zhejiang, China.

METHODS

From August 2021 to December 2022, 20 women provided complete quantitative data using the Quality of Prenatal Care Questionnaire before hospital discharge. Semi-structured interviews were conducted at 6 months postpartum. Qualitative data were analysed using Colaizzi's method.

FINDINGS

The mean (standard deviation) total score (of the 5) of the questionnaire was 4.43 (0.1) with a good quality of CBGC. Qualitative research identified five themes: motivations and concerns for participation, the appeal of interactive learning, the development of community ties and social support, healing from psychological trauma with CBGC, and suggestions for CBGC enhancement.

DISCUSSION

Women rated CBGC quality as good and benefited significantly from it in the study. As a new alternative option, the women's accounts suggested that CBGC performed excellently in enhancing knowledge, strengthening social bonds, and providing psychological support.

CONCLUSION

CBGC quality cannot be determined based on limited the sample size. This pilot study provides evidence regarding the beneficial effects of knowledge, socialization, and psychological healing on CBGC. Further research is suggested to measure CBGC effectiveness and quality.

Beyond Crisis: Understandings of Vulnerability and Its Consequences in Relation to Intimate Partner Violence

This article takes a closer look at intimate partner violence (IPV) and its semantical, political, and legal interactions with crisis and crisis discourse. Starting from the fact that IPV has been called a "shadow pandemic" and a "hidden crisis", the article conceptualizes two parallel phenomena: how the COVID-19 pandemic - and crises in general - impact on IPV by exacerbating vulnerabilities and how crisis discourse has been mobilized to argue for a responsive state and strong positive obligations to combat and reduce IPV. The article then draws a parallel between crisis discourse and vulnerability reasoning, analyzing how vulnerability has played a similar role within the case law of the European Court of Human Rights (ECtHR) and led the latter to develop a consistent strand of case law concretizing states' positive obligations. The article also takes a critical stance, examining the risks of crisis discourse and vulnerability when viewed through a crisis lens. To counter these risks, it argues for a nuanced, structural, and dynamic understanding of vulnerability and a focus on resilience-building institutions and mechanisms. Within the ECtHR case law, this signifies elaborating upon the already existing positive obligations, including by taking inspiration from the Council of Europe Convention on preventing and combating violence against women and domestic violence (Istanbul Convention). Such an approach is necessary to leave behind the emergency time usually associated with crises and work toward lasting structural change.

Improving prenatal care during lockdown: Comparing telehealth and in-person care for low-risk pregnant women in the PROTECT pilot study

Objective

to compare telehealth and in-person care during the COVID-19 lockdown in a population of low-risk pregnant women for prenatal care received and perinatal outcome.

Methods

This single-center study began during the first French lockdown in 2020. Women with at least one telehealth (remote) prenatal care visit were compared with those who received care only in person. Data include results from self-administered surveys and perinatal outcomes. The main outcome was the prenatal care experience, assessed by the 5-point Quality of Prenatal Care Questionnaire (QPCQ) score. Exploratory analyses sought to identify connections between perinatal outcomes and any of their levels of QPCQ score, health/eHealth literacy, stress, and social deprivation scores .

Results

The experimental group included 55 women and the control group 52. Maternal and neonatal outcomes were similar in both groups. The mean QPCQ scores did not support any difference between the mothers' experience of prenatal care in each group: 4.15±0.52 in the telehealth and 4.26±0.63 in the in-person groups. Similarly, levels of social deprivation, stress, and health and eHealth literacy did not differ between the groups.

Conclusion

Regardless of social deprivation or literacy level, both telehealth and in-person monitoring appeared to provide equivalent and good-quality prenatal care experiences during the pandemic, ClinicalTrial.gov registration NCT04368832 (30^th April 2020)

The relationship between grip strength with health-related quality of life and mortality in hemodialysis patients

Purpose

Hemodialysis (HD) is a therapeutic modality that enables the highest survival for individuals with chronic kidney disease (CKD). In contrast, HD contributes to the pro-inflammatory state and may negatively affect the muscle strength and quality of life (QoL) of these individuals. To date, few studies have evaluated the association between decrease in strength and QoL in HD patients. Thus, our objective was to assess whether diminished muscle strength is associated with worse health related QoL and mortality.

Methods

We included patients aged ≥ 18 years on HD. Clinical and demographic data were collected from patients' medical records. Clinical data, nutritional status (laboratory, anthropometry, bioimpedance analysis) and health-related QoL (World Health Organization's quality of life questionnaire, WHOQOL-Bref) were analyzed at baseline. Mortality was recorded for 32 months.

Results

Among the 105 patients evaluated, the median age was 52 (43-64) years, and males were predominant (n = 73; 70%). The general median of QoL was 66.8 ± 11.9. Approximately 30% of patients were considered to have a worse QoL and 12,4% to have low muscle strength. This was not associated with QoL and mortality. HD vintage greater then to 5 years was associated with higher dissatisfaction in the perception of the environmental domain and overall QoL.

Conclusion

Our data suggest that low muscle strength was not associated with health-related QoL using the WHOQOL-Bref instrument and mortality.

Hospitalization for Primary Care-Sensitive Conditions in Adults and Its Impact on Hospital Care in São Paulo City, Brazil

INTRODUCTION

Identifying conditions among all cause hospitalizations that could be prevented at the primary care level would allow the development of strategies to reduce the range of diseases treated in hospital and promote a more efficient utilization of resources.

OBJECTIVE

We sought to evaluate hospitalizations for clinical conditions that are sensitive to primary care in adults.

METHODS

Cross-sectional study with data captured in hospital electronic health records using the diagnosis related groups classification system.

RESULTS

Primary care-sensitive conditions were associated with longer duration of hospitalization, older age, higher prevalence of female patients, higher complexity at admission and during hospitalization, and a higher risk of mortality as compared with other conditions not sensitive to primary care.

CONCLUSION

A significant proportion of hospitalizations are due to causes sensitive to primary care. Hospitalizations due to primary care-sensitive conditions are associated with longer hospital stay, greater complexity and severity, and a higher risk of mortality.

Cross-cultural adaptation and psychometric properties of the Brazilian-Portuguese version of the Organizational Readiness for Implementing Change questionnaire

OBJECTIVE

The assessment of the degree to which health professionals, workers and organizations are ready to implement changes in health services deserves special attention, especially related to new technologies, public policies and innovation. The objectives of this study were to conduct a Brazilian Portuguese Brazil cross-cultural adaptation of the ORIC questionnaire and to initiate the study of its psychometric properties.

METHODS

Through a cross-sectional study, the Organizational Readiness for Implementing Change (ORIC) questionnaire, containing 12 questions, was translated and later applied to a sample of workers from traditional primary health care units undergoing transformation to family health units. Statistical analysis included Cronbach's alpha, exploratory and confirmatory factor analysis by structural equation model using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist.

RESULTS

Workers from ten health units participated in the study (n = 150). The analysis confirmed two main factors (Effectiveness and Commitment) with Eigenvalues > 1. Rotation by the orthogonal method showed that the instrument questions confirmed the factors analyzed by the original instrument. The total Cronbach's Alpha of ORIC was 0.94, showing excellent reliability.

CONCLUSION

The Brazilian Portuguese Brazil version of the ORIC-Br questionnaire showed good psychometric properties and can be used in health services to measure organizational readiness, considered as an indicator of the potential success in implementing change.