scholarly journals Women’s Views and Preferences for Mode of Birth in Public Hospitals in Argentina: a Mixed-methods Study

2021 ◽  
Author(s):  
Carla Perrotta ◽  
Mariana Romero ◽  
Yanina Sguassero ◽  
Natalia Riguetti ◽  
Celina Gialdini ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Pain Management ◽  
Caesarean Section ◽  
Post Partum ◽  
Public Hospitals ◽  
Advantages And Disadvantages ◽  
Management Interventions ◽  
Maternity Hospitals ◽  
Mode Of Birth ◽  
Las Mujeres

Abstract Background: This research explores women’s preferences for mode of birth (MOB) and their opinions on the advantages and disadvantages of MOB in public maternity hospitals with caesarean section (CS) rates higher than 30% in Argentina.Methods: Five public hospitals participated in this sequential mixed methods research. Post-partum women took part in semi-structured interviews which gathered information on obstetric history, MOB preferences, companionship, opinions on each MOB and if they would have liked to be asked about their MOB. The interviews were subsequently coded for quantitative analysis. A multiple regression model was run to explore variables associated with preferred MOB. Results: The interviews took place during eight weeks in 2019. The participating hospitals had limited availability to pain management interventions during birth. Participants were 621 women with a mean age of 26 +6. Forty percent had had a previous caesarean section (CS). Women gave birth accompanied in more than 80% of vaginal births and in less than 35% of caesarean sections. Six out of ten women would have liked to be asked about the MOB of choice. In three hospitals, the preference for vaginal birth (VB) was more than 90% and in two, 67%. Preference for MOB was strongly associated with the hospital in which the birth took place. The reasons for preferring a VB included faster recovery, feeling ready, and considering it more natural, while the disadvantages reported included birth pain and not getting anaesthesia. The most frequent reason for preferring a CS was to avoid birth pain. Women in hospitals with lower preference for VB expressed safety as a CS advantage. The disadvantages of a CS included post-procedure pain, dependence on others to take care of her or the baby afterwards and prolonged time in the hospital compared to a VB. Conclusions: Women giving birth in public hospitals in Argentina prefer VB. Safety emerged as a theme in hospitals in which women had less preference for VB. Women’s accounts indicate the need to improve access to holistic pain management during VB as well as to participate women in their desirable MOB. Trial registration: IS002316 Abstract in additional language.Spanish Introducción: Las tasas de cesárea continúan aumentando en Latinoamérica. El diseño de intervenciones no clínicas para reducir cesáreas innecesarias requiere incorporar las preferencias de las mujeres sobre modalidad de parto preferida (MDP).Métodos: El estudio se realizó en cinco hospitales públicos en Argentina a través de un diseño mixto. Las mujeres fueron entrevistadas después del parto durante 8 semanas durante el año 2019. Les preguntamos su MDP preferida, las ventajas y desventajas de cada modalidad y el acompañamiento durante el parto. Las respuestas se codificaron y se analizaron cuantitativamente. Analizamos si las preferencias variaban según variables de las mujeres o de los hospitales. ResultadosLos cinco hospitales participantes reportaron limitado acceso a anestesia epidural. Participaron 621 mujeres, edad media 26 +6, 40% con cesárea previa. El 80% tuvo acompañamiento durante el parto vaginal (PV) y menos del 30% durante la cesárea. Seis en 10 mujeres hubieran preferido que les preguntaran sobre sus preferencias de parto. En tres hospitales el 90% de las mujeres prefiere PV y en dos hospitales el 67% prefiere un PV. La preferencia por la MD se asoció solamente al hospital en donde ocurrió el parto. Las razones de la preferencia por PV fueron recuperación más rápida y sentirse más preparadas. La razón más frecuente para preferir una cesárea fue la de evitar el dolor de parto y las desventajas se centraron en el dolor postoperatorio, la falta de independencia durante el postparto y el tiempo prolongado en el hospital.Conclusiones Las mujeres en hospitales públicos en Argentina prefieren el PV sobre la cesárea, pero con diferencias entre hospitales, indicando la necesidad de adaptar intervenciones. Debemos trabajar para mejorar el manejo del dolor de parto, garantizar el acompañamiento en cesáreas e incorporar las preferencias de las mujeres en la decisión del MP.

scholarly journals Women's Views on Mode of Birth in Public Hospitals in Argentina: Inputs From a Formative Research to Optimize the Use of Caesarean Section

2021 ◽  
Author(s):  
Carla Perrotta ◽  
Mariana Romero ◽  
Yanina Sguassero ◽  
Natalia Righetti ◽  
Celia Gialdini ◽  
...  
Keyword(s):  
Pain Management ◽  
Caesarean Section ◽  
Quantitative Methods ◽  
Mode Of Delivery ◽  
Formative Research ◽  
Vaginal Birth ◽  
Public Hospitals ◽  
Postpartum Women ◽  
Maternity Hospitals ◽  
Mode Of Birth

Abstract BackgroundThis paper reports on women's perspectives on the birth mode in five public maternity hospitals in Argentina. The study is a formative research study component aimed at tailoring interventions to reduce unnecessary caesarean section (CS) use. MethodsParticipants were postpartum women aged ≥15 years old in five hospitals in the provinces of Salta, Corrientes, Tucuman, Santa Fe and Buenos Aires City. Hospitals completed an institutional survey indicating the availability of obstetric services. The fieldwork was carried out from November 2018 to June 2019. Trained interviewers gathered data on obstetric history, companionship, mode of delivery preferences, and general opinion on vaginal and caesarean section births through semi-structured interviews. The interviews were coded and analysed with standard quantitative methods. ResultsThe five hospitals had a CS rate between 29.2 and 45.5. Four institutions indicated limited access to epidural and other pain management strategies and a restricted antenatal education schedule. The sample included 621 postpartum women with a mean age of 26 years (± SD 6). 60% of them had a vaginal birth (VB). More than 90% of women in three hospitals favoured VB, and in two, 67% (p<0001). CS preference was associated with giving birth in those two hospitals and the numbers of miscarriages adjusting by maternal age and previous pregnancies. The reasons for preferring a VB included faster recovery, feeling ready, and considering it more natural. Most women chose CS as the best mode of birth to avoid birth pain. CS disadvantages included post-procedure pain, dependence on others to take care of her or the baby afterwards, and prolonged time in the hospital. Six out of ten women would have liked to be asked by their providers about the MOB of choice. ConclusionsWomen giving birth in public maternity hospitals of Argentina preferred a vaginal delivery to a caesarean section. There is an ongoing need to improve access to pain management during labour and vaginal birth and include women's opinions along the decision-making process for selecting the mode of childbirth. Hospitals with a lower preference for VB will require additional efforts to understand women's needs and values. Trial registration: IS002316

scholarly journals SOCIOCULTURAL DETERMINANTS IN PAIN PERCEPTION AND MANAGEMENT AMONG OLDER CHINESE AMERICANS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S713-S714
Author(s):  
Simona Kwon ◽  
Jazmine Wong ◽  
Janet Pan ◽  
Andrew Rosenberg ◽  
Germaine Cuff ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Pain Management ◽  
Asian American ◽  
Chinese American ◽  
Chinese Americans ◽  
Mixed Methods Study ◽  
Assessment Tools ◽  
Management Interventions ◽  
Older Chinese ◽  
Older Chinese Americans

Abstract Background: Chinese Americans make up the largest Asian American subgroup in the US. Data from a large health system indicate that older Chinese Americans experience lower satisfaction in pain management after surgery compared to all other racial/ethnic groups. Objective: To understand pain experience among older Chinese American patients to improve pain satisfaction strategies Methods: A mixed methods study was conducted, including: 1. A scoping review of the peer-reviewed published literature; 2) face-to-face survey; and 3) qualitative interviews. 14 Chinese American postsurgical patients &gt;65 years of age were recruited for the survey and interview with a trained bilingual Community Health Worker. Questions from the Survey on Disparities in Quality of Healthcare and Kleinman’s Explanatory Model of Illness guided the data collection tools. Results: The 31 studies identified in the review were largely observational; none assessed pain control or management interventions for older Chinese Americans. Most participants reported experiencing a language barrier that hindered healthcare staff communication during hospital stay. Even with an interpreter, limited English proficient patients reported lower understanding of health information compared to those who did not need interpretation. Ideas of “pushing through” pain, perceiving physicians as “busy people,” and mismatch in pain assessment tools contributed to pain attendance delay. Facilitators to care included family support, culturally and linguistically-tailored tools, and availability of cultural remedies. Conclusions: This mixed-methods study identified key themes including socio-cultural barriers and facilitators to effective pain care and management. Findings will inform tools and resources to better capture and address pain management in Chinese Americans.

scholarly journals TELAAH ARTIKEL ILMIAH EFEKTIFITAS KOMPRE DINGIN TERHADAP PENURUNAN INTENSITAS NYERI LUKA PERINEUM IBU POST PARTUM

2021 ◽  
Vol 9 (2) ◽  
pp. 1
Author(s):  
Ayu Agustina ◽  
Agustina Ningsi ◽  
Marhaeni Marhaeni ◽  
Sitti Mukarramah
Keyword(s):  
Pain Management ◽  
Post Partum ◽  
Perineal Wound ◽  
Control Group ◽  
Journal Review ◽  
Advantages And Disadvantages ◽  
Post Test ◽  
Wound Pain ◽  
Study Population ◽  
The One

Every mother who has undergone a labor process with a perineal wound will feel pain, pain that is felt by every post partum mother causes discomfort so that pain management is needed. The purpose of this journal study was to determine the effectiveness of cold compresses in reducing the intensity of perineal wound pain in post partum mothers. The literature search method was the Google Scholar database using the keywords cold compress, perineal wound pain. The study population in the article studied were post partum mothers who experienced perineal wound pain with the research sample in article one of 30 people, 15 people in article two, and 200 people in article three. Articles one and two used the one group pretest post test research design, while the pepper article three used the control group pretest post test. The article review process includes a review of the components of the article regarding the systematics of writing, language style, advantages and disadvantages. The results of the review of the article show that cold compresses are effective in reducing the intensity of post partum maternal perineal wound pain. This journal review is expected to be a reference in the implementation of perineal wound pain management in post partum mothers.

scholarly journals Delayed onset of lactogenesis and reduced breastfeeding frequency in mothers who give birth by caesarean section

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Niamh M. Kelly ◽  
Jennifer T. Smilowitz ◽  
Orla Cagney ◽  
Robin L. Flannery ◽  
Rachel M Tribe
Keyword(s):  
Caesarean Section ◽  
Late Onset ◽  
Post Partum ◽  
Elective Caesarean Section ◽  
Breastfeeding Initiation ◽  
Delayed Onset ◽  
Mode Of Birth ◽  
The Difference ◽  
Additional Support ◽  
The Uk

AbstractLactogenesis stage II, also known as when a mother's milk “comes in”, is characterised by copious milk production. Delayed lactogenesis II, when onset occurs after 72 hours post-partum, has been linked to early breastfeeding cessation. It has been suggested that caesarean section is a risk factor for late onset of lactogenesis II. It is unknown why lactogenesis II may be delayed in caesarean section but there are several potential reasons such as volume of blood loss, maternal stress, delayed breastfeeding initiation and difficulties with mobility and positioning. Analysis of timing of lactogenesis and breastfeeding frequency was carried out on data from the PROMESA and IMPRINT studies, which were looking at the supplementation of breast milk with a probiotic Bifidobacterium infantis. IMPRINT was carried out in California and enrolled eighty women prior to birth or before postnatal day 4. The PROMESA study in the UK only recruited women who were booked for elective caesarean sections, and also enrolled eighty mother-baby dyads. As part of both studies mothers filled out a variety of surveys and daily logs, including a daily feeding log, along with self-reported lactogenesis. Using logistic regression, we looked at whether mode of birth (spontaneous vaginal delivery, emergency and elective caesarean section) was associated with the timing of onset of lactogenesis, and linear regression to look at the difference in breastfeeding frequency between modes of birth. Mode of birth was significantly associated with delayed onset of lactogenesis > 3 days (OR 3.38, 95% CI 2.48–4.61). There was also a reduced frequency of breastfeeding in the first week post-partum in mother-baby dyads who underwent an elective caesarean section. These findings suggest that mothers who give birth by elective caesarean section may need additional support with breastfeeding in the early days post-partum, as well as ongoing support long-term to reduce the likelihood of early cessation of breastfeeding.

scholarly journals Pain Standards for Accredited Healthcare Organizations (ACDON Project): A Mixed Methods Study

2021 ◽  
Vol 11 (2) ◽  
pp. 102
Author(s):  
Concepción Pérez ◽  
Jimmy Martin-Delgado ◽  
Mercedes Vinuesa ◽  
Pedro J. Ibor ◽  
Mercedes Guilabert ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Pain Management ◽  
Cancer Pain ◽  
Delphi Technique ◽  
Social Impact ◽  
Poor Quality ◽  
Nominal Group ◽  
Cancer Pain Management ◽  
Healthcare Organizations ◽  
High Level

Up to 50% of cancer patients and up to 90% of those in terminal stages experience pain associated with disease progression, poor quality of life, and social impact on caregivers. This study aimed to establish standards for the accreditation of oncological pain management in healthcare organizations. A mixed methods approach was used. First, a pragmatic literature review was conducted. Second, consensus between professionals and patients was reached using the Nominal Group and Delphi technique in a step that involved anesthesiologists, oncologists, family physicians, nurses, psychologists, patient representatives, and caregivers. Third, eight hospitals participated in a pilot assessment of the level of fulfillment of each standard. A total of 37 standards were extracted. The Nominal Group produced additional standards, of which 60 were included in Questionnaire 0 that was used in the Delphi Technique. Two Delphi voting rounds were performed to reach a high level of consensus, and involved 64 and 62 participants with response rates of 90% and 87%, respectively. Finally, 39 standards for the management of cancer pain were agreed upon. In the self-evaluation, the average range of compliance was between 56.4% and 100%. The consensus standards of the ACDON Project might improve the monitoring of cancer pain management. These standards satisfied the demands of professionals and patients and could be used for the accreditation of approaches in cancer pain management.

scholarly journals Nursing-Related Barriers to Children’s Pain Management at Selected Hospitals in Ghana: A Descriptive Qualitative Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Abigail Kusi Amponsah ◽  
Evans Frimpong Kyei ◽  
John Bright Agyemang ◽  
Hanson Boakye ◽  
Joana Kyei-Dompim ◽  
...  
Keyword(s):  
Pain Management ◽  
Qualitative Study ◽  
Developed Countries ◽  
Assessment Tools ◽  
Pediatric Care ◽  
Material Resources ◽  
Management Interventions ◽  
Communication Difficulties ◽  
Children's Pain ◽  
Descriptive Qualitative

Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children’s pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children’s pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children’s pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n = 24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses’ inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children’s pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children’s pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain management.

Content of antenatal care and perception about services provided by primary hospitals in Nepal: a convergent mixed methods study

2021 ◽  
Vol 33 (2) ◽  
Author(s):  
Yubraj Acharya ◽  
Nigel James ◽  
Rita Thapa ◽  
Saman Naz ◽  
Rishav Shrestha ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Mixed Methods ◽  
Antenatal Care ◽  
Quality Care ◽  
National Level ◽  
Poor Quality ◽  
Public Hospitals ◽  
World Health ◽  
Outcome Variable

Abstract Background Nepal has made significant strides in maternal and neonatal mortality over the last three decades. However, poor quality of care can threaten the gains, as maternal and newborn services are particularly sensitive to quality of care. Our study aimed to understand current gaps in the process and the outcome dimensions of the quality of antenatal care (ANC), particularly at the sub-national level. We assessed these dimensions of the quality of ANC in 17 primary, public hospitals across Nepal. We also assessed the variation in the ANC process across the patients’ socio-economic gradient. Methods We used a convergent mixed methods approach, whereby we triangulated qualitative and quantitative data. In the quantitative component, we observed interactions between providers (17 hospitals from all 7 provinces) and 198 women seeking ANC and recorded the tasks the providers performed, using the Service Provision Assessments protocol available from the Demographic and Health Survey program. The main outcome variable was the number of tasks performed by the provider during an ANC consultation. The tasks ranged from identifying potential signs of danger to providing counseling. We analyzed the resulting data descriptively and assessed the relationship between the number of tasks performed and users’ characteristics. In the qualitative component, we synthesized users’ and providers’ narratives on perceptions of the overall quality of care obtained through focus group discussions and in-depth interviews. Results Out of the 59 tasks recommended by the World Health Organization, providers performed only 22 tasks (37.3%) on average. The number of tasks performed varied significantly across provinces, with users in province 3 receiving significantly higher quality care than those in other provinces. Educated women were treated better than those with no education. Users and providers agreed that the overall quality of care was inadequate, although providers mentioned that the current quality was the best they could provide given the constraints they faced. Conclusion The quality of ANC in Nepal’s primary hospitals is poor and inequitable across education and geographic gradients. While current efforts, such as the provision of 24/7 birthing centers, can mitigate gaps in service availability, additional equipment, infrastructure and human resources will be needed to improve quality. Providers also need additional training focused on treating patients from different backgrounds equally. Our study also points to the need for additional research, both to document the quality of care more objectively and to establish key determinants of quality to inform policy.

scholarly journals Impact of Race and Sex on Pain Management by Medical Trainees: A Mixed Methods Pilot Study of Decision Making and Awareness of Influence

Pain Medicine ◽  
2015 ◽  
Vol 16 (2) ◽  
pp. 280-290 ◽  
Author(s):  
Nicole A. Hollingshead ◽  
Marianne S. Matthias ◽  
Matthew J. Bair ◽  
Adam T. Hirsh
Keyword(s):  
Decision Making ◽  
Mixed Methods ◽  
Pain Management ◽  
Pilot Study ◽  
Medical Trainees

scholarly journals Caesarean Section in Eclampsia and its Outcome in Bangladesh

KYAMC Journal ◽  
2017 ◽  
Vol 6 (1) ◽  
pp. 583-586
Author(s):  
MA Mazid ◽  
Shahida Akter
Keyword(s):  
Heart Failure ◽  
Pulmonary Embolism ◽  
Caesarean Section ◽  
Conservative Management ◽  
Causes Of Death ◽  
Post Partum ◽  
Economic Status ◽  
Treatment Options ◽  
Age Difference ◽  
Significant Difference

This prospective study was carried out on a total number of 58 eclamptic subjects during the period of July 2010 to June 2012 where 38 were undergone caesarean section (LUCS - Lower Uterine Caesarean Section) and 20 received conservative management. Mean (±SD) Age of the subjects who undergone Caesarean Section and conservative management (NVD) were 23.67±8.63 and 23.45±9.31 years respectively. Significant mean age difference was also present between these two groups. In 38 subjects of LUCS 34 subjects were recovered and rest 4 cases were died. Possible causes of death were due to heart failure and post partum pulmonary embolism. Among these 20 subjects who were treated conservatively 14 were recovered and 6 subjects were died. Causes of death in these groups were pulmonary embolism, Septic pneumonia, and HELLP syndrome. Significant difference was found between these two treatment options. It was observed that socio-demographic, economic status and BMI had significant effects on management outcome.KYAMC Journal Vol. 6, No.-1, Jul 2015, Page 583-586

Sign in / Sign up

Export Citation Format

Share Document