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71.
Catherine Ruth Knight-Agarwal Manmeet Kaur Lauren T. Williams Rachel Davey Deborah Davis 《Women and birth : journal of the Australian College of Midwives》2014,27(2):138-144
BackgroundThe prevalence of overweight and obesity is increasing amongst women of child bearing age. The objective of this study was to investigate the views and attitudes of providers of antenatal care for women who have a body mass index (BMI) of 30 kg/m2 and over.MethodsA qualitative study using focus groups was undertaken within the department of obstetrics and gynaecology at a large teaching hospital in south-eastern Australia. Three focus group discussions were held. One with hospital midwives (n = 10), one with continuity of care midwives (n = 18) and one with obstetricians (n = 5). Data were analysed using Interpretative Phenomenological Analysis (IPA).FindingsSix dominant themes emerged: (1) obesity puts the health of mothers, babies and health professionals at risk; (2) overweight and obesity has become the norm; (3) weighing women and advising about weight gain is out of fashion; (4) weight is a sensitive topic to discuss; (5) there are significant barriers to weight control in pregnancy; and (6) health professionals and women need to deal with maternal obesity. These themes are drawn together to form a model representing current health care issues for these women.ConclusionHealth professionals, who have a high BMI, can find it difficult to discuss obesity during antenatal visits with obese women. Specialist dietary interventions and evidence based guidelines for working with child-bearing women is seen as a public health priority by health care professionals. 相似文献
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Johan Wrammert Sabitri Sapkota Kedar Baral Ashish KC Mats Målqvist Margareta Larsson 《Women and birth : journal of the Australian College of Midwives》2017,30(3):262-269
Problem
The ability of health care providers to work together is essential for favourable outcomes in neonatal resuscitation, but perceptions of such teamwork have rarely been studied in low-income settings.Background
Neonatal resuscitation is a proven intervention for reducing neonatal mortality globally, but the long-term effects of clinical training for this skill need further attention. Having an understanding of barriers to teamwork among nurse midwives can contribute to the sustainability of improved clinical practice.Aim
To explore nurse midwives’ perceptions of teamwork when caring for newborns in need of resuscitation.Methods
Nurse midwives from a tertiary-level government hospital in Nepal participated in five focus groups of between 4 and 11 participants each. Qualitative Content Analysis was used for analysis.Findings
One overarching theme emerged: looking for comprehensive guidelines and shared responsibilities in neonatal resuscitation to avoid personal blame and learn from mistakes. Participants discussed the need for protocols relating to neonatal resuscitation and the importance of shared medical responsibility, and the importance of the presence of a strong and transparent leadership.Discussion
The call for clear and comprehensive protocols relating to neonatal resuscitation corresponded with previous research from different contexts.Conclusion
Nurse midwives working at a maternity health care facility in Nepal discussed the benefits and challenges of teamwork in neonatal resuscitation. The findings suggest potential benefits can be made from clarifying guidelines and responsibilities in neonatal resuscitation. Furthermore, a structured process to deal with clinical incidents must be considered. Management must be involved in all processes. 相似文献74.
Birth centres and the national maternity services review: response to consumer demand or compromise?
Dahlen H Jackson M Schmied V Tracy S Priddis H 《Women and birth : journal of the Australian College of Midwives》2011,24(4):165-172
Background
In February 2009 the Improving Maternity Services in Australia – The Report of the Maternity Services Review (MSR) was released and recommended improving women's access to and availability of birth centres. It was unclear if this was in response to an overwhelming request for birth centres in the submissions received by the commonwealth or a compromise for excluding homebirth from the maternity service reforms.Aim
The aim of this paper was to examine what was said in the submissions to the MSR about birth centres.Methods
Data for this study comprised 832 submissions to the MSR that are publicly available on the Commonwealth of Australia Department of Health and Ageing website. All 832 submissions were downloaded, and read for any mention of the words ‘birth centre’, ‘birth center’. Content analysis was used to categorise and report the data.Results
Of the 832 submissions to the MSR 197 (24%) mentioned birth centres while 470 (60%) of the submissions mentioned homebirth. Only 31 (4%) of the submissions to the Maternity Review mentioned birth centres without mentioning home birth also. Most of the submissions emphasised that ‘everything should be on the menu’ when it came to place of birth and care provider. Reasons for choosing a birth centre were identified as: ‘the best compromise available, ‘the right and natural way’ and ‘the birth centre as safe’. Women had certain requirements of a birth centre that included: ‘continuity of carer’, ‘midwife led’, ‘a sanctum from medicalised care’, ‘resources to cope with demand’, ‘close to home’, and ‘flexible guidelines and admission criteria’. Women weighed up a series of requirements when deciding whether to give birth in a birth centre.Discussion
The recommendation by the MSR to expand birth centres and ignore home birth is at odds with the strong view expressed that ‘everything should be on the menu’. The requirements women described of birth centre care are also at odds with current trends.Conclusion
If there is to be an expansion of birth centres, service providers need to make sure that women's views are central to the design. Women will not cease having homebirths due to expanded birth centre options. 相似文献75.
76.
Titaree Phanwichatkul Elaine Burns Pranee Liamputtong Virginia Schmied 《Women and birth : journal of the Australian College of Midwives》2018,31(3):e152-e161
Background
Interpreters (lam in Thai) have been employed in maternity services in Thailand due to increasing numbers of Burmese women migrating to Thailand. Access to healthcare interpreters is crucial for health professionals and Burmese migrant women using Thai maternity services but no studies have examined the role of the lam.Aim
This paper explores the role and experiences of healthcare interpreters (lam) working in Thailand. The perspectives of nurse-midwives and migrant Burmese women regarding the role of the lam are also included.Methods
Ethnographic methods including observation of interactions between women, nurse-midwives, other health professionals and the lam were used. Individual interviews were conducted with four Burmese lam, nine health professionals, and 10 Burmese women. The data were analysed using thematic analysis.Findings
Three major themes captured the role and experiences of the Burmese lam; ‘more than an interpreter’, ‘challenges in sustaining the role of the lam’, and ‘benefits for me and my community’. The Burmese lam had two key components to their role: interpreter and, healthcare worker. Key challenges included lack of clarity around role boundaries, limited training, and, low remuneration.Discussion and conclusions
Despite the challenges, the lam believed their presence encouraged Burmese women to attend antenatal care. They described benefits for themselves, including ‘on-the-job’ training. Community trust in the lam meant that Burmese women and families sought their advice within the community. This study demonstrates the important role that migrant workers play in collaborating with nurse-midwives to ensure access to maternity services in middle-income countries. 相似文献77.
《Women and birth : journal of the Australian College of Midwives》2020,33(3):e295-e301
ProblemDespite the known prevalence of complementary medicine use by women during pregnancy and childbirth and the evolution of preferred models of maternity care, very little is known about the nature and characteristics of the care provided to women by complementary medicine practitioners during this important life stage.BackgroundWoman-centred care is a speciation of person-centred care which has achieved prominence in maternity care policy in recent years. There is also evidence that the core principles of some complementary medicine systems of medicine emphasise patient-centredness and that these principles are core drivers toward complementary medicine use in multiple populations.AimThis study aims to explore the approach to care delivered by complementary medicine practitioners to women during pregnancy and birth.MethodsSemi-structured individual interviews were conducted with 23 complementary medicine practitioners who identified as specialising in maternity care. Data from the interviews were analysed using a framework approach.FindingsThe analysis of the perspective of complementary medicine practitioner’s experiences providing care to pregnant and birthing women identified three main themes: Responding to women’s expectations of care; providing woman-centred care; and the therapeutic relationship at the heart of woman-centred care.DiscussionThe approach to maternity care reported by complementary medicine practitioners aligns with the principles of woman-centred care, possibly due to the similarities between woman-centred care and the core features of many systems of medicine within complementary medicine.ConclusionComplementary medicine practitioners may contribute to an overall experience of woman-centred maternity care for pregnant and birthing women. 相似文献
78.
《Women and birth : journal of the Australian College of Midwives》2021,34(4):e396-e405
BackgroundThe process of developing a survey instrument to evaluate women’s experiences of their maternity care is complex given that maternity care encapsulates various contexts, services, professions and professionals across the antenatal, intranatal and postnatal periods.AimTo identify and prioritise items for inclusion in the National Maternity Experience Survey, a survey instrument to evaluate women’s experiences of their maternity care in the Republic of Ireland.MethodsThis study used an adapted two-phase exploratory sequential mixed methods design. Phase one identified items for possible inclusion and developed an exhaustive item pool through a systematic review, focus groups and one to one interviews, and a gap analysis. Phase two prioritised the items for inclusion in the final item bank through a Delphi study and consensus review.FindingsFollowing iterative consultation with key stakeholder groups, a bank of 95 items have been prioritised and grouped within eight distinct care sections; care during your pregnancy, care during your labour and birth, care in hospital after the birth of your baby, specialised care for your baby, feeding your baby, care at home after the birth of your baby, overall care and you and your household.ConclusionRobust and rigorous methods have been used to develop a bank of 95 suitable items for inclusion in the National Maternity Experience Survey. 相似文献
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《Women and birth : journal of the Australian College of Midwives》2023,36(1):e161-e168
BackgroundWomen with a disability have poorer perinatal outcomes, but little is known about the prevalence of women with a disability accessing maternity services, how they are identified and what care and services are available. Estimates suggest that nine percent of women of childbearing age have a disability.AimTo explore how public maternity services in Australia identify pregnant women with a disability, what (if any) routine disability identification questions are used, and to examine availability and adequacy of services for women.MethodsCross-sectional online survey of maternity managers in Australian public hospitals.FindingsThirty-six percent (70/193) of eligible hospitals responded including all states and territories. Overall, 71 % routinely asked women about disability status (usually as part of routine history taking), however there was wide variation in how this was asked. Most (63 %) did not have standardised documentation processes and two thirds (65 %) were unable to estimate the number of women with a disability seen at their hospital. Most (68 %) did not offer specialised services, with only 13 % having specialised training for staff in disability identification, documentation and referral pathways. Only a quarter of respondents felt that there were adequate services for women with a disability related to maternity care.ConclusionThis is the first study to explore disability identification in maternity services in Australia. How women were asked was highly varied and documentation not standardised. National guidelines on disability identification for women accessing maternity services should be developed and collection of disability identification data should be routine. 相似文献