Taxonomy for complexity theory in the context of maternity care

Nieuwenhuijze, Marianne; Downe, Soo; Gottfreðsdóttir, Helga; Rijnders, Marlies; Preez, Antoinette du; Vaz-Rebelo, Piedade

doi:10.1016/j.midw.2015.05.009

Cited by 11 publications

(16 citation statements)

References 62 publications

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“…This is in line with complexity theory, which challenges the behavior of a healthcare system as a linear process. The taxonomy for complexity theory has been developed to further understand how certain techniques and procedures become widely adopted 12 .…”

Section: A Salutogenic Perspectivementioning

confidence: 99%

“…The situation of one pregnant woman is influenced by factors far beyond her needs and circumstances, and practitioners and researchers have thus put forth theories intended to shed light on the complexity of healthcare systems like maternity care 10,11 . Furthermore, a taxonomy for complexity theory has been developed to increase understanding of how some techniques become widely adopted although on a countryspecific basis 12,13 .…”

Section: Introductionmentioning

confidence: 99%

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Models for midwifery care: A mapping review

et al. 2020

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INTRODUCTION According to WHO, midwives are found competent to provide evidencebased and normalcy-facilitating maternity care. Models for midwifery care exist, but seem to be lacking explicit epistemological status, mainly focusing on the practical and organizational level of care delivery. To make the values and attitudes of care visible, it is important to implement care models with explicit epistemological status. The aim of this paper is to identify and gain an overview of publications of theoretical models for midwifery care. METHODS A mapping review was conducted with systematic searches in nine databases for studies describing a theoretical model or theory for midwifery care that either did or was intended to impact clinical practice. Eligibility criteria were refined during the selection process. RESULTS Six models from six papers originating from different parts of the world were included in the study. The included models were developed using different methodologies and had different philosophical underpinnings and complexity gradients. Some characteristics were common, the most distinctive being the emphasis of the midwife-woman relationship, secondly the focus on woman-centeredness, and thirdly the salutogenic focus in care. CONCLUSIONS Overall, scarcity exists regarding theoretical models for midwifery care with explicit epistemological status. Further research is needed in order to develop generic theoretical models with an epistemological status to serve as a knowledge base for midwifery healthcare.

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Section: A Salutogenic Perspectivementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Models for midwifery care: A mapping review

et al. 2020

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“…In this study, it was when the health professionals felt validated in how they experienced critical incidents that they resonated with it. This provided an interruption to the feedback loop with the potential for the individuals in the organization to proactively offer acts of kindness leading to reorganization-something Paley and Eva (2011) also found in their work on feedback loops-and Nieuwenhuijze et al (2015) included in their taxomony of complexity theory in women's health. It was this resonance that triggered the realization that it was something additional that caused them to resist behaving how they needed to.…”

Section: Changing the Systemmentioning

confidence: 99%

Being “nice”: A complex activity among health professionals following a critical incident

et al. 2019

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This paper reports on an action research study to explore the underpinnings of outwardly unsupportive behaviour among health professionals in New Zealand after a critical event and to develop and evaluate a resource to help them recover through mutual care and support. It explores the dynamic nature of the support system, the feedback loops, nonlinearity, underpinning “rules,” and associated behaviour. The tenets of complexity theory are applied to identify characteristics of the system, which, in turn, provide insight into ways of achieving change. The study demonstrates that these health professionals were behaving in ways which they thought were expected, rather than being “nice” to each other: behaviour that was driven by the inherent interrelatedness within an organization or system. This finding not only has significant outcomes for practice but also contributes to a deeper understanding of the emergent nature of complexity theory.

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“…On the other hand, the students on bachelor level reported a higher level of confidence in emergency situations in this study. Nieuwenhuijze et al [25] argue that academic development is required in order to understand the complexity of situations in maternity care. It could be assumed that students with a bachelor degree achieve a higher awareness of such complexity and that the finding mirrors their own sense of capability taking the lead in difficult situations.…”

Section: Program Levelmentioning

confidence: 99%

African midwifery students’ self-assessed confidence in antenatal care: a multi-country study

Hildingsson

Lindgren

Karlström

et al. 2019

Global Health Action

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Background: Evidence-based antenatal care is one cornerstone in Safe Motherhood and educated and confident midwives remain to be optimal caregivers in Africa. Confidence in antenatal midwifery skills is important and could differ depending on the provision of education among the training institutions across Africa.Objective: The aim of the study was to describe and compare midwifery students’ confidence in basic antenatal skills, in relation to age, sex, program type and level of program.Methods: A survey in seven sub-Saharan African countries was conducted. Enrolled midwifery students from selected midwifery institutions in each country presented selfreported data on confidence to provide antenatal care. Data were collected using a selfadministered questionnaire. The questionnaire consisted of 22 antenatal skills based on the competency framework from the International Confederation of Midwives. The skills were grouped into three domains; Identify fetal and maternal risk factors and educate parents; Manage and document emergent complications and Physical assessment and nutrition.Results: In total, 1407 midwifery students from seven Sub-Saharan countries responded. Almost one third (25-32%) of the students reported high levels of confidence in all three domains. Direct entry programs were associated with higher levels of confidence in all three domains, compared to post-nursing and double degree programs. Students enrolled at education with diploma level presented with high levels of confidence in two out of three domains.Conclusions: A significant proportion of student midwives rated themselves low on confidence to provide ANC. Midwifery students enrolled in direct entry programs reported higher levels of confidence in all domains. It is important that local governments develop education standards, based on recommendations from the International Confederation of midwives. Further research is needed for the evaluation of actual competence.

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Taxonomy for complexity theory in the context of maternity care

Cited by 11 publications

References 62 publications

Models for midwifery care: A mapping review

Models for midwifery care: A mapping review

Being “nice”: A complex activity among health professionals following a critical incident

African midwifery students’ self-assessed confidence in antenatal care: a multi-country study

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