Short interpregnancy interval: circumstance or choice?

2021 ◽  
pp. bmjsrh-2021-201269
Author(s):  
Rebecca Alexandra Margaret Taylor ◽  
Jenny M Yang ◽  
Kate Cheney ◽  
Kirsten Black
Keyword(s):  
Healthcare Providers ◽  
Birth Spacing ◽  
Postnatal Period ◽  
Antenatal Visit ◽  
Interpregnancy Interval ◽  
Life Planning ◽  
Lack Of Information ◽  
Reproductive Life ◽  
To Receive ◽  
Short Interpregnancy Interval

IntroductionDespite the knowledge of pregnancy risks attributable to inadequate birth spacing, over one-third of pregnancies occur within 18 months of a preceding birth. In this qualitative study we sought to interview women with a short interpregnancy interval (sIPI) to explore their knowledge of contraception and birth spacing and their experience of counselling on these themes.MethodsWe conducted in-depth interviews with women with a sIPI (live-birth less than 18 months prior to conception of current pregnancy) at Royal Prince Alfred Hospital and Canterbury Hospital in Sydney, Australia. Women were recruited at the second antenatal visit or day 3 postpartum. Interviews were recorded and transcribed. The six-phase thematic analysis framework described by Braun and Clarke was used to perform qualitative data analysis.ResultsTwenty women were interviewed (IPI range: 3–18 months). The three central themes that arose were that perceptions of IPIs are shaped by individual circumstances, a lack of information from healthcare providers (HCPs) on IPI and contraception limited women’s ability to make informed decisions, and that reproductive life planning is an important element of pregnancy care.ConclusionsIn this study, women with a sIPI did not feel informed about birth spacing, had poor knowledge of reliable contraceptives, and remained at risk of further closely spaced pregnancies. There was a desire among women with a sIPI to receive clear and consistent education on these topics. HCPs need to do more to educate women in the antenatal and postnatal period to help them space their pregnancies appropriately.

Clinical trials — the personal perspective of the research physician?

2020 ◽  
Vol 75 (3) ◽  
pp. 256-263
Author(s):  
Maria Y. Egorova ◽  
Irina A. Shuvalova ◽  
Olga I. Zvonareva ◽  
Igor D. Pimenov ◽  
Olga S. Kobyakova ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Medical Care ◽  
New Technologies ◽  
Healthcare Providers ◽  
Study Drug ◽  
Well Being ◽  
Personal Perspective ◽  
Public And Private ◽  
Factors Affecting ◽  
To Receive

Background. The organization of clinical trials (CTs) requires the participation and coordination of healthcare providers, patients, public and private parties. Obstacles to the participation of any of these groups pose a risk of lowering the potential for the implementation of CTs. Researchers are a key human resource in conducting of CT. Their motivation for participation can have a significant impact on the recruitment and retention of patients, on the quality of the data collected, which determines the overall outcome of the study. Aims to assess the factors affecting the inclusion of Russian physicians-researchers in CT, and to determine their role in relations with patients-participants. Materials and methods. The study was organized as a part of the Russian multicenter face-to-face study. A survey was conducted of researchers from 10 cities of Russia (20172018). The participation in the survey for doctors was anonymous and voluntary. Results. The study involved 78 respondents. Most research doctors highly value the importance of research for science (4,84 0,39), society (4,67 0,46) and slightly lower for participating patients (4,44 0,61). The expectations of medical researchers are related to improving their financial situation and attaining new experience (n = 14; 18,18%). However, the opportunity to work with new technologies of treatment and diagnosis (n = 41; 52,56%) acted as a motivating factor. According to the questionnaire, the vast majority of research doctors (n = 29; 37,18%) believe that the main reason for patients to participate in CT is to receive quality and free medical care. The most significant obstacle to the inclusion of participants in CT was the side effects of the study drug (n = 38; 48,71%). Conclusions. The potential of clinical researchers in Russia is very high. The patient-participant acts for the research doctor as the subject of the study, and not the object, so the well-being of the patient is not indifferent to the doctor. However, the features of the functioning of our health care system form the motivation of doctors-researchers (additional earnings, professional self-development) and the way they perceive the motivation of patients (CT as an opportunity to receive quality medical care).

scholarly journals Understanding the needs of carers in Vietnam and the development of online supportive resources

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Jenkins ◽  
H t Ho ◽  
O Santin
Keyword(s):  
Cancer Diagnosis ◽  
Healthcare Providers ◽  
Treatment Decision ◽  
Nutrition Support ◽  
Specific Information ◽  
Supportive Services ◽  
Middle Income ◽  
Treatment Decision Making ◽  
Lack Of Information ◽  
Online Resource

Abstract Issue Informal carers provide an important and often overlooked role in the care of people with a cancer diagnosis. Our study sought to better understand carers needs and develop an online resource to help address the needs identified. There are not currently any widespread or embedded support services for cancer carers in Vietnam. Description of the Problem We conducted in-depth interviews and focus groups with both carers (n = 20) and healthcare providers (n = 22) to understand the needs and challenges of caring for someone with a cancer diagnosis. We discussed what resources would alleviate challenges and used these discussions to inform a process of co-designing an online resource. This process was modelled off a peer-led online resource intervention developed in the United Kingdom. This process of co-design is transferable to other contexts, and when adapted could help meet the needs of cancer carers in other lower and middle income countries. Results Carers in Vietnam reported (i) economic challenges of care; (ii) not being able to access facilities and secure accommodation when caring for inpatients; (iii) lack of information about cancer and nutrition; (iv) lacking emotional support; and (v) requiring training to support both the treatment and recovery of people under their care. Suggestions for content of an online resource included the need for contextually appropriate Vietnamese content, specific information on diet and nutrition, support in making decisions around treatment, and signposting for other services. Lessons Successful co-design of resources requires input from multiple key stakeholders. This is necessary to successful adapt and modify interventions for new contexts. Our process revealed new information about the roles and needs of carers, and enabled us to incorporate solutions to these needs within our online resource. Given the lack of other supportive services for carers, the development of such resources should be considered a priority. Key messages Cancer carers in Vietnam experience specific challenges including provision of nutrition, supporting navigation of hospital administration, and taking a central role in treatment decision-making. Co-designed online resources have the potential to support carers in providing relevant and appropriate information and signposting to other important services.

scholarly journals 803 Short interpregnancy interval and placenta accreta spectrum

2021 ◽  
Vol 224 (2) ◽  
pp. S500
Author(s):  
Hannah McLaughlin ◽  
Ashley E. Benson ◽  
Morgan Scaglione ◽  
Jane Saviers-Steiger ◽  
Dana R. Canfield ◽  
...  
Keyword(s):  
Placenta Accreta ◽  
Interpregnancy Interval ◽  
Placenta Accreta Spectrum ◽  
Short Interpregnancy Interval

scholarly journals Adenovirus and RNA-based COVID-19 vaccines’ perceptions and acceptance among healthcare workers in Saudi Arabia: a national survey

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e048586
Author(s):  
Mohamad-Hani Temsah ◽  
Mazin Barry ◽  
Fadi Aljamaan ◽  
Abdullah Alhuzaimi ◽  
Ayman Al-Eyadhy ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Healthcare Workers ◽  
Online Survey ◽  
Healthcare Providers ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
Vectored Vaccine ◽  
To Receive

ObjectivesThe aim of this study was to compare the perception, confidence, hesitancy and acceptance rate of various COVID-19 vaccine types among healthcare workers (HCWs) in Saudi Arabia, a nation with Middle East respiratory syndrome coronavirus experience.DesignNational cross-sectional, pilot-validated questionnaire.SettingOnline, self-administered questionnaire among HCWs.ParticipantsA total of 2007 HCWs working in the Kingdom of Saudi Arabia participated; 1512 (75.3%) participants completed the survey and were included in the analysis.InterventionData were collected through an online survey sent to HCWs during 1–15 November 2020. The main outcome measure was HCW acceptance of COVID-19 candidate vaccines. The associated factors of vaccination acceptance were identified through a logistic regression analysis and via measurement of the level of anxiety, using the Generalised Anxiety Disorder 7 scale.ResultsAmong the 1512 HCWs who were included, 62.4% were women, 70.3% were between 21 and 40 years of age, and the majority (62.2%) were from tertiary hospitals. In addition, 59.5% reported knowing about at least one vaccine; 24.4% of the participants were sure about their willingness to receive the ChAdOx1 nCoV-19 vaccine, and 20.9% were willing to receive the RNA BNT162b2 vaccine. However, 18.3% reported that they would refuse to receive the Ad5-vectored vaccine, and 17.9% would refuse the Gam-COVID-Vac vaccine. Factors that influenced the differential readiness of HCWs included their perceptions of the vaccine’s efficiency in preventing the infection (33%), their personal preferences (29%) and the vaccine’s manufacturing country (28.6%).ConclusionsAwareness by HCWs of the several COVID-19 candidate vaccines could improve their perceptions and acceptance of vaccination. Reliable sources on vaccine efficiency could improve vaccine uptake, so healthcare authorities should use reliable information to decrease vaccine hesitancy among frontline healthcare providers.

scholarly journals PERCEPTIONS OF LONG-TERM CARE RESIDENTS AND THEIR FAMILY MEMBERS ABOUT USING THE CONVERSATION STARTER KIT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S157-S157
Author(s):  
Sharon Kaasalainen ◽  
Tamara Sussman
Keyword(s):  
Long Term Care ◽  
Family Members ◽  
Term Care ◽  
Disease Trajectory ◽  
Lack Of Information ◽  
Difficult Conversations ◽  
Advance Care ◽  
Future Work ◽  
To Receive

Abstract The need for a palliative approach in long term care (LTC) is widely recognized. However, advance care planning (ACP) is still rare. The purpose of this study was to explore the perceptions of LTC residents and their families about using an ACP tool called The Conversation Starter Kit (CSK). This study utilized a mixed methods approach. Data was collected in four LTC homes in Ontario, Canada from 31 residents and family members during an interview after they had completed the CSK. Data was analyzed using thematic analysis and descriptive statistics. All participants read all sections but only 73% completed all sections of the toolkit. Participants spent an average of 36 minutes discussing it with their family members and/or LTC staff. Participants reported: a better understanding of ACP after using the tool (80%), that the tool helped clarify the available resources and/or choices (53%), and that they felt less apprehensive about ACP after using the tool (60%). Qualitative findings revealed many strengths (e.g., usefulness, ability to start difficult conversations, content and clarification), and weaknesses of the tool (e.g., redundant information, difficulty understanding the content and lack of information regarding medically assisted dying). Family members noted that the toolkit would have been helpful to receive earlier on in their family members’ disease trajectory, perhaps before being admitted into LTC. These study findings support the CSK for residents and family members to have ACP discussions in LTC. Future work is needed to evaluate the effectiveness of the tool with a larger sample.

scholarly journals Evaluation the effectiveness of Abridged IMNCI (7-Day) Course v standard (11-Day) Course in Pakistan

2020 ◽  
Author(s):  
Shabina Ariff ◽  
Khalil Ahmed ◽  
Kamran Sadiq ◽  
Khadija Nuzhat ◽  
Shakeel Ahmed ◽  
...  
Keyword(s):  
Experimental Study ◽  
Clinical Skills ◽  
Healthcare Providers ◽  
Training Group ◽  
Training Groups ◽  
Training Course ◽  
Quasi Experimental ◽  
Standard Training ◽  
To Receive

Abstract Background: The conventional IMCI training for healthcare providers is delivered in 11 days, which can be expensive and disruptive to the normal clinical routines of the providers. An equally effective, shorter training course may address these difficulties.Methods: This was a quasi-experimental study that was conducted in two provinces (Sindh and Punjab) of Pakistan. 104 healthcare providers were conveniently selected to receive either the abridged (7-day) or the standard (11-day) training. Knowledge and clinical skills of the participants were assessed before, immediately on conclusion of, and six months after the training.Results: The improvement in mean knowledge scores of the 7-day and 11-day training groups was 31.6 (95% CI: 24.3, 38.8) and 29.4 (95% CI: 23.9, 34.9) respectively, p = 0.630 while the improvement in mean clinical skills scores of the 7-day and 11-day training groups was 23.8 (95% CI: 19.3, 28.2) and 23.0 (95% CI: 18.9, 27.0) respectively, p = 0.784. The decline in mean knowledge scores six months after the training was -12.4 (95% CI -18.5, -6.4) and -6.4 (95% CI: -10.5, -2.3) in the 7-day and 11-day groups respectively, p = 0.094. The decline in mean clinical skills scores six months after the training was -6.3 (95% CI -11.3, -1.3) in the 7-day training group and -9.1 (95% CI -11.5, -6.6) in the 11-day group, p = 0.308.Conclusion: An abridged IMNCI training is equally effective as the standard training. However, training for certain illnesses may be better delivered by the standard course.

scholarly journals Organizing Psycho-Oncological Care for Cancer Patients: The Patient’s Perspective

2021 ◽  
Vol 12 ◽  
Author(s):  
Anouk S. Schuit ◽  
Karen Holtmaat ◽  
Valesca van Zwieten ◽  
Eline J. Aukema ◽  
Lotte Gransier ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Cancer Care ◽  
Healthcare Providers ◽  
Structured Interviews ◽  
Oncological Treatment ◽  
Face To Face ◽  
Patient’S Perspective ◽  
Oncological Care ◽  
After Cancer ◽  
To Receive

BackgroundCancer patients often suffer from psychological distress during or after cancer treatment, but the use of psycho-oncological care among cancer patients is limited. One of the reasons might be that the way psycho-oncological care is organized, does not fit patients’ preferences. This study aimed to obtain detailed insight into cancer patients’ preferences regarding the organization of psycho-oncological care.Methods18 semi-structured interviews were conducted among cancer patients. Patients completed psycho-oncological treatment between 2015 and 2020 at the psychology department in a general hospital or a center specialized in psychological cancer care in the Netherlands. The interview comprised questions related to preferences regarding the institute where to receive treatment, the psychologist who provides treatment, and the type of treatment, as well as questions related to experienced barriers and facilitators to receive psycho-oncological care. Interviews were digitally recorded and transcribed verbatim. Data were analyzed individually by two coders into key issues and themes.ResultsRegarding the institute, easy accessibility and prompt availability of psychol-oncological care were considered important. Regarding the psychologist, most participants had a strong preference to be treated by a psychologist specialized in cancer or other somatic diseases. Individual face-to-face therapy was preferred above other types of treatment. Several barriers were mentioned to receive psycho-oncological treatment, among which poor accessibility to psycho-oncological care, lack of knowledge on the possibilities for psycho-oncological treatment, and stigma. Most frequently mentioned facilitators were being assertive to ask for help, having a good relationship with the healthcare professional, and the integration of psycho-oncological support within medical cancer care.ConclusionFrom the patient’s perspective, the organization of psycho-oncological care for cancer patients should focus on easy accessibility and availability, delivered by specialized psychologists, and integration in medical cancer care. Online and group therapy are acceptable, but individual face-to-face therapy is preferred. It is warranted to increase awareness on psycho-oncological care targeting both patients and healthcare providers.

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