scholarly journals Healthcare experiences of homeless pregnant women

Rev Rene ◽  
2020 ◽  
Vol 21 ◽  
pp. e43686
Author(s):  
Keila Cristina Costa Barros ◽  
Rita de Cássia Rocha Moreira ◽  
Mariana Silveira Leal ◽  
Tânia Cristiane Ferreira Bispo ◽  
Rosana Freitas Azevedo

Objective: to understand healthcare experiences from the perspective of women who are or were pregnant while in homelessness. Methods: qualitative study based on Heideggerian phenomenology adapted to the field of health. There were ten participants. The technique of phenomenological interview and a semi-structured instrument were used. The comprehensive analysis methodically followed the stages of phenomenological reduction, construction,and destruction. Results: the existence of pregnant homeless women represents difficulties, discrimination, violence, prejudice, racism,and vulnerability. It is a violation of human dignity, revealing specificities and nuances of the triad women-maternity-street. Conclusion: the research made it possible to understand that healthcare, from the perspective of women who are pregnant while homeless, offers risks both to the mother and to the child. Both the self-care and the healthcare offered by health workers and services is precarious and has weaknesses, being different from any type of care that could be understood as solicitous, zealous, and concerned.

2020 ◽  
Author(s):  
Daisy Krakowiak ◽  
Pamela Makabong’o ◽  
Marielle Goyette ◽  
John Kinuthia ◽  
Alfred Onyango Osoti ◽  
...  

Abstract Background Globally only 79% of adults living with HIV (human immunodeficiency virus) know their status and men in sub-Saharan Africa are considered a particularly hard-to-reach population for HIV testing. Home-based HIV couple testing during the antenatal period is a safe and effective method that has been used to test male partners of pregnant women. The goal of this qualitative study was to identify elements that made couple testing successful and describe important characteristics of this home-based intervention from couples’ perspectives. Methods Couples who received scheduled home-based couple testing during pregnancy in Kisumu, Kenya, were purposively sampled based on HIV status from January to May 2015. An interviewer administered all of the in-depth interviews and two coders were directly involved in the data analysis and reconciled codes several times in the process. Results Twenty-one couples were enrolled: 9 concordant HIV-negative couples, 8 HIV discordant couples, 3 HIV concordant HIV-positive couples, and 1 whose concordance status was unknown. Median age at the time of home-based couple testing was 24 and 28 years for women and men, respectively. Median relationship duration was 3 years and couples had a median of two pregnancies. The major themes that emerged were that home-based couple testing 1) removed the female burden of requesting couple testing, 2) overcame logistical barriers associated with clinic-based testing, 3) encouraged participants to overcome their fear of testing and disclosure, 4) provided privacy in the home, and 5) provided quality time with the health advisors. Importantly, some women appreciated individual testing at the clinic before couple testing and some couples preferred skilled, anonymous health advisors delivering the intervention rather than known community health workers. Conclusions The results of this qualitative study suggest that home-based couple testing during pregnancy overcame many of the barriers that limit men’s access to and uptake of clinic-based testing. It encouraged participants to overcome their fear of testing and disclosure through a setting that afforded privacy and quality time with skilled health advisors. These qualitative results may help design effective partner and couple HIV testing programs in the antenatal setting and alongside or within other assisted partner notification services. Trial Registration: Clinicaltrials.gov registry: NCT01784783. Registered prospectively on June 15, 2012.


2020 ◽  
Author(s):  
Daisy Krakowiak ◽  
Pamela Makabong’o ◽  
Marielle Goyette ◽  
John Kinuthia ◽  
Alfred Onyango Osoti ◽  
...  

Abstract Background Globally only 79% of HIV positive adults know their status and men in sub-Saharan Africa are considered a particularly hard-to-reach population for HIV testing. Home-based HIV couple testing during the antenatal period is a safe and effective method that has been used to test male partners of pregnant women. The goal of this qualitative study was to identify elements that made couple testing successful and describe important characteristics of this home-based intervention from couples’ perspectives. Methods Couples who received scheduled home-based couple testing during pregnancy in Kisumu, Kenya, were purposively sampled based on HIV status from January to May 2015. An interviewer administered all of the in-depth interviews and two coders were directly involved in the data analysis and reconciled codes several times in the process. Results Twenty-one couples were enrolled: 9 concordant HIV-negative couples, 8 HIV discordant couples, 3 HIV concordant HIV-positive couples, and 1 whose concordance status was unknown. Median age at the time of home-based couple testing was 24 and 28 years for women and men, respectively. Median relationship duration was 3 years and couples had a median of two pregnancies. The major themes that emerged were that home-based couple testing 1) removed the female burden of requesting couple testing, 2) overcame logistical barriers associated with clinic-based testing, 3) encouraged participants to overcome their fear of testing and disclosure, 4) was preferred due to privacy in the home, and 5) provided quality time with the health advisors. Importantly, some women appreciated individual testing at the clinic before couple testing and some couples preferred skilled, anonymous health advisors delivering the intervention rather than known community health workers. Conclusions The results of this qualitative study suggest that home-based couple testing during pregnancy overcame many of the barriers that limit men’s access to and uptake of clinic-based testing. It encouraged participants to overcome their fear of testing and disclosure through a setting that afforded privacy and quality time with skilled health advisors. These qualitative results may help design effective partner and couple HIV testing programs in the antenatal setting and alongside or within other assisted partner notification services.


2020 ◽  
Author(s):  
Daisy Krakowiak ◽  
Pamela Makabong’o ◽  
Marielle Goyette ◽  
John Kinuthia ◽  
Alfred Onyango Osoti ◽  
...  

Abstract Background Globally only 79% of HIV positive adults know their status and men in sub-Saharan Africa are considered a particularly hard-to-reach population for HIV testing. Home-based HIV couple testing during the antenatal period is a safe and effective method that has been used to test male partners of pregnant women. The goal of this qualitative study was to identify elements that made couple testing successful and describe important characteristics of this home-based intervention from couples’ perspectives. Methods Couples who received scheduled home-based couple testing during pregnancy in Kisumu, Kenya, were purposively sampled based on HIV status from January to May 2015. An interviewer administered all of the in-depth interviews and two coders were directly involved in the data analysis and reconciled codes several times in the process. Results Twenty-one couples were enrolled: 9 concordant HIV-negative couples, 8 HIV discordant couples, 3 HIV concordant HIV-positive couples, and 1 whose concordance status was unknown. Median age at the time of home-based couple testing was 24 and 28 years for women and men, respectively. Median relationship duration was 3 years and couples had a median of two pregnancies. The major themes that emerged were that home-based couple testing 1) removed the female burden of requesting couple testing, 2) overcame logistical barriers associated with clinic-based testing, 3) encouraged participants to overcome their fear of testing and disclosure, 4) provided privacy in the home, and 5) provided quality time with the health advisors. Importantly, some women appreciated individual testing at the clinic before couple testing and some couples preferred skilled, anonymous health advisors delivering the intervention rather than known community health workers. Conclusions The results of this qualitative study suggest that home-based couple testing during pregnancy overcame many of the barriers that limit men’s access to and uptake of clinic-based testing. It encouraged participants to overcome their fear of testing and disclosure through a setting that afforded privacy and quality time with skilled health advisors. These qualitative results may help design effective partner and couple HIV testing programs in the antenatal setting and alongside or within other assisted partner notification services.


2020 ◽  
pp. 17-26
Author(s):  
Arista Apriani ◽  
M Mufdlilah ◽  
Menik Sri Daryanti

ABSTRAK GDM dapat berpotensi menimbulkan komplikasi serius yang dapat mengakibatkan risiko kesehatan jangka pendek dan jangka panjang bagi ibu dan bayinya. diagnosis GDM menimbulkan efek emosional yang negatif. Persepsi ibu hamil tentang GDM dapat memengaruhi perubahan gaya hidup. Garis pertama penatalaksanaan DMG yaitu dengan perubahan gaya hidup. Tujuan menggali secara mendalam kebutuhan ibu dengan diagnosis diabetes melitus gestasional. Metode penelitian kualitatif dengan pendekatan  fenomenologi. Lokasi di Kabupaten Karanganyar yaitu Puskesmas Jaten I, Puskesmas Matesih dan RSUD Kabupaten Karanganyar, pada bulan Oktober 2019 - Januari 2020. Sampel secara criterion sampling Pengumpulan data dengan semistructure interview dengan one on one interview. Uji Keabsahan Data dengan Credibility pada penelitian ini menggunakan strategi validitas triangulasi, Tranferability, Dependability, Confirmability. Analisis data dengan Interpretative Phenomenological Analysis (IPA). Hasil penelitian kebutuhan ibu hamil dengan DMG teridentifikasi empat tema, yaitu dukungan keluarga dalam hal mengontrol pola makan, mengatarkan periksa ke tenaga kesehatan, dan mengingatkan untuk aktifitas olah raga. Dukungan sosial, yaitu cara mengontrol gula darah. Dukungan tenaga kesehatan, yaitu saran dan motivasi untuk mengontrol gula darah. Informasi mendapat saran atau perawatan DMG dalam kehamilan adalah dari tenaga kesehatan yaitu bidan, dokter, serta selain tenaga kesehatan dari teman dan internet. Kesimpulannya kebutuhan ibu hamil dengan DMG teridentifikasi empat tema, yaitu dukungan keluarga, dukungan sosial, dukungan tenaga kesehatan dan informasi.   Kata kunci: diabetes melitus gestasional, kehamilan, kebutuhan.   ABSTRACT GDM can overcome serious problems that can overcome short-term and long-term health problems for mother and baby. a diagnosis of GDM has a negative emotional effect. Pregnant women 's perception of GDM can affect lifestyle changes. The first line of management of DMG is lifestyle changes. Diagnosis of gestational diabetes mellitus. Qualitative research methods by studying phenomenology. Locations in Karanganyar Regency are Jaten I Health Center, Matesih Health Center and Karanganyar District Public Hospital, in October 2019 - January 2020. Sample sampling criteria Data collection by semi-structured interviews with one-on-one interviews. Data Validity Test with Credibility in this study using the triangulation validity strategy, Transparency, Dependability, Confirmability. Data analysis with Interpretative Phenomenological Analysis (IPA). The results of the study of the needs of pregnant women with DMG identified four themes, namely supporting the family in terms of controlling diet, sending check to health workers, and reminding for sports activities. Social support, which is a way to control blood sugar. Support of Health Workers, namely advice and motivation to control blood sugar. The information obtained from DMG advice or treatment in the assessment is from health workers, namely midwives, doctors, and also health workers from friends and the internet. In conclusion, the needs of pregnant women with DMG identified four themes, namely family support, social support, support of health workers and information.  


2020 ◽  
Author(s):  
Wanhua Xie ◽  
Yunhe Gao ◽  
Weichi Tan

BACKGROUND In the conventional method, the blood pressure values of pregnant women were measured by nurses in the obstetrics outpatient clinics, and then were entered into the computer system.The pregnant women should wait for long time to complete this process.We hypothesized that the self-service blood pressure measurement by pregnant women could be a better option rather than measuring the blood pressure by nurses. OBJECTIVE This study aimed to analyze the effect of self-service blood pressure measurement in obstetrical outpatient clinic on waiting time, satisfaction of pregnant women and outpatient volume, and provide reference for the optimization of outpatient service processes. METHODS This was a cross-sectional study. The waiting time and satisfaction degree of pregnant women, as well as the outpatient volume in the Obstetrics Outpatient Clinic were compared on the use of self-service blood pressure measurement system with the conventional method. A total of 519 pregnant women in the obstetrics outpatient clinics of Guangzhou Women and Children’s Medical Center in China participated in the satisfaction survey. The sample means were compared with t-test. RESULTS Compared to wait a longer queue for blood pressure measured by nurses, after using the self-service blood pressure measurement system, the waiting time of pregnant women for blood pressure measurement was significantly reduced from (18.57±9.68) min to (2.39±1.96) min (P<0.001). In addition, the satisfaction degree of pregnant women was significantly increased (P<0.001), and the monthly outpatient volume was significantly increased (P=0.02,P<0.05). CONCLUSIONS This study showed that after implementation of self-service blood pressure measurement, the waiting time of the pregnant women for blood pressure measurement was decreased significantly, while the satisfactory degree and outpatient flow were increased significantly, improving the cost-effectiveness.Therefore, this method is worth to be popularized in clinical practices. Relevance to clinical practice: How to use medical intelligence in clinical practices, replace manual works by self-service devices to address the high outpatient flow, high work load of medical personnel, and improve the experience of patients in seeking medical services are the most concerned issues by both patients as well as hospital managers.This study demonstrated that the self-service blood pressure measurement as a promising strategy in clinical practices and provided reference for the optimization of outpatient service processes. CLINICALTRIAL This study was approved by the Ethics Committee of the Guangzhou Women and Children’s Medical Center (approval number:SFE-KL-46401; Supplementary file 4). All the pregnant women included in this study signed the informed consent form.


2021 ◽  
pp. 103072
Author(s):  
Olga Canet-Vélez ◽  
Teresa Botigué ◽  
Ana Lavedán Santamaría ◽  
Olga Masot ◽  
Tània Cemeli Sánchez ◽  
...  

2020 ◽  
pp. 084456212097957
Author(s):  
Cynthia Kitson ◽  
Patrick O’Byrne

Background While literature exists about persons who use injection drugs, few studies explore the experience of women who use these substances. Furthermore, even less research specifically focuses on the lives and experiences of homeless women who use injection drugs. What literature does exist, moreover, is often dated and primarily addresses concerns about infectious disease transmission among these women; and some highlight that these women have lives fraught with violence. Purpose To update this knowledge and better understand the lives of women who use injection drugs in the Canadian context. Methods We undertook an exploratory qualitative study and we engaged in semi-structured interviews with 31 homeless women who use injection drugs in downtown Ottawa, Canada. We analyzed the data using the principles of applied thematic analysis. Results Our data identified that violence pervaded the lives of our participants and that these experiences of violence could be categorized into three main areas: early and lifelong experiences of violence; violence with authority figures (e.g., police, healthcare); and societal violence toward women who use injection drugs. Conclusions We take these findings to mean that, violence toward women is rampant in Canada (not just internationally) and that healthcare workers play a role in propagating and addressing this violence.


2021 ◽  
Author(s):  
Kiran Atmuri ◽  
Mahbub Sarkar ◽  
Efe Obudu ◽  
Arunaz Kumar

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chitkasaem Suwanrath ◽  
Sopen Chunuan ◽  
Phawat Matemanosak ◽  
Sutham Pinjaroen

Abstract Background Increasing worldwide rates of cesarean section are of global concern. In recent years, cesarean births upon maternal request have become a hotly debated issue. Hence, this study aimed to explore maternal reasons for cesarean preference without medical indications. Methods A descriptive qualitative study was conducted, using in-depth interviews with 27 pregnant women who preferred cesarean birth, attending antenatal care in Songklanagarind Hospital from September 2018 to June 2019. Data were analyzed using content analysis. Results Maternal reasons for cesarean preference were classified into six main categories: fear of childbirth, safety concerns related to health risk perceptions, negative previous birth experiences, positive attitudes toward cesarean birth, access to biased information and superstitious beliefs in auspicious birth dates. Most women had more than one reason for opting cesarean birth. Conclusion Several reasons for cesarean birth preference have been elucidated. One striking reason was superstitious beliefs in auspicious birth dates, which are challengable for obstetricians to deal with. Obstetricians should explore the exact reasons why women request cesarean birth in order to prevent or diminish unnecessary cesarean births.


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