Reproductive health and pregnancy experiences of women with spina bifida: A qualitative study

Author(s):  
Asia L. van Buuren ◽  
Susan E. O’rinn ◽  
Hayley Lipworth ◽  
Paige Church ◽  
Anne Berndl

PURPOSE: Despite an increasing number of individuals with spina bifida reaching reproductive age, there has been a paucity of research into their reproductive health care needs. The objective of this study was to better understand the reproductive health experiences of self-identified women with spina bifida using qualitative methodology. METHODS: A phenomenological study design was used to address this objective. Women with spina bifida identified their interest in participating in a semi-structured interview after completing an online reproductive health survey. Interviews were recorded and transcribed verbatim. Qualitative analysis followed a phenomenological approach using Dedoose software. RESULTS: Twelve self-identified women with spina bifida participated. They described experiences in four domains: sexual education, pregnancy, labor and delivery, and postpartum. In addition, an intersecting domain of social justice and advocacy emerged. Numerous themes are described, including a lack of tailored sexual health information, impact of pregnancy on function, attitudes towards delivery method, and parenting challenges. CONCLUSION: This study explored the continuum of reproductive health experiences of women with spina bifida. They face unique reproductive health challenges that provide an opportunity for health care providers to offer more holistic care.

Author(s):  
Fatemeh Rahmanian ◽  
Soheila Nazarpour ◽  
Masoumeh Simbar ◽  
Ali Ramezankhani ◽  
Farid Zayeri

AbstractBackgroundA dimension of reproductive health services that should be gender sensitive is reproductive health services for adolescents.ObjectiveThis study aims to assess needs for gender sensitive reproductive health care services for adolescents.MethodsThis was a descriptive cross-sectional study on 341 of health care providers for adolescents in health centers and hospitals affiliated to Shiraz University of Medical Sciences in Iran in 2016. The subjects of the study were recruited using a convenience sampling method. The tools for data collection were: (1) a demographic information questionnaire and; (2) a valid and reliable questionnaire to Assess the Needs of Gender-Sensitive Adolescents Reproductive Health Care Services (ANQ-GSARHS) including three sections; process, structure and policy making for the services. Data were analyzed using SPSS 21.ResultsThree hundred and forty-one health providers with an average working experience of 8.77 ± 5.39 [mean ± standard deviation (SD)] years participated in the study. The results demonstrated the highest scores for educational needs (92.96% ± 11.49%), supportive policies (92.71% ± 11.70%) and then care needs (92.37% ± 14.34%) of the services.ConclusionsProviding gender sensitive reproductive health care services for adolescents needs to be reformed as regards processes, structure and policies of the services. However, the gender appropriate educational and care needs as well as supportive policies are the priorities for reform of the services.


2007 ◽  
Vol 7 ◽  
pp. 1875-1883 ◽  
Author(s):  
Amie B. Jackson ◽  
Pamela K. Mott

Women with spina bifida have unique health care concerns and as the life expectancy of this population increases, they are transitioning from adolescence to womanhood and entering their reproductive years with little information about what to expect. Likewise, their health care providers do not have the benefit of evidence-based research that comprehensively addresses the issues these women may face related to reproduction or aging. Few studies have focused on the effects that spina bifida may have on these women's reproductive systems, nor has attention been paid to the effects that possible reproductive endocrine changes may have on their disability. Needless to say, concerns about sexuality, sexual function, and pregnancy are just as important to these women as they are to their able-bodied counterparts.


2021 ◽  
pp. 205336912110600
Author(s):  
Nargis Asad ◽  
Rozina Somani ◽  
Nausheen Peerwani ◽  
Shahina Pirani ◽  
Nadeem Zuberi ◽  
...  

Objective The study aims to explore the perceptions and experiences of menopausal women living in Karachi, Pakistan. Study design Using qualitative exploratory design, in-depth interviews were conducted with eleven women, aged 35–55 years. The data was collected through face-to-face interviews using semi structured interview guide. Creswell frame work for content analysis was used to analyze the data. Main outcome measures Perceptions and experiences of menopause women living in Karachi, Pakistan. Results Women described positive and negative experiences of menopause, though predominantly negative intensified by mental distress, lack of support from intimate partner, and misperceptions about menopause. A majority of the women emphasized the need for educating their husbands regarding menopausal changes. In clinical practices, health care professionals should screen the women for menopause challenges when they visit health care facilities and offer education regarding self-care and management to achieve better quality of life and positive coping. Conclusions We conducted a preliminary study on women’s perceptions and experiences of menopause in the context of Pakistan. Our study offers significant findings from an Asian cultural perspective, in which norms are predominantly patriarchal and male dominated. The study provides useful guidelines for health care providers to better address health care needs of menopausal women.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Villadsen ◽  
S Dias

Abstract For complex public health interventions to be effective their implementation needs to adapt to the situation of those implementing and those receiving the intervention. While context matter for intervention implementation and effect, we still insist on learning from cross-country comparison of implementation. Next methodological challenges include how to increase learning from implementation of complex public health interventions from various context. The interventions presented in this workshop all aims to improve quality of reproductive health care for immigrants, however with different focus: contraceptive care in Sweden, group based antenatal care in France, and management of pregnancy complications in Denmark. What does these interventions have in common and are there cross cutting themes that help us to identify the larger challenges of reproductive health care for immigrant women in Europe? Issues shared across the interventions relate to improved interactional dynamics between women and the health care system, and theory around a woman-centered approach and cultural competence of health care providers and systems might enlighten shared learnings across the different interventions and context. Could the mechanisms of change be understood using theoretical underpinnings that allow us to better generalize the finding across context? What adaption would for example be needed, if the Swedish contraceptive intervention should work in a different European setting? Should we distinguish between adaption of function and form, where the latter might be less important for intervention fidelity? These issues will shortly be introduced during this presentation using insights from the three intervention presentations and thereafter we will open up for discussion with the audience.


Author(s):  
Rogério Meireles Pinto ◽  
Rahbel Rahman ◽  
Margareth Santos Zanchetta ◽  
W. Galhego-Garcia

Abstract Background Narrative medicine (NM) encourages health care providers to draw on their personal experiences to establish therapeutic alliances with patients of prevention and care services. NM medicine practiced by nurses and physicians has been well documented, yet there is little understanding of how community health workers (CHWs) apply NM concepts in their day-to-day practices from patient perspectives. Objective To document how CHWs apply specific NM concepts in Brazil’s Family Health Strategy (FHS), the key component of Brazil’s Unified Health System. Design We used a semi-structured interview, grounded in Charon’s (2001) framework, including four types of NM relationships: provider–patient, provider–colleague, provider–society, and provider–self. A hybrid approach of thematic analysis was used to analyze data from 27 patients. Key Results Sample: 18 females; 13 White, 12 “Pardo” (mixed races), 12 Black. We found: (1) provider–patient relationship—CHWs offered health education through compassion, empathy, trustworthiness, patience, attentiveness, jargon-free communication, and altruism; (2) provider–colleague relationship—CHWs lacked credibility as perceived by physicians, impacting their effectiveness negatively; (3) provider–society relationship—CHWs mobilized patients civically and politically to advocate for and address emerging health care and prevention needs; (4) provider–self relationship—patients identified possible low self-esteem among CHWs and a need to engage in self-care practices to abate exhaustion from intense labor and lack of resources. Conclusion This study adds to patient perspectives on how CHWs apply NM concepts to build and sustain four types of relationships. Findings suggest the need to improve provider–colleague relationships by ongoing training to foster cooperation among FHS team members. More generous organizational supports (wellness initiatives and supervision) may facilitate the provider–self relationship. Public education on CHWs’ roles is needed to enhance the professional and societal credibility of their roles and responsibilities. Future research should investigate how CHWs’ personality traits may influence their ability to apply NM.


2018 ◽  
Vol 29 (4) ◽  
pp. 498-509 ◽  
Author(s):  
Sofía Gómez ◽  
Heide Castañeda

The “DACAmented Voices in Healthcare” project examined the intersection of restrictive immigration policies and health care via photovoice, a participatory action research approach, with immigrant youth living in Arizona, who were recipients of the Deferred Action for Childhood Arrivals (DACA) program. These “DACAmented” youth took part in nine photovoice sessions exploring their health care experiences and accessibility to care using documentary photography and narratives. They poignantly illustrated their experiences through images identifying their main health concerns and strengths, facilitating the development of health policy recommendations. This article illustrates the thematic findings and discusses policy recommendations and lessons learned from presentations to policy makers and health care providers. Findings suggest that immigrant youth are knowledgeable of their family’s health care needs and hold a unique and important position within mixed-status households. Health care providers can benefit from the proposed recommendations by building bridges to care to address health equity in immigrant communities.


2012 ◽  
Vol 19 (3) ◽  
pp. 231-256 ◽  
Author(s):  
Christina Zampas ◽  
Ximena Andión-Ibañez

Abstract The practice of conscientious objection often arises in the area of individuals refusing to fulfil compulsory military service requirements and is based on the right to freedom of thought, conscience and religion as protected by national, international and regional human rights law. The practice of conscientious objection also arises in the field of health care, when individual health care providers or institutions refuse to provide certain health services based on religious, moral or philosophical objections. The use of conscientious objection by health care providers to reproductive health care services, including abortion, contraceptive prescriptions, and prenatal tests, among other services is a growing phenomena throughout Europe. However, despite recent progress from the European Court of Human Rights on this issue (RR v. Poland, 2011), countries and international and regional bodies generally have failed to comprehensively and effectively regulate this practice, denying many women reproductive health care services they are legally entitled to receive. The Italian Ministry of Health reported that in 2008 nearly 70% of gynaecologists in Italy refuse to perform abortions on moral grounds. It found that between 2003 and 2007 the number of gynaecologists invoking conscientious objection in their refusal to perform an abortion rose from 58.7 percent to 69.2 percent. Italy is not alone in Europe, for example, the practice is prevalent in Poland, Slovakia, and is growing in the United Kingdom. This article outlines the international and regional human rights obligations and medical standards on this issue, and highlights some of the main gaps in these standards. It illustrates how European countries regulate or fail to regulate conscientious objection and how these regulations are working in practice, including examples of jurisprudence from national level courts and cases before the European Court of Human Rights. Finally, the article will provide recommendations to national governments as well as to international and regional bodies on how to regulate conscientious objection so as to both respect the practice of conscientious objection while protecting individual’s right to reproductive health care.


2002 ◽  
Vol 7 (1_suppl) ◽  
pp. 23-28 ◽  
Author(s):  
Pauline Norris

Objective This paper investigates the characteristics of pharmacies that are associated with the degree of counselling provided to customers purchasing medicines. Methods Twelve ‘mystery shoppers’ (research assistants posing as normal customers) purchased restricted medicines at 180 pharmacies around New Zealand. One drug (diclofenac) and one class of drugs (vaginal antifungals) were purchased. The amount of counselling provided was recorded, and linked to profile data on the pharmacies, obtained through a questionnaire, from Census data, and from direct observations of pharmacies. Results Location within a city, a large town, or strip shopping did not affect the level of counselling pharmacies provided. Pharmacies adjacent to medical centres gave significantly less counselling to diclofenac purchasers than other pharmacies. No consistent relationship was found between pharmacy size and the level of counselling provided. There were large differences between areas of the country. A strong negative relationship was found between the amount of counselling given about thrush, and the proportion of Pacific Island people in the population around the pharmacy. Although only some results reached statistical significance, there seems to have been a similar trend for pharmacies to provide less counselling in areas with more Maori people and with higher levels of social deprivation. Conclusions Regional variation in the provision of pharmacy services, and in particular the tendency for pharmacies to provide less counselling in areas that are likely to have higher health care needs, must be addressed if pharmacies are to fulfil their potential as health care providers.


Author(s):  
Lisa Freitag

Parents caring for children with special health care needs or long-term disabilities are called to a new level of competence as medical caregivers, often as soon as the child is discharged from the hospital. There is no accepted measure for success with this task, though failure can be met with repeated hospitalization or removal of the child from the home. This chapter evaluates, through parent narratives, how parents obtain and view their competence. Some parents perform in-depth research into their child’s medical problems and achieve a surprisingly high level of knowledge. This is often discounted by both the parents and health care providers. The moral work done in this area is significant. Parents must change their priorities and re-align their expectations for their child’s success. They must adapt to a slower developmental pace, and create for the child a safe haven where the child’s disability becomes the accepted norm.


Sign in / Sign up

Export Citation Format

Share Document