A survey on the perceptions of midwives, women, and support persons on the introduction of a support person information resource
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ABSTRACT:
SUBMITTER: Stulz V
PROVIDER: S-EPMC11339884 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:Seeking support from Facebook groups during pregnancy is now widespread and social media has been widely used by the United Kingdom National Health Service (NHS) maternity services to communicate with service users during the COVID-19 pandemic. Despite this, little is currently known about midwives' attitudes towards, and experiences of social media in practice. Research is needed to understand barriers and solutions to meeting mothers' expectations of online support and to improve services. This study explored midwife involvement in Facebook groups, exploring experiences and perceptions of its use to communicate with and support mothers. An online survey consisting of open and closed questions was completed by 719 midwives and student during August- September 2020. Quantitative questionnaire data was analysed descriptively using SPSS v26. Qualitative data gathered from free text responses was analysed using reflexive thematic analysis. Few participants were involved in providing Facebook support, and most of these were unpaid. There was a consensus on a range of benefits for mothers, but widespread concern that engaging with mothers online was a personal and professional risk, underpinned by a lack of support. Experience of being involved in midwife moderation increased belief in its benefits and reduced fear of engaging online, despite a lack of renumeration and resources. Midwives and students felt they were discouraged from offering Facebook support and sought further training, guidance and support. Although limited, experiences of providing Facebook group support are positive. Perceptions of risk and a lack of support are significant barriers to midwives' involvement in using Facebook groups to support mothers. Midwives seek support and training to safely and effectively engage with mothers using Facebook. Engaging with mothers via social media is embedded in UK national policy and NHS digital strategy, and progress is needed to fulfil these, to improve services and meet mothers' expectations. Midwives' experiences suggest extending opportunities to provide Facebook support would benefit midwives, services and families. Consultation to revise local policy to support midwives and students in line with strategic goals is recommended.
| S-EPMC10109466 | biostudies-literature
Project description:BackgroundHeart failure (HF) affects not only the person diagnosed with the syndrome but also family members, who often have the role of informal carers. The needs of these carers are not always met, and information and communications technology (ICT) could have the potential to support them in their everyday life. However, knowledge is lacking about how family members perceive ICT and see opportunities for this technology to support them.ObjectiveThe aim of this study was to explore the perceptions of ICT solutions as supportive aids among family members of persons with HF.MethodsA qualitative design was applied. A total of 8 focus groups, comprising 23 family members of persons affected by HF, were conducted between March 2015 and January 2017. Participants were recruited from 1 hospital in Sweden. A purposeful sampling strategy was used to find family members of persons with symptomatic HF from diverse backgrounds. Data were analyzed using qualitative content analysis.ResultsThe analysis revealed 4 categories and 9 subcategories. The first category, about how ICT could provide relevant support, included descriptions of how ICT could be used for communication with health care personnel, for information and communication retrieval, plus opportunities to interact with persons in similar life situations and to share support with peers and extended family. The second category, about how ICT could provide access, entailed how ICT could offer solutions not bound by time or place and how it could be both timely and adaptable to different life situations. ICT could also provide an arena for family members to which they might not otherwise have had access. The third category concerned how ICT could be too impersonal and how it could entail limited personal interaction and individualization, which could lead to concerns about usability. It was emphasized that ICT could not replace physical meetings. The fourth category considered how ICT could be out of scope, reflecting the fact that some family members were generally uninterested in ICT and had difficulties envisioning how it could be used for support. It was also discussed as more of a solution for the future.ConclusionsFamily members described multiple uses for ICT and agreed that ICT could provide access to relevant sources of information from which family members could potentially exchange support. ICT was also considered to have its limitations and was out of scope for some but with expected use in the future. Even though some family members seemed hesitant about ICT solutions in general, this might not mean they are unreceptive to suggestions about their usage in, for example, health care. Thus, a variety of factors should be considered to facilitate future implementations of ICT tools in clinical practice.
| S-EPMC6664659 | biostudies-literature
Project description:PurposeIdentifying the information and decision support needs of women interested in receiving planned oocyte cryopreservation (POC) information.MethodsAn online survey of Australian women, aged 18-45, interested in receiving POC information, proficient in English, with internet access. The survey covered POC information sources, information delivery preferences, POC and age-related infertility knowledge (study-specific scale), Decisional Conflict Scale (DCS), and time spent considering POC. Target sample size (n=120) was determined using a precision-based method.ResultsOf 332 participants, 249 (75%) had considered POC, whilst 83 (25%) had not. Over half (54%) had searched for POC information. Fertility clinic websites were predominately used (70%). Most (73%) believed women should receive POC information between ages 19-30 years. Preferred information providers were fertility specialists (85%) and primary care physicians (81%). Other methods rated most useful to deliver POC information were online. Mean knowledge score was 8.9/14 (SD:2.3). For participants who had considered POC, mean DCS score was 57.1/100 (SD:27.2) and 78% had high decisional conflict (score >37.5). In regression, lower DCS scores were associated with every 1-point increase in knowledge score (-2.4; 95% CI [-3.9, -0.8]), consulting an IVF specialist (-17.5; [-28.0, -7.1]), and making a POC decision (-18.4; [-27.5, -9.3]). Median time to decision was 24-months (IQR: 12.0-36.0) (n=53).ConclusionWomen interested in receiving POC information had knowledge gaps, and wanted to be informed about the option by age 30 years from healthcare professionals and online resources. Most women who considered using POC had high decisional conflict indicating a need for decision support.
| S-EPMC10101825 | biostudies-literature
Project description:BackgroundSmoking is the most important preventable cause of adverse pregnancy outcomes, but provision of smoking cessation support (SCS) to pregnant women is poor. We examined the association between midwives' implementation of SCS (5As - Ask, Advise, Assess, Assist, Arrange follow-up) and reported barriers/enablers to implementation.MethodsOn-line anonymous survey of midwives providing antenatal care in New South Wales (NSW), Australia, assessing provision of the 5As and barriers/enablers to their implementation, using the Theoretical Domains Framework (TDF). Factor analyses identified constructs underlying the 5As; and barriers/enablers. Multivariate general linear models examined relationships between the barrier/enabler factors and the 5As factors.ResultsOf 750 midwives invited, 150 (20%) participated. Respondents more commonly reported Asking and Assessing than Advising, Assisting, or Arranging follow-up (e.g. 77% always Ask smoking status; 17% always Arrange follow-up). Three 5As factors were identified- 'Helping', 'Assessing quitting' and 'Assessing dependence'. Responses to barrier/enabler items showed greater knowledge, skills, intentions, and confidence with Assessment than Assisting; endorsement for SCS as a priority and part of midwives' professional role; and gaps in training and organisational support for SCS. Nine barrier/enabler factors were identified. Of these, the factors of 'Capability' (knowledge, skills, confidence); 'Work Environment' (service has resources, capacity, champions and values SCS) and 'Personal priority' (part of role and a priority) predicted 'Helping'.ConclusionThe TDF enabled systematic identification of barriers to providing SCS, and the multivariate models identified key contributors to poor implementation. Combined with qualitative data, these results have been mapped to intervention components to develop a comprehensive intervention to improve SCS.
| S-EPMC7161220 | biostudies-literature
Project description:BackgroundThe Pregnancy Remote Monitoring (PREMOM) study enrolled pregnant women at increased risk of developing hypertensive disorders of pregnancy and investigated the effect of remote monitoring in addition to their prenatal follow-up.ObjectiveThe objective of this study was to investigate the perceptions and experiences of remote monitoring among mothers, midwives, and obstetricians who participated in the PREMOM study.MethodsWe developed specific questionnaires for the mothers, midwives, and obstetricians addressing 5 domains: (1) prior knowledge and experience of remote monitoring, (2) reactions to abnormal values, (3) privacy, (4) quality and patient safety, and (5) financial aspects. We also questioned the health care providers about which issues they considered important when implementing remote monitoring. We used a 5-point Likert scale to provide objective scores. It was possible to add free-text feedback at every question.ResultsA total of 91 participants completed the questionnaires. The mothers, midwives, and obstetricians reported positive experiences and perceptions of remote monitoring, although most of them had no or little prior experience with this technology. They supported a further rollout of remote monitoring in Belgium. Nearly three-quarters of the mothers (34/47, 72%) did not report any problems with taking the measurements at the required times. Almost half of the mothers (19/47, 40%) wanted to be contacted within 3 to 12 hours after abnormal measurement values, preferably by telephone.ConclusionsAlthough most of midwives and obstetricians had no or very little experience with remote monitoring before enrolling in the PREMOM study, they reported, based on their one-year experience, that remote monitoring was an important component in the follow-up of high-risk pregnancies and would recommend it to their colleagues and pregnant patients.Trial registrationClinicalTrials.gov NCT03246737; https://clinicaltrials.gov/ct2/show/NCT03246737 (Archived by WebCite at http://www.webcitation.org/76KVnHSYY).
| S-EPMC6487343 | biostudies-literature
Project description:BACKGROUND:Risk perception in relation to pregnancy and birth is a complex process influenced by multiple personal, psychological and societal factors. Traditionally, the risk perception of healthcare professionals has been presented as more objective and authoritative than that of pregnant women. Doctors have been presented as more concerned with biomedical risk than midwives. Such dichotomies oversimplify and obscure the complexity of the process. This study examines pregnancy-related risk perception in women and healthcare professionals, and what women and professionals believe about each other's risk perception. METHODS:A cross sectional survey of set in UK maternity services. Participants were doctors working in obstetrics (N = 53), midwives (N = 59), pregnant women (N = 68). Participants were recruited in person from two hospitals. Doctors were also recruited online. Participants completed a questionnaire measuring the degree of perceived risk in various childbirth-related scenarios; and the extent to which they believed others agreed with them about the degree of risk generally involved in childbirth. Main outcome measures were the degree of risk perceived to the mother in baby in pregnancy scenarios, and beliefs about own perception of risk in comparison to their own group and other groups. RESULTS:There were significant differences in total risk scores between pregnant women, doctors and midwives in perception of risk to the mother in 68/80 scenarios. Doctors most frequently rated risks lowest. Total scores for perceived risk to the baby were not significantly different. There was substantial variation within each group. There was more agreement on the ranking of scenarios according to risk. Each group believed doctors perceived most risk whereas actually doctors most frequently rated risks lowest. Each group incorrectly believed their peers rated risk similarly to themselves. CONCLUSIONS:Individuals cannot assume others share their perception of risk or that they make correct assessments regarding others' risk perception. Further research should consider what factors are taken into account when making risk assessments.
| S-EPMC6764151 | biostudies-literature
Project description:BackgroundSweden has a large population of migrant women, which contributes to communication challenges and, consequently, suboptimal maternity care. Compared with native-born women, migrant women have an increased prevalence of adverse pregnancy outcomes. Miscommunication and language barriers are among the reasons for these results. Thus, language barriers can also lead to providing less information to migrant women. A digital Swedish-Arabic dialog support tool was developed and tested at antenatal care, to facilitate communication between midwives and Arabic-speaking women. This study aimed to describe midwives' perceptions of communication via Swedish-Arabic dialog support (Sadima) in antenatal care.MethodsA qualitative study was conducted with 14 midwives in antenatal care with experience communicating using a Swedish-Arabic dialog support tool. The data were collected via semi structured individual interviews and were analyzed via phenomenographic analysis.ResultsThe analysis resulted in three categories: (1) Dialog support - the skill of constructing bridges, comprised the main finding that dialog support facilitated communication by providing a multimodal way of communication including intercultural evidence-based content;(2) Dialog support - challengingly implementing adaptive efficiency, represented the implementation of dialog support to be time-consuming and, eventually, time-efficient when midwives gained digital skills; and (3) Women and their partners - the ability to be empowered, included the main finding of increased women's empowerment and control over their lives by being less dependent on interpreters.ConclusionsThe findings contribute to the understanding of communication via dialog support based on midwives' experiences. This study highlights that communication via dialog support facilitates communication between midwives and Arabic-speaking women and enhances midwives' working conditions. Within our increasingly heterogeneous societies, health care could provide support for communication via digital dialog support that is women-centered and culturally sensitive to avoid misunderstandings and delayed or incorrect treatment of migrant women.
| S-EPMC11907776 | biostudies-literature
Project description:This study, which was part of a learning needs assessment of health professionals in England, reports a survey of the training needs of healthcare practitioners in breastfeeding support skills. Respondents rated their competence on 26 breastfeeding support skills, importance of update, actual and potential helpfulness of training, and accessibility in the next 2 years. Perception of organizational barriers to breastfeeding support and practitioners' knowledge of policies and guidance on breastfeeding were measured. Data are reported on 549 healthcare practitioners, mostly midwives and health visitors working for public health services, and some voluntary-sector practitioners, 58% had worked with women and their infants for more than 10 years, and 56% were currently spending at least 25% of their working time providing direct care to breastfeeding women. Those already competent were most likely to want more updating. Those with longer experience of breastfeeding support were more competent on three of the four competence subscales. Relationships between self-assessed competence and current intensity of breastfeeding experience were inconsistent. Respondents preferred training with a practical component. Respondents had poor knowledge of evidence-based policy, and only 51% had access to a breastfeeding policy. Organizational barriers to breastfeeding support were experienced by all, and especially by those with fewer years of experience (t = -2.32, d.f. = 547; P = 0.02) and those currently spending less time supporting breastfeeding women (t = -10.35, d.f. = 547; P < 0.0001). Core training is relevant to all practitioners, and practice-based training with access to evidence-based policies is required.
| S-EPMC6860884 | biostudies-literature
Project description:Language-based strategies are recommended to improve coherence, clarity, reciprocity, and continuity of interactions with persons living with dementia. Person-centered care is the gold standard for caring for persons with dementia. Person-centered communication (PCC) strategies include facilitation, recognition, validation, and negotiation. Little is known about which language-based strategies support PCC in home care. Accordingly, this study investigated the overlap between language-based strategies and PCC in home care interactions. Analysis of conversation of 30 audio-recorded interactions between personal support workers (PSWs) and persons living with dementia was conducted. The overlap between PCC and language-based strategies was analyzed. Of 11,347 communication units, 2578 overlapped with PCC. For facilitation, 21% were yes/no questions. For recognition, 25% were yes/no questions and 22% were affirmations. For validation, 81% were affirmations and positive feedback. Finally, 60% were yes/no questions for negotiation. The findings highlight the person-centeredness of language-based strategies. PSWs should use diverse language-based strategies that are person-centered.
| S-EPMC9996793 | biostudies-literature
Project description:BackgroundMaternity services around the world have been disrupted since the outbreak of the COVID-19 pandemic. The International Confederation of Midwives (ICM) representing one hundred and forty-three professional midwifery associations across the world sought to understand the impact of the pandemic on women and midwives.AimThe aim of this study was to understand the global impact of COVID-19 from the point of view of midwives' associations.MethodsA descriptive cross-sectional survey using an on-line questionnaire was sent via email to every midwives' association member of ICM.Survey instrumentThe survey was developed and tested by a small global team of midwife researchers and clinicians. It consisted of 106 questions divided into seven discreet sections. Each member association was invited to make one response in either English, French or Spanish.ResultsData were collected between July 2020 and April 2021. All respondents fulfilling the inclusion criteria irrespective of whether they completed all questions in the survey were eligible for analysis. All data collected was anonymous. There were 101 surveys returned from the 143 member associations across the world. Many countries reported being caught unaware of the severity of the infection and in some places, midwives were forced to make their own PPE, or reuse single use PPE. Disruption to maternity services meant women had to change their plans for place of birth; and in many countries maternity facilities were closed to become COVID-19 centres. Half of all respondents stated that women were afraid to give birth in hospitals during the pandemic resulting in increased demand for home birth and community midwifery. Midwifery students were denied access to practical or clinical placements and their registration as midwives has been delayed in many countries. More than 50% of the associations reported that governments did not consult them, and they have little or no say in policy at government levels. These poor outcomes were not exclusive to high-, middle- or low-income countries.ConclusionsStrong recommendations that stem from this research include the need to include midwifery representation on key government committees and a need to increase the support for planned out of hospital birth. Both these recommendations stand to enhance the effectiveness of midwives in a world that continues to face and may face future catastrophic pandemics.
| S-EPMC9629587 | biostudies-literature