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Thomas J, Kuliukas L, Frayne J, Bradfield Z. Factors influencing referral to maternity models of care in Australian general practice. PLoS One 2024; 19:e0296537. [PMID: 38771817 PMCID: PMC11108194 DOI: 10.1371/journal.pone.0296537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 04/02/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND In the Australian maternity system, general practitioners play a vital role in advising and directing prospective parents to maternity models of care. Optimising model of care discussions and the decision-making process avoids misaligning women with over or under specialised care, reduces the potential for disruptive care transitions and unnecessary healthcare costs, and is critical in ensuring consumer satisfaction. Current literature overwhelmingly focusses on women's decision-making around model of care discussions and neglects the gatekeeping role of the General Practitioner (GP). This study aimed to explore and describe the factors influencing Australian GPs decision-making when referring pregnant women to maternity models of care. METHODS This study used a qualitative descriptive approach. General practitioners (N = 12) with experience referring women to maternity models of care in Australia participated in a semi-structured interview. Interviews occurred between October and November 2021 by telephone or videoconference. Reflexive thematic analysis was facilitated by NVivo-12 data management software to codify and interpret themes from the data. FINDINGS Two broad themes were interpreted from the data. The first theme entitled 'GP Factors', incorporated three associated sub-themes including '1) GPs Previous Model of Care Experience', '2) Gaps in GP Knowledge' and '3) GP Perception of Models of Care'. The second theme, entitled 'Woman's Factors', encapsulated two associated sub-themes including the '4) Woman's Preferences' and '5) Access to Models'. CONCLUSIONS This study provides novel evidence regarding general practitioner perspectives of the factors influencing model of care decision-making and referral. Predominant findings suggest that gaps in GP knowledge regarding the available models of care are present and are largely informed by prior personal and professional experience. Most GPs described referring to models of care they perceive positively and centring their model of care discussions on the woman's preferences and accessibility. The exploration and description of factors influencing model of care decisions provide unique insight into the ways that all stakeholders can experience access to a broader range of models of care including midwifery-led continuity of care models aligned with consumer-demand. In addition, the role of national primary health networks is outlined as a means to achieving this.
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Affiliation(s)
- Jaime Thomas
- School of Nursing, Curtin University, Bentley, Western Australia, Australia
| | - Lesley Kuliukas
- School of Nursing, Curtin University, Bentley, Western Australia, Australia
| | - Jacqueline Frayne
- Medical School, University of Western Australia, Albany, Western Australia, Australia
| | - Zoe Bradfield
- School of Nursing, Curtin University, Bentley, Western Australia, Australia
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Susanti AI, Ali M, Hernawan AH, Rinawan FR, Purnama WG, Puspitasari IW, Stellata AG. Midwifery Continuity of Care in Indonesia: Initiation of Mobile Health Development Integrating Midwives' Competency and Service Needs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113893. [PMID: 36360772 PMCID: PMC9653760 DOI: 10.3390/ijerph192113893] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 05/25/2023]
Abstract
Midwives' competence in providing continuity of care using mobile health (mHealth) applications is limited in developing countries. This study identified and explored midwives' competency and service needs to develop mHealth in Midwifery Continuity of Care (MCOC) education and training. It used an explanatory sequential mixed method, and was conducted from August to December 2021. A cross-sectional approach was used to find the characteristics and competency scope of 373 midwives in West Java, and continued with a qualitative design through a Focus Group Discussion (FGD) of 13 midwives. Descriptive data analysis (frequency, mean, deviation standard) and qualitative data analysis (coding, sub-themes, and theme) were conducted. In terms of the midwives who participated in this study, more than half were aged ≤ 35 years (58.98%), with a working period > 10 years (56.30%), had diploma degrees (71.12%), and used smartphones on average 1-12 h/day (78.28%). Most midwives needed to develop competency in the MCOC scope, including its early detection of the risk factor of complications and treatment management. They were concerned about the purposes, benefits, and design of mHealth. In summary, midwives' competency indicators for early detection are more needed in MCOC using mHealth. Further research is required to evaluate midwives' competence in MCOC using mHealth.
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Affiliation(s)
- Ari Indra Susanti
- Faculty of Education Science, Indonesia University of Education, Jl. Dr. Setiabudi No. 229, Isola, Bandung 40154, Indonesia
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Jalan Ir. Soekarno KM. 21, Jatinangor, Sumedang 45363, Indonesia
- Center for Health System Study and Health Workforce Education Innovation, Faculty of Medicine, Universitas Padjadjaran, Jl. Eyckman No. 38, Bandung 40161, Indonesia
| | - Mohammad Ali
- Faculty of Education Science, Indonesia University of Education, Jl. Dr. Setiabudi No. 229, Isola, Bandung 40154, Indonesia
| | - Asep Herry Hernawan
- Faculty of Education Science, Indonesia University of Education, Jl. Dr. Setiabudi No. 229, Isola, Bandung 40154, Indonesia
| | - Fedri Ruluwedrata Rinawan
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Jalan Ir. Soekarno KM. 21, Jatinangor, Sumedang 45363, Indonesia
- Center for Health System Study and Health Workforce Education Innovation, Faculty of Medicine, Universitas Padjadjaran, Jl. Eyckman No. 38, Bandung 40161, Indonesia
- Indonesian Society for Remote Sensing branch West Java, Gedung 2, Fakultas Perikanan dan Ilmu Kelau-tan, Universitas Padjadjaran, Jl. Ir. Soekarno KM. 21, Jatinangor, Sumedang 45363, Indonesia
| | - Wanda Gusdya Purnama
- Center for Health System Study and Health Workforce Education Innovation, Faculty of Medicine, Universitas Padjadjaran, Jl. Eyckman No. 38, Bandung 40161, Indonesia
- Informatics Engineering Study Program, Faculty of Engineering, Universitas Pasundan, Jl. Dr. Setiabudi No.193, Bandung 40153, Indonesia
| | - Indriana Widya Puspitasari
- Center for Health System Study and Health Workforce Education Innovation, Faculty of Medicine, Universitas Padjadjaran, Jl. Eyckman No. 38, Bandung 40161, Indonesia
| | - Alyxia Gita Stellata
- Center for Health System Study and Health Workforce Education Innovation, Faculty of Medicine, Universitas Padjadjaran, Jl. Eyckman No. 38, Bandung 40161, Indonesia
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Exploring Women's Experiences of Maternity Service Delivery in Regional Tasmania: A Descriptive Qualitative Study. Healthcare (Basel) 2022; 10:healthcare10101883. [PMID: 36292330 PMCID: PMC9602368 DOI: 10.3390/healthcare10101883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/13/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
The objective of this study is to explore and understand the experiences of women who receive antenatal, birthing, and postnatal care from an integrated maternity services model in a regional area in Tasmania, Australia. This descriptive qualitative study included semi-structured, one-on-one interviews with 14 mothers aged >18 years, who were living in a regional area of Tasmania and had accessed maternity health services. Thematic analysis revealed three key themes: (i) talking about me, (ii) is this normal? and (iii) care practices. Overall, women cited mostly negative experiences from a poorly implemented fragmented service. These experiences included feelings of isolation, frustration over receiving conflicting advice, feeling ignored, and minimal to no continuity of care. In contrast, women also experienced the euphoric feelings of birth, immense support, guidance, and encouragement. Regional women’s experiences of maternity care may be improved if health services work towards place-based continuity of care models. These models should be informed by the local women’s experiences and needs in order to achieve better communication, reduce feelings of isolation, and promote positive breastfeeding experiences.
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McCaffery S, Small K, Gamble J. Rural Australian Doctors’ Views About Midwifery and Midwifery Models of Care: A Qualitative Study. INTERNATIONAL JOURNAL OF CHILDBIRTH 2022. [DOI: 10.1891/ijc-2021-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSEAustralian rural areas access to midwifery continuity of carer models is restricted. Lack of medical support has been identified as one of the reasons midwifery continuity of carer models have not been implemented. The purpose of his study was to explore rural Australian doctors’ views about midwifery and midwifery continuity of carer models.STUDY DESIGNA qualitative study with general practitioner and specialist obstetricians (n = 10) working in Australian rural maternity services. Semi-structured interviews were undertaken and analyzed using thematic analysis.FINDINGSParticipants’ views of midwifery and midwifery continuity of carer models were expressed in three themes. The themes related to the concepts of knowing: knowing the model, knowing the midwife, and knowing the system. Participants had misconceptions and misunderstandings of the model, midwifery, and systems issues relating to midwifery continuity of carer models.CONCLUSIONIncreasing understanding about midwifery and midwifery continuity of carer models may facilitate implementation of these models. A national education program for doctors about the structure and function of midwifery continuity of carer models would support knowledge building for obstetric doctors. Strong leadership and incentivization for health services may be needed to sustainably roll-out rural models. At a service level, responsibility for establishing and sustaining models should shift from local midwife leaders to hospital executives.
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Larsson B, Thies-Lagergren L. Partners' expectations and experiences of the project 'Midwife All the Way': A qualitative study. Eur J Midwifery 2021; 5:17. [PMID: 34179730 PMCID: PMC8208494 DOI: 10.18332/ejm/136424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/19/2021] [Accepted: 05/06/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Continuity models of midwifery care are significant factors in facilitating a positive childbirth experience for birthing women. A knowledge gap exists regarding partners' experiences of continuity of midwifery care during pregnancy, birth, and after birth, although it is essential to understand the experiences of both parents in relation to continuity of care. Thus, the aim of this study was to highlight partners' expectations and experiences of having participated in a continuity of midwifery care project. METHODS A qualitative interview study using thematic analysis was carried out. Thirty-six partners in a rural area in northern Sweden were recruited after the closure of the local labor ward. Interviews were conducted in October 2019 and in May 2020. RESULTS An overarching theme: 'A partner-midwife relationship facilitated a sense of security'; and two themes 'The concept of availability' and 'The midwife's competence and professionalism' reflect partners' expectations and experiences after participating in a continuity of midwifery care project. CONCLUSIONS Professionalism was most highly valued, but establishing a relationship with a known midwife facilitated a sense of security. When birthing women feel safe with the known midwife, the partners also feel safe. Having to travel a long-distance to a labor ward caused concern for the partners. This highlights the importance of an organization that supports families to gain access to continuity models of midwifery care and to have a possibility to give birth closer to their residence. The results of this qualitative study further strengthen the growing evidence of the positive effects of continuity models of midwifery care.
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Affiliation(s)
- Birgitta Larsson
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
| | - Li Thies-Lagergren
- Midwifery Research - Reproductive, Perinatal and Sexual Health, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.,Department of Obstetrics and Gynaecology, Helsingborg Hospital, Malmö, Sweden
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Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, Godfrey CM, Khalil H, Munn Z. Undertaking a scoping review: A practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs 2021; 77:2102-2113. [PMID: 33543511 PMCID: PMC8049063 DOI: 10.1111/jan.14743] [Citation(s) in RCA: 183] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/02/2020] [Accepted: 12/14/2020] [Indexed: 02/06/2023]
Abstract
AIM The aim of this study is to discuss the available methodological resources and best-practice guidelines for the development and completion of scoping reviews relevant to nursing and midwifery policy, practice, and research. DESIGN Discussion Paper. DATA SOURCES Scoping reviews that exemplify best practice are explored with reference to the recently updated JBI scoping review guide (2020) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review extension (PRISMA-ScR). IMPLICATIONS FOR NURSING AND MIDWIFERY Scoping reviews are an increasingly common form of evidence synthesis. They are used to address broad research questions and to map evidence from a variety of sources. Scoping reviews are a useful form of evidence synthesis for those in nursing and midwifery and present opportunities for researchers to review a broad array of evidence and resources. However, scoping reviews still need to be conducted with rigour and transparency. CONCLUSION This study provides guidance and advice for researchers and clinicians who are preparing to undertake an evidence synthesis and are considering a scoping review methodology in the field of nursing and midwifery. IMPACT With the increasing popularity of scoping reviews, criticism of the rigour, transparency, and appropriateness of the methodology have been raised across multiple academic and clinical disciplines, including nursing and midwifery. This discussion paper provides a unique contribution by discussing each component of a scoping review, including: developing research questions and objectives; protocol development; developing eligibility criteria and the planned search approach; searching and selecting the evidence; extracting and analysing evidence; presenting results; and summarizing the evidence specifically for the fields of nursing and midwifery. Considerations for when to select this methodology and how to prepare a review for publication are also discussed. This approach is applied to the disciplines of nursing and midwifery to assist nursing and/or midwifery students, clinicians, researchers, and academics.
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Affiliation(s)
- Danielle Pollock
- JBIFaculty of Health and Medical SciencesThe University of AdelaideAdelaideSAAustralia
| | - Ellen L. Davies
- Adelaide Nursing SchoolFaculty of Health and Medical SciencesThe University of AdelaideAdelaideSAAustralia
| | - Micah D. J. Peters
- Adelaide Nursing SchoolFaculty of Health and Medical SciencesThe University of AdelaideAdelaideSAAustralia
- Rosemary Bryant AO Research CentreClinical & Health SciencesUniversity of South AustraliaAdelaideSAAustralia
- The Centre for Evidence‐based Practice South Australia (CEPSA): A JBI Centre of ExcellenceAdelaideSAAustralia
| | - Andrea C. Tricco
- Li Ka Shing Knowledge Institute of St. Michael's HospitalUnity Health TorontoTorontoONCanada
- Epidemiology Division and Institute of Health Management, Policy, and EvaluationDalla Lana School of Public HealthUniversity of TorontoTorontoONCanada
- Queen's Collaboration for Health Care Quality: A JBI Centre of ExcellenceKingstonONCanada
| | - Lyndsay Alexander
- School of Health SciencesRobert Gordon UniversityAberdeenUK
- The Scottish Centre for Evidence‐based Multi‐professional Practice: A JBI Centre of ExcellenceAberdeenUK
| | - Patricia McInerney
- Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
- The Wits‐JBI Centre for Evidence‐Based Practice: A JBI Affiliated GroupJohannesburgSouth Africa
| | - Christina M. Godfrey
- Queen's Collaboration for Health Care Quality: A JBI Centre of ExcellenceKingstonONCanada
- School of NursingQueen's UniversityKingstonONCanada
| | - Hanan Khalil
- School of Psychology and Public HealthDepartment of Public HealthLa Trobe UniversityMelbourneVicAustralia
| | - Zachary Munn
- JBIFaculty of Health and Medical SciencesThe University of AdelaideAdelaideSAAustralia
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