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Tenaw LA, Ngai FW, Lam K. Explore the lived childbirth experiences, challenges following childbirth, and coping strategies of teenage mothers: A qualitative meta-synthesis. Midwifery 2024; 137:104128. [PMID: 39111123 DOI: 10.1016/j.midw.2024.104128] [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: 06/04/2024] [Revised: 07/22/2024] [Accepted: 07/25/2024] [Indexed: 09/01/2024]
Abstract
PROBLEM Worldwide, 16 million girls give birth during adolescence each year, which has negative health, social, and economic consequences for adolescent women's future. BACKGROUND Childbirths occurring between the ages of 13-19, before teenage girls have reached the age of maturity to handle the parenting role, are often unplanned. OBJECTIVE The aim of this study was to gain a comprehensive understanding of lived childbirth experiences, identify the challenges of early motherhood, and explore the coping strategies employed by teenage mothers to overcome these challenges during the transition to motherhood. METHODS Six commonly cited databases were used to retrieve articles using the SPIDER framework. We utilized the Walsh and Downe quality appraisal tool, which is considered the most appropriate fit for the current qualitative meta-synthesis. The thematic analysis approach was used to draw conclusions and generate hypotheses. RESULTS This meta-synthesis showed that teenage mothers often encounter negative reactions from their partners, families, and communities due to their early childbirth. They face numerous challenges, including parenting incompetency, school dropout, conflict between adolescent interests and maternal responsibilities, emotional disturbance, and financial problems. Social support and self-efficacy are the main coping strategies to navigate these challenges and attain maternal competencies. CONCLUSION AND IMPLICATIONS Families, peers, and midwives play a crucial role in providing parenting lessons for teenage mothers. Encouraging teenage mothers to believe in their capacities is an important coping strategy to facilitate a smoother motherhood transition. Further studies are needed to test the effectiveness of self-efficacy and social support interventions on teenage mothers' parenthood role attainment and in preventing mental health problems following childbirth.
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Affiliation(s)
- Lebeza Alemu Tenaw
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong; School of Public Health, College of Health Sciences, Woldia University, Ethiopia
| | - Fei Wan Ngai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | - Katherine Lam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
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Johansson M, Thies-Lagergren L. 'Like a torch that enlightens new parents along a narrow and winding path into parenthood' - Midwives' experiences by an interview study. Scand J Caring Sci 2024; 38:720-729. [PMID: 38581218 DOI: 10.1111/scs.13261] [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: 07/20/2023] [Revised: 03/01/2024] [Accepted: 03/23/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND The core of postnatal care is that midwives recognise the needs of women and new-born babies and provide the highest possible quality of care and medical safety to optimise the health and well-being of new families. The study aimed to describe midwives' experiences in providing postnatal care for families during the first week after the birth of their baby. METHODS An interview study included 18 midwives who interchangeably worked within the models of traditional hospital care, hotel-based care, home-based care, hospital-based check-ups, and specialist care at a breastfeeding clinic at one university hospital in Sweden. Data collected were analysed using thematic analysis according to Braun and Clarke. FINDINGS The main theme: 'Like a torch that enlightens new parents along a narrow and winding path into parenthood - a midwife's transitional support' was explored and comprised two themes: (1) Strengthening parents' self-confidence in their parental role by handling over parental responsibility; and (2) Challenging to facilitate parents' understanding of their parental role. CONCLUSIONS Midwives expressed that supporting parents in the parental transition was a delicate task and included balancing mothers', babies', and partners' needs. The midwives guided parents into parenthood during postnatal care in a strategic manner by strengthening parents in their parental role. Postnatal care delivered by midwives is crucial for new parents and their babies.
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Affiliation(s)
- Margareta Johansson
- Department of Women's and Children's Health, Akademiska University Hospital, Uppsala University, Uppsala, Sweden
| | - Li Thies-Lagergren
- Department of Midwifery Research - Reproductive, Perinatal and Sexual Health, Lund University, Sweden
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Sendas MV, Freitas MJ. "The needs of women in the postpartum period: A scoping review.". Midwifery 2024; 136:104098. [PMID: 38986390 DOI: 10.1016/j.midw.2024.104098] [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: 12/26/2023] [Revised: 06/17/2024] [Accepted: 07/02/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND The postpartum period is critical and challenging for women, implying emotional, physical, social and spiritual changes. For a positive postpartum experience, it is important to receive consistent information and support from health professionals. However, this is not always the case, as care is more focused on the newborn, forgetting the needs of the puerperal woman. AIM The review aimed to map the published scientific knowledge about women's needs in the postpartum period. METHODS A Scoping Review was carried out, according to the method proposed by The Joanna Briggs Institute, in the MEDLINE Complete, MedicLatina and CINAHL Complete databases, and were selected articles since 2017 that answered the research question "What is the available evidence on women's needs in the postpartum period?". For the selection of articles, the eligibility criteria were defined. RESULTS A total of 6,647 articles were identified. After the exclusion of duplicate articles and the application of the eligibility criteria, at the end of the process, 27 articles were included in the review. The extracted data were grouped into four categories, which summarize the needs of women in the postpartum period: support, sharing, care and preparation for the postpartum period. CONCLUSION In the articles analysed, women reveal that they do not feel prepared for the postpartum period and identify several unmet needs, so health education and parenting skills training during pregnancy are essential to improve the postpartum experience and the transition to parenthood.
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Affiliation(s)
- Mónica Vaz Sendas
- Centro de Investigação, Inovação e Desenvolvimento em Enfermagem de Lisboa (CIDNUR) Escola Superior de Enfermagem de Lisboa, Portugal.
| | - Maria João Freitas
- Centro de Investigação, Inovação e Desenvolvimento em Enfermagem de Lisboa (CIDNUR) Escola Superior de Enfermagem de Lisboa, Portugal
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Cithambaram K, Corby D, Rajendran SS. Experiences of family carers in providing care to children with intellectual disabilities in India: A qualitative evidence synthesis. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13269. [PMID: 38979666 DOI: 10.1111/jar.13269] [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: 11/22/2023] [Revised: 04/15/2024] [Accepted: 06/11/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND India has a significant prevalence of people with intellectual disabilities. Despite their higher prevalence, they receive poor support. Therefore, this review aims to explore the experiences of family carers in providing care for children with intellectual disabilities in India. METHODS A qualitative evidence synthesis was undertaken, searching databases such as MEDLINE, CINAHL, Web of Science, and PsycInfo up to October 2023. Grey literature was also searched for unpublished studies, with two reviewers assessing methodological quality. Eleven eligible studies, mostly qualitative in design, were included in the review. The data synthesis followed a thematic approach. RESULTS The synthesis found five themes representing family carers' experiences and perspectives. These were 'resilience and acceptance', 'parental response', 'care dynamic', 'preparing for transition to adulthood' and 'parental advocacy'. CONCLUSION Family carers hold diverse views, while almost all consider providing care complex and challenging, with few positive experiences.
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Affiliation(s)
- Kumaresan Cithambaram
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - D Corby
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
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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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Barta K. A Critical Review of Breastfeeding Instruments Derived From Self-Determination Theory. J Hum Lact 2024; 40:363-373. [PMID: 38798076 DOI: 10.1177/08903344241252647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
BACKGROUND Understanding the motivational factors that influence breastfeeding behavior is critical for addressing suboptimal breastfeeding outcomes. Self-determination theory has been used as a framework to understand these factors. RESEARCH AIM The aim of this article is to identify and critically review breastfeeding instruments derived from self-determination theory and their subsequent uses in the literature. METHOD This critical review was guided by Grant and Booth's typological description. Eligibility criteria included full-text, peer-reviewed original instrument development and validation articles, written in the English language without limitation to specific years. Articles describing the use of the eligible instruments were also included. There were 164 articles identified initially, and four instruments were included in the final sample. Finally, five articles, including subsequent uses of the instruments were critically analyzed and an overview, assessment of validation, and analysis of subsequent use of each instrument is presented. RESULTS All instruments examine the degree of autonomy underlying breastfeeding motivation. The extent and quality of validation varied. Two instruments have been used in subsequent studies; one was adapted and translated into Turkish and used in three other studies, and another was used in full in one subsequent use and in part in another study. Three of four were initially developed for prenatal administration. CONCLUSIONS Instruments derived from self-determination theory hold promise in exploring the autonomy underlying breastfeeding motivations. Researchers who wish to use or adapt these instruments should consider the instruments' domains, validity, and administration. New measures are needed to explore other constructs from self-determination theory related to breastfeeding.
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Affiliation(s)
- Kelsie Barta
- College of Nursing, Texas Woman's University, Denton, TX, USA
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
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Laverty C, Surtees A, Sutherland D, Richards C. Qualitative interview with mothers of moderately or late preterm infants in the UK: where are the care gaps? BMJ Open 2024; 14:e076057. [PMID: 39043590 PMCID: PMC11268029 DOI: 10.1136/bmjopen-2023-076057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 06/26/2024] [Indexed: 07/25/2024] Open
Abstract
INTRODUCTION Preterm birth (<37 gestational weeks) accounts for an increasing proportion of global births each year, with moderately or late preterm birth (MLPT) (32+0/7-36+6/7 gestational weeks) comprising over 80% of all preterm births. Despite the frequency, MLPT births represent only a small fraction of prematurity research, with research exploring the parental experiences of having a child born MLPT particularly neglected. It is vital this perspective is considered to provide appropriate grounding for future research and service provision. METHODS Six mothers from the UK of infants (aged between 18 and 36 months) born MLPT were invited to take part in a semistructured qualitative interview study. Reflexive thematic analysis was employed to explore the data and codes were then conceptualised through a process of inductive reasoning to identify patterns of meaning. RESULTS Five themes are presented that are conceptualised from the data: (1) the moderate or later preterm 'label-does it matter?, (2) vulnerability within a new role, (3) coming home and wanting to start 'normal' life, (4) comparisons to provide a reference to experiences and (5) experience of professionals throughout the pregnancy, newborn and early years journey. CONCLUSIONS Findings offer in-depth evidence surrounding mothers' experiences of healthcare throughout pregnancy and immediately after birth, perceptions of the 'preterm' label and thoughts on how mothers reflect on their experiences. Future research should show an awareness of the broader family context when interpreting findings and providing suggestions for future research avenues or service provision.
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Affiliation(s)
| | - Andrew Surtees
- University of Birmingham, Birmingham, UK
- Birmingham Women’s and Children’s NHS Foundation Trust, Forward Thinking Birmingham, Birmingham, UK
| | - Daniel Sutherland
- University of Birmingham, Birmingham, UK
- Centre for Research in Intellectual and Developmental Disabilities, University of Warwick, Coventry, UK
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Simmons D, Gupta Y, Hernandez TL, Levitt N, van Poppel M, Yang X, Zarowsky C, Backman H, Feghali M, Nielsen KK. Call to action for a life course approach. Lancet 2024; 404:193-214. [PMID: 38909623 DOI: 10.1016/s0140-6736(24)00826-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/08/2024] [Accepted: 04/19/2024] [Indexed: 06/25/2024]
Abstract
Gestational diabetes remains the most common medical disorder in pregnancy, with short-term and long-term consequences for mothers and offspring. New insights into pathophysiology and management suggest that the current gestational diabetes treatment approach should expand from a focus on late gestational diabetes to a personalised, integrated life course approach from preconception to postpartum and beyond. Early pregnancy lifestyle intervention could prevent late gestational diabetes. Early gestational diabetes diagnosis and treatment has been shown to be beneficial, especially when identified before 14 weeks of gestation. Early gestational diabetes screening now requires strategies for integration into routine antenatal care, alongside efforts to reduce variation in gestational diabetes care, across settings that differ between, and within, countries. Following gestational diabetes, an oral glucose tolerance test should be performed 6-12 weeks postpartum to assess the glycaemic state. Subsequent regular screening for both dysglycaemia and cardiometabolic disease is recommended, which can be incorporated alongside other family health activities. Diabetes prevention programmes for women with previous gestational diabetes might be enhanced using shared decision making and precision medicine. At all stages in this life course approach, across both high-resource and low-resource settings, a more systematic process for identifying and overcoming barriers to preventative care and treatment is needed to reduce the current global burden of gestational diabetes.
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Affiliation(s)
- David Simmons
- School of Medicine, Western Sydney University, Sydney, NSW, Australia.
| | - Yashdeep Gupta
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Teri L Hernandez
- College of Nursing, University of Colorado, Aurora, CO, USA; Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado School of Medicine, Aurora, CO, USA; Children's Hospital Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Naomi Levitt
- Chronic Disease Initiative for Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Mireille van Poppel
- Department of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Xilin Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Christina Zarowsky
- Department of Social and Preventive Medicine, University of Montréal, Montréal, QC, Canada; CReSP Public Health Research Centre, Montréal, QC, Canada
| | - Helena Backman
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Maisa Feghali
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, PA, USA
| | - Karoline Kragelund Nielsen
- Department of Prevention, Health Promotion and Community Care, Steno Diabetes Center Copenhagen, Herlev, Denmark
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Sundarapperuma TD, Katulanda P, Wijesinghe CJ, Hettiarachchi P, Wasalathanthri S. The impact of a culturally adapted lifestyle intervention on the glycaemic profile of mothers with GDM one year after delivery - a community-based, cluster randomized trial in Sri Lanka. BMC Endocr Disord 2024; 24:104. [PMID: 38977979 PMCID: PMC11229281 DOI: 10.1186/s12902-024-01643-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/02/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND A woman with a history of GDM has a high risk of developing type two diabetes (T2DM) in her future life. Lifestyle modifications are known to attenuate the progression of GDM to T2DM. Therefore, the aim of this study was to assess the impact of a simple, cost effective, culturally acceptable lifestyle intervention programme on the trajectory towards T2DM in women with a history of GDM. METHODS This cluster randomized trial was conducted in 100 postpartum women in three selected districts of Sri Lanka. The subjects were divided into intervention (n = 50) and control groups (n = 50) by cluster randomization method. A culturally adapted protocol (comprised of dietary and physical activity modifications) was administered to the intervention group. The glycemic profile was assessed using fasting and 2-hour post-OGTT plasma glucose and HbA1c, and insulin resistance by HOMA-IR at baseline and after one year of intervention. RESULTS The mean age (SD) of the subjects in the intervention and control groups were 33.0 (5.1) and 34.3 (6.5) years respectively. All glycemic and insulin resistance parameters (i.e. Fasting plasma glucose- FPG, 2-hour post-OGTT plasma glucose, HbA1c and HOMA-ir) were comparable (p > 0.05) between the two groups at baseline. FPG, 2 h post OGTT, HbA1c and HOMA-ir values between intervention vs. control (p) at 12 months were 87.3 vs. 123.2 (< 0.01); 106.5 vs. 156.1 (0.01); 5.3 vs. 6.8 (< 0.01) and 0.9 vs. 2.3 (< 0.01) respectively. All glycemic parameters showed a significant reduction in the intervention group at 12 months compared to baseline. In contrast, the control group showed a significant increase in FPG, 2-hour post-OGTT plasma glucose and HbA1c at 12 months compared to baseline. In multiple linear regression model adjusted for age, parity and family history, the control group showed an approximately 33 times risk of developing insulin resistance compared to the intervention group. CONCLUSION The culturally acceptable and individualized lifestyle intervention was able to produce remarkable reductions in glycaemic and insulin resistance parameters among postpartum women with a history of GDM. TRIAL REGISTRATION Ethical clearance was obtained from the Ethics Review Committee of the University of Sri Jayewardenepura, Sri Lanka (ERC 52/14), Sri Lanka Clinical trial registration number Sri Lanka Clinical Trials Registry (SLCTR/2015/021 date 25.09.2015).
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Affiliation(s)
- Thamudi D Sundarapperuma
- Department of Nursing, Faculty of Allied Health Sciences, University of Ruhuna, Galle, 80000, Sri Lanka.
| | - Prasad Katulanda
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, 00800, Sri Lanka
| | - Champa J Wijesinghe
- Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Galle, 80000, Sri Lanka
| | - Priyadarshika Hettiarachchi
- Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, 11222, Sri Lanka
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Nazarenko DN, Daniel AL, Durfee S, Agbemenu K. Parent-identified gaps in preparation for the postpartum period in the United States: An integrative review. Birth 2024. [PMID: 38798177 DOI: 10.1111/birt.12832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 12/16/2023] [Accepted: 05/02/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND In the United States, 35% of all pregnancy-related deaths occur between 24 h and 6 weeks after delivery, yet the first outpatient visit is not typically scheduled until 6 weeks postpartum. Thus, the ability to independently navigate this period is critical to maternal well-being and safety. However, previous research suggests that many women feel unprepared to manage the challenges they encounter during this time, and there is a current need to synthesize the existing evidence. Therefore, the purpose of this integrative review is to describe parent-identified gaps in preparation for the postpartum period in the United States. METHODS Using the Integrative Review framework by Whittemore and Knafl, a systematic search of Medline, CINAHL, PsychInfo, Web of Science, and a hand-search was conducted for peer-reviewed articles published in English between 1995 and 2023. Results were reported according to PRISMA 2020 guidelines. Studies that met eligibility criteria were synthesized in a literature matrix. RESULTS Twenty-two studies met inclusion criteria. Four themes were identified: Mental Health Concerns, Physical Concerns, Infant Feeding and Care Concerns, and General Concerns and Recommendations. Many women, regardless of parity, reported feeling unprepared for numerous postpartum experiences, including depression, anxiety, physical recovery, breastfeeding, and infant care. Parents reported difficulty differentiating normal postpartum symptoms from complications. Hospital discharge teaching was viewed as simultaneously overwhelming and inadequate. Parent recommendations included the need for earlier and more comprehensive postpartum preparation during pregnancy, delivered in multiple formats and settings. Parents also reported the need for earlier postpartum visits and improved outpatient support. CONCLUSIONS Our findings indicate that many parents in the United States feel unprepared to navigate a wide variety of emotional, physical, breastfeeding, and infant-care experiences. Future research should explore innovative educational approaches to postpartum preparation during pregnancy as well as outpatient programs to bridge the current gaps in postpartum care.
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Affiliation(s)
| | - Ariel L Daniel
- School of Nursing, University at Buffalo, Buffalo, New York, USA
| | - Stephanie Durfee
- School of Nursing, University at Buffalo, Buffalo, New York, USA
| | - Kafuli Agbemenu
- School of Nursing, University at Buffalo, Buffalo, New York, USA
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Saeed Q, Shafique K, Chaudhry N. Lived experiences of mothers with postnatal anxiety: a qualitative phenomenology study from Pakistan. BMJ Open 2024; 14:e078203. [PMID: 38772885 PMCID: PMC11110547 DOI: 10.1136/bmjopen-2023-078203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 04/11/2024] [Indexed: 05/23/2024] Open
Abstract
OBJECTIVE The prevalence of postnatal anxiety is high among women during the first year of childbirth globally. Rates are higher in low and middle-income countries (LMICs), that is, 24%. Existing literature on maternal mood and its impact on child development has largely focused on postnatal depression. Postnatal anxiety has been recognised to have significant independent effects similar to those of postnatal depression, including negative effects on various aspects of maternal well-being including quality of life, parent-child interaction and child development. The evidence exploring lived experiences of postnatal anxiety is limited from LMICs. This study explored the lived experiences of anxiety in postnatal mothers in Pakistan. DESIGN A phenomenological approach was used for this qualitative study. The audio-recorded interviews were transcribed and analysed using the process of thematic analysis. SETTINGS The study was conducted in two community settings in Karachi, Pakistan; the Bin Qasim and Gadap town. PARTICIPANTS Women who were 18 years of age or older, had a live childbirth within the previous 12 months and had a score of 10 or higher on the Generalised Anxiety Disorder-7. RESULTS In-depth, one-to-one interviews were conducted with 10 participants. The qualitative data comprised of three themes. Theme one: Factors perceived to be associated with postnatal anxiety, Theme two: The perceived impact of postnatal anxiety and Theme three: Support needs. The first theme was further subdivided into two subthemes, that is, Mothers' perception of navigating domestic responsibilities and sociocultural norms of motherhood and financial constraints. CONCLUSION Despite the high prevalence of postnatal anxiety in LMICs there is not any published evidence on exploring this phenomenon through in-depth research in Pakistan. Understanding the lived experiences will help health professionals to identify women at risk of developing postnatal anxiety and to develop effective culturally appropriate interventions for women with anxiety during this postnatal period.
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Affiliation(s)
- Qamar Saeed
- Dow University of Health Sciences, Karachi, Pakistan
| | | | - Nasim Chaudhry
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
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Kamau IW, Keraka MN, Gitonga E. Effect of post-discharge postnatal educational intervention on postnatal practices among low-income primiparas in Nairobi informal settlements, Kenya: a post-test quasi-experiment. Pan Afr Med J 2024; 48:14. [PMID: 39184849 PMCID: PMC11343503 DOI: 10.11604/pamj.2024.48.14.42194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 05/09/2024] [Indexed: 08/27/2024] Open
Abstract
Introduction informal settlements exhibit disproportionately worse maternal and newborn outcomes. Postnatal care (PNC) is a high-impact intervention for populations contributing to higher mortalities. Postnatal education is crucial to adopting evidence-based postnatal practices (PNPs) thus its post-discharge reinforcement is vital for low-income primiparas. This study aimed to determine the effect of post-discharge follow-up postnatal education intervention (PNE) on the adoption of recommended PNPs among low-income primiparas. Methods quasi-experimental study in Nairobi informal settlements with 118 primiparas discharged early after normal delivery on each arm. Facility and demographic data collected using an interviewer-administered questionnaire. Study arm received the intervention for 6 weeks in addition to routine PNC while control received routine PNC only. An interviewer-administered exit questionnaire was applied after 6 weeks. Focus group discussions were conducted for qualitative data then analyzed thematically. SPSS used to analyze quantitative data then descriptive statistics, t-tests, Chi-square, Mann-Whitney, and multiple linear or logistic regressions derived. PNPs composed of health-seeking for maternal and newborn danger signs, self and baby care practices, and utilization of PNC contacts. Results the intervention was a positive predictor of adoption of composite PNPs (β=0.26, p=0.00), self-care practices (β=0.39, p=0.00) and mothers' two weeks PNC contact (OR=4.64, p=0.00, 95% CI=1.9-11.2). Neither a significant predictor of health-seeking for maternal (β=-0.11, p=0.31) nor newborns danger signs (β=-0.04, p=0.73) though inversely related. No influence on baby care practices, two weeks of newborn contact and six weeks contact for the dyad. Multi-pronged approaches are appreciated. Conclusion follow-up post-discharge PNE intervention enhances adoption of PNPs among low-income primiparas thus a worthwhile supplement to routine PNC.
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Affiliation(s)
- Immaculate Wambui Kamau
- Department of Environmental and Occupational Health, School of Health Sciences, Kenyatta University, Nairobi, Kenya
| | - Margaret Nyanchoka Keraka
- Department of Environmental and Occupational Health, School of Health Sciences, Kenyatta University, Nairobi, Kenya
| | - Eliphas Gitonga
- Department of Environmental and Occupational Health, School of Health Sciences, Kenyatta University, Nairobi, Kenya
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Kirbaş ZÖ, Odabaşi Aktaş E, Özkan H. Validity and reliability of the Turkish version of the transition of primiparas becoming mothers scale. BMC Pregnancy Childbirth 2024; 24:259. [PMID: 38605296 PMCID: PMC11008045 DOI: 10.1186/s12884-024-06438-7] [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: 10/16/2023] [Accepted: 03/22/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND The transition to motherhood is an important life event in a woman's life and represents an important developmental process that brings physical, psychological and social changes to gain a new role. However, research on the transition to motherhood in Turkish society is scarce. There is a need for a comprehensive, practical and reliable tool to evaluate the transition to motherhood in primiparous mothers. This study evaluated the reliability and validity of the Turkish version of the Transition of Primiparous Becoming Mothers Scale (TMP-S) to evaluate the transition process of primiparous mothers to motherhood. METHODS This methodological research was carried out in obstetrics and gynecology outpatient clinics, pediatric outpatient clinics, and family health centers of a hospital in Türkiye. The sample consisted of primiparous mothers of 0 to 6- month-old babies who visited clinics and family health centers for routine postnatal examinations (n = 305). After evaluating the language equivalence and content validity of the scale, test-retest reliability, internal consistency and construct validity were examined. Factor analysis, Pearson's correlation, retest reliability, and Cronbach's alpha were employed to evaluate structural validity and reliability. RESULTS The final TPM-S had two dimensions with 25 items. Exploratory factor analysis revealed a two-factor solution, which accounted for 59.276% of the variance. Confirmatory factor analysis showed that the model fit of the two-factor model also reached a satisfactory model ft after modification. The comparative fit index was 0.894, the Tucker‒Lewis index was 0.882, and the root mean square error of approximation was 0.079. The content validity index of the scale ranged from 0.56 ~ 0.77. The Cronbach's alpha coefficient was 0.93 for the total scale, and the test-retest reliability was 0.96. CONCLUSIONS It is a valid and reliable tool for evaluating the transition to motherhood among primiparous mothers of 0 to 6 month-old babies in Türkiye. Turkish researchers and healthcare professionals can routinely apply this measurement tool to primiparous mothers in the first six months after birth to evaluate their transition to motherhood.
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Affiliation(s)
- Zila Özlem Kirbaş
- Department of Nursing, Faculty of Health Sciences, Bayburt University, Bayburt, Türkiye
| | - Elif Odabaşi Aktaş
- Department of Midwifery, Faculty of Health Sciences, Bayburt University, Bayburt, Türkiye.
| | - Hava Özkan
- Department of Midwifery, Faculty of Health Sciences, Atatürk University, Erzurum, Türkiye
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Garfield L, Watson-Singleton NN, Mathews HL, Witek Janusek L. Protocol for a pilot study assessing a virtual mindfulness intervention for postpartum African American women. BRAIN BEHAVIOR AND IMMUNITY INTEGRATIVE 2024; 6:100060. [PMID: 39036323 PMCID: PMC11258811 DOI: 10.1016/j.bbii.2024.100060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
Elevated perinatal depressive symptoms are more common among disadvantaged African American women, and they are almost four times as likely to have postpartum posttraumatic stress compared to white women. For new mothers, depressive symptoms and posttraumatic stress can lead to negative parenting, poor mother-infant bonding, and delayed infant development. For African American women, a culturally adapted mindfulness-based intervention offers great potential as an acceptable approach to reduce psycho-behavioral symptoms and improve mother-infant interactions (i.e., bonding). Additionally, it is critical that mindfulness interventions consider time constraints of new mothers, provide accessible intervention delivery, address parenting, and consider the challenges of caring for an infant. Given these considerations, we describe a pilot research protocol in which we evaluate a culturally adapted mindfulness program: Mindfulness for African Americans Postpartum (MAAP). The intervention is based upon Kabat-Zinn's Mindfulness Based Stress Reduction program, but is adapted to include culturally relevant concepts of spirituality, inter-dependence, self-empowerment, and storytelling, which are salient to African American culture. To accommodate the needs of new mothers, a certified mindfulness interventionist delivers each session virtually using Zoom. The investigation uses a randomized controlled design in which African American women within 12 months of giving birth are randomized either to the MAAP intervention or to an Education Program. The primary aim is to determine the extent to which the MAAP intervention decreases maternal psycho-behavioral symptoms (perceived stress, depressive symptoms, anxiety, poor sleep, posttraumatic stress, and fatigue) and improves mother-infant bonding. A secondary aim is to explore the effects of MAAP on proinflammatory cytokines and oxytocin. Culturally adapted mindfulness interventions delivered virtually will make mindfulness more accessible and meaningful to populations, like African American new mothers, who are at higher risk for postpartum mood disorders and poor infant outcomes.
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Affiliation(s)
- Lindsey Garfield
- Marcella Niehoff School of Nursing, 2160 S. First Ave, Maywood, IL 60153, United States
| | - Natalie N. Watson-Singleton
- Spelman College, Department of Psychology, 350 Spelman Lane, Box 1657 Giles Hall 317, Atlanta, GA 30314, United States
| | - Herbert L. Mathews
- Stritch School of Medicine, Department of Microbiology and Immunology, Loyola University Chicago, United States
| | - Linda Witek Janusek
- Marcella Niehoff School of Nursing, Loyola University Chicago, United States
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Soepnel LM, Mabetha K, Norris SA, Motlhatlhedi M, Nkosi N, Klingberg S, Lye S, Draper CE. The role of a community health worker-delivered preconception and pregnancy intervention in achieving a more positive pregnancy experience: the Bukhali trial in Soweto, South Africa. BMC Womens Health 2024; 24:161. [PMID: 38443924 PMCID: PMC10916028 DOI: 10.1186/s12905-024-02982-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 02/19/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND A patient-centered, human-rights based approach to maternal care moves past merely reducing maternal mortality and morbidity, towards achieving a positive pregnancy experience. When evaluating an intervention, particularly in the context of the complex challenges facing maternal care in South Africa, it is therefore important to understand how intervention components are experienced by women. We aimed to qualitatively explore (i) factors influencing the pregnancy and postpartum experience amongst young women in Soweto, South Africa, and (ii) the influence of Bukhali, a preconception, pregnancy, and early childhood intervention delivered by community health workers (CHWs), on these experiences. METHODS Semi-structured, in-depth interviews were conducted with 15 purposively sampled participants. Participants were 18-28-year-old women who (i) were enrolled in the intervention arm of the Bukhali randomized controlled trial; (ii) were pregnant and delivered a child while being enrolled in the trial; and (iii) had at least one previous pregnancy prior to participation in the trial. Thematic analysis, informed by the positive pregnancy experiences framework and drawing on a codebook analysis approach, was used. RESULTS The themes influencing participants' pregnancy experiences (aim 1) were participants' feelings about being pregnant, the responsibilities of motherhood, physical and mental health challenges, unstable social support and traumatic experiences, and the pressures of socioeconomic circumstances. In terms of how support, information, and care practices influenced these factors (aim 2), four themes were generated: acceptance and mother/child bonding, growing and adapting in their role as mothers, receiving tools for their health, and having ways to cope in difficult circumstances. These processes were found to be complementary and closely linked to participant context and needs. CONCLUSION Our findings suggest that, among women aged 18-28, a CHW-delivered intervention combining support, information, and care practices has the potential to positively influence women's pregnancy experience in South Africa. In particular, emotional support and relevant information were key to better meeting participant needs. These findings can help define critical elements of CHW roles in maternal care and highlight the importance of patient-centred solutions to challenges within antenatal care. TRIAL REGISTRATION Pan African Clinical Trials Registry PACTR201903750173871, 27/03/2019.
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Affiliation(s)
- Larske M Soepnel
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Khuthala Mabetha
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- School of Human Development and Health, University of Southampton, Southampton, UK
| | - Molebogeng Motlhatlhedi
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Nokuthula Nkosi
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Sonja Klingberg
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephen Lye
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Department of Obstetrics and Gynecology, Department of Physiology and Medicine, University of Toronto, Toronto, ON, Canada
| | - Catherine E Draper
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
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Ängeby K, Ternström E. Women's experiences and needs concerning care and support during the various phases of childbirth and the postnatal period: Analysis of free-text comments based on Quality from the Patient's Perspective in Sweden. Eur J Midwifery 2024; 8:EJM-8-08. [PMID: 38375418 PMCID: PMC10875707 DOI: 10.18332/ejm/176698] [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: 08/18/2023] [Revised: 12/07/2023] [Accepted: 01/18/2024] [Indexed: 02/21/2024] Open
Abstract
INTRODUCTION Positive birth experiences can be a decisive factor in the well-being and future health of both women and their newborns. The quality of care is a multidimensional concept influenced by the external structure of the organization, the administrative qualities of the environment, and the individual patient's preferences about care. The aim was to describe women's preferences and experiences concerning support and treatment, and their perception of quality of care during all phases of labor and the postnatal period. METHODS Free-text comments of 635 women from four different open comment questions were analyzed. A qualitative content analysis was conducted in two steps: an inductive phase followed by a deductive phase using the Quality of care from a Patient's Perspective framework (QPP). RESULTS A total of 1148 free-text comments were coded; and 10 sub-categories were created and inserted under the QPP framework covering the latent meaning of the sub-category. Five of the sub-categories were sorted under the identity-oriented approach, four under physical-technical conditions, and one under the sociocultural atmosphere and reflected the women's experiences and needs regarding support and treatment during early labor, the active phase of labor, and the postnatal period. CONCLUSIONS High-quality care and support are important aspects for women during childbirth, irrespective of the phase of labor or postnatal period. The need for individualized care, active participation in one's own birth and using a family centered approach were also emphasized. Organizational factors influenced the quality of care and were particularly noticeable during birth.
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Affiliation(s)
- Karin Ängeby
- Women's Department and Centre for Clinical Research Education, County Council of Värmland, Karlstad, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Elin Ternström
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Women’s and Children’s Health, Uppsala University, Akademiska Sjukhuset, Uppsala, Sweden
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Blair A, Tan A, Homer CSE, Vogel JP. How do postnatal care guidelines in Australia compare to international standards? A scoping review and comparative analysis. BMC Pregnancy Childbirth 2024; 24:121. [PMID: 38336632 PMCID: PMC10854083 DOI: 10.1186/s12884-024-06295-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 01/27/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND There is no single national guideline in Australia on the provision of postnatal care, which means there is potential for significant variation in the standard and quality of care. This review aimed to systematically identify, synthesise, and assess the quality of postnatal care guidelines produced for use in Australia. A second aim was to compare postnatal care recommendations in Australian guidelines to the National Institute for Health and Care Excellence's (NICE) and the World Health Organization's (WHO) postnatal care recommendations, to identify gaps and areas of disagreement. We focussed on recommendations regarding postnatal assessment of the woman or newborn, infant feeding, discharge planning, or community-based care. METHODS A scoping review was undertaken informed by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews. A database search and a manual search of state and national government health departments, professional associations and research institute websites was performed to identify relevant guidelines and recommendations. Guideline quality was assessed using the AGREE II tool. Guideline recommendations from Australia were mapped to 67 NICE/WHO recommendations. Recommendations that partially agreed, were modified, or in disagreement underwent further analysis. RESULTS A total of 31 Australian postnatal guidelines were identified and overall, these were of moderate- to high-quality. Of the 67 NICE/WHO recommendations, most agreed with the recommendations contained in Australian guidelines. There were five NICE/WHO recommendations with which corresponding Australian recommendations disagreed. There were 12 NICE/WHO recommendations that were commonly modified within Australia's guidelines. There were three NICE/WHO recommendations that did not appear in any Australian guideline. CONCLUSIONS Recommendations from postnatal guidelines in Australia have a high level of agreement with corresponding NICE/WHO recommendations. The few disagreements and modifications found in guideline recommendations - both across Australia's guidelines and between Australia's and the NICE/WHO guidelines - are worrying and warrant further examination, as they may result in different standards of care across Australia. Identified gaps in guidance should be prioritised for inclusion in new or updated guidelines where appropriate.
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Affiliation(s)
- Amanda Blair
- Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia.
| | - Annie Tan
- Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Caroline S E Homer
- Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
| | - Joshua P Vogel
- Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
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18
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Giouleka S, Tsakiridis I, Kostakis N, Boureka E, Mamopoulos A, Kalogiannidis I, Athanasiadis A, Dagklis T. Postnatal Care: A Comparative Review of Guidelines. Obstet Gynecol Surv 2024; 79:105-121. [PMID: 38377454 DOI: 10.1097/ogx.0000000000001224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Importance Postnatal care refers to the ongoing health care provision of both the mother and her offspring and contributes to the timely identification and effective management of complications in the postpartum period, to secure maternal and infant short- and long-term well-being. Objective The aim of this study was to review and compare the most recently published influential guidelines on postnatal care practices. Evidence Acquisition A comparative review of guidelines from the American College of Obstetricians and Gynecologists, the World Health Organization, the National Institute for Health and Care Excellence, and the Public Health Agency of Canada regarding postnatal care was conducted. Results There is a consensus among the reviewed guidelines regarding the importance of health care provision in the postpartum period, including home visits and midwifery services, the use of telemedicine for the facilitation of communication with the patient, and the appropriate preparation for discharge, as well as the discharge criteria. All medical societies also agree on the clinical aspects that should be evaluated at each postnatal visit, although discrepancies exist with regard to the contact schedule. In addition, there is consistency regarding the management of postpartum infections, perineal pain, fecal and urinary incontinence, and physical activity guidance. Mental health issues should be addressed at each postnatal visit, according to all guidelines, but there is disagreement regarding routine screening for depression. As for the optimal interpregnancy interval, the American College of Obstetricians and Gynecologists recommends avoiding pregnancy for at least 6 months postpartum, whereas the National Institute for Health and Care Excellence recommends a 12-month interval. There is no common pathway regarding the recommended contraceptive methods, the nutrition guidance, and the postpartum management of pregnancy complications. Of note, the World Health Organization alone provides recommendations concerning the prevention of specific infections during the postnatal period. Conclusions Postnatal care remains a relatively underserved aspect of maternity care, although the puerperium is a critical period for the establishment of motherhood and the transition to primary care. Thus, the development of consistent international protocols for the optimal care and support of women during the postnatal period seems of insurmountable importance to safely guide clinical practice and subsequently reduce maternal and neonatal morbidity.
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Affiliation(s)
| | | | | | | | | | - Ioannis Kalogiannidis
- Associate Professor, Third Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Smith H, Wojcieszek AM, Gupta S, Lavelanet A, Nihlén Å, Portela A, Schaaf M, Stahlhofer M, Tunçalp Ö, Bonet M. Integrating international policy standards in the implementation of postnatal care: a rapid review. BMJ Glob Health 2024; 8:e014033. [PMID: 38267069 PMCID: PMC10846851 DOI: 10.1136/bmjgh-2023-014033] [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: 09/22/2023] [Accepted: 11/06/2023] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION International legal and political documents can assist policy-makers and programme managers in countries to create an enabling environment to promote maternal and newborn health. This review aimed to map and summarise international legal and political documents relevant to the implementation of the WHO recommendations on maternal and newborn care for a positive postnatal experience. METHODS Rapid review of relevant international legal and political documents, including legal and political commitments (declarations, resolutions and treaties) and interpretations (general comments, recommendations from United Nations human rights treaty bodies, joint United Nations statements). Documents were mapped to the domains presented in the WHO postnatal care (PNC) recommendations; relating to maternal care, newborn care, and health systems and health promotion interventions, and by type of human right implied and/or stated in the documents. RESULTS Twenty-nine documents describing international legal and political commitments and interpretations were mapped, out of 45 documents captured. These 29 documents, published or entered into force between 1944 and 2020, contained content relevant to most of the domains of the PNC recommendations, most prominently the domains of breastfeeding and health systems interventions and service delivery arrangements. The most frequently mapped human rights were the right to health and the right to social security. CONCLUSION Existing international legal and political documents can inform and encourage policy and programme development at the country level, to create an enabling environment during the postnatal period and thereby support the provision and uptake of PNC and improve health outcomes for women, newborns, children and families. Governments and civil society organisations should be aware of these documents to support efforts to protect and promote maternal and newborn health.
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Affiliation(s)
- Helen Smith
- International Health Consulting Services Ltd, Liverpool, UK
| | - Aleena M Wojcieszek
- Department of Sexual and Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
- Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Shuchita Gupta
- Department of Maternal, Newborn, Child and Adolescent and Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Antonella Lavelanet
- Department of Sexual and Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Åsa Nihlén
- Department of Sexual and Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Anayda Portela
- Department of Maternal, Newborn, Child and Adolescent and Health and Ageing, World Health Organization, Geneva, Switzerland
| | | | - Marcus Stahlhofer
- Department of Maternal, Newborn, Child and Adolescent and Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Özge Tunçalp
- Department of Sexual and Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Mercedes Bonet
- Department of Sexual and Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
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Sæther KM, Holmberg Fagerlund B, Glavin K, Jøranson N. First-Time Parents' Support Needs and Perceived Support From a Child Health Service With the Integrated New Families Home Visiting Programme. QUALITATIVE HEALTH RESEARCH 2024; 34:20-32. [PMID: 37923302 PMCID: PMC10714706 DOI: 10.1177/10497323231208972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
The transition to parenthood is complex and influenced by interacting factors related to society, the parents and the child. Professional support is considered to be one of the societal factors affecting this transition by facilitating parents' sense of confidence and their competence as parents. In this study, we aimed to explore first-time parents' support needs and experiences of support from a child health service with the integrated New Families home visiting programme, in the context of their transition to parenthood in the first year postnatally. Interpretive description guided this qualitative study. Six couples and one mother, all well-educated and employed, were interviewed individually (N = 13). The parents were recruited from the research project 'New Families - Innovation and Development of the Child Health Service in Oslo'. We found that being a first-time parent is perceived as overwhelming and that defining support needs may be challenging, particularly in the first period postnatally. In addition, the support needs are constantly changing due to the complexity of interacting factors and the ongoing development of confidence in the parental role. Retrospectively, the parents were satisfied overall with the support from the child health service. The home visit during pregnancy facilitated management and relational and informational continuity. However, we identified a need for even more proactive information provision and communication to optimise the service's availability and efficiency postnatally. In addition, the importance of peers and of approaching both mothers and fathers must be acknowledged in facilitating parental confidence.
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Affiliation(s)
| | | | - Kari Glavin
- Faculty of Health Sciences, VID Specialized University, Oslo, Norway
| | - Nina Jøranson
- Faculty of Health Sciences, VID Specialized University, Oslo, Norway
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Habte A, Tamene A, Tesfaye L. Towards a positive postnatal experience in Sub-Saharan African countries: the receipt of adequate services during the immediate postpartum period: a multilevel analysis. Front Public Health 2023; 11:1272888. [PMID: 38155886 PMCID: PMC10753759 DOI: 10.3389/fpubh.2023.1272888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/21/2023] [Indexed: 12/30/2023] Open
Abstract
Background Existing studies in the Sub-Saharan African (SSA) region have focused mainly on the frequency of postnatal visits, with little emphasis on the adequacy of care provided during visits. Hence, this study aimed to investigate the magnitude of receiving an adequate number of World Health Organization-recommended contents of care during the immediate postpartum visit, and its predictors in SSA countries. Methods The appended women file of the most recent (2016-2021) standardized Demographic and Health Survey report of eighteen Sub-Saharan African countries with a weighted sample of 56,673 women was used for the study. The influence of each predictor on the uptake of adequate postnatal care has been examined using multilevel mixed-effects logistic regression. Significant predictors were reported using the adjusted odds ratio (aOR) with their respective 95% confidence intervals (95% CI). Results The pooled prevalence of adequate postnatal care service uptake was found to be 42.94% (95% CI: 34.14, 49.13). Living in the southern sub-region (aOR = 3.08 95% CI: 2.50, 3.80), institutional delivery (aOR = 3.15; 95% CI: 2.90, 3.43), early initiation of ANC (aOR = 1.74; 95% CI: 1.45, 2.09), quality of antenatal care (aOR = 1.59; 95% CI: 1.42, 1.78), Caesarean delivery (aOR = 1.59; 95% CI: 1.42, 1.78), autonomy in decision-making (aOR = 1.30; 95% CI: 1.11, 1.39), high acceptance toward wife beating attitude (aOR = 0.83; 95% CI: 0.73, 0.94), and reading newspapers (aOR = 1.37; 95% CI: 1.21, 1.56) were identified as predictors of receiving adequate postnatal services during the immediate postpartum period. Conclusion The findings revealed low coverage of adequate postnatal care service uptake in the region. The Federal Ministry of Health and healthcare managers in each country should coordinate their efforts to develop interventions that promote women's empowerment to enhance their autonomy in decision-making and to reduce attitudes towards wife beating. Healthcare providers ought to strive to provide skilled delivery services and early initiation of antenatal care.
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Affiliation(s)
- Aklilu Habte
- School of Public Health College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
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22
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Brekke M, Småstuen MC, Glavin K, Amro A, Solberg B, Øygarden AMU, Sæther KM, Haugland T. The impact of New Families home visiting program on first-time mothers' quality of life and its association with social support: a non-randomized controlled study. BMC Public Health 2023; 23:2457. [PMID: 38066502 PMCID: PMC10704737 DOI: 10.1186/s12889-023-17285-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The transition to motherhood is characterized by physical, psychological, social, and relational changes. Quality of life (QoL) changes substantially during this transition. Higher QoL is associated with social support, essential for coping with the challenges and changes of becoming a mother. An early universal home visiting program (New Families) is developed to strengthen and support families. The study aims to evaluate the impact of New Families on first-time mothers' QoL and to investigate the association between their QoL, social support, and selected possible predictive factors. METHODS A prospective non-randomized controlled study with parallel group design. Child Health Services in five city districts of Oslo were matched in intervention and control groups. First-time mothers were allocated based on the residential area and assessed at pregnancy week 28 (N = 228), six weeks postpartum (N = 184), and three months postpartum (N = 167). Measures of the World Health Organization Quality of Life brief, Perinatal Infant Care Social Support Scale, and background variables were collected from October 2018 to June 2020. Multivariate linear regression models were applied to examine intervention impact and assess associations. RESULTS Our data did not reveal a significant association between New Families intervention and the QoL levels of first-time mothers at three months postpartum. Thus, we analyzed the whole sample together. Emotional support was significantly associated with higher QoL levels in the physical health (B = 0.19, 95%CI [0.04 to 0.34]) and social relationships (B = 0.40, 95%CI [0.20 to 0.60]) domains. Appraisal support was significantly associated with higher QoL levels in the psychological (B = 0.34, 95%CI [0.18 to 0.50]) and environment (B = 0.33, 95%CI [0.19 to 0.48]) domains. QoL levels in pregnancy were significantly associated with QoL levels postpartum, showing small to medium effect size (ES = 0.30 to 0.55), depending on the domain. CONCLUSIONS Further research, including qualitative interviews, could provide more insights into the impact of New Families on QoL. A positive association between QoL levels in pregnancy and postpartum suggests that postnatal interventions targeting improved QoL could potentially improve postpartum QoL. Emotional and appraisal support seems beneficial for first-time mothers' QoL and could be provided and facilitated by public health nurses. TRIAL REGISTRATION clinicaltrial.gov NCT04162626.
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Affiliation(s)
- Malene Brekke
- Centre of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway.
- Faculty of Health Sciences, VID Specialized University, Postboks 184 Vinderen, Oslo, 0319, Norway.
| | - Milada Cvancarova Småstuen
- Faculty of Health Sciences, VID Specialized University, Postboks 184 Vinderen, Oslo, 0319, Norway
- Oslo Metropolitan University, Oslo, Norway
| | - Kari Glavin
- Faculty of Health Sciences, VID Specialized University, Postboks 184 Vinderen, Oslo, 0319, Norway
| | - Amin Amro
- Faculty of Health Sciences, VID Specialized University, Postboks 184 Vinderen, Oslo, 0319, Norway
| | - Beate Solberg
- Centre of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway
| | | | - Kristin Marie Sæther
- Centre of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway
- Faculty of Health Sciences, VID Specialized University, Postboks 184 Vinderen, Oslo, 0319, Norway
| | - Trude Haugland
- Faculty of Health Sciences, VID Specialized University, Postboks 184 Vinderen, Oslo, 0319, Norway
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Chandra N, Smitha MV. Functional status, social support, and anxiety among postnatal women of Eastern India. Eur J Obstet Gynecol Reprod Biol X 2023; 20:100238. [PMID: 37720888 PMCID: PMC10502358 DOI: 10.1016/j.eurox.2023.100238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/31/2023] [Accepted: 09/02/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Though becoming a mother is a joyous experience, the postpartum time can be difficult and stressful for women as they deal with significant physical alterations and adjustments to their daily routines. However, very few studies have focused on the functional well-being of the woman after childbirth. This study aims to find the level of functional status, social support, and anxiety among women attending immunization clinics. Methods A descriptive cross-sectional research design was adopted to recruit 220 women in this study from two immunization clinic centers in Bhubaneswar, Odisha. Data were collected using a self-reported sociodemographic profile, functional level scale after childbirth, modified multidimensional scale of perceived social support, and postnatal anxiety scale. Descriptive and inferential statistical tests were used for data analysis, including mean, percentage, and Fisher exact. Results 59.5 % of women returned to a moderate level of functional status after six weeks postpartum. The majority of women, 98.6 % and 83.6 %, reported high levels of return to personal care and baby care, respectively, whereas 34.7 % had moderate levels of return to home activities and 90 % had low levels of return to community and social tasks. Also, 70 % of women had high perceived social support, and 87.7 % had no anxiety. In this study, normal delivery women had better functional status than their cesarean delivery counterparts. Moreover, functional status was significantly associated with anxiety at six postpartum weeks. Conclusion After six weeks of childbirth, most women only partially resumed their pre-pregnancy functional state. So, much more time, rest, and support from family members were needed to recover to a fully functional level. Nurses, midwives, and the family members of women should be aware of the critical role that social support plays in enhancing a woman's functional and psychological status during the postpartum period.
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Affiliation(s)
- Nabanita Chandra
- Obstetrical and Gynecological Nursing, College of Nursing, AIIMS Bhubaneswar, Odisha, India
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Lesser IA, Nienhuis CP, Hatfield GL. Moms on the move: A qualitative exploration of a postpartum group exercise program on physical activity behaviour at three distinct time points. Int J Qual Stud Health Well-being 2023; 18:2172793. [PMID: 36710424 PMCID: PMC9888496 DOI: 10.1080/17482631.2023.2172793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
PURPOSE Physical activity (PA) after the birth of a child is associated with improved physical and mental health benefits. The aim of the study was to explore new mothers' experiences of PA before and after participation in a group-based PA program for new mothers. The study has three research questions: how new mothers felt; 1) about PA after the birth of their child 2) about engaging in a group-based PA program and 3) after the program ended about ongoing PA engagement. METHODS We conducted an 8-week bi-weekly PA program for postpartum women. To understand the experience of postpartum women engaging in a group-based PA program we conducted one-on-one semi-structured interviews before, after, and at 6-month follow-up. RESULTS Of the n = 21 participants in the Moms on the Move study; n = 17 completed pre interviews.s. One primary theme emerged from pre-program interviews where mothers shared how they were lost as to where to start PA. Post-program interviews produced two primary themes; engaging in PA helped mothers, and mothers learned to rethink PA. CONCLUSIONS Postpartum women who participated in this group-based PA program had positive benefits to their mental and physical health and were able to alter their PA behaviour.
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Affiliation(s)
- Iris A. Lesser
- School of Kinesiology, University of the Fraser Valley, Chilliwack, BC, Canada
| | - Carl P. Nienhuis
- School of Kinesiology, University of the Fraser Valley, Chilliwack, BC, Canada,CONTACT Carl P. Nienhuis School of Kinesiology, University of the Fraser Valley, ChilliwackV2R0N3, Canada
| | - Gillian L. Hatfield
- School of Kinesiology, University of the Fraser Valley, Chilliwack, BC, Canada
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Hildingsson I, Parment H, Öhrn U, Johansson M. Foreign-born women rated medical and emotional aspects of postnatal care higher than women born in Sweden: A quantitative comparative study. Eur J Midwifery 2023; 7:32. [PMID: 38023945 PMCID: PMC10644228 DOI: 10.18332/ejm/172573] [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: 05/28/2023] [Revised: 09/19/2023] [Accepted: 09/29/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Although high-quality postnatal care provides information and recognizes women's personal and cultural contexts, foreign-born women are more exposed to poor health and adverse birth outcomes. The aim of this study was to compare the length and model of postnatal care, along with the content of care, between foreign-born and native-born women living in Sweden. Another aim was to explore factors associated with being very satisfied with various aspects of postnatal care. METHODS This was a descriptive cross-sectional study of 483 postnatal women in two Swedish hospitals in 2017. Women completed a questionnaire comprising background data, pregnancy and birth related variables and the Early Postnatal Questionnaire. Data were analyzed using descriptive statistics, analysis of variance and multivariate logistic regression analyses. RESULTS Foreign-born women were more likely to have a shorter (<24 h) or longer (>48 h) length of postnatal stay than women born in Sweden. No differences in birth outcomes emerged between the two groups. Foreign-born women rated the medical (OR=1.77; 95% CI: 1.04-3.03) and emotional (OR=2.0; 95% CI: 1.17-3.40) aspects of postnatal care as being more important than Swedish-born women did. The most important aspect of overall satisfaction was the content of care, and the subscale Caring Relationship (AOR=8.15; 95% CI: 4.87-14.62) outscored all other aspects. CONCLUSIONS Important factors of satisfactory experiences with postnatal care in a Swedish context were receiving information, professional care, and a hospital environment that facilitates recovery after labor and birth. Culturally sensitive and individualized postnatal care with continuity should therefore be prioritized.
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Affiliation(s)
- Ingegerd Hildingsson
- Department of Women's and Children's Health, Faculty of Medicine, Uppsala University, Uppsala, Sweden
- Department of Nursing, Mid Sweden University, Sundsvall, Sweden
- Department of Nursing, Umea University, Umea, Sweden
| | | | - Ulrika Öhrn
- Sundsvall Regional Hospital, Sundsvall, Sweden
| | - Margareta Johansson
- Department of Women's and Children's Health, Faculty of Medicine, Uppsala University, Uppsala, Sweden
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Douma MJ, Myhre C, Ali S, Graham TAD, Ruether K, Brindley PG, Dainty KN, Smith KE, Montgomery CL, Dennet L, Picard C, Frazer K, Kroll T. What Are the Care Needs of Families Experiencing Sudden Cardiac Arrest? A Survivor- and Family-Performed Systematic Review, Qualitative Meta-Synthesis, and Clinical Practice Recommendations. J Emerg Nurs 2023; 49:912-950. [PMID: 37737785 DOI: 10.1016/j.jen.2023.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 09/23/2023]
Abstract
INTRODUCTION Cardiac arrest care systems are being designed and implemented to address patients', family members', and survivors' care needs. We conducted a systematic review and a meta-synthesis to understand family experiences and care needs during cardiac arrest care to create treatment recommendations. METHODS We searched eight electronic databases to identify articles. Study findings were extracted, coded and synthesized. Confidence in the quality, coherence, relevance, and adequacy of data underpinning the resulting findings was assessed using GRADE-CERQual methods. RESULTS In total 4181 studies were screened, and 39 met our inclusion criteria; these studies enrolled 215 survivors and 418 family participants-which includes both co-survivors and bereaved family members. From these studies findings and participant data we identified 5 major analytical themes: (1) When the crisis begins we must respond; (2) Anguish from uncertainty, we need to understand; (3) Partnering in care, we have much to offer; (4) The crisis surrounding the victim, ignore us, the family, no longer; (5) Our family's emergency is not over, now is when we need help the most. Confidence in the evidence statements are provided along with our review findings. DISCUSSION The family experience of cardiac arrest care is often chaotic, distressing, complex and the aftereffects are long-lasting. Patient and family experiences could be improved for many people. High certainty family care needs identified in this review include rapid recognition and response, improved information sharing, more effective communication, supported presence and participation, or supported absence, and psychological aftercare.
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Mehrtash H, Stein K, Barreix M, Bonet M, Bohren MA, Tunçalp Ö. Measuring women's experiences during antenatal care (ANC): scoping review of measurement tools. Reprod Health 2023; 20:150. [PMID: 37817135 PMCID: PMC10565981 DOI: 10.1186/s12978-023-01653-5] [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: 09/15/2022] [Accepted: 07/25/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND The new WHO model for antenatal care (ANC) focuses on improving practice, organisation and delivery of ANC within health systems, which includes both clinical care and women's experiences of care. The goal of this review is to identify tools and measures on women's experiences of ANC. METHODS We conducted a scoping review to identify tools and measures on women's experiences of ANC. An iterative approach was used to review all tools in a series of four steps: (1) identify papers between 2007 and 2023; (2) identify the tools from these papers; (3) map relevant measures to conceptualizations of experiences of care, notably mistreatment of women and respectful maternity care and (4) identify gaps and opportunities to improve measures. RESULTS Across the 36 tools identified, a total of 591 measures were identified. Of these, 292/591 (49.4%) measures were included and mapped to the typology of mistreatment of women used as a definition for women's experiences care during ANC in this review, while 299/591 (44.9%) irrelevant measures were excluded. Across the included measures, the highest concentration was across the domains of poor rapport between women and providers (49.8%) followed by failure to meet professional standards of care (23.3%). Approximately, 13.9% of measures were around overall respectful care, followed by health systems (6.3%), and any physical or verbal abuse, stigma and/or discrimination (4.8%) . CONCLUSION This analysis provides an overview of the existing tools, gaps and opportunities to measure women's experiences during ANC. Expanding beyond the childbirth period, these findings can be used to inform existing and future tools for research and monitoring measuring women's experiences of ANC.
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Affiliation(s)
- Hedieh Mehrtash
- 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 (WHO), Geneva, Switzerland.
- Department of Global Health, University of Washington School of Public Health, Seattle, Washington, USA.
| | - Karin Stein
- 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 (WHO), Geneva, Switzerland
| | - Maria Barreix
- 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 (WHO), Geneva, Switzerland
| | - 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 (WHO), Geneva, Switzerland
| | - Meghan A Bohren
- Gender and Women's Health Unit, Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | - Özge Tunçalp
- 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 (WHO), Geneva, Switzerland
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Foong WC, Foong SC, Ho JJ, Gautam D, Leong JJ, Tan PY, Baskaran M. Exploring factors influencing the uptake of kangaroo mother care: key informant interviews with parents. BMC Pregnancy Childbirth 2023; 23:706. [PMID: 37789260 PMCID: PMC10548712 DOI: 10.1186/s12884-023-06021-6] [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: 05/27/2023] [Accepted: 09/22/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND The updated World Health Organization (WHO) guideline recommends immediate kangaroo mother care (KMC) for all infants, particularly those born preterm. However, its uptake and sustainability have been unsatisfactory. Therefore, we aimed to gain deeper insight into factors influencing the uptake of KMC practice in our setting, and thereby identify possible solutions for the development of relevant interventions to improve its adoption and make KMC a routine practice for all infants. METHODS Using the Triandis model of social behaviour as our framework, we conducted key informant interviews with parents and healthcare providers. Trained interviewers conducted interviews with nine parents, recruited via purposive sampling. These parents were parents of preterm infants who had been introduced to KMC. Data was transcribed and analysed based on Triandis' Theory of Interpersonal Behaviour. This paper only reports the results of the parent interviews. RESULTS Major findings were how positive feelings like warmth and contentment, the sense of parenthood with KMC, the benefits of KMC for their infant and parents being enablers for KMC uptake. Conversely, the lack of KMC awareness, the initial negative feelings such as fear, uncertainty and embarrassment, the prioritization of time for milk expression, overcrowding in the ward, lack of space and privacy, limited visiting hours, lack of support and poor communication resulting in misapprehension about KMC were major barriers. CONCLUSION A deeper understanding of the factors influencing the uptake of KMC using the Triandis behavioural model provided a way forward to help improve its uptake and sustainability in our settings. TRIAL REGISTRATION This study was registered with the National Medical Research Registry (NMRR-17-2984-39191).
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Affiliation(s)
- Wai Cheng Foong
- Department of Paediatrics, RCSI & UCD Malaysia Campus, George Town, Penang, Malaysia.
| | - Siew Cheng Foong
- Department of Paediatrics, RCSI & UCD Malaysia Campus, George Town, Penang, Malaysia
| | - Jacqueline J Ho
- Department of Paediatrics, RCSI & UCD Malaysia Campus, George Town, Penang, Malaysia
| | - Divya Gautam
- Department of Obstetrics and Gynaecology, University Hospital Galway, Galway, Ireland
| | - Jen Jen Leong
- Department of Paediatrics, Sunway Medical Centre, Perai, Penang, Malaysia
| | - Pek Yong Tan
- Department of Paediatrics, Island Hospital, George Town, Penang, Malaysia
| | - Mehala Baskaran
- Department of Paediatrics, Pulau Pinang Hospital, Ministry of Health, George Town, Penang, Malaysia
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Ching H, Chua JYX, Chua JS, Shorey S. The effectiveness of technology-based cognitive behavioral therapy on perinatal depression and anxiety: A systematic review and meta-analysis. Worldviews Evid Based Nurs 2023; 20:451-464. [PMID: 37559467 DOI: 10.1111/wvn.12673] [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: 04/29/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Extensive literature has shown the effectiveness of cognitive behavioral therapy in treating perinatal depression, but little is known about the effectiveness of its technology-based version. AIM The aim of this review was to examine the effectiveness of technology-based cognitive behavioral therapy in reducing depressive and anxiety symptoms in women suffering from or at risk of experiencing perinatal depression. METHODS Six electronic databases were searched until February 2023 for articles published in English. Random-effect meta-analyses were conducted. Heterogeneity was assessed using the I2 statistics and Cochran's Q chi-squared test. Sensitivity analyses and subgroup analyses were also performed, and quality appraisals at the study and outcome levels were conducted. RESULTS A total of 16 randomized controlled trials were included in the review. Results from meta-analyses suggest that technology-based cognitive behavioral therapy has a medium effect in reducing perinatal depressive symptoms and a small effect in reducing perinatal anxiety symptoms. Overall, women suffering from or at risk of perinatal depression may benefit from technology-based cognitive behavioral therapy. LINKING EVIDENCE TO ACTION Future interventions can be improved by addressing both perinatal depression and anxiety, paying more attention to antenatal women to prevent postnatal mental health issues, and using self-guided mobile applications for accessibility.
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Affiliation(s)
- Hannie Ching
- KK Women's and Children's Hospital, Singapore City, Singapore
| | - Joelle Yan Xin Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Singapore City, Singapore
| | - Jing Shi Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Singapore City, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Singapore City, Singapore
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Kakasci CG, Durmaz A. Does individualized care make a difference in postpartum discharge?: A block randomized controlled trial. Health Care Women Int 2023; 44:1481-1499. [PMID: 35616352 DOI: 10.1080/07399332.2022.2046752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/22/2022] [Indexed: 10/18/2022]
Abstract
With this study, we aimed to determine the severity of physical symptoms displayed by mothers who received individualized care during the early postpartum period and their level of perceived readiness for discharge after birth. We conducted the study as a single-blind randomized controlled trial, assigning the mothers to the experimental (EG = 60) and control (CG = 60) groups using the permuted block randomization method. We administered the EG individualized care and the CG a routine care. Both groups received Postpartum Physical Symptom Severity Scale and Readiness for Hospital Discharge Scale-New Mother Form. The mean posttest scores the groups obtained from Postpartum Physical Symptom Severity Scale and Readiness for Hospital Discharge Scale-New Mother Form were significant in favor of the EG (p < 0.05). It is fair to state that individualized care is effective in reducing the physical complaints increasing the maternal health and improving the general health.
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Affiliation(s)
- Cigdem Gun Kakasci
- Faculty of Health Sciences, Department of Midwifery, Suleyman Demirel University, Isparta, Turkey
| | - Aysegul Durmaz
- Faculty of Health Sciences, Department of Midwifery, Kutahya Health Sciences University, Kutahya, Turkey
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Harvey CM, Smith H, Portela A, Movsisyan A. Stakeholder's perspectives of postnatal discharge: a qualitative evidence synthesis. BMJ Glob Health 2023; 8:e011766. [PMID: 37553175 PMCID: PMC10414110 DOI: 10.1136/bmjgh-2023-011766] [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: 01/13/2023] [Accepted: 05/06/2023] [Indexed: 08/10/2023] Open
Abstract
INTRODUCTION Discharge preparation prior to leaving a health facility after childbirth offers a critical window of opportunity for women, parents and newborns to receive support for the transition to care at home. However, research suggests that the quality of discharge preparation following childbirth is variable. This review synthesises qualitative evidence on stakeholder perspectives of postnatal discharge. METHODS We conducted a thematic synthesis of qualitative studies included in a larger published scoping review on discharge preparedness and readiness (reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews). For inclusion, in the qualitative evidence synthesis, studies had to have used qualitative methods for data collection and analysis to capture the perspectives of women, parents and health workers. Key characteristics and findings were extracted, and thematic analysis was used to inductively develop a conceptual coding framework. RESULTS Of a total of 130 research documents (published research articles and grey literature), six studies met the inclusion criteria; five were conducted in high-income countries, five were published in English and one was published in Swedish. Studies reported on the experiences of women, fathers and midwives with the number of participants ranging from 12 to 324. Nine descriptive themes (findings) were identified. From these, three high-level analytical themes were generated: (1) health workers need support to optimise the postnatal discharge process; (2) the allocated time for, and timing of, discharge is rushed; (3) overlooking women's and fathers'/partners' needs leads to feelings of exclusion. CONCLUSIONS Findings suggest an overall feeling of dissatisfaction among women, parents and midwives with the current provision of discharge preparation. In particular, women and midwives expressed frustration at the lack of time and resources available for ensuring adequate quality of care prior to discharge. The perspectives of included stakeholders indicate a demand for increased focus on the emotional and social needs of women and families during discharge preparation as well as better engagement of fathers and other family members. The qualitative evidence available indicates the likely positive impact of adequate discharge preparation if the identified service and system barriers can be overcome. As the updated WHO recommendations on postnatal care become embedded in country health systems and policies, there may be renewed interest on values, preferences and perspectives at system, service and end-user level.
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Affiliation(s)
| | - Helen Smith
- International Health Consulting Services Ltd, Liverpool, UK
| | - Anayda Portela
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Ani Movsisyan
- Institute for Medical Informatics, Biometry and Epidemiology, Ludwig Maximilians University Munich, Munchen, Germany
- Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munchen, Bayern, Germany
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Guure C, Aviisah PA, Adu-Bonsaffoh K, Mehrtash H, Aderoba AK, Irinyenikan TA, Balde MD, Adeyanju O, Maung TM, Tunçalp Ö, Maya E. Mistreatment of women during childbirth and postpartum depression: secondary analysis of WHO community survey across four countries. BMJ Glob Health 2023; 8:e011705. [PMID: 37612033 PMCID: PMC10450127 DOI: 10.1136/bmjgh-2023-011705] [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: 01/05/2023] [Accepted: 06/25/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Postpartum depression (PPD) is a leading cause of disability globally with estimated prevalence of approximately 20% in low-income and middle-income countries. This study aims to determine the prevalence and factors associated with PPD following mistreatment during facility-based childbirth. METHOD This secondary analysis used data from the community survey of postpartum women in Ghana, Guinea, Myanmar and Nigeria for the WHO study, 'How women are treated during facility-based childbirth'. PPD was defined using the Patient Health Questionnaire (PHQ-9) tool. Inferential analyses were done using the generalised ordered partial proportional odds model. RESULTS Of the 2672 women, 39.0% (n=1041) developed PPD. 42.2% and 5.2% of mistreated women developed minimal/mild PPD and moderate/severe PPD, respectively. 43.0% and 50.6% of women who experienced verbal abuse and stigma/discrimination, respectively developed minimal/mild PPD. 46.3% of women who experienced physical abuse developed minimal/mild PPD while 7.6% of women who experienced stigma/discrimination developed moderate/severe PPD. In the adjusted model, women who were physically abused, verbally abused and stigma/discrimination compared with those who were not were more likely to experience any form of PPD ((OR: 1.57 (95% CI 1.19 to 2.06)), (OR: 1.42 (95% CI 1.18 to 1.69)) and (OR: 1.69 (95% CI 1.03 to 2.78))), respectively. Being single and having higher education were associated with reduced odds of experiencing PPD. CONCLUSION PPD was significantly prevalent among women who experienced mistreatment during childbirth. Women who were single, and had higher education had lower odds of PPD. Countries should implement women-centred policies and programmes to reduce mistreatment of women and improve women's postnatal experiences.
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Affiliation(s)
- Chris Guure
- Department of Biostatistics, School of Public Health, University of Ghana, Legon, Ghana
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Kwame Adu-Bonsaffoh
- Department of Obstetrics Gynaecology, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Hedieh Mehrtash
- Department of Sexual and Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneve, Switzerland
| | - Adeniyi Kolade Aderoba
- Reproductive and Maternal Health, and Healthy Ageing Unit, Universal Health Coverage - Life Course Cluster, World Health Organization Regional Office for Africa, Brazzaville, Democratic Republic of Congo
- Department of Obstetrics and Gynaecology, Mother and Child, State Specialist Hospital, Akure, Nigeria
| | - Theresa Azonima Irinyenikan
- Department of Obstetrics and Gynecology, Faculty of Clinical Sciences, University of Medical Sciences, Akure, Ondo State, Nigeria
| | - Mamadou Dioulde Balde
- Cellulle de Recherche en Sante de la Reproduction en Guinee (CERREGUI), Conakry, Guinea
| | | | - Thae Maung Maung
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | - Özge Tunçalp
- Department of Sexual and Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneve, Switzerland
| | - Ernest Maya
- Department of Population, Family & Reproductive Health, School of Public Health, University of Ghana, Legon-Accra, Ghana
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Primo CC, Ferreira CI, Soares JDS, Muri LAC, Lima EDFA, Brandão MAG. Body image of women during breastfeeding: analysis supported by nursing theory. Rev Gaucha Enferm 2023; 44:e20220051. [PMID: 37283431 DOI: 10.1590/1983-1447.2023.20220051.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 09/26/2022] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVE To describe and interpret a woman's perception of her body image during the breastfeeding process. METHOD Descriptive qualitative study conducted at a university hospital in the Southeast region, Brazil. Forty-three puerperal women who were breastfeeding were interviewed. The interviews were submitted to lexical analysis using the IRAMUTEQ software and interpreted based on the Interactive Theory of Breastfeeding. RESULTS Women report dissatisfaction with changes in body image during breastfeeding. But they also value and want to keep breastfeeding because of the benefits for the child. Finally, several women express the desire to perform plastic surgery in the future because of these body changes. CONCLUSION The woman's perception of her body image as satisfactory/unsatisfactory indicates that body changes cover the breastfeeding process with feelings of ambiguity.Body changes are perceived by women in a personal, subjective and complex way.
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Affiliation(s)
- Cândida Caniçali Primo
- Universidade Federal do Espírito Santo (UFES). Centro de Ciências da Saúde. Programa de Pós-Graduação em Saúde Coletiva. Vitória, Espírito Santo, Brasil
| | - Carolina Itabaiana Ferreira
- Universidade Federal do Espírito Santo (UFES). Centro de Ciências da Saúde. Curso de Graduação em Enfermagem.Vitória, Espírito Santo, Brasil
| | - Joicilayne da Silva Soares
- Universidade Federal do Espírito Santo (UFES). Centro de Ciências da Saúde. Curso de Graduação em Enfermagem.Vitória, Espírito Santo, Brasil
| | - Lucimar Andrade Cardoso Muri
- Universidade Federal do Espírito Santo (UFES). Hospital Universitário Cassiano Antônio de Moraes. Banco de Leite Humano. Vitória, Espírito Santo, Brasil
| | - Eliane de Fátima Almeida Lima
- Universidade Federal do Espírito Santo (UFES). Centro de Ciências da Saúde. Programa de Pós-Graduação em Saúde Coletiva. Vitória, Espírito Santo, Brasil
| | - Marcos Antônio Gomes Brandão
- Universidade Federal do Rio de Janeiro (UFRJ). Escola de Enfermagem Anna Nery. Programa de Pós-Graduação em Enfermagem. Rio de Janeiro, Rio de Janeiro, Brasil
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Sjetne IS, Iversen HH. Women report better experiences from maternity care after postnatal consultations: A cross sectional study. PATIENT EDUCATION AND COUNSELING 2023; 111:107690. [PMID: 36893560 DOI: 10.1016/j.pec.2023.107690] [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: 09/16/2022] [Revised: 01/28/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To determine if the patient reported experiences (PREMs) of women in maternity care differ by whether or not they had a postnatal consultation before leaving the birth institution. METHODS Secondary analysis of cross-sectional data to compare PREMs of women who had received an individual consultation (86 %), a group consultation (3 %), and women who had received no consultation (11 %). PREMs were collected using a self-administered questionnaire. Eight summated scales were constructed from 29 single items, pertaining to different parts of the received care. Scores ranged between 0 and 100, with high scores representing positive experiences. RESULTS Among the 8156 sampled women, 3387 (42 %) responded. There were statistically significant (p ≤ 0.002) differences (from 3.7 to 16.3 points) on all eight scales. The scores from women who had an individual postnatal consultation were consistently higher than the scores from the other groups. The largest difference was in the scale with the worst score: information about women's health during the postnatal stay. CONCLUSION Women who participated in individual postnatal consultations reported more positive experiences compared to those who did not. PRACTICE IMPLICATION The consistent differences found in this study provide support for administering individual postnatal consultations.
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Javadi D, Sacks E, Brizuela V, Finlayson K, Crossland N, Langlois EV, Ziegler D, Chandra-Mouli V, Bonet M. Factors that influence the uptake of postnatal care among adolescent girls: a qualitative evidence synthesis. BMJ Glob Health 2023; 8:e011560. [PMID: 37137533 PMCID: PMC10163540 DOI: 10.1136/bmjgh-2022-011560] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/21/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Adolescent pregnancy is associated with increased risk of maternal and child morbidity and mortality globally. Access to safe, appropriate and affordable antenatal, childbirth and postnatal care (PNC) is essential in mitigating this risk. PNC is an often undervalued, underused, and understudied component of the continuum of maternal health services; however, it provides an important opportunity for adolescent girls to have access to health information and resources as they navigate the transition to motherhood and/or recovery from childbirth. This qualitative evidence synthesis seeks to highlight the experiences and perspectives of adolescent girls and their partners in accessing and using routine PNC. METHODS Papers were selected from a primary review on PNC where a global search of databases was conducted to identify studies with qualitative data focused on PNC utilisation. Within this primary review, a subset of studies focused on adolescents was tagged for subanalysis. A data extraction form drawing on an a priori framework was used to extract data from each study. Review findings were grouped across studies and mapped onto relevant themes, which were then adapted, as appropriate, to best reflect emergent themes from included studies. RESULTS Of 662 papers identified for full text review, 15 were included in this review on adolescents' experiences. Fourteen review findings were mapped onto four themes including: resources and access, social norms, experiences of care, and tailored support needs. CONCLUSION Improving uptake of PNC by adolescent girls requires multipronged approaches in improving availability of and access to adolescent-sensitive maternal health services and reducing feelings of shame and stigma in the postpartum period. Much should be done to address structural barriers to access, but tangible steps to improving the quality and responsiveness of available services can be taken immediately. PROSPERO REGISTRATION NUMBER CRD42019139183.
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Affiliation(s)
- Dena Javadi
- Social and Behavioral Sciences, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Emma Sacks
- Department of International Health, Johns Hopkins University, 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
| | - Kenneth Finlayson
- Research in Childbirth and Health (ReaCH) Unit, School of Community Health and Midwifery, University of Central Lancashire, Preston, UK
| | - Nicola Crossland
- Research in Childbirth and Health (ReaCH) Unit, School of Community Health and Midwifery, University of Central Lancashire, Preston, UK
| | - Etienne V Langlois
- Partnership for Maternal, Newborn & Child Health (PMNCH), World Health Organization, Geneva, Switzerland
| | - Daniela Ziegler
- Library, Centre Hospitalier de l'Universite de Montreal, Montreal, Québec, Canada
| | - Venkatraman Chandra-Mouli
- 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
| | - 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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Finlayson K, Sacks E, Brizuela V, Crossland N, Cordey S, Ziegler D, Langlois EV, Javadi D, Comrie-Thomson L, Downe S, Bonet M. Factors that influence the uptake of postnatal care from the perspective of fathers, partners and other family members: a qualitative evidence synthesis. BMJ Glob Health 2023; 8:e011086. [PMID: 37137532 PMCID: PMC10163465 DOI: 10.1136/bmjgh-2022-011086] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 03/14/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Postnatal care (PNC) is a key component of maternity provision and presents opportunities for healthcare providers to optimise the health and well-being of women and newborns. However, PNC is often undervalued by parents, family members and healthcare providers. As part of a larger qualitative review exploring the factors that influence PNC uptake by relevant stakeholders, we examined a subset of studies highlighting the views of fathers, partners and family members of postpartum women. METHODS We undertook a qualitative evidence synthesis using a framework synthesis approach. We searched multiple databases and included studies with extractable qualitative data focusing on PNC utilisation. We identified and labelled a subset of articles reflecting the views of fathers, partners and other family members. Data abstraction and quality assessment were carried out using a bespoke data extraction form and established quality assessment tools. The framework was developed a priori based on previous research on the topic and adapted accordingly. Findings were assessed for confidence using the GRADE-CERQual approach and are presented by country income group. RESULTS Of 12 678 papers identified from the original search, 109 were tagged as 'family members views' and, of these, 30 were eligible for this review. Twenty-nine incorporated fathers' views, 7 included the views of grandmothers or mothers-in-law, 4 incorporated other family member views and 1 included comothers. Four themes emerged: access and availability; adapting to fatherhood; sociocultural influences and experiences of care. These findings highlight the significant role played by fathers and family members on the uptake of PNC by women as well as the distinct concerns and needs of fathers during the early postnatal period. CONCLUSION To optimise access to postnatal care, health providers should adopt a more inclusive approach incorporating flexible contact opportunities, the availability of more 'family-friendly' information and access to psychosocial support services for both parents.
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Affiliation(s)
- Kenneth Finlayson
- School of Community Health and Midwifery, University of Central Lancashire, Preston, UK
| | - Emma Sacks
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Vanessa Brizuela
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Nicola Crossland
- School of Community Health and Midwifery, University of Central Lancashire, Preston, UK
| | - Sarah Cordey
- School of Community Health and Midwifery, University of Central Lancashire, Preston, UK
| | - Daniela Ziegler
- Direction de l'enseignement et l'Académie CHUM | Bibliothèque du CHUM, Centre Hospitalier de l'Universite de Montreal, Montreal, Québec, Canada
| | - Etienne V Langlois
- Partnership for Maternal, Newborn and Child Health (PMNCH), World Health Organization, Geneva, Switzerland
| | - Dena Javadi
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Liz Comrie-Thomson
- Global Women's and Newborn's Health Group, Burnet Institute, Melbourne, Victoria, Australia
| | - Soo Downe
- School of Community Health and Midwifery, University of Central Lancashire, Preston, UK
| | - Mercedes Bonet
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Leahy-Warren P, Nieuwenhuijze M. Measuring women's empowerment during the perinatal period in high income countries: A scoping review of instruments used. Heliyon 2023; 9:e14591. [PMID: 37064454 PMCID: PMC10102201 DOI: 10.1016/j.heliyon.2023.e14591] [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: 07/12/2022] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/30/2023] Open
Abstract
Empowerment is acknowledged as a process facilitating those who are less powerful to be engaged in their problem identification, decision making and actions to gain control over their life. This is an important goal for women during the perinatal period in their transition to motherhood. A concept analysis of women's empowerment during the perinatal period found that psychological and social dimensions play a role in women's perinatal empowerment and identified several defining attributes. The aim of this study was to identify robust validated instruments that measure all the attributes of women's empowerment during the perinatal period. We did a scoping review of scientific literature following the methodology of the JBI Reviewer's Manual. We searched the database MEDLINE, CINAHL, PsycINFO, PsycARTICLES and SocINDEX and selected papers meeting the inclusion criteria. Instruments measuring empowerment or related concepts were identified in the selected papers. Two authors independently cross referenced the items of each instrument against the defining attributes for empowerment. Our search resulted in 9771 unique hits of which 36 papers were finally included. Studies were from various countries with a wide variety of aims, demographics of cohorts and timepoints across the perinatal period. Twenty-one different instruments were used to measure empowerment, of which 11 were validated among women during the perinatal period. However, no identified instrument was developed specifically for women during the perinatal period or included all the dimensions of empowerment and the defining attributes. There is a need for a theoretically sound valid and reliable instrument measuring all the dimensions of empowerment of women during the perinatal period. Once developed this instrument needs testing with a broad range of women. Results from such a study will inform the development of appropriate interventions that have a coherent theoretical basis and are empirically informed to enhance women's empowerment during the perinatal period.
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Affiliation(s)
| | - Marianne Nieuwenhuijze
- Research Centre for Midwifery Science, Academie Verloskunde Maastricht, Zuyd University, the Netherlands
- CAPHRI School for Public Health and Primary Care, Maastricht University, the Netherlands
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Veiga ACD, Medeiros LDSD, Backes DS, Sousa FGMD, Hämel K, Kruel CS, Haeffner LSB. Interprofessional qualification of prenatal care in the context of primary health care. CIENCIA & SAUDE COLETIVA 2023; 28:993-1002. [PMID: 37042908 DOI: 10.1590/1413-81232023284.14402022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 09/18/2022] [Indexed: 04/13/2023] Open
Abstract
This study aims to describe and analyze an interprofessional educational intervention for the qualification of prenatal care in the context of primary health care. METHOD action-research comprising a prenatal care qualification course with 65 primary health care professionals. Collaborative learning activities were conducted in synchronous and asynchronous meetings. RESULTS the reflexive thematic analysis of participants' experiences, views and perceptions on the meanings of the intervention revealed three categories: quality of prenatal care: conceptions and meanings; collaborative learning: strategy to overcome linear and isolated care; the need to evolve from acting locally to thinking globally. CONCLUSION the analysis of the interprofessional educational intervention for the qualification of prenatal care in the context of primary health care showed that constructivist, participatory and interprofessional approaches are relevant and pertinent to broaden theoretical perceptions and give new meanings to the work process at different settings of the health network.
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Affiliation(s)
- Andressa Caetano da Veiga
- Programa de Pós-Graduação em Saúde Materno-Infantil, Universidade Franciscana. R. Duque de Caxias 938. 97010-200 Santa Maria RS Brasil.
| | | | - Dirce Stein Backes
- Programa de Pós-Graduação em Saúde Materno-Infantil, Universidade Franciscana. R. Duque de Caxias 938. 97010-200 Santa Maria RS Brasil.
| | | | - Kerstin Hämel
- School of Public Health, Bielefeld University. Bielefeld Alemanha
| | - Cristina Saling Kruel
- Programa de Pós-Graduação em Saúde Materno-Infantil, Universidade Franciscana. R. Duque de Caxias 938. 97010-200 Santa Maria RS Brasil.
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Childbirth experience during the COVID-19 pandemic: A qualitative thematic analysis. Midwifery 2023; 121:103669. [PMID: 37001431 PMCID: PMC10038889 DOI: 10.1016/j.midw.2023.103669] [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: 09/16/2022] [Revised: 02/16/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023]
Abstract
Introduction Pregnancy is a period of special vulnerability for the mental health of women. The arrival of the COVID-19 pandemic altered the routines of pregnant women, its effects on this population are thus far unknown. Therefore, the objective of this study is to understand the impact of the pandemic on the birth experience of women during the state of emergency in Andalusia, Spain. Methods A qualitative study was conducted with 14 women, using semistructured interviews via telematics. These were recorded and later transcribed using the F4transkript software. In order to analyse the data retrieved from the interviews and identify the main patterns of meaning/responses, the thematic analysis method was applied. Results The main emerging themes were 'prenatal medical care', 'hospital safety', and 'postpartum with COVID-19 restrictions'. The results indicated that the reorganization of perinatal medical care, the lack of information, and the fear of contagion were the factors that most negatively influenced the participants. Instead, the security during the birth process and the tranquillity in postpartum were the positive aspects of the birth experiences during COVID-19. Conclusion This is the first qualitative study in Andalusia that identifies the specific aspects of the COVID-19 pandemic that have affected the mental health of pregnant women. The results contribute to a broader perception of the experience of women and the creation of health protocols for emergencies akin to the COVID-19 pandemic.
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Gupta-Dame N, Macdonald D, Ross-White A, Snelgrove-Clarke E. Postnatal experiences of South Asian immigrant women in Australia, Canada, the United Kingdom, and the United States of America: a qualitative systematic review protocol. JBI Evid Synth 2023:02174543-990000000-00141. [PMID: 36924077 DOI: 10.11124/jbies-22-00402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE The goal of this review is to gain an understanding of the postnatal experiences of South Asian immigrant women in 4 English-speaking countries: Australia, Canada, the United Kingdom, and the United States of America. INTRODUCTION The postnatal period is an important time in the lives of women and their families. Major changes take place during this time as a woman's body gradually returns to its pre-pregnancy state. The postnatal period is also a time for women to adapt and transition into their new role as a mother. Immigrant women experience many challenges in accessing quality postnatal care in comparison to non-migrant populations. South Asian immigrant women, specifically, encounter unique postnatal experiences and face a myriad of hardships in accessing proper postnatal care. The presence of cultural factors and traditional norms largely influence postnatal experiences of South Asian immigrant women. Cultural factors include, but are not limited to, relationships with family and in-laws, gender-specific roles, newborn gender, mental health stigma, language barriers, acculturative stress, and expression of depression. INCLUSION CRITERIA Qualitative studies in English reporting postnatal experiences of South Asian immigrant women published after January 2000 will be considered for this review. Research designs may include, but are not limited to, feminist research, exploratory descriptive design, or ethnography. Gray literature will be limited to theses and dissertations only. METHODS MEDLINE, Embase, CINAHL, EthOS, and ProQuest Dissertations and Theses will be searched. Disagreement resolution, data extraction, and meta-aggregation will be completed through discussion between 2 reviewers. Studies will be critically appraised and assigned a level of credibility. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42022354306.
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Affiliation(s)
- Nikita Gupta-Dame
- School of Nursing, Queen's University, Kingston, ON, Canada.,Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
| | - Danielle Macdonald
- School of Nursing, Queen's University, Kingston, ON, Canada.,Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
| | - Amanda Ross-White
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada.,Queen's University Libraries, Queen's University, Kingston, ON, Canada
| | - Erna Snelgrove-Clarke
- School of Nursing, Queen's University, Kingston, ON, Canada.,Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
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Benoit B, Aston M, Price S, Iduye D, Sim SM, Ollivier R, Joy P, Nassaji NA. Mothers’ Access to Social and Health Care Systems Support during Their Infants’ First Year during the COVID-19 Pandemic: A Qualitative Feminist Poststructural Study. NURSING REPORTS 2023; 13:412-423. [PMID: 36976690 PMCID: PMC10057522 DOI: 10.3390/nursrep13010038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/09/2023] Open
Abstract
Social support and health services are crucial for mothers and families during their infants’ first year. The aim of this study was to explore the effect of self-isolation imposed by the COVID-19 pandemic on mothers’ access to social and health care systems support during their infants’ first year. We utilized a qualitative design using feminist poststructuralism and discourse analysis. Self-identifying mothers (n = 68) of infants aged 0 to 12 months during the COVID-19 pandemic in Nova Scotia, Canada completed an online qualitative survey. We identified three themes: (1) COVID-19 and the Social Construction of Isolation, (2) Feeling Forgotten and Dumped: Perpetuating the Invisibility of Mothering, and (3) Navigating and Negotiating Conflicting Information. Participants emphasized a need for support and the associated lack of support resulting from mandatory isolation during the COVID-19 pandemic. They did not see remote communication as equivalent to in-person connection. Participants described the need to navigate alone without adequate access to in-person postpartum and infant services. Participants identified conflicting information related to COVID-19 as a challenge. Social interactions and interactions with health care providers are crucial to the health and experiences of mothers and their infants during the first year after birth and must be sustained during times of isolation.
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Affiliation(s)
- Britney Benoit
- Rankin School of Nursing, St. Francis Xavier University, Antigonish, NS B2G 2W5, Canada
- Correspondence: ; Tel.: +1-(902)-867-1396
| | - Megan Aston
- School of Nursing, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Sheri Price
- School of Nursing, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Damilola Iduye
- School of Nursing, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - S Meaghan Sim
- Research, Innovation & Discovery, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Rachel Ollivier
- School of Nursing, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Phillip Joy
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada
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Eikemo R, Vikström A, Nyman V, Jonas W, Barimani M. Support during the postnatal period: Evaluating new mothers' and midwives' experiences of a new, coordinated postnatal care model in a midwifery clinic in Sweden. Scand J Caring Sci 2023; 37:260-270. [PMID: 35781315 DOI: 10.1111/scs.13103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/07/2022] [Accepted: 06/19/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Continuity of care as provided by midwives promoting the health and well-being of new mothers during the postnatal period is critical; thus, access to midwifery services needs to be facilitated. The aim of this study was to describe new mothers' and midwives' experiences and perceptions of a new coordinated postnatal care intervention in a midwifery clinic. DESIGN New mothers responded to open-ended questions in a survey, and midwives were interviewed individually about the intervention. A deductive content analysis research related to continuity of care concepts was used. SETTING AND PARTICIPANTS The study was carried out at a midwifery clinic in a larger city in Sweden, for an eight-month period in 2019 and 2020. Two hundred and sixteen answers from new mothers and nine interviews with midwives were analysed. INTERVENTION All registered pregnant women at the midwifery clinic received enhanced postnatal support based on a new coordinated postnatal care model. The focus was on continuity of care, from pregnancy to the postnatal period and included planning for the first weeks after childbirth at the end of pregnancy, early postnatal contact and several visits to the midwifery clinic. FINDINGS New mothers describing the coordinated postnatal care model highlighted continuity and accessibility as empowering factors that made them feel assured and confident. Midwives emphasised the pregnancy to postnatal continuity as crucial to providing care based on individual needs. KEY CONCLUSIONS/IMPLICATIONS FOR PRACTICE Using a structured and coordinated care model as a midwife that includes planning for the postnatal period together with the pregnant woman at the end of pregnancy may be a good and relatively easy way to create continuity and thus ensure satisfaction and confidence in expectant and new mothers.
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Affiliation(s)
- Ragnhild Eikemo
- Academic Primary Care Centre, Stockholm, Sweden.,Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Anna Vikström
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Viola Nyman
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Wibke Jonas
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Mia Barimani
- Academic Primary Care Centre, Stockholm, Sweden.,Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Adlington K, Vasquez C, Pearce E, Wilson CA, Nowland R, Taylor BL, Spring S, Johnson S. 'Just snap out of it' - the experience of loneliness in women with perinatal depression: a Meta-synthesis of qualitative studies. BMC Psychiatry 2023; 23:110. [PMID: 36849948 PMCID: PMC9970854 DOI: 10.1186/s12888-023-04532-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 01/06/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Pregnancy and the arrival of a new baby is a time of great transition and upheaval. Women often experience social isolation and loneliness at this time and may develop depression, particularly in the postnatal period. Qualitative studies have reported that loneliness is also a feature of perinatal depression. However, until now there has been no attempt to synthesise research exploring the links between loneliness and perinatal depression. This study's aim was to explore existing qualitative evidence to answer two research questions: What are the experiences of loneliness for women with perinatal depression? What helps and what makes loneliness worse for women with perinatal depression? METHODS A qualitative meta-synthesis retrieved primary qualitative studies relevant to the research questions. Four electronic databases were systematically searched (Ovid MEDLINE®; PsycINFO; Embase; Web of Science). Papers were screened according to pre-defined inclusion criteria and assigned a quality score. Thematic analysis was used to identify major overarching themes in the literature. RESULTS Twenty-seven relevant qualitative studies were included. Themes relating to the interaction between perinatal depression and loneliness included self-isolation and hiding symptoms due to stigma of perinatal depression and fear of judgement as a 'bad mother'; a sudden sense of emotional disconnection after birth; and a mismatch between expected and actual support provided by partner, family and community. There was also a double burden of loneliness for women from disadvantaged communities, due to increased stigma and decreased social support. Validation and understanding from healthcare professionals, peer support from other mothers with experience of perinatal depression, and practical and emotional family support were all important factors that could ameliorate loneliness. CONCLUSIONS Loneliness appears to play a central role in the experience of perinatal depression based on the frequency with which it emerged in women's accounts. The findings provide a foundation for the development of further theories about the role of loneliness in perinatal depression and evidence in which future psychological and social intervention design processes can be rooted. Addressing stigma and offering culturally appropriate professional and peer support are potential targets for interventions that could help women with perinatal depression, particularly in disadvantaged communities, feel less lonely. TRIAL REGISTRATION Prospero registration: https://www.crd.york.ac.uk/prospero/display_record.php? RecordID = 251,936.
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Affiliation(s)
- Katherine Adlington
- Division of Psychiatry, University College London, London, UK. .,Section of Women's Mental Health, King's College London, London, UK. .,East London NHS Foundation Trust, London, UK.
| | | | - Eiluned Pearce
- Division of Psychiatry, University College London, London, UK
| | - Claire A Wilson
- Section of Women's Mental Health, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Rebecca Nowland
- School of Health and Midwifery, University of Central Lancashire, Preston, UK
| | | | | | - Sonia Johnson
- Division of Psychiatry, University College London, London, UK.,Camden and Islington NHS Foundation Trust, London, UK
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Saether KM, Berg RC, Fagerlund BH, Glavin K, Jøranson N. First-time parents' experiences related to parental self-efficacy: A scoping review. Res Nurs Health 2023; 46:101-112. [PMID: 36564911 PMCID: PMC10107989 DOI: 10.1002/nur.22285] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 11/04/2022] [Accepted: 11/25/2022] [Indexed: 12/25/2022]
Abstract
Becoming a parent for the first time is a major transition, and parental self-efficacy (PSE) is considered an important predictor of parenting functioning. We aimed to describe and synthesize qualitative studies that explore first-time parents' experiences related to PSE in the transition to parenthood in the first-year postpartum. We conducted a scoping review in accordance with international guidelines. The main search strategy consisted of searches in six electronic databases. We selected studies based on predetermined inclusion and exclusion criteria, extracted data, and conducted a descriptive qualitative thematic analysis. We included 58 studies (presented in 61 reports) with 1341 participants from 17 countries. Most of the participants (89%) were mothers, and a third of the studies were task-specific regarding breastfeeding. The thematic analysis of the findings concerning PSE revealed five main, interconnected themes: culture-factors in society and the healthcare services; parents-processes within the parents; tasks-different parental tasks; support-parents' perceived support from professionals, peers, friends, family, and partner; and child-the child's well-being and feedback. This scoping review describes qualitative studies on first-time parents' experiences related to PSE. The findings inform future studies of PSE and clinical practice by confirming the importance of PSE in the transition to parenthood, the complexity of different factors that may have an impact, and the centrality of breastfeeding in PSE. Based on these findings, we suggest that a full systematic review with quality assessment would be appropriate.
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Affiliation(s)
- Kristin M Saether
- Centre of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway.,Faculty of Health Studies, VID Specialized University, Oslo, Norway
| | - Rigmor C Berg
- Norwegian Institute of Public Health, Oslo, Norway.,Department of Community Medicine, University of Tromsø, Tromsø, Norway
| | | | - Kari Glavin
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
| | - Nina Jøranson
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
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Wojcieszek AM, Bonet M, Portela A, Althabe F, Bahl R, Chowdhary N, Dua T, Edmond K, Gupta S, Rogers LM, Souza JP, Oladapo OT. WHO recommendations on maternal and newborn care for a positive postnatal experience: strengthening the maternal and newborn care continuum. BMJ Glob Health 2023; 8:bmjgh-2022-010992. [PMID: 36717156 PMCID: PMC9887708 DOI: 10.1136/bmjgh-2022-010992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/19/2022] [Indexed: 02/01/2023] Open
Affiliation(s)
- Aleena M Wojcieszek
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programmeof Research, Development and Research Training in HumanReproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland,Mater Research Institute (MRI-UQ), The University of Queensland, Brisbane, Queensland, Australia
| | - Mercedes Bonet
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programmeof Research, Development and Research Training in HumanReproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Anayda Portela
- Department of Maternal, Newborn, Child and Adolescent and Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Fernando Althabe
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programmeof Research, Development and Research Training in HumanReproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Rajiv Bahl
- Department of Maternal, Newborn, Child and Adolescent and Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Neerja Chowdhary
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Tarun Dua
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Karen Edmond
- Department of Maternal, Newborn, Child and Adolescent and Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Shuchita Gupta
- Department of Maternal, Newborn, Child and Adolescent and Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Lisa M Rogers
- Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland
| | - João Paulo Souza
- Department of Maternal, Newborn, Child and Adolescent and Health and Ageing, World Health Organization, Geneva, Switzerland,Department of Social Medicine, University of Sao Paulo, Butantã, Brazil
| | - Olufemi T Oladapo
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programmeof Research, Development and Research Training in HumanReproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Høgmo BK, Alstveit M, Bondas T. Being a "Warrior" to Care for the New Family: A Meta-ethnography of Nurses' Perspectives on Municipal Postnatal Healthcare. Glob Qual Nurs Res 2023; 10:23333936231218843. [PMID: 38149124 PMCID: PMC10750548 DOI: 10.1177/23333936231218843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 12/28/2023] Open
Abstract
Care in the postnatal period is a goal for all families with a newborn baby, and support from nurses might prevent long-term health problems and contribute to a positive postnatal experience. This meta-ethnography aims to integrate and synthesize qualitative studies that illuminate and describe nurses' perspectives on municipal postnatal health care in high-income countries. Systematic literature searches for qualitative studies were conducted and 13 articles were included. The analysis followed the seven phases of Noblit and Hare. Being a "warrior" to care for the new family was identified as an overarching metaphor accompanied by three main themes: Stretching human boundaries, Stretching system boundaries, and Stretching knowledge boundaries. The overarching metaphor offers a deeper understanding of the nurses as "warriors" who despite tight timeframes and heavy workloads are stretching toward a caring relationship with the families. Being a warrior continuously pushing system boundaries puts the nurses in risk of being overstretched, balancing between their ideals and the reality. As more knowledge and clearer policies and procedures regarding the inclusion of fathers and LGBTQ parents in municipal postnatal healthcare are needed, more focus placed on the father or non-birthing parent, different cultural traditions and family constellations in practice and education is suggested.
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Galle A, Moran AC, Bonet M, Graham K, Muzigaba M, Portela A, Day LT, Tuabu GK, Silva BDSÉ, Moller AB. Measures to assess quality of postnatal care: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001384. [PMID: 36963034 PMCID: PMC10021656 DOI: 10.1371/journal.pgph.0001384] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/27/2023] [Indexed: 02/19/2023]
Abstract
High quality postnatal care is key for the health and wellbeing of women after childbirth and their newborns. In 2022, the World Health Organization (WHO) published global recommendations on maternal and newborn care for a positive postnatal care experience in a new WHO PNC guideline. Evidence regarding appropriate measures to monitor implementation of postnatal care (PNC) according to the WHO PNC guideline is lacking. This scoping review aims to document the measures used to assess the quality of postnatal care and their validity. The review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Five electronic bibliographic databases were searched together with a grey literature search. Two reviewers independently screened and appraised identified articles. All data on PNC measures were extracted and mapped to the 2022 WHO PNC recommendations according to three categories: i) maternal care, ii) newborn care, iii) health system and health promotion interventions. We identified 62 studies providing measures aligning with the WHO PNC recommendations. For most PNC recommendations there were measures available and the highest number of recommendations were found for breastfeeding and the assessment of the newborn. No measures were found for recommendations related to sedentary behavior, criteria to be assessed before discharge, retention of staff in rural areas and use of digital communication. Measure validity assessment was described in 24 studies (39%), but methods were not standardized. Our review highlights a gap in existing PNC measures for several recommendations in the WHO PNC guideline. Assessment of the validity of PNC measures was limited. Consensus on how the quality of PNC should be measured is needed, involving a selection of priority measures and the development of new measures as appropriate.
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Affiliation(s)
- Anna Galle
- Department of Public Health and Primary Care, WHO Collaborating Centre on Primary Care and Family Medicine, University Centre for Nursing and Midwifery, Ghent University, Belgium
| | - Allisyn C Moran
- World Health Organization Department of Maternal, Newborn, Child and Adolescent Health and Ageing, Geneva, Switzerland
| | - Mercedes Bonet
- World Health Organization Department of Sexual and Reproductive Health and Research, Development and Research Training in Human Reproduction (HRP), UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research, Geneva, Switzerland
| | - Katriona Graham
- Department of Public Health and Primary Care, WHO Collaborating Centre on Primary Care and Family Medicine, Ghent University, Belgium
| | - Moise Muzigaba
- World Health Organization Department of Maternal, Newborn, Child and Adolescent Health and Ageing, Geneva, Switzerland
| | - Anayda Portela
- World Health Organization Department of Maternal, Newborn, Child and Adolescent Health and Ageing, Geneva, Switzerland
| | - Louise Tina Day
- Department of Infectious Disease Epidemiology, Maternal Newborn Health Group, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Godwin Kwaku Tuabu
- Department of Public Health and Primary Care, WHO Collaborating Centre on Primary Care and Family Medicine, Ghent University, Belgium
| | - Bianca De Sá É Silva
- Department of Public Health and Primary Care, WHO Collaborating Centre on Primary Care and Family Medicine, Ghent University, Belgium
| | - Ann-Beth Moller
- World Health Organization Department of Sexual and Reproductive Health and Research, Development and Research Training in Human Reproduction (HRP), UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research, Geneva, Switzerland
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Thies-Lagergren L, Johansson M. Home-based postnatal midwifery care facilitated a smooth succession into motherhood: A Swedish interview study. Eur J Midwifery 2023; 7:8. [PMID: 37101597 PMCID: PMC10123868 DOI: 10.18332/ejm/161784] [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: 01/07/2023] [Revised: 02/19/2023] [Accepted: 03/14/2023] [Indexed: 04/28/2023] Open
Abstract
INTRODUCTION If a family is discharged from a hospital earlier after birth, close supervision by a skilled midwife is essential. The aim was to describe mothers' overall experience receiving postnatal care in a Swedish home-based midwifery care model. METHODS A descriptive qualitative study was conducted. Mothers meeting the inclusion criteria for a new home-based postnatal care model at a hospital in Stockholm, Sweden, were included. In total, 24 healthy mothers participated in a semi-structured telephone interview, averaging 58 minutes. Data were analyzed using thematic analysis, according to Braun and Clarke. RESULTS The main theme explored, 'The home-based postnatal care model facilitated a smooth succession into motherhood', is explained by the themes: 1) Mothers felt 'not left adrift' when cared for by the home-based postnatal midwives; 2) Professional midwives with authority guided the way into motherhood; and 3) The home, a safe and secure space for new mothers. CONCLUSIONS Mothers valued the well-structured home-based postnatal midwifery care. Important for mothers was to receive health checks, adequate information, and that midwives have a kind and individual approach to the families. Midwives play an important role for mothers in the early days after the birth of their baby.
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Affiliation(s)
- Li Thies-Lagergren
- Midwifery research - reproductive, perinatal and sexual health, Department of Health Sciences, Faculty of Medicine, Lund University, Sweden
| | - Margareta Johansson
- Uppsala University, Department of Women's and Children's Health Akademiska University Hospital, Uppsala, Sweden
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Langlois EV, Dey T, Iaia DG, Sacks E. Improving policy, financing and delivery of postnatal care services. Bull World Health Organ 2023; 101:2-2A. [PMID: 36593785 PMCID: PMC9795378 DOI: 10.2471/blt.22.289440] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Etienne V Langlois
- Partnership for Maternal, Newborn & Child Health, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Teesta Dey
- Partnership for Maternal, Newborn & Child Health, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Domenico G Iaia
- Partnership for Maternal, Newborn & Child Health, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Emma Sacks
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, United States of America
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Mothering Ideology: A Qualitative Exploration of Mothers' Perceptions of Navigating Motherhood Pressures and Partner Relationships. SEX ROLES 2023; 88:101-117. [PMID: 36568897 PMCID: PMC9765384 DOI: 10.1007/s11199-022-01345-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 12/04/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
Good mother ideology refers to beliefs that women are only 'good' mothers if they adhere to the tenets of dominant parenting discourse, such as intensive mothering ideology, which prioritizes children's needs and child-raising above all else. Undergirded by this ideology, mothers' attempts to navigate the transition to motherhood are fraught with pressures, and the transition is associated with negative health outcomes for mothers and children; yet existing research gives little attention to the quality or dynamics of the partner relationship as part of this transition. The current study examined motherhood pressure and the impact on partner relationships through individual, semi-structured interviews with 19 mothers living in Australia who were 18 years or older in a heterosexual relationship with at least one child under the age of five. Thematic analysis revealed four key themes: discourses on motherhood: criticisms of mothers and internalised guilt; transformation of identity; entrenchment of gender roles through childrearing; and positive relationship dynamics: supportive fathers and challenging gender roles. This study contributes to the larger body of literature highlighting the complexity of dominant mothering ideology and its entanglement with and impact on partner relationships. Further, this study includes mothers' perceptions of how they navigate these pressures within the relationship with their partner and the family unit. These findings have implications for programs to support mothers and other caregivers, as well as challenge unrealistic standards for motherhood. Supplementary Information The online version contains supplementary material available at 10.1007/s11199-022-01345-7.
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