scholarly journals How do women with social risk factors experience United Kingdom maternity care? A realist synthesis

Birth ◽  
2019 ◽  
Vol 46 (3) ◽  
pp. 461-474 ◽  
Author(s):  
Hannah Rayment‐Jones ◽  
James Harris ◽  
Angela Harden ◽  
Zahra Khan ◽  
Jane Sandall
Keyword(s):  
Risk Factors ◽  
United Kingdom ◽  
Maternity Care ◽  
Realist Synthesis ◽  
Social Risk ◽  
Social Risk Factors

scholarly journals Project20: interpreter services for pregnant women with social risk factors in England: what works, for whom, in what circumstances, and how?

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Hannah Rayment-Jones ◽  
James Harris ◽  
Angela Harden ◽  
Sergio A. Silverio ◽  
Cristina Fernandez Turienzo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Maternity Care ◽  
Language Barriers ◽  
Social Risk ◽  
Social Risk Factors ◽  
Framework Analysis ◽  
High Quality ◽  
Maternity Services ◽  
Interpreter Services

Abstract Background Black and minority ethnic women and those with social risk factors such as deprivation, refugee and asylum seeker status, homelessness, mental health issues and domestic violence are at a disproportionate risk of poor birth outcomes. Language barriers further exacerbate this risk, with women struggling to access, engage with maternity services and communicate concerns to healthcare professionals. To address the language barrier, many UK maternity services offer telephone interpreter services. This study explores whether or not women with social risk factors find these interpreter services acceptable, accessible and safe, and to suggest solutions to address challenges. Methods Realist methodology was used to refine previously constructed programme theories about how women with language barriers access and experience interpreter services during their maternity care. Twenty-one longitudinal interviews were undertaken during pregnancy and the postnatal period with eight non-English speaking women and their family members. Interviews were analysed using thematic framework analysis to confirm, refute or refine the programme theories and identify specific contexts, mechanisms and outcomes relating to interpreter services. Results Women with language barriers described difficulties accessing maternity services, a lack of choice of interpreter, suspicion around the level of confidentiality interpreter services provide, and questioned how well professional interpreters were able to interpret what they were trying to relay to the healthcare professional during appointments. This resulted in many women preferring to use a known and trusted family member or friend to interpret for them where possible. Their insights provide detailed insight into how poor-quality interpreter services impact on their ability to disclose risk factors and communicate concerns effectively with their healthcare providers. A refined programme theory puts forward mechanisms to improve their experiences and safety such as regulated, high-quality interpreter services throughout their maternity care, in which women have choice, trust and confidence. Conclusions The findings of this study contribute to concerns highlighted in previous literature around interpreter services in the wider healthcare arena, particularly around the lack of regulation and access to high-quality interpretation. This is thought to have a significant effect on pregnant women who are living socially complex lives as they are not able to communicate their concerns and access support. This not only impacts on their safety and pregnancy outcomes, but also their wider holistic needs. The refined program theory developed in this study offers insights into the mechanisms of equitable access to appropriate interpreter services for pregnant women with language barriers.

An Approach to Selecting Single or Multiple Social Risk Factors for Clinic-Based Screening

2021 ◽  
Author(s):  
John F. Steiner ◽  
Glenn K. Goodrich ◽  
Kelly R. Moore ◽  
Spero M. Manson ◽  
Laura M. Gottlieb ◽  
...  
Keyword(s):  
Risk Factors ◽  
Social Risk ◽  
Social Risk Factors

СОСТОЯНИЕ ПРОБЛЕМЫ НАРКОЛОГИЧЕСКИХ РАССТРОЙСТВ В КУРСКОЙ ОБЛАСТИ И СОПРЕДЕЛЬНЫХ ТЕРРИТОРИЯХ В 2014-2019 ГОДАХ

Innova ◽  
2021 ◽  
Vol 22 (1) ◽  
pp. 33-38
Author(s):  
Владимир Игоревич Тимошилов ◽  
◽  
Альберт Генрихович Ластовецкий
Keyword(s):  
Risk Factors ◽  
Drug Addiction ◽  
Epidemiological Data ◽  
Drug Prevention ◽  
Social Risk ◽  
Social Risk Factors ◽  
Social Instability ◽  
Lower Incidence Rate ◽  
Kursk Region ◽  
Active Substances

Period 2014-2019 characterized by a certain increase in social instability in Russia, which led to an increase of social risk factors for drug addiction. In the Kursk region, at the same time, there have been changes in the regulation of anti-drug prevention, a large number of specialists have been trained, and a movement of competent volunteers has developed. In this regard, the epidemiological data for 2014-2019 are of particular interest. For the period from 2005 to 2019 the primary incidence of alcohol use disorders in Russia decreased from 147.4 to 48.3, in the Kursk region – from 106 to 53.5 cases per 100 000 population per year. Of the adjacent regions in 2019, a lower incidence rate than in the Kursk region was noted only in the Belgorod region – 39.4 cases per 100,000 population. Primary incidence of disorders associated with the use of narcotic active substances, during 2014-2019 in Russia as a whole decreased from 15 to 9.8, in the Kursk region – from 11.3 to 4 new cases per 100 000 inhabitants per year. In 2019, the detection rate of primary incidence of drug addiction and substance abuse was significantly higher than in the Kursk region in Bryansk and Lipetsk. Despite favorable trends, it was noted that the coronavirus pandemic and the restrictions introduced to combat it can have a significant impact on the risk factors for drug addiction, which requires the adaptation of preventive programs to new conditions.

scholarly journals DEVELOPMENT OF A STANDARDIZED APPROACH FOR THE ASSESSMENT OF BOWEL AND BLADDER DYSFUNCTION IN COMMUNITY PAEDIATRICS

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e6-e7
Author(s):  
Rebecca Wang ◽  
Ronik Kanani ◽  
Niraj Mistry ◽  
Yara El Bardisi ◽  
Joana Dos Santos
Keyword(s):  
Risk Factors ◽  
Bladder Dysfunction ◽  
Neuropsychiatric Symptoms ◽  
Iterative Refinement ◽  
Social Risk ◽  
Red Flags ◽  
Social Risk Factors ◽  
Voiding Symptoms ◽  
Bowel And Bladder Dysfunction ◽  
Psychosocial History

Abstract BACKGROUND Bowel and bladder dysfunction (BBD) is a common yet underdiagnosed paediatric condition that describes a constellation of lower urinary tract symptoms (LUTS) associated with constipation and/or encopresis. Many children with BBD have co-morbid neuropsychiatric symptoms (e.g., inattention, anxiety) and psychosocial stressors. Thus, clinical assessment of behavioural symptoms and social risk factors in this population is essential. However, there is no standardized approach for a comprehensive assessment of BBD. OBJECTIVES We aim to develop and evaluate physician and parent perceptions with 1) a standardized BBD history and physical intake form for physicians, and 2) a parent-reported intake form. DESIGN/METHODS From June to Oct 2017, a quality improvement study was conducted in the BBD network, an existing paediatric collaborative initiative consisting of 7 community sites with support of the paediatric urology division in a tertiary hospital. Based on literature review and expert opinions, a standardized intake form was developed for BBD assessment with targeted questions for LUTS, constipation, behavioural, dietary, and psychosocial history, along with a physical exam checklist for neurological red flags. Further, a shorter parent-reported intake questionnaire was developed to clarify patterns of dysfunctional voiding symptoms, dietary recall and stool history. Both forms underwent usability testing and iterative refinement. Prior to clinic, families of children referred for BBD were mailed an intake package for completion. During the clinic, physicians were asked to use the standardized intake form for new referrals. Afterwards, both physicians and parents were given anonymous surveys to evaluate their perceptions of the intake process. RESULTS A total of 8 physicians and 20 parents responded, with 60% of patients being between ages 4–10 and 55% male. Physicians found the standardized intake form to be a useful guide that reminded them to ask about specific urinary symptoms (88% of the time), constipation (75%), and psychosocial history (76%). The majority of physicians (75%) agreed they would use the intake form again and recommended its implementation. Further, parents responded positively by agreeing that the intake package was easy to complete (65%), felt included in care decisions (95%), and had questions answered appropriately (100%). CONCLUSION In assessment of BBD, a standardized intake form can help guide physicians to efficiently gather a comprehensive history, rule out red flags, and screen for psychosocial risk factors. With refinements, it can potentially help create a common clinical experience and empower more community paediatricians to manage BBD in the future.

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