Is self-management a burden? What are the experiences of women self-managing chronic conditions during pregnancy? A systematic review

Jakubowski, Beth; Hinton, Lisa; Khaira, Jaspreet; Roberts, Nia; McManus, Richard J; Tucker, Katherine L.

doi:10.1136/bmjopen-2021-051962

Cited by 13 publications

(5 citation statements)

References 34 publications

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“…Self-management support should be promoted in person-centred care. A review regarding pregnant women who have a chronic condition highlighted that women found the treatment shift towards self-management overwhelming; however, women's anxiety mostly stemmed from insufficient knowledge and understanding of their diagnosed condition [77]. If they have supportive friends and family, alongside supportive clinicians, they are more motivated to undertake self-management [77].…”

Section: Discussionmentioning

confidence: 99%

“…A review regarding pregnant women who have a chronic condition highlighted that women found the treatment shift towards self-management overwhelming; however, women's anxiety mostly stemmed from insufficient knowledge and understanding of their diagnosed condition [77]. If they have supportive friends and family, alongside supportive clinicians, they are more motivated to undertake self-management [77]. Peer support is known to be helpful to women with vulnerabilities during pregnancy [78][79][80] and in those who have experienced pregnancy loss [81], however specialist antenatal classes for women who are experiencing similar pregnancies are rarely provided [82].…”

Section: Discussionmentioning

confidence: 99%

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IMplementation of the Preterm Birth Surveillance PAthway: a RealisT evaluation (The IMPART Study)

Carlisle,

Dalkin,

Shennan

et al. 2024

Implement Sci Commun

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Background In the UK, 7.6% of babies are born preterm, which the Department of Health aims to decrease to 6% by 2025. To advance this, NHS England released Saving Babies Lives Care Bundle Version 2 Element 5, recommending the Preterm Birth Pathway for women at risk of preterm birth. The success of this new pathway depends on its implementation. The IMPART (IMplementation of the Preterm Birth Surveillance PAthway: a RealisT evaluation) study aimed to research how, why, for whom, to what extent and in what contexts the prediction and prevention aspects of Preterm Birth Surveillance Pathway is implemented through a realist evaluation. Realist implementation studies are growing in popularity. Methods Initial programme theories were developed through a realist informed literature scope, interviews with developers of the NHS England guidance, and a national questionnaire of current practice. Implementation theory was utilised in developing the programme theories. Data (interviews and observations with staff and women) were undertaken in 3 case sites in England to ‘test’ the programme theories. Substantive theory was utilised during data analysis to interpret and refine the theories on how implementation could be improved. Results Three explanatory areas were developed: risk assessing and referral; the preterm birth surveillance clinic; and women centred care. Explanatory area 1 dealt with the problems in correct risk assessment and referral to a preterm clinic. Explanatory area 2 focused on how once a correct referral has been made to a preterm clinic, knowledgeable and supported clinicians can deliver a well-functioning clinic. Explanatory area 3 concentrated on how the pathway delivers appropriate care to women. Conclusions The IMPART study provides several areas where implementation could be improved. These include educating clinicians on knowledge of risk factors and the purpose of the preterm clinic, having a multidisciplinary preterm team (including a preterm midwife) with specialist preterm knowledge and skills (including transvaginal cervical scanning skills), and sites actively working with their local network. This multidisciplinary preterm team are placed to deliver continuity of care for women at high-risk of preterm birth, being attentive to their history but also ensuring they are not defined by their risk status. Trial registration ISRCTN57127874.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

IMplementation of the Preterm Birth Surveillance PAthway: a RealisT evaluation (The IMPART Study)

Carlisle,

Dalkin,

Shennan

et al. 2024

Implement Sci Commun

View full text Add to dashboard Cite

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“…Evidence suggests that pregnant women may have different motivating factors for selfmanagement than the general population. The primary motivator for pregnant women with different types of diabetes selfmanaging their condition is the health of their baby 104 . This is unlikely to be a motivator for the pregnant women in this systematic review who had musculoskeletal conditions which pose little or no risk to the foetus.…”

Section: Discussionmentioning

confidence: 99%

“…This is unlikely to be a motivator for the pregnant women in this systematic review who had musculoskeletal conditions which pose little or no risk to the foetus. However, barriers to self-management of diabetes during pregnancy including anxiety, lack of understanding, and a lack of support from family and health professionals 104 are likely to be relevant to pregnant women with musculoskeletal conditions. Self-management programmes are known to be effective in managing musculoskeletal conditions amongst non-pregnant populations.…”

Section: Discussionmentioning

confidence: 99%

Community-based non-pharmacological interventions for improving pain, disability, and quality of life in pregnant women with musculoskeletal conditions: a systematic review

Igwesi-Chidobe

Emmanuel

Ozumba

2023

Preprint

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Background Majority of pregnant women experience pain and discomfort due to musculoskeletal conditions; with over a quarter experiencing some disability; all of which reduce quality of life during pregnancy. Community-based non-pharmacological interventions are more affordable, accessible, and acceptable, and have the capacity to reduce inequalities. Objectives To summarise community-based non-pharmacological interventions and determine their effectiveness for improving pain, disability, and quality of life amongst pregnant women with musculoskeletal conditions. Search Strategy Twelve bibliographic databases (and reference list of relevant systematic reviews) were searched from inception until March 2022. Selection Criteria All primary studies of community-based non-pharmacological interventions for pregnant women with musculoskeletal conditions reported in English which investigated pain, disability and quality of life were included. Data Collection and Analysis Data were extracted using modified Cochrane’s data extraction template. Studies were appraised using Cochrane Collaboration’s risk of bias tool. Narrative synthesis was used to summarise findings. This review registration number with PROSPERO is CRD42020189535. Main Results 33 studies involving 4,930 pregnant women with low back pain, pelvic pain, and lumbopelvic pain. Osteopathic manipulation plus standard obstetric care produced significantly superior reduction in pain intensity and disability than sham ultrasound therapy plus standard obstetric care amongst pregnant women with low back pain (moderate level of evidence). There was limited or conflicting evidence for other results. Acupuncture was more effective than placebo in reducing disability/sick leave but not pain intensity and quality of life. There was little or no added benefit of craniosacral therapy to standard obstetric care. Exercise and spinal manipulative therapy were equally effective, and better than no treatment. Home versus in-clinic exercise and aquatic versus land-based exercise were similar in effectiveness with conflicting evidence when compared with standard obstetric care. Wide flexible lumbopelvic belts or the addition of textured sacral pad was better than thin rigid lumbopelvic belts, belts without padding, or no belt. Kinesiotaping may not be better than placebo. Effectiveness of self-management programmes was inconsistent. Conclusions Community-based non-pharmacological interventions were better than no treatment and were better or as effective as standard obstetric care in improving pain intensity, disability, and quality of life.

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“…The theory of self-management behavior has not been sufficiently applied since its announcement in 2017 [ 11 ]. Cross-validation was performed for construct validity because, compared with non-pregnant women, pregnant women have different motivating factors for self-management [ 19 ].…”

Section: Methodsmentioning

confidence: 99%

Development and validation of a self-management self-efficacy scale for premature birth prevention (SMSE-PBP) for women of childbearing age

Kim,

Lee

2024

BMC Women's Health

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Background This study aimed to develop and evaluate the validity and reliability of a self-management self-efficacy for premature birth prevention (SMSE-PBP) in women of childbearing age (WCA). Methods Instrument development and validation were undertaken in three phases: conceptualization, item generation and evaluation of content validity, and evaluation of construct and concurrent validity and reliability. Data were analyzed using exploratory and second-order confirmatory factor analyses, and concurrent validity was examined using Pearson’s correlation coefficients. The reliability was analyzed using omega hierarchical and Cronbach’s ⍺. Results Content validity was assessed by experts and cognitive interviews of WCA. The SMSE-PBP consists of a second-order 3-dimension and 10-factor scale with 60 items; therefore, the construct and concurrent validity of the SMSE-PBP were supported. The omega values were 0.93 for pre-pregnancy SMSE-PBP, 0.92 for pregnancy SMSE-PBP, and 0.94 for hospital SMSE-PBP. Cronbach’s ⍺ was 0.88 for pre-pregnancy SMSE-PBP, 0.96 for pregnancy SMSE-PBP, and 0.96 for hospital SMSE-PBP. Conclusions The SMSE-PBP scale is valid and reliable for WCA; it is helpful for WCA and health professionals to assess women’s SMSE-PBP and pre-pregnancy, pregnancy, or hospital SMSE-PBP. The next steps should include assessing the relationship with pregnancy health behaviors.

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Is self-management a burden? What are the experiences of women self-managing chronic conditions during pregnancy? A systematic review

Cited by 13 publications

References 34 publications

IMplementation of the Preterm Birth Surveillance PAthway: a RealisT evaluation (The IMPART Study)

IMplementation of the Preterm Birth Surveillance PAthway: a RealisT evaluation (The IMPART Study)

Community-based non-pharmacological interventions for improving pain, disability, and quality of life in pregnant women with musculoskeletal conditions: a systematic review

Development and validation of a self-management self-efficacy scale for premature birth prevention (SMSE-PBP) for women of childbearing age

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