The Implementable Needs of Woman With Maternal Near Miss Experience: A Qualitative Study of Healthcare Providers

2021 ◽  
Author(s):  
Sedigheh Abdollahpour ◽  
Abbas Heydari ◽  
Hosein Ebrahimipour ◽  
Farhad Faridhoseini ◽  
Talat Khadivzadeh
Keyword(s):  
Qualitative Study ◽  
Qualitative Content Analysis ◽  
Quality Care ◽  
Healthcare Providers ◽  
Care Quality ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Health Providers ◽  
Data Saturation ◽  
Maternal Health Policy

Abstract Introduction: Maternal Near Miss (MNM) case is defined as “a woman who nearly died but survived a life-threatening and failure organ during pregnancy or childbirth complication that the challenges of this group of mothers have not been addressed. Aim: This qualitative study of healthcare providers was conducted to discover the Iranian near miss mother’s (NMM) needs. Design: conventional qualitative content analysis Methods: In this study 37 participants of key informants, health providers, NMM and their husbands were selected using purposive sampling. Semi structured in-depth interviews were conducted for data collection until data saturation was achieved. Data was analyzed using Graneheim and Lundman. MAXQDA 10 software was used for organizing data and managing the process of analysis. Results: The analysis revealed the core category of "the need for comprehensive support". Eight categories included "psychological", "fertility", "information", "improvement of the care quality care", "sociocultural", "financial", "breastfeeding" and "nutritional" needs emerged from 18 sub-categories, were formed from 2112 codes. Conclusions: Maternal health policy makers should call on health provider centers to work on program designed to support NMMs according to standard guidelines designed to assessment needs.

scholarly journals Midwives’ expectations from pregnant women regarding their participation in safe delivery: a qualitative study

2020 ◽  
Author(s):  
Roghieh Bayrami ◽  
Rahim Baghaei
Keyword(s):  
Qualitative Study ◽  
Pregnant Women ◽  
Qualitative Content Analysis ◽  
Perinatal Care ◽  
Developed Countries ◽  
Care Quality ◽  
Public Hospitals ◽  
Structured Interviews ◽  
Safe Delivery ◽  
Data Saturation

Abstract Background : Pregnant women’s participation in safe delivery is associated with safety assurance and improvement. Safety and care quality improvement in developed countries has so far been based on research and clinical evidence. Nonetheless, stakeholders’ preferences and expectations were not much taken into account. This study aimed to explore midwives’ expectations from pregnant women regarding their participation in safe delivery. Methods : This qualitative study was conducted in 2019 in three public hospitals in Urmia, Iran. Data were collected through 24 in-depth semi-structured interviews with 24 midwives. Sampling was done purposively and continued up to data saturation. Data were analyzed through Graneheim and Lundman’s qualitative content analysis. Results: Midwives’ expectations from pregnant women regarding their participation in safe delivery were grouped into the two main themes of effective communication (with two main categories) and empowerment of pregnant women (with three categories). The five main categories of these two themes were client’s interaction with midwife, confidence in midwife, readiness for delivery, health literacy improvement, and participation in safe behaviors, respectively. Conclusions : Understanding midwives’ expectations regarding pregnant women participation in safe delivery is important to the development of policies for care quality and safety improvement in perinatal care. Keywords : Patient participation, Safe delivery, Qualitative study

PATIENTS’ JOURNEY THROUGH INFLAMMATORY BOWEL DISEASE (IBD): A QUALITATIVE STUDY

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S53-S54
Author(s):  
Tina Aswani Omprakash ◽  
Norelle Reilly ◽  
Jan Bhagwakar ◽  
Jeanette Carrell ◽  
Kristina Woodburn ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Qualitative Study ◽  
Patient Experience ◽  
Bowel Disease ◽  
Quality Care ◽  
Diagnostic Testing ◽  
Healthcare Providers ◽  
Indeterminate Colitis ◽  
Patient Journey ◽  
Inflammatory Bowel

Abstract Background Inflammatory bowel disease (IBD) is a debilitating intestinal condition, manifesting as Crohn’s disease (CD), ulcerative colitis (UC) or indeterminate colitis (IC). The patient experience is impacted by a lack of awareness from other stakeholders despite growing global disease prevalence. To gain deeper insight of the patient experience, promote quality care, and enhance quality of life, we performed a qualitative study of the patient journey starting from pre-diagnosis through treatment. Methods U.S. patients with IBD were recruited via UC/CD support groups and organizations, social media platforms, blog followers, and personal networks. Participants were screened via an emailed survey and asked to self-identify as medically diagnosed on the basis of reported diagnostic testing. Interviews were conducted by qualitative researchers by phone or web conferencing. Open-ended questions were developed to support and gather information about our learning objectives—primarily, our desire to understand the unique experiences of UC/CD patients in their journey from symptom onset through diagnosis, treatment and maintenance (e.g. “Upon diagnosis, what were your immediate thoughts about the condition?”). This qualitative data were analyzed using Human-Centered Design methodology, including patient typologies (personas), forced temporal zoom (journey maps), forced semantic zoom (stakeholder system mapping), and affinity mapping for pattern recognition of unmet needs. Results A total of 32 patients were interviewed: N=17 CD patients, N=13 UC patients and N=2 IC patients. The interviewed population reflected regional, demographic, and disease-related diversity (Table 1). Five unique, mutually exclusive journeys were identified to understand and classify patient experiences: (1) Journey of Independence, (2) Journey of Acceptance, (3) Journey of Recognition, (4) Journey of Passion and (5) Journey of Determination (Figure 1). Patients with IBD expressed a need for increased awareness, education, and training for providers to shorten the path to diagnosis. Mental health support was found to be a critical gap in care, particularly for major treatment decisions (e.g., surgery). The inclusion of emotional support into the treatment paradigm was perceived as essential to long-term wellness. Patient attitudes and self-advocacy varied on their individual journeys; understanding these journeys may accelerate time to diagnosis and treatment. Conclusion Better understanding of patient journeys can help healthcare providers improve their approach to patient care and coordination.

scholarly journals White lie during patient care: A qualitative study of nurses’ perspectives

2020 ◽  
Author(s):  
Alireza Nikbakht nasrabadi ◽  
soodabeh joolaee ◽  
Elham Navab ◽  
Maryam esmaeilie ◽  
mahboobe shali
Keyword(s):  
Qualitative Study ◽  
Patient Care ◽  
Healthcare Providers ◽  
Cultural Knowledge ◽  
Hospital Nurses ◽  
Structured Interviews ◽  
Related Factors ◽  
Patient’S Rights ◽  
Wide Range ◽  
Data Saturation

Abstract Background: Keeping the patients well and fully informed about diagnosis, prognosis, and treatments is one of the patient’s rights in any healthcare system. Although all healthcare providers have the same viewpoint about rendering the truth in treatment process, sometimes the truth is not told to the patients; that is why the healthcare staff tell “white lie” instead. This study aimed to explore the nurses’ experience of white lies during patient care. Methods: This qualitative study was conducted from June to December 2018. Eighteen hospital nurses were recruited with maximum variation from ten state-run educational hospitals affiliated to Tehran University of Medical Sciences. Purposeful sampling was used and data were collected by semi-structured interviews that were continued until data saturation. Data were classified and analyzed by content analysis approach. Results: The data analysis in this study resulted in four main categories and eleven subcategories. The main categories included hope crisis, bad news, cultural diversity, and nurses’ limited professional competences. Conclusion: Results of the present study showed that, white lie told by nurses during patient care may be due to a wide range of patient, nurse and/or organizational related factors. Communication was the main factor that influenced information rendering. Nurses’ communication with patients should be based on mutual respect, trust and adequate cultural knowledge, and also nurses should provide precise information to patients, so that they can make accurate decisions regarding their health care.

scholarly journals Cigarette smokers’ views on their habit and the causes of their illness following lung cancer diagnosis: a clinical-qualitative study

2006 ◽  
Vol 124 (3) ◽  
pp. 125-129 ◽  
Author(s):  
Olívia Meira Dias ◽  
Egberto Ribeiro Turato
Keyword(s):  
Lung Cancer ◽  
Qualitative Study ◽  
Qualitative Content Analysis ◽  
Tobacco Product ◽  
Small Sample ◽  
Medical Psychology ◽  
Healthcare Team ◽  
Theoretical Concepts ◽  
Lung Cancer Diagnosis ◽  
Data Saturation

CONTEXT AND OBJECTIVE: Lung cancer is the commonest malignant tumor and is increasing in incidence by 2% a year. In 90% of diagnosed cases, it is associated with tobacco product consumption. It is the greatest cause of mortality among cancer types in Brazil. Knowledge of patients’ psychological representations is needed for evaluating treatments and educating patients. The aim here was to interpret how smokers with lung cancer interpret the possible causes of their illness and to understand their perceptions regarding cigarette use. DESIGN AND SETTING: Clinical-qualitative study (exploratory, non-experimental) at the Pulmonary Disease Service, General Hospital, Universidade Estadual de Campinas. METHODS: An intentional small sample of cancer inpatients was recruited. The group was closed with 11 subjects, following attainment of data saturation from interviews. These interviews were semi-directed, with in-depth open-ended questions on interviewees’ observations, applied in a confidential setting using a tape recorder. Interviewees’ responses were categorized using qualitative content analysis and the results were assessed using interdisciplinary theoretical concepts, particularly from medical psychology. RESULTS: Six males and five females aged between 46 and 68 years who presented diverse clinical conditions were interviewed. CONCLUSIONS: A broader approach towards the psychological comprehension of such patients is needed, considering that cigarette consumption involves conscious and unconscious motivations, sociocultural and educational factors, the glamour of tobacco advertising, and problems with psychophysical dependence. Such an approach would avoid the perception among patients that the healthcare team are "inquisitors". This would lead to better adherence to treatment and better quality of life.

scholarly journals Facilitators and Barriers of Managing Patients with Multiple Chronic Conditions in the Community: A Qualitative Study

2019 ◽  
Author(s):  
Kah Mun Foo ◽  
Meena Sundram ◽  
Helena Legido-Quigley
Keyword(s):  
Qualitative Study ◽  
Waiting Time ◽  
Chronic Conditions ◽  
Resource Constraints ◽  
Healthcare Providers ◽  
Policy Formulation ◽  
Care Quality ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Facilitators And Barriers

Abstract Background About one-third of all adults worldwide were diagnosed with multiple chronic conditions (MCCs). Literature had found several challenges of providers and patients coping with managing MCCs in the community, and yet limited research studies that consider their viewpoints in combination. A qualitative study involving healthcare providers and users was thus conducted to examine facilitators and barriers of managing patients with MCCs in the community in Singapore. Methods This involves 26 semi-structured interviews with 10 physicians, 2 caregivers and 14 patients seeking treatment in the polyclinics that provides subsidised primary care services. Topic guides were developed with reference from literature review, Chronic Care Model (CCM) and Framework for patient-centred access to healthcare. Results Despite perceived affordable charges and availability of support system, some patients still encountered financial difficulties in managing care. These include inadequacy of the nation-wide medical savings scheme to cover outpatient treatment and medications. Half of the healthcare users did not know where to seek help. While patients could access comprehensive services in polyclinics, those that did not turn up might not receive timely care. Furthermore, patients reported long consultation waiting time. Physicians were able to propose and drive quality improvement projects to improve care quality. However, there were challenges of delivering safe and quality care with limited consultation duration due to the need to manage waiting time, inadequate communication with specialists to coordinate care, and resource constraints in managing complex patients. Although providers could equip patients with self-management and lifestyle related guidelines, patients’ actions are influenced by multiple factors including work nature, beliefs and environment. Conclusions There were barriers on care access, delivery and self-management as reported. It is crucial to adopt whole-of-society approach involving individuals, community, institutions and policymakers to improve and support MCCs management. This study has also highlighted the importance to consider different viewpoints of healthcare providers and users in policy formulation and community care planning.

scholarly journals Determinant factors of maternal near miss in selected health facilities of Berak Woreda, Oromia national regional state, Ethiopia

2020 ◽  
Vol 6 (4) ◽  
pp. 131
Author(s):  
Bilal Abdulrazaq ◽  
Mulusew Getahun ◽  
Ahmed Mohammed ◽  
Shemsu Kedir ◽  
Negash Nurahmed ◽  
...  
Keyword(s):  
Sampling Technique ◽  
Simple Random Sampling ◽  
Health Facilities ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Outcome Variable ◽  
Obstructed Labor ◽  
Determinant Factors ◽  
Regional State ◽  
Maternal Health Policy

<p class="abstract"><strong>Background:</strong> Maternal near miss is one of the related concepts to maternal mortality where women survive merely by chance, luck, or by good hospital care. The present study was aimed to fill the prevailing knowledge gap on maternal near miss ratio and events and identify factors associated with near miss in selected health facilities of berak woreda. To determine associated factors of maternal near miss in selected health facilities of Berak woreda, Oromia national regional state, Ethiopia.  </p><p class="abstract"><strong>Methods:</strong> Institutional based case control study was conducted in selected health facilities of barek woreda to asses determinant factors of maternal near miss among delivered women. Data of 1272 (344 cases and 928 controls) women were included in the analysis registered from 11 September 2014 to 30 March 2018. Cases were women due to severe acute maternal morbidity while controls were women for normal labor. Simple random sampling technique was used in the delivery unit. The data were collected using WHO standard tool. Data were entered using epi data version 3.1 and exported to SPSSV.20 for data analysis.  </p><p class="abstract"><strong>Results:</strong> Majority of cases were due to obstructed labor 270 (78.8%) followed by hemorrhage 33 (9.6%), preeclampsia 29 (8.14%), abortion 6 (1.74%), anemia 3 (0.87%), congenital heart disease 2 (0.58%) and gestational infection 1 (0.29%).</p><p><strong>Conclusions:</strong> Independent variables residence, duration of labor, ANC utilization, past obstetrics complication and number of live births were statistically significant with the outcome variable near miss. Maternal health policy needs to be concerned preventing major cause of near miss.</p><strong id="tinymce" class="mceContentBody " dir="ltr"><em></em></strong>

scholarly journals Exploration of the Pregnant Women's Experiences During COVID-19 Disease Crisis: A Qualitative Study

2020 ◽  
Author(s):  
Fatemeh Bakouei ◽  
Maryam Nikpour ◽  
Hajar Adib Rad ◽  
zahra abadi marzoni
Keyword(s):  
Qualitative Study ◽  
Pregnant Women ◽  
Healthcare Providers ◽  
Pregnancy Care ◽  
Women’S Experiences ◽  
Individual Interviews ◽  
Women's Experiences ◽  
Data Saturation ◽  
North Of Iran ◽  
And Control

Abstract Background: Prevention and control of COVID-19 disease in pregnant women has become a major concern. Healthcare providers should be aware that restriction of the routine prenatal care may have adverse effects. A qualitative approach can be helpful in understanding the pregnant women's experience and perspective in crisis. The study was conducted to explain the pregnant women's experiences during COVID-19 disease crisis.Methods: The qualitative study was conducted with conventional content analysis. Pregnant women selected with purposive sampling from six urban health centers in Babol (North of Iran). The semi structured individual interviews were done by telephone from May 03 to June 10, 2020. The systematic thematic analysis was used to identify and organize themes into clusters and categories across interviews.Result: We recruited twelve pregnant women until data saturation. Three theme categories extracted from data analysis. The first was "unpleasant feelings during pregnancy", the pregnant women stated feelings in this crisis such as worry, fear, obsession, boredom, nervousness, discouragement, and the like, which led them to have no positive pregnancy experience. The second category was "adjusted lifestyle". They experienced changes in lifestyle with the aim of preventing COVID-19 disease. The third category was “safe pregnancy care”. The pregnant women, while paying attention to the importance of pregnancy care, were forced to limit, delay, or modify some cares in order to be safe. Conclusion: The pregnant women experienced unpleasant feelings in this crisis; therefore, they should receive the necessary consulting to maintain mental health. All pregnant women reported some changes in their lifestyle and pregnancy care in order to health considerations to prevent the disease. Regular training for all pregnant women is necessary to manage this important pregnancy period while maintaining the maternal and fetal health in crisis.

scholarly journals ‘It felt like a black hole, great uncertainty, but we have to take care for our patients’–Qualitative findings on the effects of the COVID-19 pandemic on specialist palliative home care

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260767
Author(s):  
Maximiliane Jansky ◽  
Franziska Schade ◽  
Nicola Rieder ◽  
Danica Lohrmann ◽  
Cordula Gebel ◽  
...  
Keyword(s):  
Home Care ◽  
Information Management ◽  
Qualitative Content Analysis ◽  
Health Care Systems ◽  
Quality Care ◽  
Multidisciplinary Teams ◽  
Local Health ◽  
Health Providers ◽  
Local Networks ◽  
Palliative Home Care

Background The COVID-19 pandemic has affected health care systems worldwide. Multidisciplinary teams provide specialist palliative home care (SPHC) for patients with incurable, severe, progressive diseases. These patients are at the same time at high risk, if infected, highly constricted by containment measures, and dependent on support. Aim To explore i) how German SPHC teams were affected by the pandemic during the first wave, ii) which challenges they faced, and iii) which strategies helped to handle the consequences of the COVID-19 pandemic for providing good SPHC. Method Four focus groups (with representatives of 18 SPHC teams) and five guided interviews with stakeholders were conducted and analysed using qualitative content analysis. Results Seven key categories emerged from the data. A category in the background describes dependence on organizational characteristics (e.g. sponsorship), which varied by regional factors. Information management was a challenge to SPHC teams, as they had to collect, interpret and adapt, and disseminate information. They reported a shift in patient care because of the COVID-19 pandemic, due to restricted home visits, visitation ban in nursing homes, and difficulties for hospital, hospice and nursing home admissions. Measures to reduce risk of infection impeded teamwork. Teams relied upon their local networks in crisis management, but felt often overlooked by local health authorities. Their respective SPHC state associations supported them in information management and exchange. Discussion The pandemic has severely impacted home care for especially vulnerable seriously ill and dying people. A good network with local health providers and authorities could help to harmonize local regulations and ensure quality care for all patient groups. SPHC teams could play an important role in caring for palliative patients with COVID-19 who are not admitted to a hospital due to preferences or resources.

scholarly journals Healthcare providers’ perspectives on use of the national guideline for family planning services in Amhara Region, Ethiopia: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023403 ◽  
Author(s):  
Gizachew Assefa Tessema ◽  
Judith Streak Gomersall ◽  
Caroline O Laurence ◽  
Mohammad Afzal Mahmood
Keyword(s):  
Family Planning ◽  
Qualitative Study ◽  
Local Level ◽  
Quality Care ◽  
Healthcare Providers ◽  
Northwest Ethiopia ◽  
Secondary Outcome ◽  
Amhara Region ◽  
Support Provision ◽  
Quality Healthcare

ObjectiveTo explore healthcare providers’ views on barriers to and facilitators of use of the national family planning (FP) guideline for FP services in Amhara Region, Ethiopia.DesignQualitative study.SettingNine health facilities including two hospitals, five health centres and two health posts in Amhara Region, Northwest Ethiopia.ParticipantsTwenty-one healthcare providers working in the provision of FP services in Amhara Region.Primary and secondary outcome measuresSemistructured interviews were conducted to understand healthcare providers’ views on barriers to and facilitators of the FP guideline use in the selected FP services.ResultsWhile the healthcare providers’ views point to a few facilitators that promote use of the guideline, more barriers were identified. The barriers included: lack of knowledge about the guideline’s existence, purpose and quality, healthcare providers’ personal religious beliefs, reliance on prior knowledge and tradition rather than protocols and guidelines, lack of availability or insufficient access to the guideline and inadequate training on how to use the guideline. Facilitators for the guideline use were ready access to the guideline, convenience and ease of implementation and incentives.ConclusionsWhile development of the guideline is an important initiative by the Ethiopian government for improving quality of care in FP services, continued use of this resource by all healthcare providers requires planning to promote facilitating factors and address barriers to use of the FP guideline. Training that includes a discussion about healthcare providers’ beliefs and traditional practices as well as other factors that reduce guideline use and increasing the sufficient number of guideline copies available at the local level, as well as translation of the guideline into local language are important to support provision of quality care in FP services.

scholarly journals Respectful care an added extra: a grounded theory study exploring intrapartum experiences in Zambia and Tanzania

2021 ◽  
Vol 6 (4) ◽  
pp. e004725
Author(s):  
Tina Lavender ◽  
Carol Bedwell ◽  
Chowa Tembo Kasengele ◽  
Debora Kimaro ◽  
Flora Kuzenza ◽  
...  
Keyword(s):  
Grounded Theory ◽  
Low Income ◽  
Quality Care ◽  
Healthcare Providers ◽  
Newborn Care ◽  
Health Providers ◽  
Training Programmes ◽  
Vantage Points ◽  
Respectful Care

BackgroundQuality of maternal and newborn care is integral to positive clinical, social and psychological outcomes. Respectful care is an important component of this but is suboptimum in many low-income settings. A renewed energy among health professionals and academics is driving an international agenda to eradicate disrespectful health facility care around the globe. However, few studies have explored respectful care from different vantage points.MethodsWe used Strauss and Corbin’s grounded theory methodology to explore intrapartum experiences in Tanzania and Zambia. In-depth interviews were conducted with 98 participants (48 women, 18 partners, 21 health-providers and 11 key stakeholders), resulting in data saturation. Analysis involved constant comparison, comprising three stages of coding: open, axial and selective. The process involved application of memos, reflexivity and positionality.ResultsFindings demonstrated that direct and indirect social discrimination led to inequity of care. Health-providers were believed to display manipulative behaviours to orchestrate situations for their own or the woman’s benefit, and were often caring against the odds, in challenging environments. Emergent categories were related to the core category: respectful care, an added extra, which reflects the notion that women did not always expect or receive respectful care, and tolerated poor experiences to obtain services believed to benefit them or their babies. Respectful care was not seen as a component of good quality care, but a luxury that only some receive.ConclusionBoth quality of care and respectful care were valued but were not viewed as mutually inclusive. Good quality treatment (transactional care) was often juxtaposed with disrespectful care; with relational care having a lower status among women and healthcare providers. To readdress the balance, respectful care should be a predominant theme in training programmes, policies and audits. Women’s and health-provider voices are pivotal to the development of such interventions.

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