A qualitative study on midwives’ identity and perspectives on the occurrence of disrespect and abuse in Maputo city

Abstract Background Midwifery care plays a vital role in the reduction of preventable maternal and newborn mortality and morbidity. There is a growing concern about the quality of care during facility based childbirth and the occurrence of disrespect and abuse (D&A) worldwide. While several studies have reported a high prevalence of D&A, evidence about the drivers of D&A is scarce. This study aims to explore midwives’ professional identity and perspectives on the occurrence of D&A in urban Mozambique. Methods A qualitative study took place in the central hospital of Maputo, Mozambique. Nine focus group discussions with midwives were conducted, interviewing 54 midwives. RQDA software was used for analysing the data by open coding and thematic analysis from a grounded theory perspective. Results Midwives felt proud of their profession but felt they were disrespected by the institution and wider society because of their inferior status compared to doctors. Furthermore, they felt blamed for poor health outcomes. The occurrence of D&A seemed more likely in emergency situations but midwives tended to blame this on women being “uncooperative”. The involvement of birth companions was a protective factor against D&A together with supervision. Conclusion In order to improve quality of care and reduce the occurrence of D&A midwives will need to be treated with more respect within the health system. Furthermore, they should be trained in handling obstetric emergency situations with respect and dignity for the patient. Systematic and constructive supervision might be another promising strategy for preventing D&A.

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Midwives’ identity and perspectives on the occurrence of disrespect and abuse in Maputo city: a qualitative study

10.21203/rs.3.rs-58904/v2 ◽

2020 ◽

Author(s):

Anna Galle ◽

Helma Manaharlal ◽

Sally Griffin ◽

Nafissa Osman ◽

Kristien Roelens ◽

...

Keyword(s):

Quality Of Care ◽

Qualitative Study ◽

Protective Factor ◽

Vital Role ◽

Disrespect And Abuse ◽

Mortality And Morbidity ◽

Emergency Situations ◽

Maputo City ◽

Inferior Status

Abstract BACKGROUND: Midwifery care plays a vital role in the reduction of preventable maternal and newborn mortality and morbidity. There is a growing concern about the quality of care during facility based childbirth and the occurrence of disrespect and abuse (D&A) worldwide. While several studies have reported a high prevalence of D&A, evidence about the drivers of D&A is scarce. AIM: This study aims to explore midwives’ professional identity and perspectives on the occurrence of D&A in urban Mozambique. METHODS: A qualitative study took place in the central hospital of Maputo, Mozambique. Nine focus group discussions with midwives were conducted, interviewing 54 midwives. RQDA software was used for analysing the data by open coding and thematic analysis from a grounded theory perspective. RESULTS: Midwives felt proud of their profession but felt they were disrespected by the institution and wider society because of their inferior status compared to doctors. Furthermore, they felt blamed for poor health outcomes. The occurrence of D&A seemed more likely in emergency situations but midwives tended to blame this on women being “uncooperative”. The involvement of birth companions was a protective factor against D&A together with supervision. CONCLUSION: In order to improve quality of care and reduce the occurrence of D&A midwives will need to be treated with more respect within the health system. Furthermore, they should be trained in handling obstetric emergency situations with respect and dignity for the patient. Systematic and constructive supervision might be another promising strategy for preventing D&A.

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A qualitative study on midwives’ identity and perspectives on the occurrence of disrespect and abuse in Maputo city

10.21203/rs.3.rs-58904/v1 ◽

2020 ◽

Author(s):

Anna Galle ◽

Helma Manaharlal ◽

Sally Griffin ◽

Nafissa Osman ◽

Kristien Roelens ◽

...

Keyword(s):

Quality Of Care ◽

Qualitative Study ◽

Protective Factor ◽

Vital Role ◽

Disrespect And Abuse ◽

Mortality And Morbidity ◽

Emergency Situations ◽

Maputo City ◽

Inferior Status

Abstract BACKGROUND Midwifery care plays a vital role in the reduction of preventable maternal and newborn mortality and morbidity. There is a growing concern about the quality of care during facility based childbirth and the occurrence of disrespect and abuse (D&A) worldwide. While several studies have reported a high prevalence of D&A, evidence about the drivers of D&A is scarce. AIM This study aims to explore midwives’ professional identity and perspectives on the occurrence of D&A in urban Mozambique. METHODS A qualitative study took place in the central hospital of Maputo, Mozambique. Nine focus group discussions with midwives were conducted, interviewing 56 midwives. RQDA software was used for analyzing the data by open coding and thematic analysis. RESULTS Midwives felt proud of their profession but felt they were disrespected by the institution and wider society because of their inferior status compared to doctors. Furthermore, they felt being blamed for poor health outcomes. The occurrence of D&A seemed more likely in emergency situations but midwives tended to blame this on women being “uncooperative”. The involvement of birth companions was a protective factor against D&A together with supervision. Conclusion In order to improve quality of care and reduce the occurrence of D&A midwives will need to be treated with more respect within the health system. Furthermore, they should be trained in handling obstetric emergency situations with respect and dignity for the patient. Systematic and constructive supervision might be another promising strategy for preventing D&A.

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Abstract P263: Computer-Assisted Decision Support in the Treatment of Acute Coronary Syndromes and Impact on Cardiovascular Outcomes

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.4.suppl_1.ap263 ◽

2011 ◽

Vol 4 (suppl_1) ◽

Author(s):

Richard V Milani ◽

Carl J Lavie ◽

Daniel P Morin ◽

Andres Rubiano

Keyword(s):

Quality Of Care ◽

Decision Support ◽

Baseline Risk ◽

Risk Scores ◽

Computer Assisted ◽

Improve Quality ◽

Consensus Guidelines ◽

Mortality And Morbidity ◽

Coronary Syndrome

Background: Evidence from clinical trials and consensus guidelines suggest that in-hospital initiation of key therapeutics can reduce mortality and morbidity in patients admitted with acute coronary syndrome (ACS). As a result, the AHA and ACC have co-developed guideline-based “performance measures” for ACS patients, such that when every measure has been performed, the patient is considered to have achieved optimal or “perfect” care (PC). Computer-assisted decision support (CADS) is a tool that can improve quality of care and is well suited for complex algorithms governing treatment decisions. We sought to determine if CADS tailored to ACS would enhance the likelihood of achieving PC, and whether achievement of PC would translate into reduced mortality. Methods: 452 consecutive patients (mean age 68±13 years) admitted with ACS in 2009 were evaluated (unstable angina 29%, NSTEMI 61%, STEMI 10%). Physicians had the option of using either pre-printed ACS orders (standard orders) versus CADS generated orders. The CADS system utilized patient clinical data including risk scoring, to suggest specific therapeutics and drug dosing based on consensus guidelines. Endpoints were attainment of PC and 30-day mortality. Results: The 77 patients admitted using CADS generated orders were statistically similar (age, gender, ACS diagnosis, TIMI risk) to the 375 patients admitted with the standard order set. Attainment of PC was almost twice as likely when using CADS versus standard orders (84% vs. 44%, p<0.05). PC patients trended towards higher TIMI risk scores (3.2 ±1.7 vs 2.9 ±1.6, p = 0.09) but had half the 30-day mortality (2% vs 4%, p=0.05) compared to patients not achieving PC. Conclusions: Use of CADS in the setting of ACS is feasible and doubles the likelihood of attaining PC. Although patients achieving PC had higher baseline risk, their mortality was reduced by 50% compared to those not achieving PC. These data support the use of CADS in the setting of ACS to improve quality of care and subsequent outcomes.

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Is quality of care during childbirth consistent from admission to discharge? A qualitative study of delivery care in Uttar Pradesh, India

PLoS ONE ◽

10.1371/journal.pone.0204607 ◽

2018 ◽

Vol 13 (9) ◽

pp. e0204607 ◽

Cited By ~ 1

Author(s):

Malvika Saxena ◽

Aradhana Srivastava ◽

Pravesh Dwivedi ◽

Sanghita Bhattacharyya

Keyword(s):

Quality Of Care ◽

Qualitative Study ◽

Uttar Pradesh ◽

Delivery Care

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Disparities in NICU quality of care: a qualitative study of family and clinician accounts

Journal of Perinatology ◽

10.1038/s41372-018-0057-3 ◽

2018 ◽

Vol 38 (5) ◽

pp. 600-607 ◽

Cited By ~ 12

Author(s):

Krista Sigurdson ◽

Christine Morton ◽

Briana Mitchell ◽

Jochen Profit

Keyword(s):

Quality Of Care ◽

Qualitative Study

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What motivates informal caregivers of people with dementia (PWD): a qualitative study

BMC Palliative Care ◽

10.1186/s12904-019-0491-9 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 1

Author(s):

Shakiba Zahed ◽

Maryam Emami ◽

Shahrzad Bazargan-Hejazi ◽

Ahmad Ali Eslami ◽

Majid Barekatain ◽

...

Keyword(s):

Social Media ◽

Quality Of Care ◽

Qualitative Study ◽

Motivating Factors ◽

Structured Interviews ◽

Thematic Content Analysis ◽

People With Dementia ◽

The Family ◽

Burden Of Caring

Abstract Background The burden of caring for People with Dementia (PWD) is heavy; identifying incentives that motivate them in providing care is essential in facilitating and optimizing care. This study aims to explore and describe these motivating factors. Methods We conducted this qualitative study between January 2016 and January 2017 in Isfahan, Iran. Data were extracted through in-depth, semi-structured interviews with 19 caregivers of PWD. These data were then examined through thematic content analysis. Results We identified four categories of psychological motives based on the caregivers’ feedback and experience. These include 1) Moral-based motives, 2) Religious, and spiritual motives; 3) Financial motives, and 4) Wicked motives. Conclusions Our results revealed several aspects of caregivers’ motives. They include moral, religious, and spiritual aspects; sharing housing accommodations, and the likelihood of inheriting a portion of the patient’s assets based on unspoken rules and informal arrangements in the family, and wicked and immoral aspects. These findings can inform future efforts in enhancing the experiences of caregivers of PWD, and subsequently, the quality of care these patients receive. It further suggests that family members, members of a religious and spiritual organization, as well as social media, could play important roles in setting the stage.

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The Potential Effects of Human Milk on Morbidity in Very-Low-Birth-Weight Preterm Infants

Nutrients ◽

10.3390/nu12061882 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1882

Author(s):

Paola Roggero ◽

Nadia Liotto ◽

Orsola Amato ◽

Fabio Mosca

Keyword(s):

Quality Of Care ◽

Birth Weight ◽

Low Birth Weight ◽

Human Milk ◽

Preterm Infants ◽

Very Low Birth Weight ◽

Mortality And Morbidity ◽

Vlbw Infants

Improvements in quality of care have led to a significant reduction in mortality and morbidity in preterm infants, especially very-low-birth-weight (VLBW) infants [...]

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