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Pringle W, Greyson D, Graham JE, Dubé È, Mitchell H, Russell ML, MacDonald SE, Bettinger JA. "I try to take all the time needed, even if i do not have it!": Knowledge, attitudes, practices of perinatal care providers in canada about vaccination. Vaccine X 2024; 18:100490. [PMID: 38699156 PMCID: PMC11063514 DOI: 10.1016/j.jvacx.2024.100490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 04/10/2024] [Accepted: 04/18/2024] [Indexed: 05/05/2024] Open
Abstract
Objective Successful clinical conversations about vaccination in pregnancy (pertussis, COVID-19, and influenza) are key to improving low uptake rates of both vaccination in pregnancy and infancy. The purpose of this study was to understand Canadian perinatal care providers' knowledge, attitudes, and practices around vaccination in pregnancy. Methods Qualitative interviews with 49 perinatal care providers (nurse practitioner, general practitioner, registered nurse, registered midwife, obstetrician-gynecologist, and family physicians) in 6 of 13 provinces and territories were deductively coded using directed content analysis [1] and analyzed according to key themes. Results Participants detailed their professional training and experiences, patient community demographics, knowledge of vaccines, views and beliefs about vaccination in pregnancy, and attitudes about vaccine counselling. Providers generally described having a good range of information sources to keep vaccine knowledge up to date. Some providers lacked the necessary logistical setups to administer vaccines within their practice. Responses suggest diverging approaches to vaccine counselling. With merely hesitant patients, some opted to dig in and have more in-depth discussions, while others felt the likelihood of persuading an outright vaccine-refusing patient to vaccinate was too low to be worthwhile. Conclusion Provider knowledge, attitudes, and practices around vaccination varied by professional background. To support perinatal providers' knowledge and practices, clinical guidelines should detail the importance of vaccination relative to other care priorities, emphasize the positive impact of engaging hesitant patients in vaccine counselling.
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Affiliation(s)
- Wendy Pringle
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, University of British Columbia, 950 W 28th Ave, Vancouver, British Columbia V5Z 4H4, Canada
| | - Devon Greyson
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, University of British Columbia, 950 W 28th Ave, Vancouver, British Columbia V5Z 4H4, Canada
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T 1Z3, Canada
| | - Janice E. Graham
- Department of Pediatrics, Dalhousie University, 5849 University Ave, C-309, Halifax, Nova Scotia B3H 4H7, Canada
| | - Ève Dubé
- Quebec National Institute of Public Health, 945, av Wolfe, Quebec City, Quebec G1V 5B3, Canada
| | - Hana Mitchell
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, University of British Columbia, 950 W 28th Ave, Vancouver, British Columbia V5Z 4H4, Canada
| | - Margaret L. Russell
- Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada
| | - Shannon E. MacDonald
- Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, Alberta T6G 1C9, Canada
| | - Julie A. Bettinger
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, University of British Columbia, 950 W 28th Ave, Vancouver, British Columbia V5Z 4H4, Canada
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Jafari E, Asghari-Jafarabadi M, Mirghafourvand M, Mohammad-Alizadeh-Charandabi S. Psychometric properties of the experiences of maternity care scale among Iranian women. BMC Health Serv Res 2024; 24:619. [PMID: 38734592 PMCID: PMC11088168 DOI: 10.1186/s12913-024-11065-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Assessing women's perceptions of the care they receive is crucial for evaluating the quality of maternity care. Women's perceptions are influenced by the care received during pregnancy, labour and birth, and the postpartum period, each of which with unique conditions, expectations, and requirements. In England, three Experience of Maternity Care (EMC) scales - Pregnancy, Labour and Birth, and Postnatal - have been developed to assess women's experiences from pregnancy through the postpartum period. This study aimed to validate these scales within the Iranian context. METHODS A methodological cross-sectional study was conducted from December 2022 to August 2023 at selected health centers in Tabriz, Iran. A panel of 16 experts assessed the qualitative and quantitative content validity of the scales and 10 women assessed the face validity. A total of 540 eligible women, 1-6 months postpartum, participated in the study, with data from 216 women being used for exploratory factor analysis (EFA) and 324 women for confirmatory factor analysis (CFA) and other analyses. The Childbirth Experience Questionnaire-2 was employed to assess the convergent validity of the Labour and Birth Scale, whereas women's age was used to assess the divergent validity of the scales. Test-retest reliability and internal consistency were also examined. RESULTS All items obtained an impact score above 1.5, with Content Validity Ratio and Content Validity Index exceeding 0.8. EFA demonstrated an excellent fit with the data (all Kaiser-Meyer-Olkin measures > 0.80, and all Bartlett's p < 0.001). The Pregnancy Scale exhibited a five-factor structure, the Labour and Birth Scale a two-factor structure, and the Postnatal Scale a three-factor structure, explaining 66%, 57%, and 62% of the cumulative variance, respectively, for each scale. CFA indicated an acceptable fit with RMSEA ≤ 0.08, CFI ≥ 0.92, and NNFI ≥ 0.90. A significant correlation was observed between the Labour and Birth scale and the Childbirth Experience Questionnaire-2 (r = 0.82, P < 0.001). No significant correlation was found between the scales and women's age. All three scales demonstrated good internal consistency (all Cronbach's alpha values > 0.9) and test-retest reliability (all interclass correlation coefficient values > 0.8). CONCLUSIONS The Persian versions of all three EMC scales exhibit robust psychometric properties for evaluating maternity care experiences among urban Iranian women. These scales can be utilized to assess the quality of current care, investigate the impact of different care models in various studies, and contribute to maternal health promotion programs and policies.
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Affiliation(s)
- Elham Jafari
- Student Research Comittee, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari-Jafarabadi
- Cabrini Research, Cabrini Health, Malvern, VIC, 3144, Australia.
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, 3168, Australia.
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Shariati Ave, P.O. Box: 51745- 347, Tabriz, 513897977, Iran
| | - Sakineh Mohammad-Alizadeh-Charandabi
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Shariati Ave, P.O. Box: 51745- 347, Tabriz, 513897977, Iran.
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Cheung PS, McCaffrey T, Tighe SM, Mohamad MM. Healthcare practitioners' experiences and perspectives of music in perinatal care in Ireland: An exploratory survey. Midwifery 2024; 132:103987. [PMID: 38599130 DOI: 10.1016/j.midw.2024.103987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 03/11/2024] [Accepted: 04/02/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION Evidence shows that music can promote the wellbeing of women and infants in the perinatal period. Ireland's National Maternity Strategy (2016-2026) suggests a holistic approach to woman's healthcare needs and music interventions are ideally placed as a non-pharmacological and cost-effective intervention to improve the quality of care offered to women and infants. This cross-sectional survey aimed to explore the healthcare practitioners' personal and professional experiences of using music therapeutically and its impact and barriers in practice. The survey also investigated practitioners' knowledge and attitudes towards the use of music as a therapeutic tool in perinatal care. METHODS A novel online survey was developed and distributed through healthcare practitioners' electronic mailing lists, social media, Perinatal Mental Health staff App, and posters at the regional maternity hospital during 26th June and 26th October 2020. Survey items included demographics, personal and professional use of music, and perspectives on music intervention in perinatal care. RESULTS Forty-six healthcare practitioners from across 11 professions were recruited and 42 were included in this study. 98 % of perinatal practitioners used music intentionally to support their wellbeing and 75 % referred to using music in their work. While 90 % found music beneficial in their practice, 15 % reported some negative effect. Around two-thirds of the respondents were familiar with the evidence on music and perinatal wellbeing and 95 % thought there was not enough guidance. 40 % considered music therapy an evidence-based practice and 81 % saw a role for music therapy in standard maternity service in Ireland. The qualitative feedback on how music was used personally and professionally, its' reported benefits, negative effects, and barriers are discussed. DISCUSSION This study offers insights into how healthcare practitioners viewed and applied music in perinatal practice. The findings indicate high interest and positive experiences in using music as a therapeutic tool in perinatal care which highlights the need for more evidence and guidance.
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Affiliation(s)
- Pui Sze Cheung
- Irish World Academy of Music and Dance, University of Limerick, Limerick V94DK18, Ireland; Health Research Institute, University of Limerick, Limerick, V94DK18, Ireland.
| | - Tríona McCaffrey
- Irish World Academy of Music and Dance, University of Limerick, Limerick V94DK18, Ireland; Health Research Institute, University of Limerick, Limerick, V94DK18, Ireland
| | - Sylvia Murphy Tighe
- Health Research Institute, University of Limerick, Limerick, V94DK18, Ireland; Department of Nursing and Midwifery, University of Limerick, Limerick V94DK18, Ireland
| | - Mas Mahady Mohamad
- Specialist Perinatal Mental Health Team, University Maternity Hospital Limerick, Limerick V94C566, Ireland; School of Medicine, University of Limerick, V94DK18, Ireland
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Zielinski MJ, Smith MS, Stahman A. Custodial and perinatal care patterns of women who received prenatal care while incarcerated in the Arkansas state prison system, 2014-2019. Health Justice 2024; 12:16. [PMID: 38613729 PMCID: PMC11015593 DOI: 10.1186/s40352-024-00268-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/15/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND The extraordinary growth in women's incarceration over the past several decades has resulted in calls for expansion of research into their unique needs and experiences, including those related to pregnancy and perinatal care. However, while research into the health outcomes of women who are incarcerated while pregnant has grown, research on women's custodial and perinatal care patterns has remained nearly non-existent. Here, we sought to describe (1) the characteristics of the population of women who came to be incarcerated in a state prison system during pregnancy and (2) the characteristics of women's custodial and perinatal care patterns during and after incarceration. METHODS We conducted a retrospective chart review of the population of women who received perinatal care while incarcerated in the Arkansas state prison system over a 5-year period from June 2014 to May 2019. Electronic medical records and state prison records were merged to form our study population. Data were from 212 women (Mage = 28.4 years; 75.0% non-Latina White) with a singleton pregnancy who received at least one obstetric care visit while incarcerated. RESULTS Drug-related convictions were the most common crimes leading to women's incarceration while pregnant, and violent crime convictions were rare. Nearly half (43.4%) of women who gave birth in custody did so within 90 days of admission and the great majority (80.4%) released within 1-year of giving birth, including 13.3% who released within 30 days. DISCUSSION The frequency with which women who became incarcerated while pregnant released from prison either prior to or shortly after giving birth was a striking, novel finding of this study given the implications for perinatal care disruption among a high-risk population and the harms of forced separation from infants within hours of birth. CONCLUSIONS Diversionary programs for pregnant women convicted of crimes, particularly in states without current access, are urgently needed and should be a priority for future policy work.
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Affiliation(s)
- Melissa J Zielinski
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72205, USA.
| | - Mollee Steely Smith
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72205, USA
| | - Alleigh Stahman
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72205, USA
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Lee King P, Surenian A, Odom RM, Shah K, Lee S, Jenkins E, Borders A. Using quality improvement to address social determinants of health needs in perinatal care. Semin Perinatol 2024; 48:151908. [PMID: 38692995 DOI: 10.1053/j.semperi.2024.151908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
There are unacceptable racial inequities in perinatal outcomes in the United States. Social determinants of health (SDOH) are associated with health outcomes and contribute to disparities in maternal and newborn health. In this article, we (1) review the literature on SDOH improvement in the perinatal space, (2) describe the SDOH work facilitated by the Illinois Perinatal Quality Collaborative (ILPQC) in the Birth Equity quality improvement initiative, (3) detail a hospital's experience with implementing strategies to improve SDOH screening and linkage to needed resources and services and (4) outline a framework for success for addressing SDOH locally. A state-based quality improvement initiative can facilitate implementation of strategies to increase screening for SDOH. Engaging patients and communities with specific actionable strategies is key to increase linkage to needed SDOH resources and services.
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Affiliation(s)
- Patricia Lee King
- Northwestern University, Feinberg School of Medicine, Center for Healthcare Services and Outcomes Research-Institute for Public Health and Medicine, 633N. St. Clair, 20th Fl, Chicago, IL 60611, United States; University of Chicago, Pritzker School of Medicine, Obstetrics and Gynecology, 5841 S. Maryland Avenue Chicago, IL 60637, United States; NorthShore University HealthSystem (now Endeavor Health), Maternal-Fetal-Medicine, 2650 Ridge Avenue, Evanston, IL 60201, United States.
| | - Aleena Surenian
- Northwestern University, Feinberg School of Medicine, Center for Healthcare Services and Outcomes Research-Institute for Public Health and Medicine, 633N. St. Clair, 20th Fl, Chicago, IL 60611, United States
| | - Renee M Odom
- NorthShore University HealthSystem (now Endeavor Health), Maternal-Fetal-Medicine, 2650 Ridge Avenue, Evanston, IL 60201, United States
| | - Kshama Shah
- University of Chicago, Pritzker School of Medicine, Obstetrics and Gynecology, 5841 S. Maryland Avenue Chicago, IL 60637, United States; NorthShore University HealthSystem (now Endeavor Health), Maternal-Fetal-Medicine, 2650 Ridge Avenue, Evanston, IL 60201, United States
| | - SuYeon Lee
- Northwestern University, Feinberg School of Medicine, Center for Healthcare Services and Outcomes Research-Institute for Public Health and Medicine, 633N. St. Clair, 20th Fl, Chicago, IL 60611, United States
| | - Elena Jenkins
- SSM Health St. Mary's Hospital - St. Louis, 6420 Clayton Road, Richmond Heights, MO 63117, United States
| | - Ann Borders
- Northwestern University, Feinberg School of Medicine, Center for Healthcare Services and Outcomes Research-Institute for Public Health and Medicine, 633N. St. Clair, 20th Fl, Chicago, IL 60611, United States; University of Chicago, Pritzker School of Medicine, Obstetrics and Gynecology, 5841 S. Maryland Avenue Chicago, IL 60637, United States; NorthShore University HealthSystem (now Endeavor Health), Maternal-Fetal-Medicine, 2650 Ridge Avenue, Evanston, IL 60201, United States
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Suarez A, Yakupova V. Childbirth experiences of women with a history of physical, sexual, and child abuse: a cross-sectional study of 2,575 Russian women. BMC Pregnancy Childbirth 2024; 24:186. [PMID: 38459457 PMCID: PMC10921683 DOI: 10.1186/s12884-024-06369-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/24/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND A substantial number of women who subsequently become pregnant and give birth have a history of physical, sexual, and/or child abuse. This study investigated the associations of these types of traumas and their cumulative effect with childbirth experiences, namely, mode of birth, maternal and child complications during pregnancy/childbirth, preterm birth, medical procedures, and obstetric violence during labour. METHODS A group of Russian women (n = 2,575) who gave birth within the previous 12 months, completed a web-based survey, where they provided demographic information, details about their childbirth experiences, and a history of trauma. RESULTS Women with any type of past abuse were at higher risk for maternal complications during pregnancy/childbirth (exp(β) < 0.73, p < 0.010 for all). More specific to the type of trauma were associations of physical abuse with caesarean birth, child abuse with complications during pregnancy/childbirth for the baby, and physical and child abuse with obstetric violence (exp(β) < 0.54, p < 0.022 for all). There was a cumulative effect of trauma for all the outcomes except for medical procedures during childbirth and preterm birth. CONCLUSION This study provides insights into potential different individual effects of physical, sexual, and/or child abuse as well as their cumulative impact on the childbirth experiences. The robust findings about maternal complications during pregnancy/childbirth and obstetric violence highlight the importance of trauma-informed care, supportive policies, and interventions to create safe and empowering birthing environments that prioritise patient autonomy, dignity, and respectful communication.
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Affiliation(s)
- Anna Suarez
- Department of Psychology, Lomonosov Moscow State University, Mokhovaya St, 11/9, Moscow, 125009, Russia.
| | - Vera Yakupova
- Department of Psychology, Lomonosov Moscow State University, Mokhovaya St, 11/9, Moscow, 125009, Russia
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Hense H, Mathiebe J, Helfer S, Glaubitz R, Rüdiger M, Birdir C, Schmitt J, Müller G. Evaluation of the telemedical health care network "SAFE BIRTH" for pregnant women at risk, premature and sick newborns and their families: study protocol of a cluster-randomized controlled stepped-wedge trial. BMC Health Serv Res 2024; 24:200. [PMID: 38355579 PMCID: PMC10865646 DOI: 10.1186/s12913-024-10667-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 01/31/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND The Perinatal Center of the University Hospital Carl Gustav Carus Dresden has initiated the telemedical healthcare network "SAFE BIRTH" to coordinate and improve specialized care in non-metropolitan regions for pregnant women and newborns. The network incorporates five intervention bundles (IB): (1) Multi-professional, inter-disciplinary prenatal care plan; (2) Neonatal resuscitation; (3) Neonatal antibiotic stewardship; (4) Inter-facility transfer of premature and sick newborns; (5) Psycho-social support for parents. We evaluate if the network improves care close to home for pregnant women, premature and sick newborns. METHODS To evaluate the complex healthcare intervention "SAFE BIRTH" we will conduct a cluster-randomized controlled stepped-wedge trial in five prenatal medical outpatient offices and eight non-metropolitan hospitals in Saxony, Germany. The offices and hospitals will be randomly allocated to five respectively eight sequential steps over a 30-month period to implement the telemedical IB. We define one specific primary process outcome for each IB (for instance IB#1: "Proportion of patients with inclusion criterion IB#1 who have a prenatal care plan and psychosocial counseling within one week"). We estimated a separate multilevel logistic regression model for each primary process outcome using the intervention status as a regressor (control or intervention group). Across all IB, a total of 1,541 and 1,417 pregnant women or newborns need to be included in the intervention and control group, respectively, for a power above 80% for small to medium intervention effects for all five hypothesis tests. Additionally, we will assess job satisfaction and sense of safety of health professionals caring for newborns (questionnaire survey) and we will assess families' satisfaction, resilience, quality of life and depressive, anxiety and stress symptoms (questionnaire surveys). We will also evaluate the cost-effectiveness of "SAFE BIRTH" (statutory health insurance routine data, process data) and barriers to its implementation (semi-structured interviews). We use multilevel regression models adjusting for relevant confounders (e.g. socioeconomic status, age, place of residence), as well as descriptive analyses and qualitative content analyses. DISCUSSION If the telemedical healthcare network "SAFE BIRTH" proves to be effective and cost-efficient, strategies for its translation into routine care should be developed. TRIAL REGISTRATION German clinical trials register. DRKS-ID DRKS00031482.
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Affiliation(s)
- Helene Hense
- Center for Evidence-Based Healthcare, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
| | - Josephine Mathiebe
- Center for Evidence-Based Healthcare, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Sven Helfer
- Saxony Center for Feto/Neonatal Health, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Rick Glaubitz
- Center for Evidence-Based Healthcare, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Mario Rüdiger
- Saxony Center for Feto/Neonatal Health, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Cahit Birdir
- Saxony Center for Feto/Neonatal Health, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Gabriele Müller
- Center for Evidence-Based Healthcare, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Gupta A, De Vera MA, Rebić N, Amiri N. Pre-pregnancy planning for female patients seen at a pregnancy and rheumatic diseases clinic: a retrospective analysis of patients with rheumatic diseases seeking pregnancy-related care. Rheumatol Int 2024; 44:283-289. [PMID: 37535072 DOI: 10.1007/s00296-023-05398-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 07/18/2023] [Indexed: 08/04/2023]
Abstract
To assess the clinical utility of pre-pregnancy planning among female patients with rheumatic diseases attending a targeted pregnancy and rheumatic diseases clinic. We conducted a retrospective review using data collected via chart review of female patients with rheumatic diseases seen at the Pregnancy and Rheumatic Diseases Clinic at the Mary Pack Arthritis Centre in Vancouver, Canada, between January 2017 and July 2020. Patients were categorized according to an initial presentation at the clinic as (1) pregnant without pre-pregnancy planning; and (2) not pregnant with pre-pregnancy planning. The latter group was further categorized according to whether they had contraindications to pregnancy. Pregnancy outcomes were extracted from electronic medical records and analyzed using descriptive statistics. Our study included 230 female patients with rheumatic diseases. At the initial clinical presentation, 86 were pregnant and 144 were planning to become pregnant and presenting for pre-pregnancy planning. Compared to patients without pre-pregnancy planning, patients who received pregnancy planning experienced fewer prenatal disease flares (61.3% [38/62] vs. 22.6% [7/31]; p < 0.001), fewer medication changes during pregnancy (46.4% [39/84] vs. 18.9% [10/53]; p = 0.002), and improved disease control in the first trimester of pregnancy (p = 0.018). There were no statistically significant differences in the frequency of adverse pregnancy or fetal outcomes between patients with and without pre-pregnancy planning. Evaluation of patient outcomes suggests that pre-pregnancy planning may support early assessment of high-risk pregnancy status; therein, allowing healthcare providers to identify and manage risk factors for adverse pregnancy outcomes among patients living with rheumatic diseases.
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Affiliation(s)
- Amit Gupta
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
- Arthritis Research Centre of Canada, Richmond, BC, Canada
- Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - Mary A De Vera
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
- Arthritis Research Centre of Canada, Richmond, BC, Canada
- Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada
| | - Nevena Rebić
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
- Arthritis Research Centre of Canada, Richmond, BC, Canada
- Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada
| | - Neda Amiri
- Arthritis Research Centre of Canada, Richmond, BC, Canada.
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
- Mary Pack Arthritis Centre, Vancouver, BC, Canada.
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FDI World Dental Federation. Perinatal and Infant Oral Health Care. Int Dent J 2024; 74:167-8. [PMID: 38218600 DOI: 10.1016/j.identj.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2024] Open
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Salajegheh Z, Nasiri M, Imanipour M, Zamanifard M, Sadeghi O, Ghasemi Dehcheshmeh M, Asadi M. Is oral consumption of dates (Phoenix dactylifera L. fruit) in the peripartum period effective and safe integrative care to facilitate childbirth and improve perinatal outcomes: a comprehensive revised systematic review and dose-response meta-analysis. BMC Pregnancy Childbirth 2024; 24:12. [PMID: 38166785 PMCID: PMC10759543 DOI: 10.1186/s12884-023-06196-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Recent reviews have reported inconclusive results regarding the usefulness of consuming dates (Phoenix dactylifera L. fruit) in the peripartum period. Hence, this updated systematic review with meta-analysis sought to investigate the efficacy and safety of this integrated intervention in facilitating childbirth and improving perinatal outcomes. METHODS Eight data sources were searched comprehensively from their inception until April 30, 2023. Parallel-group randomized and non-randomized controlled trials published in any language were included if conducted during peripartum (i.e., third trimester of pregnancy, late pregnancy, labor, or postpartum) to assess standard care plus oral consumption of dates versus standard care alone or combined with other alternative interventions. The Cochrane Collaboration's Risk of Bias (RoB) assessment tools and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were employed to evaluate the potential RoB and the overall quality of the evidence, respectively. Sufficient data were pooled by a random-effect approach utilizing Stata software. RESULTS Of 2,460 records in the initial search, 48 studies reported in 55 publications were included. Data were insufficient for meta-analysis regarding fetal, neonatal, or infant outcomes; nonetheless, most outcomes were not substantially different between dates consumer and standard care groups. However, meta-analyses revealed that dates consumption in late pregnancy significantly shortened the length of gestation and labor, except for the second labor stage; declined the need for labor induction; accelerated spontaneity of delivery; raised cervical dilatation (CD) upon admission, Bishop score, and frequency of spontaneous vaginal delivery. The dates intake in labor also significantly reduced labor duration, except for the third labor stage, and increased CD two hours post-intervention. Moreover, the intervention during postpartum significantly boosted the breast milk quantity and reduced post-delivery hemorrhage. Likewise, dates supplementation in the third trimester of pregnancy significantly increased maternal hemoglobin levels. The overall evidence quality was also unacceptable, and RoB was high in most studies. Furthermore, the intervention's safety was recorded only in four trials. CONCLUSION More well-designed investigations are required to robustly support consuming dates during peripartum as effective and safe integrated care. TRIAL REGISTRATION PROSPERO Registration No: CRD42023399626.
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Affiliation(s)
- Zahra Salajegheh
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Morteza Nasiri
- Department of Anesthesiology, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Imanipour
- Department of Medical-Surgical Nursing, School of Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Mina Zamanifard
- Department of Pediatric Nursing, School of Nursing and Midwifery, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Omid Sadeghi
- Nutrition and Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Masoomeh Asadi
- Religion, Health and Technology Studies Center, Abadan University of Medical Sciences, P.O. Box 6313833177, Abadan, Iran.
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Constaín GA, Ocampo Saldarriaga MV, Franco Vásquez JGF, Naranjo LF, Restrepo Conde C, Estrada Muñoz D, Chaverra López L, Buriticá González JB. Psychiatric disorders in pregnant women admitted to the high-risk obstetric service in a Colombian university clinic between 2013 and 2017. Rev Colomb Psiquiatr (Engl Ed) 2024; 53:17-25. [PMID: 38670824 DOI: 10.1016/j.rcpeng.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 01/12/2022] [Indexed: 04/28/2024]
Abstract
OBJECTIVE To determine the psychiatric diagnoses and treatments of patients admitted to the high-risk obstetric service who underwent a consultation with a liaison psychiatrist. METHODS A descriptive observational study that included pregnant women from the high-risk obstetric service of a highly specialised clinic in Medellín, who had a liaison psychiatry consultation between 2013 and 2017. The main variables of interest were psychiatric and obstetric diagnoses and treatments, in addition to biopsychosocial risk factors. RESULTS A total of 361 medical records were screened, with 248 patients meeting the inclusion criteria. The main prevailing psychiatric diagnosis was major depressive disorder (29%), followed by adaptive disorder (21.8%) and anxiety disorders (12.5%). The pharmacologic treatments most used by the psychiatry service were SSRI antidepressants (24.2%), trazodone (6.8%) and benzodiazepines (5.2%). The most common primary obstetric diagnosis was spontaneous delivery (46.4%), and the predominant secondary obstetric diagnoses were hypertensive disorder associated with pregnancy (10.4%), gestational diabetes (9.2%) and recurrent abortions (6.4%). Overall, 71.8% of the patients had a high biopsychosocial risk. CONCLUSIONS The studied population's primary psychiatric disorders were major depressive disorder, adjustment disorder and anxiety disorders, which implies the importance of timely recognition of the symptoms of these perinatal mental pathologies, together with obstetric and social risks, in the prenatal consultation. Psychiatric intervention should be encouraged considering the negative implications of high biopsychosocial risk in both mothers and children.
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Affiliation(s)
- Gustavo A Constaín
- Grupo de Investigación en Psiquiatría de Enlace (GIPE), Departamento de Psiquiatría, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia.
| | - María Victoria Ocampo Saldarriaga
- Grupo de Investigación en Psiquiatría de Enlace (GIPE), Departamento de Psiquiatría, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - José Gabriel Franco Franco Vásquez
- Grupo de Investigación en Psiquiatría de Enlace (GIPE), Departamento de Psiquiatría, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Luisa Fernanda Naranjo
- Departamento de Psiquiatría, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Cristóbal Restrepo Conde
- Departamento de Psiquiatría, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Daniel Estrada Muñoz
- Departamento de Obstetricia y Ginecología, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia
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Ding S, Wang X, Wang Q, Shen J, Xie H, Fu X, Liao L, Chen J, Zhu L, Huang J, Yang S, Huang X, Zhang Y. Translation and psychometric testing of the Chinese version of the Perinatal Missed Care Survey. Int J Nurs Sci 2024; 11:106-112. [PMID: 38352293 PMCID: PMC10859582 DOI: 10.1016/j.ijnss.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/05/2023] [Accepted: 12/11/2023] [Indexed: 02/16/2024] Open
Abstract
Objective This study aimed to translate and evaluate the psychometric properties of the Perinatal Missed Care Survey in China. Methods The Perinatal Missed Care Survey was translated according to the guidelines of the cross-cultural debugging scale recommended by the American Academy of Orthopaedic Surgeons Evidence-Based Medicine Committee, including forward translation, back translation, cultural adaption, and content validation, and its Chinese version was used in a cross-sectional study conducted from February to April in 2023. A total of 491 midwives from 14 different level hospitals in southwest China were recruited through a convenience sampling method. The discrimination ability of the items was tested through item analysis, and construct validity was assessed through exploratory factory and confirmatory factor analyses. The content validity index and Cronbach's α coefficients evaluated content validity and reliability, respectively. Results The Chinese version's item-total correlation coefficients ranged from 0.641 to 0.866 in part A and from 0.644 to 0.819 in part B (P < 0.001). Parts A and B's scale-level content validity indexes were 0.95, and the item-level content validity indexes were from 0.86 to 1.00. The three common factors of part A (necessary care, basic care, and postnatal care) and part B (communication, labor resources, and material resources) were extracted, accounting for 70.186% and 71.984% of the total variance, respectively. Confirmatory factor analysis indicated that the good fit of the three-factor models was acceptable. The Cronbach's α coefficients were 0.968 (part A) and 0.940 (part B). Conclusion The Chinese version of the Perinatal Missed Care Survey is a reliable and valid instrument for assessing nursing care missed by midwives during labor and birth and the reasons it was missed. Studies with large sample sizes are needed to verify the instrument's applicability in China.
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Affiliation(s)
- Shenglan Ding
- Birth Room, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xin Wang
- Department of Nursing, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Qingxia Wang
- Birth Room, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Juan Shen
- Birth Room, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Huili Xie
- Birth Room, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiujuan Fu
- Birth Room, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Luxi Liao
- Birth Room, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiaojiao Chen
- Department of Medical Imaging, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lian Zhu
- School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Jing Huang
- School of Nursing, Peking University, Beijing, China
| | - Siyuan Yang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiuhua Huang
- Surgery Intensive Care Unit, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yilan Zhang
- Birth Room, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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DESCHAMPS C, BARDON T, BLAISE T, BONIFAY T, BOUTROU M, FREMERY A, HENRY K, LAMBERT Y, LE TURNIER P, MUTRICY R, OBERLIS M, QUINTIN B, SAUVAGE B, THOMAS E, EPELBOIN L, HUREAU-MUTRICY L. [6th day dedicated to the scientific works of caregivers in French Guiana. Our caregivers have talent! May 25 & 26, 2023, Cayenne, French Guiana]. Med Trop Sante Int 2023; 3:mtsi.v3i4.2023.439. [PMID: 38390010 PMCID: PMC10879897 DOI: 10.48327/mtsi.v3i4.2023.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/07/2023] [Indexed: 02/24/2024]
Affiliation(s)
- Camille DESCHAMPS
- Service d'accueil des urgences, SAMU/SMUR, Centre hospitalier de Cayenne, Guyane, France
| | - Teddy BARDON
- Centre d'investigation clinique Antilles-Guyane, CIC INSERM 1424, Centre hospitalier de Cayenne, Guyane
| | - Théo BLAISE
- Centre d'investigation clinique Antilles-Guyane, CIC INSERM 1424, Centre hospitalier de Cayenne, Guyane
| | - Timothée BONIFAY
- Centre d'investigation clinique Antilles-Guyane, CIC INSERM 1424, Centre hospitalier de Cayenne, Guyane
- Unité sanitaire en milieu pénitentiaire de Rémire, Centre hospitalier de Cayenne, Guyane
| | - Mathilde BOUTROU
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Guyane
| | - Alexis FREMERY
- Service d'accueil des urgences, SAMU/SMUR, Centre hospitalier de Cayenne, Guyane, France
| | - Kim HENRY
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Guyane
| | - Yann LAMBERT
- Centre d'investigation clinique Antilles-Guyane, CIC INSERM 1424, Centre hospitalier de Cayenne, Guyane
| | - Paul LE TURNIER
- Centre d'investigation clinique Antilles-Guyane, CIC INSERM 1424, Centre hospitalier de Cayenne, Guyane
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Guyane
| | - Rémi MUTRICY
- Service d'accueil des urgences, SAMU/SMUR, Centre hospitalier de Cayenne, Guyane, France
| | | | - Benoît QUINTIN
- Centre délocalisé de prévention et de soins de Saint-Georges-de-l'Oyapock, Centre hospitalier de Cayenne, Guyane
| | | | - Estelle THOMAS
- Centre d'investigation clinique Antilles-Guyane, CIC INSERM 1424, Centre hospitalier de Cayenne, Guyane
| | - Loïc EPELBOIN
- Centre d'investigation clinique Antilles-Guyane, CIC INSERM 1424, Centre hospitalier de Cayenne, Guyane
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Guyane
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Corsi Decenti E, Salvatore MA, Mandolini D, Sampaolo L, D'Aloja P, Donati S. Perinatal care in SARS-CoV-2 infected women: the lesson learnt from a national prospective cohort study during the pandemic in Italy. BMC Public Health 2023; 23:2562. [PMID: 38129838 PMCID: PMC10740257 DOI: 10.1186/s12889-023-17390-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Despite the growing importance given to ensuring high-quality childbirth, perinatal good practices have been rapidly disrupted by SARS-CoV-2 pandemic. This study aimed at describing the childbirth care provided to infected women during two years of COVID-19 emergency in Italy. METHODS A prospective cohort study enrolling all women who gave birth with a confirmed SARS-CoV-2 infection within 7 days from hospital admission in the 218 maternity units active in Italy during the periods February 25, 2020-June 30, 2021, and January 1-May 31, 2022. Perinatal care was assessed by evaluating the prevalence of the following indicators during the pandemic: presence of a labour companion; skin-to-skin; no mother-child separation at birth; rooming-in; breastfeeding. Logistic regression models including women' socio-demographic, obstetric and medical characteristics, were used to assess the association between the adherence to perinatal practices and different pandemic phases. RESULTS During the study period, 5,360 SARS-CoV-2 positive women were enrolled. Overall, among those who had a vaginal delivery (n = 3,574; 66.8%), 37.5% had a labour companion, 70.5% of newborns were not separated from their mothers at birth, 88.1% were roomed-in, and 88.0% breastfed. These four indicators showed similar variations in the study period with a negative peak between September 2020 and January 2021 and a gradual increase during the Alpha and Omicron waves. Skin-to-skin (mean value 66.2%) had its lowest level at the beginning of the pandemic and gradually increased throughout the study period. Among women who had a caesarean section (n = 1,777; 33.2%), all the indicators showed notably worse outcomes with similar variations in the study period. Multiple logistic regression analyses confirm the observed variations during the pandemic and show a lower adherence to good practices in southern regions and in maternity units with a higher annual number of births. CONCLUSIONS Despite the rising trend in the studied indicators, we observed concerning substandard childbirth care during the SARS-CoV-2 pandemic. Continued efforts are necessary to underscore the significance of the experience of care as a vital component in enhancing the quality of family-centred care policies.
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Affiliation(s)
- Edoardo Corsi Decenti
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore Di Sanità - Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Michele Antonio Salvatore
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore Di Sanità - Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
| | - Donatella Mandolini
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore Di Sanità - Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
| | - Letizia Sampaolo
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore Di Sanità - Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
| | - Paola D'Aloja
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore Di Sanità - Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
| | - Serena Donati
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore Di Sanità - Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
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Obeng CS, Jackson F, Brandenburg D, Byrd KA. Black/African American Women's Woes: Women's Perspectives of Black/African American Maternal Mortality in the USA. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01883-0. [PMID: 38051429 DOI: 10.1007/s40615-023-01883-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/15/2023] [Accepted: 11/27/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Despite advances in perinatal care in the USA, maternal mortality is on the rise, and maternal death is higher than in any other high-income country. Maternal mortality in the USA is a persistent public health concern. This issue disproportionately affects Black/African American women, with their likelihood of pregnancy-related death being three times more likely compared to White women. This study aimed to explore the resources needed for Black/African American women to address the relatively higher maternal mortality rates recorded for them. METHODS An anonymous link with demographic and open-ended questions was sent to US women 18 years and older to participate in the study. A total of 140 participants responded to the survey. We retained a final sample of 118 responses after eliminating responses with missing data. Descriptive statistics are reported for closed-ended items. Open-ended responses were analyzed using content analysis procedures, where we coded and categorized the data into themes. RESULTS Six themes were identified from the study data: (1) Diversity, Equity, and Inclusion (DEI) training for health providers focused on racial bias and discrimination, (2) Advocacy, (3) Provider selection, (4) Researching doctors and delivery hospitals to inform women's birthing decision-making, (5) Women's care-seeking behaviors, and (6) Addressing the Social Determinants of Health. CONCLUSION Based on the study's findings, we recommend DEI training for healthcare professionals providing direct care to pregnant and postpartum women, advocacy and resource-awareness training for pregnant Black/African American women and their spouses/partners, or a family member, to assist them in their pregnancy and birthing journeys.
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Affiliation(s)
- Cecilia S Obeng
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA.
| | - Frederica Jackson
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA
| | - Dakota Brandenburg
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA
| | - Kourtney A Byrd
- College of Pharmacy, Center for Health Equity and Innovation (CHEqI), Purdue University, Indianapolis, IN, USA
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Sternberger L, Sorensen-Alawad A, Prescott T, Sakai H, Brown K, Finkelstein N, Salomon A, Schiff DM. Lessons Learned Serving Pregnant, Postpartum, and Parenting People with Substance Use Disorders in Massachusetts: The Moms Do Care Program. Matern Child Health J 2023; 27:67-74. [PMID: 37792152 PMCID: PMC10692242 DOI: 10.1007/s10995-023-03775-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE The purpose of this paper is to describe the design and implementation of a multidisciplinary, integrated approach to supporting pregnant, postpartum, and parenting people (PPPP) and their families affected by substance use disorders (SUD). DESCRIPTION Between 2015 and 2022, the Moms Do Care (MDC) Program, sponsored by the Massachusetts Department of Public Health Bureau of Substance Addiction Services, established or expanded 11 co-located medical and behavioral health teams in locations across Massachusetts. These teams provided trauma-informed primary and obstetrical health care, SUD treatment and recovery services, parenting support, and case management for approximately 1048 PPPP with SUD. ASSESSMENT By enhancing the capacity of medical and behavioral health providers offering integrated care across the perinatal health care continuum, MDC created a network of support for PPPP with SUD. Lessons learned include the need to continually invest in staff training to foster teambuilding and improve integrated service delivery, uplift the peer recovery coach role within the care team, improve engagement with and access to services for communities of color, and conduct evaluation and sustainability planning. CONCLUSION MDC prioritizes trauma-informed integrated care, peer recovery, and commits to addressing inequities and stigma; thus, this program represents a promising approach to supporting PPPP impacted by SUD. The MDC model is relevant for those working to build multidisciplinary, integrated systems of health care and perinatal SUD services for marginalized populations.
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Affiliation(s)
| | | | | | - Hibiki Sakai
- Advocates for Human Potential, Inc. Center for Research and Evaluation, Chicago, USA
| | - Kayla Brown
- Advocates for Human Potential, Inc. Center for Research and Evaluation, Sudbury, USA
| | | | - Amy Salomon
- Advocates for Human Potential, Inc. Center for Research and Evaluation, Sudbury, USA
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Kumar J, Saini SS, Kumar P. Care During Labour, Childbirth, and Immediate Newborn Care in India: A Review. Indian J Pediatr 2023; 90:20-28. [PMID: 37380919 DOI: 10.1007/s12098-023-04721-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 06/05/2023] [Indexed: 06/30/2023]
Abstract
India is committed to achieve a single-digit neonatal mortality rate (NMR) and stillbirth rate (SBR) by 2030 through India Newborn Action Plan (INAP) 2014. However, the current rate of decline is not enough to achieve the target neonatal mortality rate. Course correction and renewed efforts are required. This review outlines the current scenario and proposed scale-up of services included during labour, childbirth, and the immediate newborn period. The article summarises the challenges and bottlenecks in achieving a reduction in neonatal mortality rate and INAP targets. India has achieved over 80% coverage of three of the four ENAP coverage targets, but antenatal care coverage is still poor. There are concerns about the quality and completeness of antenatal care visits and other program interventions. The ongoing quality assurance should be strengthened through continuous supportive supervision by involving the medical colleges in a hub and spoke model and other key stakeholders. There is a need for effective and strategic engagement of the private sector in these initiatives. The states need to systematically assess the gaps as per population requirements and find effective solutions to overcome them quickly. The state and district-wise data maps show immense variations in coverage between states and within states, mirroring the variations in NMR. This indicates the need to ensure contextual micro-plans and provides an opportunity for the districts and states to learn from each other. The recent initiatives to strengthen primary healthcare should be used as a platform for all stillbirth and neonatal mortality prevention interventions in India.
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Affiliation(s)
- Jogender Kumar
- Division of Neonatology, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shiv Sajan Saini
- Division of Neonatology, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Praveen Kumar
- Division of Neonatology, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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King A, Piccinini-Vallis H. Patient-Perceived Patient-Centeredness During Pregnancy. J Obstet Gynaecol Can 2023; 45:102194. [PMID: 37625642 DOI: 10.1016/j.jogc.2023.102194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/10/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVES Although patient-centeredness is a pinnacle in high-quality healthcare, there is a lack of research measuring patient-centeredness from the perspective of the patient in the context of perinatal care. Therefore, the objectives of this study were to (1) measure patient-perceived patient-centeredness from pregnant people receiving prenatal care in Nova Scotia, and (2) explore potential correlates of patient-perceived patient-centeredness. METHODS Participants completed an e-survey through REDCap software. Questions comprised of the Patient-Perceived Patient-Centeredness (Revised) (PPPC-R) questionnaire and demographic questions. The PPPC-R total score was calculated. Descriptive statistics were calculated to describe the sample, and inferential statistics were conducted. Linear regression analysis was used to determine how the independent variables predicted the PPPC-R total score. RESULTS A total of 98 patients participated in the survey to completion. The mean PPPC-R total score was 62.2 (SD 10.5), equivalent to a score of 3.45/4. No significant correlates of the PPPC-R total score were identified; however, trends were observed related to age, parity, Body mass index, race/ethnicity, and education. CONCLUSIONS Participants in our study rated their clinicians' patient-centeredness very highly. There was no significant difference in PPPC-R score among pregnant people based on the independent variables we collected.
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Doyle C, Che M, Lu Z, Roesler M, Larsen K, Williams LA. Women's desires for mental health support following a pregnancy loss, termination of pregnancy for medical reasons, or abortion: A report from the STRONG Women Study. Gen Hosp Psychiatry 2023; 84:149-157. [PMID: 37490825 DOI: 10.1016/j.genhosppsych.2023.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVE We report on women's mental health care desires following a miscarriage, medical termination, or abortion. METHOD 689 women completed a questionnaire on reproductive history, health care following miscarriage/medical termination/abortion, and current mental health. Descriptive statistics and logistic regression analyses examined: miscarriage/termination/abortion incidence, desires for mental health support following miscarriages/terminations/abortions, and current mental health. RESULTS Of 365 women with a pregnancy history, 37% reported ≥1 miscarriage, 9% ≥1 medical termination, 16% ≥1 abortion, and 3% endorsed all three. Current mental health did not differ between women with a history of miscarriage/termination/abortion and those with only live births (p = 0.82). Following miscarriage, 68% of women discussed options for the medical management of pregnancy loss with their provider, 32% discussed grief/loss, and 25% received mental health care recommendations. Engagement in mental health services was reported by 16% of women with a history of miscarriage, 38% after medical termination, and 19% following an abortion. Of women who became pregnant after their most recent miscarriage/termination/abortion and did not receive mental health care, 55% wished they had received services during the subsequent pregnancy. CONCLUSIONS Women desire mental health care after miscarriages, medical terminations, or abortions, warranting improved access to mental health care for these individuals.
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Affiliation(s)
- Colleen Doyle
- Women's Wellbeing Program, Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Mambo Che
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Zhanni Lu
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Michelle Roesler
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Karin Larsen
- Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Lindsay A Williams
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA; Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA.
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Pan WL, Lin LC, Kuo LY, Chiu MJ, Ling PY. Effects of a prenatal mindfulness program on longitudinal changes in stress, anxiety, depression, and mother-infant bonding of women with a tendency to perinatal mood and anxiety disorder: a randomized controlled trial. BMC Pregnancy Childbirth 2023; 23:547. [PMID: 37525110 PMCID: PMC10388457 DOI: 10.1186/s12884-023-05873-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 07/25/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Stress is a risk factor for poor physical and mental health, affecting new mothers' ability, especially those with perinatal mood and anxiety disorders, to maintain their everyday lives. Over the past 50 years, global incidences of depression and anxiety disorders have increased, reaching pandemic levels. These incidences represent major public health issues that are challenging to detect and treat. Mindfulness programs are viable for reducing stress, anxiety, and depression. The present study evaluates mindfulness intervention effects on stress, anxiety, depression, and mother-infant bonding. METHODS We collected data on 102 women participating in a prenatal mindfulness program between July 2021 and March 2022; they were parallel and randomly assigned to experimental or control groups. The intervention group received an 8-week course in a prenatal mindfulness program, and the control group received usual standard prenatal care. The self-reported stress, pregnancy-related anxiety, and depression were assessed before and after the intervention and at 36 weeks of gestation. At 2 and 4 months postpartum, all participants provided self-reported their levels of stress, depression, and quality of mother-infant bonding. RESULTS Compared to the control group, the experimental group that received the prenatal mindfulness intervention experienced reduced prenatal stress, anxiety, and depression and reduced postnatal stress and depression. Despite this, there was no significant difference between the groups in terms of the quality of mother-infant bonding. CONCLUSIONS Mindfulness prenatal programs are convenient and effective methods of decreasing stress, anxiety, and depression during the perinatal period. Based on our findings, prenatal mindfulness may play a role in mitigating mood and anxiety disorders and should be considered in future approaches to preventing psychological distress. TRIAL REGISTRATION NUMBER This trial has been prospectively registered at ClinicalTrials.gov (NCT04693130) and the first registration date was 12/24/2020.
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Affiliation(s)
- Wan-Lin Pan
- School of Nursing, National Taipei University of Nursing and Health Sciences, No.365, Ming-Te Road, Peitou District, Taipei, Taiwan.
| | - Li-Chiu Lin
- Department of Nursing, HungKuang University, Taichung, Taiwan
| | - Li-Yen Kuo
- Department of Thanatology and Health Counseling, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Mu-Jung Chiu
- Department of Nursing, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Pei-Ying Ling
- Department of Obstetrics and Gynecology, Taiwan Adventist Hospital, Taipei, Taiwan
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Tanaka A, Higeta D, Arai S, Ishibashi Y, Kyoya T, Iwase A. Single coronary artery diagnosed in the perinatal period: A case report. Taiwan J Obstet Gynecol 2023; 62:562-565. [PMID: 37407195 DOI: 10.1016/j.tjog.2022.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2022] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVE Having a single coronary artery (SCA) is a rare congenital anomaly in which a single artery arises from the aorta. Although most cases of SCA are asymptomatic and incidental, its effects during the perinatal period remain unknown. Herein, we report a case of pregnant woman with suspected SCA, based on transthoracic echocardiography (TTE) findings. CASE REPORT A 33-year-old multiparous woman presented with preterm premature rupture of the membrane at 29 weeks gestation. The patient's preoperative electrocardiogram (ECG) showed slight ST changes. TTE showed dilated right coronary artery and hypoplastic left coronary artery. Cesarean section was performed at 30 weeks of gestation due to non-reassuring fetal status. Although poor oxygenation was observed postoperatively, the patient was managed appropriately. She was diagnosed with SCA based on coronary computed tomographic angiography findings one month after delivery. CONCLUSION Pregnant women with SCA require careful perinatal care.
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Affiliation(s)
- Ayuko Tanaka
- Department of Obstetrics and Gynecology, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Daisuke Higeta
- Department of Obstetrics and Gynecology, Gunma University Hospital, Maebashi, Gunma, Japan.
| | - Syuhei Arai
- Department of Cardiology, Gunma Children's Medical Center, Shibukawa, Gunma, Japan
| | - Yohei Ishibashi
- Department of Cardiology, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Takuji Kyoya
- Department of Obstetrics, Gunma Children's Medical Center, Shibukawa, Gunma, Japan
| | - Akira Iwase
- Department of Obstetrics and Gynecology, Gunma University Hospital, Maebashi, Gunma, Japan
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Maruyama N, Horiuchi S, Kataoka Y. Prevalence and associated factors of intimate partner violence against pregnant women in urban areas of Japan: a cross-sectional study. BMC Public Health 2023; 23:1168. [PMID: 37328737 PMCID: PMC10276381 DOI: 10.1186/s12889-023-16105-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 06/12/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) against pregnant women is associated with many negative maternal and fetal outcomes and is a common public health problem all over the world. However, the issue has not been fully explored in Japan. This study aimed to explore the prevalence and risk factors of IPV against pregnant women in urban areas of Japan. METHODS This study was a secondary data analysis of a cross-sectional survey that was conducted on women beyond 34 weeks' gestation in five perinatal facilities in urban areas of Japan, from July to October 2015. The sample size was calculated to be 1230. The Violence Against Women Screen was used for IPV screening. Multiple logistic regression analysis was used to calculate the adjusted odds ratio (AOR) with 95% confidence interval (CI) for risks of IPV while adjusting for confounding factors. RESULTS Of the 1346 women who participated in this study, 180 (13.4%) were identified as experiencing IPV. Compared to those who did not experience IPV (n = 1166 (86.6%)), women experiencing IPV had higher odds of being single mothers (AOR = 4.8; 95%CI: 2.0, 11.2), having lower household income (< 3 million yen, AOR = 2.6; 95%CI: 1.4, 4.6; ≥ 3 million yen and < 6 million yen, AOR = 1.9; 95%CI: 1.2, 2.9), having junior high school education background (AOR = 2.3; 95%CI: 1.0, 5.3) and being multipara (AOR = 1.6; 95%CI: 1.1, 2.4). CONCLUSIONS 13.4%, or about one in seven women, experienced IPV while pregnant. This high proportion indicates the need for policy to address the issue of violence against pregnant women. There is an urgent need to build a system for the early detection of victims that offers appropriate support to prevent the recurrence of violence while encouraging victim recovery.
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Affiliation(s)
- Naoko Maruyama
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-0044, Japan.
- Research Institute, National Center for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo, 157-8535, Japan.
| | - Shigeko Horiuchi
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-0044, Japan
| | - Yaeko Kataoka
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-0044, Japan
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Reppen K, Henriksen L, Schei B, Magnussen EB, Infanti JJ. Experiences of childbirth care among immigrant and non-immigrant women: a cross-sectional questionnaire study from a hospital in Norway. BMC Pregnancy Childbirth 2023; 23:394. [PMID: 37245035 DOI: 10.1186/s12884-023-05725-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/20/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Immigrant women have higher risks for poor pregnancy outcomes and unsatisfactory birth experiences than the general population. The mechanisms behind these associations remain largely unknown, but they may result from differential care provided to immigrant women or unsatisfactory interactions with health providers. This study aimed to investigate immigrant and non-immigrant women's experiences of health care during childbirth, particularly assessing two dimensions: perceived general quality of care and attainment of health care needs during childbirth. METHODS This was a cross-sectional study carried out over 15 months in 2020 and 2021, and data were collected from a self-completed questionnaire. The labour and birth subscale from the Experience of Maternity Care questionnaire was used to assess the primary outcome of care experiences. A total of 680 women completed the questionnaire approximately within two days after birth (mean 2.1 days) at a hospital in Trondheim, in central Norway. The questionnaire was provided in eight languages. RESULTS The 680 respondents were classified as immigrants (n = 153) and non-immigrants (n = 527). Most women rated their quality of care during childbirth as high (91.5%). However, one-quarter of the women (26.6%) reported unmet health care needs during childbirth. Multiparous immigrant women were more likely than multiparous non-immigrant women to report that their health care needs were unmet during childbirth (OR: 3.31, 95% CI: 1.91-5.72, p < 0.001, aOR: 2.83, 95% CI: 1.53-5.18, p = 0.001). No other significant differences between immigrant versus non-immigrant women were found in subjective ratings of childbirth care experiences. Having a Norwegian-born partner and a high level of Norwegian language skills did not influence the immigrant women's experience of childbirth care. CONCLUSIONS Our findings indicate that many women feel they receive high-quality health care during childbirth, but a considerable number still report not having their health care needs met. Also, multiparous immigrant women report significantly more unmet health care needs than non-immigrants. Further research is required to assess immigrant women's childbirth experiences and for health care providers to give optimal care, which may need to be tailored to a woman's cultural background and individual expectations.
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Affiliation(s)
- Kristin Reppen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Lena Henriksen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Berit Schei
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Division of Obstetrics and Gynecology, St. Olavs University Hospital, Trondheim, Norway
| | - Elisabeth Balstad Magnussen
- Division of Obstetrics and Gynecology, St. Olavs University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jennifer Jean Infanti
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
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Depla AL, Pluut B, Lamain-de Ruiter M, Kersten AW, Evers IM, Franx A, Bekker MN. PROMs and PREMs in routine perinatal care: mixed methods evaluation of their implementation into integrated obstetric care networks. J Patient Rep Outcomes 2023; 7:26. [PMID: 36894797 PMCID: PMC9998006 DOI: 10.1186/s41687-023-00568-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 02/23/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND In the transition towards value-based healthcare, patient-reported outcome and experience measures (PROM and PREM) are recommended by international collaborations and government programs to guide clinical practice and quality improvement. For many conditions, using PROM/PREM over the complete continuum of care requires implementation across care organizations and disciplines. Along PROM/PREM implementation in obstetric care networks (OCN), we aimed to evaluate implementation outcomes and the processes influencing these outcomes in the complex context of care networks across the continuum of perinatal care. METHODS Three OCN in the Netherlands implemented PROM/PREM in routine practice, using an internationally developed outcomes set with care professionals and patient advocates. Their aim was to use PROM/PREM results individually to guide patient-specific care decisions and at group-level to improve quality of care. The implementation process was designed following the principles of action research: iteratively planning implementation, action, data generation and reflection to refine subsequent actions, involving both researchers and care professionals. During the one-year implementation period in each OCN, implementation outcomes and processes were evaluated in this mixed-methods study. Data generation (including observation, surveys and focus groups) and analysis were guided by two theoretical implementation frameworks: the Normalization Process Theory and Proctor's taxonomy for implementation outcomes. Qualitative findings were supplemented with survey data to solidify findings in a broader group of care professionals. RESULTS Care professionals in OCN found the use of PROM/PREM acceptable and appropriate, recognized their benefits and felt facilitated in their patient-centered goals and vision. However, feasibility for daily practice was low, mainly due to IT issues and time constraints. Hence PROM/PREM implementation did not sustain, but strategies for future PROM/PREM implementation were formulated in all OCN. Processes contributing positively to implementation outcomes were internalization (understand the value) and initiation (driven by key-participants), whereas challenges in relational integration (maintain confidence) and reconfiguration (refine activities) affected implementation negatively. CONCLUSION Although implementation did not sustain, network-broad PROM/PREM use in clinic and quality improvement matched professionals' motivation. This study provides recommendations to implement PROM/PREM meaningfully in practice in ways that support professionals in their drive towards patient-centered care. In order for PROM/PREM to fulfill their potential for value-based healthcare, our work highlights the need for sustainable IT infrastructures, as well as an iterative approach to refine their complex implementation into local contexts.
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Affiliation(s)
- Anne L Depla
- Department of Obstetrics and Gynecology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, KE.04.123.1, Lundlaan 6, 3584 EA, Utrecht, The Netherlands
| | - Bettine Pluut
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Marije Lamain-de Ruiter
- Department of Obstetrics and Gynecology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, KE.04.123.1, Lundlaan 6, 3584 EA, Utrecht, The Netherlands
- Department of Obstetrics and Gynecology, Erasmus MC Sophia, Rotterdam, The Netherlands
| | - Anna W Kersten
- Department of Public Health, Julius Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Inge M Evers
- Department of Obstetrics and Gynecology, Meander Medical Centre, Amersfoort, The Netherlands
| | - Arie Franx
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Mireille N Bekker
- Department of Obstetrics and Gynecology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, KE.04.123.1, Lundlaan 6, 3584 EA, Utrecht, The Netherlands.
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Lalor JG, Sheaf G, Mulligan A, Ohaja M, Clive A, Murphy-Tighe S, Ng ED, Shorey S. Parental experiences with changes in maternity care during the Covid-19 pandemic: A mixed-studies systematic review. Women Birth 2023; 36:e203-e212. [PMID: 35973917 PMCID: PMC9364727 DOI: 10.1016/j.wombi.2022.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/01/2022] [Accepted: 08/08/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, pregnant women were identified as a high-risk and vulnerable group. To reduce risk of transmission, maternity healthcare services were modified to limit exposure but maintain services for pregnant women. However, the change in hospital practice may have compromised quality maternal care standards. Therefore, this review aims to explore parental experiences and views with maternity care received from healthcare institutions during the COVID-19 pandemic. METHODS A mixed studies systematic review was conducted. Six electronic databases (Medline, CINAHL, Embase, PsycInfo, Web of Science, and Maternity and Infant Care) were searched for qualitative, observational, and mixed method studies from the year 2019 to February 2022. Study quality was appraised using the Mixed Methods Appraisal Tool. Quantitative findings were converted to narrative findings. Data was synthesised thematically using a convergent synthesis design. RESULTS Fifty-eight articles were included. Four themes were generated: (1) Distress associated with COVID-19 regulations (perception of hospital restrictions, confusion with ever changing policies), (2) adaptability with maternity services (prenatal: changes in birth plans, prenatal: altered antenatal appointments, education, and care, intrapartum: medicalization of birth, postpartum: varied views on care received and Breastfeeding woes, postpartum: skin-to-skin contact and mother infant bonding) (3) importance of support persons, and (4) future direction for maternity services. CONCLUSIONS Parental experiences highlighted how maternity care during the COVID-19 pandemic did not adhere to WHO standards of quality maternity care. This calls for healthcare institutions to continuously appraise the implementation of restrictive practices that deviate from evidence-based frameworks underpinning quality care.
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Affiliation(s)
- Joan Gabrielle Lalor
- School of Nursing and Midwifery, Trinity College Dublin, 24 D’Olier St, Dublin 2, Ireland
| | - Greg Sheaf
- The Library of Trinity College Dublin, Dublin 2, Ireland
| | - Andrea Mulligan
- School of Law, Trinity College Dublin, House 39, New Square, Dublin 2, Ireland
| | - Magdalena Ohaja
- School of Nursing and Midwifery, National University of Ireland Galway, Ireland
| | - Ashamole Clive
- School of Nursing and Midwifery, Trinity College Dublin, 24 D’Olier St, Dublin 2, Ireland
| | | | - Esperanza Debby Ng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11,10 Medical Drive, 117597, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11,10 Medical Drive, 117597, Singapore.
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van Amesfoort JE, van Rooij FB, Painter RC, Valkenburg-van den Berg AW, Kreukels BPC, Steensma TD, Huirne JAF, de Groot CJM, Van Mello NM. The barriers and needs of transgender men in pregnancy and childbirth: A qualitative interview study. Midwifery 2023; 120:103620. [PMID: 36893550 DOI: 10.1016/j.midw.2023.103620] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/30/2022] [Accepted: 01/24/2023] [Indexed: 02/18/2023]
Abstract
OBJECTIVE Transgender and gender diverse individuals are individuals whose gender identity differs from their sex assigned at birth. The discordance between gender identity and sex assignment may cause significant psychological distress: gender dysphoria. Transgender individuals may choose to undergo gender-affirming hormone treatment or surgery, but some decide to (temporarily) refrain from surgery and gender affirming hormone treatment and hence retain the possibility to become pregnant. Pregnancy may enhance feelings of gender dysphoria and isolation. To improve perinatal care for transgender individuals and their health care providers, we conducted interviews to explore the needs and barriers of transgender men in family planning, pregnancy, childbirth, puerperium and perinatal care. DESIGN In this qualitative study five in-depth semi-structured interviews were conducted with Dutch transgender men who had given birth while identifying on the transmasculine spectrum. The interviews were conducted online through a video remote-conferencing software program (n=4) or live (n=1). Interviews were transcribed verbatim. An inductive approach was used to find patterns and collect data from the participants' narratives and constant comparative method was adapted in analysing the interviews. MEASUREMENTS AND FINDINGS The experiences of transgender men regarding the preconception period, pregnancy and puerperium and with perinatal care varied widely. Though all participants expressed overall positive experiences, their narratives emphasized they had to overcome substantial hurdles pursuing pregnancy. For instance the necessity to prioritise becoming pregnant over gender transitioning, lack of support by healthcare providers and increased gender dysphoria and isolation during pregnancy KEY CONCLUSIONS: Since pregnancy in transgender men enhances feelings of gender dysphoria, transgender men comprise a vulnerable group in perinatal care. Health care providers are perceived as feeling unaccustomed for the care of transgender patients, as they are perceived to often lack the right tools and knowledge to provide adequate care. Our findings help strengthen the foundation of insight in the needs and hurdles of transgender men pursuing pregnancy and therefore may guide health care providers to provide equitable perinatal care, and emphasize the necessity of patient-centred gender-inclusive perinatal care. A guideline including the option for consultation of an expertise center is advised to facilitate patient-centered gender-inclusive perinatal care.
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Affiliation(s)
- J E van Amesfoort
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, Reproduction and Development Research Institute, Amsterdam, the Netherlands
| | - F B van Rooij
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands
| | - R C Painter
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, Reproduction and Development Research Institute, Amsterdam, the Netherlands
| | - A W Valkenburg-van den Berg
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, Reproduction and Development Research Institute, Amsterdam, the Netherlands
| | - B P C Kreukels
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands; Department of Medical Psychology, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands
| | - T D Steensma
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands; Department of Medical Psychology, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands
| | - J A F Huirne
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, Reproduction and Development Research Institute, Amsterdam, the Netherlands; Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands
| | - C J M de Groot
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, Reproduction and Development Research Institute, Amsterdam, the Netherlands
| | - N M Van Mello
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, Reproduction and Development Research Institute, Amsterdam, the Netherlands; Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands.
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Dowse G, Perkins E, Stein H, Chidini G, Danhaive O, Elsayed Y, Carvalho W, AlNaqeeb N, Rooze S, Cetinkaya M, Vetter-Laracy S, Pilar-Orive F, Torpiano P, Gonçalves Ferri W, Buonsenso D, Rogdo B, Medina A, Polito A, Brouwer C, Kneyber M, De Luca D, Tingay D. Born into an isolating world: family-centred care for babies born to mothers with COVID-19. EClinicalMedicine 2023; 56:101822. [PMID: 36846297 PMCID: PMC9941883 DOI: 10.1016/j.eclinm.2022.101822] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND The benefits of facilitating breastmilk feeding and close contact between mother and neonate (family-centred care; FCC) in the perinatal period are well-established. The aim of this study was to determine how the delivery of FCC practices were impacted for neonates born to mothers with perinatal SARS-CoV-2 infection during the COVID-19 pandemic. METHODS Neonates born to mothers with confirmed SARS-CoV-2 infection during pregnancy were identified from the 'EsPnIC Covid paEdiatric NeonaTal REgistry' (EPICENTRE) multinational cohort between 10 March 2020 and 20 October 2021. The EPICENTRE cohort collected prospective data on FCC practices. Rooming-in and breastmilk feeding practice were the main outcomes, and factors influencing each were determined. Other outcomes included mother-baby physical contact prior to separation and the pattern of FCC components relative to time and local site guidelines. FINDINGS 692 mother-baby dyads (13 sites, 10 countries) were analysed. 27 (5%) neonates were positive for SARS-CoV-2 (14 (52%) asymptomatic). Most sites had policies that encouraged FCC during perinatal SARS-CoV-2 infection for most of the reporting period. 311 (46%) neonates roomed-in with their mother during the admission. Rooming-in increased over time from 23% in March-June 2020 to 74% in January-March 2021 (boreal season). 330 (93%) of the 369 separated neonates had no FCC physical contact with their mother prior, and 319 (86%) were asymptomatic. Maternal breastmilk was used for feeding in 354 (53%) neonates, increasing from 23% to 70% between March-June 2020 and January-March 2021. FCC was most impacted when mothers had symptomatic COVID-19 at birth. INTERPRETATION This is the largest report of global FCC practice during the COVID-19 pandemic to date. The COVID-19 pandemic may have impacted FCC despite low perinatal transmission rates. Fortunately, clinicians appear to have adapted to allow more FCC delivery as the COVID-19 pandemic progressed. FUNDING The National Health and Medical Research Council (Australia): Grant ID 2008212 (DGT), Royal Children's Hospital Foundation: Grant ID 2019-1155 (EJP), Victorian Government Operational Infrastructure Support Program.
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Affiliation(s)
- G. Dowse
- Neonatal Research, Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Corresponding author. Neonatal Research, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, 3052, Victoria, Australia.
| | - E.J. Perkins
- Neonatal Research, Murdoch Children's Research Institute, Parkville, Australia
| | - H.M. Stein
- Department of Pediatrics, Division of Neonatology, Promedica Ebied Children's Hospital, Toledo, OH, USA
| | - G. Chidini
- Department of Anaesthesia, Intensive Care and Emergency, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - O. Danhaive
- Division of Neonatology (Pediatrics), Catholic University of Louvain, Brussels, Belgium
- Division of Neonatology (Pediatrics), University of California San Francisco, California, USA
| | - Y.N. Elsayed
- Pediatrics, University of Manitoba, Winnipeg, Canada
| | - W.B. Carvalho
- Pediatric Intensive Care/Neonatology of the Department of Pediatrics, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - N. AlNaqeeb
- Neonatal Department, AL-Adan Hospital, Ahmadi Area, Kuwait
| | - S. Rooze
- Unités de Soins Intensifs, Hôpital Universitaire des Enfants Reine Fabiola, Laeken, Belgium
| | - M. Cetinkaya
- Health Sciences University, Department of Neonatology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - S. Vetter-Laracy
- Division of Neonatology (Pediatrics), University Hospital Son Espases / Balearic Island Health Research Institute IdISBa, Palma, Spain
| | - F.J. Pilar-Orive
- Pediatrics Department, PICU, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, Barakaldo, Spain
| | - P. Torpiano
- Department of Paediatrics and Adolescent Health, Mater Dei Hospital, Msida, Malta
| | - W.A. Gonçalves Ferri
- Department of Pediatrics, Ribeirão Preto Medical School - University of São Paulo, São Paulo State, Ribeirão Preto, Brazil
| | - D. Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - B. Rogdo
- NICU/PICU, Children's Hospital of Eastern Switzerland, St Gallen, Switzerland
| | - A. Medina
- Pediatric Intensive Care Unit, University Hospital Central de Asturias, Oviedo, Spain
| | - A. Polito
- Department of Pediatrics, Gynecology and Obstetrics, University Hospital of Geneva, University of Geneva, Geneva, Switzerland
| | - C.N.M. Brouwer
- Pediatric Intensive Care Unit, Leiden University Medical Center, Leiden, the Netherlands
| | - M.C.J. Kneyber
- Department of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children's Hospital, Groningen, the Netherlands
- Critical Care, Anesthesiology, Peri-operative & Emergency Medicine (CAPE), University Medical Center Groningen, the Netherlands
| | - D. De Luca
- Division of Pediatrics and Neonatal Critical Care, “A.Béclère” Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
- Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University, Paris, France
| | - D.G. Tingay
- Neonatal Research, Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
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Fu Y, Lin YA, Zheng J, Hong H, Huang S, Li J, Huang F. Supporting routine cognitive reactivity assessment during the perinatal period: psychometric testing of the Chinese version of the Leiden Index of Depression Sensitivity. BMC Pregnancy Childbirth 2022; 22:911. [PMID: 36474194 DOI: 10.1186/s12884-022-05233-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND It is critical to find optimal forms to identify perinatal depression (PND) and its vulnerable factors and make them more applicable to depression screening. This study aims to evaluate the reliability and validity of the Chinese version of the Leiden Index of Depression Sensitivity (LEIDS-RR-CV) among perinatal women in China and determine the cut-off values for screening for high-risk depression. METHODS Women in their third trimester of pregnancy and six weeks postpartum completed the LEIDS-RR-CV and a diagnostic reference standard online. We assessed the LEIDS-RR-CV using classical test theory (CTT) and item response theory (IRT). We also assessed the test performance for cut-off scores using receiver operator characteristic analysis to further screen for high-risk depression at each time point. RESULTS In total, 396 (third trimester) and 321 (six weeks postpartum) women participated. Cronbach's alpha, two-week test-retest reliability, and marginal reliability for the scale were all greater than 0.8. It showed a five-factor model; the cut-off values were 58 (third trimester) and 60 (six weeks postpartum). The areas under the curve were acceptable (≥ 0.7), and the LEIDS-RR-CV was positively correlated with the total Edinburgh Postnatal Depression Scale (EPDS) score (r = 0.52 and 0.56, p = 0.00), indicating its predictive validity. An IRT analysis further confirmed its discriminative validity. CONCLUSIONS The LEIDS-RR-CV was found to be reliable, valid, and can be used to quantify cognitive reactivity among perinatal Chinese women and for screening for high-risk depression during this period.
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Alhalel J, Patterson L, Francone NO, Danner S, Osei C, O'Brian CA, Tom LS, Masinter L, Adetoro E, Lazar D, Ekong A, Simon MA. Addressing racial disparities in perinatal care for African American/Black individuals in the Chicago community health setting: a qualitative study. BMC Pregnancy Childbirth 2022; 22:771. [PMID: 36229787 PMCID: PMC9558023 DOI: 10.1186/s12884-022-05100-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 09/21/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There are persistent disparities in maternal and infant perinatal outcomes experienced by Black birthing persons compared with non-Hispanic white (NHW) individuals in the US. The differences in outcomes arise from not only socioeconomic factors and individual health behaviors but also structural racism. Recent research is beginning to elucidate the benefits of patient navigation to support underserved minoritized individuals who experience this constellation of barriers to equitable care. Qualitative research that utilizes both the experiences of Black birthing individuals and the expert opinion of healthcare providers working with them can serve to guide a patient navigation intervention to further decrease disparities in perinatal outcomes. METHODS We conducted 30 interviews between August and December 2020 with Black birthing individuals in the Chicago metropolitan area and healthcare providers who care for this population both in Chicago and across the nation to explore their experiences, perceptions of barriers to care and ways to decrease inequities. RESULTS Clinical care team members acknowledged the presence of health disparities experienced by Black pregnant individuals compared with their NHW counterparts stemming from racism, discrimination, and lack of resources. Patients similarly reported personal experiences with these disparities and barriers to care. The successful methods used by clinical care teams to help decrease these differences in the past included patient education on important topics such as breastfeeding and the use of patient advocates. Effectively screening for social determinants of health by someone the patient trusts was also cited as important. Regarding perinatal care practices, clinical care team members described the importance of patient education needs and care team cultural competency. Patients' reported positive and negative experiences corroborated these findings, emphasizing the importance of trust, listening, education, access to care, support, and patient advocacy. Finally, the care team members and patients agreed that active trust-building can help the provider/patient relationship and ultimately improve outcomes. CONCLUSIONS These qualitative research findings improve the understanding of barriers to care and will help guide development of an intervention to reduce the health disparities experienced by Black pregnant persons.
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Affiliation(s)
- Jonathan Alhalel
- Feinberg School of Medicine CHET (Center for Health Equity Transformation), Northwestern University, Evanston, USA.
| | - Lane Patterson
- Feinberg School of Medicine CHET (Center for Health Equity Transformation), Northwestern University, Evanston, USA
| | - Nicolás O Francone
- Feinberg School of Medicine CHET (Center for Health Equity Transformation), Northwestern University, Evanston, USA
| | - Sankirtana Danner
- Feinberg School of Medicine CHET (Center for Health Equity Transformation), Northwestern University, Evanston, USA
| | - Cassandra Osei
- Feinberg School of Medicine CHET (Center for Health Equity Transformation), Northwestern University, Evanston, USA
| | - Catherine Ann O'Brian
- Feinberg School of Medicine CHET (Center for Health Equity Transformation), Northwestern University, Evanston, USA
| | - Laura S Tom
- Feinberg School of Medicine CHET (Center for Health Equity Transformation), Northwestern University, Evanston, USA
| | | | | | | | | | - Melissa A Simon
- Feinberg School of Medicine CHET (Center for Health Equity Transformation), Northwestern University, Evanston, USA
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Khanna A, Smith LD, Parish SL, Mitra M. Pregnancy recommendations from women with intellectual and developmental disabilities to their peers. Disabil Health J 2022; 15:101343. [PMID: 35739053 DOI: 10.1016/j.dhjo.2022.101343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND As recent as the mid-twentieth century, eugenics practices on women with intellectual and developmental disabilities were commonplace. Deinstitutionalization has led to an increasing proportion of women with intellectual and developmental disabilities living in the community and becoming pregnant. Previous research has reported barriers to maternal health care (i.e., perceived provider stigma, inadequate communication, stress surrounding child protective services involvement, and financial strain). Research shows that this population is at increased risk of adverse outcomes including preterm delivery, low birth weight babies, and maternal mortality. OBJECTIVE/HYPOTHESIS This study aimed to explore recommendations from mothers with intellectual and developmental disabilities for other women to potentially improve pregnancy experiences for this population. METHODS We conducted semi-structured individual interviews among 16 women with intellectual and developmental disabilities. Data were coded using a content analysis process and iteratively analyzed using inductive and deductive techniques to determine emergent themes. RESULTS Participants offered recommendations for navigating pregnancy to their peers who are pregnant, or thinking about becoming pregnant. Themes included: (1) planning for birth; (2) advocating at the point-of-care; (3) seeking supports and services; (4) interacting with child protective services; (5) communicating with providers; and (6) exhibiting resilience. CONCLUSION Our study highlights recommendations for improving pregnancy experiences of women with intellectual and developmental disabilities. Informed by the lived pregnancy experiences of our participants, these recommendations can inform clinician training, new guidelines, and services to support and improve pregnancy experiences for women with intellectual and developmental disabilities.
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Affiliation(s)
- Aishwarya Khanna
- The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA, 02453, USA; Center for Healthcare Organization and Implementation Research (CHOIR), Bedford VA Healthcare System, 200 Spring Rd, Bedford, MA, 01730, USA
| | - Lauren D Smith
- The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA, 02453, USA.
| | - Susan L Parish
- College of Health Professions, Virginia Commonwealth University, 907 Floyd Ave, Richmond, VA, 23284, USA
| | - Monika Mitra
- The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA, 02453, USA
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Logan RG, Vamos CA, Detman LA, Sappenfield WM. An Initiative "that you do for one person": Identifying Barriers and Facilitators to Implementing an Immediate Postpartum LARC Initiative in Florida Hospitals. Matern Child Health J 2022; 26:2283-2292. [PMID: 36125672 DOI: 10.1007/s10995-022-03491-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION In the United States (U.S.), perinatal quality improvement collaboratives have pursued implementing immediate postpartum long-acting reversible contraception (LARC) initiatives to increase people's access to contraception and support their fertility desires. This process evaluation aimed to identify barriers and facilitators to implementing an immediate postpartum LARC initiative in Florida. METHODS Data collection included in-depth qualitative assessments (i.e., interviews, small focus group discussions) with hospitals in pre- and early stages of the implementation process. Snowball sampling was used to recruit participants. Interviews were conducted in-person or via Zoom or phone and were audio-recorded and transcribed verbatim. Four of the five domains within the Consolidated Framework for Implementation Research (e.g., process, intervention characteristics, inner and outer settings) informed the study design and data collection/analysis. RESULTS Fourteen staff of diverse job roles from five hospitals participated. Factors that facilitated implementation were the strength of the evidence, relative advantage, internal and external networks, and engaging staff. Barriers to implementation included billing and reimbursement and needing significant support from external networks to progress through implementation phases. DISCUSSION Findings suggest that depending on the task or phase, multiple factors work in tandem to serve as implementation barriers and facilitators. Additionally, evaluating hospitals' progress at the pre- and early implementation phases was critical for quickly finding solutions and benefited other hospitals in different stages. As this initiative requires substantial support, health systems should create and sustain a culture of excellence and efficiency to facilitate implementing initiatives that improve care quality.
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Affiliation(s)
- Rachel G Logan
- College of Public Health, The Chiles Center, University of South Florida, Tampa, FL, 33613-4660, USA. .,University of California, San Francisco, USA.
| | - Cheryl A Vamos
- College of Public Health, The Chiles Center, University of South Florida, Tampa, FL, 33613-4660, USA
| | - Linda A Detman
- Florida Perinatal Quality Collaborative, The Chiles Center, University of South Florida, Tampa, FL, 33613-4660, USA
| | - William M Sappenfield
- College of Public Health, The Chiles Center, University of South Florida, Tampa, FL, 33613-4660, USA.,Florida Perinatal Quality Collaborative, The Chiles Center, University of South Florida, Tampa, FL, 33613-4660, USA
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Bunik M, Jimenez-Zambrano A, Solano M, Beaty BL, Juarez-Colunga E, Zhang X, Moore SL, Bull S, Leiferman JA. Mother's Milk Messaging™: trial evaluation of app and texting for breastfeeding support. BMC Pregnancy Childbirth 2022; 22:660. [PMID: 36002798 PMCID: PMC9400217 DOI: 10.1186/s12884-022-04976-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND New mothers experience BF challenges but have limited evidence-based technology-enabled support. OBJECTIVES 1) Determine if using the Mother's Milk Messaging™ app improved aspects of breastfeeding and breastfeeding rates and 2) Describe engagement as well as themes from the qualitative feedback on the app. METHOD Randomized Controlled Trial National sample of primiparous, singleton mothers recruited online and then randomized using stratification by language into three arms: 1) BF text messages plus app; 2) BF text messages, app and physician-moderated private Facebook (FB) group; 3) Attention control group who received injury prevention texts. Exclusive breastfeeding rates as primary outcome and knowledge/attitude, confidence, and social support as secondary outcomes. We determined engagement through analysis of app usage metrics. We conducted and content-coded interviews with participants to learn more about app usage and BF experience. Due to the nature of the intervention participants could not be blinded. RESULTS There were a total of 346 participants in the trial, with 227 in the Intervention (n = 154 group 1 and n = 156 group 2) and 119 in the control group. Because of minimal Facebook activity, the two intervention groups 1 and 2 were combined. There were no differences in breastfeeding exclusivity and duration. (NS). Women in the intervention arm reported significantly higher confidence with breastfeeding and perceived social support to the control group (p < .05). Greater than 80% registered the app and those that engaged with the app had higher scores with time. Mothers appreciated receiving text messages and videos with reliable information. No harm was reported in this study. CONCLUSION MMM increased confidence with breastfeeding and with gathering social supports. Exclusively BF was high in all participants. Mothers perceived it as useful and dependable especially the texting.
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Affiliation(s)
- Maya Bunik
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. .,Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. .,Children's Hospital Colorado, 13123 E. 16th Ave B032, Aurora, CO, 80045, USA.
| | - Andrea Jimenez-Zambrano
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Michael Solano
- Children's Hospital Colorado, 13123 E. 16th Ave B032, Aurora, CO, 80045, USA
| | - Brenda L Beaty
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Elizabeth Juarez-Colunga
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Xuhong Zhang
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Susan L Moore
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sheana Bull
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jenn A Leiferman
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Sweet L, Muller A, Kearney L, Martis R, Hartney N, Davey K, Daellenbach R, Hall H, Atchan M. Predictors and impact of women's breastfeeding self-efficacy and postnatal care in the context of a pandemic in Australia and Aotearoa New Zealand. Midwifery 2022; 114:103462. [PMID: 36001943 DOI: 10.1016/j.midw.2022.103462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 07/05/2022] [Accepted: 08/16/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate predictors of breastfeeding self-efficacy, postnatal care experiences, and there subsequent impact on breastfeeding outcomes in Australia and Aotearoa New Zealand in the context of the COVID-19 pandemic. DESIGN A cross-sectional online survey collected data between August and October 2020 with recruitment via social media. Quantitative data were analyzed using descriptive analyses, and linear and logistic regression analysis related to the Breastfeeding Self-Efficacy Scale-Short Form findings. Open text responses were analyzed using content analysis. FINDINGS There were 1001 complete responses. Visitor restrictions impacted the woman's early parenting experience in both positive and negative ways. One third of participants stated their postnatal needs were not met with 82 stating that they had no postnatal care at all. During the first six weeks postnatal, 48.1% felt not very or not at all confident caring for their baby. Despite 94.3% of participants initiating breastfeeding, only 70% were exclusively breastfeeding at six weeks. The mean self-efficacy score was 49.98 suggesting the need for additional help, with first time mothers having a statistically significant lower score. DISCUSSION/CONCLUSION Sub-optimal postnatal care and support negatively influence breastfeeding self-efficacy. Women desired additional help during the COVID-19 pandemic inclusive of support and education to meet their postnatal needs and exclusively breastfeed. IMPLICATIONS FOR PRACTICE Women require appropriate and timely postnatal care and support to promote confidence in caring for baby and achieve their breastfeeding goals. Preferably this care should be provided face-to-face.
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Affiliation(s)
- Linda Sweet
- School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood 3125, Australia; Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia.
| | - Amanda Muller
- College of Nursing and Health Sciences, Flinders University, South Australia, Australia
| | - Lauren Kearney
- School of Nursing, Midwifery and Social Work, University of Queensland, Australia
| | - Ruth Martis
- Liggins Institute, The University of Auckland, Aotearoa New Zealand
| | - Nicki Hartney
- School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood 3125, Australia
| | - Kym Davey
- School of Nursing and Midwifery, Monash University, Australia
| | - Rea Daellenbach
- Department of Health Practice, Ara Institute of Canterbury, New Zealand
| | - Helen Hall
- School of Health, Federation University, Australia
| | - Marjorie Atchan
- School of Nursing, Midwifery & Public Health, University of Canberra, Australia
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Due C, Walsh M, Aldam I, Winter A, Cooper S, Sheriff J, Ziersch A. Perinatal care for women with refugee backgrounds from African countries: a qualitative study of intersections with psychological wellbeing. BMC Pregnancy Childbirth 2022; 22:628. [PMID: 35941567 PMCID: PMC9358632 DOI: 10.1186/s12884-022-04957-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Experiences with healthcare services, including perinatal healthcare services, contribute to psychological wellbeing for refugees post-resettlement. To address the paucity of literature examining the relationship between perinatal healthcare and psychological wellbeing in women with refugee backgrounds from African countries this study aimed to: (1) understand the relationship between psychological wellbeing and perinatal care amongst this population, and; (2) identify areas for improved perinatal healthcare services to ensure positive wellbeing outcomes in this population. Methods A total of 39 participants were included in the study. Nineteen women from seven African countries participated in interviews – seven both prior to and after having their babies, two only while pregnant and ten only after their baby had been born. In addition, interviews were conducted with 20 service providers. Interviews were thematically analysed. Results Four key themes were identified, covering continuity of care, cultural safety of care, agency in decision making, and ongoing impacts of perinatal care experiences. Conclusions The results highlighted the need for changes to perinatal healthcare provision at the systems level, including implementing a continuity of care model, and ensuring women’s access to individualised, trauma-informed perinatal services which attend to the cultural and psychosocial resettlement needs of this population. These findings informed recommendations for improving perinatal healthcare services and better psychological outcomes – and in turn broader health outcomes – for African-background refugee mothers.
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Affiliation(s)
- Clemence Due
- The School of Psychology, The University of Adelaide, Adelaide, SA, Australia. .,College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
| | - Moira Walsh
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Isadora Aldam
- The School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Amelia Winter
- The School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Susan Cooper
- Flinders Medical Centre, Adelaide, SA, Australia
| | - Josephine Sheriff
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Anna Ziersch
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
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Greenfield M, Jomeen J, Glover L. 'After last time, would you trust them?' - Rebuilding trust in midwives after a traumatic birth. Midwifery 2022; 113:103435. [PMID: 35908444 DOI: 10.1016/j.midw.2022.103435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 06/27/2022] [Accepted: 07/15/2022] [Indexed: 10/17/2022]
Abstract
AIM To explore the processes pregnant women used to rebuild their trust in midwives and obstetricians, after a previous traumatic birth. DESIGN A longitudinal feminist constructivist Grounded Theory methods study, using semi-structured interviews to investigate how women made sense of their journeys through pregnancy and maternity care, when they had previously experienced a traumatic birth. SETTING Nine UK women were recruited in early pregnancy via the internet and social media, and were interviewed three times during the perinatal period. FINDINGS During pregnancy, participants re-analysed their previous birth experience(s) in order to plan for this pregnancy and birth. Once they had conceptualised their plans, they sought out healthcare professionals who could offer support, and used naturally occurring or engineered trust diagnostic situations to establish whether trust could be rebuilt. CONCLUSION Without a trusting relationship, midwives and obstetricians cannot deliver appropriate and efficient healthcare to pregnant people. Understanding the processes that pregnant women utilise to rebuild trust may help healthcare professionals to better understand their role in re-establishing these relationships.
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Affiliation(s)
- Mari Greenfield
- Women's Health Academic Unit, King's College, 10(th) Floor St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK.
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36
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van Blarikom E, de Kok B, Bijma HH. "Who am I to say?" Dutch care providers' evaluation of psychosocial vulnerability in pregnant women. Soc Sci Med 2022; 307:115181. [PMID: 35792411 DOI: 10.1016/j.socscimed.2022.115181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 06/21/2022] [Accepted: 06/25/2022] [Indexed: 11/17/2022]
Abstract
Maternity care increasingly focuses on evaluating psychosocial vulnerability during pregnancy. Research and nationwide (public health) programs, both in the USA and Europe, led to the development of new protocols and screening instruments for care providers to systematically screen for psychosocial vulnerability in pregnant women. However, standardised screening for vulnerability is complex since it requires discussion of sensitive issues. Women may fear stigmatisation and may have limited trust in their care providers or the health system. Our study contributes to the growing field of client-facing risk work by exploring care providers' interpretations and evaluation of psychosocial vulnerability in pregnant women. Drawing on semi-structured interviews with Dutch maternity care providers, we explore how they conceptualise risk and vulnerability and identify 'vulnerable pregnant women' in their practices. We find that care providers conceptualise 'vulnerability' as primarily based on risk, which contributes to an imbalanced focus on individual mothers, rather than on both parents and the social context. Our findings highlight care providers' concerns around 'care avoidance', seen as a risk factor affecting 'vulnerability' during pregnancy and as a possible consequence of risk screening. The care providers we interviewed employ "in between-strategies" based on intuition, emotion, and trust to skillfully attend to the risk that comes with risk work, in terms of its potential impact on relationships of trust and open communication. We conclude that 'vulnerability' should be understood as a multi-layered, situated and relational concept rather than simply as an epidemiological category. Since a trusting relationship between pregnant women and care providers is crucial for the evaluation of vulnerability, we reflect critically on the risk of standardised perinatal psychosocial risk evaluations. Policy should recognise providers' "in between-strategies" to embed epidemiological understandings of risk in the context of everyday risk work.
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Affiliation(s)
- Esca van Blarikom
- Department of Anthropology, Amsterdam Institute of Social Science Research, Amsterdam, Netherlands; Wolfson Institute of Population Health, Centre for Primary Care, Queen Mary University of London, United Kingdom
| | - Bregje de Kok
- Department of Anthropology, Amsterdam Institute of Social Science Research, Amsterdam, Netherlands.
| | - Hilmar H Bijma
- Department of Obstetrics and Gynaecology, Division of Obstetrics & Foetal Medicine, Erasmus MC, Rotterdam, Rotterdam, Netherlands
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LUCARELLI A, HUREAU-MUTRICY L, SOLIGNAT B, BOURNE-WATRIN M, BLAISE T, OSEI L, COUSIN P, BOUTROU M, DESTOOP J, FREMERY A, MUTRICY R, BONIFAY T, EPELBOIN L. [5 th day dedicated to the scientific works of Caregivers in French Guiana. Our CAregivers have talent! May 19 & 20, 2022, Cayenne, French Guiana]. Med Trop Sante Int 2022; 2:mtsi.v2i2.2022.248. [PMID: 35919248 PMCID: PMC9326777 DOI: 10.48327/mtsi.v2i2.2022.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Aude LUCARELLI
- COREVIH Guyane & CIC INSERM 1424, Centre hospitalier de Cayenne Andrée Rosemon, Guyane, France
| | - Louise HUREAU-MUTRICY
- COREVIH Guyane & CIC INSERM 1424, Centre hospitalier de Cayenne Andrée Rosemon, Guyane, France
| | - Blandine SOLIGNAT
- Institut de formation en soins infirmiers de Cayenne (IFSI), Guyane, France
| | | | - Théo BLAISE
- Centre d'investigation clinique Antilles Guyane (CIC INSERM 1424), Centre hospitalier de Cayenne, Guyane, France
| | - Lindsay OSEI
- Service de pédiatrie, Centre hospitalier de Cayenne, Guyane, France
| | - Pauline COUSIN
- Centre délocalisé de prévention et de soins de Grand Santi, Centre hospitalier de Cayenne, Guyane, France
| | - Mathilde BOUTROU
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Guyane, France
| | - Justin DESTOOP
- Service de dermatologie, Centre hospitalier de Cayenne, Guyane, France
| | - Alexis FREMERY
- Service de pédiatrie, Centre hospitalier de Cayenne, Guyane, France
| | - Rémi MUTRICY
- Service de pédiatrie, Centre hospitalier de Cayenne, Guyane, France
| | - Timothée BONIFAY
- Service de pédiatrie, Centre hospitalier de Cayenne, Guyane, France
| | - Loïc EPELBOIN
- Service de pédiatrie, Centre hospitalier de Cayenne, Guyane, France,*
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Awad-Sirhan N, Simó-Teufel S, Molina-Muñoz Y, Cajiao-Nieto J, Izquierdo-Puchol MT. Factors associated with prenatal stress and anxiety in pregnant women during COVID-19 in Spain. Enferm Clin (Engl Ed) 2022; 32 Suppl 1:S5-S13. [PMID: 35183488 DOI: 10.1016/j.enfcle.2021.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 10/04/2021] [Indexed: 01/12/2023]
Abstract
AIM OF THE STUDY To describe prenatal stress and state anxiety levels in pregnant women living in Spain during the lockdown of the first wave of COVID-19 and its relation with obstetric factors, perception of health care, and concerns about the socio-sanitary situation. METHODS The present study is an observational, correlational, and cross-sectional quantitative study. The participants in the study were pregnant women recruited through non-probabilistic convenience and snowball sampling during the lockdown. A web link was provided to an online questionnaire designed for this research, which collected socio-demographic and obstetric variables, perceptions of health care received during the pandemic and preoccupations associated with COVID-19. It also included the Prenatal Stress Questionnaire (PDQ) and the State Anxiety Inventory (STAI-S). RESULTS Based on the responses of 695 pregnant women, the results showed a mean of 16.98 (SD = 25.20) of prenatal stress and elevated levels of anxiety (M = 25.20/SD = 11.07) in the first wave of the pandemic. Risk factors for prenatal stress and anxiety were the level of preoccupation associated with COVID-19 and previous mental health issues. A specific risk factor for anxiety was having more than one child and a protective factor were perceiving accessibility and availability of health care, with clear and consistent pregnancy care and follow-up protocols. CONCLUSIONS The lockdown period for COVID-19 was a stressful experience for pregnant women, highlighting the need to address their psychological well-being through clear and coherent protocols in terms of maternal-foetal health control and follow-up.
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Durowaye TD, Rice AR, Konkle ATM, Phillips KP. Public health perinatal promotion during COVID-19 pandemic: a social media analysis. BMC Public Health 2022; 22:895. [PMID: 35513864 PMCID: PMC9069960 DOI: 10.1186/s12889-022-13324-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Canadian public health agencies, both municipal/regional and provincial/territorial, are responsible for promoting population health during pregnancy and the early postnatal period. This study examines how these agencies use web-based and Facebook channels to communicate perinatal health promotion during the emergence of the COVID-19 pandemic. Methods Perinatal health promotion content of websites and Facebook posts from a multijurisdictional and geographically diverse sample of government and non-governmental organizations (NGO) were evaluated using thematic content analysis in 2020. Results Major Facebook perinatal health promotion themes included breastfeeding, infant care, labor/delivery, parenting support and healthy pregnancy. Facebook COVID-19-themed perinatal health promotion peaked in the second quarter of 2020. Websites emphasized COVID-19 transmission routes, disease severity and need for infection control during pregnancy/infant care, whereas Facebook posts focussed on changes to local health services including visitor restrictions. NGO perinatal health promotion reflected organizations’ individual mandates. Conclusions Canadian government use of Facebook to disseminate perinatal health promotion during the COVID-19 pandemic varied in terms of breadth of topics and frequency of posts. There were missed opportunities to nuance transmission/severity risks during pregnancy, thereby proactively countering the spread of misinformation.
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Affiliation(s)
- Toluwanimi D Durowaye
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Alexandra R Rice
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Anne T M Konkle
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, K1N 6N5, Canada.,University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario, Canada
| | - Karen P Phillips
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, K1N 6N5, Canada.
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Awad-Sirhan N, Simó-Teufel S, Molina-Muñoz Y, Cajiao-Nieto J, Izquierdo-Puchol MT. [Factors associated with prenatal stress and anxiety in pregnant women during COVID-19 in Spain]. Enferm Clin 2022; 32:S5-S13. [PMID: 34697530 PMCID: PMC8529258 DOI: 10.1016/j.enfcli.2021.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 10/04/2021] [Indexed: 11/20/2022]
Abstract
Aim of the study To describe prenatal stress and state anxiety levels in pregnant women living in Spain during the lockdown of the first wave of COVID-19 and its relation with obstetric factors, perception of health care, and concerns about the socio-sanitary situation. Methods The present study is an observational, correlational, and cross-sectional quantitative study. The participants in the study were pregnant women recruited through non-probabilistic convenience and snowball sampling during the lockdown. A web link was provided to an online questionnaire designed for this research, which collected socio-demographic and obstetric variables, perceptions of health care received during the pandemic and preoccupations associated with COVID-19. It also included the Prenatal Stress Questionnaire (PDQ) and the State Anxiety Inventory (STAI-S). Results Based on the responses of 695 pregnant women, the results showed a mean of 16.98 (SD = 25.20) of prenatal stress and elevated levels of anxiety (M = 25.20/SD = 11.07) in the first wave of the pandemic. Risk factors for prenatal stress and anxiety were the level of preoccupation associated with COVID-19 and previous mental health issues. A specific risk factor for anxiety was having more than one child and a protective factor were perceiving accessibility and availability of health care, with clear and consistent pregnancy care and follow-up protocols. Conclusions The lockdown period for COVID-19 was a stressful experience for pregnant women, highlighting the need to address their psychological well-being through clear and coherent protocols in terms of maternal-foetal health control and follow-up.
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Affiliation(s)
- Natalia Awad-Sirhan
- Facultad de Psicología, Universidad de Valencia, Valencia, España
- Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | | | | | - Juanita Cajiao-Nieto
- Grupo Interdisciplinario de Investigación en Salud, Fundación Universitaria CAFAM, Bogotá, Colombia
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Pederson A, Mirlashari J, Lyons J, Brotto LA. How to Facilitate Disclosure of Violence while Delivering Perinatal Care: The Experience of Survivors and Healthcare Providers. J Fam Violence 2022; 38:571-583. [PMID: 35342223 PMCID: PMC8938212 DOI: 10.1007/s10896-022-00371-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
Gender-based Violence (GBV) during the perinatal period is a serious concern as it is associated with many adverse outcomes for both the mother and the baby. It is well known that violence is under-reported. Thus, official statistics (both police reports and survey data) underestimate the prevalence of violence in general and during the perinatal period specifically. In this study conducted in Canada, we sought to explore the barriers to and facilitators of women disclosing their experiences of GBV within healthcare services to safely facilitate more disclosure in the future and reduce the harms that arise from GBV. We used thematic analysis to analyze in-depth interviews with 16 healthcare providers (nurses, midwives and physicians) and 12 survivors of GBV. The data reflect three main themes: "raising awareness of gender-based violence", "creating a shift in the healthcare system's approach toward gender-based violence" and "providing support for survivors and care providers." Our findings suggest that the healthcare system should increase its investments in raising awareness regarding GBV, training healthcare providers to respond appropriately, and building trust between survivors and healthcare providers. Healthcare providers need to be aware of their role and responsibility regarding identifying GBV as well as how to support survivors who talk about violence. Expanding a relationship-based approach in the care system and providing support for both survivors and health care providers would likely lead to more disclosures.
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Affiliation(s)
- Ann Pederson
- Population Health School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Jila Mirlashari
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
| | - Janet Lyons
- Division of General Gynecology & Obstetrics, University of British Columbia, BC Women’s Hospital, Provincial Health Services Authority (PHSA), Vancouver, Canada
| | - Lori A. Brotto
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
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Dicky O, Dahan S, Reynaud A, Goffinet F, Lecarpentier E, Deruelle P, Jarreau PH, Kuhn P, Gire C, Pierrat V, Caeymaex L. Current attitudes and beliefs toward perinatal care orientation before 25 weeks of gestation: The French perspective in 2020. Semin Perinatol 2022; 46:151533. [PMID: 34865886 DOI: 10.1016/j.semperi.2021.151533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The survival rate of infants born before 25 weeks of gestational age in France is extremely low compared with that of many other countries: 0%, 1%, and 31% at 22, 23, and 24 weeks' in the last national cohort study. A non-optimal regionalization and variations in practice are prevalent. Some parents in social media and support groups have reported feeling lost and confused with mixed messages leading to lack of trust. These data kindled a major debate in France around perinatal management leading to an investigation exploring neonatologists' perspectives and ways to improve care. The majority (81%) of the responding neonatologists reported more active care and higher survival rates than in 2011, although others continued preferring delivery room comfort care and limited NICU treatment at or before 24 weeks. The desire to improve was an overarching theme in all the respondents' answers to open-ended questions. Barriers to active care included an absence of expertise and of benchmarking to guide optimal care, and limited resources in the NICU and during follow-up - all leading to self-fulfilling prophecies of poor prognosis. Optimization of regionalization, perinatal teamwork and parental involvement, fostering experience by creating specific perinatal centers, stimulating benchmarking, and working with policy makers to allow better long-term outcomes could enable higher survival.
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Gold S, Clarfield L, Johnstone J, Diambomba Y, Shah PS, Whittle W, Abbasi N, Arzola C, Ashraf R, Biringer A, Chitayat D, Czikk M, Forte M, Franklin T, Jacobson M, Keunen J, Kingdom J, Lapinsky S, MacKenzie J, Maxwell C, Preisman M, Ryan G, Selk A, Sermer M, Silversides C, Snelgrove J, Watts N, Young B, De Castro C, D'Souza R. Adapting obstetric and neonatal services during the COVID-19 pandemic: a scoping review. BMC Pregnancy Childbirth 2022; 22:119. [PMID: 35148698 PMCID: PMC8840792 DOI: 10.1186/s12884-022-04409-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 01/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background The provision of care to pregnant persons and neonates must continue through pandemics. To maintain quality of care, while minimizing physical contact during the Severe Acute Respiratory Syndrome-related Coronavirus-2 (SARS-CoV2) pandemic, hospitals and international organizations issued recommendations on maternity and neonatal care delivery and restructuring of clinical and academic services. Early in the pandemic, recommendations relied on expert opinion, and offered a one-size-fits-all set of guidelines. Our aim was to examine these recommendations and provide the rationale and context to guide clinicians, administrators, educators, and researchers, on how to adapt maternity and neonatal services during the pandemic, regardless of jurisdiction. Method Our initial database search used Medical subject headings and free-text search terms related to coronavirus infections, pregnancy and neonatology, and summarized relevant recommendations from international society guidelines. Subsequent targeted searches to December 30, 2020, included relevant publications in general medical and obstetric journals, and updated society recommendations. Results We identified 846 titles and abstracts, of which 105 English-language publications fulfilled eligibility criteria and were included in our study. A multidisciplinary team representing clinicians from various disciplines, academics, administrators and training program directors critically appraised the literature to collate recommendations by multiple jurisdictions, including a quaternary care Canadian hospital, to provide context and rationale for viable options. Interpretation There are different schools of thought regarding effective practices in obstetric and neonatal services. Our critical review presents the rationale to effectively modify services, based on the phase of the pandemic, the prevalence of infection in the population, and resource availability. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04409-4.
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Affiliation(s)
- Shira Gold
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | | | - Jennie Johnstone
- Department of Laboratory Medicine and Pathobiology, Mount Sinai Hospital, Toronto, ON, Canada
| | - Yenge Diambomba
- Department of Paediatrics, Mount Sinai Hospital, Toronto, ON, Canada
| | - Prakesh S Shah
- Department of Paediatrics, Mount Sinai Hospital, Toronto, ON, Canada
| | - Wendy Whittle
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Nimrah Abbasi
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Cristian Arzola
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Rizwana Ashraf
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Anne Biringer
- Department of Family Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - David Chitayat
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Marie Czikk
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Milena Forte
- Department of Family Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Tracy Franklin
- Department of Family and Community Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Michelle Jacobson
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Johannes Keunen
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - John Kingdom
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | | | - Joanne MacKenzie
- Department of Nursing, Mount Sinai Hospital, Toronto, ON, Canada
| | - Cynthia Maxwell
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Mary Preisman
- Department of Psychiatry, Mount Sinai Hospital, Toronto, ON, Canada
| | - Greg Ryan
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Amanda Selk
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Mathew Sermer
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Candice Silversides
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - John Snelgrove
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Nancy Watts
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Beverly Young
- Department of Psychiatry, Mount Sinai Hospital, Toronto, ON, Canada
| | | | - Rohan D'Souza
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada.
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Arteaga-Gómez AC, Vázquez-Castellanos G, Sepúlveda-Rivera CM, Rocha-Zavaleta L, Reyes-Muñoz E. Perinatal outcomes in young women with breast cancer and pregnancy. GAC MED MEX 2022; 157:416-421. [PMID: 35133333 DOI: 10.24875/gmm.m21000584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Breast cancer associated with pregnancy is defined as a malignant neoplasm of the breast that is diagnosed during pregnancy, breastfeeding or one year after delivery. OBJECTIVE To analyze perinatal outcomes in a series of young patients with breast cancer and pregnancy in a tertiary care hospital. METHODS Retrospective, analytical study of 26 women younger than 40 years of age with breast cancer who resolved their pregnancy at the National Institute of Perinatology between 2013 and 2018. Clinical-pathological characteristics, perinatal outcomes and family planning methods were studied. Percentages and central tendency measures were obtained, and comparisons were made with the chi-square test or Fisher's exact test. RESULTS Association of breast cancer with pregnancy was observed in 0.26% of all births; mean age of presentation was 34 years, 38.4% of cases had cancer at advanced clinical stages and 57.1% of the women were treated with modified radical mastectomy; no trend towards higher perinatal complications was observed. CONCLUSIONS Breast cancer associated with pregnancy implies an oncological challenge and does not appear to be a risk factor for adverse perinatal outcomes.
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Affiliation(s)
- Ana C Arteaga-Gómez
- Oncology Department, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes"
| | | | | | - Leticia Rocha-Zavaleta
- Department of Molecular Biology and Biotechnology, Institute of Biomedical Research, Universidad Nacional Autónoma de México
| | - Enrique Reyes-Muñoz
- Gynecologic and Perinatal Endocrinology Coordination, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes". Mexico City, Mexico
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Stanhope KK, Piper K, Goedken P, Johnson T, Joseph NT, Ti A, Geary F, Boulet SL. Quality and satisfaction with care following changes to the structure of obstetric care during the COVID-19 pandemic in a safety-net hospital in Georgia: Results from a mixed-methods study. J Natl Med Assoc 2022:S0027-9684(21)00230-3. [PMID: 35039177 DOI: 10.1016/j.jnma.2021.12.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/13/2021] [Accepted: 12/29/2021] [Indexed: 11/29/2022]
Abstract
Objective To understand perceived quality of obstetric care following changes to the structure of care in a safety-net institution during the COVID-19 pandemic. Methods We conducted a mixed-methods study including a web-based survey (n = 67) and in-depth interviews (n = 16) between October 2020 and January 2021. We present a descriptive analysis of quantitative results and key qualitative themes on reactions to changes and drivers of perceived quality. Results Reported quality was high for in-person and phone visits (median subscale responses: 5/5). Respondents were willing to include phone visits in care for a future pregnancy (77.8% (49)) but preferred in-person visits (84.1% (53)). In interviews, provider communication was the key driver of quality. Respondents found changes to care to be inconvenient but acceptable. Conclusions To improve satisfaction with changes to care, health systems should ensure that relationship building remains a priority and offer patients information about the reason behind changes.
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Harmsen van der Vliet-Torij HW, Venekamp AA, van Heijningen-Tousain HJM, Wingelaar-Loomans E, Scheele J, de Graaf JP, Lambregtse-van den Berg MP, Steegers EAP, Goumans MJBM. Development of a Blueprint for Integrated Care for Vulnerable Pregnant Women. Matern Child Health J 2022. [PMID: 35000072 DOI: 10.1007/s10995-021-03340-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2021] [Indexed: 11/27/2022]
Abstract
Purpose There has been increasing awareness of perinatal health and organisation of maternal and child health care in the Netherlands as a result of poor perinatal outcomes. Vulnerable women have a higher risk of these poor perinatal outcomes and also have a higher chance of receiving less adequate care. Therefore, within a consortium, embracing 100 organisations among professionals, educators, researchers, and policymakers, a joint aim was defined to support maternal and child health care professionals and social care professionals in providing adequate, integrated care for vulnerable pregnant women. Description Within the consortium, vulnerability is defined as the presence of psychopathology, psychosocial problems, and/or substance use, combined with a lack of individual and/or social resources. Three studies focussing on population characteristics, organisation of care and knowledge, skills, and attitudes of professionals regarding vulnerable pregnant women, were carried out. Outcomes were discussed in three field consultations. Assessment The outcomes of the studies, followed by the field consultations, resulted in a blueprint that was subsequently adapted to local operational care pathways in seven obstetric collaborations (organisational structures that consist of obstetricians of a single hospital and collaborating midwifery practices) and their collaborative partners. We conducted 12 interviews to evaluate the adaptation of the blueprint to local operational care pathways and its’ embedding into the obstetric collaborations. Conclusion Practice-based research resulted in a blueprint tailored to the needs of maternal and child health care professionals and social care professionals and providing structure and uniformity to integrated care provision for vulnerable pregnant women.
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Reid C, Gee G, Bennetts SK, Clark Y, Atkinson C, Dyall D, Nicholson JM, Chamberlain C. Using participatory action research to co-design perinatal support strategies for Aboriginal and Torres Strait Islander parents experiencing complex trauma. Women Birth 2021:S1871-5192(21)00198-0. [PMID: 34961730 DOI: 10.1016/j.wombi.2021.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/07/2021] [Accepted: 12/17/2021] [Indexed: 11/20/2022]
Abstract
PROBLEM & BACKGROUND Support is important for all parents but critical for those experiencing complex trauma. The The Healing the Past by Nurturing the Future project uses participatory action research to co-design effective perinatal support for Aboriginal and Torres Strait Islander parents. AIM This research aims to identify and refine culturally appropriate support strategies for Aboriginal and Torres Strait Islander parents experiencing complex trauma. DESIGN We presented our synthesised eight parent support goals and 60 strategies, collated from Elder and parent focus groups, previous participatory workshops, and evidence reviews, for discussion at a stakeholder workshop. Stakeholder perspectives were captured using a three-point agreement activity and, self- and scribe-recorded comments. Aboriginal and non-Aboriginal researchers analysised the qualitative data, to identify core factors which might facilitate or help enact the parenting related goals. FINDINGS Overall, stakeholders (n = 37) strongly endorsed all eight goals. Workshop attendees (57% Aboriginal) represented multiple stakeholder roles including Elder, parent and service provider. Four core factors were identified as crucial for supporting parents to heal from complex trauma: Culture (cultural traditions, practices and strengths), Relationality (family, individual, community and services), Safety (frameworks, choice and control) and Timing (the right time socio-emotionally and stage of parenting). DISCUSSION Context-specific support tailored to the Culture, Relationality, Safety, and Timing needs of parents is essential. These four factors are important elements to help enact or facilitate parenting support strategies. CONCLUSION Further work is now required to develop practical resources for parents, and to implement and evaluate these strategies in perinatal care to address cumulative and compounding cycles of intergenerational trauma.
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Horton R, Lee H, Perosky JE, Kofa A, Lori JR. Comparison of quality, birth outcomes, and service utilization between health facilities with and without maternity waiting homes in Liberia. Midwifery 2021; 105:103235. [PMID: 34959000 PMCID: PMC8811480 DOI: 10.1016/j.midw.2021.103235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/29/2021] [Accepted: 12/19/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE 1) To assess the quality of health facilities associated with functional Maternity Waiting Homes and health facilities without functional maternity waiting homes in Liberia. 2) To examine birth outcomes and care utilization amongst health facilities with and without functional maternity waiting homes in Liberia. DESIGN Secondary analysis design using data from a facility capacity checklist and Liberia's Health Management Information System. SETTING 71 health facilities associated with functional maternity waiting homes and 14 health facilities without functional maternity waiting homes across 14 counties of Liberia. PARTICIPANTS No human participants were used in this study. METHODS Independent t-test, Pearson chi-square test, and logistic regression were performed to assess quality, birth outcomes, and service utilization between health facilities with and without functional maternity waiting homes. FINDINGS The overall health facility quality was not significantly different between health facilities associated with functional maternity waiting homes and those without. However, health facilities with functional maternity waiting homes had better infection control with the presence of soap and sharps boxes. Health facilities with functional maternity waiting homes were also more likely to have parenteral oxytocic drugs and were better able to perform assisted vaginal deliveries. The presence of functional maternity waiting homes were not significantly associated with health facility quality, birth outcomes, or care utilization. CONCLUSION AND IMPLICATIONS Health facilities with functional MWHs were better prepared to prevent infection and manage complicated deliveries. This study further highlights specific areas for quality improvement amongst these health facilities, including labor complications management.
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Affiliation(s)
- Rachel Horton
- Undergraduate Student, University of Michigan, School of Nursing, 400 North Ingalls, Ann Arbor, MI 48104, United States.
| | - Haeun Lee
- Graduate Student, University of Michigan, School of Nursing, 400 North Ingalls, Ann Arbor, MI 48104, United States.
| | - Joseph E Perosky
- Resident Physician, Department of Obstetrics, Gynecology and Reproductive Biology, Michigan State University, 400 North Ingalls, Ann Arbor, MI 48104, United States.
| | | | - Jody R Lori
- Professor & Associate Dean for Global Affairs, University of Michigan, School of Nursing, 400 North Ingalls, Ann Arbor, MI 48104, United States.
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Mohammadi A, Tahmasebi M, Mojen LK, Rassouli M, Ashrafizadeh H. Evaluation of Care Providers' Attitude toward Perinatal Palliative Care and its Challenges in the Selected Teaching Hospitals of Tehran in 2019. Indian J Palliat Care 2021; 27:513-520. [PMID: 34898946 PMCID: PMC8655650 DOI: 10.25259/ijpc_90_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 08/22/2021] [Indexed: 11/08/2022] Open
Abstract
Objectives: The present study aims to determine the attitudes of care providers including obstetricians, paediatricians and midwives working in perinatal, obstetric and neonatal intensive care unit (NICU) wards of the selected teaching hospitals in Tehran in 2019. In addition, the challenges of providing palliative care from the perspective of these individuals have been examined. Materials and Methods: In this descriptive study, the research population was selected through convenience sampling based on the inclusion criteria. To assess care providers’ attitude toward the perinatal palliative care and the challenges of its implementation, in addition to the questionnaire of demographic characteristics, a researcher-made questionnaire was also used. Results: Most of the care providers (90.5%) believed that parents should be involved in decision-making to select the treatment type. Most of the care providers (90%) believed that the lack of prepared infrastructures is one of the major challenges in providing these types of care. Conclusion: Care providers have almost positive attitudes toward the various dimensions of providing perinatal palliative care, but it has not been properly implemented yet due to the insufficient knowledge of this type of care, the lack of required infrastructures (appropriate conditions in NICUs to provide this type of care, the sufficient number of staff and experts in this field), as well as the health authorities’ neglecting this type of care.
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Affiliation(s)
- Arman Mohammadi
- Department of Paediatric Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mamak Tahmasebi
- Department of Radiotherapy and Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Khanali Mojen
- Department of Medical-Surgical Nursing, Paediatric Congenital Hematologic Disorders Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Rassouli
- Cancer Research Center, Department of Paediatric Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hadis Ashrafizadeh
- Department of Medical-Surgical nursing, Nursing and Midwifery School, Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Kazal HR, Flanagan PJ, Mello MJ, Monteiro K, Goldman RE. Birth Stories, Support, and Perinatal Emotional Health among Minority Adolescent Mothers: A Mixed Methods Study. J Pediatr Adolesc Gynecol 2021; 34:847-856. [PMID: 34023524 DOI: 10.1016/j.jpag.2021.04.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 04/16/2021] [Accepted: 04/25/2021] [Indexed: 12/01/2022]
Abstract
STUDY OBJECTIVE To explore minority, adolescent birth and perinatal experiences to inform and improve quality of care for this unique group. DESIGN Mixed quantitative and qualitative study guided by Bourdieu's Social Fields framework. SETTING Clinic dedicated to parenting adolescents, and a local charter school founded to serve pregnant and parenting young adults. PARTICIPANTS Sample size for quantitative data: n = 27; qualitative data: n = 14. Average age was 16.39 years (SD = 1.29); most self-identified as Latina/Hispanic or African American/Black/Afro-Caribbean/African. INTERVENTIONS AND MAIN OUTCOME MEASURES We used 2 validated surveys: Birth Satisfaction Scale-Revised (BSS-R), and the Postpartum Worry Scale-Revised (PWS-R). The BSS-R has 10 items, and quantifies labor and delivery experiences. The PWS-R has 20 items, and quantifies maternal, infant, and social-emotional worries. The qualitative, semistructured 30-minute interviews with a subset of survey respondents further explored perinatal mental health, labor experiences, and support networks. RESULTS BSS-R data resulted in an average score of 25.14 (SD = 5.35), which correlated to moderate satisfaction with birth experience (range, 0-40 with 0 = most negative). The PWS-R average score of 55.79 (SD = 21.06) indicated elevated postpartum worry (range, 20-100 with 20 = most worry). Qualitative interviewees worried about relationships and newborn well-being; support networks fluctuated; distinct events, pain, and fear during labor dominated birth stories. Advice for peers included: tending to social support, stress, and self-care. Nonjudgmental communication, empathy, and emotional connection were desired attributes of their health care team. Participants had anxiety related to social networks and newborn care. Although birth experiences were moderately positive, they were also described as stressful. However, participants were resourceful, insightful, and took advantage of social supports. CONCLUSION Birth experiences, patterns of stress, and support networks are uniquely identified and utilized by adolescent mothers. Being heard and feeling connected to providers empowered this group of young, minority adolescents. Participant advice could inform future educational courses, programs, and hospital innovations for perinatal adolescents.
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Affiliation(s)
- Hannah R Kazal
- Warren Alpert Medical School of Brown University, Providence, Rhode Island.
| | - Patricia J Flanagan
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Michael J Mello
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Kristina Monteiro
- Assessment and Evaluation, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Roberta E Goldman
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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