Translation and factor analysis of structural models of Edinburgh Postnatal Depression Scale in Serbian pregnant and postpartum women – Web-based study

BackgroundThe Edinburgh Postnatal Depression Scale (EPDS) is well accepted for detecting symptoms of postnatal depression. The aim of this study was to examine psychometric properties and to evaluate structural models of the Serbian translation of EPDS in pregnant and postpartum women.MethodsThe original English version of the EPDS was translated into Serbian, and checked by means of back-translation. Data were collected via an anonymous online questionnaire posted on a Serbian website devoted to pregnancy topics. The study sample included 201 women (76 pregnant, 125 postpartum). The internal consistency of the scale was measured by Cronbach's α coefficient. Principal component analysis was used to determine scale dimensions while confirmatory factor analysis was used to evaluate model fit.FindingsCronbach α coefficient was 0.84 and 0.83 in pregnant and postpartum women, respectively, which indicated good internal consistency of the Serbian EPDS. Three dimensions of the scale were revealed in both groups of women. Goodness of fit indices described good and excellent model in pregnant and postpartum women, respectively. High level of depression symptoms (score ≥13) was recorded in 27.6% and 24.8% (p > 0.05) of pregnant and postpartum women, respectively. Moderate level of depression symptoms (score 10–12) was recorded in 21.1% and 16.8% (p > 0.05) of pregnant and postpartum women, respectively.ConclusionThe Serbian translation of the EPDS showed good consistency and good model characteristics in pregnant and postpartum women. However, cut-off values, sensitivity and specificity of the scale should be determined in the further studies with more representative samples of women.     

Bonding in neonatal intensive care units: Experiences of extremely preterm infants’ mothers

Background

The birth of an extremely preterm infant can disrupt normal mother–infant physical contact and the care provided by the mother. This situation has an impact on the process of bonding between the mother and the child.

Women’s experiences of antenatal transfer for threatened premature labour in NSW: A qualitative study

BackgroundEach year thousands of pregnant women experiencing threatened premature labour are transferred considerable distances across Australia to access higher level facilities but only a small proportion of these women go on to actually give birth to a premature baby. Women from regional areas are required to move away from their home, children and support networks because of a perceived risk of birthing in a centre without neonatal intensive care facilities.AimThis study examines the experience of women undergoing antenatal transfer for threatened premature labour in New South Wales and the Australian Capital Territory who do not give birth during their transfer admission.MethodsThirteen semi-structured in-depth interviews were held with women across five tertiary referral sites across New South Wales and the Australian Capital Territory, and analysed until saturation for themes.FindingsSeven urban and six rural women were interviewed. Women and their families were all negatively affected by antenatal transfer. Factors that helped enable a positive experience were; enhanced sense of safety in the tertiary unit, and individual qualities of staff. Factors that contributed to negative experiences were; inadequate and conflicting information, and no involvement or choice in the clinical decision-making process to move to another facility.ConclusionsAntenatal transfer is an extremely stressful experience for women and their families. The provision of high quality written and verbal information, and the inclusion of women's perception of risk in the clinical decision making process will improve the experience for women and their families in NSW and the ACT.     

Development and Validation of a Scale for the Measurement of Adolescents’ Developmental Assets in the Neighborhood

The aim of this study was to develop a valid and reliable instrument to assess features of a neighborhood that are relevant to the development and adjustment of adolescents. First, a scale was created from a literature review. Second, the content validity of this scale was validated through expert opinion. Finally, the scale was administered to a sample population for analysis of its psychometric properties. The sample consisted of 2,400 adolescents (1,068 boys and 1,332 girls) between ages 12 and 17 who were secondary students in public and private schools in Western Andalusia. The results demonstrate the adequacy of the psychometric properties of the constructed scale.     

Midwives’ provision of health promotion in antenatal care: A qualitative explorative study

ProblemStudies indicate that health promotion in antenatal care can be improved. Moreover, a schism seems to exist between health promotion and prevention in antenatal care.BackgroundAntenatal care to support and improve maternal health is a core midwifery activity in which prevention as well as HP and woman-centeredness are important.AimTo explore how Danish midwives experienced antenatal care and practiced health promotion.MethodsMidwives undertaking antenatal care were interviewed individually (n = 8) and two focus groups (n = 10) were created. Thematic analysis was performed inductively, and the theoretical models from Piper’s health promotion practice Framework for midwives were used to analyse the midwives’ health promotion approach.FindingsTwo major themes were highlighted. Theme 1: ‘The antenatal care context for health promotion’ described factors contributing to quality in health promotion in antenatal care, such as communication and building relationships with the pregnant women. Theme 2: ‘The health promotion approach in antenatal care’ described both midwife-focused and woman-focused approaches to pregnant women’s health. Barriers to high-quality antenatal care and a holistic health promotion approach were identified, such as shared-care issues, documentation demands and lack of time.DiscussionThe midwives’ experiences were discussed in the context of a health promotion approach. Why midwives practice using a midwife-centred approach has many explanations, but midwives need to learn and help each other understand how they can practice woman-focused care while simultaneously providing prophylactic, evidence-based care.ConclusionMidwives mainly had a midwife-focused approach. To further promote women’s health, midwives need to focus on a woman-focused approach.     

My quitting stories: A qualitative study exploring Aboriginal women’s experiences of smoking cessation and preventing relapse in the context of pregnancy

BackgroundMost women who give up smoking during pregnancy relapse to smoking postnatally. Evidence on strategies that are helpful in maintaining smoking cessation during and beyond pregnancy is limited.AimThis paper aims to explore Aboriginal women’s experiences of quitting smoking, relapsing, and preventing relapse, focusing on the strategies they applied for attaining and maintaining abstinence and the support they received.MethodsQualitative interviews were conducted between October 2020 and June 2021, in urban New South Wales, Australia, with 12 Aboriginal women who either smoked tobacco or quit smoking and had been pregnant in the last five years. Aboriginal Research Assistants recruited participants, participated in data collection and data analysis. Data were thematically analysed.ResultsMajor themes that emerged from the data include: a) aspiration to be abstinent; b) strong mindset; c) strategies to stay smoke-free; d) supports received; and e) service and policy recommendations. Protecting children from second-hand smoke had salience for the maintenance of abstinence. Having a strong mindset was perceived as a prerequisite to staying smoke-free. Use of multiple coping strategies in combination was frequently expressed. Knowledge about tobacco-related harms, the way nicotine dependence works, and the available support options was empowering and enabled informed decision making and actions around smoking cessation.ConclusionThis qualitative study conducted with 12 Aboriginal women revealed that Aboriginal women employ multiple strategies (cognitive, behavioural and social) to quit smoking and stay smoke-free. The strategies warrant further exploration with different Aboriginal communities across Australia and consideration of inclusion in smoking cessation care.     

A qualitative exploration of how midwives’ and obstetricians’ perception of risk affects care practices for low-risk women and normal birth

Background

Maternity care is facing increasing intervention and iatrogenic morbidity rates. This can be attributed, in part, to higher-risk maternity populations, but also to a risk culture in which birth is increasingly seen as abnormal. Technology and intervention are used to prevent perceived implication in adverse outcomes and litigation.

Women from migrant and refugee backgrounds’ perceptions and experiences of the continuum of maternity care in Australia: A qualitative evidence synthesis

BackgroundWomen who were born overseas represent an increasing proportion of women giving birth in the Australian healthcare system.ProblemWomen from migrant and refugee backgrounds have an increased risk of poor pregnancy and birth outcomes, including experiences of care.AimTo understand how women from migrant and refugee backgrounds perceive and experience the continuum of maternity care (pregnancy, birth, postnatal) in Australia.MethodologyWe conducted a qualitative evidence synthesis, searching MEDLINE, CIHAHL, and PsycInfo for studies published from inception to 23/05/2020. We included studies that used qualitative methods for data collection and analysis, that explored migrant/refugee women’s experiences or perceptions of maternity care in Australia. We used a thematic synthesis approach, assessed the methodological limitations of included studies, and used GRADE-CERQual to assess confidence in qualitative review findings.Results27 studies met the inclusion criteria, representing women in Australia from 42 countries. Key themes were developed into 24 findings, including access to interpreters, structural barriers to service utilisation, experiences with health workers, trust in healthcare, experiences of discrimination, preferences for care, and conflicts between traditional cultural expectations and the Australian medical system.ConclusionThis review can help policy makers and organisations who provide care to women from migrant and refugee backgrounds to improve their experiences with maternity care. It highlights factors linked to negative experiences of care as well as factors associated with more positive experiences to identify potential changes to practices and policies that would be well received by this population.     

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.     

Receiving maternity care during the COVID-19 pandemic: Experiences of women’s partners and support persons

BackgroundIn Australia, the provision of maternity care during the COVID-19 pandemic was significantly altered to limit transmission of the virus. Many hospitals limited face-to-face appointments to only the pregnant woman and restricted the number of support people present during labour, birth, and postnatal visits to one person. How these restrictions were experienced by partners and support persons of childbearing women are unknown.AimTo explore the experiences of partners and support persons of women receiving maternity care during the COVID-19 pandemic.MethodsA two-phased qualitative study including an online survey and interviews. Analysis was undertaken using content analysis.FindingsPartners and support persons experienced a sense of ‘missing out’ from the pregnancy and maternity care experience because of changes in the provision of care during the pandemic. They reported feelings of isolation, psychological distress, and reduced bonding time with babies. Conflicting information and processes within and across maternity services contributed to feelings of uncertainty and a perceived reduction in the quality of care. Partners and support persons were negatively impacted by restrictions on maternity wards, however they also perceived these to be of benefit to women.DiscussionMany partners and support persons were negatively impacted by restrictions in maternity services during the pandemic; strategies to ensure their active involvement in maternity care are needed.ConclusionThis study offers insights from the unique perspective of partners and support people of women receiving maternity care during the pandemic. Policies and processes that exclude partners and support persons need to be reconsidered.     

Measuring older women’s resilience: Evaluating the suitability of the Connor-Davidson Resilience Scale and the Resilience Scale

ABSTRACT

The author provides conceptual and operational definitions of the construct of resilience in the context of research with older adults (aged 60 years or older). Two psychometric instruments (the Connor-Davidson Resilience Scale and the Resilience Scale) are described. The psychometric properties of each instrument are discussed in relation to the research of the original developers of the tools and research conducted by other investigators. Research on the resilience of older women has yet to be initiated. The author evaluated the psychometric properties of both instruments to determine their suitability for investigation of resilience in older women.     

More than Mobile: Migration and Mobility Impacts from the ‘Technologies of Change’ for Aboriginal Communities in the Remote Northern Territory of Australia

Changes in the patterns of quotidian physical mobility of the population are at the very centre of transformations in contemporary urban life. The city of Santiago, Chile is no exception to this trend. But these changes do not affect the whole population in the same way. This paper is based on a case study of a low‐income population group and how their situation of social exclusion interferes with their patterns of everyday mobility. In order to do so we describe in‐depth their everyday mobility in two central interrelated aspects: where and how these individuals travel during workdays and weekends. We conclude that in contemporary Santiago the low degrees of motility of low income population constitute one of the main ways in which contemporary social exclusion is enacted in everyday practice.     

Women’s Agency and the Quality of Family Relationships in India

The role of family context in determining women’s agency has been addressed through kinship patterns, household structure, and domestic violence. This study suggests that another aspect of family context—family relationship quality—can also influence women’s agency. Data from the Women’s Reproductive Histories Survey, collected in Madhya Pradesh, India, are used to examine whether family relationship quality is a determinant of women’s agency. Results show that women with higher quality relationships with husbands and parents-in-law do have greater agency. Further, family relationship quality is just as influential as other well known determinants of agency, including education and employment.     

The assessment of parental stress and support in the neonatal intensive care unit using the Parent Stress Scale – Neonatal Intensive Care Unit

ProblemParental stress in the neonatal intensive care unit (NICU) has been reported, however identifying modifiable stress factors and looking for demographic parent factors related to stress has not been well researched.AimThis study aims to identify the most stressful elements for parents in the neonatal intensive care unit.MethodsParents of babies in an Australian neonatal intensive care unit (N = 73) completed both the Parent Stress Scale – Neonatal Intensive Care Unit and a survey of parent and baby demographic and support experience variables (Parent Survey) over an 18-month period.FindingsOlder parental age, very premature birth and twin birth were significantly associated with a higher Parent Stress Scale – Neonatal Intensive Care Unit score. Having a high score in the Relationship and Parental Role scale was strongly associated with attendance at the parent support group.ConclusionThese results indicate the variables associated with stress and this knowledge can be used by teams within hospitals to provide better supportive emotional care for parents.     

Travel and the ‘Freedom of Movement’: Racialised Encounters and Experiences Amongst Ethnic Minority Tourists in the EU

This paper presents a conceptual‐based discussion dealing with social and geo‐political concerns associated with the tourism experiences and travel encounters of ethnic minority citizens living in member‐states of the European Union (EU). Although EU legislation emphasises that its citizens have freedom of movement throughout member‐states, the prevalence of racialised situations transpiring within, across and beyond EU borders suggests that this commitment is socio‐politically ambiguous. The popular hysteria that has developed towards increased immigration from non‐EU countries extends to those minorities who have legal status of entry, residency and/or citizenship – as they too are visibly different from Europe's white majorities. The paper thus reflects on ways in which the 11 September 2001 attacks in America have had a detrimental impact on people's tourism and travel experiences, particularly in instances where individuals have been treated with high levels of suspicion from institutional bodies and ethnic (white) majorities. The work firmly emphasises that racial prejudice, institutional racism and xeno‐racist practices restrict ethnic minority citizens from appreciating cosmopolitan‐based tourism experiences and engaging in congenial exchanges with other European cultures and societies. One of the main contentions asserts that racialised movements limit ethnic minority citizens from achieving full rights to social and (multi)cultural forms of citizenship. The conclusion suggests ways in which researchers ought to respond to the study of tourism and racism within the EU.     

Women’s experiences of care and support following perinatal death in high burden countries: A metasynthesis

ProblemThe experiences of women in low and middle-income countries following perinatal death remains difficult and challenging, thereby increasing their susceptibility to negative psychological impact particularly with insufficient bereavement care and support.BackgroundPerinatal death invariably brings intense grief which significantly impacts women, and requires adequate bereavement care to limit negative outcomes in the short and long-term.AimTo develop deeper understanding of women’s experience of care and support following perinatal death in high burden settings.MethodsSix electronic databases were searched with relevant terms established using the SPIDER tool, supplemented by hand search of reference lists. Studies were independently screened for inclusion by all authors. Meta-ethnography (Noblit and Hare,1988) was used to synthesise existing qualitative studies.FindingsEight studies conducted in Sub-Saharan African and South Asian countries namely South Africa, Uganda, Ghana, Kenya, India and Malawi were included, and three main themes were identified; mothers’ reaction to their baby’s death, care and support after perinatal death, and coping strategies in the absence of care and support. Perinatal death was not appropriately acknowledged therefore care and support was inadequate and, in some cases, non-existent. Consequently, mothers resorted to adopting coping strategies as they were unable to express their grief.DiscussionThere is insufficient care and support for women following perinatal death in high burden settings.ConclusionsFurther research is required into the care and support being given by healthcare professionals and families in high burden settings, thereby ultimately aiding the development of guidance on perinatal bereavement care.