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3. Access to and experience of later abortion: accounts from women in Scotland

Author

Purcell, Carrie, Cameron, Sharon, Caird, Lucy, Flett, Gillian, Laird, George, Melville, Catriona, and McDaid, Lisa M.

Subjects
embryonic structures, reproductive and urinary physiology
Abstract

Context:\ud Except in the presence of significant medical indications, the legal limit for abortion in Great Britain is 24 weeks’ gestation. Nevertheless, abortion for nonmedical reasons is not usually provided in Scotland after 18–20 weeks, meaning women have to travel to England for the procedure.\ud \ud Methods:\ud In-depth interviews were conducted with 23 women presenting for "later" abortions (i.e., at 16 or more weeks’ gestation) in Scotland. Participants were women who sought an abortion at a participating National Health Service clinic between January and July 2013. Interviews addressed reasons for and consequences of later presentation, as well as women's experiences of abortion. Thematic analysis attended to emerging issues and employed the conceptual tool of candidacy.\ud \ud Results:\ud Delayed recognition of pregnancy, changed life circumstances and conflicting candidacies for motherhood and having an abortion were common reasons for women's presentation for later abortion. Women perceived that the resources required to travel to England for a later abortion were potential barriers to access, and felt that such travel was distressing and stigmatizing. Participants who continued their pregnancy did so after learning they were at a later gestational age than expected or after receiving assurances of support from partners, friends or family.\ud \ud Conclusions:\ud Reasons for seeking later abortion are complex and varied among women in Scotland, and suggest that reducing barriers to access and improving local provision of such abortions are a necessity. The candidacy framework allows for a fuller understanding of the difficulties involved in obtaining abortions.

Published
2014

10. Social network interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease

Author

Purcell, Carrie, Dibben, Grace, Hilton Boon, Michele, Matthews, Lynsay, Palmer, Victoria J., Thomson, Meigan, Smillie, Susie, Simpson, Sharon A., Taylor, Rod S., Purcell, Carrie, Dibben, Grace, Hilton Boon, Michele, Matthews, Lynsay, Palmer, Victoria J., Thomson, Meigan, Smillie, Susie, Simpson, Sharon A., and Taylor, Rod S.

Abstract

Background Globally, cardiovascular diseases (CVD, that is, coronary heart (CHD) and circulatory diseases combined) contribute to 31% of all deaths, more than any other cause. In line with guidance in the UK and globally, cardiac rehabilitation programmes are widely offered to people with heart disease, and include psychosocial, educational, health behaviour change, and risk management components. Social support and social network interventions have potential to improve outcomes of these programmes, but whether and how these interventions work is poorly understood. Objectives To assess the effectiveness of social network and social support interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease. The comparator was usual care with no element of social support (i.e. secondary prevention alone or with cardiac rehabilitation). Search methods We undertook a systematic search of the following databases on 9 August 2022: CENTRAL, MEDLINE, Embase, and the Web of Science. We also searched ClinicalTrials.gov and the WHO ICTRP. We reviewed the reference lists of relevant systematic reviews and included primary studies, and we contacted experts to identify additional studies. Selection criteria We included randomised controlled trials (RCTs) of social network or social support interventions for people with heart disease. We included studies regardless of their duration of follow‐up, and included those reported as full text, published as abstract only, and unpublished data. Data collection and analysis Using Covidence, two review authors independently screened all identified titles. We retrieved full‐text study reports and publications marked ‘included’, and two review authors independently screened these, and conducted data extraction. Two authors independently assessed risk of bias, and assessed t

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