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Faktor L, Small K, Bradfield Z, Baird K, Fenwick J, Gray JE, Robinson M, Warton C, Cusack S, Homer CS. What do women in Australia want from their maternity care: A scoping review. Women Birth 2024; 37:278-287. [PMID: 38142159 DOI: 10.1016/j.wombi.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/14/2023] [Accepted: 12/17/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Just over 300,000 women give birth in Australia each year. It is important for health care providers, managers, and policy makers know what women want from their care so services can be provided appropriately. This review is a part of the Midwifery Futures Project, which aims to prepare the midwifery workforce to best address the needs of women. The aim of this review was to describe and analyse current literature on the maternity care needs of women in Australia. METHODS A scoping review methodology was used, guided by the Joanna Briggs Institute framework. A systematic search of the literature identified 9023 studies, and 59 met inclusion criteria: being peer-reviewed research focusing on maternity care needs, conducted in Australian populations, from 2012 to 2023. The studies were analysed using inductive content analysis. RESULTS Four themes were developed: Continuity of care, being seen and heard, being safe, and being enabled. Continuity of care, especially a desire for midwifery continuity of care, was the central theme, as it was a tool supporting women to be seen and heard, safe, and enabled. CONCLUSION This review highlights that women in Australia consistently want access to midwifery continuity of care as an enabler for addressing their maternity care needs. Transforming Australian maternity care policy and service provision towards continuity would better meet women's needs.
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Affiliation(s)
- Lachlan Faktor
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC, Australia; School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia
| | - Kirsten Small
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC, Australia; School of Nursing and Midwifery, Griffith University, Logan, QLD, Australia
| | - Zoe Bradfield
- Faculty of Health Sciences, Curtin University, WA, Australia
| | - Kathleen Baird
- Faculty of Health, University of Technology Sydney, NSW, Australia
| | - Jennifer Fenwick
- Faculty of Health, University of Technology Sydney, NSW, Australia
| | - Joanne E Gray
- Faculty of Health, University of Technology Sydney, NSW, Australia
| | | | - Chanelle Warton
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC, Australia
| | | | - Caroline Se Homer
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC, Australia; Faculty of Health, University of Technology Sydney, NSW, Australia.
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Keten Edis E, Kurtgöz A. Care experiences and care expectations of hospitalized high-risk pregnant women: a qualitative study. Women Health 2023; 63:704-712. [PMID: 37758687 DOI: 10.1080/03630242.2023.2262614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 09/19/2023] [Indexed: 09/29/2023]
Abstract
Gaining insight into the prenatal care experiences and expectations of high-risk pregnant women is crucial for offering holistic care that aligns with their individualized needs. This study aimed at determining the care experiences and expectations of women with high-risk pregnancies. We adopted a descriptive qualitative approach in the research. The data were collected through in-depth interviews between March and June 2022. The participants included 27 high-risk pregnant women selected by purposive sampling. We analyzed the data using inductive content analysis. We utilized the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist to report data. The participants' ages ranged from 22 to 40 years. The participants' gestational ages ranged from 29 to 38 weeks. We identified three themes, namely "Emotions felt in the course of pregnancy", "Care experiences; satisfaction and dissatisfaction", and "Expectations for ideal care". The findings showed that women experienced fear, stress, and anxiety while expecting supportive, attentive, and understanding care during the course of pregnancy. Our results revealed that high-risk pregnant women have some unmet care needs. Healthcare professionals should strive to provide individualized and holistic care for high-risk pregnant women.
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Affiliation(s)
- Elif Keten Edis
- Department of Nursing, Faculty of Health Sciences, Amasya University, Amasya, Turkey
| | - Aslı Kurtgöz
- Sabuncuoglu Serefeddin Health Services Vocational School, Amasya University, Amasya, Turkey
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Theroux R, Violette C. Fetal Anomaly: Family Experiences and Preferences for Care: An Integrative Review. J Perinat Neonatal Nurs 2023; 37:310-324. [PMID: 37878516 DOI: 10.1097/jpn.0000000000000752] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
BACKGROUND The prenatal diagnosis of a fetal anomaly is unexpected, creating a family crisis. Expectant parents are at an increased risk for perinatal depression and traumatic stress. Prior reviews examined parents' experiences when terminating but not continuing the pregnancy. This review synthesized qualitative research to describe the experiences, emotional responses, and needs of families continuing their pregnancy. METHODS An integrative review was performed using the Whitemore and Knafl methodology and PRISMA guidelines. A systematic review of peer-reviewed articles published between 2000 and 2200 on the experiences of fetal anomaly was performed using 5 databases. Eligible articles included qualitative studies describing families' experiences with a fetal anomaly diagnosis who elected to continue their pregnancy. Methodological quality was evaluated using the Critical Skills Appraisal Program checklist. RESULTS Of the 678 article results, 16 met inclusion criteria. There were 298 participants from 5 countries. The major overarching theme of Response to the Diagnosis of Fetal Anomaly was identified. The major categories were emotional response, coping strategies, influences, health care experiences, and family needs. Uncertainty and grief were the most common emotions. DISCUSSION Parents choosing to continue pregnancy benefit from compassionate, sensitive care, and accurate, concise information, provided in tailored instruction using multiple styles.
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Affiliation(s)
- Rosemary Theroux
- UMass Chan Medical School, Tan Chingfen Graduate School of Nursing, Worcester (Dr Theroux); and UMASS Chan Medical School Obstetrics and Gynecology & Tan Chingfen Graduate School of Nursing, Worcester (Dr Violette)
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Slater K, Taylor R, McLaughlin K, Pennell C, Collins C, Hutchesson M. Barriers and Facilitators to Cardiovascular Disease Prevention Following Hypertensive Disorders of Pregnancy in Primary Care: Cross-Sectional Surveys. Nutrients 2023; 15:3817. [PMID: 37686849 PMCID: PMC10490358 DOI: 10.3390/nu15173817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/21/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
Women with a history of hypertensive disorders of pregnancy (HDP) have an increased risk of cardiovascular disease (CVD). Guidelines recommend that women diagnosed with HDP should be advised of their increased CVD risk, have regular blood pressure monitoring by their general practitioner (GP), and adopt healthy lifestyle behaviours. However, within Australia, the current practice in primary health care is unknown. The aim of this study was to describe current practices, barriers, and facilitators to the provision of CVD preventative services for women after HDP in the primary care setting and to identify potential strategies to support GPs in providing recommended care. Separate cross-sectional online surveys were undertaken with 35 GPs and 105 women with a history of HDP. Surveys included both closed- and open-ended questions. Closed-ended questions were analysed using basic descriptive statistics, and open-ended questions were themed and tallied. The survey of GPs revealed that GPs are more likely to assess traditional CVD risk markers than lifestyle risk factors or HDP history. GPs identified a lack of resources and skills as barriers to providing CVD preventative care post-HDP. The survey with women after HDP revealed that women with a history of HDP are more likely to be assessed for blood pressure than lifestyle CVD risk factors, and that the women's barriers to obtaining care included difficulty obtaining an appointment and time required for attending appointments. Strategies to improve CVD preventative care were consistent between surveys, where 70% of GPs and 59% of women chose 'increasing women's awareness of increased CVD risk' and 67% of GPs and 55% of women chose 'improving communication between hospitals and primary care' as their preferred strategies. While the findings suggest that women with a history of HDP are receiving advice consistent with guidelines for traditional CVD risk markers, such as blood pressure, they are less likely to receive CVD preventative care for lifestyle or female-specific CVD risk factors.
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Affiliation(s)
- Kaylee Slater
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.S.); (R.T.); (C.C.)
- Food and Nutrition Research Program, Hunter Medical Research Institute, Lot 1, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Rachael Taylor
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.S.); (R.T.); (C.C.)
- Food and Nutrition Research Program, Hunter Medical Research Institute, Lot 1, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Karen McLaughlin
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Craig Pennell
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Clare Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.S.); (R.T.); (C.C.)
- Food and Nutrition Research Program, Hunter Medical Research Institute, Lot 1, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Melinda Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.S.); (R.T.); (C.C.)
- Food and Nutrition Research Program, Hunter Medical Research Institute, Lot 1, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
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Expectant Fathers' perceptions towards high-risk pregnancy and experiences in this period: A study of hermeneutic phenomenology. Appl Nurs Res 2022; 68:151639. [PMID: 36473719 DOI: 10.1016/j.apnr.2022.151639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/20/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022]
Abstract
BACKROUND High-risk pregnancy affects maternal and infant health negatively and it may be the beginning of a process with traumatic outcomes for women and their spouses. Identifying the experiences and perceptions of expectant fathers in this process is important to develop support factors for women and their spouses. OBJECTIVE To identify expectant fathers' perceptions towards high-risk pregnancy and their experiences during the high-risk pregnancy period. PARTICIPANTS Fifteen expectant fathers whose spouses were admitted to the hospital due to high-risk pregnancy were interviewed for the study. DESIGN This study was conducted using an interpretive paradigm based on the Heideggerian hermeneutic phenomenology, which is a qualitative research method. Data were collected through in-depth telephonic interviews. The interviews were recorded, transcribed verbatim and analyzed thematically. FINDINGS Four main themes were obtained: "Emotional burden", "Coping mechanisms", "Adaptation to fatherhood" and "High-risk pregnancy journey". The expectant fathers said that they had so many emotions during this process, could cope by praying and with support from their spouses, longed for their unborn child and had increased responsibilities due to paternity. CONCLUSIONS The results of this study indicated that men struggled emotionally, had very few coping strategies, questioned the high-risk pregnancy process, had several expectations and formed father-infant attachment during the high-risk pregnancy. Further studies are needed that review how midwives and nurses can support expectant fathers in this process and that provide opportunities for the improvement of clinical roles in this regard.
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