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Hadjigeorgiou E, Frangou M, Koliandri Y, Christofi MD, Middleton N. Description of the culture of childbirth and parenting classes in Cyprus: An ethnographic approach. Eur J Midwifery 2024; 8:EJM-8-25. [PMID: 38832252 PMCID: PMC11145719 DOI: 10.18332/ejm/186665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 03/29/2024] [Accepted: 04/15/2024] [Indexed: 06/05/2024] Open
Abstract
INTRODUCTION Childbirth and parenting classes are very important because they potentially help couples to make the right decisions during pregnancy, childbirth, and the postpartum period, which has a direct effect on the health of the mother and neonate. However, in Cyprus, the culture of childbirth and parenting classes has not been previously explored. METHODS An ethnographic study design was adopted, specifically non-participant observation was undertaken of 19 classes. Semi-structured telephone interviews were employed to collect data in addition to field notes and a reflective diary. Inductive content analysis was undertaken to analyze the data. RESULTS Four main thematic categories emerged from data analysis: 1) Views and opinions about the course, 2) Important perinatal topics, 3) Usefulness and reasons for attending the classes, and 4) The journey of learning. The importance of antenatal classes has not been given sufficient attention in Cyprus. CONCLUSIONS There is a clear need for a standardized curriculum within the current configuration of national maternity healthcare in Cyprus. Policymakers must implement a standardized curriculum, integrating diverse pedagogical methods to provide in-depth information for expectant parents and parents. While emphasizing the crucial role of midwives in perinatal education, this study also advocates for collaboration with other healthcare professionals emphasizing the imperative need for a comprehensive, standardized approach to perinatal education within the national healthcare system of Cyprus.
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Affiliation(s)
- Eleni Hadjigeorgiou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Maria Frangou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Yianna Koliandri
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Maria-Dolores Christofi
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Nicos Middleton
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
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Diezi AS, Vanetti M, Robert M, Schaad B, Baud D, Horsch A. Informing about childbirth without increasing anxiety: a qualitative study of first-time pregnant women and partners' perceptions and needs. BMC Pregnancy Childbirth 2023; 23:797. [PMID: 37978462 PMCID: PMC10655283 DOI: 10.1186/s12884-023-06105-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Complications requiring medical interventions during childbirth are far from rare, even after uncomplicated pregnancies. It is often a challenge for maternity healthcare professionals to know how to prepare future parents for these eventualities without causing unnecessary anxiety. Studies on traumatic birth experiences have shown that feelings of loss of control, insufficient information, and lack of participation in medical decisions during childbirth are factors of difficult experiences. However, little is known about the information and communication needs of expectant parents about childbirth during the prenatal period. To gain a deeper understanding of the information and communication needs of first-time pregnant women and partners, we explored their perceptions and expectations for their upcoming childbirth, and the actions they initiated to prepare for it. METHODS Semi-structured interviews were conducted individually with first-time pregnant women and partners of pregnant women aged 18 years or older, with an uncomplicated pregnancy. Thematic analysis was used to identify themes and sub-themes. RESULTS Twenty expectant parents (15 pregnant women and five partners of pregnant women) were interviewed. Six themes were identified: Childbirth event; Childbirth experience; Childbirth environment; Organisation of care; Participation in decision making; Roles within the couple and transition to parenthood. CONCLUSIONS This study contributes to a better understanding of the information needs of future parents expecting their first child. Results highlighted that the notion of "childbirth risks" went beyond the prospect of complications during birth, but also encompassed concerns related to a feeling of loss of control over the event. Expectant parents showed an ambivalent attitude towards consulting risk information, believing it important to prepare for the unpredictability of childbirth, while avoiding information they considered too worrying. They expressed a desire to receive concrete, practical information, and needed to familiarise themselves in advance with the birth environment. Establishing a respectful relationship with the healthcare teams was also considered important. The findings suggest that information on childbirth should not be limited to the transmission of knowledge, but should primarily be based on the establishment of a relationship of trust with healthcare professionals, taking into account each person's individual values and expectations.
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Affiliation(s)
- Anne-Sylvie Diezi
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de La Corniche 10, 1011, Lausanne, Switzerland
- Communication Department, Lausanne University Hospital, Rue du Bugnon 21, 1011, Lausanne, Switzerland
| | - Mélanie Vanetti
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de La Corniche 10, 1011, Lausanne, Switzerland
| | - Marie Robert
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de La Corniche 10, 1011, Lausanne, Switzerland
| | - Béatrice Schaad
- Communication Department, Lausanne University Hospital, Rue du Bugnon 21, 1011, Lausanne, Switzerland
- Institute of Humanities in Medicine, Lausanne University Hospital and University of Lausanne, Av. de Provence 82, 1007, Lausanne, Switzerland
| | - David Baud
- Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, Av. Pierre-Decker 10, 1011, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de La Corniche 10, 1011, Lausanne, Switzerland.
- Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, Av. Pierre-Decker 10, 1011, Lausanne, Switzerland.
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Koliandri I, Hadjigeorgiou E, Karanikola M, Kolokotroni O, Nicolaou C, Christodoulides V, Papadopoulou M, Kouta C, Middleton N. Informational support and information-seeking during transition to parenthood: Baby Buddy Forward's focus groups with pregnant women and new mothers in Cyprus. Eur J Midwifery 2023; 7:29. [PMID: 37920451 PMCID: PMC10619000 DOI: 10.18332/ejm/171360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/07/2023] [Accepted: 09/13/2023] [Indexed: 11/04/2023] Open
Abstract
INTRODUCTION Relevant and accurate information during the transition to parenthood is vital for active participation in decision-making. The aim of the study was to gain an in-depth understanding of informational support and information-seeking practices among women in Cyprus during the transition to parenthood with a focus on the use of the internet and informed decision making. METHODS Qualitative descriptive exploratory design of 12 focus groups with 64 participants representing different language-cultural groups served by the Baby Buddy Cyprus app. A topic guide covering expectations, experiences and practices guided the discussions. Data were analyzed using inductive content analysis. RESULTS Seven themes and several subthemes emerged. In an 'unsupportive system', 'void' of informational support, pregnant women strive to have a 'confident voice'. They find themselves 'self-navigating in parallel worlds' of formal and informal information, where the internet holds a prominent place. 'Supplementing and filtering', instinctively and selectively, results in a state of 'doubt and faith' towards the trustworthiness of the information but also healthcare providers. Effective communication with providers is needed to break the cycle, but seems dependent on the self-efficacy of the women themselves ('art of communication'). Women 'deconstruct and reimagine' their experiences, often assigning responsibility on themselves for not having been better prepared. CONCLUSIONS Women want control over decisions affecting their pregnancy. While the internet is a prevalent source of information, they value communication with healthcare providers and want direction. A shift is needed from current practices of unguided information-searching. Maternity healthcare professionals need to recognize this phenomenon, offer appropriate guidance, and support active participation in informed decision-making.
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Affiliation(s)
- Ioanna Koliandri
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Eleni Hadjigeorgiou
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Maria Karanikola
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Ourania Kolokotroni
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
- Birth Forward Non-Governmental Organization, Nicosia, Cyprus
| | - Christiana Nicolaou
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | | | - Maria Papadopoulou
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Christiana Kouta
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Nicos Middleton
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
- Birth Forward Non-Governmental Organization, Nicosia, Cyprus
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Lewis-Jones B, Nielsen TC, Svensson J, Nassar N, Henry A, Lainchbury A, Kim S, Kiew I, McLennan S, Shand AW. Cross-sectional survey of antenatal education attendance among nulliparous pregnant women in Sydney, Australia. Women Birth 2023; 36:e276-e282. [PMID: 35987732 DOI: 10.1016/j.wombi.2022.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/07/2022] [Accepted: 08/07/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Antenatal education aims to provide expectant parents with strategies for dealing with pregnancy, childbirth and parenthood and may have the potential to reduce obstetric intervention and fear of childbirth. We aimed to investigate antenatal education attendance, reasons for and barriers to attending, and techniques taught and used to manage labour. METHODS Antenatal and postnatal surveys were conducted among nulliparous women with a singleton pregnancy at two maternity hospitals in Sydney, Australia in 2018. Classes were classified into psychoprophylaxis, birth and parenting, other, or no classes. Reasons for and barriers to attendance, demographic characteristics, and techniques taught and used in labour were compared by class type, using Pearson's Chi Squared tests of independence. FINDINGS 724 women were surveyed antenatally. The main reasons for attending classes were to better manage the birth (86 %), feel more secure in baby care (71 %) and as a parent (60 %); although this differed by class type. Reasons for not attending classes included being too busy (33 %) and cost (27 %). Epidural, breathing techniques, massage and nitrous oxide were the most common techniques taught. Women who attended psychoprophylaxis classes used a wider range of pain relief techniques in labour. Women found antenatal classes useful preparation for birth (94 %) and parenting (74 %). Women surveyed postnatally wanted more information on baby care/sleeping and breastfeeding. CONCLUSION The majority of women found antenatal education useful and utilised techniques taught. Education providers should ensure breastfeeding and infant care information is provided, and barriers to attendance such as times and cost should be addressed.
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Affiliation(s)
| | - Timothy C Nielsen
- Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Jane Svensson
- Royal Hospital for Women, Randwick, Sydney, NSW, Australia
| | - Natasha Nassar
- Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Amanda Henry
- School of Women's and Children's Health, UNSW Medicine and Health, Sydney, NSW, Australia; Department of Women's and Children's Health, St George Hospital, Sydney, NSW, Australia
| | | | - Sara Kim
- School of Women's and Children's Health, UNSW Medicine and Health, Sydney, NSW, Australia
| | - Isabelle Kiew
- School of Women's and Children's Health, UNSW Medicine and Health, Sydney, NSW, Australia
| | - Sarah McLennan
- School of Women's and Children's Health, UNSW Medicine and Health, Sydney, NSW, Australia
| | - Antonia W Shand
- Royal Hospital for Women, Randwick, Sydney, NSW, Australia; Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, NSW, Australia
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Lungu GG, Chodzaza E, Kamanga M, Chikazinga W, Jere D. Status of information, education, and communication as perceived by clients receiving antenatal care at Chiradzulu District Hospital in Malawi. BMC Womens Health 2023; 23:53. [PMID: 36759826 PMCID: PMC9909957 DOI: 10.1186/s12905-023-02209-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Information, education, and communication is a strategy to spread awareness through communication channels to a target audience to achieve a desired positive result. Women are supposed to receive information, education, and communication at each contact with the health worker during antenatal care. In Malawi, information, education, and communication for antenatal care is inadequate despite high antenatal care coverage. Most women do not receive it as stipulated. This could be one of the reasons that maternal and neonatal mortality is high. The provision of information, education, and communication is supposed to help in reducing maternal mortality because it is intended to develop positive attitudes towards health behaviours to support pregnant women accessing health services when required. This study, therefore, assessed the status of information, education, and communication as perceived by clients receiving antenatal care at Chiradzulu District Hospital in Malawi. METHODS A descriptive study design with a sample of 384 pregnant women attending antenatal care was used. The sample size for the study was calculated using Lemeshow, Hosmer, Klar and Rwanga's formula. Systematic random sampling method was used to select the study participants. Data were analysed using a statistical package for social sciences software version 20.0. RESULTS Findings revealed that information, education, and communication provided during antenatal care were inadequate. Most information was offered. However, no topic was rated adequate by 80% of the respondents according to the Likert Scale that was used. The majority of the respondents (71.4%, n = 274) (95% CI 66.5. 75.8) preferred to receive information, education, and communication from midwives who are in the category of skilled attendants. Results further showed that more than half of the respondents participated passively and spent little time receiving information, education, and communication. CONCLUSION The findings signify that information, education, and communication provided to women receiving antenatal care at Chiradzulu District Hospital had some gaps. It was inadequate and some topics were not taught. The target audience participated passively. It is recommended that midwives should provide the information, education, and communication and must have adequate contact time with the women. This is so because they are believed to be trusted sources of information.
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Affiliation(s)
- Gaily Graysham Lungu
- Department of Midwifery, School of Maternal, Neonatal and Reproductive Health, Kamuzu University of Health Sciences, P/Bag 360, Chichiri, Blantyre 3., Blantyre, Malawi.
| | - Elizabeth Chodzaza
- grid.517969.5Department of Midwifery, School of Maternal, Neonatal and Reproductive Health, Kamuzu University of Health Sciences, P/Bag 360, Chichiri, Blantyre 3., Blantyre, Malawi
| | - Martha Kamanga
- grid.517969.5Department of Midwifery, School of Maternal, Neonatal and Reproductive Health, Kamuzu University of Health Sciences, P/Bag 360, Chichiri, Blantyre 3., Blantyre, Malawi
| | - Wanangwa Chikazinga
- grid.517969.5School of Nursing. Department of Nursing Education, Kamuzu University of Health Sciences, P/Bag 1, Capital City, Lilongwe Malawi
| | - Diana Jere
- grid.517969.5School of Nursing, Department of Mental Health, Kamuzu University of Health Sciences, P/Bag 360, Chichiri Blantyre 3, Malawi
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Middleton N, Hadjigeorgiou E, Kolokotroni O, Christodoulides V, Koliandri I, Nicolaou C, Papadopoulou M, Kouta C, Karanikola M, Baum A. Identifying barriers to the educational role of midwives in Cyprus and defining determinants in behaviour terms using the Behaviour Change Wheel: a mixed-method formative study. BMC Health Serv Res 2022; 22:1233. [PMID: 36199135 PMCID: PMC9534462 DOI: 10.1186/s12913-022-08599-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/23/2022] [Indexed: 12/01/2022] Open
Abstract
Background Τhe Baby Buddy Cyprus webapp was co-created with parents and health professionals within a Participatory Action Research framework. While using Baby Buddy in routine consultations can support the educational role of mother–child healthcare providers (HP), antenatal education (AE) may be currently perceived as a formal activity within the physical space of the antenatal class. We aimed to gain an understanding of influences on midwives engaging in an educational role during routine appointments and identify potential interventions using the Behaviour Change Wheel (BCW) framework. Methods This is a formative mixed-methods research study, with a convergent parallel design, guided by the COM-B model and related Theoretical Domains Framework (TDF). Complimentary methods were used to collect information from in-training and registered midwives: focus group (N = 11), questionnaire survey (N = 24) and Nominal Group Technique during workshops (N = 40). Deductive content analysis of qualitative data and quantitative survey analysis shaped the behaviour diagnosis along the 6 COM-B and 14 TDF domains, and informed the selection of relevant intervention functions and related Behaviour Change Techniques from the BCW taxonomy. Results AE is viewed as a core function of the professional role, yet neither supported nor prioritized by current practices. Problematic areas relate to organizational context, such as weak interprofessional collaboration and lack of policy, protocols and resources. In addition, medicalization of birth and related socio-cultural norms, pertaining to users and providers, are sustaining alienation of the midwife and conditions of power dynamics. AE was perceived as a means to enhance the autonomy of the profession but there might be issues with procedural knowledge and the need for skill development was identified. Several intervention functions were identified as promising, however cognitive re-framing through strategic communication and modelling may also be needed both in terms of providing “credible models” for the role itself as well as re-framing AE through the concept of “making every contact count”. Conclusions AE is currently perceived to be a ‘bad fit’ with routine practice. The study identified several barriers to the educational role of midwives, influencing Capacity, Opportunity and Motivation. While digital tools, such as Baby Buddy, can facilitate aspects of the process, a much wider behaviour and system change intervention is needed to enhance midwives’ educational role and professional identity. In addition to proposing a theory-driven research-informed intervention, the process functioned as a participatory learning experience through collective reflection. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08599-7.
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Affiliation(s)
- Nicos Middleton
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus. .,Birth Forward, Non-Governmental Organization, Nicosia, Cyprus.
| | - Eleni Hadjigeorgiou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Ourania Kolokotroni
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.,Birth Forward, Non-Governmental Organization, Nicosia, Cyprus.,Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | | | - Ioanna Koliandri
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Christiana Nicolaou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Maria Papadopoulou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Christiana Kouta
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Maria Karanikola
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Alison Baum
- Best Beginnings, Registered Charity Organization, London, UK
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Shorey S, Loh DNL, Chan V, Chua C, Choolani MA. Parents' perceptions of antenatal educational programs: A meta-synthesis. Midwifery 2022; 113:103432. [PMID: 35907268 DOI: 10.1016/j.midw.2022.103432] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 06/17/2022] [Accepted: 07/12/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Contents and mode of delivery of antenatal educational programs differed considerably. Yet there is a lack of high-level evidence about the delivery of these programs. OBJECTIVE We aimed to understand the experiences and needs of parents who have attended antenatal educational programs. DESIGN Six databases were searched from each database. Included studies were appraised using the Critical Appraisal Skills Program tool. Qualitative data were meta-summarized and meta-synthesized. FINDINGS Seventeen studies were included, and three themes were developed: (1) Contradicting views on antenatal educational programs, (2) Feeling 'well prepared' after attending the antenatal educational programs, and (3) Parents' expectations and way forward for the antenatal educational programs. DISCUSSION Findings revealed that the description of contents of antenatal educational programs needed to be more specific. Mindfulness strategies were well-received by parents in the included studies. Educators should take into account inclusivity and increase educational resources related to individual, cultural and community needs. Learning needs can be assessed before and after classes. Parents with specific needs that were not addressed should be identified and referred to the relevant professionals for continued support. More deliberate actions were needed during the programs to foster social and professional networks for attendees to support them throughout antenatal and postnatal periods. CONCLUSION We consolidated the experiences and needs of parents who have attended antenatal educational programs. Findings can help refine policies related to antenatal care to improve pregnancy, birth and parenthood experiences for both mothers and fathers.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, 117597, Singapore.
| | - Doris Ngiuk Lan Loh
- Obstetrics and Gynecology Department, National University of Singapore, 5 Lower Kent Ridge Rd, 119074, Singapore
| | - Valerie Chan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, 117597, Singapore
| | - Crystal Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, 117597, Singapore
| | - Mahesh A Choolani
- Obstetrics and Gynecology Department, National University Hospital, 5 Lower Kent Ridge Rd, 119074, Singapore
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Diotaiuti P, Valente G, Mancone S, Falese L, Corrado S, Siqueira TC, Andrade A. A Psychoeducational Intervention in Prenatal Classes: Positive Effects on Anxiety, Self-Efficacy, and Temporal Focus in Birth Attendants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137904. [PMID: 35805564 PMCID: PMC9266264 DOI: 10.3390/ijerph19137904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/18/2022] [Accepted: 06/24/2022] [Indexed: 01/27/2023]
Abstract
Background: Previous studies have reported associations between high maternal anxiety, temporal perceptions during pregnancy, and a poor sense of self-efficacy. One type of anxiety expecting mothers experience is associated with childbirth, which previous studies have shown can be reduced by antenatal training. Recent contributions have pointed out that current prenatal courses, while providing important and useful knowledge, do not devote sufficient content to the mental health of the parturient and to the psychological issues that can arise before and after the birth. Methods: In total, 80 pregnant women were provided with a special prepartum course in which ample space was devoted to topics such as maternal mental health, parenting skills and couple relationship, relaxation techniques, and assertiveness. Perception of threat, state anxiety, temporal focus, needs and expectations, and self-efficacy were assessed by comparing this psychoeducational intervention group with a traditional antenatal course group (n = 80), and a control group (n = 80). Two-way mixed ANOVAS (3 × 2) were performed for each dependent variable considered, including the time variable (pre-course–post-course) as a factor within the participants and the group variable as a factor between the subjects. Results: The psychoeducational intervention actually induced significant and positive changes primarily on four dimensions: state anxiety, perceived self-efficacy, the need for information, and reassurance of the pregnant women who participated in this trial. Conclusions: The study suggests improving the quality of prenatal classes by paying particular attention to the content and communication used within the group, in order to gratify at the highest level, the need for information, reassurance, and sharing that characterize the parturient’s request for support. The evidence collected recommends further replicating the intervention protocol described in order to improve the psychophysical well-being of women in a delicate moment such as pregnancy and preparation for childbirth, but especially in terms of the prevention and containment of the risks of psychological distress that currently affect a significant number of women after childbirth.
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Affiliation(s)
- Pierluigi Diotaiuti
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy; (G.V.); (S.M.); (L.F.); (S.C.)
- Correspondence:
| | - Giuseppe Valente
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy; (G.V.); (S.M.); (L.F.); (S.C.)
| | - Stefania Mancone
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy; (G.V.); (S.M.); (L.F.); (S.C.)
| | - Lavinia Falese
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy; (G.V.); (S.M.); (L.F.); (S.C.)
| | - Stefano Corrado
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy; (G.V.); (S.M.); (L.F.); (S.C.)
| | - Thais Cristina Siqueira
- Health and Sports Science Center, Department of Physical Education, CEFID, Santa Catarina State University, Florianópolis 88035-901, Brazil; (T.C.S.); (A.A.)
| | - Alexandro Andrade
- Health and Sports Science Center, Department of Physical Education, CEFID, Santa Catarina State University, Florianópolis 88035-901, Brazil; (T.C.S.); (A.A.)
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9
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Shand AW, Lewis-Jones B, Nielsen T, Svensson J, Lainchbury A, Henry A, Nassar N. Birth outcomes by type of attendance at antenatal education: An observational study. Aust N Z J Obstet Gynaecol 2022; 62:859-867. [PMID: 35581951 PMCID: PMC10083900 DOI: 10.1111/ajo.13541] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/14/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Antenatal education aims to prepare expectant parents for pregnancy, birth, and parenthood. Studies have reported antenatal education teaching breathing and relaxation methods for pain relief, termed psychoprophylaxis, is associated with reduction in caesarean section rates compared with general birth and parenting classes. Given the rising rates of caesarean section, we aimed to determine whether there was a difference in mode of birth in women based on the type of antenatal education attended. MATERIALS AND METHODS A cross-sectional antenatal survey of nulliparous women ≥28 weeks gestation with a singleton pregnancy was conducted in two maternity hospitals in Sydney, Australia in 2018. Women were asked what type of antenatal education they attended and sent a follow-up survey post-birth. Hospital birth data were also obtained. Education was classified into four groups: psychoprophylaxis, birth and parenting, other, or none. RESULTS Five hundred and five women with birth data were included. A higher proportion of women who attended psychoprophylaxis education had a vaginal birth (instrumental/spontaneous) (79%) compared with women who attended birth and parenting, other or no education (69%, 67%, 60%, respectively P = 0.045). After adjusting for maternal characteristics, birth and hospital factors, the association was attenuated (odds ratio 2.03; 95% CI 0.93-4.43). CONCLUSIONS Women who attended psychoprophylaxis couple-based education had a trend toward higher rates of vaginal birth. Randomised trials comparing different types of antenatal education are required to determine whether psychoprophylaxis education can reduce caesarean section rates and improve other birth outcomes.
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Affiliation(s)
- Antonia W Shand
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Royal Hospital for Women, Sydney, New South Wales, Australia
| | | | - Timothy Nielsen
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jane Svensson
- Royal Hospital for Women, Sydney, New South Wales, Australia
| | - Anne Lainchbury
- Royal Hospital for Women, Sydney, New South Wales, Australia
| | - Amanda Henry
- School of Women's and Children's Health, University of New South Wales Medicine, Sydney, New South Wales, Australia.,St George Hospital, Sydney, New South Wales, Australia
| | - Natasha Nassar
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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10
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O’Mahen HA, Ramchandani PG, King DX, Lee-Carbon L, Wilkinson EL, Thompson-Booth C, Ericksen J, Milgrom J, Dunkley-Bent J, Halligan SL, Fearon P. Adapting and testing a brief intervention to reduce maternal anxiety during pregnancy (ACORN): report of a feasibility randomized controlled trial. BMC Psychiatry 2022; 22:129. [PMID: 35177019 PMCID: PMC8851863 DOI: 10.1186/s12888-022-03737-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 01/10/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND We investigated the acceptability and feasibility of a new brief intervention for maternal prenatal anxiety within maternity services in London and Exeter, UK. METHODS One hundred fourteen pregnant individuals attending their 12-week scan at a prenatal clinic with elevated symptoms of anxiety (GAD-7 score of ≥7) were randomly assigned to either the ACORN intervention + Treatment as usual (TAU) (n = 57) or to usual care only (n = 57). The ACORN intervention consisted of 3 2-h group sessions, led by a midwife and psychological therapist, for pregnant individuals and their partners. The intervention included psychoeducation about anxiety, strategies for problem-sovling and tolerating uncertainty during pregnancy, including communicating about these with others, and mindfulness exercises. RESULTS Engagement rates with ACORN met or exceeded those in primary care services in England. In the intervention arm, 77% (n = 44) of participants attended at least one session, 51% (n = 29) were adherent, defined as attending two or more sessions. Feedback was positive, and participants in the ACORN treatment group demonstrated evidence of a larger drop in their levels of anxiety than the participants in the TAU-only group (Cohen's d = 0.42). CONCLUSION The ACORN intervention was acceptable to pregnant individuals and their partners and resulted in reductions in anxiety. With further evaluation in a larger-scale trial with child outcomes, there is significant potential for large scale public health benefit.
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Affiliation(s)
- Heather A. O’Mahen
- grid.8391.30000 0004 1936 8024Mood Disorders Research Centre, University of Exeter, Perry Road, Exeter, EX4 4QG UK
| | - Paul G. Ramchandani
- grid.7445.20000 0001 2113 8111Centre for Mental Health, Imperial College London, 7th Floor Commonwealth Building, Hammersmith Campus, Du Cane Road, London, W12 0NN UK ,grid.450578.b0000 0001 1550 1922Central and North West London NHS Foundation Trust, Stephenson House, 75 Hampstead Road, London, NW1 2PL UK ,grid.5335.00000000121885934Centre for Research on Play in Education, Development, and Learning, Faculty of Education, University of Cambridge, 184 Hills Road, Cambridge, CB2 8PQ England
| | - Dorothy X. King
- grid.7445.20000 0001 2113 8111Centre for Mental Health, Imperial College London, 7th Floor Commonwealth Building, Hammersmith Campus, Du Cane Road, London, W12 0NN UK ,grid.450578.b0000 0001 1550 1922Central and North West London NHS Foundation Trust, Stephenson House, 75 Hampstead Road, London, NW1 2PL UK
| | - Leonie Lee-Carbon
- grid.7445.20000 0001 2113 8111Centre for Mental Health, Imperial College London, 7th Floor Commonwealth Building, Hammersmith Campus, Du Cane Road, London, W12 0NN UK
| | - Esther L. Wilkinson
- grid.7445.20000 0001 2113 8111Centre for Mental Health, Imperial College London, 7th Floor Commonwealth Building, Hammersmith Campus, Du Cane Road, London, W12 0NN UK ,grid.450578.b0000 0001 1550 1922Central and North West London NHS Foundation Trust, Stephenson House, 75 Hampstead Road, London, NW1 2PL UK ,grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 16 De Crespigny Park, London, SE5 8AF UK
| | - Chloe Thompson-Booth
- grid.83440.3b0000000121901201Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB UK ,Essex Partnership University NHS Foundation Trust, Trust Head Office, The Lodge, Lodge Approach, Runwell, Wickford, Essex, SS11 7XX UK
| | - Jennifer Ericksen
- grid.413976.e0000 0004 0645 3457Parent-Infant Research Institute, Centaur Building, Heidelberg Repatriation Hospital, Austin Health, 300 Waterdale Road, Heidelberg Heights, Melbourne, VIC Australia
| | - Jeannette Milgrom
- grid.413976.e0000 0004 0645 3457Parent-Infant Research Institute, Centaur Building, Heidelberg Repatriation Hospital, Austin Health, 300 Waterdale Road, Heidelberg Heights, Melbourne, VIC Australia ,grid.1008.90000 0001 2179 088XMelbourne School of Psychological Sciences, University of Melbourne, Level 12, Redmond Barry Building, Parkville, VIC 3010 Australia
| | - Jacqueline Dunkley-Bent
- grid.451052.70000 0004 0581 2008NHS England, Nursing Directorate, Skipton House, 80 London Road, London, SE1 6LH UK
| | - Sarah L. Halligan
- grid.7340.00000 0001 2162 1699Department of Psychology, University of Bath, Bath, BA2 7AY UK ,grid.413335.30000 0004 0635 1506Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur Hospital, Observatory, Cape Town, South Africa
| | - Pasco Fearon
- grid.83440.3b0000000121901201Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
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Loezar-Hernández M, Briones-Vozmediano E, Gea-Sánchez M, Otero-García L. Percepción de la atención sanitaria en la primera experiencia de maternidad y paternidad. GACETA SANITARIA 2022; 36:425-432. [DOI: 10.1016/j.gaceta.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 12/14/2021] [Accepted: 12/18/2021] [Indexed: 11/04/2022]
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STEWART J, WATTS DK, HUGHES DAJ, SLADE PP, SPIBY PH. The importance of face to face, group antenatal education classes for first time mothers: A qualitative study. Midwifery 2022; 109:103295. [DOI: 10.1016/j.midw.2022.103295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 01/28/2022] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
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13
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Mah B, Cibralic S, Hanna J, Hart M, Loughland C, Cosh S. Outcomes for infants whose mothers had an eating disorder in the perinatal period: A systematic review of the evidence. Int J Eat Disord 2021; 54:2077-2094. [PMID: 34608655 DOI: 10.1002/eat.23612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 09/11/2021] [Accepted: 09/12/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To establish any health outcomes for infants to age one, associated with their mother having a diagnosis of an active eating disorder during pregnancy or the 12-month postnatal period. METHOD A qualitative systematic literature review of numerous databases (Medline, PsycINFO, CINAHL, Scopus, Cochrane Library, MedNar, PsycExtra, National Institute for Health and Care Excellence and Open Grey) was performed examining any infant health outcomes. RESULTS This resulted in 22 included studies (17 cohort, 3 cross-sectional, 1 case controlled and 1 mixed methods study). A range of adverse infant outcomes including poor birth, growth and interactional feeding outcomes were identified. DISCUSSION Antenatal identification and treatment for women with an eating disorder during the perinatal period and their infants are vital. Optimizing pregnancy nutrition, maternal eating disorder symptoms and feeding interactions appear particularly important.
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Affiliation(s)
- Beth Mah
- Raphael Services, Blacktown, New South Wales, Australia.,School of Psychiatry, AGSM Building, UNSW, Sydney, New South Wales, Australia.,Centre for Brain and Mental Health, University of Newcastle, Waratah, New South Wales, Australia
| | - Sara Cibralic
- School of Psychiatry, AGSM Building, UNSW, Sydney, New South Wales, Australia.,The Toddler Clinic, Karitane, The Horsley Drive, Carramar, New South Wales, Australia
| | - Joanne Hanna
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Melissa Hart
- Centre for Brain and Mental Health, University of Newcastle, Waratah, New South Wales, Australia.,Hunter New England Mental Health, Hunter New England Local Health District, Waratah, New South Wales, Australia
| | - Carmel Loughland
- Centre for Brain and Mental Health, University of Newcastle, Waratah, New South Wales, Australia.,Hunter New England Mental Health, Hunter New England Local Health District, Waratah, New South Wales, Australia
| | - Suzanne Cosh
- School of Psychology, University of New England, Armidale, New South Wales, Australia
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14
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Alnuaimi K, Almalik M. Sexual educational needs of Jordanian women after giving birth. Birth 2021; 48:52-60. [PMID: 33215767 DOI: 10.1111/birt.12509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pregnancy and birth entail many bodily changes, including changes in sexual activity. The postpartum period is a time of considerable recovery and adaptation for women, yet women do not always receive adequate information, especially in countries where such topics may be considered taboo. The purpose of this project was to explore the sexual educational needs of Jordanian women after giving birth. METHODS A qualitative, phenomenological approach was used. A purposive sample of 25 women were recruited from two health care centers. Semi-structured, in-depth interviews were conducted in person in Arabic between August and November 2015. Transcripts were independently analyzed and coded by each researcher. RESULTS Two major themes with six subthemes emerged. Theme 1, sexual education, included discussions about the women's needs for scientific information and the husband's involvement, and their psychological needs. Theme 2, professional approaches, involved discussions about the most appropriate person to deliver education, preferred place and time for education, and effective educational approaches to be used. DISCUSSION Congruent with previous studies, findings indicated that issues related to sexuality are often ignored in this population. CONCLUSIONS Jordanian women have many unmet educational needs with respect to sexuality after giving birth. More efforts are needed from health care professionals and other stakeholders to help improve Jordanian women's sexual health education after giving birth. These should include greater access to classes, websites with scientific information, and informational handouts that target husbands, and postpartum women themselves.
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Affiliation(s)
- Karimeh Alnuaimi
- Maternal and Child Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Mona Almalik
- Maternal and Child Health Nursing Department, Faculty of Nursing, University of Mutah, Mutah, Jordan.,Department of Health Sciences, Higher colleges of Technology, SJW, UAE
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15
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Cutajar L, Miu M, Fleet JA, Cyna AM, Steen M. Antenatal education for childbirth: Labour and birth. Eur J Midwifery 2021; 4:11. [PMID: 33537613 PMCID: PMC7839135 DOI: 10.18332/ejm/120002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/01/2020] [Accepted: 04/01/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION This study aimed to identify the way information is described and presented by childbirth educators during antenatal classes for expectant parents, and analyse the language structures used when discussing labour and birth. METHODS This cross-sectional study of antenatal education was conducted at a single tertiary referral centre for Maternity Care in Western Sydney, Australia. All childbirth educators (n=3) were recorded whilst providing information to parents during antenatal classes. Audio data were subsequently transcribed and then analysed by two researchers, independently categorising the various language structures and types of information provided. This is the second study in a series of antenatal education topics. RESULTS During the labour and birth class, information statements were the predominant language structure that was spoken with 241 of 655 statements; negative statements were the next most frequent at 119 while there were 79 positive statements. The second stage of labour had a greater proportion of negative statements for two educators, followed by information and positive statements combined. Misinformation statements were minimal for this topic however, and there was an absence of any statements discussing the rest period between contractions. CONCLUSIONS The findings further emphasise the need to examine the language used by health professionals when educating parents. Negative statements during antenatal education are still common despite research in other contexts suggesting that these are potentially unhelpful. Further research into the language and suggestions used during antenatal education is required to determine whether improved outcomes seen in other contexts are confirmed in the childbirth setting.
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Affiliation(s)
- Lisa Cutajar
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia.,Department of Women's and Children's Health, Birth Unit, Nepean Hospital, Penrith, Australia
| | - Michelle Miu
- Anaesthesia and Pain Management, Nepean Hospital, Penrith, Australia
| | - Julie-Anne Fleet
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Allan M Cyna
- Anaesthesia and Pain Management, Nepean Hospital, Penrith, Australia.,Acute Care Medicine, University of Adelaide, Adelaide, Australia
| | - Mary Steen
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
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16
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Lee E, Cho I, Cho SJ, Lee E. [Information Resource Network Analysis of Factors Influencing Breastfeeding Planning and Duration]. J Korean Acad Nurs 2021; 51:232-244. [PMID: 33993128 DOI: 10.4040/jkan.20280] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/15/2021] [Accepted: 02/22/2021] [Indexed: 11/09/2022]
Abstract
PURPOSE This study aimed to identify the modifiable factors affecting breastfeeding planning and duration among healthy mothers and their use of breastfeeding information resources. METHODS A cross-sectional survey was conducted in a community setting. Four hundreds participants were recruited at five pediatric clinics and three community health centers located in Paju-si and Goyang-si, Gyeonggi-do, between January and May 2019. Based on the breastfeeding decision-making model, driven by Martens and Young's work, the survey items consisted of demographics, childbirth and breastfeeding characteristics, and breastfeeding information resources. In the analysis, 389 responses were used in the t-test, ANOVA, and logistic regression. Information resource networks were compared before and after childbirth including a subgroup analysis depending on the breastfeeding duration. RESULTS The modifiable factors affecting breastfeeding planning and duration were antenatal and postpartum breastfeeding education and the provision of information in the hospital. The frequency of Internet use and websites visited were notable and potentially modifiable factors, which were also observed in the networks showing different relationship patterns according to participant subgroups and times. The childbirth event increased the centralization of the network in the planned group, while the network of the non-planned group was more diffused after childbirth. The network of the short-term breastfeeding group was characterized by a more centralized pattern and the resources of high betweenness centrality than the long-term group. CONCLUSION Breastfeeding education is a consistent factor that affects breastfeeding behavior. A well-designed internet-based approach would be an effective nursing intervention to meet the needs of women seeking breastfeeding information and changing their behaviors.
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Affiliation(s)
- Eunyoung Lee
- Nursing Department, Inha University Graduate School, Incheon, Korea
| | - Insook Cho
- Nursing Department, College of Medicine, Inha University, Incheon, Korea.
| | - Seong Jin Cho
- Department of Statistics, Inha University Graduate School, Incheon, Korea
| | - Eunju Lee
- Nursing Department, College of Medicine, Inha University, Incheon, Korea
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Tan ML, Foong SC, Ho JJ, Foong WC, Mohd R, Harun Z. Postpartum women's perception of antenatal breastfeeding education: a descriptive survey. Int Breastfeed J 2020; 15:85. [PMID: 33054789 PMCID: PMC7557059 DOI: 10.1186/s13006-020-00328-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 10/05/2020] [Indexed: 11/26/2022] Open
Abstract
Background Antenatal breastfeeding education (ANBE) is provided to all pregnant women attending Ministry of Health (MOH) clinics and some private health facilities in Malaysia, in line with the WHO/UNICEF Baby-Friendly Hospital Initiative (BFHI). However, the 6 month exclusive breastfeeding prevalence remains relatively low in Malaysia, suggesting that there may be a gap between what is currently taught and what is received by the women. Objectives To determine how women perceived their ANBE experience in the first 8 weeks postpartum including what was useful and what they would like to have been included, sources of ANBE and infant feeding practices at the time of survey. Methods Women during their first 8 weeks postpartum who attended MOH clinics in Penang State, Malaysia were surveyed using a self-administered questionnaire in April and May 2015. Categorical responses were presented as numbers and proportions while free text responses were compiled verbatim and categorised into themes. The perceptions of primiparous and multiparous women were compared. Multivariate logistic regression adjusted to known confounders was used to determine if ANBE was associated with exclusive breastfeeding at the time of survey. Results A total of 421 women completed the 15-item questionnaire (84% response rate) of which 282 were complete and available for analysis. Of these, 95% had received ANBE, majority (88%) from MOH clinics. Almost all women found it useful. However, there were areas both in the delivery (e.g. too short) and the content (e.g. nothing new) that were described as not useful; and areas they would like more coverage (e.g. milk expression, storage and overcoming low milk supply). The exclusive breastfeeding prevalence at the time of survey was 61%. ANBE was significantly associated with exclusive breastfeeding even after adjusting for confounders (adjusted odds ratio [aOR] 8.1, 95% confidence interval 1.7, 38.3). Conclusions ANBE is widely implemented and perceived as useful and may be associated with exclusive breastfeeding. Our findings give insight into content that women would like more of and how delivery of ANBE could be improved, including individualized sessions and communicating at a suitable level and language. Future studies could focus on the quality of ANBE delivery.
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Affiliation(s)
- May Loong Tan
- Department of Paediatrics, RCSI & UCD Malaysia Campus (formerly Penang Medical College), 4 Jalan Sepoy Lines, 10450, George Town, Penang, Malaysia.
| | - Siew Cheng Foong
- Department of Paediatrics, RCSI & UCD Malaysia Campus (formerly Penang Medical College), 4 Jalan Sepoy Lines, 10450, George Town, Penang, Malaysia
| | - Jacqueline J Ho
- Department of Paediatrics, RCSI & UCD Malaysia Campus (formerly Penang Medical College), 4 Jalan Sepoy Lines, 10450, George Town, Penang, Malaysia
| | - Wai Cheng Foong
- Department of Paediatrics, RCSI & UCD Malaysia Campus (formerly Penang Medical College), 4 Jalan Sepoy Lines, 10450, George Town, Penang, Malaysia
| | - Rokiah Mohd
- Department of Public Health, Penang State Health Department, George Town, Penang, Malaysia
| | - Zuhaida Harun
- Nutrition & Community Health, Penang State Health Department, George Town, Penang, Malaysia
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The Role of Antenatal Education in Promoting Maternal and Family Health Literacy. INTERNATIONAL JOURNAL OF CHILDBIRTH 2020. [DOI: 10.1891/ijcbirth-d-20-00012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUNDAntenatal education (ANE) supports expectant parents in developing their knowledge, skills, and confidence in preparing for childbirth and early parenting. This is called health literacy, and it is part of the global healthcare system agenda that empowers women to participate fully in making decisions about their health and care before, during, and after birth. The aim of this study was to examine the perspectives of educators and ANE class participants on the extent to which existing courses are meeting this goal.METHODSA qualitative study, conceptualized within the health literacy framework, was conducted in Australia with 10 antenatal educators and 8 participants from antenatal classes. Data were collected through individual interviews and were analyzed using interpretive description.RESULTSThe findings revealed five themes relating to the participants' experiences in either providing or attending antenatal classes. These included: “balancing provider influences with participant expectations,” “accommodating participant learning styles and preferences,” “influence of the environment on pedagogy and practice,” “empowering participants for decision-making,” and “reflections on what is and is not meaningful and effective.”CONCLUSIONSFindings from this study strongly suggest that to meet the needs of class participants, educators need to be mindful of their expectations. They should adopt a flexible approach to accommodate participants' knowledge, goals, and preferences as well as characteristics of the context. Conceptualizing ANE within the framework of health literacy provides a clear, targeted approach to meeting the information needs of this important population that is focused on evidence-based safe practice across the birthing continuum and beyond.
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Wadephul F, Jones C, Jomeen J. ‘Welcome to the World’: parents' experiences of an antenatal nurturing programme. ACTA ACUST UNITED AC 2019. [DOI: 10.12968/bjom.2019.27.6.353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background The transition to parenthood lays the foundations for the parent-infant relationship, but can also be a time of increased vulnerability. It can therefore be a suitable time for interventions to increase parents' emotional wellbeing and support couple relationships as well as the relationship with the baby. Aims This study aimed to explore the experiences of attendees at an antenatal nurturing programme and its effect on their experiences of the early postnatal period. Methods A total of 36 attendees took part in six focus groups across the UK. Findings Participants' experiences of the programme were very positive; it provided knowledge and skills and gave participants a safe space in which to explore feelings and concerns. The programme encouraged participants to nurture themselves, as well as their babies and their relationships. Some groups formed strong support networks, while others did not. Conclusion Participants felt they had benefitted from the programme, particularly in terms of their emotional wellbeing and couple relationships.
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Affiliation(s)
- Franziska Wadephul
- Postdoctoral Research Assistant, Department of Midwifery and Child Health, Faculty of Health Sciences, University of Hull
| | - Catriona Jones
- Senior Research Fellow, Department of Midwifery and Child Health, Faculty of Health Sciences, University of Hull
| | - Julie Jomeen
- Professor of Midwifery, Department of Midwifery and Child Health, Faculty of Health Sciences, University of Hull
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20
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Forslund Frykedal K, Barimani M, Rosander M, Berlin A. Parents' reasons for not attending parental education groups in antenatal and child health care: A qualitative study. J Clin Nurs 2019; 28:3330-3338. [PMID: 31091340 DOI: 10.1111/jocn.14912] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/18/2019] [Accepted: 05/03/2019] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To explore expectant and new parents' reasons not to participate in parental education (PE) groups in antenatal care or child health care. BACKGROUND In Sweden, expectant and new parents are offered PE groups in antenatal care and in child health care. Although many parents feel unprepared for parenthood, an urgent task is to attract parents to attend the PE groups. DESIGN A total of 915 parents with children aged 0 to 21 months answered a web questionnaire with open questions about (a) reasons not to participate; (b) anything that could change their mind; and (c) parenting support instead of PE groups. This was analysed using content analysis. The study follows the SRQR guidelines. RESULTS Parents expressed private reasons for not attending PE groups. Some parents also asked for more heterogeneity regarding content and methods, as well as accommodation of parents' different interests. Other parents asked for like-minded individuals who were in similar situation to themselves. Lack of information or invitations from antenatal care or child health care, or that PE groups were unavailable, were additional reasons for not participating in groups. CONCLUSIONS Reasons for not attending PE groups were multifaceted from personal, self-interested and norm-critical reasons, to that the groups were not available or that the parents were not aware of their existence. RELEVANCE TO CLINICAL PRACTICE Parents of today are a diverse group with different interests and needs. Nevertheless, all parents need to feel included in a way that makes participation in PE groups relevant for them. Thus, it is important for leaders to be aware of structures and norms, and to be able to create a group climate and a pedagogy of acceptance where group members value each other's differences. However, to attract parents to participate in PE groups, it is necessary for clinical practice to work on individual, group and organisational levels.
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Affiliation(s)
- Karin Forslund Frykedal
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.,Department of Social and Behavioural Studies, University West, Trollhättan, Sweden
| | - Mia Barimani
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Michael Rosander
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Anita Berlin
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge, Sweden
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Ruiz-Rodríguez M, Sánchez-Martínez Y, Ramírez-Muñoz PC, Camargo-Lemos DM. Recommendations of physical activity and rest in a Colombian prenatal control program. Rev Saude Publica 2019; 53:41. [PMID: 31066819 PMCID: PMC6536106 DOI: 10.11606/s1518-8787.2019053000934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 07/27/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To determine the frequency of the registry of physical activity and rest recommendations made to pregnant women and to explore their associated factors in a prenatal care program of primary care public institutions in Bucaramanga, Colombia. METHODS An observational study was conducted. The sampling frame consisted of the medical records of the pregnant women who attended at least one prenatal care program between January 1 and December 31, 2012 (n = 2.932), in 21 primary care health centers. We analyzed sociodemographic variables, prenatal and clinical antecedents, and information related to health personnel and the organization of health centers as possible factors associated with the recommendations of physical activity and rest recorded in the clinical history. Logistic regression models were applied to explore associations with α = 0.10. RESULTS There was a frequency of 26.1% of PA recommendations and 3.6% of rest recommendation on record, issued by nutrition (97.3%) and medical (86.7%) professionals, respectively. The factors associated with the registration of physical activity recommendations were: being nulliparous pregnant (OR = 1.7), attending more than four Prenatal Care Attention Programs (OR = 2.2), having high or medium obstetric risk in the first prenatal care program (OR = 0.6), and being attended in the western (OR = 0.5) and eastern (OR = 0.2) administrative areas health centers. CONCLUSIONS The low frequency of physical activity recommendations found in the records makes it necessary to reinforce the management strategies of health centers and strengthen the monitoring and accompaniment to comply with the care protocols. In addition, it is necessary to train health teams on the benefits of physical activity and their proper prescription, considering the multiple benefits derived from their practice on the maternal-fetal health.
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Affiliation(s)
- Myriam Ruiz-Rodríguez
- Universidad Industrial de Santander. Departamento de Salud Pública. Bucaramanga, Colombia
| | - Yuri Sánchez-Martínez
- Universidad Industrial de Santander. Departamento de Salud Pública. Bucaramanga, Colombia
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Frykedal KF, Rosander M, Barimani M, Berlin A. Leaders' limitations and approaches to creating conditions for interaction and communication in parental groups: A qualitative study. J Child Health Care 2019; 23:147-159. [PMID: 29804465 DOI: 10.1177/1367493518777311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to describe and understand parental group (PG) leaders' experiences of creating conditions for interaction and communication. The data consisted of 10 interviews with 14 leaders. The transcribed interviews were analysed using thematic analysis. The results showed that the leaders' ambition was to create a parent-centred learning environment by establishing conditions for interaction and communication between the parents in the PGs. However, the leaders' experience was that their professional competencies were insufficient and that they lacked pedagogical tools to create constructive group discussions. Nevertheless, they found other ways to facilitate interactive processes. Based on their experience in the PG, the leaders constructed informal socio-emotional roles for themselves (e.g. caring role and personal role) and let their more formal task roles (e.g. professional role, group leader and consulting role) recede into the background, so as to remove the imbalance of power between the leaders and the parents. They believed this would make the parents feel more confident and make it easier for them to start communicating and interacting. This personal approach places them in a vulnerable position in the PG, in which it is easy for them to feel offended by parents' criticism, questioning or silence.
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Antenatal education for pregnant women attending maternal and child health clinics in Brunei Darussalam. Women Birth 2018; 32:564-569. [PMID: 30482512 DOI: 10.1016/j.wombi.2018.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 10/28/2018] [Accepted: 11/14/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Antenatal education is an essential component of antenatal care that prepares and facilitates the acquisition of women's skills and confidence required for positive experiences throughout pregnancy, birth and the postnatal period. AIM To evaluate pregnant women's experiences of education during the antenatal period in Brunei Darussalam. METHODS A descriptive cross-sectional study was conducted using a pre-designed instrument to examine the provision of antenatal education among 110 pregnant women attending two major Maternal and Child Health Clinics in Brunei Darussalam. The quantitative data was analysed descriptively whereby the scores of each scale was calculated and reported accordingly. FINDINGS A majority of participants possess good health knowledge and live a healthy lifestyle. They have a positive perception about baby and postnatal care. However, participants only possess average knowledge about practical health techniques. DISCUSSION Overall, the majority of women were satisfied with the antenatal education provided in the Maternal and Child Health Clinics in Brunei Darussalam. Good rapport and interactive learning were the two most quoted important characteristics in antenatal education classes. Breastfeeding, which required both practical knowledge and the acquisition of skills was found to be the most interesting antenatal education topic. Antenatal education provided through verbal information was identified as the least interesting to the women. CONCLUSION This first study, which aimed to evaluate antenatal education in Brunei Darussalam could provide baseline data and guide strategies to engage pregnant women and relevant agencies in antenatal education. Future studies involving a more in-depth exploration of the women's experiences are recommended.
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Abstract
Objective The purpose of this study was to examine the content of the first prenatal visit within an academic medical center clinic and to compare the topics discussed to 2014 American College of Obstetrics and Gynecologists guidelines for the initial prenatal visit. Methods Clinical interactions were audio recorded and transcribed (n = 30). A content analysis was used to identify topics discussed during the initial prenatal visit. Topics discussed were then compared to the 2014 ACOG guidelines for adherence. Coded data was queried though the qualitative software and reviewed for accuracy and content. Results First prenatal visits included a physician, nurse practitioner, nurse midwife, medical assistant, medical students, or a combination of these providers. In general, topics that were covered in most visits and closely adhered to ACOG guidelines included vitamin supplementation, laboratory testing, flu vaccinations, and cervical cancer screening. Topics discussed less often included many components of the physical examination, education about pregnancy, and screening for an identification of psychosocial risk. Least number of topics covered included prenatal screening. Conclusions for Practice While the ACOG guidelines may include many components that are traditional in addition to those based on evidence, the guidelines were not closely followed in this study. Identifying new ways to disseminate information during the time constrained initial prenatal visit are needed to ensure improved patient outcomes.
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Affiliation(s)
- J Dyer
- College of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA
| | - G Latendresse
- College of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA
| | - E Cole
- College of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA
| | - J Coleman
- College of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA
| | - E Rothwell
- College of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA.
- Division of Medical Ethics and Humanities, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA.
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Koury H, Corral J, Hurt KJ, Muffly TM. “I Have a Tear Down There?”: Implementing a Three‐dimensional Anatomical Education Tool Into Post‐partum Perineal Laceration Care. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.635.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Hannah Koury
- Modern Human AnatomyUniversity of Colorado Anschutz Medical CampusAuroraCO
| | - Janet Corral
- School of MedicineUniversity of Colorado Anschutz Medical CampusAuroraCO
| | - K. Joseph Hurt
- School of Medicine, Obstetrics and GynecologyUniversity of Colorado Anschutz Medical CampusAuroraCO
| | - Tyler M. Muffly
- Obstetrics and GynecologyDenver Health Hospital and AuthorityDenverCO
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Using eHealth to Increase Autonomy Supportive Care: A Multicenter Intervention Study in Antenatal Care. Comput Inform Nurs 2018; 36:77-83. [PMID: 28984634 DOI: 10.1097/cin.0000000000000389] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
eHealth solutions are increasingly implemented in antenatal care to enhance women's involvement. The main aim of this study was to evaluate women's assessment of autonomy supportive care during the antenatal care visits among low-risk pregnant women. An intervention study was conducted including a control group attending standard antenatal care and an intervention group having access to an eHealth knowledge base, in addition to standard care. A total of 87 women were included in the control group and a total of 121 women in the intervention group. Data were collected using an online questionnaire 2 weeks after participants had given birth. Data were analyzed using χ tests and Wilcoxon rank sums. Use of an eHealth knowledge base was associated with statistically significant higher scores for women's overall assessment of antenatal care visits, the organization of antenatal care visits, confidence after antenatal care visits, and involvement during antenatal care visits. We also found a statistically significant higher overall self-perceived autonomy supportive care in the intervention group compared with the control group.
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Morrell CJ, Sutcliffe P, Booth A, Stevens J, Scope A, Stevenson M, Harvey R, Bessey A, Cantrell A, Dennis CL, Ren S, Ragonesi M, Barkham M, Churchill D, Henshaw C, Newstead J, Slade P, Spiby H, Stewart-Brown S. A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression. Health Technol Assess 2018; 20:1-414. [PMID: 27184772 DOI: 10.3310/hta20370] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Postnatal depression (PND) is a major depressive disorder in the year following childbirth, which impacts on women, their infants and their families. A range of interventions has been developed to prevent PND. OBJECTIVES To (1) evaluate the clinical effectiveness, cost-effectiveness, acceptability and safety of antenatal and postnatal interventions for pregnant and postnatal women to prevent PND; (2) apply rigorous methods of systematic reviewing of quantitative and qualitative studies, evidence synthesis and decision-analytic modelling to evaluate the preventive impact on women, their infants and their families; and (3) estimate cost-effectiveness. DATA SOURCES We searched MEDLINE, EMBASE, Science Citation Index and other databases (from inception to July 2013) in December 2012, and we were updated by electronic alerts until July 2013. REVIEW METHODS Two reviewers independently screened titles and abstracts with consensus agreement. We undertook quality assessment. All universal, selective and indicated preventive interventions for pregnant women and women in the first 6 postnatal weeks were included. All outcomes were included, focusing on the Edinburgh Postnatal Depression Scale (EPDS), diagnostic instruments and infant outcomes. The quantitative evidence was synthesised using network meta-analyses (NMAs). A mathematical model was constructed to explore the cost-effectiveness of interventions contained within the NMA for EPDS values. RESULTS From 3072 records identified, 122 papers (86 trials) were included in the quantitative review. From 2152 records, 56 papers (44 studies) were included in the qualitative review. The results were inconclusive. The most beneficial interventions appeared to be midwifery redesigned postnatal care [as shown by the mean 12-month EPDS score difference of -1.43 (95% credible interval -4.00 to 1.36)], person-centred approach (PCA)-based and cognitive-behavioural therapy (CBT)-based intervention (universal), interpersonal psychotherapy (IPT)-based intervention and education on preparing for parenting (selective), promoting parent-infant interaction, peer support, IPT-based intervention and PCA-based and CBT-based intervention (indicated). Women valued seeing the same health worker, the involvement of partners and access to several visits from a midwife or health visitor trained in person-centred or cognitive-behavioural approaches. The most cost-effective interventions were estimated to be midwifery redesigned postnatal care (universal), PCA-based intervention (indicated) and IPT-based intervention in the sensitivity analysis (indicated), although there was considerable uncertainty. Expected value of partial perfect information (EVPPI) for efficacy data was in excess of £150M for each population. Given the EVPPI values, future trials assessing the relative efficacies of promising interventions appears to represent value for money. LIMITATIONS In the NMAs, some trials were omitted because they could not be connected to the main network of evidence or did not provide EPDS scores. This may have introduced reporting or selection bias. No adjustment was made for the lack of quality of some trials. Although we appraised a very large number of studies, much of the evidence was inconclusive. CONCLUSIONS Interventions warrant replication within randomised controlled trials (RCTs). Several interventions appear to be cost-effective relative to usual care, but this is subject to considerable uncertainty. FUTURE WORK RECOMMENDATIONS Several interventions appear to be cost-effective relative to usual care, but this is subject to considerable uncertainty. Future research conducting RCTs to establish which interventions are most clinically effective and cost-effective should be considered. STUDY REGISTRATION This study is registered as PROSPERO CRD42012003273. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- C Jane Morrell
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Paul Sutcliffe
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - John Stevens
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Alison Scope
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Matt Stevenson
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Rebecca Harvey
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Alice Bessey
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Anna Cantrell
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Cindy-Lee Dennis
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Shijie Ren
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Margherita Ragonesi
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Michael Barkham
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Dick Churchill
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Carol Henshaw
- Division of Psychiatry, Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
| | - Jo Newstead
- Nottingham Experts Patients Group, Clinical Reference Group for Perinatal Mental Health, Nottingham, UK
| | - Pauline Slade
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Helen Spiby
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Sarah Stewart-Brown
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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Kamali S, Ahmadian L, Khajouei R, Bahaadinbeigy K. Health information needs of pregnant women: information sources, motives and barriers. Health Info Libr J 2017; 35:24-37. [PMID: 29131537 DOI: 10.1111/hir.12200] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 09/24/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Pregnant women should be provided with relevant and useful information to manage this specific period of their lives. Assessing information needs of this group is a prerequisite for providing this information. OBJECTIVE The aim of this study was to assess the information needs of pregnant women during their pregnancy and childbirth. METHODS This descriptive study was conducted on the pregnant women who attended antenatal clinics and obstetricians/gynaecologists' offices in Kerman, Iran, in 2015. Data were collected using a self-administered, valid and reliable questionnaire. A total of 400 women participated in the study. FINDINGS Most pregnant women needed information about care of the foetus (n = 344, 86%), physical and psychological complications after delivery (n = 333, 83%), development and growth of the foetus (n = 330, 82.5%), pregnancy nutrition (n = 327, 82%) and special tests during pregnancy (n = 326, 81.5%). They mostly (n = 195, 49%) looked for information when they were suffering from a disease or pregnancy complications. CONCLUSIONS As pregnant women need extensive information to be able to take care of themselves and their babies, their information needs should be identified and taken into consideration when planning educational programmes for this group of women.
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Affiliation(s)
- Sudabeh Kamali
- Health Information Sciences Department, Kerman University of Medical Sciences, Kerman, Iran
| | - Leila Ahmadian
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Khajouei
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Kambiz Bahaadinbeigy
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Childbirth and parenting preparation in antenatal classes. Midwifery 2017; 57:1-7. [PMID: 29128739 DOI: 10.1016/j.midw.2017.10.021] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 10/22/2017] [Accepted: 10/29/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVES to describe topics (1) presented by midwives' during antenatal classes and the amount of time spent on these topics and (2) raised and discussed by first-time parents and the amount of time spent on these topics. DESIGN qualitative; data were gathered using video or tape recordings and analysed using a three-pronged content analysis approach, i.e., conventional, summative, and directed analyses. SETTING AND PARTICIPANTS 3 antenatal courses in 2 antenatal units in a large Swedish city; 3 midwives; and 34 course participants. FINDINGS class content focused on childbirth preparation (67% of the entire antenatal course) and on parenting preparation (33%). Childbirth preparation facilitated parents' understanding of the childbirth process, birthing milieu, the partner's role, what could go wrong during delivery, and pain relief advantages and disadvantages. Parenting preparation enabled parents to (i) plan for those first moments with the newborn; (ii) care for/physically handle the infant; (iii) manage breastfeeding; (iv) manage the period at home immediately after childbirth; and (v) maintain their relationship. During the classes, parents expressed concerns about what could happened to newborns. Parents' questions to midwives and discussion topics among parents were evenly distributed between childbirth preparation (52%) and parenting preparation (48%). KEY CONCLUSIONS childbirth preparation and pain relief consumed 67% of course time. Parents particularly reflected on child issues, relationship, sex, and anxiety. Female and male participants actively listened to the midwives, appeared receptive to complex issues, and needed more time to ask questions. Parents appreciated the classes yet needed to more information for managing various post-childbirth situations. IMPLICATIONS FOR PRACTICE while midwifery services vary among hospitals, regions, and countries, midwives might equalise content focus, offer classes in the second trimester, provide more time for parents to talk to each other, allow time in the course plan for parents to bring up new topics, and investigate: (i) ways in which antenatal course development and planning can improve; (ii) measures for evaluating courses; (iii) facilitator training; and (iv) parent satisfaction surveys.
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Kahn LS, Mendel WE, Fallin KL, Borngraber EA, Nochajski TH, Rea WE, Blondell RD. A parenting education program for women in treatment for opioid-use disorder at an outpatient medical practice. SOCIAL WORK IN HEALTH CARE 2017; 56:649-665. [PMID: 28594601 DOI: 10.1080/00981389.2017.1327470] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Opioid use during pregnancy poses serious risks for the mother and the unborn child. Opioid-use disorder may be managed with medication-assisted treatment (MAT) in an outpatient setting, but few MAT practices specifically address the challenges faced by pregnant women. This article describes a medical office-based educational support group for women in MAT for opioid-use disorder who were pregnant and/or parenting young children. Focus groups were conducted to elicit patient feedback. Women indicated that they found the educational support groups beneficial and offered suggestions. In-office educational support groups for pregnant women in treatment for opioid-use disorder are feasible and well received.
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Affiliation(s)
- Linda S Kahn
- a Department of Family Medicine , Primary Care Research Institute, University at Buffalo , Buffalo , NY , USA
| | - Whitney E Mendel
- b Master of Public Health Program, Daemen College , Amherst , NY , USA
| | - Kyla L Fallin
- c School of Social Work , University at Buffalo , Amherst , NY , USA
| | | | | | - William E Rea
- d Center for Development of Human Services , Institute for Community Health Promotion , Rochester , NY , USA
| | - Richard D Blondell
- a Department of Family Medicine , Primary Care Research Institute, University at Buffalo , Buffalo , NY , USA
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Secginli S, Nahcivan NO, Gunes G, Fernandez R. Interventions Promoting Breast Cancer Screening Among Turkish Women With Global Implications: A Systematic Review. Worldviews Evid Based Nurs 2017; 14:316-323. [PMID: 28605115 DOI: 10.1111/wvn.12245] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Breast cancer is a major health concern and remains the most common malignancy in women worldwide and in Turkey. Mammography, clinical breast examination (CBE), and breast self-examination (BSE) are recommended methods to detect early breast cancer in women. Many strategies have been developed to increase the rates of mammography, CBE, and BSE among Turkish women. Despite the benefits of breast cancer screening, these modalities are still underutilized by the majority of Turkish women. AIM To systematically review the scientific evidence on the effectiveness of various strategies aimed at improving screening behaviors for breast cancer in Turkish women. METHODS A systematic review of the literature published between 2000 and 2015 was conducted, searching 10 databases of Ovid MEDLINE, PubMed, Cochrane CENTRAL Register of Controlled Trials, CINAHL, PsycINFO, Web of Knowledge, Scopus, Google Scholar, ULAKBIM Turkish Medical Database, and Council of Higher Education Thesis Center. RESULTS Twenty-three studies were included in the final review. The majority of the studies investigated the effects of multiple strategies to improve BSE. Group education comprised educational sessions, printed and audiovisual materials, which significantly improved BSE, CBE, and mammography screening rates at 3 months, 6 months, and 12 months after the intervention. One-to-one education demonstrated no significant difference in BSE rates at 6-month and 12-month follow-up. However, one-to-one education demonstrated significant differences in CBE and mammography rates at the 3-month follow-up. LINKING EVIDENCE TO ACTION The use of group education comprising a multicomponent intervention demonstrated an increase in breast-screening behaviors among Turkish women. Further research investigating the duration of educational interventions is needed in order to suggest a "dose response."
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Affiliation(s)
- Selda Secginli
- Associate Professor, Public Health Nursing Department, Florence Nightingale Nursing Faculty, Istanbul University, Sisli, Istanbul, Turkey
| | - Nursen O Nahcivan
- Professor, Public Health Nursing Department, Florence Nightingale Nursing Faculty, Istanbul University, Sisli, Istanbul, Turkey
| | - Gussun Gunes
- Assistant Professor, Library and Documentation Department, Marmara University, Goztepe Campus, Kadikoy, Istanbul, Turkey
| | - Ritin Fernandez
- Professor, School of Nursing and Midwifery, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong.,Centre for Research in Nursing and Health, St. George Hospital, Kogarah, NSW, Australia
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Koushede V, Brixval CS, Thygesen LC, Axelsen SF, Winkel P, Lindschou J, Gluud C, Due P. Antenatal small-class education versus auditorium-based lectures to promote positive transitioning to parenthood - A randomised trial. PLoS One 2017; 12:e0176819. [PMID: 28464006 PMCID: PMC5413036 DOI: 10.1371/journal.pone.0176819] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 04/06/2017] [Indexed: 11/19/2022] Open
Abstract
Prospective parents widely use education to gain information about, e.g., labour and parenting skills. It is unknown if antenatal education in small classes is more beneficial for parenting stress and parenting alliance compared with other types of antenatal education. In the present randomised trial, we examined the effect of antenatal education in small classes versus auditorium-based lectures on perceived stress, parenting stress, and parenting alliance. A total of 1,766 pregnant women were randomised to receive: antenatal education in small classes three times in pregnancy and one time after delivery, each session lasted 2.5 hours, versus standard care consisting of two times two hours auditorium-based lectures. Previous analysis of the primary outcome showed no difference between intervention and control group. Here we conduct an exploratory analysis of three secondary outcomes. Effects of the interventions on parents’ global feelings of stress at 37 weeks gestation and nine weeks and six months postpartum and parenting stress nine weeks and six months postpartum were examined using linear regression analyses and mixed models with repeated measurements. The effect on parenting alliance six months postpartum was examined using the non-parametric Wilcoxon rank-sum test. Antenatal education in small classes had a small beneficial main effect on global feelings of stress six months postpartum and a statistically significant interaction between time and group favoring antenatal education in small classes. The P values of intervention effects on parenting stress and parenting alliance were all larger than the threshold value (0.05).
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Affiliation(s)
- Vibeke Koushede
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- * E-mail:
| | - Carina Sjöberg Brixval
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lau Caspar Thygesen
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Per Winkel
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen, Denmark
| | - Jane Lindschou
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen, Denmark
| | - Christian Gluud
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen, Denmark
| | - Pernille Due
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Artieta-Pinedo I, Paz-Pascual C, Grandes G, Espinosa M. Framework for the establishment of a feasible, tailored and effective perinatal education programme. BMC Pregnancy Childbirth 2017; 17:58. [PMID: 28178926 PMCID: PMC5299744 DOI: 10.1186/s12884-017-1234-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/21/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Antenatal education needs to be renewed and adapted to the needs of women. OBJECTIVES to assess women needs, identify factors that influence the desired outcomes, and propose a framework for developing new perinatal education based on the guidance published by the UK Medical Research Council for the development and evaluation of complex interventions in primary care. METHODS For this study: (a) four focus group sessions were held from October to November 2010 in Bizkaia (Spain) with 30 women exploring their needs during pregnancy and postpartum; (b) two literature reviews were conducted on women's needs at these times and theoretical models of healthcare education; and (c) seven discussion and consensus sessions were run with a group of experts composed of midwifes, gynaecologists, paediatricians, and paediatric and postpartum nurses. RESULTS Various areas for improvement were identified: needs assessment of each woman/family, consideration of pregnancy and childbirth as normal physiological processes, participation of fathers, establishment of social networks, continuity of postpartum care, better access to and training for midwives, and more flexible format and contents for the programme. We propose a woman-focused framework that includes three exploratory interviews during pregnancy, personalized interventions coordinated between professionals, empowerment to choose the type of birth, and postpartum activities. CONCLUSION New perinatal education should be on-going and focused on each woman. It is necessary to assess the feasibility of implementing this type of programme, depending on the context, professionals' readiness for change and characteristics of the proposed interventions. Then, its effectiveness and sustainability must be assessed.
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Affiliation(s)
- Isabel Artieta-Pinedo
- Primary Care Midwife Zuazo Health Centre, Barakaldo, (Bizkaia); and Associate Professor of the School of Nursing, University of the Basque Country, Leioa, Bizkaia, Spain.
- Primary Care Research Unit of Bizkaia, Centro de Salud de Deusto, 4ª planta, 48014, Bilbao, Bizkaia, Spain.
| | - Carmen Paz-Pascual
- Primary Care Midwife in Sestao Health Centre, Bizkaia; and Lecturer in the Midwifery Training Unit of the Basque Country, Bilbao, Bizkaia, Spain
| | - Gonzalo Grandes
- Primary Care Research Unit of Bizkaia, Centro de Salud de Deusto, 4ª planta, 48014, Bilbao, Bizkaia, Spain
| | - Maite Espinosa
- Primary Care Research Unit of Bizkaia, Centro de Salud de Deusto, 4ª planta, 48014, Bilbao, Bizkaia, Spain
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Invested in Success: A Qualitative Study of the Experience of CenteringPregnancy Group Prenatal Care for Perinatal Educators. J Perinat Educ 2017; 26:125-135. [PMID: 30723376 DOI: 10.1891/1058-1243.26.3.125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The objective of this study was to understand the central meaning of the experience of providing CenteringPregnancy for perinatal educators who were facilitators for the group sessions. Four perinatal educators participated in one-on-one interviews and/or a validation focus group. Six themes emerged: (a) "stepping back and taking on a different role," (b) "supporting transformation," (c) "getting to knowing," (d) "working together to bridge the gap," (e) "creating the environment," and (f) "fostering community." These themes contributed to the core phenomenon of being "invested in success." Through bridging gaps and inconsistencies in information received from educators and physicians, this model of CenteringPregnancy provides an opportunity for women to act on relevant information more fully than more traditional didactic approaches to perinatal education.
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Fitzgerald C, Heery E, Conneally N, Linnane B, George S, Fitzpatrick P. An evaluation of pregnant women's knowledge and attitudes about newborn bloodspot screening. Midwifery 2016; 45:21-27. [PMID: 27978478 DOI: 10.1016/j.midw.2016.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 08/11/2016] [Accepted: 11/20/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES research suggests that information provided to parents about newborn bloodspot screening (NBS) can be inconsistent. The majority of international NBS programmes recommend that parents should receive information about NBS in the antenatal period, however prior studies have mostly focused on postnatal women's knowledge, with no quantitative study of women's knowledge in the antenatal period conducted to date. Thus, the aim of this study was to determine if antenatal women received information about NBS in the antenatal period and to evaluate their knowledge and attitudes about NBS. DESIGN/PARTICIPANTS we conducted a cross-sectional study among antenatal attendees at three maternity hospitals in Ireland. A total of 662 antenatal women (≥36 weeks gestation) were recruited into the study (279 primiparous, 368 multiparous). Women were asked to complete a self reported knowledge and attitude questionnaire about NBS. FINDINGS primiparity (OR 2.75; 95% CI 1.65, 4.59) lower educational status (OR 1.79; 95% CI 1.02, 3.15) and not having private health insurance (OR 1.84; 95% CI 1.19, 2.85) were independently associated with poor NBS knowledge. Fourteen per cent of antenatal women recalled receiving an information leaflet about NBS, yet over 87 % reported that they would like more information. Thirty four per cent of women agreed that they understand everything they need to know about NBS. CONCLUSIONS/IMPLICATIONS FOR PRACTICE the process of providing women with information about NBS in the antenatal period is inconsistent; consequently their awareness about NBS is limited. To make an informed choice about NBS women require information to be provided in a more structured format. There are many missed opportunities in the antenatal period for maternity care providers to provide women with information about NBS. Our study recommends that healthcare providers should have a more formal and structured approach with regard to the provision of information about NBS in the antenatal period. This could be achieved by incorporating NBS education into antenatal education classes or through multimedia while women are waiting in the antenatal clinic. Healthcare providers may need education about the importance and benefits of providing women with information about NBS in the antenatal period.
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Affiliation(s)
- Catherine Fitzgerald
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Woodview House, Belfield, Dublin 4, Ireland.
| | - Emily Heery
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Woodview House, Belfield, Dublin 4, Ireland
| | - Neasa Conneally
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Woodview House, Belfield, Dublin 4, Ireland
| | - Barry Linnane
- Department of Paediatrics, University Hospital Limerick, Ireland; Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity (4i), University of Limerick, Limerick, Ireland
| | - Sherly George
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Woodview House, Belfield, Dublin 4, Ireland
| | - Patricia Fitzpatrick
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Woodview House, Belfield, Dublin 4, Ireland
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Paz Pascual C, Artieta Pinedo I, Grandes G, Espinosa Cifuentes M, Gaminde Inda I, Payo Gordon J. [Perceived needs of women regarding maternity. Qualitative study to redesign maternal education]. Aten Primaria 2016; 48:657-664. [PMID: 27039971 PMCID: PMC6875922 DOI: 10.1016/j.aprim.2015.12.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 12/07/2015] [Accepted: 12/09/2015] [Indexed: 11/29/2022] Open
Abstract
Objetivo Explorar las necesidades expresadas por las mujeres a lo largo del proceso de convertirse en madre y sus demandas relacionadas con la educación maternal. Diseño Estudio cualitativo con grupos focales. Emplazamiento Área de salud de Bizkaia, Servicio Vasco de Salud/Osakidetza. Participantes Treinta mujeres seleccionadas de forma consecutiva por matronas de atención primaria de 6 centros de salud diferentes. Métodos Entre septiembre y noviembre de 2010 se formaron 4 grupos focales estratificados por situación socioeconómica y etapa del proceso (embarazo/puerperio). Para recoger las preocupaciones de las embarazadas, de las puérperas y su opinión sobre la educación maternal se siguió el método de análisis del contenido temático con el apoyo del software ATLAS.ti. Resultados El foco de preocupación de las mujeres va cambiando con el tiempo. Pasaba de la necesidad de confirmar que «todo va bien» a necesitar más apoyo emocional y confianza para enfrentarse a sus miedos al parto y al cuidado de los hijos. Necesitaban mayor acompañamiento en el puerperio y menos presión con la lactancia materna. En cuanto a la educación maternal, demandaban un programa de educación perinatal en lugar de solo prenatal, más actualizado, con mayor participación de su pareja, más interactivo y flexible. Conclusión Las mujeres de nuestro entorno perciben necesidades similares a las de los países anglosajones, independientemente de las diferencias culturales. Parece claro la necesidad de rediseñar un programa de educación perinatal extenso, personalizado, dinámico, que empodere a las mujeres para gestionar su propia salud y la de su familia
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Affiliation(s)
- Carmen Paz Pascual
- Servicio Vasco de Salud/Osakidetza, Unidad Docente de Matronas del País Vasco, Centro de Salud de Markonzaga , OSI Barakaldo Sestao , Bizkaia, España.
| | - Isabel Artieta Pinedo
- Servicio Vasco de Salud/Osakidetza, Escuela Universitaria de Enfermería de la EHU-UPV, Centro de Salud de Zuazo , OSI Barakaldo Sestao , Bizkaia, España
| | - Gonzalo Grandes
- Medicina Familiar y Comunitaria, Medicina Preventiva y Salud Pública, Unidad de Investigación de Atención Primaria, Servicio Vasco de Salud/Osakidetza, Bilbao, Bizkaia, España
| | - Maite Espinosa Cifuentes
- Unidad de Investigación de Atención Primaria, Servicio Vasco de Salud/Osakidetza, Bilbao, Bizkaia, España
| | - Idoia Gaminde Inda
- Unidad de Evaluación, Servicio de Investigación, Innovación y Formación Sanitaria, Departamento de Salud, Gobierno de Navarra, Pamplona, Navarra, España
| | - Janire Payo Gordon
- Unidad de Investigación de Atención Primaria, Servicio Vasco de Salud/Osakidetza, Bilbao, Bizkaia, España
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Olfati F, Asefzadeh S, Changizi N, Keramat A, Yunesian M. Patient Involvement in Safe Delivery: A Qualitative Study. Glob J Health Sci 2015; 8:33-40. [PMID: 26755469 PMCID: PMC4954900 DOI: 10.5539/gjhs.v8n6p33] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 08/24/2015] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Patient involvement in safe delivery planning is considered important yet not widely practiced. The present study aimed at identifythe factors that affect patient involvementin safe delivery, as recommended by parturient women. METHODS This study was part of a qualitative research conducted by content analysis method and purposive sampling in 2013.The data were collected through 63 semi-structured interviews in4 hospitalsand analyzed using thematic content analysis. The participants in this research were women before discharge and after delivery. Findings were analyzed using Colaizzi's method. RESULTS Four categories of factors that could affect patient involvement in safe delivery emerged from our analysis: patient-related (true and false beliefs, literacy, privacy, respect for patient), illness-related (pain, type of delivery, patient safety incidents), health care professional-relatedand task-related factors (behavior, monitoring &training), health care setting-related (financial aspects, facilities). CONCLUSION More research is needed to explore the factors affecting the participation of mothers. It is therefore, recommended to: 1) take notice of mother education, their husbands, midwives and specialists; 2) provide pregnant women with insurance coverage from the outset of pregnancy, especially during prenatal period; 3) form a labor pain committee consisting of midwives, obstetricians, and anesthesiologists in order to identify the preferred painless labor methods based on the existing facilities and conditions, 4) carry out research on observing patients' privacy and dignity; 5) pay more attention on the factors affecting cesarean.
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Finlayson K, Downe S, Hinder S, Carr H, Spiby H, Whorwell P. Unexpected consequences: women's experiences of a self-hypnosis intervention to help with pain relief during labour. BMC Pregnancy Childbirth 2015; 15:229. [PMID: 26407981 PMCID: PMC4583759 DOI: 10.1186/s12884-015-0659-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 09/16/2015] [Indexed: 11/30/2022] Open
Abstract
Background Self-hypnosis is becoming increasingly popular as a means of labour pain management. Previous studies have produced mixed results. There are very few data on women’s views and experiences of using hypnosis in this context. As part of a randomized controlled trial of self-hypnosis for intra-partum pain relief (the SHIP Trial) we conducted qualitative interviews with women randomized to the intervention arm to explore their views and experiences of using self-hypnosis during labour and birth. Methods Participants were randomly selected from the intervention arm of the study, which consisted of two antenatal self-hypnosis training sessions and a supporting CD that women were encouraged to listen to daily from 32 weeks gestation until the birth of their baby. Those who consented were interviewed in their own homes 8–12 weeks after birth. Following transcription, the interviews were analysed iteratively and emerging concepts were discussed amongst the authors to generate organizing themes. These were then used to develop a principal organizing metaphor or global theme, in a process known as thematic networks analysis. Results Of the 343 women in the intervention group, 48 were invited to interview, and 16 were interviewed over a 12 month period from February 2012 to January 2013. Coding of the data and subsequent analysis revealed a global theme of ‘unexpected consequences’, supported by 5 organising themes, ‘calmness in a climate of fear’, ‘from sceptic to believer’, ‘finding my space’, ‘delays and disappointments’ and ‘personal preferences’. Most respondents reported positive experiences of self-hypnosis and highlighted feelings of calmness, confidence and empowerment. They found the intervention to be beneficial and used a range of novel strategies to personalize their self-hypnosis practice. Occasionally women reported feeling frustrated or disappointed when their relaxed state was misinterpreted by midwives on admission or when their labour and birth experiences did not match their expectations. Conclusion The women in this study generally appreciated antenatal self-hypnosis training and found it to be beneficial during labour and birth. The state of focused relaxation experienced by women using the technique needs to be recognized by providers if the intervention is to be implemented into the maternity service.
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Affiliation(s)
- Kenneth Finlayson
- Research in Childbirth and Health Unit (REACH), School of Health, University of Central Lancashire, Preston, UK.
| | - Soo Downe
- Research in Childbirth and Health Unit (REACH), School of Health, University of Central Lancashire, Preston, UK.
| | - Susan Hinder
- RaFT Research, Lower Hall, Main Street, Downham, Clitheroe, Lancashire, UK.
| | - Helen Carr
- Royal Bolton Hospital, Minerva Road, Farnworth, Bolton, Lancashire, UK.
| | - Helen Spiby
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK.
| | - Peter Whorwell
- Centre for Gastrointestinal Sciences, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK.
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Wright K, Golder S, Lewis-Light K. What value is the CINAHL database when searching for systematic reviews of qualitative studies? Syst Rev 2015; 4:104. [PMID: 26227391 PMCID: PMC4532258 DOI: 10.1186/s13643-015-0069-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 06/02/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The Cumulative Index to Nursing and Allied Health Literature (CINAHL) is generally thought to be a good source to search when conducting a review of qualitative evidence. Case studies have suggested that using CINAHL could be essential for reviews of qualitative studies covering topics in the nursing field, but it is unclear whether this can be extended more generally to reviews of qualitative studies in other topic areas. METHODS We carried out a retrospective analysis of a sample of systematic reviews of qualitative studies to investigate CINAHL's potential contribution to identifying the evidence. In particular, we planned to identify the percentage of included studies available in CINAHL and the percentage of the included studies unique to the CINAHL database. After screening 58 qualitative systematic reviews identified from the Database of Abstracts of Reviews of Effects (DARE), we created a sample set of 43 reviews covering a range of topics including patient experience of both illnesses and interventions. RESULTS For all 43 reviews (21 %) in our sample, we found that some of the included studies were available in CINAHL. For nine of these reviews, all the studies that had been included in the final synthesis were available in the CINAHL database, so it could have been possible to identify all the included studies using just this one database, while for an additional 21 reviews (49 %), 80 % or more of the included studies were available in CINAHL. Consequently, for a total of 30 reviews, or 70 % of our sample, 80 % or more of the studies could be identified using CINAHL alone. 11 reviews, where we were able to recheck all the databases used by the original review authors, had included a study that was uniquely identified from the CINAHL database. The median % of unique studies was 9.09%; while the range had a lowest value of 5.0% to the highest value of 33.0%. [corrected]. CONCLUSIONS Assuming a rigorous search strategy was used and the records sought were accurately indexed, we could expect CINAHL to be a good source of primary studies for qualitative evidence syntheses. While we found some indication that CINAHL had the potential to provide unique studies for systematic reviews, we could only fully test this on a limited number of reviews, so we are less confident about this finding.
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Affiliation(s)
- Kath Wright
- Centre for Reviews & Dissemination, University of York, York, UK.
| | - Su Golder
- Department of Health Sciences, University of York, York, UK.
| | - Kate Lewis-Light
- Centre for Reviews & Dissemination, University of York, York, UK.
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Forslund Frykedal K, Rosander M. The role as moderator and mediator in parent education groups - a leadership and teaching approach model from a parent perspective. J Clin Nurs 2015; 24:1966-74. [DOI: 10.1111/jocn.12856] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2015] [Indexed: 11/29/2022]
Affiliation(s)
| | - Michael Rosander
- Department of Behavioural Sciences and Learning; Linköping University; Linköping Sweden
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Smyth S, Spence D, Murray K. Does antenatal education prepare fathers for their role as birth partners and for parenthood? ACTA ACUST UNITED AC 2015. [DOI: 10.12968/bjom.2015.23.5.336] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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A descriptive survey of the educational preparation and practices of antenatal educators in ireland. J Perinat Educ 2014; 23:33-40. [PMID: 24453466 DOI: 10.1891/1058-1243.23.1.33] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Antenatal education is recommended to prospective parents, yet little is known about the educational preparation of the facilitators of this education, or of the educational practices they use. The aim of this study was to investigate the educational preparation and practices of antenatal educators in Ireland. Data were collected using a questionnaire structured on the three components (abilities, opportunities, and means) of Stamler's theoretical framework of enablement. Eighty-four of the 120 antenatal educators responded (70%), and this included midwives, public health nurses, physiotherapists, and private antenatal educators. Findings describe a picture of varied educational preparation for the antenatal educator with a range of educational practices being used. Within public antenatal classes, large class size was a barrier to providing a participatory educational approach.
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Miquelutti MA, Cecatti JG, Makuch MY. Antenatal education and the birthing experience of Brazilian women: a qualitative study. BMC Pregnancy Childbirth 2013; 13:171. [PMID: 24007540 PMCID: PMC3766656 DOI: 10.1186/1471-2393-13-171] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 07/29/2013] [Indexed: 11/10/2022] Open
Abstract
Background Information is still scarce on the birthing experience of women who participate in antenatal systematic education programs. The objective of the study was to report the experience of labor as described by nulliparous women who participated and who did not in a systematic Birth Preparation Program (BPP). Method A qualitative study was conducted with eleven women who participated in a BPP and ten women attending routine prenatal care selected through purposeful sampling. The BPP consisted of systematized antenatal group meetings structured to provide physical exercise and information on pain prevention during pregnancy, the role of the pelvic floor muscles, the physiology of labor, and pain relief techniques. A single, semi-structured interview was conducted with each participant. All interviews were recorded, transcribed verbatim and thematic analyses performed. The relevant themes were organized in the following categories of analysis: control of labor, positions adopted during labor, and satisfaction with labor. Results Women who participated in the systematic educational activities of the BPP reported they maintained self-control during labor and used breathing exercises, exercises on the ball, massage, baths and vertical positions to control pain. Also they reported satisfaction with their birthing experience. Women who did not participate in systematic educational activities referred to difficulties in maintaining control during labor and almost half of them reported lack of control. Also they were more likely to report dissatisfaction with labor. Conclusions Women who participated in the BPP reported self-control during labor and used non-pharmacological techniques to control pain and facilitate labor and expressed satisfaction with the birthing experience.
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Affiliation(s)
- Maria Amelia Miquelutti
- Center for Research on Reproductive Health of Campinas (Cemicamp), Caixa Postal 6181, 13084-971 Campinas, SP, Brazil.
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Mitchell M. Women's use of complementary and alternative medicine in pregnancy: a journey to normal birth. ACTA ACUST UNITED AC 2013. [DOI: 10.12968/bjom.2013.21.2.100] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mary Mitchell
- Senior Lecturer, Midwifery University of the West of England
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Abstract
The dominant culture in labor and birth is the medical model, not the midwifery model of woman-centered care. Consensus among professional and governmental groups is that, based on the evidence, intermittent auscultation is safer to use in healthy women with uncomplicated pregnancies than electronic fetal monitoring (EFM). Barriers impact the laboring woman's ability to give informed choice regarding fetal monitoring. Lack of informed choice denies a woman her right to be in control of her birth experience, and is in opposition to a woman's right to autonomy and self-determination.
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Fisher C, Hauck Y, Bayes S, Byrne J. Participant experiences of mindfulness-based childbirth education: a qualitative study. BMC Pregnancy Childbirth 2012; 12:126. [PMID: 23145970 PMCID: PMC3534482 DOI: 10.1186/1471-2393-12-126] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 11/09/2012] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Childbirth is an important transitional life event, but one in which many women are dissatisfied stemming in part from a sense that labour is something that happens to them rather than with them. Promoting maternal satisfaction with childbirth means equipping women with communication and decision making skills that will enhance their ability to feel involved in their labour. Additionally, traditional antenatal education does not necessarily prepare expectant mothers and their birth support partner adequately for birth. Mindfulness-based interventions appear to hold promise in addressing these issues. Mindfulness-based Child Birth Education (MBCE) was a pilot intervention combining skills-based antenatal education and Mindfulness Based Stress Reduction. Participant experiences of MBCE, both of expectant mothers and their birth support partners are the focus of this article. METHODS A generic qualitative approach was utilised for this study. Pregnant women between 18 and 28 weeks gestation, over 18 years of age, nulliparous with singleton pregnancies and not taking medication for a diagnosed mental illness or taking illicit drugs were eligible to undertake the MBCE program which was run in a metropolitan city in Australia. Focus groups with 12 mothers and seven birth support partners were undertaken approximately four months after the completion of MBCE. Audio recordings of the groups were transcribed verbatim and analysed thematically using the method of constant comparison by all four authors independently and consensus on analysis and interpretation arrived at through team meetings. RESULTS A sense of both 'empowerment' and 'community' were the essences of the experiences of MBCE both for mothers and their birth support partner and permeated the themes of 'awakening my existing potential' and 'being in a community of like-minded parents'. Participants suggested that mindfulness techniques learned during MBCE facilitated their sense of control during birth, and the content and pedagogical approach of MBCE enabled them to be involved in decision making during the birth. The pedagogical approach also fostered a sense of community among participants which extended into the postnatal period. CONCLUSIONS MBCE has the potential to empower women to become active participants in the birthing process, thus addressing common concerns regarding lack of control and satisfaction with labour and facilitate peer support into the postnatal period. Further education of health professionals may be needed to ensure that they respond positively to those women and birth support partners who remain active in decision making during birth.
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Affiliation(s)
- Colleen Fisher
- School of Population Health, The University of Western Australia, Perth, Australia
| | - Yvonne Hauck
- Curtin University and King Edward Memorial Hospital, Curtin Health Innovation Research Institute, Perth, Australia
| | - Sara Bayes
- Research Implementation Fellow, Collaboration for Leadership in Applied Health Research and Care - Nottinghamshire, Derbyshire and Lincolnshire, University of Nottingham, England, UK
- Adjunct Midwifery Research Fellow, Curtin University, Curtin Health Innovation Research Institute, Perth, Australia
| | - Jean Byrne
- Honorary Research Fellow, Curtin University, Curtin Health Innovation Research Institute, Perth, Australia
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Kadomoto N, Iwasa H, Takahashi M, Dulnuan MM, Kai I. Ifugao males, learning and teaching for the improvement of maternal and child health status in the Philippines: an evaluation of a program. BMC Public Health 2011; 11:280. [PMID: 21548972 PMCID: PMC3112120 DOI: 10.1186/1471-2458-11-280] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Accepted: 05/07/2011] [Indexed: 11/16/2022] Open
Abstract
Background Improving Maternal and Child Health (MCH) is a prioritized global agenda in achieving the United Nations Millennium Development Goal 5. In this challenge, involving males has been an important agenda, and a program with such intent was conducted in Alfonso Lista, Ifugao, of the Philippines. The objectives of this study were: (1) to evaluate the effectiveness in knowledge, attitude, and practice before and after a MCH session; (2) to evaluate the session's effectiveness in relation to socio-demographic characteristics; and (3) to examine if males who have learned about MCH topics can teach another group of males. Methods A male community representative who received a lecture from the health office staff was assigned to teach a group of community males [Group 1, N = 140] in 5 sessions, using educational materials. 10 male volunteers from Group 1 then taught a different group of males [Group 2, N = 105] in their own barangays (villages). To evaluate its effectiveness, a self-administered questionnaire survey pertaining knowledge, attitude and practice regarding MCH was conducted at three different time points: before the session (Time 1, T1), after the session (Time 2, T2), and 3 months following the session (Time 3, T3). A repeated measures analysis of variance was conducted to test for changes over time and its interaction effect between specific socio-demographic variables. Results In Group 1, there was a significant positive increase in knowledge score over time at T1-T2 and T1-T3 (p < 0.001). For attitude, the score increased only at T1-T2 (p = 0.027). The effectiveness in knowledge and attitude did not vary by socio-demographic characteristics. As for practice, majority of the participants reported that they had talked about MCH topics in their community and assisted a pregnant woman in some ways. A comparison between Group 1 and Group 2 revealed that Group 2 had similar effectiveness as Group 1 in knowledge improvement immediately after the session (p < 0.001), but no such improvement in the attitude score. Conclusion Although the change in attitude needs further assessment, this strategy of continuous learning and teaching of MCH topics within community males is shown to improve knowledge and has a potential to uplift the MCH status, including the reduction of maternal deaths, in Alfonso Lista, Ifugao, Philippines.
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Affiliation(s)
- Noriko Kadomoto
- The University of Tokyo, School of Public Health, Tokyo, Japan.
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Abstract
In this column, the author reprises recent selections from the Lamaze International research blog, Science & Sensibility. Each selection discusses opportunities to establish a culture of consumer engagement in maternity care. The author demonstrates how improving health literacy, ensuring multi-stakeholder participation in the development of clinical guidelines, and supporting comparative effectiveness research of woman- and family-centered care practices may improve maternity care.
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Affiliation(s)
- Amy M Romano
- AMY M. ROMANO is a midwife, author, and advocate for mother-friendly maternity care. She has analyzed, summarized, and critiqued research for the Lamaze International community since 2004 and is currently co-authoring the second edition of Obstetric Myths Versus Research Realities with Henci Goer
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