Factors associated with a positive childbirth experience in Brazilian women: A cross-sectional study

BackgroundHaving a positive childbirth experience is an increasingly valued outcome. Few studies evaluated the women’s satisfaction with childbirth through face-to-face interviews out of the health service environment. The objective of this study was to identify factors associated with a higher level of satisfaction with the childbirth experience among Brazilian women.MethodsThis cross-sectional study involved 287 women giving birth in two hospitals in southern Brazil. Women who gave birth to healthy newborns at term were randomly selected. Face-to-face interviews were conducted 31–37 days after delivery, at the mothers’ homes, using a structured questionnaire. Satisfaction with the childbirth experience was measured using a Likert-type scale ranging from very satisfied to very dissatisfied. Prevalence ratios (PR) were estimated using Poisson regression with robust variance.ResultsFollowing hierarchical multivariate analysis, the following factors remained associated with a higher level of satisfaction with the childbirth experience: being satisfied with antenatal care (PR = 1.30; 95% confidence interval [95%CI] = 1.06−1.59), understanding the information provided by health professionals during labor and delivery (PR = 1.40; 95%CI = 1.01−1.95), not having reported disrespect and abuse (PR = 1.53; 95%CI = 1.01−2.31), and having had the baby put to the breast within the first hour of life (PR = 1.63; 95%CI = 1.26−2.11). No association was observed with type of delivery or hospital status (public or private).ConclusionsA higher level of satisfaction with the childbirth experience is related to satisfactory antenatal care, a non-abusive, respectful, and informative environment during childbirth, and to the opportunity to breastfeed the baby within the first hour of life. In clinical practice, greater attention to these basic principles of care during pregnancy and delivery could provide more positive experiences during birth.     

Towards an assessment for organizational participatory research health partnerships: A systematic mixed studies review with framework synthesis

Within the health sciences, organizational participatory research (OPR) is defined as a blend of research and action, in which academic researchers partner with health organization members. OPR is based on a sound partnership between all stakeholders to improve organizational practices. However, little research on the evaluation of OPR health partnership exists. This systematic mixed studies review sought to produce a new theoretical model that structures the evaluation of the OPR processes and related outcomes of OPR health partnerships. Six bibliographic databases were searched together with grey literature sources for OPR health partnership evaluation questionnaires. Six questionnaires were included, from which a pool of 95 OPR health partnership evaluation items were derived. The included questionnaires were appraised for the quality of their origin, development and measurement properties. A framework synthesis was performed using an existing OPR framework by organizing questionnaire items in a matrix using a hybrid thematic analysis. This led to our proposed Organizational Participatory Research Evaluation Model (OPREM) that includes three axes, Trust, Collective Learning and Sustainability (with specific dimensions) and 95 items. This model provides information to help stakeholders comprehensively structure the evaluation of their partnerships and subsequent improvement; thus, potentially helping to improve health organization practices.     

The Mediating Effect of Resilience Between Social Support for Exercise and Resident Satisfaction in Assisted Living

This study examined whether residents' level of resilience mediated the relationship between social support for exercise from staff and resident satisfaction in assisted living. This was a secondary data analysis using baseline data from a function-focused care intervention study including 171 residents from four assisted living facilities. Using structural equation modeling, we found that mood and social support for exercise from staff were the only variables associated with resilience. Mood, gender, cognition, and social support for exercise from staff directly influenced resident satisfaction and explained 31% of the variance in the model. Implications for future research and practice are discussed.     

Health insurance literacy: A mixed methods study of college students

Objective: This study examines the health insurance literacy, or the ability to use health insurance effectively, of college students. Participants: A total of 455 students from a large, public university completed an online questionnaire in November 2016. Methods: A questionnaire examined students’ knowledge of commonly encountered health insurance terms and ability to apply that knowledge to determine cost-sharing in a clinical setting. Results: The majority of students were able to correctly identify the most commonly encountered terms, but could not identify terms related to plan types and options. Eighty-eight percent of students could not determine their cost-sharing for two presented scenarios. Approximately half of the students indicated they had been confused about their health insurance plan, with one-quarter of students stopping or delaying medical care due to confusion. Conclusions: Outreach and education for students should target specific deficits in knowledge such as those identified in this study.     

When women veterans return: The role of postsecondary education in transition in their civilian lives

Objective: The purpose of this study was to assess the current state of postsecondary educational settings’ outreach to military women who become students postservice. Participants: Data for the present cross-sectional study were obtained from the American College Health Association’s (ACHA) 2011–2014 National College Health Assessment II (NCHA). Methods: Demographic characteristics of the study sample were explored by calculating frequencies and percentages by military service status. Research questions were explored with Fisher’s exact test, maximum likelihood multiple logistic regression, as appropriate. Results: Women service member and veteran students received health information from their university/college less often than women students with no military experience on the following topics: alcohol and other drug use, depression and anxiety, sexual assault and relationship violence prevention, and stress reduction. Conclusions: The findings of this research identified clear gaps in service provision for women student veterans on college campuses and provided some possible models for intervention development.     

Building a health communication brand for University of Texas System tobacco control

Objective: Despite declining cigarette smoking rates in the US, there is a continued need for tobacco prevention education campaigns to reach young adults. Recognizing the need for improved tobacco control messaging, the University of Texas (UT) System engaged The University of Texas at Austin Center for Health Communication to develop a brand and message that would strengthen tobacco control efforts at its 14 institutions. Methods: This article describes the iterative process involved in creating a brand for tobacco control, including an environmental scan, identifying potential message themes, and creating and refining logos. Results: This article highlights the process of developing a system-wide tobacco control brand. Specifically, the process included coordinating an interdisciplinary team with content and design experts, and presenting ideas to stakeholders for serial feedback and refinement, among others. Conclusions: Ultimately, this project offers a model for other systems of higher education interested in pursuing similar initiatives.     

Impact of mindful self-care and perceived stress on the health related quality of life among young-adult students in West Virginia

ABSTRACT

There are substantial gaps in research on Health Related Quality of Life (HRQoL) in students aged 18 and above in West Virginia. The purpose of this study is to explore the associations between mindful self-care, perceived stress, and the HRQoL in this population. We conducted a cross-sectional study between March and April 2017. We included participants who were students, aged 18 years and above, living in West Virginia and were able to answer online questions in English. Data was obtained from an online survey using a structured questionnaire, including the SF12v2®, mindful self-care scale- SHORT, and Perceived Stress Scale (PSS)-10. We applied linear regressions to determine the predictors of HRQoL (physical health and mental health) using SF12v2®. 194 participants met the inclusion criteria of the study. Mindful self-care was negatively associated with perceived stress. Better mindful self-care mediated the relationship between perceived stress and psychological well-being, controlling for gender, age, race, marital status, education level, annual household income, and chronic disease status. Perceived stress and mindful self-care were not related to the physical well-being. Better mindful self-care may safeguard against perceived stress among students aged 18 years and above. Our findings in this study recommend more mindfulness-based interventions targeted to this subpopulation to improve psychological well-being.     

Qualitative exploration of supporting figures in the lives of emerging adults who left care compared with their noncare‐leaving peers

Studies on youth leaving care have emphasized their limited social support and their need for continuing support after emancipation. However, less is known about the nature of their existing social networks after emancipation and their roles during their transition to adulthood compared with their noncare‐leaving peers. With this in mind, 32 young adults aged 18 to 25 participated in semi‐structured interviews regarding their current support figures in order to learn whether they were congruent with their needs after emancipation. Thematic analysis revealed four main features of the two groups' social networks: (a) stability versus uncertainty as to the lasting presence of the supportive figure, (b) reliance on parents as main supportive figures versus relying on different supportive figures, (c) confidence versus uncertainty in the supportive figures' ability to help, and (d) holistic versus fragmented support of the young adults' needs. The discussion addresses the unique characteristics of care leavers in emerging adulthood and the implications of their social networks' features for their adjustment after emancipation. One of the study's recommendations is to proactively connect them to new supportive figures such as professionals or mentors by offering them mentoring programs cognizant of the instrumental and developmental tasks of emerging adulthood.     

Supporting foster and kinship carers to promote the mental health of children

The majority of children and young people removed from the care of their parents by the state of Victoria, Australia, reside in foster or kinship care. These children have experienced a broad range of adverse conditions and are up to 4 times more likely to experience problems with mental health than their mainstream peers. This paper draws on the perspectives of foster and kinship carers, describing the disconnection between their role as mental health advocates and their interest in early intervention in a field which is dominated by crisis and the historic marginalisation of foster and kinship carers. Thirty‐one foster and kinship carers across greater metropolitan Melbourne, Australia, contributed to this study through interviews and focus groups. Participants demonstrated a practical understanding of mental health and an ability to identify a range of conditions that have an adverse impact on the mental health of children and young people in their care. The paper concludes that there is a lack of systemic support and even a range of barriers that affect the capacity of foster and kinship carers to promote the mental health and well‐being of the children and young people in their care.