140 results on '"Finlayson, Kenneth"'
Search Results
102. Cost analysis of the CTLB Study, a multitherapy antenatal education programme to reduce routine interventions in labour
- Author
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Levett, Kate M, primary, Dahlen, Hannah G, additional, Smith, Caroline A, additional, Finlayson, Kenneth William, additional, Downe, Soo, additional, and Girosi, Federico, additional
- Published
- 2018
- Full Text
- View/download PDF
103. Factors that influence the provision of good-quality routine antenatal services: a qualitative evidence synthesis of the views and experiences of maternity care providers
- Author
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Downe, Soo, primary, Finlayson, Kenneth, additional, Tunçalp, Özge, additional, and Gülmezoglu, A Metin, additional
- Published
- 2017
- Full Text
- View/download PDF
104. Factors that influence the provision of good-quality routine antenatal services: a qualitative evidence synthesis of the views and experiences of maternity care providers [Protocol]
- Author
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Downe, Soo, Finlayson, Kenneth William, Tunçalp, Özge, Gülmezoglu, A Metin, Downe, Soo, Finlayson, Kenneth William, Tunçalp, Özge, and Gülmezoglu, A Metin
- Abstract
This is a protocol for a Cochrane Review (Qualitative). The objectives are as follows: - To identify the factors influencing the provision of quality ANC according to health care providers - To explore how these factors relate to, and help to explain the findings of, the related Cochrane intervention reviews
- Published
- 2017
105. Engaging with birth stories in pregnancy: A hermeneutic phenomenological study of women's experiences across two generations
- Author
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Thomson, Gillian, Downe, Soo, Finlayson, Kenneth William, Thomson, Gillian, Downe, Soo, and Finlayson, Kenneth William
- Abstract
Background: The birth story has been widely understood as a crucial source of knowledge about childbirth. What has not been reported is the effect that birth stories may have on primigravid women's understandings of birth. Findings are presented from a qualitative study exploring how two generations of women came to understand birth in the milieu of other's stories. The prior assumption was that birth stories must surely have a positive or negative influence on listeners, steering them towards either medical or midwifery-led models of care. Methods: A Heideggerian hermeneutic phenomenological approach was used. Twenty UK participants were purposively selected and interviewed. Findings from the initial sample of ten women who were pregnant in 2012 indicated that virtual media was a primary source of birth stories. This led to recruitment of a second sample of ten women who gave birth in the 1970s-1980s, to determine whether they were more able to translate information into knowledge via stories told through personal contact and not through virtual technologies. Results: Findings revealed the experience of 'being-in-the-world' of birth and of stories in that world. From a Heideggerian perspective, the birth story was constructed through 'idle talk' (the taken for granted assumptions of things, which come into being through language). Both oral stories and those told through technology were described as the 'modern birth story'. The first theme 'Stories are difficult like that', examines the birth story as problematic and considers how stories shape meaning. The second 'It's a generational thing', considers how women from two generations came to understand what their experience might be. The third 'Birth in the twilight of certainty,' examines women's experience of Being in a system of birth as constructed, portrayed and sustained in the stories being shared. Conclusions: The women pregnant in 2012 framed their expectations in the language of choice, whilst the women w
- Published
- 2017
106. Self-hypnosis for intrapartum pain management in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness
- Author
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Downe, Soo, Finlayson, Kenneth, Melvin, C., Spiby, Helen, Ali, A., Diggle, P., Gyte, G., Hinder, S., Miller, V., Slade, P., Trepel, D., Weeks, A., and Whorwell, Peter
- Subjects
Cost-analysis, epidural, group antenatal training, hypnosis, labour pain, psychological outcomes, randomised trial - Abstract
Objective: (Primary) To establish the effect of antenatal group self-hypnosis for nulliparous women on intra-partum epidural use. Design: Multi-method randomised control trial (RCT). Setting: Three NHS Trusts. Population: Nulliparous women not planning elective caesarean, without medication for hypertension and without psychological illness. Methods: Randomisation at 28–32 weeks’ gestation to usual care, or to usual care plus brief self-hypnosis training (two × 90-minute groups at around 32 and 35 weeks’ gestation; daily audio self-hypnosis CD). Follow up at 2 and 6 weeks postnatal. Main outcome measures: Primary: epidural analgesia. Secondary: associated clinical and psychological outcomes; cost analysis. Results: Six hundred and eighty women were randomised. There was no statistically significant difference in epidural use: 27.9% (intervention), 30.3% (control), odds ratio (OR) 0.89 [95% confidence interval (CI): 0.64–1.24], or in 27 of 29 pre-specified secondary clinical and psychological outcomes. Women in the intervention group had lower actual than anticipated levels of fear and anxiety between baseline and 2 weeks post natal (anxiety: mean difference −0.72, 95% CI −1.16 to −0.28, P = 0.001); fear (mean difference −0.62, 95% CI −1.08 to −0.16, P = 0.009) [Correction added on 7 July 2015, after first online publication: ‘Mean difference’ replaced ‘Odds ratio (OR)’ in the preceding sentence.]. Postnatal response rates were 67% overall at 2 weeks. The additional cost in the intervention arm per woman was £4.83 (CI −£257.93 to £267.59). Conclusions: Allocation to two-third-trimester group self-hypnosis training sessions did not significantly reduce intra-partum epidural analgesia use or a range of other clinical and psychological variables. The impact of women's anxiety and fear about childbirth needs further investigation.
- Published
- 2015
107. Factors that influence the uptake of routine antenatal services by pregnant women: a qualitative evidence synthesis
- Author
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Downe, Soo, Finlayson, Kenneth William, Tunçalp, Özge, Gülmezoglu, A Metin, Downe, Soo, Finlayson, Kenneth William, Tunçalp, Özge, and Gülmezoglu, A Metin
- Abstract
A B S T R A C T This is a protocol for a Cochrane Review (Qualitative). The objectives are as follows: To identify, appraise, and synthesise qualitative studies exploring: • women’s views and experiences of antenatal care; and • factors influencing the uptake of antenatal care arising from women’s accounts.
- Published
- 2016
108. U.S. Army Doctrine: From the American Revolution to the War on Terror Walter E. Kretchik
- Author
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Finlayson, Kenneth
- Published
- 2012
109. Factors that influence the uptake of routine antenatal services by pregnant women: a qualitative evidence synthesis
- Author
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Downe, Soo, primary, Finlayson, Kenneth, additional, Tunçalp, Özge, additional, and Gülmezoglu, A Metin, additional
- Published
- 2016
- Full Text
- View/download PDF
110. Global access to antenatal care: a qualitative perspective
- Author
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Finlayson, Kenneth William and Finlayson, Kenneth William
- Published
- 2015
111. The feasibility and acceptability of using the Mother-Generated Index (MGI) as a Patient Reported Outcome Measure in a randomised controlled trial of maternity care
- Author
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Symon, Andrew, Downe, Soo, Finlayson, Kenneth William, Knapp, Rebecca, Diggle, Peter, Symon, Andrew, Downe, Soo, Finlayson, Kenneth William, Knapp, Rebecca, and Diggle, Peter
- Abstract
Background: Using patient-reported outcome measures (PROMs) to assess Quality of Life (QoL) is well established, but commonly-used PROM item-sets do not necessarily capture what all respondents consider important. Measuring complex constructs is particularly difficult in randomised controlled trials (RCTs). The Mother-Generated Index (MGI) is a validated antenatal and postnatal QoL instrument in which the variables and scores are completely respondent-driven. This paper reports on the feasibility and acceptability of the MGI in an RCT, and compares the resulting variables and QoL scores with more commonly used instruments. Methods: The single-page MGI was included at the end of a ten page questionnaire pack and posted to the RCT participants at baseline (28–32 weeks’ gestation) and follow-up (six weeks postnatal). Feasibility and acceptability were assessed by ease of administration, data entry and completion rates. Variables cited by women were analysed thematically. MGI QoL scores were compared with outcomes from the EQ-5D-3 L; Edinburgh Postnatal Depression Scale; Satisfaction With Life Scale; and State Trait Anxiety Inventory. Results: Six hundred and seventy eight pregnant women returned the pack at baseline; 668 completed the MGI (98.5 %); 383/400 returns at follow up included a completed MGI (95.7 %). Quantitative data were scanned into SPSS using a standard data scanning system, and were largely error-free; qualitative data were entered manually. The variables recorded by participants on the MGI forms incorporated many of those in the comparison instruments, and other outcomes commonly used in intrapartum trials, but they also revealed a wider range of issues affecting their quality of life. These included financial and work-related worries; moving house; and concerns over family illness and pets. The MGI scores demonstrated low-to-moderate correlation with other tools (all r values p < .01). Conclusions: Without face-to-face explanation and at the
- Published
- 2015
112. Unexpected Consequences: Women’s experiences of a self-hypnosis intervention to help with pain relief during labour.
- Author
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Finlayson, Kenneth William, Downe, Soo, Hinder, Susan, Carr, Helen, Spiby, Helen, Whorwell, Peter, Finlayson, Kenneth William, Downe, Soo, Hinder, Susan, Carr, Helen, Spiby, Helen, and Whorwell, Peter
- Abstract
Background Self-hypnosis is becoming increasingly popular as a means of labour pain management. Previous studies have produced mixed results. There are very few data on women’s views and experiences of using hypnosis in this context. As part of a randomized controlled trial of self-hypnosis for intra-partum pain relief (the SHIP Trial) we conducted qualitative interviews with women randomized to the intervention arm to explore their views and experiences of using self-hypnosis during labour and birth. Methods Participants were randomly selected from the intervention arm of the study, which consisted of two antenatal self-hypnosis training sessions and a supporting CD that women were encouraged to listen to daily from 32 weeks gestation until the birth of their baby. Those who consented were interviewed in their own homes 8-12 weeks after birth. Following transcription, the interviews were analysed iteratively and emerging concepts were discussed amongst the authors to generate organizing themes. These were then used to develop a principal organizing metaphor or global theme, in a process known as thematic networks analysis. Results Of the 343 women in the intervention group, 48 were invited to interview, and 16 were interviewed over a 12 month period from February 2012 to January 2013. Coding of the data and subsequent analysis revealed a global theme of ‘unexpected consequences’, supported by 5 organising themes, ‘calmness in a climate of fear’, ‘from sceptic to believer’, ‘finding my space’, ‘delays and disappointments’ and ‘personal preferences’. Most respondents reported positive experiences of self-hypnosis and highlighted feelings of calmness, confidence and empowerment. They found the intervention to be beneficial and used a range of novel strategies to personalize their self-hypnosis practice. Occasionally women reported feeling frustrated or disappointed when their relaxed state was misinterpreted by midwives on admission or when their labour and birth expe
- Published
- 2015
113. Self-Hypnosis for Intrapartum Pain management (SHIP) in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness
- Author
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Downe, Soo, Finlayson, Kenneth, Melvin, Cathie, Spiby, Helen, Ali, Shehzad, Diggle, Peter, Gyte, Gill, Hinder, Susan, Miller, Vivien, Slade, Pauline, Treppel, Dominic, Weeks, Andrew, Whorwell, Peter, Williamson, Maria, Downe, Soo, Finlayson, Kenneth, Melvin, Cathie, Spiby, Helen, Ali, Shehzad, Diggle, Peter, Gyte, Gill, Hinder, Susan, Miller, Vivien, Slade, Pauline, Treppel, Dominic, Weeks, Andrew, Whorwell, Peter, and Williamson, Maria
- Abstract
Objective: (Primary): to establish the effect of antenatal group self-hypnosis for nulliparous women on intra-partum epidural use Design: Multi-method RCT Setting: Three NHS Trusts Population: Nulliparous women not planning elective caesarean, without medication for hypertension and without psychological illness. Methods: Randomisation at 28-32 weeks gestation to usual care, or to usual care plus brief self-hypnosis training (two x 90 minute groups at around 32 and 35 weeks gestation; daily audio self-hypnosis CD). Follow up at two and six weeks postnatal. Main outcome measures:- Primary: epidural analgesia Secondary: associated clinical and psychological outcomes; economic analysis. Results: 680 women were randomised. There was no statistically significant difference in epidural use: 27.9% (intervention), 30.3% (control), odds ratio (OR) 0.89 (95% confidence interval (CI): 0.64 to 1.24), or in 27 of 29 pre-specified secondary clinical and psychological outcomes. Women in the intervention group had lower actual than anticipated levels of fear and anxiety between baseline and two weeks post natal (anxiety: OR -0.72, 95% CI -1.16 to -0.28, P= 0.001); fear (OR -0.62, 95% CI -1.08 to -0.16, p = 0.009) Postnatal response rates were 67% overall at two weeks. The additional cost of the intervention per woman was £4.83 (CI -£257.93 to £267.59). Conclusions: Allocation to two third-trimester group self-hypnosis training sessions did not significantly reduce intra-partum epidural analgesia use or a range of other clinical and psychological variables. The impact of women’s anxiety and fear about childbirth needs further investigation. Trial registration: ISRCTN27575146 http://www.controlled-trials.com/ISRCTN27575146
- Published
- 2015
114. Unexpected consequences: women’s experiences of a self-hypnosis intervention to help with pain relief during labour
- Author
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Finlayson, Kenneth, primary, Downe, Soo, additional, Hinder, Susan, additional, Carr, Helen, additional, Spiby, Helen, additional, and Whorwell, Peter, additional
- Published
- 2015
- Full Text
- View/download PDF
115. Mothers’ perceptions of family centred care in neonatal intensive care units
- Author
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Finlayson, Kenneth William, Dixon, Annie, Smith, Chris, Dykes, Fiona Clare, Flacking, Renee, Finlayson, Kenneth William, Dixon, Annie, Smith, Chris, Dykes, Fiona Clare, and Flacking, Renee
- Abstract
Objective To explore mothers’ perceptions of family centred care (FCC) in neonatal intensive care units (NICUs) in England. Design The qualitative experiences of 12 mothers from three NICUs in the UK were elicited using individual interviews. A thematic network analysis was conducted on the transcribed interviews Main outcome measures A central global theme supported by a number of organizing themes were developed reflecting the views of the mothers and their experiences of FCC. Results A global theme of “Finding My Place” was identified, supported by six organizing themes: Mothering in Limbo; Deference to the Experts; Anxious Surveillance; Muted Relations, Power Struggles and Consistently Inconsistent. Mothers experienced a state of liminality and were acutely sensitive to power struggles, awkward relationships and inconsistencies in care. To try to maintain their equilibrium and protect their baby they formed deferential relationships with health professionals and remained in a state of anxious surveillance. Conclusions This study illustrates that despite the rhetoric around the practice of FCC in NICUs, there was little in the mother's narratives to support this. It is of the utmost importance to minimize the consequences of the liminal experience, to improve staff–mother interactions and to facilitate mothers’ opportunities to be primary caregivers.
- Published
- 2014
116. When Historians and Curators Go to War: Capturing History When and Where It Happens.
- Author
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Bonnell, Françoise B., Finlayson, Kenneth, Hanselman, David, and Killblane, Richard E.
- Subjects
AMERICAN historians ,MUSEUM curators ,UNITED States history ,EXHIBITIONS - Published
- 2017
117. Why do women not use antenatal services in low and middle income countries? A metasynthesis of qualitative studies
- Author
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Finlayson, Kenneth William, Downe, Soo, Finlayson, Kenneth William, and Downe, Soo
- Abstract
Background: Almost 50% of women in low & middle income countries (LMIC’s) don’t receive adequate antenatal care. Women’s views can offer important insights into this problem. Qualitative studies exploring inadequate use of antenatal services have been undertaken in a range of countries, but the findings are not easily transferable. We aimed to inform the development of future antenatal care programmes through a synthesis of findings in all relevant qualitative studies. Methods and Findings: Using a pre-determined search strategy, we identified robust qualitative studies reporting on the views and experiences of women in LMIC’s who received inadequate antenatal care. We used meta-ethnographic techniques to generate themes and a line of argument synthesis. We derived policy relevant hypotheses from the findings. We included 21 papers representing the views of more than 1230 women from 15 countries. Three key themes were identified: ‘Pregnancy as socially risky and physiologically healthy’; ‘Resource use and survival in conditions of extreme poverty’and ‘Not getting it right first time’. The line of argument synthesis describes a dissonance between programme design and cultural contexts that may restrict access and discourage return visits. We hypothesize that centralized, risk-focused antenatal care programmes may be at odds with the resources, beliefs and experiences of pregnant women who underuse antenatal services. Conclusions: Our findings suggest that there may be a mis-alignment between current antenatal provision and the social and cultural context of some women in LMIC’s. Antenatal care provision that is theoretically and contextually at odds with local contextual beliefs and experiences are likely to be underused, especially when attendance generates increased personal risks of lost family resource or physical danger during travel; when the promised care is not delivered due to resource constraints; and when women experience covert or overt abuse in care sett
- Published
- 2013
118. Creating a Collaborative Culture in Maternity Care
- Author
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Downe, Soo, Finlayson, Kenneth William, Fleming, Anita, Downe, Soo, Finlayson, Kenneth William, and Fleming, Anita
- Published
- 2010
119. Qualitative meta-synthesis: a guide for the novice
- Author
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Finlayson, Kenneth, Dixon, Annie, Finlayson, Kenneth, and Dixon, Annie
- Abstract
The emerging field of qualitative synthesis is an exciting area of research with the potential to influence policy and practice. It is also saturated with a variety of unresolved philosophical, terminological and methodological discussions which may seem daunting to the novice researcher. This article by Kenneth Finlayson and Annie Dixon attempts to clarify some of the more controversial issues and, by providing a set of guidelines, hopes to encourage novices to enter this stimulating environment with confidence and understanding
- Published
- 2008
120. A simple element inverse jacket transform coding
- Author
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Lee, Moon Ho, Finlayson, Kenneth, Lee, Moon Ho, and Finlayson, Kenneth
- Abstract
Jacket transforms are a class of transforms which are simple to calculate, easily inverted and are size-flexible. Previously reported jacket transforms were generalizations of the well-known Walsh-Hadamard transform (WHT) and the center-weighted Hadamard transform (CWHT). In this paper we present a new class of jacket transform not derived from either the WHT or the CWHT. This class of transform can be applied to any even length vector, and is applicable to finite fields and is useful for constructing error control codes.
- Published
- 2005
121. Colonel Robert S. Moore U.S. Army (ret.) 1919-2003
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Finlayson, Kenneth
- Subjects
History ,Military and naval science - Abstract
Robert S. Moore joined the First Special Service Force at Fort William Henry Harrison, Mont., in January 1943 as commander of the 2nd Battalion, 2nd Regiment. At the time, he [...]
- Published
- 2003
122. An Uncertain Trumpet: the Evolution of U.S. Army Infantry Doctrine, 1919-1941
- Author
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Schifferle, Peter J. and Finlayson, Kenneth
- Subjects
An Uncertain Trumpet: the Evolution of U.S. Army Infantry Doctrine, 1919-1941. (Book) -- Book reviews ,Books -- Book reviews ,General interest ,Military and naval science - Abstract
Kenneth Finlayson, Greenwood Press, Westport, CT, 2001, 178 pages, $62.50. Everyone concerned with the direction of current Army Transformation should read Kenneth Finlayson's small book An Uncertain Trumpet: The Evolution [...]
- Published
- 2003
123. Global access to antenatal care: a qualitative perspective.
- Author
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Finlayson, Kenneth
- Published
- 2015
124. Qualitative synthesis and the development of clinical guidelines: towards a person-centred approach
- Author
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Finlayson, Kenneth William
- Subjects
B720
125. Self-hypnosis for intrapartum pain management in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness
- Author
-
Downe, Soo, Finlayson, Kenneth, Melvin, C., Spiby, Helen, Ali, A., Diggle, P., Gyte, G., Hinder, S., Miller, V., Slade, P., Trepel, D., Weeks, A., Whorwell, Peter, Downe, Soo, Finlayson, Kenneth, Melvin, C., Spiby, Helen, Ali, A., Diggle, P., Gyte, G., Hinder, S., Miller, V., Slade, P., Trepel, D., Weeks, A., and Whorwell, Peter
- Abstract
Objective: (Primary) To establish the effect of antenatal group self-hypnosis for nulliparous women on intra-partum epidural use. Design: Multi-method randomised control trial (RCT). Setting: Three NHS Trusts. Population: Nulliparous women not planning elective caesarean, without medication for hypertension and without psychological illness. Methods: Randomisation at 28–32 weeks’ gestation to usual care, or to usual care plus brief self-hypnosis training (two × 90-minute groups at around 32 and 35 weeks’ gestation; daily audio self-hypnosis CD). Follow up at 2 and 6 weeks postnatal. Main outcome measures: Primary: epidural analgesia. Secondary: associated clinical and psychological outcomes; cost analysis. Results: Six hundred and eighty women were randomised. There was no statistically significant difference in epidural use: 27.9% (intervention), 30.3% (control), odds ratio (OR) 0.89 [95% confidence interval (CI): 0.64–1.24], or in 27 of 29 pre-specified secondary clinical and psychological outcomes. Women in the intervention group had lower actual than anticipated levels of fear and anxiety between baseline and 2 weeks post natal (anxiety: mean difference −0.72, 95% CI −1.16 to −0.28, P = 0.001); fear (mean difference −0.62, 95% CI −1.08 to −0.16, P = 0.009) [Correction added on 7 July 2015, after first online publication: ‘Mean difference’ replaced ‘Odds ratio (OR)’ in the preceding sentence.]. Postnatal response rates were 67% overall at 2 weeks. The additional cost in the intervention arm per woman was £4.83 (CI −£257.93 to £267.59). Conclusions: Allocation to two-third-trimester group self-hypnosis training sessions did not significantly reduce intra-partum epidural analgesia use or a range of other clinical and psychological variables. The impact of women's anxiety and fear about childbirth needs further investigation.
- Full Text
- View/download PDF
126. Unexpected consequences: women’s experiences of a self-hypnosis intervention to help with pain relief during labour
- Author
-
Finlayson, Kenneth, Downe, Soo, Hinder, Susan, Carr, Helen, Spiby, Helen, Whorwell, Peter, Finlayson, Kenneth, Downe, Soo, Hinder, Susan, Carr, Helen, Spiby, Helen, and Whorwell, Peter
- Abstract
Background: Self-hypnosis is becoming increasingly popular as a means of labour pain management. Previous studies have produced mixed results. There are very few data on women’s views and experiences of using hypnosis in this context. As part of a randomized controlled trial of self-hypnosis for intra-partum pain relief (the SHIP Trial) we conducted qualitative interviews with women randomized to the intervention arm to explore their views and experiences of using self-hypnosis during labour and birth. Methods: Participants were randomly selected from the intervention arm of the study, which consisted of two antenatal self-hypnosis training sessions and a supporting CD that women were encouraged to listen to daily from 32 weeks gestation until the birth of their baby. Those who consented were interviewed in their own homes 8–12 weeks after birth. Following transcription, the interviews were analysed iteratively and emerging concepts were discussed amongst the authors to generate organizing themes. These were then used to develop a principal organizing metaphor or global theme, in a process known as thematic networks analysis. Results: Of the 343 women in the intervention group, 48 were invited to interview, and 16 were interviewed over a 12 month period from February 2012 to January 2013. Coding of the data and subsequent analysis revealed a global theme of ‘unexpected consequences’, supported by 5 organising themes, ‘calmness in a climate of fear’, ‘from sceptic to believer’, ‘finding my space’, ‘delays and disappointments’ and ‘personal preferences’. Most respondents reported positive experiences of self hypnosis and highlighted feelings of calmness, confidence and empowerment. They found the intervention to be beneficial and used a range of novel strategies to personalize their self-hypnosis practice. Occasionally women reported feeling frustrated or disappointed when their relaxed state was misinterpreted by midwives on admission or when their labour and birth e
- Full Text
- View/download PDF
127. Unexpected consequences: women’s experiences of a self-hypnosis intervention to help with pain relief during labour
- Author
-
Finlayson, Kenneth, Downe, Soo, Hinder, Susan, Carr, Helen, Spiby, Helen, Whorwell, Peter, Finlayson, Kenneth, Downe, Soo, Hinder, Susan, Carr, Helen, Spiby, Helen, and Whorwell, Peter
- Abstract
Background: Self-hypnosis is becoming increasingly popular as a means of labour pain management. Previous studies have produced mixed results. There are very few data on women’s views and experiences of using hypnosis in this context. As part of a randomized controlled trial of self-hypnosis for intra-partum pain relief (the SHIP Trial) we conducted qualitative interviews with women randomized to the intervention arm to explore their views and experiences of using self-hypnosis during labour and birth. Methods: Participants were randomly selected from the intervention arm of the study, which consisted of two antenatal self-hypnosis training sessions and a supporting CD that women were encouraged to listen to daily from 32 weeks gestation until the birth of their baby. Those who consented were interviewed in their own homes 8–12 weeks after birth. Following transcription, the interviews were analysed iteratively and emerging concepts were discussed amongst the authors to generate organizing themes. These were then used to develop a principal organizing metaphor or global theme, in a process known as thematic networks analysis. Results: Of the 343 women in the intervention group, 48 were invited to interview, and 16 were interviewed over a 12 month period from February 2012 to January 2013. Coding of the data and subsequent analysis revealed a global theme of ‘unexpected consequences’, supported by 5 organising themes, ‘calmness in a climate of fear’, ‘from sceptic to believer’, ‘finding my space’, ‘delays and disappointments’ and ‘personal preferences’. Most respondents reported positive experiences of self hypnosis and highlighted feelings of calmness, confidence and empowerment. They found the intervention to be beneficial and used a range of novel strategies to personalize their self-hypnosis practice. Occasionally women reported feeling frustrated or disappointed when their relaxed state was misinterpreted by midwives on admission or when their labour and birth e
- Full Text
- View/download PDF
128. Self-hypnosis for intrapartum pain management in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness
- Author
-
Downe, Soo, Finlayson, Kenneth, Melvin, C., Spiby, Helen, Ali, A., Diggle, P., Gyte, G., Hinder, S., Miller, V., Slade, P., Trepel, D., Weeks, A., Whorwell, Peter, Downe, Soo, Finlayson, Kenneth, Melvin, C., Spiby, Helen, Ali, A., Diggle, P., Gyte, G., Hinder, S., Miller, V., Slade, P., Trepel, D., Weeks, A., and Whorwell, Peter
- Abstract
Objective: (Primary) To establish the effect of antenatal group self-hypnosis for nulliparous women on intra-partum epidural use. Design: Multi-method randomised control trial (RCT). Setting: Three NHS Trusts. Population: Nulliparous women not planning elective caesarean, without medication for hypertension and without psychological illness. Methods: Randomisation at 28–32 weeks’ gestation to usual care, or to usual care plus brief self-hypnosis training (two × 90-minute groups at around 32 and 35 weeks’ gestation; daily audio self-hypnosis CD). Follow up at 2 and 6 weeks postnatal. Main outcome measures: Primary: epidural analgesia. Secondary: associated clinical and psychological outcomes; cost analysis. Results: Six hundred and eighty women were randomised. There was no statistically significant difference in epidural use: 27.9% (intervention), 30.3% (control), odds ratio (OR) 0.89 [95% confidence interval (CI): 0.64–1.24], or in 27 of 29 pre-specified secondary clinical and psychological outcomes. Women in the intervention group had lower actual than anticipated levels of fear and anxiety between baseline and 2 weeks post natal (anxiety: mean difference −0.72, 95% CI −1.16 to −0.28, P = 0.001); fear (mean difference −0.62, 95% CI −1.08 to −0.16, P = 0.009) [Correction added on 7 July 2015, after first online publication: ‘Mean difference’ replaced ‘Odds ratio (OR)’ in the preceding sentence.]. Postnatal response rates were 67% overall at 2 weeks. The additional cost in the intervention arm per woman was £4.83 (CI −£257.93 to £267.59). Conclusions: Allocation to two-third-trimester group self-hypnosis training sessions did not significantly reduce intra-partum epidural analgesia use or a range of other clinical and psychological variables. The impact of women's anxiety and fear about childbirth needs further investigation.
- Full Text
- View/download PDF
129. Unexpected consequences: women’s experiences of a self-hypnosis intervention to help with pain relief during labour
- Author
-
Finlayson, Kenneth, Downe, Soo, Hinder, Susan, Carr, Helen, Spiby, Helen, Whorwell, Peter, Finlayson, Kenneth, Downe, Soo, Hinder, Susan, Carr, Helen, Spiby, Helen, and Whorwell, Peter
- Abstract
Background: Self-hypnosis is becoming increasingly popular as a means of labour pain management. Previous studies have produced mixed results. There are very few data on women’s views and experiences of using hypnosis in this context. As part of a randomized controlled trial of self-hypnosis for intra-partum pain relief (the SHIP Trial) we conducted qualitative interviews with women randomized to the intervention arm to explore their views and experiences of using self-hypnosis during labour and birth. Methods: Participants were randomly selected from the intervention arm of the study, which consisted of two antenatal self-hypnosis training sessions and a supporting CD that women were encouraged to listen to daily from 32 weeks gestation until the birth of their baby. Those who consented were interviewed in their own homes 8–12 weeks after birth. Following transcription, the interviews were analysed iteratively and emerging concepts were discussed amongst the authors to generate organizing themes. These were then used to develop a principal organizing metaphor or global theme, in a process known as thematic networks analysis. Results: Of the 343 women in the intervention group, 48 were invited to interview, and 16 were interviewed over a 12 month period from February 2012 to January 2013. Coding of the data and subsequent analysis revealed a global theme of ‘unexpected consequences’, supported by 5 organising themes, ‘calmness in a climate of fear’, ‘from sceptic to believer’, ‘finding my space’, ‘delays and disappointments’ and ‘personal preferences’. Most respondents reported positive experiences of self hypnosis and highlighted feelings of calmness, confidence and empowerment. They found the intervention to be beneficial and used a range of novel strategies to personalize their self-hypnosis practice. Occasionally women reported feeling frustrated or disappointed when their relaxed state was misinterpreted by midwives on admission or when their labour and birth e
- Full Text
- View/download PDF
130. Self-hypnosis for intrapartum pain management in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness
- Author
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Downe, Soo, Finlayson, Kenneth, Melvin, C., Spiby, Helen, Ali, A., Diggle, P., Gyte, G., Hinder, S., Miller, V., Slade, P., Trepel, D., Weeks, A., Whorwell, Peter, Downe, Soo, Finlayson, Kenneth, Melvin, C., Spiby, Helen, Ali, A., Diggle, P., Gyte, G., Hinder, S., Miller, V., Slade, P., Trepel, D., Weeks, A., and Whorwell, Peter
- Abstract
Objective: (Primary) To establish the effect of antenatal group self-hypnosis for nulliparous women on intra-partum epidural use. Design: Multi-method randomised control trial (RCT). Setting: Three NHS Trusts. Population: Nulliparous women not planning elective caesarean, without medication for hypertension and without psychological illness. Methods: Randomisation at 28–32 weeks’ gestation to usual care, or to usual care plus brief self-hypnosis training (two × 90-minute groups at around 32 and 35 weeks’ gestation; daily audio self-hypnosis CD). Follow up at 2 and 6 weeks postnatal. Main outcome measures: Primary: epidural analgesia. Secondary: associated clinical and psychological outcomes; cost analysis. Results: Six hundred and eighty women were randomised. There was no statistically significant difference in epidural use: 27.9% (intervention), 30.3% (control), odds ratio (OR) 0.89 [95% confidence interval (CI): 0.64–1.24], or in 27 of 29 pre-specified secondary clinical and psychological outcomes. Women in the intervention group had lower actual than anticipated levels of fear and anxiety between baseline and 2 weeks post natal (anxiety: mean difference −0.72, 95% CI −1.16 to −0.28, P = 0.001); fear (mean difference −0.62, 95% CI −1.08 to −0.16, P = 0.009) [Correction added on 7 July 2015, after first online publication: ‘Mean difference’ replaced ‘Odds ratio (OR)’ in the preceding sentence.]. Postnatal response rates were 67% overall at 2 weeks. The additional cost in the intervention arm per woman was £4.83 (CI −£257.93 to £267.59). Conclusions: Allocation to two-third-trimester group self-hypnosis training sessions did not significantly reduce intra-partum epidural analgesia use or a range of other clinical and psychological variables. The impact of women's anxiety and fear about childbirth needs further investigation.
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131. Unexpected consequences: women’s experiences of a self-hypnosis intervention to help with pain relief during labour
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Finlayson, Kenneth, Downe, Soo, Hinder, Susan, Carr, Helen, Spiby, Helen, Whorwell, Peter, Finlayson, Kenneth, Downe, Soo, Hinder, Susan, Carr, Helen, Spiby, Helen, and Whorwell, Peter
- Abstract
Background: Self-hypnosis is becoming increasingly popular as a means of labour pain management. Previous studies have produced mixed results. There are very few data on women’s views and experiences of using hypnosis in this context. As part of a randomized controlled trial of self-hypnosis for intra-partum pain relief (the SHIP Trial) we conducted qualitative interviews with women randomized to the intervention arm to explore their views and experiences of using self-hypnosis during labour and birth. Methods: Participants were randomly selected from the intervention arm of the study, which consisted of two antenatal self-hypnosis training sessions and a supporting CD that women were encouraged to listen to daily from 32 weeks gestation until the birth of their baby. Those who consented were interviewed in their own homes 8–12 weeks after birth. Following transcription, the interviews were analysed iteratively and emerging concepts were discussed amongst the authors to generate organizing themes. These were then used to develop a principal organizing metaphor or global theme, in a process known as thematic networks analysis. Results: Of the 343 women in the intervention group, 48 were invited to interview, and 16 were interviewed over a 12 month period from February 2012 to January 2013. Coding of the data and subsequent analysis revealed a global theme of ‘unexpected consequences’, supported by 5 organising themes, ‘calmness in a climate of fear’, ‘from sceptic to believer’, ‘finding my space’, ‘delays and disappointments’ and ‘personal preferences’. Most respondents reported positive experiences of self hypnosis and highlighted feelings of calmness, confidence and empowerment. They found the intervention to be beneficial and used a range of novel strategies to personalize their self-hypnosis practice. Occasionally women reported feeling frustrated or disappointed when their relaxed state was misinterpreted by midwives on admission or when their labour and birth e
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132. Self-hypnosis for intrapartum pain management in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness
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Downe, Soo, Finlayson, Kenneth, Melvin, C., Spiby, Helen, Ali, A., Diggle, P., Gyte, G., Hinder, S., Miller, V., Slade, P., Trepel, D., Weeks, A., Whorwell, Peter, Downe, Soo, Finlayson, Kenneth, Melvin, C., Spiby, Helen, Ali, A., Diggle, P., Gyte, G., Hinder, S., Miller, V., Slade, P., Trepel, D., Weeks, A., and Whorwell, Peter
- Abstract
Objective: (Primary) To establish the effect of antenatal group self-hypnosis for nulliparous women on intra-partum epidural use. Design: Multi-method randomised control trial (RCT). Setting: Three NHS Trusts. Population: Nulliparous women not planning elective caesarean, without medication for hypertension and without psychological illness. Methods: Randomisation at 28–32 weeks’ gestation to usual care, or to usual care plus brief self-hypnosis training (two × 90-minute groups at around 32 and 35 weeks’ gestation; daily audio self-hypnosis CD). Follow up at 2 and 6 weeks postnatal. Main outcome measures: Primary: epidural analgesia. Secondary: associated clinical and psychological outcomes; cost analysis. Results: Six hundred and eighty women were randomised. There was no statistically significant difference in epidural use: 27.9% (intervention), 30.3% (control), odds ratio (OR) 0.89 [95% confidence interval (CI): 0.64–1.24], or in 27 of 29 pre-specified secondary clinical and psychological outcomes. Women in the intervention group had lower actual than anticipated levels of fear and anxiety between baseline and 2 weeks post natal (anxiety: mean difference −0.72, 95% CI −1.16 to −0.28, P = 0.001); fear (mean difference −0.62, 95% CI −1.08 to −0.16, P = 0.009) [Correction added on 7 July 2015, after first online publication: ‘Mean difference’ replaced ‘Odds ratio (OR)’ in the preceding sentence.]. Postnatal response rates were 67% overall at 2 weeks. The additional cost in the intervention arm per woman was £4.83 (CI −£257.93 to £267.59). Conclusions: Allocation to two-third-trimester group self-hypnosis training sessions did not significantly reduce intra-partum epidural analgesia use or a range of other clinical and psychological variables. The impact of women's anxiety and fear about childbirth needs further investigation.
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133. Unexpected consequences: women’s experiences of a self-hypnosis intervention to help with pain relief during labour
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Finlayson, Kenneth, Downe, Soo, Hinder, Susan, Carr, Helen, Spiby, Helen, Whorwell, Peter, Finlayson, Kenneth, Downe, Soo, Hinder, Susan, Carr, Helen, Spiby, Helen, and Whorwell, Peter
- Abstract
Background: Self-hypnosis is becoming increasingly popular as a means of labour pain management. Previous studies have produced mixed results. There are very few data on women’s views and experiences of using hypnosis in this context. As part of a randomized controlled trial of self-hypnosis for intra-partum pain relief (the SHIP Trial) we conducted qualitative interviews with women randomized to the intervention arm to explore their views and experiences of using self-hypnosis during labour and birth. Methods: Participants were randomly selected from the intervention arm of the study, which consisted of two antenatal self-hypnosis training sessions and a supporting CD that women were encouraged to listen to daily from 32 weeks gestation until the birth of their baby. Those who consented were interviewed in their own homes 8–12 weeks after birth. Following transcription, the interviews were analysed iteratively and emerging concepts were discussed amongst the authors to generate organizing themes. These were then used to develop a principal organizing metaphor or global theme, in a process known as thematic networks analysis. Results: Of the 343 women in the intervention group, 48 were invited to interview, and 16 were interviewed over a 12 month period from February 2012 to January 2013. Coding of the data and subsequent analysis revealed a global theme of ‘unexpected consequences’, supported by 5 organising themes, ‘calmness in a climate of fear’, ‘from sceptic to believer’, ‘finding my space’, ‘delays and disappointments’ and ‘personal preferences’. Most respondents reported positive experiences of self hypnosis and highlighted feelings of calmness, confidence and empowerment. They found the intervention to be beneficial and used a range of novel strategies to personalize their self-hypnosis practice. Occasionally women reported feeling frustrated or disappointed when their relaxed state was misinterpreted by midwives on admission or when their labour and birth e
- Full Text
- View/download PDF
134. Self-hypnosis for intrapartum pain management in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness
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Downe, Soo, Finlayson, Kenneth, Melvin, C., Spiby, Helen, Ali, A., Diggle, P., Gyte, G., Hinder, S., Miller, V., Slade, P., Trepel, D., Weeks, A., Whorwell, Peter, Downe, Soo, Finlayson, Kenneth, Melvin, C., Spiby, Helen, Ali, A., Diggle, P., Gyte, G., Hinder, S., Miller, V., Slade, P., Trepel, D., Weeks, A., and Whorwell, Peter
- Abstract
Objective: (Primary) To establish the effect of antenatal group self-hypnosis for nulliparous women on intra-partum epidural use. Design: Multi-method randomised control trial (RCT). Setting: Three NHS Trusts. Population: Nulliparous women not planning elective caesarean, without medication for hypertension and without psychological illness. Methods: Randomisation at 28–32 weeks’ gestation to usual care, or to usual care plus brief self-hypnosis training (two × 90-minute groups at around 32 and 35 weeks’ gestation; daily audio self-hypnosis CD). Follow up at 2 and 6 weeks postnatal. Main outcome measures: Primary: epidural analgesia. Secondary: associated clinical and psychological outcomes; cost analysis. Results: Six hundred and eighty women were randomised. There was no statistically significant difference in epidural use: 27.9% (intervention), 30.3% (control), odds ratio (OR) 0.89 [95% confidence interval (CI): 0.64–1.24], or in 27 of 29 pre-specified secondary clinical and psychological outcomes. Women in the intervention group had lower actual than anticipated levels of fear and anxiety between baseline and 2 weeks post natal (anxiety: mean difference −0.72, 95% CI −1.16 to −0.28, P = 0.001); fear (mean difference −0.62, 95% CI −1.08 to −0.16, P = 0.009) [Correction added on 7 July 2015, after first online publication: ‘Mean difference’ replaced ‘Odds ratio (OR)’ in the preceding sentence.]. Postnatal response rates were 67% overall at 2 weeks. The additional cost in the intervention arm per woman was £4.83 (CI −£257.93 to £267.59). Conclusions: Allocation to two-third-trimester group self-hypnosis training sessions did not significantly reduce intra-partum epidural analgesia use or a range of other clinical and psychological variables. The impact of women's anxiety and fear about childbirth needs further investigation.
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135. Walter E. Kretchik. U.S. Army Doctrine: From the American Revolution to the War on Terror.
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Finlayson, Kenneth
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- *
MILITARY policy , *NONFICTION , *HISTORY ,HISTORY of the United States Army - Abstract
The article reviews the book "U.S. Army Doctrine: From the American Revolution to the War on Terror," by Walter E. Kretchik, part of the "Modern War Studies" book series.
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- 2012
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136. The AEDUCATE Collaboration. Comprehensive antenatal education birth preparation programmes to reduce the rates of caesarean section in nulliparous women. Protocol for an individual participant data prospective meta-analysis
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Federico Girosi, Anna Lene Seidler, Elizabeth Newnham, Lisa M. Askie, Kenneth William Finlayson, Hannah G Dahlen, Sarah J. Lord, Mary-Ann Davey, Caroline Smith, Soo Downe, Julie Fleet, Leslie Arnott, Mary Steen, Kate M Levett, Kylie E Hunter, Anette Werner, Kerry Sutcliffe, Levett, Kate M, Lord, Sarah J, Dahlen, Hannah G, Smith, Caroline A, Girosi, Federico, Downe, Soo, Finlayson, Kenneth W, Fleet, Julie, Steen, Mary, Davey, Mary A, Newnham, Elizabeth, Werner, Anette, Arnott, Leslie, Sutcliffe, Kerry, Seidler, Anna Lene, Hunter, Kylie E, and Askie, Lisa
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Population ,Psychological intervention ,Subgroup analysis ,Meta-Analysis as Topic ,Prenatal Education ,Pregnancy ,Obstetrics and Gynaecology ,medicine ,complementary medicine ,Humans ,Data monitoring committee ,Childbirth ,Caesarean section ,Prospective Studies ,education ,education.field_of_study ,maternal medicine ,obstetrics ,Cesarean Section ,business.industry ,maternal medicine 8 ,Infant, Newborn ,Parturition ,General Medicine ,Parity ,pain management ,Family medicine ,Meta-analysis ,Medicine ,1114 Paediatrics and Reproductive Medicine ,Female ,antenatal education ,business ,Psychosocial - Abstract
IntroductionRates of medical interventions in normal labour and birth are increasing. This prospective meta-analysis (PMA) proposes to assess whether the addition of a comprehensive multicomponent birth preparation programme reduces caesarean section (CS) in nulliparous women compared with standard hospital care. Additionally, do participant characteristics, intervention components or hospital characteristics modify the effectiveness of the programme?Methods and analysisPopulation: women with singleton vertex pregnancies, no planned caesarean section (CS) or epidural.Intervention: in addition to hospital-based standard care, a comprehensive antenatal education programme that includes multiple components for birth preparation, addressing the three objectives: preparing women and their birth partner/support person for childbirth through education on physiological/hormonal birth (knowledge and understanding); building women’s confidence through psychological preparation (positive mindset) and support their ability to birth without pain relief using evidence-based tools (tools and techniques). The intervention could occur in a hospital-based or community setting.Comparator: standard care alone in hospital-based maternity units.OutcomesPrimary: CS.Secondary: epidural analgesia, mode of birth, perineal trauma, postpartum haemorrhage, newborn resuscitation, psychosocial well-being.Subgroup analysis: parity, model of care, maternal risk status, maternal education, maternal socio-economic status, intervention components.Study designAn individual participant data (IPD) prospective meta-analysis (PMA) of randomised controlled trials, including cluster design. Each trial is conducted independently but share core protocol elements to contribute data to the PMA. Participating trials are deemed eligible for the PMA if their results are not yet known outside their Data Monitoring Committees.Ethics and disseminationParticipants in the individual trials will consent to participation, with respective trials receiving ethical approval by their local Human Research Ethics Committees. Individual datasets remain the property of trialists, and can be published prior to the publication of final PMA results. The overall data for meta-analysis will be held, analysed and published by the collaborative group, led by the Cochrane PMA group.Trial registration numberCRD42020103857.
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- 2020
137. Provision and uptake of routine antenatal services: a qualitative evidence synthesis
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Soo Downe, Ahmet Metin Gülmezoglu, Özge Tunçalp, Kenneth William Finlayson, Downe, Soo, Finlayson, Kenneth William, Tuncalp, Ozge, and Gulmezoglu, Ahmet Metin
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Medicine General & Introductory Medical Sciences ,Attitude of Health Personnel ,Health Personnel ,Culture ,Psychological intervention ,Personnel Staffing and Scheduling ,Context (language use) ,CINAHL ,B720 ,Health Services Accessibility ,03 medical and health sciences ,0302 clinical medicine ,Sex Factors ,Nursing ,Pregnancy ,Medicine ,Humans ,Pharmacology (medical) ,L321 ,030212 general & internal medicine ,Developing Countries ,Qualitative Research ,Quality of Health Care ,business.industry ,Service design ,Developed Countries ,Fraud ,Postpartum Period ,Theory of planned behavior ,Attendance ,Prenatal Care ,Health Care Costs ,Health Facility Environment ,Female ,Pregnant Women ,business ,030217 neurology & neurosurgery ,Postpartum period ,Qualitative research - Abstract
Background Antenatal care (ANC) is a core component of maternity care. However, both quality of care provision and rates of attendance vary widely between and within countries. Qualitative research can assess factors underlying variation, including acceptability, feasibility, and the values and beliefs that frame provision and uptake of ANC programmes. This synthesis links to the Cochrane Reviews of the effectiveness of different antenatal models of care. It was designed to inform the World Health Organization guidelines for a positive pregnancy experience and to provide insights for the design and implementation of improved antenatal care in the future. Objectives To identify, appraise, and synthesise qualitative studies exploring: · Women’s views and experiences of attending ANC; and factors influencing the uptake of ANC arising from women’s accounts; · Healthcare providers’ views and experiences of providing ANC; and factors influencing the provision of ANC arising from the accounts of healthcare providers. Search methods To find primary studies we searched MEDLINE, Ovid; Embase, Ovid; CINAHL, EbscoHost; PsycINFO, EbscoHost; AMED, EbscoHost; LILACS, VHL; and African Journals Online (AJOL) from January 2000 to February 2019. We handsearched reference lists of included papers and checked the contents pages of 50 relevant journals through Zetoc alerts received during the searching phase. Selection criteria We included studies that used qualitative methodology and that met our quality threshold; that explored the views and experiences of routine ANC among healthy, pregnant and postnatal women or among healthcare providers offering this care, including doctors, midwives, nurses, lay health workers and traditional birth attendants; and that took place in any setting where ANC was provided. We excluded studies of ANC programmes designed for women with specific complications. We also excluded studies of programmes that focused solely on antenatal education. Data collection and analysis Two authors undertook data extraction, logged study characteristics, and assessed study quality. We used meta‐ethnographic and Framework techniques to code and categorise study data. We developed findings from the data and presented these in a 'Summary of Qualitative Findings' (SoQF) table. We assessed confidence in each finding using GRADE‐CERQual. We used these findings to generate higher‐level explanatory thematic domains. We then developed two lines of argument syntheses, one from service user data, and one from healthcare provider data. In addition, we mapped the findings to relevant Cochrane effectiveness reviews to assess how far review authors had taken account of behavioural and organisational factors in the design and implementation of the interventions they tested. We also translated the findings into logic models to explain full, partial and no uptake of ANC, using the theory of planned behaviour. Main results We include 85 studies in our synthesis. Forty‐six studies explored the views and experiences of healthy pregnant or postnatal women, 17 studies explored the views and experiences of healthcare providers and 22 studies incorporated the views of both women and healthcare providers. The studies took place in 41 countries, including eight high‐income countries, 18 middle‐income countries and 15 low‐income countries, in rural, urban and semi‐urban locations. We developed 52 findings in total and organised these into three thematic domains: socio‐cultural context (11 findings, five moderate‐ or high‐confidence); service design and provision (24 findings, 15 moderate‐ or high‐confidence); and what matters to women and staff (17 findings, 11 moderate‐ or high‐confidence) The third domain was sub‐divided into two conceptual areas; personalised supportive care, and information and safety. We also developed two lines of argument, using high‐ or moderate‐confidence findings: For women, initial or continued use of ANC depends on a perception that doing so will be a positive experience. This is a result of the provision of good‐quality local services that are not dependent on the payment of informal fees and that include continuity of care that is authentically personalised, kind, caring, supportive, culturally sensitive, flexible, and respectful of women’s need for privacy, and that allow staff to take the time needed to provide relevant support, information and clinical safety for the woman and the baby, as and when they need it. Women’s perceptions of the value of ANC depend on their general beliefs about pregnancy as a healthy or a risky state, and on their reaction to being pregnant, as well as on local socio‐cultural norms relating to the advantages or otherwise of antenatal care for healthy pregnancies, and for those with complications. Whether they continue to use ANC or not depends on their experience of ANC design and provision when they access it for the first time. The capacity of healthcare providers to deliver the kind of high‐quality, relationship‐based, locally accessible ANC that is likely to facilitate access by women depends on the provision of sufficient resources and staffing as well as the time to provide flexible personalised, private appointments that are not overloaded with organisational tasks. Such provision also depends on organisational norms and values that overtly value kind, caring staff who make effective, culturally‐appropriate links with local communities, who respect women’s belief that pregnancy is usually a normal life event, but who can recognise and respond to complications when they arise. Healthcare providers also require sufficient training and education to do their job well, as well as an adequate salary, so that they do not need to demand extra informal funds from women and families, to supplement their income, or to fund essential supplies. Authors' conclusions This review has identified key barriers and facilitators to the uptake (or not) of ANC services by pregnant women, and in the provision (or not) of good‐quality ANC by healthcare providers. It complements existing effectiveness reviews of models of ANC provision and adds essential insights into why a particular type of ANC provided in specific local contexts may or may not be acceptable, accessible, or valued by some pregnant women and their families/communities. Those providing and funding services should consider the three thematic domains identified by the review as a basis for service development and improvement. Such developments should include pregnant and postnatal women, community members and other relevant stakeholders., Provision and uptake of routine antenatal services What is the aim of this review? The aim of this Cochrane qualitative evidence synthesis is to explore women’s and healthcare workers’ views and experiences of antenatal care. We collected and analysed all relevant qualitative studies to answer this question, and include 85 studies. The synthesis links to the Cochrane Reviews of the effectiveness of different antenatal models of care. The synthesis was designed to inform the World Health Organization guidelines for a positive pregnancy experience. Key messages Three areas of antenatal care are important to both women and service providers in all regions of the world. These are: the need to recognise and take account of the socio‐cultural context in which care is provided; the need to ensure that service design and provision are appropriate, accessible, acceptable and of high quality: and that what matters to women and staff is personalised supportive care, information, and safety. What was studied in this review? Antenatal care is the health care women get while they are pregnant. During antenatal care visits, pregnant women are provided with support, reassurance, and information about pregnancy and birth, as well as tests and examinations to see if they and their baby are healthy. If any issues or problems are discovered, these can be managed during the clinic visit. If needed, women can be referred to other care providers. Different types of healthcare workers can give antenatal care. These include midwives, doctors, nurses, and, sometimes, traditional birth attendants. The World Health Organization recommends that all pregnant women get antenatal care, but pregnant women do not always use this care. This may be because they do not think it is important, or because they cannot get to the healthcare facility. It may also be because the antenatal care they receive is of poor quality or because they are badly treated when they are there. By looking at studies of women’s and healthcare workers’ views and experiences of antenatal care, we aimed to learn more about what might help women to use antenatal care, and what might stop them using it. What are the main findings of this review? We include 85 studies in our synthesis. Forty‐six studies explored the views and experiences of women who were pregnant or who had recently given birth. 17 studies explored the views and experiences of healthcare providers, including lay or community health workers, and 22 studies included the views of both women and healthcare providers. The studies took place in eight high‐income countries, 18 middle‐income countries and 12 low‐income countries, in rural and urban locations. Our findings suggest that women use antenatal care if they find it is a positive experience that fits with their beliefs and values, is easy for them to access, affordable, and treats them as an individual. They want care that helps them to feel that they and their baby are safe, and that is provided by kind, caring, culturally sensitive, flexible, and respectful staff that have time to give them support and reassurance about the health and well‐being of them and their babies. They also value tests and treatments that are offered when they need them, and information and advice that is relevant to them. Our findings also suggest that healthcare staff want to be able to offer this kind of care. They would like to work in antenatal services that are properly funded, and that give them proper support, pay, training and education. They believe this will help them to have enough time to treat each pregnant woman as an individual, and to have the knowledge, skills resources and equipment to do their job well. How up‐to‐date is this review? The review authors searched for studies that had been published up to February 2019.
- Published
- 2019
138. Pregnancy, childbirth and the postpartum period: opportunities to improve lifetime outcomes for women with non-communicable diseases.
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Ramson JA, Williams MJ, Afolabi BB, Colagiuri S, Finlayson KW, Hemmingsen B, Venkatesh KK, and Chou D
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- 2024
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139. The feasibility and acceptability of using the Mother-Generated Index (MGI) as a Patient Reported Outcome Measure in a randomised controlled trial of maternity care.
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Symon A, Downe S, Finlayson KW, Knapp R, and Diggle P
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- Adult, Anxiety diagnosis, Depression diagnosis, Female, Humans, Patient Satisfaction, Pregnancy, Quality of Life, Health Status, Mothers statistics & numerical data, Patient Outcome Assessment, Personality Inventory, Surveys and Questionnaires
- Abstract
Background: Using patient-reported outcome measures (PROMs) to assess Quality of Life (QoL) is well established, but commonly-used PROM item-sets do not necessarily capture what all respondents consider important. Measuring complex constructs is particularly difficult in randomised controlled trials (RCTs). The Mother-Generated Index (MGI) is a validated antenatal and postnatal QoL instrument in which the variables and scores are completely respondent-driven. This paper reports on the feasibility and acceptability of the MGI in an RCT, and compares the resulting variables and QoL scores with more commonly used instruments., Methods: The single-page MGI was included at the end of a ten page questionnaire pack and posted to the RCT participants at baseline (28-32 weeks' gestation) and follow-up (six weeks postnatal). Feasibility and acceptability were assessed by ease of administration, data entry and completion rates. Variables cited by women were analysed thematically. MGI QoL scores were compared with outcomes from the EQ-5D-3 L; Edinburgh Postnatal Depression Scale; Satisfaction With Life Scale; and State Trait Anxiety Inventory., Results: Six hundred and seventy eight pregnant women returned the pack at baseline; 668 completed the MGI (98.5%); 383/400 returns at follow up included a completed MGI (95.7%). Quantitative data were scanned into SPSS using a standard data scanning system, and were largely error-free; qualitative data were entered manually. The variables recorded by participants on the MGI forms incorporated many of those in the comparison instruments, and other outcomes commonly used in intrapartum trials, but they also revealed a wider range of issues affecting their quality of life. These included financial and work-related worries; moving house; and concerns over family illness and pets. The MGI scores demonstrated low-to-moderate correlation with other tools (all r values p < .01)., Conclusions: Without face-to-face explanation and at the end of a long questionnaire, the MGI was feasible to use, and acceptable to RCT participants. It allowed individual participants to include issues that were important to them, but which are not well captured by existing tools. The MGI unites the explanatory power of qualitative research with the comparative power of quantitative designs, is inexpensive to administer, and requires minimal linguistic and conceptual translation., Trial Registration: ISRCTN27575146 (date assigned 23 March 2011).
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- 2015
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140. Square pegs into round holes?
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Finlayson K
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- Delivery, Obstetric nursing, Female, Humans, Infant, Newborn, Pregnancy, Randomized Controlled Trials as Topic, Complementary Therapies methods, Delivery, Obstetric methods, Evidence-Based Nursing, Holistic Health, Midwifery methods, Perinatal Care methods
- Published
- 2013
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