Critical ethnography in maternity care research: bridging creativity and rigour – a discussion paper.

Midwifery ◽  
2021 ◽  
pp. 103014
Author(s):  
Elizabeth Newnham ◽  
Kirsten Small ◽  
Jyai Allen
Author(s):  
Barbara Korth

This paper uses the findings of a critical ethnography studying the interactions of adult colleagues (Korth, 1998) to propose a critical approach to care theory and research. The argument proceeds from Jaggar's (1995) critique of the scholarship on care. Her criticism voices concerns regarding the lack of attention to the justificatory potential of care research/theory and the over-dependence on particularities. This paper provides one set of responses capable of addressing these concerns and of reformulating the concerns into a more complex conceptualization of care. The resulting analysis implies a theory of care as a pragmatic-communicative construct, one that is more precise, but compatible with the interpersonal rationality to which Noddings (1991) attributes caring. Care emerges as a communicative act with a complex but definitive horizon structure. Care did not reconstruct from on-going interactions as a simple intention, nor a feeling, nor anything extra-rational or non-rational. This approach to understanding caring locates Jaggars concerns within the interpretive life of interactants. The papers specific contributions include exemplifying a refined analysis of care-in-action, articulating a meta-theory useful for the theory and study of care, introducing a typology of caring acts, demonstrating the critical potential of care research, and illustrating the connection between critique and justification.


2015 ◽  
Vol 28 ◽  
pp. S33
Author(s):  
Holly Powell Kennedy ◽  
Alison Teate

Author(s):  
Marina Alice Sylvia Daniele

Male partners/fathers are key support persons for many childbearing women and their involvement in pregnancy, childbirth and the postpartum/postnatal period has beneficial effects on a wide range of outcomes related to maternal and child health and family wellbeing. Social support is implicated in the relevant causal pathway, but has received largely tangential attention in the public health literature. This discussion paper aims to reframe men's participation in maternity care as an opportunity to enhance their readiness and ability to provide social support to women, contributing to the debate on the definition and rationale for male partner involvement, and paving the way for further empirical work. I begin by presenting a theory of change illustrating the causal pathway leading from male partner participation, through the key intermediate step of social support, to improved health and wellbeing for women and children. I proceed by arguing that many people desire male partner participation in maternity care; however, in practice, this is often limited owing to cultural, social and institutional barriers. I use examples from the intervention literature to demonstrate how participation in care can boost men's motivation to support women and enhance their ability to do so by increasing their knowledge and skills. Finally, I draw up general implications for further male partner involvement programmes, suggesting that in order to achieve meaningful and sustainable gains, attention to design is crucial in order to avoid reinforcing patriarchal gender norms. Programmes should be implemented alongside other efforts to improve quality and promote woman-centred care. This article is part of the theme issue ‘Multidisciplinary perspectives on social support and maternal–child health’.


Author(s):  
Angel L. Ball ◽  
Adina S. Gray

Pharmacological intervention for depressive symptoms in institutionalized elderly is higher than the population average. Among the patients on such medications are those with a puzzling mix of symptoms, diagnosed as “dementia syndrome of depression,” formerly termed “pseudodementia”. Cognitive-communicative changes, potentially due to medications, complicate the diagnosis even further. This discussion paper reviews the history of the terminology of “pseudodementia,” and examines the pharmacology given as treatment for depressive symptoms in the elderly population that can affect cognition and communication. Clinicians can reduce the risk of misdiagnosis or inappropriate treatment by having an awareness of potential side effects, including decreased attention, memory, and reasoning capacities, particularly due to some anticholinergic medications. A team approach to care should include a cohesive effort directed at caution against over-medication, informed management of polypharmacology, enhancement of environmental/communication supports and quality of life, and recognizing the typical nature of some depressive signs in elderly institutionalized individuals.


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