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1.
Hong Kong Med J ; 27(2): 113-117, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33154187

RESUMO

INTRODUCTION: Owing to the coronavirus disease 2019 outbreak Hong Kong hospitals have suspended visiting periods and made mask wearing mandatory. In obstetrics, companionship during childbirth has been suspended and prenatal exercises, antenatal talks, hospital tours, and postnatal classes have been cancelled. The aim of the present study was to investigate the effects of these restrictive measures on delivery plans and risks of postpartum depression. METHODS: We compared pregnancy data and the Edinburgh Postpartum Depression Scale (EPDS) scores of women who delivered between the pre-alert period (1 Jan 2019 to 4 Jan 2020) and post-alert period (5 Jan 2020 to 30 Apr 2020) in a tertiary university public hospital in Hong Kong. Screening for postpartum depression was performed routinely using the EPDS questionnaire 1 day and within 1 week after delivery. RESULTS: There was a 13.1% reduction in the number of deliveries between 1 January and 30 April from 1144 in 2019 to 994 in 2020. The EPDS scores were available for 4357 out of 4531 deliveries (96.2%). A significantly higher proportion of women had EPDS scores of ≥10 1 day after delivery in the post-alert group than the pre-alert group (14.4% vs 11.9%; P<0.05). More women used pethidine (6.2% vs 4.6%) and fewer used a birthing ball (8.5% vs 12.4%) for pain relief during labour in the post-alert group. CONCLUSIONS: Pregnant women reported more depressive symptoms in the postpartum period following the alert announcement regarding coronavirus infection in Hong Kong. This was coupled with a drop in the delivery rate at our public hospital. Suspension of childbirth companionship might have altered the methods of intrapartum pain relief and the overall pregnancy experience.


Assuntos
COVID-19 , Salas de Parto/organização & administração , Depressão Pós-Parto , Amigos/psicologia , Controle de Infecções , Planejamento de Assistência ao Paciente/organização & administração , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/prevenção & controle , Depressão Pós-Parto/psicologia , Feminino , Hong Kong/epidemiologia , Humanos , Controle de Infecções/instrumentação , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Inovação Organizacional , Gravidez , Cuidado Pré-Natal/organização & administração , Cuidado Pré-Natal/psicologia , Educação Pré-Natal/organização & administração , Prevalência , SARS-CoV-2
2.
BMC Pregnancy Childbirth ; 19(1): 264, 2019 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-31340770

RESUMO

BACKGROUND: Maternal education is wide-ranging and covers many areas from pregnancy to the immediate postpartum period and childrearing. However, for it to be effective, more resources need to be assigned to key topics. The goal of this study was to identify and prioritize the most important issues in maternal education, so that specific objectives could subsequently be set and learning outcomes evaluated. METHODS: We drew up a comprehensive list of topics addressed in existing maternal education programs, based on a systematic review of information obtained from the Internet and the experience of the research team. The topics were presented to a multidisciplinary panel whose members were asked to rate them from 1 to 9, and consensus of opinion was reached using a two-round Delphi survey, with consensus defined beforehand as 80% agreement among panelists in awarding a score of 7, 8 or 9. The most highly-rated topics were then discussed and again prioritized by a multidisciplinary team of healthcare and non-healthcare experts, using a nominal group technique. RESULTS: Initially, 650 topics were identified and grouped into 80 categories which were then prioritized by 54 healthcare and non-healthcare experts using a Delphi survey with a study participation rate of around 20%. 63 topics were considered very important, so criteria were restricted and only the 24 highest-scoring selected (95% of agreement on scores ≥7 or 80% of agreement on scores ≥8). Using the nominal group technique, a group of 12 experts identified the following priorities: initiation and establishment of breastfeeding, development of a birth plan, identification of problems and self-care postpartum, nutrition and a healthy lifestyle, options for pain management in labor and birth and characteristics of a normal newborn/looking after a newborn baby. CONCLUSION: This study, with a Delphi study and the Consensus among Experts: the nominal group technique, has succeeded in identifying priority topics in maternal education. We need to assess women's needs in relation to these topics, design an intervention to respond to these needs and evaluate its effectiveness.


Assuntos
Consenso , Promoção da Saúde/métodos , Mães/educação , Complicações na Gravidez/prevenção & controle , Cuidado Pré-Natal/métodos , Educação Pré-Natal/organização & administração , Técnica Delphi , Feminino , Humanos , Gravidez , Revisões Sistemáticas como Assunto
3.
BMC Pregnancy Childbirth ; 19(1): 253, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31331285

RESUMO

BACKGROUND: During pregnancy and postnatally, women seek information from a variety of sources. The potential to incorporate educational pregnancy and parenting resources into conventional health services is underexplored. In 2014-2016, UK-based charity Best Beginnings used an embedding model to embed three of their resources - the Baby Buddy app, Baby Express magazine, and 'From Bump to Breastfeeding' DVD - into maternity and early years care pathways at three sites in the north of England. A mixed-methods evaluation comprising an impact evaluation and a process evaluation was undertaken. Here we report findings from the process evaluation that aimed to understand the embedding process, explore maternity and early years' professionals' views and use of the resources, explore women's engagement with and views of the resources, and identify barriers and facilitators to the embedding process. METHODS: We carried out semi-structured interviews with stakeholders (professionals involved in embedding) and observations of embedding activities to understand how embedding worked. Surveys of postnatal women were conducted over a two-month period both prior to, and after, the resources had been embedded, to ascertain engagement with and views of the resources. A survey of professionals was carried out post-embedding to understand how, where and when the resources were used in practice, and professionals' views. Descriptive and thematic analyses were undertaken. RESULTS: Thirty stakeholders took part in interviews. Surveys were completed by 146 professionals, and by 161 and 192 women in the pre and post-embedding phases respectively. Themes derived from analysis of qualitative data were 'Implementation of the embedding model', 'Promotion and distribution of, and engagement with, the resources', 'Fit with care pathways', and 'Perceptions of the resources'. While survey responses indicated that embedding of the resources into practice was not yet complete, those who had used the resources believed that they had helped increase knowledge, build confidence and support relationship-building. CONCLUSIONS: Incorporating supportive parenting resources into maternity and early years' care pathways requires a planned embedding approach, committed champions, and senior management support. Findings indicate largely positive views of women and professionals, and suggest the resources can be a beneficial aid for families.


Assuntos
Promoção da Saúde , Comportamento Materno/psicologia , Educação Pré-Natal , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Promoção da Saúde/organização & administração , Humanos , Comportamento de Busca de Informação , Serviços de Saúde Materna , Participação do Paciente/métodos , Gravidez , Educação Pré-Natal/métodos , Educação Pré-Natal/organização & administração , Avaliação de Programas e Projetos de Saúde/métodos , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Apoio Social , Reino Unido
4.
BMC Pregnancy Childbirth ; 19(1): 384, 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31660898

RESUMO

BACKGROUND: Increasing male involvement during pregnancy is considered an important, but often overlooked intervention for improving maternal health in sub-Saharan Africa. Intervention studies aimed at improving maternal health mostly target mothers hereby ignoring the crucial role their partners play in their ability to access antenatal care (ANC) and to prevent and treat infectious diseases like HIV and malaria. Very little is known about the current level of male involvement and barriers at different levels. This study explores the attitudes and beliefs of health policymakers, health care providers and local communities regarding men's involvement in maternal health in southern Mozambique. METHODS: Ten key informant interviews with stakeholders were carried out to assess their attitudes and perspectives regarding male involvement in programmes addressing maternal health, followed by 11 days of semi structured observations in health care centers. Subsequently 16 focus group discussions were conducted in the community and at provider level, followed by three in depth couple interviews. Analysis was done by applying a socio-ecological systems theory in thematic analysis. RESULTS: Results show a lack of strategy and coherence at policy level to stimulate male involvement in maternal health programmes. Invitation cards for men are used as an isolated intervention in health facilities but these have not lead to the expected success. Providers have a rather passive attitude towards male involvement initiatives. In the community however, male attendance at ANC is considered important and men are willing to take a more participating role. Main barriers are the association of male attendance at ANC with being HIV infected and strong social norms and gender roles. On the one hand men are seen as caretakers of the family by providing money and making the decisions. On the other hand, men supporting their wife by showing interest in their health or sharing household tasks are seen as weak or as a manifestation of HIV seropositivity. CONCLUSION: A clear strategy at policy level and a multi-level approach is needed. Gender-equitable relationships between men and women should be encouraged in all maternal health interventions and providers should be trained to involve men in ANC.


Assuntos
Pessoal Administrativo/psicologia , Infecções por HIV , Pessoal de Saúde/psicologia , Relações Interpessoais , Malária , Saúde Materna/normas , Cuidado Pré-Natal , Educação Pré-Natal , Adulto , Atitude do Pessoal de Saúde , Feminino , Grupos Focais , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Colaboração Intersetorial , Malária/epidemiologia , Malária/prevenção & controle , Masculino , Moçambique/epidemiologia , Gravidez , Cuidado Pré-Natal/métodos , Cuidado Pré-Natal/organização & administração , Educação Pré-Natal/métodos , Educação Pré-Natal/organização & administração , Pesquisa Qualitativa , Melhoria de Qualidade/organização & administração
5.
Reprod Health ; 16(1): 107, 2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31311563

RESUMO

BACKGROUND: In Tanzania, the information on Birth Preparedness and Complication Readiness is insufficiently provided to pregnant women and their families. The aim of this study was to evaluate the maternal and infant outcomes of a family-oriented antenatal group education program that promotes Birth Preparedness and Complication Readiness in rural Tanzania. METHODS: Pregnant women and families were enrolled in a program about nutrition and exercise, danger signs, and birth preparedness. The cross sectional survey was conducted one year later to evaluate if the participants of the program (intervention group) were different from those who did not participate (control group) with respect to birth-preparedness and maternal and infant outcomes. RESULTS: A total of 194 participants (intervention group, 50; control group, 144) were analyzed. For Birth Preparedness and Complication Readiness, the intervention group participants knew a health facility in case of emergency (OR: 3.11, 95% CI: 1.39-6.97); arranged accompaniment to go to a health facility for birth (OR: 2.56, 95% CI: 1.17-5.60); decided the birthplace with or by the pregnant women (OR: 3.11, 95% CI: 1.44-6.70); and attended antenatal clinic more than four times (OR: 2.39, 95% CI: 1.20-4.78). For birth outcomes, the intervention group had less bleeding or seizure during labour and birth (OR: 0.28, 95%CI: 0.13-0.58); fewer Caesarean sections (OR: 0.16, 95% CI: 0.07-0.36); and less neonatal complications (OR: 0.28, 95% CI: 0.13-0.60). CONCLUSIONS: The four variables were significantly better in the intervention group, i.e., identifying a health facility for emergencies, family accompaniment for facility birth, antenatal visits, and involvement of women in decision-making, which may be key factors for improving birth outcome variables. Having identified these key factors, male involvement and healthy pregnant lives should be emphasized in antenatal education to reduce pregnancy and childbirth complications. TRIAL REGISTRATION: No.2013-273-NA-2013-101 . Registered 12 August 2013.


Assuntos
Parto Obstétrico/psicologia , Educação em Saúde/métodos , Conhecimentos, Atitudes e Prática em Saúde , Complicações do Trabalho de Parto/prevenção & controle , Complicações na Gravidez/prevenção & controle , Gestantes/psicologia , Cuidado Pré-Natal/métodos , Educação Pré-Natal/organização & administração , Adulto , Estudos Transversais , Família , Feminino , Humanos , Masculino , Gravidez , Inquéritos e Questionários , Tanzânia
6.
Nurs Outlook ; 67(6): 696-706, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31248629

RESUMO

BACKGROUND: Mindfulness-based childbirth education programs are gaining popularity among expectant parents. PURPOSE: To synthesize knowledge on current available evidence of mindfulness-based childbirth education programs on maternal outcomes and to provide recommendations to improve future mindfulness-based childbirth education programs. METHOD: A mixed-studies systematic review using a narrative synthesis was conducted. Four electronic databases were searched from each database's inception, through November 26, 2018. FINDINGS: Three themes emerged from the synthesis: (a) the duration and receptivity of the programs, (b) improved maternal psychosocial outcomes, and (c) the practice of mindfulness during the postpartum period. A conceptual map was produced. DISCUSSION: The programs resulted in improved maternal psychosocial outcomes. A greater focus on the practice of informal mindfulness should be taught in future mindfulness-based childbirth education programs. Nurses can consider teaching mindfulness techniques in current antenatal classes. The cost effectiveness and receptivity of the programs should be examined. Future mixed-methods longitudinal studies with ideal sample sizes and the exclusion of participants with prior yoga or medication experiences should be conducted.


Assuntos
Atenção Plena , Mães/psicologia , Parto/psicologia , Gestantes/psicologia , Educação Pré-Natal/organização & administração , Adulto , Feminino , Humanos , Gravidez
7.
Aust J Rural Health ; 27(5): 405-411, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31334900

RESUMO

OBJECTIVE: To describe the development and evaluation of an educational resource that aimed to provide the non-midwifery workforce in rural and remote health facilities with basic knowledge and skills to assist women who present when birth is imminent. DESIGN: Descriptive methods using surveys were employed to evaluate the resource named the Imminent Birth Education Program. PARTICIPANTS: Health professionals employed in Queensland Health rural and remote non-birthing facilities. INTERVENTION: An evidence-based, blended educational program comprising an online component, a face-to-face workshop and an education package for midwives to facilitate the workshop in their health service. RESULTS: More than 600 participants completed the online course component, and the majority of these participants were employed in non-birthing facilities. Throughout the project, two project officers facilitated face-to-face workshops, training participants to facilitate the workshop in their own health services. The reach of the Imminent Birth Education Program was statewide with clinical staff from all 16 Hospital and Health Services participating. CONCLUSION: The uptake of the Imminent Birth Education Program has been widespread across the state and positively evaluated by the rural and remote non-midwifery workforce in non-birthing facilities. This evidence-based program is an effective way to provide the knowledge, skills and confidence to assist health professionals to care for women who present to these facilities when birth is imminent.


Assuntos
Pessoal de Saúde/educação , Serviços de Saúde Materna/organização & administração , Tocologia/educação , Educação Pré-Natal/organização & administração , Serviços de Saúde Rural/organização & administração , Adulto , Feminino , Humanos , Gravidez , Queensland , Inquéritos e Questionários
8.
BMC Pregnancy Childbirth ; 18(1): 276, 2018 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-29970042

RESUMO

BACKGROUND: Ethiopia houses the second largest population of female adolescents in Africa. Adolescent childbearing can have detrimental effect to the health and wellbeing of women and their offspring. This study examined trends, sub-national variations and determinants of early childbearing (i.e. childbearing before age 20) in Ethiopia. METHODS: Data from the 2000-2011 Ethiopia Demographic and Health Surveys and from the 2014-2016 Performance Monitoring and Accountability surveys were pooled for this analysis. Based on the year the women reached puberty, five different cohorts were reconstructed that date back to the early 1970s. Kaplan-Meier methodology was used to estimate the cumulative probability of early childbearing and a Cox proportional hazard regression model to examine the associated factors. RESULTS: The cumulative probability of early childbearing declined by approximately two-fifth in the past four decades, from 57.6 to 35.3%. The occurrence of early childbearing varies substantially by region. In the most recent period, it ranged from 9.6% in Addis Ababa to 59% in Benishangul-Gumuz. Early childbearing risk was reduced by 95% for women who did not marry before the age of 20 years compared to those who married before the age of 18 years. For adolescents who married at the age of 18 and 19 years, early childbearing risk decreased by 60 and 78%, respectively. During the same period, there was a parallel decline in the cumulative probability of early marriage (i.e., before the legal age of 18 years) from 55.3 to 28.7%. Compared with adolescents with no education, those with elementary and secondary or higher education had a 50 and 82% lower risk of early childbearing, respectively. CONCLUSIONS: Early childbearing declined in Ethiopia, largely driven by a parallel reduction in early marriage. However, a large portion of adolescents are still facing early childbearing, and the situation is more dismal in some regions than others. A further reduction in early childbearing is warranted by enforcing the law on the minimum marriage age and expanding secondary and higher education for females. These efforts should give greater emphasis to regions where early childbearing is markedly high.


Assuntos
Eficácia de Contraceptivos/estatística & dados numéricos , Serviços de Planejamento Familiar , Gravidez na Adolescência , Educação Pré-Natal/organização & administração , Adolescente , Etiópia/epidemiologia , Serviços de Planejamento Familiar/organização & administração , Serviços de Planejamento Familiar/tendências , Feminino , Humanos , Estado Civil/estatística & dados numéricos , Avaliação das Necessidades , Gravidez , Gravidez na Adolescência/prevenção & controle , Gravidez na Adolescência/psicologia , Gravidez na Adolescência/estatística & dados numéricos , Puberdade , Fatores de Risco , Comportamento de Redução do Risco , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
9.
J Pak Med Assoc ; 68(10): 1496-1501, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30317349

RESUMO

OBJECTIVE: To explore women's perceptions regarding obstetric danger signs and their practices to deal with them in their cultural context. METHODS: The exploratory qualitative study was conducted in Moorian, Jagiot and Kurri, three rural areas around Islamabad, Pakistan, from June to September, 2016. Data about understanding and practices regarding obstetric danger signs was collected from married women of reproductive age through focus group discussions. Data analysis was done manually using the content analysis approach. RESULTS: There were 85 women with a mean age 32±6.80 years who participated in a total of 12 focus group discussions in batches of 6-8 subjects each. Majority of women 64(75%) were unaware of key obstetric danger signs and symptoms. Traditional practices and several home remedies were commonly used to manage complications in pregnancy before seeking medical care, which was only done when the condition became unmanageable at home. However, mostly women 78(92%) preferred hospital for antenatal care services, especially private health facilities, due to perceived better quality of services. CONCLUSIONS: Cultural practices were found to be deep-rooted in rural population.


Assuntos
Parto Obstétrico/psicologia , Casamento , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Percepção , Educação Pré-Natal/organização & administração , Pesquisa Qualitativa , População Rural , Adulto , Feminino , Grupos Focais , Seguimentos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Paquistão , Gravidez , Complicações na Gravidez/psicologia , Estudos Retrospectivos
10.
Sex Transm Dis ; 44(6): 371-375, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28499289
11.
Rev Gaucha Enferm ; 37(spe): e20160029, 2017 Jun 05.
Artigo em Português, Inglês | MEDLINE | ID: mdl-28640332

RESUMO

OBJECTIVE: To describe changes in nurses' care following the implementation of a group of pregnant teenagers in prenatal care based on the expectations and experiences of pregnant teenagers. METHOD: Qualitative and descriptive study conducted from February to November 2013 at a Primary Care Unit in Fortaleza, Ceará, Brazil, through focus groups with 16 adolescents from the group of pregnant women in the second or third trimester of pregnancy. The analysis identified central ideas and units of meanings that formed the categories. RESULTS: The strategy of a group of pregnant teenagers, which provides a space for coexistence and the establishment of ties encourages these individuals to talk about their needs, re-signifying their ties. Educational strategies to promote self-care of pregnant teenagers and care for their babies involve the sharing of experiences, doubts and beliefs. CONCLUSION: Considerations and suggestions of the adolescents contributed to guide nurses' practice and provide a strategic space of care and support for pregnant adolescents in primary care.


Assuntos
Cuidados de Enfermagem , Enfermagem Obstétrica , Gravidez na Adolescência , Cuidado Pré-Natal/organização & administração , Educação Pré-Natal/organização & administração , Adolescente , Feminino , Grupos Focais , Necessidades e Demandas de Serviços de Saúde , Humanos , Papel do Profissional de Enfermagem , Paridade , Gravidez , Psicologia do Adolescente , Pesquisa Qualitativa , Autocuidado , Adulto Jovem
12.
Pract Midwife ; 18(2): 22-4, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26333248

RESUMO

Historically antenatal education has been seen as an important part of antenatal care and a mechanism to provide women with close to realistic interpretations of childbirth and motherhood. Through the years, the main themes and emphases of parenting education have changed, sometimes to reflect the new socio-economic structure and sometimes forced by the women themselves seeking specific information and knowledge. Yet again, this time the invasion of online information and social media is about to change the perception and the philosophy of antenatal education from an informative opportunity to a powerful and effective intervention.


Assuntos
Instrução por Computador/métodos , Mães/educação , Cuidado Pré-Natal/organização & administração , Educação Pré-Natal/organização & administração , Feminino , Humanos , Internet , Comportamento Materno , Educação de Pacientes como Assunto , Gravidez
13.
BMC Pregnancy Childbirth ; 13: 176, 2013 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-24041135

RESUMO

BACKGROUND: Neonatal death accounts for one fifth of all under-five mortality in Uganda. Suboptimal newborn care practices resulting from hypothermia, poor hygiene and delayed initiation of breastfeeding are leading predisposing factors. Evidence suggests focused educational prenatal care messages to mitigate these problems. However, there is a paucity of data on the interaction between the service provider and the prenatal service user. This study aims to understand the scope of educational information and current practices on newborn care from the perspectives of prenatal mothers and health workers. METHODS: A qualitative descriptive methodology was used. In-depth interviews were conducted with lactating mothers (n = 31) of babies younger than five months old across Masindi in western Uganda. Additional interviews with health workers (n = 17) and their employers or trainers (n = 5) were conducted to strengthen our findings. Data were audio-taped and transcribed verbatim. A thematic content analysis was performed using NVivo 8. RESULTS: Vertical programmes received more attention than education for newborn care during prenatal sessions. In addition, attitudinal and communication problems existed among health workers thereby largely ignoring the fundamental principles of patient autonomy and patient-centred care. The current newborn care practices were largely influenced by relatives' cultural beliefs rather than by information provided during prenatal sessions. There is a variation in the training curriculum for health workers deployed to offer recommended prenatal and immediate newborn care in the different tiers of health care. CONCLUSIONS: Findings revealed serious deficiencies in prenatal care organisations in Masindi. Pregnant mothers remain inadequately prepared for childbirth and newborn care, despite their initiative to follow prenatal sessions. These findings call for realignment of prenatal care by integrating education on newborn care practices into routine antenatal care services and be based on principles of patient-centred care.


Assuntos
Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/educação , Cuidado do Lactente , Mães/educação , Educação Pré-Natal , Adolescente , Adulto , Comunicação , Cultura , Currículo , Feminino , Humanos , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Gravidez , Cuidado Pré-Natal/organização & administração , Educação Pré-Natal/organização & administração , Uganda , Adulto Jovem
14.
Sex Reprod Healthc ; 22: 100456, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31494356

RESUMO

Pregnancy is an ideal time to focus on health promotion. Many women and their partners attend childbirth education classes to prepare themselves for pregnancy, birth and parenting. However, rather than promoting health, these classes have been criticized for preparing women and their partners for a medicalized birth, which has become the norm in many well-resourced countries. This paper describes the development of a childbirth education program using the theory of salutogenesis. While much has been written about the theory, few have attempted to operationalize the theory for health service delivery, particularly in the maternity care context. The aim of the program was to move individuals participating in the program towards greater health on the health-ease/dis-ease continuum by increasing their sense of coherence, focusing on generalized resistance resources and strengthening the key components comprehensibility, manageability and meaningfulness. This paper describes the development of the program.


Assuntos
Promoção da Saúde/organização & administração , Mães/educação , Parto , Educação de Pacientes como Assunto , Educação Pré-Natal/organização & administração , Senso de Coerência , Adulto , Parto Obstétrico , Feminino , Humanos , Mães/psicologia , Poder Familiar , Gravidez , Desenvolvimento de Programas
15.
Sex Reprod Healthc ; 20: 13-19, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31084812

RESUMO

OBJECTIVE: To explore how antenatal parental education is provided in southern Sweden and midwives' experiences of it. METHODS: A cross-sectional survey with data collection from 66 antenatal clinics and 189 midwives during 2016. Descriptive and comparative statistics, chi-square and t-tests, were used to present the findings. RESULTS: Antenatal parental education was most commonly offered in small parental groups and the number of hours provided varied between two and ten (mean 5.8) hours. A common and structured program for the sessions was used at 37.3% of the clinics. Normal birth, pain relief, partner role during birth, breastfeeding advantages and breastfeeding initiation were the topics most extensively covered. Topic coverage was in 12 topics, mostly related to the time after birth, lower than midwives' rated importance of the topic: p-values between 0.05 and <0.01. Only 14.2% of the midwives often provided guidance to websites. Although midwives enjoyed working with antenatal parental education, they expressed lack of organizational support and lack of personal skills in group leadership and teaching. Years of experience did not significantly affect their self-rated skills in group leadership or teaching. CONCLUSION: These results contribute to knowledge about contemporary antenatal parental education in Sweden. Our results showed that antenatal parental education is not always in accordance with parents' expectations, especially concerning early parenthood and guidance on the internet. To provide antenatal parental education tailored to the needs of expectant parents it is vital to develop evidence-based guidelines and to address midwives' needs for improved skills in group leadership and teaching.


Assuntos
Tocologia , Pais/educação , Educação Pré-Natal/métodos , Autoeficácia , Adulto , Idoso , Aleitamento Materno , Estudos Transversais , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Tocologia/métodos , Medição da Dor , Parto , Período Pós-Parto , Educação Pré-Natal/organização & administração , Educação Pré-Natal/estatística & dados numéricos , Inquéritos e Questionários , Suécia , Ensino
16.
Medicine (Baltimore) ; 97(16): e0456, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29668615

RESUMO

Italy, along with Poland and Hungary, has the highest cesarean section rate (35.7%) in Europe. Among Italian regions, Campania has the highest rate of cesarean section (58.4%).We developed a standardized antenatal class to evaluate whether women who attend this class during pregnancy have a lower cesarean section rate. This antenatal class was developed according to the indication of the Italian Ministry of Health and the World Health Organization. We selected a cohort of women who participated in this antenatal class and a cohort of women who did not participate. We collected information on the mode of delivery, and other characteristics, of these women from certificate of birth assistance form available in 2 hospitals where the women gave birth.Among women who participated in the antenatal class, there were more Italians, the women were more educated, more women were employed and there were more primiparas compared with those who did not participate. Non-participants of antenatal class showed a higher rate of cesarean section than those who participated (56.2% vs 23.1%; relative risk [RR] = 2.43; 95% confidence interval [CI] 1.95-3.03; P < .0001), as well as after adjustment for other variables. This difference was stronger in 1 hospital (RR = 2.88; 95% CI 2.13-3.89; P < .0001) than in the other hospital (RR = 1.86; 95% CI 1.36-2.55; P < .0001).Our standardized antenatal class, which was performed in an area with a high rate of cesarean section, significantly reduced this rate, and this was still significant after adjustment for potential confounders.


Assuntos
Cesárea/estatística & dados numéricos , Cuidado Pré-Natal/métodos , Educação Pré-Natal , Adulto , Estudos de Coortes , Eficiência Organizacional , Feminino , Humanos , Itália/epidemiologia , Gravidez , Gestantes , Educação Pré-Natal/organização & administração , Educação Pré-Natal/normas , Estudos Retrospectivos , Fatores Socioeconômicos , Procedimentos Desnecessários/estatística & dados numéricos
17.
Rev Calid Asist ; 32(5): 255-261, 2017.
Artigo em Espanhol | MEDLINE | ID: mdl-28866258

RESUMO

OBJECTIVE: To assess knowledge, wish for inclusion and implementation of normal childbirth care protocols at La Ribera University Hospital, the reason why they are not applied, and to assess the attendance at antepartum training activities. MATERIAL AND METHOD: Cross-sectional descriptive study. They were carried out 186 surveys by convenience sampling to pregnant women attending fetal well-being control at hospital between 2014 and 2015. They were collected data about knowledge, wish for inclusion, compliance of protocols and reasons for non-compliance, and attendance at antepartum training activities. Percentages and confidence intervals were calculated. Chi-square test was used to compare categorical variables. RESULTS: They were collected percentages of knowledge (77%, CI95%: 75,5-78,5) and wish for inclusion (84,6%, CI95%: 82,5-86,7). Protocol compliance ranged from 6% (nitrous oxide administration) to 91% (skin-to-skin contact). The main reasons for non-compliance were due to circumstances of childbirth process (56,3%, CI95%: 51,1-61,5). Attendance at maternal education classes was 62%, mainly primiparous women (p=0,0001) with medium or high education level (p=0,001). CONCLUSIONS: Pregnant women have a high knowledge and wish for inclusion of normal childbirth care protocols. Attendance at antepartum training activities could by improved and the main reason for non-attendance is lack of information. Compliance is good enough in most protocols; when they are not applied is due to childbirth circumstances. Remaining tasks include the introduction of additional protocols and to involve pregnant women in decision-making.


Assuntos
Salas de Parto/organização & administração , Parto Normal , Educação Pré-Natal/organização & administração , Adulto , Estudos Transversais , Tomada de Decisões , Escolaridade , Feminino , Hospitais Universitários/organização & administração , Humanos , Motivação , Paridade , Participação do Paciente , Satisfação do Paciente , Gravidez , Espanha , Inquéritos e Questionários
19.
Breastfeed Med ; 10(10): 451-7, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26651541

RESUMO

A central goal of the Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.


Assuntos
Aleitamento Materno , Promoção da Saúde , Educação Pré-Natal/organização & administração , Adulto , Aleitamento Materno/psicologia , Comportamento de Escolha , Protocolos Clínicos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Recém-Nascido , Guias de Prática Clínica como Assunto , Gravidez , Apoio Social
20.
Br J Gen Pract ; 65(638): e570-7, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26324493

RESUMO

BACKGROUND: It is known that couples may experience emotional distress while undergoing infertility treatment, but less is known about their experience of pregnancy following successful conception. Typically, couples are discharged from the fertility clinic to receive standard antenatal care. Recent research has raised questions about whether this care adequately meets their needs. AIM: To explore the antenatal experiences of females and males who have successfully conceived through infertility treatment. DESIGN AND SETTING: An exploratory qualitative approach was undertaken, using individual, in-depth interviews with females and males who had successfully undergone infertility treatment in one of three fertility clinics in the south of England. METHOD: Twenty participants were interviewed (12 females and eight male partners) when their pregnancy had reached 28 weeks' gestation. Participants were asked about their experiences of infertility treatment, pregnancy, and antenatal care. Interviews were audiorecorded, transcribed, and analysed thematically. RESULTS: Analysis of the interviews suggested females and males experienced a 'gap' in their care, in terms of time and intensity, when discharged from the fertility clinic to standard antenatal care. This gap, combined with their previous experience of infertility treatment, heightened their fear of pregnancy loss and increased their need for support from their health professionals. Participants' previous experience of infertility treatment also appeared to deter them from preparing for the birth and parenthood, and disclosing negative feelings to others about the pregnancy. CONCLUSION: Females and males who have successfully undergone infertility treatment may require additional support in primary care to address anxiety during pregnancy, enable disclosure of negative feelings, and to help them prepare for childbirth and parenthood.


Assuntos
Adaptação Psicológica , Infertilidade/terapia , Educação Pré-Natal , Atenção Primária à Saúde , Adulto , Continuidade da Assistência ao Paciente/organização & administração , Características da Família , Feminino , Fertilização , Humanos , Relações Interpessoais , Masculino , Saúde Mental , Avaliação das Necessidades , Gravidez , Cuidado Pré-Natal/métodos , Cuidado Pré-Natal/organização & administração , Educação Pré-Natal/métodos , Educação Pré-Natal/organização & administração , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/organização & administração , Reino Unido
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