Patient-centered Care in Maternity Services: A Critical Appraisal and Synthesis of the Literature

Labrusse, Claire de; Ramelet, Anne‐Sylvie; Humphrey, Tracy; MacLennan, Sara

doi:10.1016/j.whi.2015.09.003

Cited by 56 publications

(38 citation statements)

References 23 publications

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“…The need for enhancing the relationships between patients and their HCP has been identified in many areas of health care, including prenatal care [36–38]. Finally, although some focus groups were conducted with a small number of participants, findings were similar across the groups and saturation was reached.…”

Section: Discussionmentioning

confidence: 99%

Women’s perceptions of discussions about gestational weight gain with health care providers during pregnancy and postpartum: a qualitative study

Nikolopoulos

Mayan

MacIsaac

et al. 2017

BMC Pregnancy Childbirth

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BackgroundMaternal body weight is an indicator of the health of a mother and her developing fetus. Risks of poor maternal and fetal health issues increase when women gain too little or too much weight during pregnancy. A study of 600 women from Alberta, Canada, reported approximately 30, 46, 80, and 80% of underweight, healthy weight, overweight, and obese women, respectively, gained in excess of Health Canada gestational weight gain guidelines. Behavioural interventions during pregnancy have shown to be effective at supporting women achieve gestational weight gain (GWG) recommendations and return to their pre-pregnancy weight postpartum, yet few women are counseled about weight gain during pregnancy. A discrepancy exists between health care providers’ (HCP) reported counseling behaviours and women’s perceptions of counseling by HCPs; most HCPs report counseling women about GWG; conversely, most women report not receiving counseling about GWG. This study explored women’s experiences with GWG and their perceptions of discussions about GWG with HCPs during pregnancy and postpartum. This will help to identify gaps in service delivery and highlight areas for improvement that may better support women to achieve GWG recommendations leading to better health outcomes for women and children.MethodsFive focus groups (n = 26) were conducted with women up to 1 year postpartum across the five Alberta health zones. Focus groups were transcribed verbatim and analyzed using qualitative content analysis.ResultsGWG is important to women, for their health and for the health of their baby. In-depth conversations with HCPs about GWG or weight loss do not occur; however, women want the opportunity to discuss weight gain/loss with HCPs. Women would like discussions about gestational weight gain/loss to become part of standard care and offered to all women.ConclusionsWomen suggested that discussions about GWG should occur with all women, and that HCPs should initiate these discussions by asking women how they feel about discussing weight. Conversations should begin early on in pregnancy and continue through to the postpartum period. Interventions assessing discussions about GWG should be implemented and evaluated as this has been identified as a gap in prenatal service delivery.

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Section: Discussionmentioning

confidence: 99%

Women’s perceptions of discussions about gestational weight gain with health care providers during pregnancy and postpartum: a qualitative study

Nikolopoulos

Mayan

MacIsaac

et al. 2017

BMC Pregnancy Childbirth

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“…Woman-centered care has been recognized as a marker of quality in maternity services 1 . This phenomenon has been derived from labels such as person-, patient-or clientcentered care.…”

Section: Introductionmentioning

confidence: 99%

“…This phenomenon has been derived from labels such as person-, patient-or clientcentered care. These concepts relate to various healthcare contexts [1][2][3][4] . The concept label woman-centered care is used in relation to midwifery care because woman-centered care emphasizes a strong midwifery-specific focus 5 .…”

Section: Introductionmentioning

confidence: 99%

“…shared decision making, continuity) [15][16][17][18][19] . It has been debated whether womancentered care is suitable solely for the healthy childbearing woman or may also enhance the experience for the woman with health and/or psychosocial problems 1 . Unclear use of woman-centered language may affect correct understanding of the concept 20 .…”

Section: Introductionmentioning

confidence: 99%

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Woman-centered care 2.0: Bringing the concept into focus

Fontein-Kuipers¹,

Groot²,

Staa³

2018

Eur J Midwifery

118

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INTRODUCTION Woman-centered care has become a midwifery concept with implied meaning. In this paper we aim to provide a clear conceptual foundation of woman-centered care for midwifery science and practice. METHODS An advanced concept analysis was undertaken. At the outset, a systematic search of the literature was conducted in PubMed, OVID and EBSCO. This was followed by an assessment of maturity of the retrieved data. Principle-based evaluation was done to reveal epistemological, pragmatic, linguistic and logic principles, that attribute to the concept. Summative conclusions of each respective component and a detailed analysis of conceptual components (antecedents, attributes, outcomes, boundaries) resulted in a definition of woman-centered care. RESULTS Eight studies were selected for analyses. In midwifery, woman-centered care has both a philosophical and a pragmatic meaning. There is strong emphasis on the woman-midwife relationship during the childbearing period. The concept demonstrates a dual and equal focus on physical parameters of pregnancy and birth, and on humanistic dimensions in an interpersonal context. The concept is epistemological, dynamic and multidimensional. The results reveal the concept's boundaries and fluctuations regarding equity and control. The role of the unborn child is not incorporated in the concept. CONCLUSION An in-depth understanding and a broad conceptual foundation of womancentered care has evolved. Now, the concept is ready for research and educational purposes as well as for practical utility.

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“…Finally, the PCC 'respect for patient values, preferences and expressed needs' domain is comprehensive enough to consider the general and specific issues of women's needs and expectations when using maternity services. When one of the most referenced definitions of PCC is reviewed, it appears that PCC may be a more appropriate model of care for maternity services, as per described; see [63]. Shaller's [60] framework of PCC described a brief outline of the six domains including: A revised model could integrate a stronger appreciation of the importance to provide individualised information by their care provider (d1), highlighting the opportunity for a greater involvement of the family and friends (d2), with a continuity of care (d3), an awareness of anxiety in any pregnancies and the midwife as the person to refer to in this situation (d4), and the development of clear and achievable expectations (d5), using multiple interventions that support communication.…”

Section: Reflection On Shaller's Pcc Model and Redefinition [60]mentioning

confidence: 99%

Patient-Centred Care in Maternity Services

Labrusse¹,

Ramelet²,

Humphrey³

et al. 2017

Patient Centered Medicine

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Providing patient-centred care (PCC) is one of the goals described by the Institute of Medicine (IOM) to deliver quality of care. Across several interventions described in the literature, there is no clear consensus of one that will best fit the diversity of women coming to seek care in maternity services and across the variety of healthcare providers (HCPs) who provide that care. A reason for that may be the lack of consensus about the model of care to adopt for maternity services reveals a neglected area of research. Managing quality of care should also mean considering the best model of care in practice for all women, incorporating the core and legitimate attributes of maternity care.

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Patient-centered Care in Maternity Services: A Critical Appraisal and Synthesis of the Literature

Abstract: This review highlights Shaller's definitions of PCC as the one that would be the most inclusive of all women using maternity services. Future research should concentrate on evaluating programs that support PCC in maternity services, and testing/validating this model of care.

Cited by 56 publications

References 23 publications

Women’s perceptions of discussions about gestational weight gain with health care providers during pregnancy and postpartum: a qualitative study

Women’s perceptions of discussions about gestational weight gain with health care providers during pregnancy and postpartum: a qualitative study

Woman-centered care 2.0: Bringing the concept into focus

Patient-Centred Care in Maternity Services

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