scholarly journals Drawing a Line between Hope and Accountability: Midwives’ Response to a “Psychosocial Antenatal Care” Pilot Project in Gauteng, South Africa

2020 ◽  
Vol 22 (2) ◽  
Author(s):  
Johanna Mathibe-Neke ◽  
Kgomotso Makobe
Keyword(s):  
South Africa ◽  
Antenatal Care ◽  
Assessment Tool ◽  
Phase 1 ◽  
Quality Care ◽  
Healthcare Providers ◽  
Psychosocial Care ◽  
Pilot Project ◽  
Psychosocial Assessment ◽  
Human Beings

Psychosocial care during pregnancy is embedded in women-centred care, and the improvement of quality care based on compassion has become a top priority for healthcare providers. Compassion is a deep feeling of connecting to human beings’ suffering, a moral response that leads to patient care with comfort. Such caring is skilful and worthy, respects the dignity of individuals and is intertwined with professional competency. The purpose of the pilot project was to raise the midwives’ awareness of the importance of psychosocial care during pregnancy, to assess the use of the psychosocial assessment tool, to fill the gap between routine physical antenatal care and psychosocial care, and to enhance the use of psychosocial services. An exploratory and descriptive study design was applied. The study population consisted of 34 midwives who participated in the implementation of the assessment tool in the 12 participating health facilities in Gauteng, South Africa. The data collection was conducted in two phases. Phase 1 consisted of a self-administered questionnaire to establish competency when using the assessment tool. Phase 2 consisted of focus group discussions. The four main themes that emerged were the importance of psychosocial risk assessments, experiences of the implementation of the assessment tool, challenges and barriers, and identified risk factors. The results reflected the midwives’ ability and willingness to implement the tool as part of their accountability, despite the challenges experienced. Moreover, the midwives hoped that the tool will be incorporated as part of routine antenatal care.

scholarly journals MyHEARTSMAP: development and evaluation of a psychosocial self-assessment tool, for and by youth

2019 ◽  
Vol 3 (1) ◽  
pp. e000493 ◽  
Author(s):  
Punit Virk ◽  
Samara Laskin ◽  
Rebecca Gokiert ◽  
Chris Richardson ◽  
Mandi Newton ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Phase 1 ◽  
Community Sample ◽  
Mental Healthcare ◽  
Cross Sectional Study ◽  
Psychosocial Assessment ◽  
Management Tool ◽  
Phase 2 ◽  
Cross Sectional ◽  
Health Related

BackgroundPaediatric mental health-related visits to the emergency department are rising. However, few tools exist to identify concerns early and connect youth with appropriate mental healthcare. Our objective was to develop a digital youth psychosocial assessment and management tool (MyHEARTSMAP) and evaluate its inter-rater reliability when self-administered by a community-based sample of youth and parents.MethodsWe conducted a multiphasic, multimethod study. In phase 1, focus group sessions were used to inform tool development, through an iterative modification process. In phase 2, a cross-sectional study was conducted in two rounds of evaluation, where participants used MyHEARTSMAP to assess 25 fictional cases.ResultsMyHEARTSMAP displays good face and content validity, as supported by feedback from phase 1 focus groups with youth and parents (n=38). Among phase 2 participants (n=30), the tool showed moderate to excellent agreement across all psychosocial sections (κ=0.76–0.98).ConclusionsOur findings show that MyHEARTSMAP is an approachable and interpretable psychosocial assessment and management tool that can be reliably applied by a diverse community sample of youth and parents.

The psychosocial matrix: A community-derived evaluative tool for designing quality psychosocial cancer care.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 250-250
Author(s):  
Laura Pence Forsythe ◽  
Julia Howe Rowland ◽  
Lynne Padgett ◽  
Karyl Blaseg ◽  
Scott Siegel ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Assessment Tool ◽  
Quality Care ◽  
Psychosocial Care ◽  
Institute Of Medicine ◽  
Distress Screening ◽  
Cancer Centers ◽  
Future Aspirations ◽  
Essential Components

250 Background: Although the Institute of Medicine provided a vision for effective psychosocial care for cancer survivors, guidance regarding the essential components of comprehensive care or progressive steps for implementing each component is limited. This abstract presents a unique tool for self-assessing capacity to provide quality psychosocial care to cancer survivors and results of the first full-scale implementation of this tool. Methods: The psychosocial workgroup of the National Cancer Institute Community Cancer Centers Program (NCCCP) developed the Psychosocial Care Matrix Assessment Tool which covers 7 domains (e.g., distress screening, patient-provider communication, evaluation of psychosocial programs). All NCCCP sites (16 enrolled in 2007, 14 enrolled in 2010) completed the matrix in 2010 regarding their capacity for psychosocial care at entry into NCCCP (baseline), after two years of NCCCP participation (2007 sites only), and within the coming year (future aspirations). Results: At baseline, matrix responses reflected few or no systematic processes in place for most components of psychosocial care. However, reported capacity to deliver specific components improved at two years post-NCCCP entry for the 2007 sites and in all sites’ future aspirations. For example, about 80% of all sites reported no or inconsistent distress screening at baseline. After two years, 48% of the 2007 sites reported consistent screening with a standardized tool or consistent screening plus a comprehensive interview. Nearly all 2007 sites (89%) aspired to provide consistent screening plus comprehensive interview with 50% also hoping to add systematic follow-up screenings. The majority of 2010 sites (71%) aspired to provide consistent screening with a standardized tool. Conclusions: The psychosocial matrix tool was found to be useable and valuable. At the NCCCP sites, some aspects of psychosocial care (e.g., communicating the importance of psychosocial care) are more readily implemented than others (e.g., follow-up after a positive distress screen). With growing demand on cancer centers to meet new metrics of quality care, the psychosocial matrix can help identify and develop steps to address gap areas.

scholarly journals The perception of midwives regarding psychosocial risk assessment during antenatal care

2014 ◽  
Vol 19 (1) ◽  
Author(s):  
Johanna M. Mathibe-Neke ◽  
Allan Rothberg ◽  
Gayle Langley
Keyword(s):  
Risk Assessment ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Psychosocial Support ◽  
Psychosocial Care ◽  
Psychosocial Problems ◽  
Structured Interview ◽  
Psychosocial Risk ◽  
Psychosocial Assessment ◽  
Psychosocial Risk Assessment

Background: The physiological and psychological changes caused by pregnancy may increase a woman’s vulnerability to depression, which may in turn have adverse effects on both maternal and foetal wellbeing. Inadequate psychosocial risk assessment of women by midwives may lead to lack of psychosocial support during pregnancy and childbirth. Pregnant women who lack psychosocial support may experience stress, anxiety and depression that could possibly affect foetal wellbeing.Objective: The objective of this study was to explore and describe the perception of psychosocial risk assessment and psychosocial care by midwives providing antenatal care to pregnant women.Method: An interpretive and descriptive qualitative approach was adopted. Three focus group interviews were conducted with midwives working in three Maternal Obstetric Units in Gauteng Province, using a semi-structured interview guide. The constant comparison data analysis approach was used.Results: Findings revealed that midwives are aware of and have encountered a high prevalence of psychosocial problems in pregnant women. Furthermore, they acknowledged the importance of psychosocial care for pregnant women although they stated that they were not equipped adequately to offer psychosocial assessment and psychosocial care.Conclusion: The findings provided a basis for incorporation of psychosocial care into routine antenatal care. Agtergrond: Die fisiologiese en psigologiese veranderings wat deur swangerskap veroorsaak word, kan ‘n vrou se kwetsbaarheid vir depressie verhoog. Dit kan op sy beurt negatiewe gevolge vir sowel die moeder as die fetus se welstand hê. As vroedvroue nie voldoende psigososiale riskio-assesserings op swanger vrouens doen nie, kan dit tot ‘n gebrek aan psigososiale ondersteuning tydens die swangerskap en geboorte lei. Swanger vrouens wat ‘n gebrek aan psigososiale ondersteuning het, kan stres, angs en depressie ervaar wat weer die fetus se welstand kan beïnvloed.Doelwit: Die doelwit van hierdie studie was om die persepsies van vroedvroue, wat voorgeboortesorg aan swanger vrouens bied, te ondersoek en te beskryf sover dit hulle persepsies oor psigososiale risiko-assessering en psigososiale aangaan.Metode: ’n Interpretatiewe en beskrywende kwalitatiewe benadering is gevolg. Drie fokusgroep-onderhoude is deur middel van ‘n gestruktureerde onderhoudsgids gevoer met verloskundiges wat in drie voorgeboorteklinieke in die Gauteng Provinsie werksaam is. ’n Benadering tot data-analise wat van voortdurende vergelyking gebruik maak, is gevolg.Resultate: Die studie het aan die lig gebring dat verloskundiges bewus is van psigososiale probleme onder swanger vroue en dat die prevalensie van sulke probleme onder swanger vroue hoog is. Vroedvroue erken die belang van psigososiale sorg aan swanger vroue alhoewel hulle nie toereikend toegerus is om psigososiale assessering en -sorg te verleen nie.Gevolgtrekking: Die bevindinge stel ’n basis daar vir die insluiting van psigososiale sorg in roetine voorgeboortesorg.

scholarly journals Implementation of family psychosocial risk assessment in pediatric cancer with the Psychosocial Assessment Tool (PAT): Study protocol for a cluster randomized comparative effectiveness trial

2020 ◽  
Author(s):  
Anne Kazak ◽  
Janet Deatrick ◽  
Michele Scialla ◽  
Eric Sandler ◽  
Rebecca Madden ◽  
...  
Keyword(s):  
Pediatric Cancer ◽  
Comparative Effectiveness ◽  
Assessment Tool ◽  
Psychosocial Care ◽  
Implementation Strategies ◽  
Interactive Systems ◽  
Psychosocial Assessment ◽  
Use Of Resources ◽  
Healthcare Needs ◽  
Cluster Randomized

Abstract BackgroundChildhood cancer affects and is affected by multiple levels of the social ecology, including social and relational determinants of health (e.g. economic stability, housing, childcare, healthcare access, child and family problems). The 2015 Standards of Psychosocial Care in Pediatric Cancer outline optimal psychosocial care sensitive to these ecological factors, starting with assessment of psychosocial healthcare needs to promote medical and psychosocial outcomes across all children with cancer. To address the first standard of family psychosocial assessment, the Psychosocial Assessment Tool (PAT) is a validated screener ready for broad implementation.MethodThe PAT will be implemented across a national sample of 18 pediatric cancer programs ranging in size (annual new patients) in a mixed methods, comparative effectiveness study, guided by the Interactive Systems Framework for Dissemination and Implementation, comparing two implementation Strategies. It is hypothesized that implementation will be more successful at the patient/family, provider, and institutional level when Training (Strategy I) is combined with Implementation Expanded Resources (Strategy II). There are three aims: 1) Refine the two implementation strategies using semi-structured qualitative interviews with 19 stakeholders including parent advocates, providers, pediatric oncology organization representatives, healthcare industry leaders; 2) Compare the two theoretically based and empirically informed strategies to implement the PAT in English and Spanish using a cluster randomized controlled trial across 18 sites. Stratified by size, sites will be randomized to cohort (3) and strategy (2). Outcomes include adoption and penetration of screening (patient/family), staff job satisfaction/burnout (provider), and cost effective use of resources consistent with family risk (institution); 3) Based on the results of the trial and feedback from the first and second aim, we will develop and disseminate a web-based PAT Implementation Toolkit.DiscussionUse of the PAT across children’s cancer programs nationally can achieve the assessment Standard and inform equitable delivery of psychosocial care matched to family need for all patients.Trial RegistrationClinicalTrials.gov, NCT04446728, registered 23 June 2020

scholarly journals External injuries, trauma and avoidable deaths in Agincourt, South Africa: a retrospective observational and qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027576 ◽  
Author(s):  
Idara J Edem ◽  
Anna J Dare ◽  
Peter Byass ◽  
Lucia D’Ambruoso ◽  
Kathleen Kahn ◽  
...  
Keyword(s):  
South Africa ◽  
Health System ◽  
Low Income ◽  
Quality Care ◽  
Healthcare Providers ◽  
Middle Income ◽  
Avoidable Deaths ◽  
Avoidable Death ◽  
Three Delays ◽  
Trauma Deaths

ObjectiveInjury burden is highest in low-income and middle-income countries. To reduce avoidable deaths, it is necessary to identify health system deficiencies preventing timely, quality care. We developed criteria to use verbal autopsy (VA) data to identify avoidable deaths and associated health system deficiencies.SettingAgincourt, a rural Bushbuckridge municipality, Mpumalanga Province, South Africa.ParticipantsAgincourt Health and Socio-Demographic Surveillance System and healthcare providers (HCPs) from local hospitals.MethodsA literature review to explore definitions of avoidable deaths after trauma and barriers to access to care using the ‘three delays framework’ (seeking, reaching and receiving care) was performed. Based on these definitions, this study developed criteria, applicable for use with VA data, for identifying avoidable death and which of the three delays contributed to avoidable deaths. These criteria were then applied retrospectively to the VA-defined category external injury deaths (EIDs—a subset of which are trauma deaths) from 2012 to 2015. The findings were validated by external expert review. Key informant interviews (KIIs) with HCPs were performed to further explore delays to care.ResultsUsing VA data, avoidable death was defined with a focus on survivability, using level of consciousness at the scene and ability to seek care as indicators. Of 260 EIDs (189 trauma deaths), there were 104 (40%) avoidable EIDs and 78 (30%) avoidable trauma deaths (41% of trauma deaths). Delay in receiving care was the largest contributor to avoidable EIDs (61%) and trauma deaths (59%), followed by delay in seeking care (24% and 23%) and in reaching care (15% and 18%). KIIs revealed context-specific factors contributing to the third delay, including difficult referral systems.ConclusionsA substantial proportion of EIDs and trauma deaths were avoidable, mainly occurring due to facility-based delays in care. Interventions, including strengthening referral networks, may substantially reduce trauma deaths.

scholarly journals Implementation of family psychosocial risk assessment in pediatric cancer with the Psychosocial Assessment Tool (PAT): Study protocol for a cluster randomized comparative effectiveness trial

2020 ◽  
Author(s):  
Anne Kazak ◽  
Janet Deatrick ◽  
Michele Scialla ◽  
Eric Sandler ◽  
Rebecca Madden ◽  
...  
Keyword(s):  
Pediatric Cancer ◽  
Comparative Effectiveness ◽  
Assessment Tool ◽  
Psychosocial Care ◽  
Implementation Strategies ◽  
Interactive Systems ◽  
Psychosocial Assessment ◽  
Use Of Resources ◽  
Healthcare Needs ◽  
Cluster Randomized

Abstract Background: Childhood cancer affects and is affected by multiple levels of the social ecology, including social and relational determinants of health (e.g. economic stability, housing, childcare, healthcare access, child and family problems). The 2015 Standards of Psychosocial Care in Pediatric Cancer outline optimal psychosocial care sensitive to these ecological factors, starting with assessment of psychosocial healthcare needs to promote medical and psychosocial outcomes across all children with cancer. To address the first standard of family psychosocial assessment, the Psychosocial Assessment Tool (PAT) is a validated screener ready for broad implementation. Method: The PAT will be implemented across a national sample of 18 pediatric cancer programs ranging in size (annual new patients) in a mixed methods, comparative effectiveness study, guided by the Interactive Systems Framework for Dissemination and Implementation, comparing two implementation Strategies. It is hypothesized that implementation will be more successful at the patient/family, provider, and institutional level when Training (Strategy I) is combined with Implementation Expanded Resources (Strategy II). There are three aims: 1) Refine the two implementation strategies using semi-structured qualitative interviews with 19 stakeholders including parent advocates, providers, pediatric oncology organization representatives, healthcare industry leaders; 2) Compare the two theoretically based and empirically informed strategies to implement the PAT in English and Spanish using a cluster randomized controlled trial across 18 sites. Stratified by size, sites will be randomized to cohort (3) and strategy (2). Outcomes include adoption and penetration of screening (patient/family), staff job satisfaction/burnout (provider), and cost effective use of resources consistent with family risk (institution); 3) Based on the results of the trial and feedback from the first and second aim, we will develop and disseminate a web-based PAT Implementation Toolkit. Discussion: Use of the PAT across children’s cancer programs nationally can achieve the assessment Standard and inform equitable delivery of psychosocial care matched to family need for all patients.Trial Registration: ClinicalTrials.gov, NCT04446728, registered 23 June 2020

Psychosocial Assessment Tool

2001 ◽  
Author(s):  
Anne E. Kazak ◽  
Alice Prusak ◽  
Mary McSherry ◽  
Steven Simms ◽  
David Beele ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Psychosocial Assessment

Current Practices and Challenges of Medical Services on Health Care System of Mandalay General Hospital

2019 ◽  
Vol 31 (2) ◽  
pp. 131
Keyword(s):  
Health Care ◽  
General Hospital ◽  
Health Care Providers ◽  
Quality Care ◽  
Healthcare Providers ◽  
Medical Services ◽  
Tertiary Level ◽  
Care Providers ◽  
Level Hospital ◽  
Care System

In Myanmar, the main challenge to provide quality healthcare by Universal Health Care approach is documented as low health services coverage with substantial wealth-based inequality. To achieve the effective health care system, strong medical care system is essential. Understanding on challenges and needs in provision of medical services among patients and health care providers is critical to provide quality care with desirable outcomes. The aim of the study was to explore the patients’ and health care providers’ perceptions on the challenges in provision of medical services at the Mandalay General Hospital. This was a qualitative study conducted at the tertiary level hospital (Mandalay General Hospital). The data was collected by using focus group discussions and in-depth interviews with hospitalized patients or attendants, healthcare providers such as medical doctors, nurses, laboratory scientists and hospital administrators in March 2017. The qualitative data was analyzed using themes by themes matrix analysis. Most patients were satisfied with the care provided by the doctors because they believed that they received quality care. However, some patients complained about long waiting time for elective operation, congested conditions in the ward, burden for investigations outside the hospital for urgent needs and impolite manners of general workers. Healthcare providers reported that they had heavy workload due to limited human and financial resources in the hospital, poor compliances with hospital rules and regulation among patients and attendants, and inefficient referral practices from other health facilities. Other challenges experienced by healthcare providers were lack of ongoing training to improve knowledge and skills, limited health infrastructure and inadequate medicinal supplies. The findings highlighted the areas needed to be improved to provide quality health care at the tertiary level hospital. The challenges and problems encountered in this hospital can be improved by allocating adequate financial and human resources. The systematic referral system and hospital management guidelines are needed to reduce workload of health staff.

scholarly journals A mixed reception: perceptions of pregnant adolescents’ experiences with health care workers in Cape Town, South Africa

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Ronel Sewpaul ◽  
Rik Crutzen ◽  
Natisha Dukhi ◽  
Derrick Sekgala ◽  
Priscilla Reddy
Keyword(s):  
South Africa ◽  
Health Care ◽  
Antenatal Care ◽  
Health Care Workers ◽  
Cape Town ◽  
Pregnant Adolescents ◽  
High Quality ◽  
Care Workers ◽  
Antenatal Clinics ◽  
Antenatal Services

Abstract Background Maternal mortality among adolescent mothers in South Africa is higher than many middle-income countries. This is largely attributable to conditions that can be prevented or managed by high quality antenatal care. The way in which pregnant adolescents are treated at antenatal clinics influences their timely utilization of antenatal services. This qualitative study reports on the experiences of pregnant adolescents with health care workers when accessing antenatal care. Methods Pregnant girls aged 13–19 (n = 19) who attended public health care facilities that provide Basic Antenatal Care (BANC) services in Cape Town, South Africa were recruited. Four face to face in-depth interviews and four mini focus group discussions were undertaken, facilitated by a topic guide. Thematic analyses were used to analyse the data. Results Experiences that reinforce antenatal attendance, such as respectful and supportive treatment, were outweighed by negative experiences, such as victimization; discrimination against being pregnant at a young age; experiencing disregard and exclusion; inadequate provision of information about pregnancy, health and childbirth; clinic attendance discouragement; and mental health turmoil. Conclusions There is evidence of a discordant relationship between the health care workers and the pregnant adolescents. Adolescents feel mistreated and discriminated against by the health care workers, which in turn discourages their attendance at antenatal clinics. Maternal health care workers need to receive support and regular training on the provision of youth friendly antenatal care and be regularly evaluated, to promote the provision of fair and high quality antenatal services for adolescent girls.

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