scholarly journals Midwives’ experiences of caring for women with antenatal anxiety and depression: A qualitative study with midwifery acupuncturists

2021 ◽  
Vol 57 ◽  
Author(s):  
Lee-Ana Lowe ◽  
Debra Betts
Keyword(s):  
Mixed Methods ◽  
Health Services ◽  
Pregnant Women ◽  
Online Survey ◽  
Maternal Mental Health ◽  
Mixed Methods Study ◽  
Anxiety And Depression ◽  
Structured Interviews ◽  
Convenience Sample ◽  
Antenatal Anxiety

Background: Pregnant women seek help for a range of physical and emotional pregnancy symptoms from traditional acupuncturists. Whether midwifery acupuncturists in Aotearoa New Zealand (Aotearoa NZ) provide acupuncture for antenatal anxiety and depression (AAD) in practice is currently unknown. Aim: This qualitative arm of a mixed-methods study aimed to explore midwifery acupuncturist experiences of caring for pregnant women with AAD in Aotearoa NZ. The aim of the research was to examine the factors that influence midwifery acupuncturists' perceptions of acupuncture use for AAD. Method: This was a mixed-methods study involving an online survey and in-depth interviews from a convenience sample of Aotearoa NZ midwifery acupuncturists who had completed a Certificate of Midwifery Acupuncture. This paper describes the thematic analysis of the semi-structured interviews. Findings: The eight interviewees were mostly NZ European (n=6) and Lead Maternity Carers (LMCs; n=6) caring for pregnant women in rural and urban locations throughout Aotearoa NZ. The interviews revealed an overarching theme, “helping midwives to navigate the ocean of AAD”, which identified the lack of support participants experienced from current maternity health services for AAD in Aotearoa NZ. Subthemes “Missing the boat during pregnancy” expressed how participants felt no options were available for AAD prevention, while “keeping women afloat with no ship in sight” represented how interviewees tried to keep women in their care stable even though access to maternal mental health services was difficult. Participants felt acupuncture was a useful non-pharmaceutical tool that works; however, they had reservations about “adding acupuncture to the midwifery toolbox”. Conclusion: Aotearoa NZ midwifery acupuncturists were concerned about AAD and the limited conventional options available for women in their care. Acupuncture was viewed as a promising adjunct to usual treatment for AAD. Reservations included adding acupuncture to an already heavy midwifery workload, the cost of acupuncture, and the appropriateness of the treatment.

scholarly journals Development of a tool for identifying and addressing prioritised determinants of quality improvement projects led by healthcare professionals: a mixed-methods study

2020 ◽  
Author(s):  
Anne van Tuijl ◽  
Hub C. Wollersheim ◽  
Cornelia R.M.G. Fluit ◽  
Petra. J. van Gurp ◽  
Hiske Calsbeek
Keyword(s):  
Quality Improvement ◽  
Mixed Methods ◽  
Online Survey ◽  
Healthcare Professionals ◽  
Learning By Doing ◽  
Mixed Methods Study ◽  
Quality Improvement Initiative ◽  
Structured Interviews ◽  
Priority Score ◽  
A Priority

Abstract Background: Several frameworks have been developed to identify essential determinants for healthcare improvement. These frameworks aim to be comprehensive, leading to the creation of long lists of determinants that are not prioritised based on being experienced as most important. Furthermore, most existing frameworks do not describe the methods or actions used to identify and address the determinants, limiting their practical value. The aim of this study is to describe the development of a tool with prioritised facilitators and barriers supplemented with methods to identify and address each determinant. The tool can be used by those performing quality improvement initiatives in healthcare practice. Methods: A mixed-methods study design was used to develop the tool. First, an online survey was used to ask healthcare professionals about the determinants they experienced as most facilitating and most hindering during the performance of their quality improvement initiative . A priority score was calculated for every named determinant, and those with a priority score ≥ 20 were incorporated into the tool. Semi-structured interviews with implementation experts were performed to gain insight on how to analyse and address the determinants in our tool Results: The 25 healthcare professionals in this study experienced 64 facilitators and 66 barriers when performing their improvement initiatives. Of these, 12 facilitators and nine barriers were incorporated into the tool. Sufficient support from management of the department was identified as the most important facilitator, while having limited time to perform the initiative was considered the most important barrier. The interviews with 16 experts in implementation science led to various inputs for identifying and addressing each determinant. Important themes included maintaining adequate communication with stakeholders, keeping the initiative at a manageable size, learning by doing and being able to influence determinants. Conclusions: This paper describes the development of a tool with prioritized determinants for performing quality improvement initiatives with suggestions for analysing and addressing these determinants. The tool is developed for those engaged in quality improvement initiatives in practice, so in this ways it helps to bridging the research to practice gap of determinants frameworks. More research is needed to validate and develop the tool further.

scholarly journals Engagement with and delivery of the ‘parkrun practice initiative’ in general practice: a mixed methods study

2020 ◽  
Vol 70 (697) ◽  
pp. e573-e580
Author(s):  
Joanna Fleming ◽  
Carol Bryce ◽  
Joanne Parsons ◽  
Chrissie Wellington ◽  
Jeremy Dale
Keyword(s):  
General Practice ◽  
Mixed Methods ◽  
Focus Group ◽  
Online Survey ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Practice Staff ◽  
Health And Wellbeing ◽  
Positive Effects ◽  
Improve Patient

BackgroundThe parkrun practice initiative, a joint collaboration between parkrun and the Royal College of General Practitioners, was launched to encourage general practices to improve the health and wellbeing of patients and staff through participating in local 5 km parkrun events. Why and how practices engage with the initiative is unknown.AimTo investigate engagement with and delivery of the parkrun practice initiative in general practice.Design and settingMixed methods study conducted from April–July 2019 comprising an online survey of all registered parkrun practices, and interviews and a focus group with practice staff in the West Midlands.MethodThe designated contacts at 780 registered parkrun practices were invited to complete an online survey. A purposive sample of parkrun practice staff and non-registered practice staff took part either in semi-structured interviews or a focus group, with transcripts analysed thematically.ResultsOf the total number of parkrun practices, 306 (39.2%) completed the survey. Sixteen practice staff (from nine parkrun practices and four non-registered practices) took part in either semi-structured interviews (n = 12) or a focus group (n = 4). Key motivators for becoming a parkrun practice were: to improve patient and staff health and wellbeing, and to become more engaged with the community and enhance practice image. Practices most commonly encouraged patients, carers, and staff to take part in parkrun and displayed parkrun flyers and posters. Challenges in implementing activities included lack of time (both personal and during consultations) and getting staff involved. Where staff did engage there were positive effects on morale and participation. Non-registered practices were receptive to the initiative, but had apprehensions about the commitment involved.ConclusionPractices were keen to improve patient and staff health. Addressing time constraints and staff support needs to be considered when implementing the initiative.

scholarly journals The views of pregnant women in New Zealand on vaginal seeding: a mixed-methods study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Éadaoin M. Butler ◽  
Abigail J. Reynolds ◽  
José G. B. Derraik ◽  
Brooke C. Wilson ◽  
Wayne S. Cutfield ◽  
...  
Keyword(s):  
Mixed Methods ◽  
New Zealand ◽  
Pregnant Women ◽  
Gut Microbiome ◽  
Natural Process ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Online Questionnaire ◽  
Infant Gut Microbiome ◽  
The Media

Abstract Background Vaginal seeding is the administration of maternal vaginal bacteria to babies following birth by caesarean section (CS), intended to mimic the microbial exposure that occurs during vaginal birth. Appropriate development of the infant gut microbiome assists early immune development and might help reduce the risk of certain health conditions later in life, such as obesity and asthma. We aimed to explore the views of pregnant women on this practice. Methods We conducted a sequential mixed-methods study on the views of pregnant women in New Zealand (NZ) on vaginal seeding. Phase one: brief semi-structured interviews with pregnant women participating in a clinical trial of vaginal seeding (n = 15); and phase two: online questionnaire of pregnant women throughout NZ (not in the trial) (n = 264). Reflexive thematic analysis was applied to interview and open-ended questionnaire data. Closed-ended questionnaire responses were analysed using descriptive statistics. Results Six themes were produced through analysis of the open-ended data: “seeding replicates a natural process”, “microbiome is in the media”, “seeding may have potential benefits”, “seeking validation by a maternity caregiver”, “seeding could help reduce CS guilt”, and “the unknowns of seeding”. The idea that vaginal seeding replicates a natural process was suggested by some as an explanation to help overcome any initial negative perceptions of it. Many considered vaginal seeding to have potential benefit for the gut microbiome, while comparatively fewer considered it to be potentially beneficial for specific conditions such as obesity. Just under 30% of questionnaire respondents (n = 78; 29.5%) had prior knowledge of vaginal seeding, while most (n = 133; 82.6%) had an initially positive or neutral reaction to it. Few respondents changed their initial views on the practice after reading provided evidence-based information (n = 60; 22.7%), but of those who did, most became more positive (n = 51; 86.4%). Conclusions Given its apparent acceptability, and if shown to be safe and effective for the prevention of early childhood obesity, vaginal seeding could be a non-stigmatising approach to prevention of this condition among children born by CS. Our findings also highlight the importance of lead maternity carers in NZ remaining current in their knowledge of vaginal seeding research.

scholarly journals Development of a tool for identifying and addressing prioritised determinants of quality improvement initiatives led by healthcare professionals: a mixed-methods study

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Anne A. C. van Tuijl ◽  
Hub C. Wollersheim ◽  
Cornelia R. M. G. Fluit ◽  
Petra J. van Gurp ◽  
Hiske Calsbeek
Keyword(s):  
Quality Improvement ◽  
Mixed Methods ◽  
Online Survey ◽  
Healthcare Professionals ◽  
Learning By Doing ◽  
Mixed Methods Study ◽  
Quality Improvement Initiative ◽  
Structured Interviews ◽  
Priority Score ◽  
A Priority

Abstract Background Several frameworks have been developed to identify essential determinants for healthcare improvement. These frameworks aim to be comprehensive, leading to the creation of long lists of determinants that are not prioritised based on being experienced as most important. Furthermore, most existing frameworks do not describe the methods or actions used to identify and address the determinants, limiting their practical value. The aim of this study is to describe the development of a tool with prioritised facilitators and barriers supplemented with methods to identify and address each determinant. The tool can be used by those performing quality improvement initiatives in healthcare practice. Methods A mixed-methods study design was used to develop the tool. First, an online survey was used to ask healthcare professionals about the determinants they experienced as most facilitating and most hindering during the performance of their quality improvement initiative. A priority score was calculated for every named determinant, and those with a priority score ≥ 20 were incorporated into the tool. Semi-structured interviews with implementation experts were performed to gain insight on how to analyse and address the determinants in our tool. Results The 25 healthcare professionals in this study experienced 64 facilitators and 66 barriers when performing their improvement initiatives. Of these, 12 facilitators and nine barriers were incorporated into the tool. Sufficient support from management of the department was identified as the most important facilitator, while having limited time to perform the initiative was considered the most important barrier. The interviews with 16 experts in implementation science led to various inputs for identifying and addressing each determinant. Important themes included maintaining adequate communication with stakeholders, keeping the initiative at a manageable size, learning by doing and being able to influence determinants. Conclusions This paper describes the development of a tool with prioritised determinants for performing quality improvement initiatives with suggestions for analysing and addressing these determinants. The tool is developed for those engaged in quality improvement initiatives in practice, so in this way it helps in bridging the research to practice gap of determinants frameworks. More research is needed to validate and develop the tool further.

scholarly journals Development of a tool for identifying and addressing prioritised determinants of quality improvement projects led by healthcare professionals: a mixed-methods study

2020 ◽  
Author(s):  
Anne van Tuijl ◽  
Hub C. Wollersheim ◽  
Cornelia R.M.G. Fluit ◽  
Petra. J. van Gurp ◽  
Hiske Calsbeek
Keyword(s):  
Quality Improvement ◽  
Mixed Methods ◽  
Online Survey ◽  
Healthcare Professionals ◽  
Learning By Doing ◽  
Mixed Methods Study ◽  
Quality Improvement Initiative ◽  
Structured Interviews ◽  
Priority Score ◽  
A Priority

Abstract Background: Several frameworks have been developed to identify essential determinants for healthcare improvement. These frameworks aim to be comprehensive, leading to the creation of long lists of determinants that are not prioritised based on being experienced as most important. Furthermore, most existing frameworks do not describe the methods or actions used to identify and address the determinants, limiting their practical value. The aim of this study is to describe the development of a tool with prioritised facilitators and barriers supplemented with methods to identify and address each determinant. The tool can be used by those performing quality improvement initiatives in healthcare practice. Methods: A mixed-methods study design was used to develop the tool. First, an online survey was used to ask healthcare professionals about determinants they experienced as most facilitating and most hindering during the performance of their quality improvement initiative. A priority score was calculated for every named determinant, and those with a priority score ≥ 20 were incorporated into the tool. Semi-structured interviews with implementation experts were performed to gain insight on how to analyse and address the determinants in our tool. Results: The 25 healthcare professionals in this study experienced 64 facilitators and 66 barriers when performing their improvement initiatives. Of these, 12 facilitators and nine barriers were incorporated into the tool. Sufficient support from management of the department was identified as the most important facilitator, while having limited time to perform the initiative was considered the most important barrier. The interviews with 16 experts in implementation science led to various inputs for identifying and addressing each determinant. Important themes included maintaining adequate communication with stakeholders, keeping the initiative at a manageable size, learning by doing and being able to influence determinants. Conclusions: This paper describes the development of a tool with prioritized determinants for performing quality improvement initiatives with suggestions for analysing and addressing these determinants. The tool is developed for those engaged in quality improvement initiatives in practice, so in this ways it helps to bridging the research to practice gap of determinants frameworks. More research is needed to validate and develop the tool further.

scholarly journals Assessing the Potential for Integrating Routine Data Collection on Complementary Feeding to Child Health Visits: A Mixed-Methods Study

2019 ◽  
Vol 16 (10) ◽  
pp. 1722 ◽  
Author(s):  
Louise Tully ◽  
Charlotte M. Wright ◽  
Deirdre McCormick ◽  
Ada L. Garcia
Keyword(s):  
Mixed Methods ◽  
Child Health ◽  
Data Collection ◽  
Online Survey ◽  
Dietary Diversity ◽  
Family Health ◽  
Routine Data ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Routine Data Collection

There is no routine data collection in the UK on infant dietary diversity during the transition to solid foods, and health visitors (HVs) (nurses or midwives with specialist training in children and family health) have the potential to play a key role in nutrition surveillance. We aimed to assess items for inclusion in routine data collection, their suitability for collecting informative data, and acceptability among HVs. A mixed-methods study was undertaken using: (i) an online survey testing potential questionnaire items among parents/caregivers, (ii) questionnaire redevelopment in collaboration with community staff, and (iii) a survey pilot by HVs followed by qualitative data collection. Preliminary online questionnaires (n = 122) were collected to identify useful items on dietary diversity. Items on repeated exposure to foods, aversive feeding behaviors, flavor categories, and sugar intake were selected to correspond to nutrition recommendations, and be compatible with electronic records via tablet. HVs surveyed 187 parents of infants aged 12 months. Semi-structured interviews indicated that HVs found the questionnaire comparable with standard nutrition conversations, which prompted helpful discussions, but questions on eating behavior did not prompt such useful discussions and, in some cases, caused confusion about what was ‘normal.’ Lack of time among HVs, internet connectivity issues, and fear of losing rapport with parents were barriers to completing electronic questionnaires, with 91% submitted by paper. Routine nutrition data collection via child health records seems feasible and could inform quality improvement projects.

Determining Emotional Tone and Verbal Behavior in Patients With Tinnitus and Hyperacusis: An Exploratory Mixed-Methods Study

2019 ◽  
Vol 28 (3) ◽  
pp. 660-672
Author(s):  
Suzanne H. Kimball ◽  
Toby Hamilton ◽  
Erin Benear ◽  
Jonathan Baldwin
Keyword(s):  
Mixed Methods ◽  
Verbal Behavior ◽  
Coping Strategies ◽  
Mixed Methods Study ◽  
Self Report ◽  
Anxiety And Depression ◽  
Negative Consequences ◽  
Emotional Tone ◽  
Explanatory Mixed Methods ◽  
Quantitative Results

Purpose The purpose of this study was to evaluate the emotional tone and verbal behavior of social media users who self-identified as having tinnitus and/or hyperacusis that caused self-described negative consequences on daily life or health. Research Design and Method An explanatory mixed-methods design was utilized. Two hundred “initial” and 200 “reply” Facebook posts were collected from members of a tinnitus group and a hyperacusis group. Data were analyzed via the LIWC 2015 software program and compared to typical bloggers. As this was an explanatory mixed-methods study, we used qualitative thematic analyses to explain, interpret, and illustrate the quantitative results. Results Overall, quantitative results indicated lower overall emotional tone for all categories (tinnitus and hyperacusis, initial and reply), which was mostly influenced by higher negative emotion. Higher levels of authenticity or truth were found in the hyperacusis sample but not in the tinnitus sample. Lower levels of clout (social standing) were indicated in all groups, and a lower level of analytical thinking style (concepts and complex categories rather than narratives) was found in the hyperacusis sample. Additional analysis of the language indicated higher levels of sadness and anxiety in all groups and lower levels of anger, particularly for initial replies. These data support prior findings indicating higher levels of anxiety and depression in this patient population based on the actual words in blog posts and not from self-report questionnaires. Qualitative results identified 3 major themes from both the tinnitus and hyperacusis texts: suffering, negative emotional tone, and coping strategies. Conclusions Results from this study suggest support for the predominant clinical view that patients with tinnitus and hyperacusis have higher levels of anxiety and depression than the general population. The extent of the suffering described and patterns of coping strategies suggest clinical practice patterns and the need for research in implementing improved practice plans.

Risk perception on the labour ward: A mixed methods study

2021 ◽  
Vol 26 (2) ◽  
pp. 56-63
Author(s):  
Claire McCarthy ◽  
Sarah Meaney ◽  
Marie Rochford ◽  
Keelin O’Donoghue
Keyword(s):  
Mixed Methods ◽  
Lived Experience ◽  
Healthcare Providers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Daily Basis ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Staff Support ◽  
Staff Wellbeing

Healthcare providers commonly experience risky situations in the provision of maternity care, and there has been increased focus on the lived experience in recent years. We aimed to assess opinions on, understanding of and behaviours of risk on the LW by conducting a mixed methods study. Staff working in a LW setting completed a descriptive questionnaire-based study, followed by qualitative structured interviews. Statistical analysis was performed with SPSS on quantitative data and thematic analysis performed on qualitative data. Nearly two thirds of staff (64%; 73/114) completed the questionnaire, with 56.2% (n = 47) experiencing risk on a daily basis. Experiencing risk evoked feelings of apprehension (68.4%; n = 50) and worry (60.2%; n = 44) which was echoed in the qualitative work. Structured clinical assessment was utilised in risky situations, and staff described “ going on autopilot” to manage these situations. A large number of respondents reflected on their provision of care following an adverse event (87.7%; n = 64). Debriefing was mentioned as an important practice following such events by all respondents. This study describes the negative terminology prevailing in emergency obstetric care. These experiences can have a profound impact on staff. Risk reduction strategies and the provision of increased staff support and training are crucial to improve staff wellbeing in stressful scenarios.

scholarly journals An intervention to decrease burnout and increase retention of early career nurses: a mixed methods study of acceptability and feasibility

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Judy Brook ◽  
Leanne M. Aitken ◽  
Julie-Ann MacLaren ◽  
Debra Salmon
Keyword(s):  
Mixed Methods ◽  
Nursing Students ◽  
Focus Groups ◽  
Academic Staff ◽  
Skills Training ◽  
Early Career ◽  
Mixed Methods Study ◽  
Healthcare Organisation ◽  
Structured Interviews ◽  
Over Time

Abstract Aims To understand the experiences of nursing students and academic staff of an intervention to decrease burnout and increase retention of early career nurses, in order to identify acceptability and feasibility in a single centre. Background Internationally, retention of nurses is a persistent challenge but there is a dearth of knowledge about the perspectives of stakeholders regarding the acceptability and feasibility of interventions to resolve the issue. This study reports an intervention comprising of mindfulness, psychological skills training and cognitive realignment to prepare participants for early careers as nurses. Methods This is an explanatory sequential mixed methods study, conducted by a UK university and healthcare organisation. Participants were final year pre-registration nursing students (n = 74) and academics (n = 7) involved in the implementation of the intervention. Pre and post measures of acceptability were taken using a questionnaire adapted from the Theoretical Framework of Acceptability. Wilcoxon Signed Ranks test was used to assess change in acceptability over time. Qualitative data from semi-structured interviews, focus groups and field notes were thematically analysed, adhering to COREQ guidelines. Data were collected February to December 2019. Results One hundred and five questionnaires, 12 interviews with students and 2 focus groups engaging 7 academic staff were completed. The intervention was perceived as generally acceptable with significant positive increases in acceptability scores over time. Student nurses perceived the intervention equipped them with skills and experience that offered enduring personal benefit. Challenges related to the practice environment and academic assessment pressures. Reported benefits align with known protective factors against burnout and leaving the profession. Conclusion Planning is needed to embed the intervention into curricula and maximise relationships with placement partners. Evaluating acceptability and feasibility offers new knowledge about the value of the intervention for increasing retention and decreasing burnout for early career nurses. Wider implementation is both feasible and recommended by participants.

scholarly journals The PROMISES study: a mixed methods approach to explore the acceptability of salivary progesterone testing for preterm birth risk among pregnant women and trained frontline healthcare workers in rural India

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040268
Author(s):  
Danielle Ashworth ◽  
Pankhuri Sharma ◽  
Sergio A Silverio ◽  
Simi Khan ◽  
Nishtha Kathuria ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Barriers And Facilitators ◽  
Rural India ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Thematic Framework

IntroductionIndia has an overall neonatal mortality rate of 28/1000 live births, with higher rates in rural India. Approximately 3.5 million pregnancies in India are affected by preterm birth (PTB) annually and contribute to approximately a quarter of PTBs globally. Embedded within the PROMISES study (which aims to validate a low-cost salivary progesterone test for early detection of PTB risk), we present a mixed methods explanatory sequential feasibility substudy of the salivary progesterone test.MethodsA pretraining and post-training questionnaire to assess Accredited Social Health Activists (ASHAs) (n=201) knowledge and experience of PTB and salivary progesterone sampling was analysed using the McNemar test. Descriptive statistics for a cross-sectional survey of pregnant women (n=400) are presented in which the acceptability of this test for pregnant women is assessed. Structured interviews were undertaken with ASHAs (n=10) and pregnant women (n=9), and were analysed using thematic framework analysis to explore the barriers and facilitators influencing the use of this test in rural India.ResultsBefore training, ASHAs’ knowledge of PTB (including risk factors, causes, postnatal support and testing) was very limited. After the training programme, there was a significant improvement in the ASHAs’ knowledge of PTB. All 400 women reported the salivary test was acceptable with the majority finding it easy but not quick or better than drawing blood. For the qualitative aspects of the study, analysis of interview data with ASHAs and women, our thematic framework comprised of three main areas: implementation of intervention; networks of influence and access to healthcare. Qualitative data were stratified and presented as barriers and facilitators.ConclusionThis study suggests support for ongoing investigations validating PTB testing using salivary progesterone in rural settings.

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