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Background

Vaginal birth after caesarean can be a safe and satisfying option for many women who have had a previous caesarean, yet rates of vaginal birth after caesarean remain low in the majority of countries. Exploring women’s experiences of vaginal birth after caesarean can improve health practitioners’ understanding of the factors that facilitate or hinder women in the journey to have a vaginal birth after caesarean.

Methods

This paper reports on a meta-ethnographic review of 20 research papers exploring women’s experience of vaginal birth after caesarean in a variety of birth locations. Meta-ethnography utilises a seven-stage process to synthesise qualitative research.

Results

The overarching theme was ‘the journey from pain to power’. The theme ‘the hurt me’ describes the previous caesarean experience and resulting feelings. Women experience a journey of ‘peaks and troughs’ moving from their previous caesarean to their vaginal birth after caesarean. Achieving a vaginal birth after caesarean was seen in the theme ‘the powerful me,’ and the resultant benefits are described in the theme ‘the ongoing journey’.

Conclusion

Women undergo a journey from their previous caesarean with different positive and negative experiences as they move towards their goal of achieving a vaginal birth after caesarean. This ‘journey from pain to power’ is strongly influenced by both negative and positive support provided by health care practitioners. Positive support from a health care professional is more common in confident practitioners and continuity of care with a midwife.  相似文献   
43.
Parental conversations with their teenage children about alcohol, tobacco, and drugs are associated with lower rates of use. Looked‐after young people are at greater risk of early initiation, higher rates of use, and more problematic use. However, there is no evidence regarding whether these conversations occur in settings where the parental role is assumed by someone other than the biological parent. The aim of the study was to examine how carers communicate with looked‐after young people about alcohol, tobacco, and drug use. In‐depth interviews were conducted with 16 residential care staff and foster carers in Scotland. Data were analysed using a thematic analysis approach. Participants talked about “shared doing” as a way of building relationships and communicating about substance use. Shared doing encompassed particular activities that carers and young people would do together, such as driving in the car, cooking, watching TV, and going for a walk. Shared doing provided an opportunity to spend time together and to create an environment in which communication could be facilitated. These environments were shaped by space, time, and context. Carers should be encouraged to take advantage of the time‐limited occasions they are with young people to have conversations about substance use.  相似文献   
44.
The article examines the geographies of collective labour struggle in the platform economy. It distinguishes between the unique spatial features associated with place-based work and crowdwork to examine the divergent collective organizing strategies developed therein. Taking works councils, collective bargaining and multi-enterprise agreements as three examples of social dialogue, the article considers why different types of platform workers gravitate towards particular strategies, analyses the regulatory frameworks within which these workers' collective struggles are bound, and assesses the propensity for these expressions of solidarity to improve the terms and conditions of platform work.  相似文献   
45.
This article argues that Alfred Chandler's analysis of the British firm cannot be transposed to the very different context of non-profit organisations in Britain. Both in relation to charitable non-profit organisations and mutual benefit organisations, Chandler's theory of the development of firms does not help explain organisational development. The main thrust of the argument is that the explanation for the smaller size of charitable non-profits in Britain than in America is largely institutional and partly socio-cultural; the explanation does not lie in any failure in Britain to adopt new techniques of management and organisation. With mutual benefit non-profits, a rather different account is presented. ‘Mutuals’ which had a strong fraternal element were relatively more successful in Britain than in America, although there is less difference between the two countries with regard to ‘non-fraternal’ mutuals. Once again, it is argued that institutional and socio-cultural factors—rather than the factors identified by Chandler—account for this. I wish to thank Desmond King for his helpful comments on an earlier version of this essay.  相似文献   
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47.
Defining and measuring patient satisfaction with medical care   总被引:19,自引:0,他引:19  
This paper describes the development of Form II of the Patient Satisfaction Questionnaire (PSQ), a self-administered survey instrument designed for use in general population studies. The PSQ contains 55 Likert-type items that measure attitudes toward the more salient characteristics of doctors and medical care services (technical and interpersonal skills of providers, waiting time for appointments, office waits, emergency care, costs of care, insurance coverage, availability of hospitals, and other resources) and satisfaction with care in general. Scales are balanced to control for acquiescent response set. Scoring rules for 18 multi-item subscales and eight global scales were standardized following replication of item analyses in four field tests. Internal-consistency and test-retest estimates indicate satisfactory reliability for studies involving group comparisons. The PSQ well represents the content of characteristics of providers and services described most often in the literature and in response to open-ended questions. Empirical tests of validity have also produced generally favorable results.  相似文献   
48.
Ware H 《Population studies》1976,30(3):413-427
Summary Current and retrospective data on the fertility control, work-force participation intentions and practice of Melbourne wives are combined in an examination of the causal link between work-force participation and reduced family size. Stress is laid on the analysis of the interaction between work-force participation and fertility over time, taking into account the proportion of married life spent in the work-force, rather than relying exclusively on a measure of current participation, the only option available in the analysis of census-type data. The wide range of information available makes it possible to study the effects of work-force participation on wives of unimpaired fertility, as well as the different consequences of planned and unplanned participation, and of working in a variety of occupations and for a number of distinct reasons. Examination of the future fertility intentions and current contraceptive practice of the younger wives shows that working wives are not, in these respects, markedly different from their house-wife peers. Overall, the balance of the evidence indicates that in the majority of cases fertility influences work-force participation rather than the converse.  相似文献   
49.
Although social media use has grown dramatically, program policies have not kept pace. Some programs now state that student social media activities have led to professional conduct reviews and may violate ethical standards. This article reviews current social media policies and conceptualizes their key elements. A review of current social media policies is reported, pointing to the need for further policy development. Six domains of a social media policy are identified: understanding social media, ethical and legal obligations, implications of one’s personal and professional online presence, institutional obligations to the program and agency, productivity implications, and possible consequences for violations of the policy. A model social media policy is detailed, and unresolved issues are identified.  相似文献   
50.
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