scholarly journals How communication can help women who experience a maternal near-miss: a qualitative study from Tanzania

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e045514
Author(s):  
Hilda Alinda Kwezi ◽  
Lilian T Mselle ◽  
Sebalda Leshabari ◽  
Claudia Hanson ◽  
Andrea Barnabas Pembe

ObjectivesThis study aimed to explore experiences of communication as an element of quality of care, among women surviving a maternal near-miss event, thus women who nearly died but survived haemorrhage, or pre-eclampsia complication during pregnancy, childbirth or within 42 days of termination of pregnancy.DesignA descriptive, phenomenological, qualitative study using semistructured interviews with women who survived a maternal near-miss in Southern Tanzania.SettingThe participants were recruited from two selected hospitals in Mtwara Region, where women sought child birth care and developed near-miss condition.ParticipantsParticipants for this study were women who experienced and survived a maternal near-miss event and who had lived in the study area for at least 1 year. Women were recruited using an adapted version of the WHO criteria for maternal near-miss.Data collectionWe identified 16 women and were able to conduct 10 in-depth interviews with women at their homes, 4 weeks after they were discharged. The interviews were audiorecorded and transcribed and translated word for word from Kiswahili. Thematic analysis was used to identify emerging themes.ResultsThree major themes evolved: (1) Being informed about the care and interaction, (2) Being engaged and encouraged and (3) Being afraid to ask questions. The study highlighted that good communication with women during the provision of care helped women feel grateful, supported and cared for. Women who were unconscious during care were often not informed later of what happened. This created some negative feelings and anxiety.ConclusionThis study highlights the importance of communication, and of being informed of what happened and why. Empathetic communication with sufficient explanation on what happened and why created trust among women—a positive finding which should encourage the development of consistent approaches to strengthen healthcare provider communication skills.

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046537
Author(s):  
Sheera Sutherland ◽  
Kirsty E Durley ◽  
Kirsty Gillies ◽  
Margaret Glogowska ◽  
Daniel S Lasserson ◽  
...  

ObjectiveTo explore the impact of the death of a patient in the haemodialysis unit on fellow patients.MethodsWe interviewed patients on dialysis in a tertiary dialysis centre using semistructured interviews. We purposively sampled patients who had experienced the death of a fellow patient. After interviews were transcribed, they were thematically analysed by independent members of the research team using inductive analysis. Input from the team during analysis ensured the rigour and quality of the findings.Results10 participants completed the interviews (6 females and 4 males with an age range of 42–88 years). The four core themes that emerged from the interviews included: (1) patients’ relationship to haemodialysis, (2) how patients define the haemodialysis community, (3) patients’ views on death and bereavement and (4) patients’ expectations around death in the dialysis community. Patients noticed avoidance behaviour by staff in relation to discussing death in the unit and would prefer a culture of open acknowledgement.ConclusionStaff acknowledgement of death is of central importance to patients on haemodialysis who feel that the staff are part of their community. This should guide the development of appropriate bereavement support services and a framework that promotes the provision of guidance for staff and patients in this unique clinical setting. However, the authors acknowledge the homogenous sample recruited in a single setting may limit the transferability of the study. Further work is needed to understand diverse patient and nurse experiences and perceptions when sharing the knowledge of a patient’s death and how they react to loss.


Author(s):  
Ida Erika Wieborg Von Rosen ◽  
Rayan Mohamud Shiekh ◽  
Bariki Mchome ◽  
Chunsen Wu ◽  
Khalid S. Khan ◽  
...  

2017 ◽  
pp. 27-30
Author(s):  
Yu.V. Dondyuk ◽  

Maternal near miss and maternal death audit has become an esssential process in the context of obstetric care in both developed and developing countries. The objective: of the present study was to assess the quality of medical services provided within the multilevel regionalized Perinatal Health System in the Republic of Moldova, by identifying the inconsistencies with existing standards of medical care, in cases of severe obstetric complications and maternal deaths. Materials and methods. All cases of maternal near miss cases and maternal deaths recorded in the Secondary and Tertiary Perinatal Centers of the Republic of Moldova during the period 2009–2014 were analyzed retrospectively. To assess the quality of obstetric care, the following indices have been calculated: maternal near miss/ maternal deaths ratio; the mortality index for each obstetric condition/ complication. Results. During a period of 6 years, in 11 Secondary and Tertiary Perinatal Centers of the Republic of Moldova there were registered 154 651 births, 2881 cases of maternal near miss and 21 maternal deaths. The General Mortality index was 0.72%, and the Mortality Index by direct obstetric morbidity was 0.48%. 92.86% of maternal deaths through direct obstetric causes were avoidable, and the proportion of near miss cases with substandard care was 81.85%. The most frequent gaps (82.48%) were caused by human factors, such as insufficient team work, communication deficiency, lack of knowledge and clinical skills necessary to properly recognize and treat critical obstetric patients, delay and errors in diagnosis and treatment, non-compliance with clinical protocols. Conclusions. The excessively high proportion of avoidable factors highlighted in the study is alarming and implies the need for more extensive activities and the development of strategies focused on ensuring the presence of qualified medical workers in medical institutions, which will allow the provision of qualitative care and safety for patients in the Republic of Moldova, reducing maternal morbidity and mortality. Key words: severe maternal morbidity, maternal near miss, maternal death, maternal mortality.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Christiane Horwood ◽  
Lyn Haskins ◽  
Silondile Luthuli ◽  
Neil McKerrow

Abstract Background There is a high global burden of neonatal mortality, with many newborn babies dying of preventable and treatable conditions, particularly in low and middle-income countries. Improving quality of newborn care could save the lives of many thousands of babies. Quality of care (QoC) is a complex and multifaceted construct that is difficult to measure, but patients’ experiences of care are an important component in any measurement of QoC. We report the findings of a qualitative study exploring observations and experiences of health workers (HWs) and mothers of babies in neonatal units in South Africa. Methods A qualitative case study approach was adopted to explore care of newborn babies admitted to neonatal units in district hospitals. Observation data were collected by a registered nurse during working hours over a continuous five-day period. Doctors and nurses working in the neonatal unit and mothers of babies admitted during the observation period were interviewed using a semi-structured interview guide. All interviews were audio recorded. Observation data were transcribed from hand written notes. Audiotapes of interviews were transcribed verbatim and, where necessary, translated into English. A thematic content analysis was used to analyse the data. Results Observations and interviews were conducted in seven participating hospitals between November 2015 and May 2016. Our findings highlight the importance of information sharing between HWs and mothers of babies, contrasting the positive communication reported by many mothers which led to them feeling empowered and participating actively in the care of their babies, with incidents of poor communication. Poor communication, rudeness and disrespectful behaviour of HWs was frequently described by mothers, and led to mothers feeling anxious, unwilling to ask questions and excluded from their baby’s care. In some cases poor communication and misunderstandings led to serious mismanagement of babies with HWs delaying or withholding care, or to mothers putting their babies at risk by not following instructions. Conclusion Good communication between mothers and HWs is critical for building mothers’ confidence, promoting bonding and participation of mothers in the care of their baby and may have long term benefits for the health and well-being of the mother and her baby.


2020 ◽  
Vol 5 (15) ◽  
pp. 395-401
Author(s):  
Wahyuni Zahrah

In Medan, Indonesia, shop houses are famous buildings, though they have spatial and thermal comfort limitations. This investigation aims to find out the essence of shop house women residents' quality of life. This research is a qualitative study with a phenomenological approach. The collection of data used in-depth interviews with seven women dwellers. The research indicates that the quality of life in women's view is not determined by mere material abundance, but rather by feeling sufficient and gratitude. This research can contribute to enriching the quality of life and built environment studies of urban mixed-use living.   Keywords: shop house; quality of life; women; mixed-use living eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v5i15.2495.


2019 ◽  
Vol 9 (4) ◽  
pp. 255-262
Author(s):  
Sedigheh Abdollahpour ◽  
Hamid Heidarian Miri ◽  
Talat Khadivzadeh

Background: Improving the maternal health is one of the world’s most challenging problems. Despite significant movements over the past decades, maternal health has been still considered as a central goal for sustainable development. Maternal near miss (MNM) cases experience long-term physical and psychological effects. To present a clear portrait of the current situation, we performed a systematic review and meta-analysis with the purpose to assess the worldwide prevalence of MNM. Methods: We conducted a systematic review on PubMed, Scopus and Web of Science electronic databases to find published papers in English, before March 2019 and regardless of the type of study. We, then, assessed the prevalence of MNM according to the World Health Organization(WHO) criteria. Finally, 49 papers were included in the study. Random effects meta-analysis was used to pool the available prevalence. The quality of studies was also evaluated. Results: The weighted pooled worldwide prevalence of MNM, was 18.67/1000 (95% CI: 16.28-21.06). Heterogeneity was explored using subgroup analyses based on the continent and the country. We used meta-regression of MNM on MD which resulted in adjusted R-squared as78.88%. Conclusion: The prevalence of MNM was considerable. Low- and middle-income countries should develop systematic approaches to improve quality of care in the facilities and to reducethe risk of MNM events, with the hope to women’s health.


2016 ◽  
Vol 20 (4) ◽  
pp. 44-50 ◽  
Author(s):  
Meriam El Ghardallou ◽  
Thouraya Nabli Ajmi ◽  
Afef Mkhazni ◽  
Chekib Zedini ◽  
Sawssen Meddeb ◽  
...  

2020 ◽  
Author(s):  
Aloysius Chow ◽  
Sok Huang Teo ◽  
Jing Wen Kong ◽  
Simon Biing Ming Lee ◽  
Yee Kiat Heng ◽  
...  

BACKGROUND Teledermatology is a cost-effective treatment modality for the management of skin disorders. Most evaluations use quantitative data and far less is understood about the patients’ experience. OBJECTIVE This qualitative study explores patients’ perceptions of a teledermatology service linking public primary care clinics to the national specialist dermatology clinic in Singapore. A better understanding of patients’ experiences can help refine and develop the care provided. METHODS Semi-structured in-depth interviews were conducted with patients who had been referred to the teledermatology service. Interviews were digitally recorded and transcribed before undergoing thematic content analysis. RESULTS Twenty-one patients aged between 22 and 72 years were recruited. Three themes were identified from the data of patients’ experiences: positive perceptions of teledermatology, concerns about teledermatology, and ideas for improving the teledermatology service. Patients found the teledermatology service convenient, saving them time, expense and liberating them from the stresses incurred when making an in-person visit to a specialist facility. They valued the confidence and reassurance they gained from having a dermatologist involved in their management plan. Their concerns included data security and the quality of the images shared. Nonetheless, they were keen to see the service expanded beyond the polyclinics. Their experiences and perceptions will inform future service refinement and development. CONCLUSIONS This narrative exploration of users’ experiences of teledermatology produced rich data enabling a better understanding of the patient’s journey, the way they understand and interpret their experiences, and ideas for service refinement. Telemedicine reduces travelling and enables safe distancing, factors that are much needed during pandemics.


2020 ◽  
Vol 9 (3) ◽  
pp. 487-502 ◽  
Author(s):  
Judit Takács

This study examines what can enable or constrain Hungarian fathers to be actively involved in care through analysing interviews by applying Hanlon’s approach to caring masculinities as valued identities for men and Dermott’s concept of intimate fathering. The empirical base of this qualitative study ‐ the first of its kind in Hungary ‐ is a collection of 55 semi-structured in-depth interviews. Several interrelated factors were shown as potentially enabling or constraining men’s active engagement in their paternal role, including work- and work‐life balance-related factors, practical cost-benefit calculations, quality of life concerns, childhood socialisation patterns and attitudes towards the gendered parenting models of one’s own parents.


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