A systematic review of person-centered care interventions to improve quality of facility-based delivery

Rubashkin, Nicholas; Warnock, Ruby; Diamond‐Smith, Nadia

doi:10.1186/s12978-018-0588-2

Cited by 51 publications

(53 citation statements)

References 70 publications

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“…Tailored group educational activities and peer support motivates behaviour change among pregnant women and increases women's satisfaction with maternity care [47]. In this study, late initiation of antenatal care meant that women are not familiar with the health system and might not have the benefit of psychological support and sharing of experiences which help women feel more empowered as decision makers during childbirth [48].…”

Section: Discussionmentioning

confidence: 94%

Person-Centred Maternity Care in a Poor-Resource Setting: Evidence from a Cross-Sectional Study in Enugu State, Nigeria

Ogbuabor

Nwankwor

2020

Preprint

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Background Women are not getting adequate person-centred maternity care (PCMC) in low-income and middle-income countries despite being important in reducing maternal morbidity and mortality. This study assessed perceptions and predictors of PCMC among childbearing women in Enugu State, South-east Nigeria.Methods The study was conducted in two health districts in Enugu State using a descriptive, cross-sectional survey design. We conveniently selected 450 childbearing women, within 9 weeks post-partum, from 11 health facilities purposively selected based on high maternal and child health attendance. Data was collected from women using an interviewer administered 30-item PCMC scale (scores 0–90) consisting of: dignity and respect (6 items, scores 0–18), communication and autonomy (9 items, scores 0–27), and supportive care (15 items, scores 0–45). We categorized full PCMC and each sub-scale into “low, medium and high” using 25th and 75th percentile of the summative scores. The questionnaire also collected data on women characteristics, facility characteristics and service type. Data were analysed using descriptive statistics, t- tests, analysis of variance and Generalized Linear Models.Results Women had medium scores on full PCMC scale and sub-scales. The lowest score was in communication and autonomy. A quarter of women perceived PCMC as high. Marrying at age 20–29 years (β = 5.83, ρ = 0.002), self-employed women (β = -10.23, ρ = 0.004), starting antenatal care in the third trimester (β = -7.93, ρ = 0.008), high participation in household decisions (β = -4.98, ρ = 0.011), domestic violence experience (β = 5.41, ρ = 0.002), delivery at health centre (β = 7.09, ρ = 0.000), delivery at private/mission hospital (β = 17.47, ρ = 0.000), delivery by non-skilled attendant (β = -9.61, ρ = 0.001); delivery by community health workers (β = -7.65, ρ = 0.001), and experience of pregnancy complication (β = 6.20, ρ = 0.028) predicted PCMC.Conclusions Person-centred maternity care was generally inadequate. Improving PCMC would entail sustaining dignified care, enhancing provider-patient communication, addressing facility-level drivers, increasing women’s personal empowerment and self-employment, timely initiation of antenatal care, and paying attention to women with pregnancy complication.

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Section: Discussionmentioning

confidence: 94%

Person-Centred Maternity Care in a Poor-Resource Setting: Evidence from a Cross-Sectional Study in Enugu State, Nigeria

Ogbuabor

Nwankwor

2020

Preprint

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“…Evidence in support of person-centered care is extensive, particularly in the reproductive health arena. [25][26][27][28][29] Elements of person-centered care, including individualized care, communication, creating partnerships in autonomy and decision making, and building relationships, are well documented as ways to improve the experience and quality of health care, especially with women of color. 14,29,30 Respectful perinatal care, in relation to experiences of respect, autonomy, and mistreatment, has also been extensively studied and reported upon.…”

Section: Discussionmentioning

confidence: 99%

Listening to Women: Recommendations from Women of Color to Improve Experiences in Pregnancy and Birth Care

Altman

McLemore

Oseguera

et al. 2020

J Midwife Womens Health

115

108

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Introduction Women of color are at increased risk for poor birth outcomes, often driven by upstream social determinants and socially structured systems. Given the increasing rate of maternal mortality in the United States, particularly for women of color, there is a pressing need to find solutions to improving care quality and access for racially marginalized communities. This study aims to describe and thematically analyze the recommendations to improve pregnancy and birth care made by women of color with lived experience of perinatal health care. Methods Twenty‐two women of color living in the San Francisco Bay Area and receiving support services from a community‐based nonprofit organization participated in semistructured interviews about their experiences receiving health care during pregnancy and birth. Interviews were audio‐recorded and transcribed, and transcripts were analyzed using thematic analysis to highlight recommendations for improving perinatal care experiences. Results Participants shared experiences and provided recommendations for improving care at the individual health care provider level, including spending quality time, relationship building and making meaningful connections, individualized person‐centered care, and partnership in decision making. At the health systems level, recommendations included continuity of care, racial concordance with providers, supportive health care system structures to meet the needs of women of color, and implicit bias trainings and education to reduce judgment, stereotyping, and discrimination. Discussion Participants in this study shared practical ways that health care providers and systems can improve pregnancy and birth care experiences for women of color. In addition to the actions needed to address the recommendations, health care providers and systems need to listen more closely to women of color as experts on their experiences in order to create effective change. Community‐centered research, driven by and for women of color, is essential to improve health disparities during pregnancy and birth.

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“…In group 3 (53)(54)(55), PCC features of patient as a person, individual expectations, patient as an active part of society and documentation were mentioned in conjunction with relational ethics actions of environment, embodied knowledge and uncertainty.…”

Section: Article Groupsmentioning

confidence: 99%

Person-Centered Care From a Relational Ethics Perspective for the Delivery of High Quality and Safe Healthcare: A Scoping Review

Tomaselli

Buttiġieġ

Rosano³

et al. 2020

Front. Public Health

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Background: The aim of this scoping review is to explore whether or not person-centered care (PCC), in its quest to deliver high quality and safe health care, has a relational-ethics perspective. To do so, we first need to relate the extant literature pertaining to PCC and relational ethics. To this extent, the specific features that define PCC and relational ethics were identified. PCC dimensions include: patient and provider concordance, improved health outcomes, improved patient safety, individual expectations, patients' integration within the environment, patient as a person, patient as an active part of society, dialogue and interaction, sharing experience, and documentation of patient's (person's) narrative. Relational ethics framework includes the following actions: mutual respect, engagement, embodied knowledge, environment, and uncertainty.Methods: Data were retrieved through multiple keywords search on PubMed, Medline, and Scopus. Inclusion/exclusion criteria were set, and these were based on year of publication (2008-2018), language, paper focus, research method and document types. A total of 23 articles (N = 23) were selected and reviewed. Content analysis was conducted in order to identify and compare the main features of PCC and relational ethics. Results:The most important relational ethics action referred to in conjunction with PCC features is environment (referred to as person's integration within a social environment/community). This is followed by mutual respect, engagement and embodied knowledge. These were the salient relational ethics actions both directly and indirectly linked to PCC. Uncertainty was the less recurrent relational ethical action mentioned.Conclusions: This paper revealed that while PCC features embrace most of the relational ethics approaches, these are not exploited in their entirety and therefore PCC emerges as a unique ethical stance in healthcare. PCC's ethical approach goes beyond what is explained within provider-patient relational ethics and emphasizes that the patient is an active person and a partner in care with capabilities and resources.Tomaselli et al. Person-Centered Care and Relational EthicsThis distinction enables us to explain the paradigm shift from "patient-centered" to "person-centered" care. The healthcare provider partnership and co-creation of the healthcare plan contributes to the delivery of high quality, safe and cost-contained healthcare.

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A systematic review of person-centered care interventions to improve quality of facility-based delivery

Cited by 51 publications

References 70 publications

Person-Centred Maternity Care in a Poor-Resource Setting: Evidence from a Cross-Sectional Study in Enugu State, Nigeria

Person-Centred Maternity Care in a Poor-Resource Setting: Evidence from a Cross-Sectional Study in Enugu State, Nigeria

Listening to Women: Recommendations from Women of Color to Improve Experiences in Pregnancy and Birth Care

Person-Centered Care From a Relational Ethics Perspective for the Delivery of High Quality and Safe Healthcare: A Scoping Review

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