scholarly journals Partners of female patients with rheumatoid arthritis and reproductive decision making: a Constructivist Grounded Theory study

2021 ◽  
Author(s):  
Ria Garg ◽  
Nevena Rebić ◽  
Neda Amiri ◽  
Glen Hazlewood ◽  
Corisande Baldwin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Decision Making ◽  
Grounded Theory ◽  
Romantic Relationship ◽  
Healthcare Providers ◽  
Constructivist Grounded Theory ◽  
Structured Interviews ◽  
Female Patients ◽  
Reproductive Decision ◽  
Reproductive Decision Making

Abstract Objectives Partners of patients with rheumatoid arthritis (RA) often take on supportive roles given the debilitating nature of RA. Our objective was to explore the perspectives, attitudes, and experiences of partners of female patients with RA regarding reproductive experiences and decision making. Methods We conducted a qualitative study involving semi-structured interviews with partners of female patients with RA. We defined a ‘partner’ as an individual within a romantic relationship. Constructivist grounded theory was applied to interview transcripts to identify and conceptualize themes. Results We interviewed 10 partners of female patients with RA (10 males; mean age, 35 [23–56]) of which 40% had at least one child with a female patient with RA and did not desire additional children. We identified four themes representing stages of reproductive decision making: (1) developing an understanding of RA, (2) contemplating future family decision making, (3) initiating reproductive decision making with partner, and (4) reflecting on past reproductive experiences. Participants contemplated their attitudes and perspectives towards pregnancy and employed available information to support their partner’s medication decisions. When reflecting on their reproductive experiences, participants shared the impacts of past reproductive decisions on their romantic relationship and their mental health and wellbeing. Conclusion Our study highlights the need for comprehensive supports for both female patients with RA and their partners at all stages of reproductive decision making. Healthcare providers can identify opportunities for intervention that involves female patients with RA and their partners to minimize stress and its negative impacts on the family.

scholarly journals Motherhood and decision-making among women living with HIV in developed countries: a systematic review with qualitative research synthesis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Ariadna Huertas-Zurriaga ◽  
Patrick A. Palmieri ◽  
Joan E. Edwards ◽  
Sandra K. Cesario ◽  
Sergio Alonso-Fernandez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Qualitative Research ◽  
Research Synthesis ◽  
Developed Countries ◽  
Evidence Based ◽  
Reproductive Decision ◽  
Women Living With Hiv ◽  
Reproductive Decision Making ◽  
Living With Hiv

Abstract Background Women living with HIV (WLH) lack evidence-based information about reproductive options while managing pressures from family, clinicians, and communities to give up the idea of having children. As the reproduction intentions of WLH are not well understood, stigmatizing behaviors force them to hide their disease to avoid rejection by their family, partner, and social networks. Compliance with social norms, fear of stigma, and discrimination influence their experience. Current research is individual qualitative studies lacking the synthesis perspective necessary to guide intervention development. The purpose of this study was to synthesize the evidence to explain the reproductive decision-making process for WLH in developed countries. Methods A systematic review with qualitative research synthesis was conducted through searches in 10 electronic databases (CINAHL, EMBASE, MEDLINE, Scopus, Social Science Citation Index, Web of Science, Google Scholar, Cuidatge, Cuiden Enfispo, and SciELO). Studies published in journals from 1995 to 2019 with qualitative data about reproductive decision-making among WLH in developed countries were eligible for inclusion. Developed country was operationalized by membership in the OECD for comparative conditions of social wellbeing and economic stability. The CASP and JBI checklists for qualitative research were used to assess study quality and methodological integrity. Thematic analysis and qualitative meta-summary techniques were used for the synthesis. Results Twenty studies from 12 developed countries were included in the synthesis. Findings were organized into 3 meta-themes from 15 themes and 45 subthemes, including: (1) Shattered identity, (2) Barriers, inequities, and misinformation, (3) Coping, resiliency, and support. Reproductive decision-making was perceived as a complex process influenced by facilitators and barriers. The facilitators helped WLH cope with their new situation to become more resilient, while the barriers made their situation more difficult to manage. Conclusion WLH encounter reproductive decision-making with knowledge deficits and limited social support. An integrated approach to holistic care with comprehensive multidisciplinary counseling is needed to support WLH. Clinicians could benefit from professional development to learn how to be authentically present for WLH, including engaging in conversations, demonstrating compassion, and understanding situations. Evidence-based clinical practice guidelines need to be tailored for the family planning and sexual health needs of WLH.

Reproductive decision‐making in families containing multiple individuals with epilepsy

Epilepsia ◽  
2021 ◽  
Author(s):  
Jacquelyn Nakamura ◽  
Shawn T. Sorge ◽  
Melodie R. Winawer ◽  
Jo C. Phelan ◽  
Wendy K. Chung ◽  
...  
Keyword(s):  
Decision Making ◽  
Reproductive Decision ◽  
Reproductive Decision Making

Reproductive decision-making among postpartum HIV-infected women in rural South Africa

2018 ◽  
Vol 29 (9) ◽  
pp. 908-916 ◽  
Author(s):  
Deborah L Jones ◽  
Violeta J Rodriguez ◽  
Suat Babayigit ◽  
Antonio Chahine ◽  
Stephen M Weiss ◽  
...  
Keyword(s):  
South Africa ◽  
Decision Making ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Rural South ◽  
Factors Associated ◽  
Reproductive Decision ◽  
Reproductive Decision Making ◽  
Mother To Child ◽  
Rural South Africa

Despite pregnancy spacing recommendations to optimize health outcomes among mothers and neonates, unplanned pregnancy in sub-Saharan Africa is common among women living with human immunodeficiency virus (HIV) (WLHIV). This study examined factors associated with reproductive decision-making among WLHIV to inform pregnancy-planning interventions. WLHIV in rural South Africa (n = 165) were assessed at 12 months postpartum. The relative importance of factors associated with reproductive decision-making was estimated. Women were a mean of 28 years old (SD = 5.71). Risk of mother-to-child transmission (MTCT) of HIV (Mean = 0.43; SD = 0.33) had the greatest impact on decision-making, followed by partners’ desires (M = 0.22; SD = 0.18), family preferences (M = 0.18; SD = 0.13), and community opinion (M = 0.17; SD = 0.13). MTCT was most important to women with greater HIV knowledge. However, WLHIV who had been diagnosed with HIV for a longer time placed more emphasis on partner preference and community opinion, and less importance on MTCT risk. Prevention of mother-to-child transmission (PMTCT) was less important to women experiencing intimate partner violence and those with depression. Findings highlight the need for tailored, focused interventions to support the unique circumstances of WLHIV and support the inclusion of families and/or partners in the counseling process. Results underscore the need for perinatal preconception counseling for women during routine HIV care.

Day-to-Day Decision Making by Adolescents and Young Adults with Cancer

2022 ◽  
pp. 275275302110687
Author(s):  
Kimberly A. Pyke-Grimm ◽  
Linda S. Franck ◽  
Bonnie Halpern-Felsher ◽  
Robert E. Goldsby ◽  
Roberta S. Rehm
Keyword(s):  
Decision Making ◽  
Young Adults ◽  
Participant Observation ◽  
Healthcare Providers ◽  
Adolescents And Young Adults ◽  
Structured Interviews ◽  
Self Advocacy ◽  
Daily Lives ◽  
Life Threatening Illness ◽  
The Impact

Background: Adolescents and young adults (AYAs) with cancer must negotiate the transition between childhood and adulthood while dealing with a life-threatening illness. AYA involvement in decision making varies depending on the type of decision and when decisions occur during treatment, and evidence suggests that AYAs want to be involved in decision making. Objective: To explore involvement of AYAs with cancer in day-to-day decisions affected by their cancer and treatment. Methods: This qualitative study used interpretive focused ethnography within the sociologic tradition, informed by symbolic interactionism. Semi-structured interviews and informal participant observation took place at two quaternary pediatric oncology programs. Results: Thirty-one interviews were conducted with 16 AYAs ages 15 to 20 years. Major day to day decision-making categories identified included: (1) mental mindset, (2) self-care practices, (3) self-advocacy, and (4) negotiating relationships. Participants described how they came to grips with their illness early on and decided to fight their cancer. They described decisions they made to protect their health, how they advocated for themselves and decisions they made about relationships with family and friends. Conclusions: Through day-to-day decisions, participants managed the impact of cancer and its treatment on their daily lives. Research should focus on developing and implementing interventions to empower AYAs to participate in day-to-day decisions that will affect how they manage their cancer, its treatment and ultimately their outcomes. Implications for Practice: Healthcare providers can facilitate AYA's participation in day-to-day decision making through encouraging autonomy and self-efficacy by providing support and through effective communication.

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