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Dol J, Campbell-Yeo M, Leahy-Warren P, Hambly LaPointe C, Dennis CL. Bibliometric analysis of published articles on perinatal anxiety from 1920 to 2020. J Affect Disord 2024; 351:314-322. [PMID: 38290588 DOI: 10.1016/j.jad.2024.01.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/01/2024]
Abstract
INTRODUCTION Trends and gaps in perinatal anxiety research remain unknown. The objective of this bibliometric review was to analyze the characteristics and trends in published research on perinatal anxiety to inform future research. METHODS All published literature in Web of Science on perinatal anxiety from January 1, 1920 to December 31, 2020 were screened by two reviewers. VOSViewer was utilized to visualize linkages between publications. Bibliometric data were extracted from abstracts. RESULTS The search strategy identified 4561 publications. After screening, 2203 publications related to perinatal anxiety were used for the visualization analysis. For the bibliometric data, 1534 publications had perinatal anxiety as a primary focus. There were 7910 different authors, over half named only once (55.5 %), from 63 countries. 495 journals were identified, with over half (56.0 %) publishing only one article. Most articles were published between 2011 and 2020 (75.9 %). In terms of perinatal timing, over half (54.2 %) published on antenatal anxiety. Only 6.0 % of studies reported on perinatal anxiety in fathers and 56.5 % also reported on perinatal depression. LIMITATIONS Web of Science was solely used, and manual screening of each publication was required. CONCLUSION This bibliometric analysis found: (1) perinatal anxiety is a growing field of research, with publications increasing over time; (2) there is variation in authors and journals; (3) over half of the publications focus on antenatal anxiety; (4) paternal anxiety is understudied; and (5) only 6 % of publications came from low and lower-middle income countries. Gaps related to maternal postnatal anxiety and paternal perinatal anxiety exist.
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Affiliation(s)
- Justine Dol
- IWK Health, Halifax, Nova Scotia, Canada; Dalhousie University, Nova Scotia, Canada.
| | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Nova Scotia, Canada
| | | | | | - Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada; Lunenfeld-Tannenbaum Research Institute, Sinai Health, Ontario, Canada
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Goyal D, Dol J, Huynh J, Anand S, Dennis CL. Postpartum Mental Health and Perceptions of Discrimination Among Asian Fathers During the COVID-19 Pandemic. MCN Am J Matern Child Nurs 2024; 49:88-94. [PMID: 38108414 DOI: 10.1097/nmc.0000000000000984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
PURPOSE The purpose of this study was twofold: (1) to examine the prevalence of postpartum depression and anxiety symptomatology among fathers of Asian descent living in North America during the COVID-19 pandemic, and (2) to identify the occurrences of online racial discrimination. STUDY DESIGN AND METHODS Using a cross-sectional design and convenience sampling methods, we recruited fathers online via social media sites (Facebook, Instagram) between March 12 and July 31, 2022. The Edinburgh Postnatal Depression Scale, General Anxiety Scale, and the Online Victimization Scale assessed mental health well-being and discrimination outcomes. Data were analyzed using descriptive statistics, two sample t-test, chi-square test of independence, and Pearson's correlation analysis. RESULTS Our sample included 61 fathers within 6 months postpartum living in the United States and Canada. Participants were on average 34 years old, married, and represented 17 Asian ethnic groups, including Asian Indian (41%), Filipino (11.3%), and Korean (8.1%). One-third of our participants (31.1%, n = 19) were at high risk of developing postpartum depression and scores of three (4.9%) fathers indicated they had clinically significant anxiety. Overall, 26.3% reported experiencing direct online racial discrimination and 65% reported occurrences of indirect online racial discrimination. CLINICAL IMPLICATIONS There was a high rate of depressive symptoms and occurrences of online racial discrimination among fathers of Asian descent living in North America. These rates are higher than the general perinatal population and further research is warranted to examine risk factors and preventive strategies among this unique paternal ethnic group.
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Dol J, Dennis CL, Campbell-Yeo M, Leahy-Warren P. Bibliometric analysis of published articles on perinatal depression from 1920 to 2020. Birth 2024; 51:28-38. [PMID: 37795646 DOI: 10.1111/birt.12779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/01/2023] [Accepted: 09/12/2023] [Indexed: 10/06/2023]
Abstract
AIM To analyze the characteristics and trends in published research on perinatal depression between 1920 and 2020. METHODS A search strategy in Web of Science identified all published literature on perinatal depression between January 1, 1920, and December 31, 2020. Output from Web of Science was used to analyze bibliometric information, and VOSViewer was used to visualize the networks of linkages between identified publications. RESULTS There were 16,961 publications identified. Among these publications, there were 82,726 unique authors and 140 countries represented. The United States had the highest frequency of publications (44.6%). Most publications (69.8%) occurred between 2011 and 2020, with the first publication identified in 1928. There were 2197 unique journals identified, with over half publishing only one (n = 948, 43.2%) or two relevant publications (n = 314, 14.3%). Authors with the largest number of publications were Wisner (n = 115), Dennis (n = 95), and Murray (n = 92), while authors with the largest number of citations were Cox (n = 7225), Murray (n = 2755), and O'Hara (n = 2069). LIMITATIONS While the Web of Science is a representative database identifying the greatest number of relevant articles, it may be unrepresentative of all published literature. CONCLUSION This is the first study mapping publications on perinatal depression between 1920 and 2020. The rate of publication on perinatal depression has been steadily increasing in recent years with a wide variety of authors, countries, and journals represented. As the field continues to grow, trends may shift as early career researchers emerge and the importance of mental health in low-income countries is prioritized.
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Affiliation(s)
- Justine Dol
- Li Ka Shing Knowledge Institute, St. Michael's Hospital; IWK Health, Halifax, Nova Scotia, Canada
| | - Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; Women's Health Research Chair, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
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Dennis CL, McQueen K, Dol J, Brown H, Beck C, Shorey S. Psychometrics of the breastfeeding self-efficacy scale and short form: a systematic review. BMC Public Health 2024; 24:637. [PMID: 38419045 PMCID: PMC10903029 DOI: 10.1186/s12889-024-17805-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/18/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The Breastfeeding Self-Efficacy Scale and its short-form were developed in Canada and have been used internationally among numerous maternal populations. However, the psychometric properties of the scales have not been reviewed to confirm their appropriateness in measuring breastfeeding self-efficacy in culturally diverse populations. The purpose of this research was to critically appraise and synthesize the psychometric properties of the scales via systematic review. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Three databases (EMBASE, MEDLINE, and PsycINFO) were searched from 1999 (original publication of the Scale) until April 27, 2022. The search was updated on April 1, 2023. Studies that assessed the psychometric properties of the BSES or BSES-SF were included. Two researchers independently extracted data and completed the quality appraisals. RESULTS Forty-one studies evaluated the psychometrics of the BSES (n = 5 studies) or BSES-SF (n = 36 studies) among demographically or culturally diverse populations. All versions of the instrument demonstrated good reliability, with Cronbach's alphas ranging from .72 to .97. Construct validity was supported by statistically significant differences in mean scores among women with and without previous breastfeeding experience and by correlations between the scales and theoretically related constructs. Predictive validity was demonstrated by statistically significant lower scores among women who ultimately discontinued breastfeeding compared to those who did not. CONCLUSION The BSES and BSES-SF appear to be valid and reliable measures of breastfeeding self-efficacy that may be used globally to (1) assess women who may be at risk of negative breastfeeding outcomes (e.g., initiation, duration and exclusivity), (2) individualize breastfeeding support, and (3) evaluate the effectiveness of breastfeeding interventions.
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Affiliation(s)
- Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada.
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Lavergne J, Langman E, Mansell D, Dol J, West C, Benoit B. Procedural pain assessment in neonates at risk of neonatal opioid withdrawal syndrome: a scoping review protocol. JBI Evid Synth 2023; 21:2107-2114. [PMID: 37232693 PMCID: PMC10566591 DOI: 10.11124/jbies-22-00414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE The objective of this review is to identify evidence on pain assessment during acute procedures in hospitalized neonates at risk of neonatal opioid withdrawal syndrome (NOWS). INTRODUCTION While all neonates are routinely exposed to various painful procedures, neonates at risk of NOWS have longer hospital stays and are exposed to multiple painful procedures. NOWS occurs when a neonate is born to a birth parent who identifies as having sustained opioid use (such as morphine or methadone) during pregnancy. Accurate pain assessment and management during painful procedures is critical for minimizing the well-documented adverse effects of unmanaged pain in neonates. While pain indicators and composite pain scores are valid and reliable for healthy neonates, there is no review of evidence regarding procedural pain assessment in neonates at risk of NOWS. INCLUSION CRITERIA Eligible studies will include those reporting on hospitalized pre-term and full-term neonates at risk of NOWS having pain assessments (ie, behavioral indicators, physiological indicators, validated composite pain scores) during and/or after exposure to an acute painful procedure. METHODS This review will follow the JBI scoping review methodology. Databases to be searched will include MEDLINE (Ovid), CINAHL (EBSCO), Embase, PsyclNFO (EBSCO), and Scopus. The relevant data will be extracted by 2 reviewers using a modified JBI extraction tool. The results will be summarized in narrative and tabular format, including the components of participants, concept, and context (PCC). REVIEW REGISTRATION Open Science Framework https://osf.io/fka8s .
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Affiliation(s)
- Julianna Lavergne
- Rankin School of Nursing, Faculty of Science, St. Francis Xavier University, Antigonish, NS, Canada
| | - Erin Langman
- Aligning Health Needs and Evidence for Transformative Change (AHNET-C): A JBI Centre of Excellence, Halifax, NS, Canada
| | - Deborah Mansell
- Rankin School of Nursing, Faculty of Science, St. Francis Xavier University, Antigonish, NS, Canada
| | | | - Claire West
- Rankin School of Nursing, Faculty of Science, St. Francis Xavier University, Antigonish, NS, Canada
| | - Britney Benoit
- Rankin School of Nursing, Faculty of Science, St. Francis Xavier University, Antigonish, NS, Canada
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MacNeil M, Campbell-Yeo M, McCulloch H, Hughes B, Dol J, Marriott N, Smith V, Alcock L. Parental Perspectives on Impact of Parental Presence Restrictions in the Neonatal Intensive Care Unit During the COVID-19 pandemic: A Cross-Sectional Study. J Perinat Neonatal Nurs 2023; 37:E17-E23. [PMID: 37773590 DOI: 10.1097/jpn.0000000000000714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
PURPOSE To describe parental experiences in the neonatal intensive care unit (NICU) during the COVID-19 restrictions. We explore what parents found most challenging, the impact these restrictions had on them and their infant, and how they coped. METHODS A cross-sectional online survey was completed by parents of infants who required care in a Canadian NICU during the early period of the COVID-19 pandemic. Data from 3 questions were coded using thematic analysis. RESULTS Participants ( n = 161) were primarily mothers (93%), with an average length of stay of 32.1 days. Three themes were identified from responses: (1) emotional and physical closeness of the parents to their infant; (2) physical and psychosocial well-being of the infant and parent; and (3) how parents coped, and strategies for moving forward. Parents reported that parental restriction policies adversely impacted their perceived physical and emotional closeness with their infant and their infant's physical and psychosocial well-being. Parents reported that being able to be present with their infant, having their partner able to be present with them, and effective communication helped them cope. CONCLUSION Despite the need for some restrictive policies to control the spread of the virus, the benefits and risks to the overall well-being of the parents and infants must be weighed.
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Affiliation(s)
- Morgan MacNeil
- School of Nursing, Faculty of Health (Mss MacNeil and Hughes and Dr Campbell-Yeo), and Departments of Pediatrics, Psychology and Neuroscience (Dr Campbell-Yeo), Dalhousie University, Halifax, Nova Scotia, Canada; IWK Health, Halifax, Nova Scotia, Canada (Mss MacNeil, McCulloch, Hughes, Marriott, Smith, and Alcock and Drs Campbell-Yeo and Dol); Department of Nursing, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada (Ms Hughes); and Mothering Transitions Research Lab, St Michael's Hospital, Toronto, Ontario, Canada (Dr Dol)
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Dennis CL, Marini F, Prioreschi A, Dol J, Birken C, Bell RC. The Canadian Healthy Life Trajectories Initiative (HeLTI) Trial: a study protocol for monitoring fidelity of a preconception-lifestyle behaviour intervention. Trials 2023; 24:262. [PMID: 37024918 PMCID: PMC10079485 DOI: 10.1186/s13063-023-07271-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/23/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND In evaluating technology-based behaviour change interventions, it is increasingly important to have a monitoring plan for intervention fidelity. It is important to maintain intervention fidelity to ensure that the theory-based intervention that is being tested is what causes the observed changes, particularly for eHealth behaviour change interventions. In this protocol, we outline the intervention fidelity and monitoring protocol for Healthy Life Trajectory Initiative (HeLTI) Canada, a randomized controlled trial evaluating the effect of a preconception-early childhood technology-based intervention delivered by public health nurses among pregnancy-planning women and their partners to optimize child growth and development. METHODS The HeLTI Canada fidelity protocol is based on the National Institutes of Health Behaviour Change Consortium (NIH BCC) Treatment Fidelity Framework, outlining the following components of intervention fidelity: study design, provider training, intervention delivery, intervention receipt, and intervention enactment. The intervention fidelity components and associated monitoring strategies were developed to align with the HeLTI Canada approach. Strategies for intervention fidelity monitoring include a pre-post written evaluation of training, standardization of provider training, use and monitoring of activity logs, and intervention session checklists. Possible challenges to intervention fidelity include provider turnover due to the length of the trial and lack of ability to directly monitor participant behaviour change in real-life settings. Details about intervention fidelity monitoring are provided in detail. The study launched in January 2021 and is currently recruiting. DISCUSSION Using the NIH BCC Treatment Fidelity Framework, HeLTI Canada has a robust framework for monitoring and reporting intervention fidelity to improve intervention validity, ability to assess intervention effectiveness, and transparency. TRIAL REGISTRATION ISRCN ISRCTN13308752 . Registered on February 29, 2019.
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Affiliation(s)
- Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada.
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
- Department of Psychiatry, University of Toronto, Toronto, Canada.
| | - Flavia Marini
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Alessandra Prioreschi
- SAMRC Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Justine Dol
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Catherine Birken
- Faculty of Medicine, University of Toronto, Toronto, Canada
- Hospital for Sick Children, Toronto, Canada
| | - Rhonda C Bell
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Canada
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Hughes Née Richardson B, Benoit B, Rutledge K, Dol J, Martin-Misener R, Latimer M, Smit M, McGrath P, Campbell-Yeo M. Impact of parent-targeted eHealth educational interventions on infant procedural pain management: a systematic review. JBI Evid Synth 2023; 21:669-712. [PMID: 36591975 DOI: 10.11124/jbies-21-00435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The objective of this review was to determine whether electronic health (eHealth) educational interventions about infant procedural pain and pain management impact parental outcomes (eg, mental health, knowledge uptake), eHealth outcomes (eg, acceptance, use), and pain management outcomes (eg, parental involvement, infant pain response). INTRODUCTION Pain in infants is a common concern for parents. Routine postpartum care for infants in early life requires them to endure painful procedures, such as immunizations, yet infants often receive little to no pain management. Parents are an essential component of effective pain management, although they may not be aware of the roles they play. Despite the increased number of eHealth resources available to educate parents about infant pain management, their impact has yet to be synthesized. INCLUSION CRITERIA This review considered studies that evaluated eHealth educational interventions targeted at parents during pregnancy and up to 1 year postpartum. Interventions included, but were not limited to, mobile applications, web-based applications, websites, videos, interactive training, hands-on direct simulation, short message service (SMS), and desktop applications. Primary outcomes included parental outcomes (eg, stress or anxiety, self-efficacy, knowledge, attitudes), eHealth outcomes (eg, acceptance, use), and pain management outcomes (eg, parental involvement, infant pain response). Experimental, quasi-experimental, and observational study designs were included. METHODS MEDLINE, CINAHL, PsycINFO, Embase, Scopus, Web of Science, and SciELO were searched for studies published in English up to June 14, 2021. Citation lists of relevant reviews and included studies were also searched for additional peer-reviewed articles. Two independent reviewers conducted critical appraisal using standardized tools from JBI, and data extraction, using a data extraction form designed by the authors. Statistical pooling of quantitative data was not possible due to heterogeneity; thus, the findings were reported narratively. RESULTS A total of 4163 unique studies were screened, with 11 studies ultimately included for synthesis. Five articles were randomized controlled trials, 5 articles were analytical cross-sectional studies, and 1 article was quasi-experimental. Studies reported on 4 unique eHealth educational interventions, all of which used video format and primarily targeted the postnatal period. The findings for all primary outcomes were mixed but suggested either improvements in outcomes or no impact. The certainty of evidence was determined as low or very low across primary outcomes for reasons related to imprecision, risk of bias, and indirectness. CONCLUSIONS Although heterogeneity of findings limited quantitative synthesis of data, this review suggests that short and engaging educational videos have the potential to positively impact parents' knowledge, confidence, and desire to be involved in procedural pain management for their children. Most of the interventions presented in this review describe evidence-based information about procedural pain management strategies that are known to be effective for infant populations. Thus, it is reasonable to assume that infant pain response should be lower when parents appropriately apply the strategies. However, the findings of this review were not able to confirm this assumption. More research is needed to evaluate the impact of parent-targeted pain management education on infant pain response. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020151569.
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Affiliation(s)
- Brianna Hughes Née Richardson
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- Centre for Transformative Nursing and Health Research, Halifax, NS, Canada
| | - Britney Benoit
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- Centre for Transformative Nursing and Health Research, Halifax, NS, Canada
- Elizabeth and Thomas Rankin School of Nursing, St. Francis Xavier University, NS, Antigonish, Canada
| | - Kallen Rutledge
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
| | - Justine Dol
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- The Mothering Transitions Research Lab, St. Michael's Hospital, Toronto, ON, Canada
| | - Ruth Martin-Misener
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- Centre for Transformative Nursing and Health Research, Halifax, NS, Canada
| | - Margot Latimer
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- Centre for Transformative Nursing and Health Research, Halifax, NS, Canada
| | - Michael Smit
- School of Information Management, Dalhousie University, Halifax, NS, Canada
| | - Patrick McGrath
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Marsha Campbell-Yeo
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- Centre for Transformative Nursing and Health Research, Halifax, NS, Canada
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, NS, Canada
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Dennis CL, Vigod S, Grigoriadis S, Brown H, Brennenstuhl S, Dol J, Wade M, Falah-Hassani K, Shiri R, Marini F. Cohort profile: Impact of Maternal and Paternal Mental Health - Assessing Concurrent Depression, Anxiety and Comorbidity in the Canadian Family (IMPACT study). BMJ Open 2023; 13:e071691. [PMID: 36889829 PMCID: PMC10008457 DOI: 10.1136/bmjopen-2023-071691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
PURPOSE This paper describes a prospective cohort, Impact of Maternal and Paternal Mental Health: Assessing Concurrent Depression, Anxiety and Comorbidity in The Canadian Family (IMPACT) study, which followed maternal-paternal dyads and their children across the first 2 years post partum. PARTICIPANTS A total of 3217 cohabitating maternal-paternal dyads were recruited into the study from 2014 to 2018. Each dyad member separately completed online questionnaires at baseline (<3 weeks post partum) and again at 3, 6, 9, 12, 18 and 24 months on a variety of measures, including mental health, parenting environment, family functioning and child health and development. FINDINGS TO DATE At baseline, the mean maternal age was 31.9±4.2 years and 33.8±5.0 years for fathers. Overall, 12.8% of families had a household income below the poverty line of $C50 000, and 1 in 5 mothers and 1 in 4 fathers were not born in Canada. One in 10 women experienced depressive symptoms during pregnancy (9.7%) and 1 in 6 had markedly anxious symptoms (15.4%) while 1 in 20 men reported feeling depression during their partner's pregnancy and 1 in 10 had marked anxiety (10.1%). Approximately 91% of mothers and 82% of fathers completed the 12-month questionnaire as did 88% of mothers and 78% of fathers at 24 months postpartum. FUTURE PLANS The IMPACT study will examine the influence of parental mental illness in the first 2 years of a child's life with a focus on understanding the mechanisms by which single (maternal or paternal) versus dual (maternal and paternal) parental depression, anxiety and comorbidity symptoms affect family and infant outcomes. Future analyses planned to address the research objectives of IMPACT will consider the longitudinal design and dyadic interparental relationship.
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Affiliation(s)
- Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Ontario, Canada
| | - Simone Vigod
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Women's College Hospital, Toronto, Ontario, Canada
| | - Sophie Grigoriadis
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Women's Mood and Anxiety Clinic: Reproductive Transitions, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Hillary Brown
- Health & Society, University of Toronto at Scarborough, Toronto, Ontario, Canada
| | - Sarah Brennenstuhl
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Justine Dol
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - Mark Wade
- Applied Psychology & Human Development, University of Toronto, Toronto, Ontario, Canada
| | - Kobra Falah-Hassani
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Rahman Shiri
- Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Flavia Marini
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
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Goyal D, Dol J, Leckey M, Naraine S, Dennis CL, Chan EK, Basu G. Scoping Review of Racial and Ethnic Representation of Participants in Mental Health Research Conducted in the Perinatal Period During the COVID-19 Pandemic. J Obstet Gynecol Neonatal Nurs 2023; 52:117-127. [PMID: 36462529 PMCID: PMC9710717 DOI: 10.1016/j.jogn.2022.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/09/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To identify the racial and ethnic representation of participants in mental health research conducted in the perinatal period during the COVID-19 pandemic. DATA SOURCES MEDLINE, CINAHL, Cochrane Library, PsycINFO, Scopus, Web of Science. STUDY SELECTION We included peer-reviewed research articles in which researchers reported mental health outcomes of women during the perinatal period who were living in the United States or Canada during the COVID-19 pandemic. We included 25 articles in the final review. DATA EXTRACTION We extracted the citation, publication date, design, aim, country of origin, participant characteristics, sampling method, method of measurement of race and ethnicity, and mental health outcome(s). DATA SYNTHESIS The combined racial and ethnic representation of the 16,841 participants in the included studies was White (76.5%), Black (9.8%), other/multiracial (6.2%), Asian (3.9%), Hispanic/Latina (2.6%), Indigenous or Ethnic Minority Canadian (0.9%), and Native American or Alaska Native (0.1%). Most studies were conducted in the United States, used a cross-sectional design, and incorporated social media platforms to recruit participants. Depression, anxiety, and stress were the most frequently assessed mental health outcomes. CONCLUSION Relatively few women of color who were pregnant or in the postpartum period during the pandemic participated in mental health research studies. Future studies should develop intentional recruitment strategies to increase participation of women of color. Researchers should use updated guidance on reporting race and ethnicity to accurately represent every participant, minimize misclassification of women of color, and report meaningful results.
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Campbell-Yeo M, McCulloch H, Hughes B, Hundert A, Dol J, Smit M, Afifi J, Bacchini F, Bishop T, Dorling J, Earle R, Elliott Rose A, Inglis D, Leighton C, MacRae G, Melanson A, Simpson DC, Whitehead L. Parental perspectives on technology use to enhance communication and closeness during the COVID-19 parental presence restrictions. J Neonatal Nurs 2023; 29:169-173. [PMID: 35578634 PMCID: PMC9095434 DOI: 10.1016/j.jnn.2022.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/22/2022] [Accepted: 05/03/2022] [Indexed: 01/07/2023]
Abstract
Objective To explore parental perspectives on the use of technology in neonatal intensive care units (NICU), and its impact during COVID-19 parental presence restrictions. Methods Co-designed online survey targeting parents of infants admitted to a Canadian NICU from March 1st, 2020 until March 5th, 2021. Results Parents (n = 117) completed the survey from 38 NICUs. Large variation in policies regarding parental permission to use technology across sites was reported. Restrictive use of technology was reported as a source of parental stress. While families felt that technology helped them feel close to their infant when they could not be in the NICU, it did not replace being in-person. Conclusion Large variation in policies were reported. Despite concerns about devices in NICUs, evidence on how to mitigate these concerns exists. Benefits of using technology to enhance parental experiences appear substantial. Future study is needed to inform recommendations on technology use in the NICU.
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Affiliation(s)
- Marsha Campbell-Yeo
- School of Nursing, Dalhousie University, Halifax, NS, Canada,Departments of Pediatrics, Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada,IWK Health, Halifax, NS, Canada,Corresponding author.IWK Health, MOM-LINC Lab, 5850/5980 University Ave., Halifax, NS B3K 6R8, Canada
| | | | - Brianna Hughes
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | | | | | - Michael Smit
- School of Information Management, Dalhousie University, Halifax, NS, Canada
| | - Jehier Afifi
- Departments of Pediatrics, Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada,IWK Health, Halifax, NS, Canada
| | | | | | - Jon Dorling
- Department of Neonatal Medicine, Princess Anne Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, England, United Kingdom
| | | | | | | | | | | | | | - David C. Simpson
- Departments of Pediatrics, Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada,IWK Health, Halifax, NS, Canada
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12
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Campbell-Yeo M, Dol J, McCulloch H, Hughes B, Hundert A, Bacchini F, Whitehead L, Afifi J, Alcock L, Bishop T, Dorling J, Earle R, Elliott Rose A, Inglis D, Leighton C, MacRae G, Melanson A, Simpson CD, Smit M. The Impact of Parental Presence Restrictions on Canadian Parents in the NICU During COVID-19: A National Survey. J Fam Nurs 2023; 29:18-27. [PMID: 35915967 PMCID: PMC9850074 DOI: 10.1177/10748407221114326] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The purpose of this research was to explore parental perspectives on the impact of parent restrictions imposed in response to the COVID-19 pandemic across Canadian Neonatal Intensive Care Units (NICUs). A co-designed online survey was conducted targeting parents (n = 235) of infants admitted to a Canadian NICU from March 1, 2020, until March 5, 2021. Parents completed the survey from 38 Canadian NICUs. Large variation in the severity of policies regarding parental presence was reported. Most respondents (68.9%) were classified as experiencing high restrictions, with one or no support people allowed in the NICU, and felt that policies were less easy to understand, felt less valued and respected, and found it more challenging to access medicine or health care. Parents reported gaps in care related to self-care, accessibility, and mental health outcomes. There is significant variation in parental restrictions implemented across Canadian NICUs. National guidelines are needed to support consistent and equitable care practices.
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Affiliation(s)
| | | | | | | | | | | | | | - Jehier Afifi
- Dalhousie University, Halifax, NS,
Canada
- IWK Health, Halifax, NS, Canada
| | | | | | - Jon Dorling
- University Hospital Southampton NHS
Foundation Trust, Southampton, UK
| | | | | | | | | | | | | | - C. David Simpson
- Dalhousie University, Halifax, NS,
Canada
- IWK Health, Halifax, NS, Canada
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13
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Dol J, Hughes B, Aston M, McMillan D, Tomblin Murphy G, Campbell-Yeo M. Impact of COVID-19 restrictions on the postpartum experience of women living in Eastern Canada during the early pandemic period: A cross-sectional study. J Nurs Scholarsh 2023; 55:178-186. [PMID: 36380451 DOI: 10.1111/jnu.12843] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To (1) compare changes in parenting self-efficacy, social support, postpartum anxiety, and postpartum depression in Canadian women before and during the early COVID-19 pandemic; (2) explore how women with a newborn felt during the pandemic; (3) explore ways that women coped with challenges faced. METHODS A cross-sectional design was used. Prior to the pandemic, an online survey was conducted with women who an infant 6 months old or less in one of the three Eastern Canadian Maritime provinces. A similar survey was conducted during the pandemic in mid-2020. RESULTS Pre-COVID, 561 women completed the survey, and 331 women during the pandemic. There were no significant differences in parenting self-efficacy, social support, postpartum anxiety, and depression between the cohorts. Difficulties that women reported because of COVID-19 restrictions included lack of support from family and friends, fear of COVID-19 exposure, feeling isolated and uncertain, negative impact on perinatal care experience, and hospital restrictions. Having support from partners and families, in-person/virtual support, as well as engaging in self-care and the low prevalence of COVID-19 during the summer of 2020 helped women cope. CLINICAL RELEVANCE Women identified challenges and negative impacts due to the COVID-19 pandemic, although no differences in psychosocial outcomes were found. Consideration of public health policy during the postpartum period for the ongoing COVID-19 pandemic is needed. CONCLUSION While there were no significant differences in psychosocial outcomes, there were still challenges and negative impacts that women identified.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, Nova Scotia, Halifax, Canada
| | - Brianna Hughes
- School of Nursing, Faculty of Health, Dalhousie University, Nova Scotia, Halifax, Canada
| | - Megan Aston
- School of Nursing, Faculty of Health, Dalhousie University, Nova Scotia, Halifax, Canada
| | - Douglas McMillan
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Nova Scotia, Halifax, Canada
| | | | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Nova Scotia, Halifax, Canada.,Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Nova Scotia, Halifax, Canada
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14
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Dol J, Hughes B, Bonet M, Dorey R, Dorling J, Grant A, Langlois EV, Monaghan J, Ollivier R, Parker R, Roos N, Scott H, Shin HD, Curran J. Timing of neonatal mortality and severe morbidity during the postnatal period: a systematic review. JBI Evid Synth 2022; 21:98-199. [PMID: 36300916 PMCID: PMC9794155 DOI: 10.11124/jbies-21-00479] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The objective of this review was to determine the timing of overall and cause-specific neonatal mortality and severe morbidity during the postnatal period (1-28 days). INTRODUCTION Despite significant focus on improving neonatal outcomes, many newborns continue to die or experience adverse health outcomes. While evidence on neonatal mortality and severe morbidity rates and causes are regularly updated, less is known on the specific timing of when they occur in the neonatal period. INCLUSION CRITERIA This review considered studies that reported on neonatal mortality daily in the first week; weekly in the first month; or day 1, days 2-7, and days 8-28. It also considered studies that reported on timing of severe neonatal morbidity. Studies that reported solely on preterm or high-risk infants were excluded, as these infants require specialized care. Due to the available evidence, mixed samples were included (eg, both preterm and full-term infants), reflecting a neonatal population that may include both low-risk and high-risk infants. METHODS MEDLINE, Embase, Web of Science, and CINAHL were searched for published studies on December 20, 2019, and updated on May 10, 2021. Critical appraisal was undertaken by 2 independent reviewers using standardized critical appraisal instruments from JBI. Quantitative data were extracted from included studies independently by 2 reviewers using a study-specific data extraction form. All conflicts were resolved through consensus or discussion with a third reviewer. Where possible, quantitative data were pooled in statistical meta-analysis. Where statistical pooling was not possible, findings were reported narratively. RESULTS A total of 51 studies from 36 articles reported on relevant outcomes. Of the 48 studies that reported on timing of mortality, there were 6,760,731 live births and 47,551 neonatal deaths with timing known. Of the 34 studies that reported daily deaths in the first week, the highest proportion of deaths occurred on the first day (first 24 hours, 38.8%), followed by day 2 (24-48 hours, 12.3%). Considering weekly mortality within the first month (n = 16 studies), the first week had the highest mortality (71.7%). Based on data from 46 studies, the highest proportion of deaths occurred on day 1 (39.5%), followed closely by days 2-7 (36.8%), with the remainder occurring between days 8 and 28 (23.0%). In terms of causes, birth asphyxia accounted for the highest proportion of deaths on day 1 (68.1%), severe infection between days 2 and 7 (48.1%), and diarrhea between days 8 and 28 (62.7%). Due to heterogeneity, neonatal morbidity data were described narratively. The mean critical appraisal score of all studies was 84% (SD = 16%). CONCLUSION Newborns experience high mortality throughout the entire postnatal period, with the highest mortality rate in the first week, particularly on the first day. Ensuring regular high-quality postnatal visits, particularly within the first week after birth, is paramount to reduce neonatal mortality and severe morbidity.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, Halifax, NS, Canada,Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
| | - Brianna Hughes
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada,School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Mercedes Bonet
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Rachel Dorey
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Jon Dorling
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, NS, Canada
| | - Amy Grant
- Maritime SPOR Support Unit, Halifax, NS, Canada
| | - Etienne V. Langlois
- Partnership for Maternal, Newborn and Child Health, World Health Organization, Geneva, Switzerland
| | - Joelle Monaghan
- Centre for Research in Family Health, IWK Health Centre, Halifax, NS, Canada
| | - Rachel Ollivier
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Robin Parker
- W.K. Kellogg Health Sciences Library, Dalhousie Libraries, Dalhousie University, Halifax, NS, Canada
| | - Nathalie Roos
- Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Heather Scott
- Department of Obstetrics and Gynecology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Hwayeon Danielle Shin
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada,School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Janet Curran
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada,School of Nursing, Dalhousie University, Halifax, NS, Canada
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15
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Dol J, Roos N, Bonet M. Timing and causes of postpartum maternal mortality: a call for more consistent reporting. JBI Evid Synth 2022; 20:2117-2118. [DOI: 10.11124/jbies-22-00303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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16
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Ke JXC, Vidler M, Dol J, Carvalho B, Blake LEA, George RB, Bone J, Seligman KM, Coombs M, Chau A, Saville L, Gibbs RS, Sultan P. Incidence, prevalence, and timing of postpartum complications and mortality in Canada and the United States: a systematic review and meta-analysis protocol. JBI Evid Synth 2022; 20:2344-2353. [DOI: 10.11124/jbies-21-00437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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17
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Dol J, Aston M, Grant A, McMillan D, Tomblin Murphy G, Campbell-Yeo M. Implementing Essential Coaching for Every Mother during the COVID-19 pandemic: A pre-post intervention study. Birth 2022; 49:273-280. [PMID: 34862659 DOI: 10.1111/birt.12603] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The primary objective of this project was to evaluate the preliminary impact of Essential Coaching for Every Mother on maternal self-efficacy, social support, postpartum anxiety, and postpartum depression. The secondary objective was to explore the acceptability of the Essential Coaching for Every Mother program provided during the COVID-19 pandemic. METHODS A prospective pre-post study was conducted with first-time mothers in Nova Scotia, Canada, between July 15 and September 19, 2020. Participants completed a self-report survey at enrollment (after birth) and 6 weeks postpartum. Various standardized measures were used, and qualitative feedback on the program was also collected. Paired t tests were carried out to determine changes from baseline to follow-up on psychosocial outcomes, and qualitative feedback was analyzed through thematic analysis. RESULTS A total of 88 women enrolled. Maternal self-efficacy increased between baseline (B) and follow-up (F) (B: 33.33; F: 37.11, P = 0.000), whereas anxiety (STAI) declined (B: 38.49; F: 34.79, P = 0.004). In terms of acceptability, 89% of participants felt that the number of messages was just right, 84.5% felt the messages contained all the information they needed relative to caring for a newborn, and 98.8% indicated they would recommend this program to other new mothers. CONCLUSIONS Essential Coaching for Every Mother may play a role in increasing maternal self-efficacy and decreasing anxiety, although future work with a control group is needed to delineate the true effects of the program. Overall, mothers were satisfied with the Essential Coaching for Every Mother program and would recommend it for other mothers, during the COVID-19 pandemic and beyond.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Megan Aston
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Amy Grant
- Maritime SPOR Support Unit, Halifax, Nova Scotia, Canada
| | - Douglas McMillan
- Department of Paediatrics, IWK Health Centre & Dalhousie University, Halifax, Nova Scotia, Canada
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18
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Dol J, Boulos L, Somerville M, Saxinger L, Doroshenko A, Hastings S, Reynolds B, Gallant A, Shin HD, Wong H, Crowther D, Macdonald M, Martin-Misener R, McCulloch H, Tricco AC, Curran JA. Health system impacts of SARS-CoV − 2 variants of concern: a rapid review. BMC Health Serv Res 2022; 22:544. [PMID: 35461246 PMCID: PMC9034743 DOI: 10.1186/s12913-022-07847-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 03/21/2022] [Indexed: 01/06/2023] Open
Abstract
Background As of November 25th 2021, four SARS-CoV − 2 variants of concern (VOC: Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), and Delta (B.1.617.2)) have been detected. Variable degrees of increased transmissibility of the VOC have been documented, with potential implications for hospital and health system capacity and control measures. This rapid review aimed to provide a synthesis of evidence related to health system responses to the emergence of VOC worldwide. Methods Seven databases were searched up to September 27, 2021, for terms related to VOC. Titles, abstracts, and full-text documents were screened independently by two reviewers. Data were extracted independently by two reviewers using a standardized form. Studies were included if they reported on at least one of the VOC and health system outcomes. Results Of the 4877 articles retrieved, 59 studies were included, which used a wide range of designs and methods. Most of the studies reported on Alpha, and all except two reported on impacts for capacity planning related to hospitalization, intensive care admissions, and mortality. Most studies (73.4%) observed an increase in hospitalization, but findings on increased admission to intensive care units were mixed (50%). Most studies (63.4%) that reported mortality data found an increased risk of death due to VOC, although health system capacity may influence this. No studies reported on screening staff and visitors or cohorting patients based on VOC. Conclusion While the findings should be interpreted with caution as most of the sources identified were preprints, evidence is trending towards an increased risk of hospitalization and, potentially, mortality due to VOC compared to wild-type SARS-CoV − 2. There is little evidence on the need for, and the effect of, changes to health system arrangements in response to VOC transmission. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07847-0.
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19
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Dol J, Hughes B, Bonet M, Dorey R, Dorling J, Grant A, Langlois EV, Monaghan J, Ollivier R, Parker R, Roos N, Scott H, Shin HD, Curran J. Timing of maternal mortality and severe morbidity during the postpartum period. JBI Evid Synth 2022; 20:2119-2194. [PMID: 35916004 PMCID: PMC9594153 DOI: 10.11124/jbies-20-00578] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Objective: The objective of this review was to determine the timing of overall and cause-specific maternal mortality and severe morbidity during the postpartum period. Introduction: Many women continue to die or experience adverse health outcomes in the postpartum period; however, limited work has explored the timing of when women die or present complications during this period globally. Inclusion criteria: This review considered studies that reported on women after birth up to 6 weeks postpartum and included data on mortality and/or morbidity on the first day, days 2–7, and days 8–42. Studies that reported solely on high-risk women (eg, those with antenatal or intrapartum complications) were excluded, but mixed population samples were included (eg, low-risk and high-risk women). Methods: MEDLINE, Embase, Web of Science, and CINAHL were searched for published studies on December 20, 2019, and searches were updated on May 11, 2021. Critical appraisal was undertaken by 2 independent reviewers using standardized critical appraisal instruments from JBI. Quantitative data were extracted from included studies independently by at least 2 reviewers using a study-specific data extraction form. Quantitative data were pooled, where possible. Identified studies were used to obtain the summary estimate (proportion) for each time point. Maternal mortality was calculated as the maternal deaths during a given period over the total number of maternal deaths known during the postpartum period. For cause-specific analysis, number of deaths due to a specific cause was the numerator, while the total number of women who died due to the same cause in that period was the denominator. Random effects models were run to pool incidence proportion for relative risk of overall maternal deaths. Subgroup analysis was conducted according to country income classification and by date (ie, data collection before or after 2010). Where statistical pooling was not possible, the findings were reported narratively. Results: A total of 32 studies reported on maternal outcomes from 17 reports, all reporting on mixed populations. Most maternal deaths occurred on the first day (48.9%), with 24.5% of deaths occurring between days 2 and 7, and 24.9% occurring between days 8 and 42. Maternal mortality due to postpartum hemorrhage and embolism occurred predominantly on the first day (79.1% and 58.2%, respectively). Most deaths due to postpartum eclampsia and hypertensive disorders occurred within the first week (44.3% on day 1 and 37.1% on days 2–7). Most deaths due to infection occurred between days 8 and 42 (61.3%). Due to heterogeneity, maternal morbidity data are described narratively, with morbidity predominantly occurring within the first 2 weeks. The mean critical appraisal score across all included studies was 85.9% (standard deviation = 13.6%). Conclusion: Women experience mortality throughout the entire postpartum period, with the highest mortality rate on the first day. Access to high-quality care during the postpartum period, including enhanced frequency and quality of postpartum assessments during the first 42 days after birth, is essential to improving maternal outcomes and to continue reducing maternal mortality and morbidity worldwide. Systematic review registration number: PROSPERO CRD42020187341
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change (AH_NET-C): A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
| | - Brianna Hughes
- Aligning Health Needs and Evidence for Transformative Change (AH_NET-C): A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Mercedes Bonet
- UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Rachel Dorey
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Jon Dorling
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, NS, Canada
| | - Amy Grant
- Maritime SPOR Support Unit, Halifax, NS, Canada
| | - Etienne V. Langlois
- Partnership for Maternal, Newborn and Child Health, World Health Organization, Geneva, Switzerland
| | - Joelle Monaghan
- Centre for Research in Family Health, IWK Health Centre, Halifax, NS, Canada
| | - Rachel Ollivier
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Robin Parker
- W.K. Kellogg Health Sciences Library, Dalhousie Libraries, Dalhousie University, Halifax, NS, Canada
| | - Nathalie Roos
- Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Heather Scott
- Department of Obstetrics and Gynecology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Hwayeon Danielle Shin
- Aligning Health Needs and Evidence for Transformative Change (AH_NET-C): A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Janet Curran
- Aligning Health Needs and Evidence for Transformative Change (AH_NET-C): A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- School of Nursing, Dalhousie University, Halifax, NS, Canada
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20
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Dennis CL, Marini F, Dol J, Vigod SN, Grigoriadis S, Brown HK. Paternal prevalence and risk factors for comorbid depression and anxiety across the first 2 years postpartum: A nationwide Canadian cohort study. Depress Anxiety 2022; 39:233-245. [PMID: 34964202 DOI: 10.1002/da.23234] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/07/2021] [Accepted: 12/12/2021] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To determine the prevalence of comorbid depression and anxiety symptoms in fathers and investigate the predictors for comorbidity during the first- and second-year following birth. METHODS In a longitudinal Canadian study, couples were recruited within 3 weeks of childbirth. Fathers completed a survey after the birth of their child followed by questionnaires at 3, 6, 9, 12, 18, and 24 months postpartum on paternal depression and anxiety symptoms and potential risk factors. Sequential logistic regression was used for analysis. RESULTS Of the 3217 enrolled fathers, 2544 (79.08%) provided data for at least one time point during the first year postpartum and 2442 (75.29%) in the second year. Overall, 569 fathers (22.4%) had comorbid depression and anxiety symptoms at some point during the first year postpartum (2.2% at baseline to 8.9% at 6 months), and 323 fathers (13.2%) had comorbidity at some point during their second year postpartum (8.1% at 18 months and 8.6% at 24 months). Strongest risk factors associated with paternal comorbidity were poor or fair perceived health at 4 weeks postpartum, depression before pregnancy, anxiety in the current pregnancy, significant adverse childhood experiences, positive ADHD screen, and victim of intimate partner violence. CONCLUSION High rates of comorbidity among fathers in the first 2 years postpartum demonstrate the importance of perinatal mental health management at a family level. The identification of important modifiable comorbidity risk factors highlights areas for further research and the development of interventions to support paternal mental health to optimize child and family outcomes.
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Affiliation(s)
- Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Flavia Marini
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Justine Dol
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Simone N Vigod
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Sophie Grigoriadis
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Hilary K Brown
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Department of Health & Society, University of Toronto Scarborough, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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21
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Dennis CL, Carsley S, Brennenstuhl S, Brown HK, Marini F, Bell RC, Miller A, Ravindran S, D’Paiva V, Dol J, Birken CS. Screen use and internet addiction among parents of young children: A nationwide Canadian cross-sectional survey. PLoS One 2022; 17:e0257831. [PMID: 35100281 PMCID: PMC8803162 DOI: 10.1371/journal.pone.0257831] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 09/12/2021] [Indexed: 11/19/2022] Open
Abstract
Objectives
To establish the factorial structure and internal consistency of the Internet Addiction Test (IAT) in parents, the level and correlates of problematic internet use, and patterns and types of screen use.
Study design
Data were collected through an online questionnaire about preconception health among Canadian women and men with ≥1 child. The questionnaire included the IAT and questions about time spent on screens by device type, use of screens during meals and in the bedroom, and perceptions of overuse. Factor analysis was completed to determine the factorial structure of the IAT, with multivariable linear regression used to determine correlates of the IAT.
Results
The sample included 1,156 respondents (mean age: 34.3 years; 83.1% female). The IAT had two factors: “impairment in time management” and “impairment in socio-emotional functioning” of which respondents had more impairment in time management than socio-emotional functioning. Based on the original IAT, 19.4% of respondents would be classified as having a mild internet use problem with 3.0% having a moderate or severe issue. In the multivariable model, perceived stress (b = .28, SE = .05, p < .001) and depressive symptoms (b = .24, SE = .10, p = .017) were associated with higher IAT scores. Handheld mobile devices were the most common type of screen used (mean = 3 hours/day) followed by watching television (mean = 2 hours/day).
Conclusion
Parents spent a significant portion of their time each day using screens, particularly handheld mobile devices. The disruption caused by mobile devices may hinder opportunities for positive parent-child interactions, demonstrating the need for resources to support parents ever-growing use of technologies.
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Affiliation(s)
- Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- * E-mail:
| | - Sarah Carsley
- Public Health Ontario, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sarah Brennenstuhl
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Hilary K. Brown
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Interdisciplinary Centre for Health & Society, University of Toronto Scarborough, Toronto, Canada
| | - Flavia Marini
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
| | - Rhonda C. Bell
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Canada
| | | | | | | | - Justine Dol
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
| | - Catherine S. Birken
- Faculty of Medicine, University of Toronto, Toronto, Canada
- Hospital for Sick Children, Toronto, Canada
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Dol J, Aston M, McMillan D, Tomblin Murphy G, Campbell-Yeo M. Participants perceptions of Essential Coaching for Every Mother, a Canadian text-message postpartum program: Process evaluation of a randomized controlled trial (Preprint). JMIR Form Res 2022; 6:e36821. [PMID: 35559855 PMCID: PMC9143775 DOI: 10.2196/36821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/19/2022] [Accepted: 04/22/2022] [Indexed: 11/18/2022] Open
Abstract
Background “Essential Coaching for Every Mother” is a Canadian text message–based program that sends daily messages to mothers for 6 weeks after they give birth. There is a need to explore the program’s effectiveness in terms of the participants’ experience to guide refinement and modification. Objective This study aimed to describe the process evaluation of the Essential Coaching for Every Mother randomized controlled trial through an evaluation of the research implementation extent and quality. Methods Participants were recruited from Nova Scotia, Canada, between January 5 and August 1, 2021. Enrolled participants were randomized into the intervention or control group. Participants randomized to the intervention group received standard care along with the Essential Coaching for Every Mother program’s text messages related to newborn and maternal care for the first 6 weeks after giving birth, while the control group received standard care. Usage data were collected from the SMS text message program used, and participants completed web-based questionnaires at 6 weeks after birth. Quantitative data and qualitative responses to open-ended questions were used to triangulate findings. Quantitative data were summarized using means, SDs, and percentages, as appropriate, while qualitative data were analyzed using thematic analysis. Results Of the 295 unique initial contacts, 150 mothers were eligible and completed the baseline survey to be enrolled in the study (intervention, n=78; control, n=72). Of those randomized into the intervention group, 75 (96%) completed the 6-week follow-up survey to provide feedback on the program. In total, 48 (62%) intervention participants received all messages as designed in the Essential Coaching for Every Mother program, with participants who enrolled late missing on average 4.7 (range 1-12) messages. Intervention participants reported an 89% satisfaction rate with the program, and 100% of participants would recommend the program to other new mothers. Participants liked how the program made them feel, the format, appropriate timing of messages, and content while disliking the frequency of messages and gaps in content. Participants also provided suggestions for future improvement. Conclusions Our process evaluation has provided a comprehensive understanding of interest in the program as well as identified preference for program components. The findings of this study will be used to update future iterations of the Essential Coaching for Every Mother program. Trial Registration ClincalTrials.gov NCT04730570; https://clinicaltrials.gov/ct2/show/NCT04730570
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
- St. Michael's Hospital, Toronto, ON, Canada
| | - Megan Aston
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Douglas McMillan
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
| | | | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
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Dol J, Aston M, Grant A, McMillan D, Tomblin Murphy G, Campbell-Yeo M. Effectiveness of the “Essential Coaching for Every Mother” postpartum text message program on maternal psychosocial outcomes: A randomized controlled trial. Digit Health 2022; 8:20552076221107886. [PMID: 35720618 PMCID: PMC9203955 DOI: 10.1177/20552076221107886] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/30/2022] [Indexed: 11/15/2022] Open
Abstract
Objective To determine the effectiveness of the Essential Coaching for Every Mother program on maternal self-efficacy, perceived social support, postpartum anxiety, and postpartum depression at six-weeks postpartum. Methods Participants from Nova Scotia were randomized, stratified by parity, to receive either the Essential Coaching for Every Mother postpartum text-message program or usual care, from birth to six-weeks postpartum. Participants completed surveys at enrollment (after birth) and at 6 weeks. Differences between groups were analyzed using analysis of covariance, considering parity and group allocation. Results Of the 171 participants recruited (53% primiparous), 150 completed the baseline survey (intervention n = 78, control n = 72). At baseline, newborns were on average 4.4 days old (SD: 3.9) and mothers 31.4 years old (SD: 4.5). Controlling for maternal age, primiparous women in the intervention group had a greater increase in maternal self-efficacy than primiparous women in the control group (mean difference [MD] = 4.84 (standard error [SE] = 0.75) vs. MD = 2.13 (SE = 0.81), p = 0.034). Women allocated to the intervention group had a greater reduction in postpartum anxiety symptoms than women in the control group for both multiparous and primiparous women (MD = −3.91 (SE = 1.82) vs. 2.81 (SE = 1.86), p = 0.011). There was no significant change in postpartum depression scores or perceived social support for either group. Discussion This study presents the results of the first Canadian postpartum text message program, which found improved psychosocial outcomes for postpartum women. Given the potential to reach numerous women at a low cost across geographical locations, the scalability of this intervention can improve maternal self-efficacy and reduce postpartum anxiety.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
- St Michael's Hospital, Toronto, ON, Canada
| | - Megan Aston
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Amy Grant
- Maritime SPOR Support Unit, Halifax, NS, Canada
| | - Douglas McMillan
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
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24
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McCulloch H, Campbell-Yeo M, Richardson B, Dol J, Hundert A, Dorling J, Whitehead L, MacRae G, Bishop T, Afifi J, Earle R, Rose AE, Foye S, Inglis D, Kim T, Leighton C, Melanson A, Simpson DC, Smit M. The Impact of Restrictive Family Presence Policies in Response to COVID-19 on Family Integrated Care in the NICU: A Qualitative Study. HERD 2021; 15:49-62. [PMID: 34931565 PMCID: PMC9072949 DOI: 10.1177/19375867211065178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objectives: To conduct a needs assessment with families and their healthcare team to understand the impact of restrictive family presence policies in the neonatal intensive care unit (NICU) in response to COVID-19. Background: In response to the COVID-19 pandemic, significant restrictive family presence policies were instituted in most NICUs globally intended to protect infants, families, and HCPs. However, knowledge on the impact of the stress of the pandemic and policies restricting family presence in the NICU on vulnerable neonates and their families remains limited. Methods: Individuals were eligible to participate if they were a caregiver of an infant requiring NICU care or a healthcare provider (HCP) in the NICU after March 1, 2020. Semi-structured interviews were conducted using a virtual communication platform, and transcripts were analyzed using inductive thematic qualitative content analysis. Results: Twenty-three participants were interviewed (12 families and 11 HCPs). Three themes emerged: (1) successes (family-integrated care, use of technology), (2) challenges (lack of standardized messaging and family engagement, impact on parental wellbeing, institutional barriers, and virtual care), and (3) moving forward (responsive and supportive leadership). Conclusions: Our findings highlight the significant impact of family restrictions on the mental well-being of families, physical closeness with parents, and empathetic stress to HCPs. Further study of potential long-term impact is warranted.
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Affiliation(s)
| | - Marsha Campbell-Yeo
- IWK Health, Halifax, Nova Scotia, Canada.,Faculty of Health, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Brianna Richardson
- Faculty of Health, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Justine Dol
- IWK Health, Halifax, Nova Scotia, Canada.,Faculty of Health, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | | | | | | | | | | | | | - Sarah Foye
- IWK Health, Halifax, Nova Scotia, Canada
| | | | | | | | | | | | - Mike Smit
- School of Information Management, Dalhousie University, Halifax, Nova Scotia, Canada
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25
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Somerville M, Curran JA, Dol J, Boulos L, Saxinger L, Doroshenko A, Hastings S, Reynolds B, Gallant AJ, Shin HD, Wong H, Crowther D, Macdonald M, Martin-Misener R, Comeau J, McCulloch H, Tricco AC. Public health implications of SARS-CoV-2 variants of concern: a rapid scoping review. BMJ Open 2021; 11:e055781. [PMID: 34857582 PMCID: PMC8640198 DOI: 10.1136/bmjopen-2021-055781] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/22/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES The four SARS-CoV-2 variants of concern (VOC; Alpha, Beta, Gamma and Delta) identified by May 2021 are highly transmissible, yet little is known about their impact on public health measures. We aimed to synthesise evidence related to public health measures and VOC. DESIGN A rapid scoping review. DATA SOURCES On 11 May 2021, seven databases (MEDLINE, Embase, the Cochrane Database of Systematic Reviews, Central Register of Controlled Trials, Epistemonikos' L-OVE on COVID-19, medRxiv, bioRxiv) were searched for terms related to VOC, public health measures, transmission and health systems. No limit was placed on date of publication. ELIGIBILITY CRITERIA Studies were included if they reported on any of the four VOCs and public health measures, and were available in English. Only studies reporting on data collected after October 2020, when the first VOC was reported, were included. DATA EXTRACTION AND SYNTHESIS Titles, abstracts and full-text articles were screened by two independent reviewers. Data extraction was completed by two independent reviewers using a standardised form. Data synthesis and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. RESULTS Of the 37 included studies, the majority assessed the impact of Alpha (n=32) and were conducted in Europe (n=12) or the UK (n=9). Most were modelling studies (n=28) and preprints (n=28). The majority of studies reported on infection control measures (n=17), followed by modifying approaches to vaccines (n=13), physical distancing (n=6) and either mask wearing, testing or hand washing (n=2). Findings suggest an accelerated vaccine rollout is needed to mitigate the spread of VOC. CONCLUSIONS The increased severity of VOC requires proactive public health measures to control their spread. Further research is needed to strengthen the evidence for continued implementation of public health measures in conjunction with vaccine rollout. With no studies reporting on Delta, there is a need for further research on this and other emerging VOC on public health measures.
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Affiliation(s)
- Mari Somerville
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pediatrics, IWK Health, Halifax, Nova Scotia, Canada
| | - Janet A Curran
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pediatrics, IWK Health, Halifax, Nova Scotia, Canada
| | - Justine Dol
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Leah Boulos
- Maritime SPOR SUPPORT Unit, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Lynora Saxinger
- Division of Infectious Diseases, Department of Medicine, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
| | - Alexander Doroshenko
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Stephanie Hastings
- Health Systems Evaluation and Evidence, Alberta Health Services, Calgary, Alberta, Canada
| | - Bearach Reynolds
- Department of Infectious Diseases, St Vincents Hospital, Dublin, Leinster, UK
- Evidence Synthesis Ireland, National University of Ireland, Galway, UK
| | - Allyson J Gallant
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Helen Wong
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Daniel Crowther
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Marilyn Macdonald
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Jeannette Comeau
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Division of Infectious Diseases, IWK Health, Halifax, Nova Scotia, Canada
| | - Holly McCulloch
- Department of Pediatrics, IWK Health, Halifax, Nova Scotia, Canada
| | - Andrea C Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Epidemiology Division and Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Queen's Collaboration for Health Care Quality Joanna Briggs Institute Centre of Excellence, School of Nursing, Queen's University, Kingston, Ontario, Canada
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26
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Campbell-Yeo M, Dol J, Richardson B, McCulloch H, Hundert A, Foye S, Dorling J, Afifi J, Bishop T, Earle R, Elliott Rose A, Inglis D, Kim T, Leighton C, MacRae G, Melanson A, Simpson DC, Smit M, Whitehead L. A co-design of clinical virtual care pathways to engage and support families requiring neonatal intensive care in response to the COVID-19 pandemic (COVES study). J Neonatal Nurs 2021; 27:463-470. [PMID: 34220279 PMCID: PMC8233852 DOI: 10.1016/j.jnn.2021.06.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/20/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND In response to the COVID-19 pandemic, family presence restrictions in neonatal intensive care units (NICU) were enacted to limit disease transmission. This has resulted in communication challenges, negatively impacting family integrated care. AIM To develop clinical care pathways to ensure optimal neonatal care to support families in response to parental presence restrictions imposed during the COVID-19 pandemic. METHODS An agile, co-design process utilizing expert consensus of a large interdisciplinary team and focus groups and semi-structured interviews with families and HCPs were used to co-design clinical virtual care pathways. RESULTS Three clinical virtual care pathways were co-designed: (1) building and maintaining relationships between family and healthcare providers; (2) awareness of resources; and (3) standardized COVID-19 messaging. Modifications were made to optimize uptake and utilization in the clinical areas. CONCLUSION Clinical care virtual pathways were successfully co-designed to meet these needs to ensure more equitable family centered care.
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Affiliation(s)
- Marsha Campbell-Yeo
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada,Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada,Department of Pediatrics, IWK Health & Dalhousie University, Halifax, Nova Scotia, Canada,Centre for Pediatric Pain Research, IWK Health, Halifax, Nova Scotia, Canada,IWK Health, Halifax, Nova Scotia, Canada,Corresponding author. School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Justine Dol
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada,Centre for Pediatric Pain Research, IWK Health, Halifax, Nova Scotia, Canada
| | - Brianna Richardson
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada,Centre for Pediatric Pain Research, IWK Health, Halifax, Nova Scotia, Canada
| | - Holly McCulloch
- Centre for Pediatric Pain Research, IWK Health, Halifax, Nova Scotia, Canada
| | - Amos Hundert
- Centre for Pediatric Pain Research, IWK Health, Halifax, Nova Scotia, Canada
| | - Sarah Foye
- Centre for Pediatric Pain Research, IWK Health, Halifax, Nova Scotia, Canada
| | - Jon Dorling
- Department of Pediatrics, IWK Health & Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jehier Afifi
- Department of Pediatrics, IWK Health & Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | | | | | | | - Carye Leighton
- Parent Partner, Neonatal Intensive Care Unit, IWK Health, Halifax, Nova Scotia, Canada
| | | | | | - David C. Simpson
- Department of Pediatrics, IWK Health & Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michael Smit
- School of Information Management, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Leah Whitehead
- Parent Partner, Neonatal Intensive Care Unit, IWK Health, Halifax, Nova Scotia, Canada
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Abstract
Background The postnatal period remains unstandardized in terms of care and postnatal visits with a dearth of information on the experience from Canadian women. Purpose To explore (1) with whom and how often women receive postnatal follow-up visits and (2) the postnatal care experiences of Canadian mothers. Methods Using a cross-sectional design, women who had given birth within the past 6 months were recruited to complete an online survey. Frequencies were computed for quantitative outcomes and thematic analysis was used for qualitative responses. Results A total of 561 mothers completed the survey. Women saw on average 1.9 different postnatal healthcare providers, primarily family doctors (72.4%). 3.2% had no postnatal visits and 37.6% had 4 or more within 6 weeks. 76.1% women were satisfied with their postnatal care. Women's satisfactory care in the postnatal period was associated with in-person and at home follow-ups, receiving support, and receiving timely, appropriate care for self and newborn. Unsatisfactory care was associated with challenges accessing care, experiencing gaps in follow-up visits, and having unsatisfactory assessment for their own recovery. Conclusion There is considerable variation in the timing and frequency of postnatal visits. While many women are experiencing satisfactory care, women are still reporting dissatisfaction and are facing challenges.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
- Justine Dol, Faculty of Health, Dalhousie University, Halifax, NS, Canada.
| | - Brianna Hughes
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | | | - Megan Aston
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Douglas McMillan
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, NS, Canada
| | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, NS, Canada
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Dol J, Dennis CL. Striving for evidence-based health care with eHealth and technology in a time of half-truths and disinformation. JBI Evid Synth 2021; 19:2474-2475. [PMID: 34645772 DOI: 10.11124/jbies-21-00359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Justine Dol
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Cindy-Lee Dennis
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Campbell-Yeo M, Kim T, Disher T, Richardson B, Dol J, Bishop T, Delahunty-Pike A, Dorling J, Glover M, Inglis D, Johnson T, Macmillan D, Mcgrath P, Monaghan J, Orovec A, Simpson DC, Skinner N, Whitehead L, Wozney L. Do Single-Family Rooms Increase Parental Presence, Involvement, and Maternal Well-Being in Neonatal Intensive Care? J Perinat Neonatal Nurs 2021; 35:350-361. [PMID: 34726653 DOI: 10.1097/jpn.0000000000000600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives of this study were to determine whether single-family room (SFR) design enhances parental presence, involvement, and maternal well-being during neonatal intensive care hospitalization. An observational cohort including mothers of infants was randomly assigned to receive care in a tertiary-level open-bay (OB) (n = 35) or SFR (n = 36). Mothers were asked to complete daily diaries documenting parental presence, involvement in care, and questionnaires examining maternal well-being. Mother and father mean presence (standard deviation) was significantly higher in the SFR-17.4 (5.2) and 13.6 (6.8)-compared to OB-11.9 (6.3) and 4.6 (3.7) hours/day. Total time spent in care activities did not differ for mothers, except SFR mothers spent more time expressing breast milk (EBM). SFR fathers had greater involvement with care activities. There were no other significant differences. The SFR was associated with greater maternal presence, but not greater involvement in care activities except for EBM, nor improved maternal well-being. The SFR appears to have greater impact on fathers' involvement in care and comforting activities, although the amount of time involved remained quite low compared with mothers. Further studies examining ways to enhance parental involvement in the neonatal intensive care unit are warranted.
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Affiliation(s)
- Marsha Campbell-Yeo
- IWK Health, Halifax, Nova Scotia, Canada (Drs Campbell-Yeo, Kim, Dorling, Macmillan, Mcgrath, Simpson, and Wozney and Mss Bishop, Delahunty-Pike, Glover, Inglis, Johnson, Monaghan, Skinner, and Whitehead); Faculty of Health, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada (Drs Campbell-Yeo, Disher, Richardson, and Dol); Department of Pediatrics (Drs Campbell-Yeo, Dorling, Macmillan, Simpson) and Department of Psychiatry (Dr Mcgrath), Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; and Department of Medical Sciences, Faculty of Science, Dalhousie University, Halifax, Nova Scotia, Canada (Ms Orovec)
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30
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Kim THM, Campbell-Yeo M, Disher T, Dol J, Richardson B, Bishop T, Delahunty-Pike A, Dorling J, Glover M, Inglis D, Johnson T, Lalanne D, Mcmillan D, Mcgrath P, Monaghan J, Orovec A, Simpson DC, Skinner N, Wozney L, Whitehead L. Caregiver Presence and Involvement in a Canadian Neonatal Intensive Care Unit: An Observational Cohort Study. J Pediatr Nurs 2021; 60:123-129. [PMID: 33945945 DOI: 10.1016/j.pedn.2021.04.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/12/2021] [Accepted: 04/21/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Presence in the neonatal intensive care unit (NICU) is a vital step for caregivers initiating involvement, such as skin-to-skin contact, holding or singing/reading to their newborn. Little is known about caregiver presence and involvement in Canadian NICU's context by caregiver type (mother, father, other), and the association between maternal presence and key maternal and newborn characteristics. PURPOSE The primary objective was to examine the presence and involvement of family caregivers in the NICU. The secondary objective was to examine the relationship between maternal presence and maternal and newborn characteristics. DESIGN AND METHODS A prospective observational cohort study in an open bay setting of an Eastern Canadian NICU. Presence (physically present at the newborn's bedside) and involvement (e.g., skin-to-skin, singing/reading) were tracked daily by families in the NICU until discharge. Demographic information was also collected. RESULTS Participants included 142 mothers and their newborns. Mothers were present 8.7 h/day, fathers were present 4.1 h/day, and other caregivers were present 1.8 h/day in the NICU in the first 34 days. Mothers were involved in care activities 50% of the time they were present in the NICU, whereas fathers and other caregivers were spending 20% and 6% of their time respectively. Regression identified maternal age, distance to home, parity, birthweight, and length of stay to be statistically significant variables related to maternal presence. CONCLUSIONS There is variation in presence and involvement by caregiver type. Targeted interventions to maintain and increase mothers, fathers and other caregivers' presence and involvement in care throughout their stay in the NICU are recommended.
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Affiliation(s)
| | - Marsha Campbell-Yeo
- IWK Health Centre, Nova Scotia, Canada; Faculty of Health, School of Nursing, Dalhousie University, Nova Scotia, Canada; Faculty of Medicine, Department of Pediatrics, Dalhousie University, Nova Scotia, Canada.
| | - Tim Disher
- Faculty of Health, School of Nursing, Dalhousie University, Nova Scotia, Canada
| | - Justine Dol
- Faculty of Health, School of Nursing, Dalhousie University, Nova Scotia, Canada
| | - Brianna Richardson
- Faculty of Health, School of Nursing, Dalhousie University, Nova Scotia, Canada
| | | | | | | | - Jon Dorling
- IWK Health Centre, Nova Scotia, Canada; Faculty of Medicine, Department of Pediatrics, Dalhousie University, Nova Scotia, Canada
| | | | | | | | | | - Doug Mcmillan
- IWK Health Centre, Nova Scotia, Canada; Faculty of Medicine, Department of Pediatrics, Dalhousie University, Nova Scotia, Canada
| | - Patrick Mcgrath
- IWK Health Centre, Nova Scotia, Canada; Faculty of Medicine, Department of Psychiatry, Nova Scotia, Canada
| | | | - Adele Orovec
- Faculty of Science, Department of Medical Sciences, Dalhousie University, Nova Scotia, Canada
| | - David C Simpson
- IWK Health Centre, Nova Scotia, Canada; Faculty of Medicine, Department of Pediatrics, Dalhousie University, Nova Scotia, Canada
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Dol J, Richardson B, Grant A, Aston M, McMillan D, Tomblin Murphy G, Campbell-Yeo M. Influence of parity and infant age on maternal self-efficacy, social support, postpartum anxiety, and postpartum depression in the first six months in the Maritime Provinces, Canada. Birth 2021; 48:438-447. [PMID: 34008241 DOI: 10.1111/birt.12553] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND After giving birth, women experience significant changes related to maternal self-efficacy and social support and are at risk of experiencing postpartum anxiety and depression. PROBLEM No studies have focused on the relationship between parity and infant age and their impact on psychosocial outcomes, particularly in a Canadian context. AIM To explore the relationship between parity and infant age on perceived maternal self-efficacy, social support, postpartum anxiety, and postpartum depression. METHODS Women from three Canadian provinces within the first 6 months postpartum completed standardized online questionnaires. Multivariate analysis of covariance was used to examine the primary aim. FINDINGS A total of 561 women (56.5% primiparous, 55.1% infant 0-3 months) participated. There were significant main effects for both parity (P < .001) and age of infant (P < .001), but no significant interaction (P = .463). Primiparous women had lower maternal self-efficacy (P = .004) and higher postpartum anxiety (P = .000) than multiparous women. Women with younger infants had more perceived social support (P = .002). Women with older infants had higher levels of postpartum anxiety (P = .003) and depression (P = .000). DISCUSSION The transition that women experience, independent of parity, within the first six months is dynamic with women of older infants experiencing more postpartum mental health concerns and less perceived social support. Our findings emphasize that postnatal support should extend beyond the typical six-week follow-up period. CONCLUSIONS Additional studies are warranted to determine ways to provide ongoing support throughout the first six months and beyond to improve maternal well-being and address postpartum needs.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Brianna Richardson
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Amy Grant
- Maritime SPOR Support Unit, Halifax, NS, Canada
| | - Megan Aston
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Douglas McMillan
- Department of Pediatrics, Division of Neonatal Perinatal Medicine, Faculty of Medicine, IWK Health Centre, Dalhousie University, Halifax, NS, Canada
| | | | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada.,Department of Pediatrics, Division of Neonatal Perinatal Medicine, Faculty of Medicine, IWK Health Centre, Dalhousie University, Halifax, NS, Canada
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Stirling Cameron E, Almukhaini S, Dol J, Aston M. Access and use of sexual and reproductive health services among resettled refugee and refugee-claimant women in high-income countries: a scoping review protocol. JBI Evid Synth 2021; 19:604-613. [PMID: 32833790 DOI: 10.11124/jbies-20-00054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The purpose of this review is to understand access to and use of sexual and reproductive health services among resettled refugees and refugee-claimant women in high-income countries. INTRODUCTION Sexual and reproductive health is a critical component of women's well-being and quality of life. Refugee and refugee-claimant women have demonstrated a lower level of sexual health knowledge and reduced usage of sexual and reproductive health services after resettling in high-income countries. This has led to negative outcomes among resettled refugee populations, including unwanted pregnancies and abortion, lower than recommended rates of cervical cancer screening, high rates of sexually transmitted infections, and non-consensual sex. Despite these negative outcomes, no review has been conducted to understand access to and use of sexual and reproductive health services among resettled refugee women in high-income countries. INCLUSION CRITERIA This scoping review will seek to identify studies that describe access to and use of sexual and reproductive health services among refugee and refugee-claimant women who have resettled in a high-income country. Evidence from qualitative, quantitative, mixed method studies, and gray literature will be included. METHODS This review will be conducted in accordance with JBI methodology for scoping reviews. A comprehensive search strategy, developed with a librarian scientist, will be used to identify relevant sources. Titles, abstracts, and full texts will be evaluated against inclusion criteria. Information will be extracted by two independent reviewers using a screening tool. Data will be synthesized and presented narratively, with tables and figures where appropriate.
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Affiliation(s)
- Emma Stirling Cameron
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Salma Almukhaini
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada.,Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Halifax, NS, Canada
| | - Justine Dol
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Halifax, NS, Canada.,Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Megan Aston
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada.,Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Halifax, NS, Canada
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Dol J, Richardson B, Bonet M, Langlois EV, Parker R, Scott H, Curran J. Timing of maternal and neonatal mortality and morbidity in healthy women and newborns during the postnatal period: a systematic review protocol. JBI Evid Synth 2021; 19:629-643. [PMID: 33074983 DOI: 10.11124/jbies-20-00036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To determine the timing of overall and cause-specific maternal and neonatal mortality and severe morbidity in healthy women and newborns during the postnatal period. INTRODUCTION Despite significant focus on improving maternal and neonatal outcomes, many women and newborns continue to die or suffer negative health outcomes within the postnatal period. While the maternal and neonatal mortality and morbidity rates and causes are regularly updated, less is known on when they occur during the postnatal period. INCLUSION CRITERIA This review will consider studies that include healthy women and newborns after birth to six weeks' and four weeks' postnatally, respectively, and includes data regarding time to death or complications. Studies that report solely on high risk women (eg, antenatal complications) or preterm or high-risk newborns will not be included in this review. METHODS The search strategy will aim to locate both published and unpublished studies. After the initial search and removal of duplicates, titles and abstracts of all retrieved studies will be screened and the full text of selected reports will be assessed against the eligibility criteria. The reference list of all studies selected for critical appraisal will be screened for additional relevant studies/reports. Screening, critical appraisal, and data extraction will be completed by two independent reviewers. Findings from the studies/reports will be pooled in statistical meta-analysis or presented in narrative form including tables and figures. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020187341.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, Halifax, NS, Canada.,Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Halifax, NS, Canada
| | - Brianna Richardson
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Halifax, NS, Canada.,School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Mercedes Bonet
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Etienne V Langlois
- Partnership for Maternal, Newborn and Child Health, World Health Organization, Geneva, Switzerland
| | - Robin Parker
- W.K. Kellogg Health Sciences Library, Dalhousie Libraries, Dalhousie University, Halifax, NS, Canada
| | - Heather Scott
- Department of Obstetrics and Gynecology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Janet Curran
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Halifax, NS, Canada.,School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
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Dol J, Richardson B, Murphy GT, Aston M, McMillan D, Campbell-Yeo M. Impact of mobile health interventions during the perinatal period on maternal psychosocial outcomes: a systematic review. JBI Evid Synth 2021; 18:30-55. [PMID: 31972680 DOI: 10.11124/jbisrir-d-19-00191] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The objective of this review was to evaluate the effectiveness of mother-targeted mobile health (mHealth) education interventions during the perinatal period on maternal psychosocial outcomes in high-income countries. INTRODUCTION The perinatal period is an exciting yet challenging period for mothers that requires physical, emotional and social adjustment to new norms and expectations. In recent years, there has been an increase in the use of mHealth by new mothers who are seeking health information through online or mobile applications. While there have been systematic reviews on the impact of mHealth interventions on maternal and newborn health in low- and middle-income countries, the impact of these interventions on maternal psychosocial health outcomes in high-income countries remains uncertain. INCLUSION CRITERIA This review considered studies of mHealth education interventions targeting mothers in high-income countries (as defined by the World Bank) during the perinatal period. Interventions must have started between the antenatal period (conception through birth) through six weeks postpartum. All experimental study designs were included. Outcomes included self-efficacy, social support, postpartum anxiety and postpartum depression. METHODS PubMed, CINAHL, PsycINFO and Embase were searched for published studies in English on December 16, 2018. Gray literature was also searched for non-peer reviewed articles, including Google Scholar, mHealth intelligence and clinical trials databases. Critical appraisal was undertaken by two independent reviewers using standardized critical appraisal instruments from JBI. Quantitative data were extracted from included studies independently by two reviewers using the standardized data extraction tool from JBI. All conflicts were solved through consensus with a third reviewer. Quantitative data were, where possible, pooled in statistical meta-analysis using RevMan. Where statistical pooling was not possible, findings were reported narratively. RESULTS Of the 1,607 unique articles identified, 106 full-text papers were screened and 24 articles were critically appraised, with 21 included in the final review. Eleven were quasi-experimental and 10 were randomized controlled trials. The mHealth intervention approach varied, with text message and mobile applications being the most common. Length of intervention ranged from four weeks to six months. The topics of the mHealth intervention varied widely, with the most common topic being postpartum depression. Mothers who received an mHealth intervention targeting postpartum depression showed a decreased score on the Edinburgh Postnatal Depression Scale when measured post-intervention (odds ratio = -6.01, 95% confidence interval = -8.34 to -3.67, p < 0.00001). The outcomes related to self-efficacy, social support and anxiety showed mixed findings of effectiveness (beneficial and no change) across the studies identified. CONCLUSIONS This review provides insight into the effectiveness of mHealth interventions targeting mothers in high-income countries in the perinatal period to enhance four psychosocial outcomes: self-efficacy, social support, anxiety and depression. Despite a wide variety of outcome measurements used, the predominant findings suggest that there are insufficient data to conclude that mHealth interventions can improve self-efficacy and anxiety outcomes. Potential benefits on social support were related to interventions targeting postnatal behaviors. Postpartum depression was the mostly commonly reported outcome. Findings related to the comparison of pre-post outcomes and intervention versus control demonstrated that mHealth interventions targeting postpartum depression were associated with a reduction in postpartum depression.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, Halifax, Canada.,Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A Joanna Briggs Institute Centre of Excellence.,World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Canada
| | - Brianna Richardson
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A Joanna Briggs Institute Centre of Excellence.,School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Gail Tomblin Murphy
- World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Canada.,Nova Scotia Health Authority, Halifax, Canada
| | - Megan Aston
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A Joanna Briggs Institute Centre of Excellence.,School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Douglas McMillan
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, Canada
| | - Marsha Campbell-Yeo
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A Joanna Briggs Institute Centre of Excellence.,World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Canada.,School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada.,Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, Canada
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Dol J, Aston M, McMillan D, Tomblin Murphy G, Campbell-Yeo M. Effectiveness of a Postpartum Text Message Program (Essential Coaching for Every Mother) on Maternal Psychosocial Outcomes: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e27138. [PMID: 33764309 PMCID: PMC8088838 DOI: 10.2196/27138] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Women experience changes both physically and psychologically during their transition to motherhood. The postnatal period is a critical time for women to develop maternal self-efficacy. Mobile health interventions may offer a way to reach women during this critical period to offer support and information. Essential Coaching for Every Mother is a text message program that seeks to educate and support women during the first 6 weeks postpartum. OBJECTIVE The primary effectiveness objective is to compare the effectiveness of the Essential Coaching for Every Mother program on maternal psychosocial outcomes (self-efficacy, social support, postpartum depression, and postpartum anxiety) immediately after the intervention and 6 months postpartum, collectively as well as stratified by parity. The primary implementation objective is to evaluate the implementation extent and quality of the Essential Coaching for Every Mother program. METHODS This will be a hybrid type 1 effectiveness-implementation randomized controlled trial. A total of 140 mothers-to-be or new mothers from Nova Scotia will be recruited and randomized to the intervention or control arm, stratified by parity. The intervention arm will receive the Essential Coaching for Every Mother program, which consists of 53 messages sent twice a day for the first 2 weeks and daily for weeks 3 through 6. The control group will receive usual care. Messages are personalized based on the infant's age and the woman's self-selected preference for breastfeeding or formula feeding and tailored with the infant's name and gender. Women can enroll in the program if they are ≥37 weeks pregnant or within 10 days postpartum, with the first message designed to be sent on the second evening after birth. The actual number of messages received will vary based on the timing of enrollment and the infant's date of birth. Participants will complete questionnaires assessing self-efficacy, social support, and postpartum depression and anxiety at baseline (enrollment after birth) and 6 weeks (postintervention) and 6 months postpartum. Implementation data will be collected throughout the trial, and evaluation feedback will be collected at 6 weeks from women who received the intervention. RESULTS Recruitment for this study started on January 5, 2021, and is currently ongoing, with an anticipated date of recruitment completion of January 2022. CONCLUSIONS This study will assess the effectiveness of a postpartum text message program to improve maternal self-efficacy and social support while decreasing postpartum depression and anxiety. It will also shed light on the implementation effectiveness of the program. TRIAL REGISTRATION ClinicalTrials.gov NCT04730570; https://clinicaltrials.gov/ct2/show/NCT04730570. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/27138.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Megan Aston
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Douglas McMillan
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | | | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
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Dol J, Richardson B, Tomblin Murphy G, Aston M, McMillan D, Campbell-Yeo M. Impact of mHealth interventions during the perinatal period on maternal psychosocial outcomes: a systematic review protocol. ACTA ACUST UNITED AC 2020; 17:2491-2498. [PMID: 31356572 DOI: 10.11124/jbisrir-d-19-00003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This review aims to evaluate the effectiveness of mother-targeted mobile health (mHealth) education interventions during the perinatal period on maternal psychosocial outcomes in high-income countries. INTRODUCTION Mobile health (i.e. mHealth) is defined as the use of mobile devices to transmit health content and services. The use of mHealth to provide education and support to mothers is a growing field of health innovation. Mothers seek health information online during the postpartum period to learn about health concerns and get advice and support. Despite the potential benefits of mHealth, the potential impact on maternal psychosocial outcomes requires further evaluation. INCLUSION CRITERIA The review will consider studies that include mHealth interventions targeting mothers in high-income countries. The mHealth education interventions must occur during the antenatal or postnatal period. This review will consider studies that compare the intervention to any comparators. Studies published in English from 2000 will be included. METHODS The search strategy will aim to locate both published and unpublished studies. Following the search, all identified citations will be collated and duplicates removed. Titles and abstracts will be screened and full text of selected citations will then be assessed in detail against inclusion criteria. The results of the search will be reported in full in the final systematic review. Eligible studies will be critically appraised by two independent reviewers. Data extracted will include specific details about the interventions, populations, study methods and outcomes. Studies will be pooled in statistical meta-analysis or presented in narrative form including tables and figures.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, Halifax, Canada.,Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence
| | - Brianna Richardson
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence.,School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada
| | | | - Megan Aston
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence.,School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Douglas McMillan
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, Canada
| | - Marsha Campbell-Yeo
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence.,School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada.,Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, Canada
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Dol J, Tomblin Murphy G, Aston M, McMillan D, Campbell-Yeo M. Design, development and usability testing of Essential Coaching for Every Mother: A postnatal text message educational intervention. Women Birth 2020; 34:e228-e236. [PMID: 32475782 DOI: 10.1016/j.wombi.2020.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 04/10/2020] [Accepted: 05/18/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND The transition to motherhood is an exciting yet challenging period that requires physical, emotional, and social adjustment. During the postpartum period, mothers require support and information to ensure a smooth transition and adjustment to motherhood. One innovative strategy to provide mothers with this information is mobile health (mHealth), and specifically, text messaging. OBJECTIVE To describe the design, development and usability testing of a postnatal text message intervention called Essential Coaching for Every Mother. METHODS First time mothers (n=11) and postpartum healthcare providers (n=18) were involved in iterative interviewing in Halifax, Canada. Adaption of content occurred through three rounds of user testing using semi-structured interviews. The Information Assessment Method (IAM) Parents survey was also completed by mothers. RESULTS Three cycles of iterative testing were conducted with eight participants (3 mothers, 5 healthcare providers), thirteen participants (8 mothers, 5 healthcare providers) and 8 participants (8 healthcare providers), respectively. Messages evolved from risk-focused to prevention and education focused. Mothers felt the messages addressed their needs and healthcare providers ensured the content was consistent with the messaging currently provided to postpartum mothers. CONCLUSION Essential Coaching for Every Mother is the first postnatal educational text message intervention developed for mothers in Halifax, Canada. We sought to involve first time mothers (end-users) and postpartum healthcare providers (experts) in the development and usability evaluation to ensure the intervention adequately met needs and was consistent with current practices related to postpartum education.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, Halifax, NS, Canada.
| | | | - Megan Aston
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Douglas McMillan
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, NS, Canada
| | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada; Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, NS, Canada
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Monaghan J, Kim T, Dol J, Orovec A, Campbell-Yeo M. Parents’ learning needs and preferences in a neonatal intensive care unit: A desire for enhanced communication and eHealth technology. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.jnn.2019.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Chambers CT, Dol J, Parker JA, Caes L, Birnie KA, Taddio A, Campbell-Yeo M, Halperin SA, Langille J. Implementation Effectiveness of a Parent-Directed YouTube Video ("It Doesn't Have To Hurt") on Evidence-Based Strategies to Manage Needle Pain: Descriptive Survey Study. JMIR Pediatr Parent 2020; 3:e13552. [PMID: 32130190 PMCID: PMC7081136 DOI: 10.2196/13552] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 05/07/2019] [Accepted: 09/20/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Despite the availability of high-quality evidence and clinical practice guidelines for the effective management of pediatric pain, this evidence is rarely used in practice for managing children's pain from needle procedures such as vaccinations. Parents are generally unaware of pain management strategies they can use with their children. OBJECTIVE This study aimed to develop, implement, and evaluate the implementation effectiveness of a parent-directed YouTube video on evidence-based strategies to manage needle pain in children. METHODS This was a descriptive study. Analytics were extracted from YouTube to describe video reach. A Web-based survey was used to seek parent and health care professional (HCP) feedback about the video. The 2-minute 18-second video was launched on YouTube on November 4, 2013. In the video, a 4-year-old girl tells parents what they should and should not do to help needles hurt less. The key evidence-based messages shared in the video were distraction, deep breathing, and topical anesthetic creams. A group of parents (n=163) and HCPs (n=278) completed the Web-based survey. Measures of reach included number of unique views, country where the video was viewed, sex of the viewer, and length of watch time. The Web-based survey assessed implementation outcomes of the video, such as acceptability, appropriateness, penetration, and adoption. RESULTS As of November 4, 2018 (5 years after launch), the video had 237,132 unique views from 182 countries, with most viewers watching an average of 55.1% (76/138 seconds) of the video. Overall, both parents and HCPs reported strong acceptance of the video (ie, they liked the video, found it helpful, and felt more confident) and reported significant improvements in plans to use distraction, deep breathing, and topical anesthetic creams. CONCLUSIONS This parent-directed YouTube video was an acceptable and appropriate way to disseminate evidence about the procedure of pain management to a large number of parents.
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Affiliation(s)
- Christine T Chambers
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
| | - Justine Dol
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Jennifer A Parker
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
| | - Line Caes
- Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, United Kingdom
| | - Kathryn A Birnie
- Alberta Children's Hospital, Calgary, AB, Canada
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Anna Taddio
- The Hospital for Sick Children, Toronto, ON, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Marsha Campbell-Yeo
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Department of Pediatrics, IWK Health Centre, Halifax, NS, Canada
| | - Scott A Halperin
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
- Department of Pediatrics, IWK Health Centre, Halifax, NS, Canada
- Canadian Center for Vaccinology, IWK Health Centre, Halifax, NS, Canada
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Dol J, Tomblin Murphy G, Rigby J, Campbell-Yeo M. The inclusion of mothers in human resources for health planning. Int Nurs Rev 2020; 67:101-108. [PMID: 31943202 DOI: 10.1111/inr.12557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 07/10/2019] [Accepted: 08/14/2019] [Indexed: 11/27/2022]
Abstract
AIM This paper examines the possibility of including families, particularly mothers, within the health workforce using the human resource for health planning model to improve newborn outcomes. BACKGROUND In many low- and middle-income countries, there is a critical shortage of healthcare providers which impacts care for the neonatal population. A maternal and newborn health need that is prevalent in such countries is the care available between pregnancy and the postnatal period, where significant maternal and newborn deaths occur. SOURCES OF EVIDENCE Using the population health need of the neonatal population in Tanzania, this paper explores the opportunity to include mothers as an additional human resource for health within the Needs-Based Health Human Resources and Health Systems Planning model. DISCUSSION In relation to educating and engaging family caregivers, the possible extension of the health workforce to include mothers as a response to meeting the healthcare needs of the neonatal population has yet to be explored. Through mothers and healthcare providers working together to address the population health need of essential newborn care, it offers a way forward for planning the resources needed in a health system. If utilized, mothers offer the opportunity to supplement the demand for human resources for health in the provision of newborn care, without replacing healthcare providers. CONCLUSION Mothers as potential members of the health workforce furthers the health system as a whole whereby population health needs are addressed and newborn mortality declines. IMPLICATIONS FOR HEALTH POLICY To solve the critical gap based on the supply of and demand for providers including doctors, nurses and midwives, a broader look at innovative solutions is essential. IMPLICATIONS FOR NURSING PRACTICE Mothers offer the opportunity to supplement the available human resources for health in the provision of newborn care, thus helping to close existing gaps.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, Halifax, NS, Canada.,World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, NS, Canada
| | - Gail Tomblin Murphy
- Nova Scotia Health Authority, Halifax, NS, Canada.,World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, NS, Canada
| | - Janet Rigby
- World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, NS, Canada
| | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada.,Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, NS, Canada.,World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, NS, Canada
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Dol J, Tutelman PR, Chambers CT, Barwick M, Drake EK, Parker JA, Parker R, Benchimol EI, George RB, Witteman HO. Health Researchers' Use of Social Media: Scoping Review. J Med Internet Res 2019; 21:e13687. [PMID: 31719028 PMCID: PMC6881779 DOI: 10.2196/13687] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/16/2019] [Accepted: 06/29/2019] [Indexed: 11/13/2022] Open
Abstract
Background Health researchers are increasingly using social media in a professional capacity, and the applications of social media for health researchers are vast. However, there is currently no published evidence synthesis of the ways in which health researchers use social media professionally, and uncertainty remains as to how best to harness its potential. Objective This scoping review aimed to explore how social media is used by health researchers professionally, as reported in the literature. Methods The scoping review methodology guided by Arksey and O’Malley and Levac et al was used. Comprehensive searches based on the concepts of health research and social media were conducted in MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, and Web of Science databases, with no limitations applied. Articles were screened at the title and abstract level and at full text by two reviewers. One reviewer extracted data that were analyzed descriptively to map the available evidence. Results A total of 8359 articles were screened at the title and abstract level, of which 719 were also assessed at full text for eligibility. The 414 articles identified for inclusion were published in 278 different journals. Studies originated from 31 different countries, with the most prevalent being the United States (52.7% [218/414]). The health discipline of the first authors varied, with medicine (33.3% [138/414]) being the most common. A third of the articles covered health generally, with 61 health-specific topics. Papers used a range of social media platforms (mean 1.33 [SD 0.7]). A quarter of the articles screened reported on social media use for participant recruitment (25.1% [104/414]), followed by practical ways to use social media (15.5% [64/414]), and use of social media for content analysis research (13.3% [55/414]). Articles were categorized as celebratory (ie, opportunities for engagement, 72.2% [299/414]), contingent (ie, opportunities and possible limitations, 22.7% [94/414]) and concerned (ie, potentially harmful, 5.1% [21/414]). Conclusions Health researchers are increasingly publishing on their use of social media for a range of professional purposes. Although most of the sentiment around the use of social media in health research was celebratory, the uses of social media varied widely. Future research is needed to support health researchers to optimize their social media use.
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Affiliation(s)
- Justine Dol
- Dalhousie University, Faculty of Health, Halifax, NS, Canada.,IWK Health Centre, Centre for Pediatric Pain Research, Halifax, NS, Canada
| | - Perri R Tutelman
- IWK Health Centre, Centre for Pediatric Pain Research, Halifax, NS, Canada.,Dalhousie University, Department of Psychology and Neuroscience, Halifax, NS, Canada
| | - Christine T Chambers
- IWK Health Centre, Centre for Pediatric Pain Research, Halifax, NS, Canada.,Dalhousie University, Department of Psychology and Neuroscience, Halifax, NS, Canada.,Dalhousie University, Department of Pediatrics, Halifax, NS, Canada
| | - Melanie Barwick
- The Hospital for Sick Children, SickKids Research Institute, Child Health Evaluative Sciences, Toronto, ON, Canada.,University of Toronto, Faculty of Medicine, Toronto, ON, Canada.,University of Toronto, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - Emily K Drake
- Dalhousie University, Faculty of Health, Halifax, NS, Canada
| | - Jennifer A Parker
- IWK Health Centre, Centre for Pediatric Pain Research, Halifax, NS, Canada
| | - Robin Parker
- Dalhousie University, WK Kellogg Health Sciences Library, Halifax, NS, Canada
| | - Eric I Benchimol
- University of Ottawa, Faculty of Medicine, Department of Pediatrics, Ottawa, ON, Canada.,University of Ottawa, Faculty of Medicine, School of Epidemiology and Public Health, Ottawa, ON, Canada
| | - Ronald B George
- University of California San Francisco, Department of Anesthesia and Perioperative Care, San Francisco, CA, United States
| | - Holly O Witteman
- Laval University, Faculty of Medicine, Department of Family and Emergency Medicine, Quebec, QC, Canada.,Laval University, Faculty of Medicine, Office of Education and Professional Development, Quebec, QC, Canada.,CHU de Québec-Université Laval, Quebec, QC, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
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Dol J, Campbell-Yeo M, Murphy GT, Aston M, McMillan D, Richardson B. The impact of the Helping Babies Survive program on neonatal outcomes and health provider skills: a systematic review. ACTA ACUST UNITED AC 2019. [PMID: 29521869 DOI: 10.11124/jbisrir-2017-003535] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review was to evaluate the impact of the Helping Babies Survive program on neonatal outcomes and healthcare provider knowledge and skills. INTRODUCTION The Helping Babies Survive program consists of three modules: Helping Babies Breathe, Essential Care for Every Baby, and Essential Care for Small Babies. It was developed to reduce preventable newborn deaths through skill-based learning using simulation, learning exercises, and peer-to-peer training of healthcare providers in low-resource areas. Despite the widespread increase in healthcare provider training through Helping Babies Survive and the growing number of studies that have been conducted, there has been no systematic review of the Helping Babies Survive program to date. INCLUSION CRITERIA The review included studies on healthcare providers and/or birth attendants providing essential neonatal care during and post birth. Types of interventions were any Helping Babies Survive module (Helping Babies Breathe, Essential Care for Every Baby, Essential Care for Small Babies). Studies including experimental study designs with the following outcomes were considered: neonatal outcomes and/or healthcare provider knowledge and skills obtained, maintained, and used over time. METHODS PubMed, Embase, Web of Science, ProQuest Databases, Scopus and CINAHL were searched for published studies in English between January 2010 to December 2016. Critical appraisal was undertaken by two independent reviewers using standardized critical appraisal instruments from the Joanna Briggs Institute (JBI). Conflicts were solved through consensus with a third reviewer. Quantitative data were extracted from included studies independently by two reviewers using the standardized data extraction tool from JBI. Conflicts were solved through consensus with a third reviewer. Quantitative data was, where possible, pooled in statistical meta-analysis using RevMan (Copenhagen: The Nordic Cochrane Centre, Cochrane). Where statistical pooling was not possible the findings have been reported narratively. RESULTS A total of 17 studies were identified - 15 on Helping Babies Breathe (n = 172,685 infants and n = 2,261 healthcare providers) and two on Essential Care for Every Baby (n = 206 healthcare providers). No studies reported on Essential Care for Small Babies. Helping Babies Survive was found to significantly reduce fresh stillbirth rates and first day mortality rates, but was not found to influence stillbirth rates or mortality rates, measured at seven or 28 days post birth. Short-term improvements were significant in knowledge and skills scores but not significant in sustainability over time. Additionally, implementation of resuscitations skills in clinical practice related to the Helping Babies Breathe module including drying/stimulation, suction, and bag and mask ventilation did not show a significant increase after training even though the number of fresh stillbirth and first-day mortality rate decreased. CONCLUSIONS Helping Babies Survive has a significant positive impact on early neonatal outcomes, including fresh stillbirth and first-day mortality primarily through Helping Babies Breathe, but limited conclusions can be drawn about its impact on other neonatal outcomes. While Helping Babies Survive was found to improve immediate knowledge and skill acquisition, there is some evidence that one-time training may not be sufficient for sustained knowledge or the incorporation of key skills related to resuscitation into clinical practice. Continued research on the sustained knowledge and skills is needed to evaluate the long-term impact of the Helping Babies Survive program.
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Affiliation(s)
- Justine Dol
- Department of Health, Faculty of Health, Dalhousie University, Halifax, Canada.,Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence, Dalhousie University, Halifax, Canada.,World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Canada
| | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada.,Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, Canada.,Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence, Dalhousie University, Halifax, Canada.,World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Canada
| | - Gail Tomblin Murphy
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada.,Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence, Dalhousie University, Halifax, Canada.,World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Canada
| | - Megan Aston
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada.,Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence, Dalhousie University, Halifax, Canada.,World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Canada
| | - Douglas McMillan
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, Canada
| | - Brianna Richardson
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada.,Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence, Dalhousie University, Halifax, Canada
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Dol J, Campbell-Yeo M, Bulemela J, McMillan D, Abel Z, Nyamtema A, LeBlanc JC. Knowledge acquisition after Helping Babies Survive training in rural Tanzania. Int Health 2019; 11:136-142. [PMID: 30252052 DOI: 10.1093/inthealth/ihy068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/02/2018] [Accepted: 09/13/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND While the effectiveness of Helping Babies Breathe (HBB) training in Tanzania has been reported, no published studies of Essential Care for Every Baby (ECEB) and Essential Care for Small Babies (ECSB) in this setting have been found. This study compared knowledge before and after HBB, ECEB and ECSB training in Tanzania. METHODS Training was provided to future facilitators (n=16) and learners (n=24) in Tanzania. Using standardized multiple-choice questions, knowledge was assessed pre- and post-HBB and ECEB courses for both learners and facilitators, while ECSB assessment was conducted with facilitators only. A >80% score was considered to be a pass. Paired t-tests were used for hypothesis testing. RESULTS Knowledge significantly improved for both facilitators and learners on HBB and ECEB (p<0.001) and for facilitators on ECSB (p<0.001). After training, learners had difficulty identifying correct responses on one HBB item (21% incorrect) and three ECEB items (25-29% incorrect). After training, facilitators had difficulty identifying correct responses on five ECSB items (22-44% incorrect). CONCLUSIONS Training improved knowledge in Tanzania, but not sufficiently for feeding, especially for low birthweight babies. Targeted training on feeding is warranted both within the Helping Babies Survive program and in preclinical training to improve knowledge and skill to enhance essential newborn care.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Janeth Bulemela
- Tanzanian Training Center for International Health & St Francis University College of Health and Allied Sciences, Ifakara, Tanzania
| | - Douglas McMillan
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, & IWK Health Centre, Halifax, NS, Canada
| | - Zabron Abel
- Tanzanian Training Center for International Health, Ifakara
| | - Angelo Nyamtema
- Tanzanian Training Center for International Health & St Francis University College of Health and Allied Sciences, Ifakara, Tanzania
| | - John C LeBlanc
- Departments of Pediatrics, Community Health and Epidemiology and Psychiatry, Dalhousie University & IWK Health Centre, Halifax, NS, Canada
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Dol J, Richardson B, Tomblin Murphy G, Aston M, McMillan D, Campbell-Yeo M. Impact of mobile health (mHealth) interventions during the perinatal period for mothers in low- and middle-income countries. ACTA ACUST UNITED AC 2019; 17:1634-1667. [DOI: 10.11124/jbisrir-2017-004022] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Richardson B, Benoit B, Rutledge K, Dol J, Misener RM, Latimer M, Smit M, McGrath P, Campbell-Yeo M. The impact of parent-targeted eHealth educational interventions on infant procedural pain management: a systematic review protocol. JBI Database System Rev Implement Rep 2019; 17:1589-1599. [PMID: 31404050 DOI: 10.11124/jbisrir-d-19-00007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective of this review is to determine if electronic health (eHealth) educational interventions for infant procedural pain and pain management impact parental outcomes (mental health outcomes, knowledge utilization outcomes, and parental involvement in care outcomes) and infant outcomes (morbidity outcomes, pain outcomes, health system outcomes). INTRODUCTION Pain in infants is a common concern for parents. Routine postpartum care for infants in early life requires them to endure painful procedures, yet infants often receive little to no pain management. While research has shown that parents can reduce their infant's pain during procedures by breastfeeding or skin-to-skin contact, parents may not be aware of their role in pain management. Despite the recent rapid increase in eHealth resources to educate parents about infant pain management, their impact has yet to be evaluated. INCLUSION CRITERIA This review will consider studies that include eHealth educational interventions targeted at parents during pregnancy and up to one year postpartum. All experimental study designs will be included. Primary outcomes will include: parental stress and anxiety, self-efficacy, knowledge, attitudes, eHealth intervention usage, acceptance of eHealth intervention, involvement in pain management, and infant pain response. METHODS PubMed, CINAHL, PsycINFO, Embase, Scopus, Web of Science, and SciELO will be searched for studies published in English. Critical appraisal and data extraction will be conducted by two independent reviewers using standardized tools. Quantitative data, where possible, will be pooled in statistical meta-analysis, or if statistical pooling is not possible, the findings will be reported narratively.
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Affiliation(s)
- Brianna Richardson
- School of Nursing, Dalhousie University, Halifax, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Canada
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence
- Centre for Transformative Nursing and Health Research, Halifax, Canada
| | - Britney Benoit
- School of Nursing, Dalhousie University, Halifax, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Canada
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence
- Centre for Transformative Nursing and Health Research, Halifax, Canada
| | - Kallen Rutledge
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Canada
| | - Justine Dol
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Canada
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence
- Faculty of Health, Dalhousie University, Halifax, Canada
| | - Ruth Martin Misener
- School of Nursing, Dalhousie University, Halifax, Canada
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence
- Centre for Transformative Nursing and Health Research, Halifax, Canada
| | - Margot Latimer
- School of Nursing, Dalhousie University, Halifax, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Canada
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence
- Centre for Transformative Nursing and Health Research, Halifax, Canada
| | - Michael Smit
- School of Information Management, Dalhousie University, Halifax, Canada
| | - Patrick McGrath
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Canada
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Marsha Campbell-Yeo
- School of Nursing, Dalhousie University, Halifax, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Canada
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence
- Centre for Transformative Nursing and Health Research, Halifax, Canada
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, Canada
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Dol J, Kohi T, Campbell-Yeo M, Tomblin Murphy G, Aston M, Mselle L. Exploring maternal postnatal newborn care postnatal discharge education in Dar es Salaam, Tanzania: Barriers, facilitators and opportunities. Midwifery 2019; 77:137-143. [PMID: 31325744 DOI: 10.1016/j.midw.2019.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 07/05/2019] [Accepted: 07/13/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Previous studies in Tanzania have shown that mothers do not often receive the recommended number of postnatal contacts, which limits their ability to not only have health checks but also to be provided with sufficient and quality postnatal education. Educating mothers while in the hospital is important yet there remains a paucity on the experiences of mothers in a hospital setting related to newborn care education. Therefore, the objective of this study was to explore the experience of newborn care discharge education at a national hospital in Dar es Salaam, Tanzania from the perspective of mothers and nurse midwives. METHODS Using convenience sampling, participants were recruited from Muhimbili National Hospital. Eight mothers who recently gave birth and eight nurse midwives working on the postnatal and labour ward participated. In-depth semi-structured interviews were conducted in Swahili and transcribed and translated into English. Interviews were analyzed using thematic coding. RESULTS Most mothers were multiparous (75%) and averaged 29.6 years of age (SD = 5.1). Nurse midwives had an average of 10 years of experience (SD = 7.5). The primary themes identified included barriers, facilitators, and opportunities related to newborn care discharge education. Barriers included lack of standard postnatal education guidelines; community norms against hospital teaching; gaps in hospital care; and expectations of mothers' previous knowledge. Facilitators identified were that education was already being provided on some relevant newborn care topics; nurse midwives desired to teach; and mothers desired to learn and build on their previous knowledge and confidence. Opportunities to improve included developing standardized guidelines related to postnatal discharge education; training nurses how to engage mothers and families; and engaging mothers through varied learning methods. CONCLUSION While mothers received some education prior to discharge and nurses expressed a desire to teach, challenges remained in receiving sufficient education on all recommended postnatal education topics. Opportunity to improve postnatal education can be addressed through the development of standardized education and engaging mothers through preferred learning methods.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, 6299 South St., Halifax, B3H 4R2 Nova Scotia, Canada; World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Thecla Kohi
- School of Nursing, St. Joseph College of Health and Allied Sciences, Dar es Salaam, Tanzania; School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Marsha Campbell-Yeo
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada; Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia, Canada; World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gail Tomblin Murphy
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada; World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Megan Aston
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada; World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lilian Mselle
- School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Mselle LT, Kohi TW, Dol J. Humanizing birth in Tanzania: a qualitative study on the (mis) treatment of women during childbirth from the perspective of mothers and fathers. BMC Pregnancy Childbirth 2019; 19:231. [PMID: 31277609 PMCID: PMC6612108 DOI: 10.1186/s12884-019-2385-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 06/27/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND While there has been a trend for greater number of women to deliver at health facilities across Tanzania, mothers and their family members continue to face mistreatment with respectful maternity care during childbirth being violated. The objective of this study was to describe the experience of mothers and fathers in relation to (mis) treatment during childbirth in Tanzania. METHODS Using a qualitative descriptive design, 12 semi-structured interviews and four focus group discussions were held with mothers and fathers who were attending a postnatal clinic in the Lake Zone region of Tanzania. Mothers' age ranged from 20 to 45 years whereas fathers' age ranged from 25 to 60 years. Data were analyzed using a priori coding based on Bohren's et al. typology of the mistreatment of women during childbirth. RESULTS Mothers reported facing mistreatment and disrespectful maternity care through verbal abuse (harsh or rude language and judgmental or accusatory comments), failure to meet professional standards of care (refused pain relief, unconsented surgical operations, neglect, abandonment or long delays, and skilled attendant absent at time of delivery), poor rapport between women and providers (poor communication, lack of supportive care, denied husbands presence at birth, denied mobility, denied safe traditional practices, no respect for their preferred birth positions), and health system conditions and constraints (poor physical condition of facilities, supply constraints, bribery and extortion, unclear fee structures). Despite some poor care, some mothers also reported positive birthing experiences and respectful maternity care by having a skilled attendant assistance at delivery, having good communication from nurses, receiving supportive care from nurses and privacy during delivery. CONCLUSION Despite the increasing number of deliveries occurring in the hospital, there continue to be challenges in providing respectful maternity care. Humanizing birth care in Tanzania continues to have a long way to go, however, there is evidence that changes are occurring as mothers notice and report positive changes in delivery care practices.
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Affiliation(s)
- Lilian T Mselle
- Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
| | - Thecla W Kohi
- School of Medicine, St. Joseph College of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Justine Dol
- Faculty of Health, Dalhousie University, Halifax, Canada
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Richardson B, Dol J, Rutledge K, Monaghan J, Orovec A, Howie K, Boates T, Smit M, Campbell-Yeo M. Evaluation of Mobile Apps Targeted to Parents of Infants in the Neonatal Intensive Care Unit: Systematic App Review. JMIR Mhealth Uhealth 2019; 7:e11620. [PMID: 30985282 PMCID: PMC6487340 DOI: 10.2196/11620] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/10/2018] [Accepted: 10/29/2018] [Indexed: 01/07/2023] Open
Abstract
Background Parents of preterm infants increasingly use their mobile phone to search for health information. In a recent review, websites targeted toward parents with infants in the neonatal intensive care unit (NICU) were found to have poor to moderate quality educational material; however, there is a dearth of literature regarding mobile apps for NICU parents. Objective This study aimed to identify and evaluate apps targeting parents of infants in the NICU for quality of information, usability, and credibility. Methods We systematically searched the Apple App Store and Google Play using 49 key terms (eg, “preterm infant”) from July 26 to August 18, 2017. English apps targeting NICU parents that cost less than $20 were included. Apps for health care professionals, e-books/magazines, or nonrelevant results were excluded. In total, 3 tools were used for evaluation: Mobile Application Rating Scale (MARS) to measure quality; Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-AV) to measure the app’s content usability; and Trust it or Trash It to measure credibility. Results The initial search yielded 6579 apps, with 49 apps eligible after title and description screening. In total, 27 apps met the eligibility criteria with 9 apps available in both app stores; of those, the app with the most recent update date was chosen to be included in the analysis. Thus, 18 unique apps were included for final analysis. Using MARS, 7 apps (7/18, 39%) received a good score on overall quality (ie, 4.0 out of 5.0), with none receiving an excellent score. In addition, 8 apps (8/18, 44%) received a PEMAT-AV score between 51% and 75% on the understandability subscale, and 8 apps (8/18, 44%) scored between 76% and 100% on the actionability subscale. Trust It or Trash It deemed 13 apps (13/18, 72%) as trash for reasons including no identification of sources or lack of current information, with only 5 (5/18, 28%) deemed trustworthy. Reviewer’s expert evaluation found 16 apps contained content that matched information provided by multiple sources; however, most apps did not meet other objective measurement items to support credibility. When comparing the MARS overall quality and subjective quality scores with trustworthiness of apps, there was no statistically significant difference. A statistically significant difference was found between the 2 MARS quality scores, indicating that, on average, apps were ranked significantly lower on subjective quality compared with overall quality measures. Conclusions This evaluation revealed that of the available apps targeting NICU parents, less than half should be considered as acceptable educational material. Over two-thirds of the apps were found to have issues regarding credibility and just over a quarter were considered good quality. The apps currently available for NICU parents are lacking and of concern in terms of quality and credibility.
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Affiliation(s)
- Brianna Richardson
- School of Nursing, Dalhousie University, Halifax, NS, Canada.,Faculty of Health, Dalhousie University, Halifax, NS, Canada.,Centre for Pediatric Pain, Izaak Walton Killam Health Centre, Halifax, NS, Canada
| | - Justine Dol
- Faculty of Health, Dalhousie University, Halifax, NS, Canada.,Centre for Pediatric Pain, Izaak Walton Killam Health Centre, Halifax, NS, Canada
| | - Kallen Rutledge
- Centre for Pediatric Pain, Izaak Walton Killam Health Centre, Halifax, NS, Canada
| | - Joelle Monaghan
- Centre for Pediatric Pain, Izaak Walton Killam Health Centre, Halifax, NS, Canada
| | - Adele Orovec
- Centre for Pediatric Pain, Izaak Walton Killam Health Centre, Halifax, NS, Canada
| | - Katie Howie
- Centre for Pediatric Pain, Izaak Walton Killam Health Centre, Halifax, NS, Canada
| | - Talia Boates
- Centre for Pediatric Pain, Izaak Walton Killam Health Centre, Halifax, NS, Canada
| | - Michael Smit
- School of Information Management, Dalhousie University, Halifax, NS, Canada
| | - Marsha Campbell-Yeo
- School of Nursing, Dalhousie University, Halifax, NS, Canada.,Centre for Pediatric Pain, Izaak Walton Killam Health Centre, Halifax, NS, Canada.,Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.,Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Izaak Walton Killam Health Centre, Halifax, NS, Canada
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Dol J, Campbell-Yeo M, Tomblin Murphy G, Aston M, McMillan D, Gahagan J, Richardson B. Parent-targeted postnatal educational interventions in low and middle-income countries: A scoping review and critical analysis. Int J Nurs Stud 2019; 94:60-73. [PMID: 30933873 DOI: 10.1016/j.ijnurstu.2019.03.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 03/10/2019] [Accepted: 03/12/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To identify and map existing postnatal educational interventions targeting parents in low and middle-income countries. A secondary objective is to conduct a critical analysis of the strengths and limitations of the educational strategies used for parent-targeted postnatal education. Design & data sources: Using scoping review methodology, MedLine, CINAHL, and SCOPUS were searched in October 2017. REVIEW METHODS All studies published after 2000 reporting on educational interventions that targeted parents from the period of birth to 6 weeks postnatally in low and middle-income countries were included. Studies were excluded if they targeted healthcare professionals or were community interventions that spanned antenatal to postnatal care. Title, abstract and full-text screening was conducted by two reviewers. RESULTS We initially identified 9284 articles with 77 articles included after title, abstract and full-text screening. Most of the studies were quantitative (94%) with over half published after 2014. Most studies (61%) targeted a single newborn care education intervention, of which 75% targeted breastfeeding. Interventions used on average three different methods of implementation (e.g., verbal, written information, counselling). Interventions were provided in the hospital (76%), at home (23%), at a clinic/hospital (8%), and/or virtually through an eHealth intervention, including phone or text messages (12%). Maternal outcomes primarily included knowledge, self-efficacy, anxiety and stress while newborn outcomes primarily included exclusive breastfeeding, weight gain at follow-up, and morbidities. Positive changes were found to occur for reported maternal outcomes (89%) and newborn outcomes (56%). CONCLUSIONS Parent-targeted education varied in terms of educational topics covered, method and location of intervention, and outcomes examined. While the best strategies of implementing postnatal education interventions to parents in low and middle-income countries is yet to be determined, evidence suggests that current interventions had a positive impact on parents' outcomes using a combined approach. Further work is needed to evaluate the impact on newborn outcomes and to identify the most effective methods and timing of the interventions.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, 6299 South St., Halifax, NS, 902-470-2638, Canada; World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, 6299 South St., Halifax, NS, Dalhousie University, Canada.
| | - Marsha Campbell-Yeo
- Faculty of Health, Dalhousie University, 6299 South St., Halifax, NS, 902-470-2638, Canada; School of Nursing, Faculty of Health, Dalhousie University, 6299 South St., Halifax, NS, Canada; Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, 6299 South St., Halifax, NS, Canada; World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, 6299 South St., Halifax, NS, Dalhousie University, Canada
| | - Gail Tomblin Murphy
- School of Nursing, Faculty of Health, Dalhousie University, 6299 South St., Halifax, NS, Canada; World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, 6299 South St., Halifax, NS, Dalhousie University, Canada
| | - Megan Aston
- School of Nursing, Faculty of Health, Dalhousie University, 6299 South St., Halifax, NS, Canada; World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, 6299 South St., Halifax, NS, Dalhousie University, Canada
| | - Douglas McMillan
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, 6299 South St., Halifax, NS, Canada
| | - Jacqueline Gahagan
- School of Health and Human Performance, Faculty of Health, 6299 South St., Halifax, NS, Dalhousie University, Canada
| | - Brianna Richardson
- School of Nursing, Faculty of Health, Dalhousie University, 6299 South St., Halifax, NS, Canada
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Dol J, Campbell-Yeo M, Tomblin Murphy G, Aston M, McMillan D, Richardson B. Impact of mobile health interventions during the perinatal period for mothers in low- and middle-income countries: a systematic review protocol. JBI Database System Rev Implement Rep 2019; 17:137-146. [PMID: 30204713 DOI: 10.11124/jbisrir-2017-003801] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
REVIEW QUESTION The objective of this review is to determine the impact of mother-targeted mobile health (mHealth) education interventions available during the perinatal period in low- and middle-income countries on maternal and newborn outcomes. Thus, the review questions are: what is the impact of mother-targeted mHealth education interventions on.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, Halifax, Canada
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence
- World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Canada
| | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, Canada
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence
- World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Canada
| | - Gail Tomblin Murphy
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence
- World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Canada
| | - Megan Aston
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence
- World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Canada
| | - Douglas McMillan
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, Canada
| | - Brianna Richardson
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): a Joanna Briggs Institute Centre of Excellence
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