Exploring women's self-reported health problems in pregnancy in the UK and Norway

Women usually conceptualize pregnancy as a normal physiological state. In contrast, formal maternity care provision tends to be focused on pathology and risk. The authors aim to explore the extent to which childbearing women apply a sickness lens to pregnancy. We have therefore examined antenatal problems spontaneously reported by 4,000 UK and Norwegian women who responded to the international social media-based Babies Born Better survey. We coded and classified the free-text comments of the respondents as either complaint or disease. We found striking differences in the rates and types of problems reported by the women. We discuss our findings by applying different perspectives of medicalization and of lay and biomedical knowledge.

Knowledge Management from Senior Users of Online Health Information Point of View

In today’s society, all citizens who need digital information to manage their everyday life must be able to access it and trust it. They should have enough knowledge to use information and communication technologies (ICTs) and online health information (OHI) in an intended and purposeful way. The broader aim of this paper is to present and discuss health knowledge management (KM) from senior users of the online health information point of view. The theoretical point of departure is based on an understanding of health, knowledge and the Internet as social practices. This paper investigates e-Health literacy (eHL) and KM in health amongst seniors aged 65-90. It presents a case study on how they access, apprais, share and apply OHI in comparison to the way they use face-to-face health-encounters. Data comes from 17 open-ended interviews. E-HL and KM concepts are used to analyse and describe online behaviour and knowledge management in health as an interplay between individual and social factors.  The results show how participants engage in self- and co-management of their own or others' health and illustrate how they get or receive help to understand OHI. By examining how they use ICT and do (not) trust OHI regarding “serious cases,” this paper provides critical insight into ways seniors acquire information and how they appraise, understand or trust in it. Their information-seeking activities are performed mainly in private settings, seldom with professionals. They have lower levels of trust in their own, individual appraisal skills, compared to collective searches and discussions. Norwegian seniors are cool and pragmatic, and emphatic on the “when needs must, see your GP!”. By examining differences in ICT use, knowledge acquisition and support given or received, the results pinpoint how providers must affirm seniors’ ICT use and individual and collective online health behaviour as assets for healthy ageing. A potential barrier for citizens’ use of OHI and health technology is the built-in understanding of health as an individual capacity and ICT use as an individual activity, compared to a contemporary understanding of health and the Internet as social practices and collective resources. Designers of health technologies and OHI should critically consider built-in understandings of content and users to enhance accessibility and value for citizens of all ages.

Where else would I look for it? A five-country qualitative study on purposes, strategies, and consequences of online health information seeking

Background

Online health information (OHI) is widely available and consulted by many people in Western countries to gain health advice. The main goal of the present study is to provide a detailed account of the experiences among people from various demographic backgrounds living in high-income countries, who have used OHI.

Design and methods

Thematic analysis of 165 qualitative semi-structured interviews conducted among OHI users residing in Australia, Israel, the Netherlands, Norway, and Switzerland was performed.

Results

The lived experience of people using OHI seem not to differ across countries. The interviews show that searches for OHI are motivated from curiosity, sharing of experiences, or affirmation for actions already taken. Most people find it difficult to appraise the information, leading them to cross-check sources or discuss OHI with others. OHI seems to impact mostly some specific types of health behaviors, such as changes in diet or physical activity, while it only plays a complementary role for more serious health concerns. Participants often check OHI before seeing their GP, but are reluctant to discuss online content with health care personnel due to expected negative reception.

Conclusions

This study adds to the body of knowledge on eHealth literacy by demonstrating how OHI affects overall health behavior, strengthens patients’ ability to understand, live with, and prepare themselves for diverse health challenges. The increasing digitalization of health communication and health care calls for further research on digital divides and patient-professional relations. Health care professionals should acknowledge OHI seeking and engage in discussions with patients to enable them to appreciate OHI, and to support shared decision making in health care. The professionals can utilize patient’s desire to learn as a resource for health prevention, promotion or treatment, and empowerment.

How do health professionals acknowledge Web-based knowledge in pregnancy consultations?

Websites for pregnancy health are an important source of information for pregnant women, but how different cadres of health professionals value and utilize pregnant women's e-health literacy (e-HL) and Web-based knowledge in pregnancy consultations is not well understood. Using a qualitative research design and pelvic girdle pain as a tracer condition, we explored how Norwegian doctors, midwives and physiotherapists manage women's e-HL and Web-based knowledge in pregnancy consultations. The recognition of pregnant women's e-HL and Web-based knowledge differed across professional groups and produced dismissive, reactive and proactive attitudes depending on time pressure, professional identity and Internet experience.

Web-based Discussion Forums on Pregnancy Complaints and Maternal Health Literacy in Norway: A Qualitative Study

Background

The Internet is one of the fastest growing information sources for pregnant women and seems to be used across social and economic strata. However, we still lack knowledge on how interaction in Web-based discussion forums influence maternal health literacy, in terms of how pregnant women access, appraise, and apply information to promote and maintain good health.

Objective

The aim of this study was to understand how Web-based discussion forums influence maternal health literacy; hence, we explored the role of interactions in Web-based discussion forums among women who experienced health problems during pregnancy. More specifically, we explored why media-literate women experiencing the medically unexplained condition, pelvic girdle pain (PGP), during pregnancy participated in Web-based discussion forums and how they appraised and applied the information and advice that they gained from the Web-based interaction with other women.

Methods

Women were invited to participate in the study via postings on 3 different open websites for pregnant women and mothers. The sample included 11 Norwegian women who participated in open Web-based discussion forums when experiencing PGP in pregnancy. The data were collected using synchronous qualitative email interviews and were analyzed using thematic analysis.

Results

In our study sample, interaction in Web-based discussion forums influenced maternal health literacy in terms of increased health-related knowledge and competencies, increased awareness of health promotion and health protection, and increased system navigation. The women appraised and selectively applied information and advice that resonated with their own experiences. For many, the information provided online by other women in the same situation was valued more highly than advice from health professionals. Women reported that they used their knowledge and competency in encounters with health professionals but hesitated to disclose the origin of their knowledge. Those with a high level of education in medicine-related fields raised a concern about the Internet as a source of horror stories and erroneous information and were actively engaged in trying to minimize potential negative effects, by providing biomedical information.

Conclusions

The popularity of Web-based discussion forums among pregnant women suggests that this group needs additional sources of information and support to complement traditional consultations with the health professionals. The professionals need to recognize that pregnant women access Web-based discussion forums for support and information to increase their ability to take better health decisions for themselves. This is a potential resource that health professionals may find useful in consultations with pregnant women.

"They ask whether this is real or fake": a qualitative norwegian study of pregnancy complaints and access to social benefits

Women increasingly combine paid work and childbearing, but working full time throughout pregnancy is commonly experienced as overtaxing. We explored access to sick leave or medical care as experienced by Norwegian women suffering from pelvic girdle pain during pregnancy. Through a grounded theory approach we compared results from qualitative interviews and open Internet discussions, and found that women struggled with credibility and that their claims for sick leave or medical care were commonly disregarded. Support from peers was seen as instrumental in regaining control over their health and was a vehicle in developing critical health literacy.

"Listen to your body". A qualitative text analysis of internet discussions related to pregnancy health and pelvic girdle pain in pregnancy

OBJECTIVE

To explore popular perspectives on pelvic girdle pain (PGP) in pregnancy through an analysis of women's discussions on the Internet, and to investigate how these discussions compare with the prevailing official discourses on PGP and pregnancy health.

METHODS

A qualitative text analysis of women's contributions to a commercial online web-based discussion forum related to PGP in Norway.

RESULTS

The website works as a meeting point between pregnant women seeking advice on how to interpret and handle pregnancy-related pain, and women with experience of PGP. The worries expressed are met with strong messages of precautions and self-care, and in general PGP is perceived as an unpredictable and potentially disabling condition.

CONCLUSION

A popular discourse on PGP as an "unpredictable condition" emerges in the discussions, and challenges the official discourse on PGP as a "common complaint". The "unpredictable condition" discourse may work to justify pregnant women's perceived need for rest and care, and may be interpreted as an expression of a lack of acknowledgement of pregnancy as a state of being that requires special care in contemporary Norwegian society.

PRACTICE IMPLICATIONS

This popular discourse reflects a gap between the policy of pregnancy as a normal condition and women's experiences that should be taken seriously in policy-making and medical practice.