scholarly journals How did the introduction of mifepristone impact the availability of abortion care in Ottawa? A qualitative study with abortion patients

FACETS ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 559-570 ◽  
Author(s):  
Kathryn J. LaRoche ◽  
Isabelle N. Labeca-Gordon ◽  
Angel M. Foster
Keyword(s):  
Health Service ◽  
Qualitative Study ◽  
Pregnancy Termination ◽  
Wait Times ◽  
Service Encounters ◽  
Available N ◽  
Medication Abortion ◽  
Telephone Interviews ◽  
Abortion Care ◽  
Abortion Clinic

In 2017, mifepristone and misoprostol became available for early pregnancy termination as the combination pack Mifegymiso® in Ottawa, Ontario, Canada. We conducted 40 semi-structured telephone interviews with Ottawa residents who had abortions before mifepristone’s introduction ( n = 20) and after mifepristone–misoprostol became available ( n = 20) to explore their experiences obtaining care. We audio-recorded and transcribed all interviews and analyzed these data for content and themes using deductive and inductive techniques. Prior to the introduction of mifepristone, our participants reported obtaining abortion care at two facilities and many faced long wait times. Those who had an abortion after mifepristone became available reported obtaining care from a wider array of providers and few waited more than two weeks. However, several mifepristone–misoprostol users reported having to go through a process that involved as many as 10 health service encounters. Both groups reflected positively on their abortion experiences, but some patients who obtained mifepristone–misoprostol outside of an abortion clinic did not feel as well informed as they would have liked. The introduction of mifepristone appears to have expanded the number of service delivery points and reduced wait times for those seeking abortion care in Ottawa. Identifying ways to expand access to medication abortion information and streamline services appears warranted.

Negotiating Masculinity in a Women’s Space: Findings from a Qualitative Study of Male Partners Accompanying Women at the Time of Abortion

2018 ◽  
Vol 23 (1) ◽  
pp. 65-82
Author(s):  
Sara L. Newton ◽  
Luciana E. Hebert ◽  
Brian T. Nguyen ◽  
Melissa L. Gilliam
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Focal Point ◽  
Male Partner ◽  
Male Partners ◽  
Community Based ◽  
Female Partners ◽  
Abortion Care ◽  
Abortion Clinic ◽  
Depth Interviews

Although women are the focal point of abortion care, a woman’s male partner may accompany her to the abortion appointment. Using Connell’s “hierarchy of masculinities” framework, this study examines how male partners negotiate their identity and role in an unfamiliar setting while their female partners undergo an abortion. Twenty-seven in-depth interviews with male partners of women obtaining abortions at a community-based and a university-based abortion clinic were conducted. The interviews reflected the tension male partners felt while attempting to maintain characteristics of hegemonic masculinity (e.g., dominance, stoicism, ambition, and fatherhood) in an environment where their female partner’s needs were prioritized. Some male partners expressed distress about their inexperience with the process and procedure as well as their inability to participate or better care for their partners. Others negotiated alternative definitions of masculinity, emphasizing a duty and/or desire to provide support during his female partner’s pregnancy decision-making and abortion experience.

Understanding the Abortion Experiences of Young People to Inform Quality Care in Argentina, Bangladesh, Ethiopia, and Nigeria

2021 ◽  
pp. 0044118X2110110
Author(s):  
Laura E. Jacobson ◽  
Ana Maria Ramirez ◽  
Chiara Bercu ◽  
Anna Katz ◽  
Caitlin Gerdts ◽  
...  
Keyword(s):  
Young People ◽  
Quality Care ◽  
First Trimester ◽  
Structural Barriers ◽  
Structured Interviews ◽  
Safe Abortion ◽  
Medication Abortion ◽  
Abortion Care ◽  
The Mean ◽  
Reproductive Healthcare

Young people face social and structural barriers when accessing abortions. High-quality, sexual and reproductive healthcare is needed; however, literature on youth-informed abortion services is limited. This study assesses accounts of youth who obtained an abortion in Argentina, Bangladesh, Ethiopia, and Nigeria and provides recommendations to improve person-centered aspects of abortion quality. We analyzed 48 semi-structured interviews with clients recruited from clinics, safe abortion hotlines, and patent and proprietary medicine vendors. We coded transcripts and conducted a thematic analysis. The mean age was 21 years (range 16–24), and the majority had a first trimester, medication abortion. Prominent themes included access to information; privacy; stigma associated with age or marital status; the decision-making process; and comfort and rapport with providers. Youth-centered abortion care should anticipate the distinct needs of younger clients. Supportive providers have an important role in offering a non-judgmental service that makes young clients feel comfortable and prepared.

scholarly journals A qualitative study of home care client and caregiver experiences with a complex cardio-respiratory management model

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Connie Schumacher ◽  
Darly Dash ◽  
Fabrice Mowbray ◽  
Lindsay Klea ◽  
Andrew Costa
Keyword(s):  
Health Service ◽  
Qualitative Study ◽  
Home Care ◽  
Therapeutic Relationship ◽  
Service Use ◽  
Management Model ◽  
Health Service Use ◽  
Self Management ◽  
Home Based ◽  
Respiratory Management

Abstract Background Home care clients are typically older and have some degree of medical, physical, cognitive or social conditions that require formal or informal support to promote healthy aging in the community. Home care clients contribute a significant proportion of health service use, including emergency department visits. The DIVERT-CARE trial introduced a cardio-respiratory management model to improve client motivation, symptoms and rates of unwarranted health service use. Our objective was to explore the perceptions and experiences of individuals who participated in the DIVERT-CARE self-management support and education intervention. Methods A qualitative study was nested within a pragmatic randomized control trial and conducted following a 15-week multi-component cardio-respiratory intervention. A phenomenological descriptive design was employed using thematic analysis. Post-intervention, clients and their caregivers were invited to participate in a semi-structured telephone interview. Interview questions were designed to elicit the experience with the intervention components. Results A total of 29 interviews were completed from June 2018 to March 2020 from participants in Ontario, Newfoundland, and British Columbia. Three themes were identified; self-care trajectory and burden of responsibility, learning and behaviour change, and feeling connected pre-emptively to care providers, the information and medical advice, and connection through the therapeutic relationship. Conclusions Home care clients experience unique challenges in managing cardio-respiratory related chronic disease. Home-based interventions fostered a therapeutic relationship of connectedness while equipping clients with necessary knowledge and skills. These results inform recommendations for community nursing, and home-based self-management supports for older community-residing individuals.

Women's Pathways to Abortion Care in South Carolina: A Qualitative Study of Obstacles and Supports

2016 ◽  
Vol 48 (4) ◽  
pp. 199-207 ◽  
Author(s):  
Judy Margo ◽  
Lois McCloskey ◽  
Gouri Gupte ◽  
Melanie Zurek ◽  
Seema Bhakta ◽  
...  
Keyword(s):  
South Carolina ◽  
Qualitative Study ◽  
Abortion Care

scholarly journals Long COVID and the role of physical activity: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e047632
Author(s):  
Helen Humphreys ◽  
Laura Kilby ◽  
Nik Kudiersky ◽  
Robert Copeland
Keyword(s):  
Physical Activity ◽  
Qualitative Study ◽  
Lived Experience ◽  
Well Being ◽  
Telephone Interviews ◽  
Semistructured Interviews ◽  
The Usa ◽  
The Uk ◽  
Insight Into

ObjectivesTo explore the lived experience of long COVID with particular focus on the role of physical activity.DesignQualitative study using semistructured interviews.Participants18 people living with long COVID (9 men, 9 women; aged between 18–74 years; 10 white British, 3 white Other, 3 Asian, 1 black, 1 mixed ethnicity) recruited via a UK-based research interest database for people with long COVID.SettingTelephone interviews with 17 participants living in the UK and 1 participant living in the USA.ResultsFour themes were generated. Theme 1 describes how participants struggled with drastically reduced physical function, compounded by the cognitive and psychological effects of long COVID. Theme 2 highlights challenges associated with finding and interpreting advice about physical activity that was appropriately tailored. Theme 3 describes individual approaches to managing symptoms including fatigue and ‘brain fog’ while trying to resume and maintain activities of daily living and other forms of exercise. Theme 4 illustrates the battle with self-concept to accept reduced function (even temporarily) and the fear of permanent reduction in physical and cognitive ability.ConclusionsThis study provides insight into the challenges of managing physical activity alongside the extended symptoms associated with long COVID. Findings highlight the need for greater clarity and tailoring of physical activity-related advice for people with long COVID and improved support to resume activities important to individual well-being.

scholarly journals Using Supermarket Loyalty Card Data to Provide Personalised Advice to Help Reduce Saturated Fat Intake among Patients with Hypercholesterolemia: A Qualitative Study of Participants’ Experiences

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1146
Author(s):  
Charlotte L. Lee ◽  
Paul N. Aveyard ◽  
Susan A. Jebb ◽  
Carmen Piernas
Keyword(s):  
Qualitative Study ◽  
Saturated Fat ◽  
Behavioural Intervention ◽  
Telephone Interviews ◽  
Food Purchases ◽  
Acceptable Method ◽  
The One ◽  
High Level ◽  
Brief Advice ◽  
Loyalty Card

Background: The ‘Primary Care SHOPping Intervention for Cardiovascular Disease Prevention’ (PCSHOP) trial tested the effectiveness and feasibility of a behavioural intervention to reduce saturated fat in food purchases. The intervention offered feedback from data collected through a supermarket loyalty card to supplement brief advice from a nurse. This qualitative study aimed to describe participants’ experiences of receiving this intervention. Methods: We conducted semi-structured, one-to-one, telephone interviews with participants from the PCSHOP trial. Interviews were audio-recorded and transcribed verbatim. We employed the one sheet of paper technique and a thematic analysis to develop high-level themes in NVivo software. Results: Twenty-four participants were interviewed (mean age: 63 years (SD 12)). They reported that the brief advice did not provide any new information but they welcomed the sense of accountability the nurse provided. The personalised shopping feedback and healthier swap suggestions provided novel information that challenged previously held beliefs about the saturated fat content of food purchases and encouraged some positive dietary changes. However, the taste preferences of the participant or other household members were a barrier to changing food shopping behaviours. Conclusion: Harnessing loyalty card data is a novel and acceptable method to offering personalised dietary feedback. Yet, issues on the suitability of the healthier swap suggestions limited the extent of dietary change. Trial registration: ISRCTN14279335. Registered 1 September 2017.

Selecting an Abortion Clinic: The Role of Social Myths and Risk Perception in Seeking Abortion Care

2021 ◽  
pp. 002214652110444
Author(s):  
Orlaith Heymann ◽  
Tamika Odum ◽  
Alison H. Norris ◽  
Danielle Bessett
Keyword(s):  
Health Care ◽  
Risk Perception ◽  
Health Care Facilities ◽  
Previous Experience ◽  
Care Seeking ◽  
Abortion Care ◽  
Care Facilities ◽  
Abortion Clinic

Recent shifts in the abortion provision landscape have generated increased concern about how people find abortion care as regulations make abortion less accessible and clinics close. Few studies examine the reasons that people select particular facilities in such constrained contexts. Drawing from interviews with 41 Ohio residents, we find that people’s clinic selections are influenced by the risks they associate with abortion care. Participants’ strategies for selecting an abortion clinic included: drawing on previous experience with clinics, consulting others online, discerning reputation through name recognition and clinic type, and considering location, especially perceptions about place (privacy, legality, safety). We argue that social myths inform the risks people anticipate when seeking health care facilities, shaping care seeking in ways that are both abortion-specific and more general. These findings can also inform research in other health care contexts where patients increasingly find their options constrained by rising costs, consolidation, and facility closure.

scholarly journals Identifying National Availability of Abortion Care and Distance From Major US Cities: Systematic Online Search (Preprint)

2017 ◽  
Author(s):  
Alice F Cartwright ◽  
Mihiri Karunaratne ◽  
Jill Barr-Walker ◽  
Nicole E Johns ◽  
Ushma D Upadhyay
Keyword(s):  
United States ◽  
The United States ◽  
Online Information ◽  
Medical Procedure ◽  
Online Search ◽  
Facility Locations ◽  
Medication Abortion ◽  
Abortion Care ◽  
Online Searches ◽  
Us Cities

BACKGROUND Abortion is a common medical procedure, yet its availability has become more limited across the United States over the past decade. Women who do not know where to go for abortion care may use the internet to find abortion facility information, and there appears to be more online searches for abortion in states with more restrictive abortion laws. While previous studies have examined the distances women must travel to reach an abortion provider, to our knowledge no studies have used a systematic online search to document the geographic locations and services of abortion facilities. OBJECTIVE The objective of our study was to describe abortion facilities and services available in the United States from the perspective of a potential patient searching online and to identify US cities where people must travel the farthest to obtain abortion care. METHODS In early 2017, we conducted a systematic online search for abortion facilities in every state and the largest cities in each state. We recorded facility locations, types of abortion services available, and facility gestational limits. We then summarized the frequencies by region and state. If the online information was incomplete or unclear, we called the facility using a mystery shopper method, which simulates the perspective of patients calling for services. We also calculated distance to the closest abortion facility from all US cities with populations of 50,000 or more. RESULTS We identified 780 facilities through our online search, with the fewest in the Midwest and South. Over 30% (236/780, 30.3%) of all facilities advertised the provision of medication abortion services only; this proportion was close to 40% in the Northeast (89/233, 38.2%) and West (104/262, 39.7%). The lowest gestational limit at which services were provided was 12 weeks in Wyoming; the highest was 28 weeks in New Mexico. People in 27 US cities must travel over 100 miles (160 km) to reach an abortion facility; the state with the largest number of such cities is Texas (n=10). CONCLUSIONS Online searches can provide detailed information about the location of abortion facilities and the types of services they provide. However, these facilities are not evenly distributed geographically, and many large US cities do not have an abortion facility. Long distances can push women to seek abortion in later gestations when care is even more limited.

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