Women’s experiences of decision-making and attitudes in relation to induction of labour: A survey study

BackgroundRates of induction of labour have been increasing globally to up to one in three pregnancies in many high-income countries. Although guidelines around induction, and strength of the underlying evidence, vary considerably by indication, shared decision-making is increasingly recognised as key. The aim of this study was to identify women’s mode of birth preferences and experiences of shared decision-making for induction of labour.MethodAn antenatal survey of women booked for an induction at eight Sydney hospitals was conducted. A bespoke questionnaire was created assessing women’s demographics, indication for induction, pregnancy model of care, initial birth preferences, and their experience of the decision-making process.ResultsOf 189 survey respondents (58% nulliparous), major reported reasons for induction included prolonged pregnancy (38%), diabetes (25%), and suspected fetal growth restriction (8%). Most respondents (72%) had hoped to labour spontaneously. Major findings included 19% of women not feeling like they had a choice about induction of labour, 26% not feeling adequately informed (or uncertain if informed), 17% not being given alternatives, and 30% not receiving any written information on induction of labour. Qualitative responses highlight a desire of women to be more actively involved in decision-making.ConclusionA substantial minority of women did not feel adequately informed or prepared, and indicated they were not given alternatives to induction. Suggested improvements include for face-to-face discussions to be supplemented with written information, and for shared decision-making interventions, such as the introduction of decision aids and training, to be implemented and evaluated.     

The Potential Impact of Discrimination Fears of Older Gays,Lesbians, Bisexuals and Transgender Individuals Living in Small- to Moderate-Sized Cities on Long-Term Health Care

ABSTRACT

As an exploration of the potential impact of fears of discrimination against GLBTs in long-term health care settings, this study compared perceptions of GLBT persons and heterosexuals. A total of 132 GLBT persons and 187 heterosexuals living in Eastern Washington completed a survey that contained demographic questions and perceptions of discrimination in long-term care settings. Most respondents suspected that staff and residents of care facilities discriminate against GLBTs. GLBT respondents who believed that residents of care facilities are victims of discrimination were more likely to believe that they would have to hide their sexual orientation if admitted to a care facility. GLBT respondents were more likely than heterosexual respondents to believe that GLBTs do not have equal access to health care and social services, that GLBTs residents of care facilities are victims of discrimination, that GLBT sensitivity training programs would benefit staff and residents of care facilities, and that GLBT retirement facilities would be a positive development for older GLBTs. This study is offered as a preliminary investigation of concerns about GLBT discrimination in health care settings, how concerns are expressed, and the implications of those concerns for health care needs.     

Panel Conditioning in Longitudinal Studies: Evidence From Labor Force Items in the Current Population Survey

Does participating in a longitudinal survey affect respondents?? answers to subsequent questions about their labor force characteristics? In this article, we investigate the magnitude of panel conditioning or time-in-survey biases for key labor force questions in the monthly Current Population Survey (CPS). Using linked CPS records for household heads first interviewed between January 2007 and June 2010, our analyses are based on strategic within-person comparisons across survey months and between-person comparisons across CPS rotation groups. We find considerable evidence for panel conditioning effects in the CPS. Panel conditioning downwardly biases the CPS-based unemployment rate, mainly by leading people to remove themselves from its denominator. Across surveys, CPS respondents (claim to) leave the labor force in greater numbers than otherwise equivalent respondents who are participating in the CPS for the first time. The results cannot be attributed to panel attrition or mode effects. We discuss implications for CPS-based research and policy as well as for survey methodology more broadly.     

Measuring social indicators in opinion surveys: A method to improve accuracy on sensitive questions

Asking sensitive questions, without risking a terminated interview or response bias, is a major problem in deriving accurate social indicators based on public opinion surveys. This problem has become particularly acute as the topics that interest researchers have become more personal in nature. Mail and telephone surveys, and methods such as the randomized response technique, have all been used to try and overcome this problem, with varying degrees of success. In this paper, we describe an alternative approach using a sealed booklet. We report results from a question-format experiment that asked respondents the same sensitive questions in a sealed booklet, completed in the presence of the interviewer, and in a standard face-to-face interview. The survey used for the experiment was a personal interview survey of drug use based on a national population sample. The sealed booklet format was found to produce more accurate estimates of drug use compared to direct questions. In addition to assuring the respondent greater anonymity, the sealed booklet permits a wide range of questions to be asked and does not limit the analyses that can be conducted on the data.     

“Paper,face-to-face and on my mobile please”: A survey of women’s preferred methods of receiving antenatal education

BackgroundAntenatal education prepares women for childbirth and can be delivered face-to-face, in hard-copy and electronically. Smartphones allow access to online learning and internet searching is common among pregnant women. It is unclear which mode of health information delivery women prefer.AimThis study aimed to investigate how women at one Local Health District (LHD) preferred to receive health information during pregnancy and the early postnatal period.MethodsWe developed a survey to gather data on women’s preferences for educational information. Women who were discharged from one LHD, in NSW Australia, were invited, in 2019, to participate in a simple 14 question survey, either online or in hard copy format.FindingsIn total, 685 women completed the survey which represented a 40% response rate over a period of two months. The survey revealed women commonly used smart phones, or other devices, to source information. Despite this, most women preferred to receive antenatal education via non-electronic methods. Of note many participants felt underprepared for the post-birth period. The method of survey completion, whether hardcopy or online, aligned with individuals’ preferences for information delivery.ConclusionNon-electronic methods of education delivery were the preferred method for most women, and this was consistent across all educational, cultural and socioeconomic levels. Women sought information online, or through apps, but these options did not always meet their knowledge needs, especially regarding the postnatal period. We recommend that hospitals continue to provide information in a variety of modes, as exclusively electronic methods may marginalise groups of women.     

Attribution of rape blame as a function of victim gender and sexuality,and perceived similarity to the victim

This study examined respondents' perceived level of blame and responsibility for three victims of rape, as a function of attitudes toward homosexuals, and perceived similarity to the victim, as indicative of Shaver's (1970) Defensive Attribution Hypothesis. Victims were a homosexual and heterosexual male, and a female. A sample of 168 university students completed questionnaires, which included three rape scenarios and subsequent questions, the Index of Attitudes Toward Homosexuals (Hudson & Ricketts, 1980), and the short-form Marlowe-Crowne Social Desirability Scale (Reynolds, 1982). Results indicated that respondents higher in homophobia (regardless of gender) blamed the homosexual male rape victim and the behavior and character of the heterosexual male rape victim, more than the female rape victim. Male respondents in general also blamed the heterosexual male rape victim, more than female respondents. Shaver's defensive attribution hypothesis was not supported. Results are discussed in terms of the possible link between homophobia and male blame.     

Confidence in selected institutions in 1975: An attempt at replication across two national surveys

A comparison of responses to four attitudinal items included in two national surveys reveals significant differences between surveys in the marginal distributions of all four items. These discrepancies are attributed to differences in survey ‘context’ (i.e., the nature of the questions which preceded the items of interest in the interview schedules). Despite the differences in marginal distributions, however, the four items showed identical relationships in both surveys to five background characteristics of respondents in 18 of 20 tests. Although the generalizability of these findings to other attitudinal items is an open question, they do suggest the inadvisability of combining data collected in surveys using markedly different interview schedules into a time series of subjective social indicators. Contextual effects are apparently less critical in cross-sectional analyses of survey data.     

Women and Retirement Planning: Towards the “Feminization of Poverty” in an Aging Hong Kong

ABSTRACT

Hong Kong's population is aging but retirement research is largely missing from the research agenda in Hong Kong. This study, based on a telephone survey of 1,078 respondents, examines middle-aged adult's retirement planning activities in Hong Kong. The findings show men are more likely to be involved in financial planning, while women are more likely to take part in some forms of health, living arrangement and psychological planning for retirement. Further, there are age, education and income differences in the various forms of retirement planning activities within genders. Women are living longer; because of their lack of financial retirement planning, they are prime candidates for poverty. The discussion concludes with policy implications related to assisting midlife individuals, in particular women, in planning for retirement.     

Use of a Telephone Screener to Identify a Probability Sample of Gays,Lesbians, and Bisexuals

Abstract

Objectives. To examine public response to a telephone screener used to identify a probability sample of lesbians, gays, and bisexuals.

Methods.A telephone screener was designed to provide a representative sample of self-identified lesbians, gays, and bisexuals (LGB) in the 30 central cities of the 15 largest Consolidated Metropolitan Areas.

Results. Of 14,458 households contacted, 11,612 completed at least part of the survey. Of these, only 2.6% refused or responded “don't know” to the sexual orientation screener question. Respondents from the northeast were more reluctant to answer than respondents from the west.

Conclusions. The use of a screener on a national telephone survey to screen households for self-identified lesbian, gay, and bisexual adults was a successful way to generate a representative sample.     

Context Effects as an Illustration of Response Uncertainty –A Cautionary Tale

Many years of experience make it difficult to believe that survey answers are mostly unambiguous. For example, by going through accessible studies, a lot of problems concerning memory can be identified in the field of living conditions and in other domains. Consequently, it may be claimed that facts are seldom stored in an easily accessible manner. It is probably not the case that people – when answering questions – respond promptly and automatically. Rather, some sort of thinking activity is initiated. Accordingly, the answers may be dependent on the occasion when the questions are asked, which background information is given, how familiar the respondents are with the phenomenon in question, how much time there is for reflection, and so on. We have had the opportunity to compare answers to the same questions asked in different contexts. The results clearly indicate the existence of context effects. At the same time, the results give some clues to how these effects can be interpreted, and even avoided. Problems may be minimized if questions are more precisely formulated, if their focus is on strictly limited aspects, and if they are only about things to which people have devoted a lot of interest and thought.     

Tolerance as a correlate of experience with stigma: the case of the homosexual

Scales measuring attitudes toward various unconventional groups were presented to 100 college students and 51 homosexual respondents. Homosexual respondents expressed significantly more tolerant attitudes toward deviantly labeled groups than did student respondents. Homosexuals were also significantly less likely to place social restrictions on those who opted for unconventional alternatives. However, differences between student and homosexual respondents were smaller on the public tolerance scale. The findings suggest that although gays expressed a significantly higher amount of tolerance for other unconventional groups, they appeared to have reservations in terms of total personal acceptance.     

A mixed methods evaluation of Multiple Mini Interviews for entry into the Bachelor of Midwifery

BackgroundMultiple-mini interviews (MMI) are increasingly used as part of the admission process into healthcare degrees. Evaluations have found MMIs to be a fair assessment tool in terms of reliability and validity and viewed positively by those involved in the MMI process. The use of MMIs in midwifery is novel and evaluation is lacking.AimTo evaluate the use of MMIs as part of the admission process for the Bachelor of Midwifery in one Australian university.MethodsA basic convergent mixed methods study design was utilised. Data included linked data sets, Likert scale responses to survey questions, focus groups and open-ended survey questions. Integration took place at the interpretation and reporting stage.FindingsParticipants viewed the MMI experience positively. The study confirmed the reliability of the MMIs as an assessment tool. Most variance in MMI scores was attributed to the candidate at 31.4 % with the interviewer and the interview station having less influence on the MMI score at 11 % and 6.4 % variance. Older applicants on average achieved higher MMI scores, and those who spoke a language other than English at home or were first in family to attend university had lower on average MMI scores. Being born overseas did not impact an applicant’s MMI score. The overall experience was seen as fair, offering further opportunity to gain entry into the Bachelor of Midwifery.ConclusionMMIs were viewed positively and findings support the use of MMIs as part of an admissions process for the Bachelor of Midwifery.     

The future in their hands: Graduating student midwives’ plans,job satisfaction and the desire to work in midwifery continuity of care

BackgroundMidwife-led continuity of care models benefit women and the midwives who work in them. Australian graduate midwives are familiar with, and educated to provide, continuity of care to women although the opportunity to work exclusively in positions providing continuity of care on graduation is uncommon.AimTo explore the immediate and aspirational employment plans and workforce choices, reasons for staying in midwifery and perceptions around factors likely to influence job satisfaction of midwives about to graduate from one Australian university during the years 2012–2016.MethodsThis longitudinal study draws on survey responses from five cohorts of midwifery students in their final year of study.FindingsNinety five out of 137 midwifery students responded to the survey. Almost nine out of ten respondents either aspired to work in a continuity of care model or recognised that they would gain job satisfaction by providing continuity of care to women. Factors leading to job satisfaction identified included making a difference to the women for whom they care, working in models of care which enabled them to provide women with ‘the care I want to give’, and having the ability to make autonomous midwifery decisions.ConclusionAligning early graduate work experiences with continuity of care models may have a positive impact on the confidence and professional development of graduate midwives, which in turn may lead to greater satisfaction and retention among a workforce already committed to supporting the maternity healthcare reform agenda.     

Defining Life Partnerships: Does Sexual Orientation Matter?

ABSTRACT

This study compared the responses of gay men, lesbians, heterosexual men, and heterosexual women to a number of questions investigating the needs and tensions in life partnerships between two individuals. Overall, the groups had similar attitudes toward life partnerships. Nearly all respondents found great meaning in the idea of life partnership, the pursuits of psychological and physical intimacy and the importance of family and social support, and all three of these categories were actually considered more important than the ability to marry legally. Respondents recognized that having children may encourage commitment to life partnerships, though this was less influential for gay men. A significant percentage of respondents, regarding HIV status, either had no opinion or felt that HIV was not particularly or not at all threatening to life partnerships. Men and women, regardless of sexual orientation, appear to experience similar needs and aspirations regarding life partnerships.     

The relationship between sexism and attitudes toward homosexuality in a sample of Turkish college students

This study examined the relationship of sexism, having traditional and conservative values, and contact with homosexual individuals to attitudes toward homosexuality. Two hundred seven male and female students from Middle East Technical University completed Hudson and Rickett's Homophobia scale, Glick and Fiske's Ambivalent Sexism Inventory and questions about: (1) their sexual preferences, (2) whether they described themselves as traditional and conservative, and (3) whether they knew a homosexual or not. Sexist attitudes, being more traditional and conservative, and not knowing any homosexual individuals all predicted more negative attitudes toward homosexuality. The correlation between hostile sexism and anti-homosexual attitudes was higher than the correlation between benevolent sexism and anti-homosexual attitudes. In addition, male, as compared to female, respondents were both more sexist and held more negative attitudes toward homosexuality.     

‘I really needed help’: What mothers say about their post-birth care in Queensland,Australia

BackgroundAustralian mothers consistently rate postnatal care as the poorest aspect of their maternity care, and researchers and policymakers have widely acknowledged the need for improvement in how postnatal care is provided.AimTo identify and analyse mothers’ comments about postnatal care in their free text responses to an open ended question in the Having a Baby in Queensland Survey, 2010, and reflect on their implications for midwifery practice and maternity service policies.MethodsThe survey assessed mothers’ experiences of maternity care four months after birth. We analysed free-text data from an open-ended question inviting respondents to write ‘anything else you would like to tell us’. Of the final survey sample (N = 7193), 60% (N = 4310) provided comments, 26% (N = 1100) of which pertained to postnatal care. Analysis included the coding and enumeration of issues to identify the most common problems commented on by mothers. Comments were categorised according to whether they related to in-hospital or post-discharge care, and whether they were reported by women birthing in public or private birthing facilities.ResultsThe analysis revealed important differences in maternal experiences according to birthing sector: mothers birthing in public facilities were more likely to raise concerns about the quality and/or duration of their in-hospital stay than those in private facilities. Conversely, mothers who gave birth in private facilities were more likely to raise concerns about inadequate post-discharge care. Regardless of birthing sector, however, a substantial proportion of all mothers spontaneously raised concerns about their experiences of inadequate and/or inconsistent breastfeeding support.ConclusionWomen who birth in private facilities were more likely to spontaneously report concerns about their level of post-discharge care than women from public facilities in Queensland, and publically provided community based care is not sufficient to meet women's needs. Inadequate or inconsistent professional breastfeeding support remains a major issue for early parenting women regardless of birthing sector.