The experience of pregnant women in contexts of vulnerability of prenatal primary nursing care: a descriptive interpretative qualitative study

Abstract

Background Prenatal primary nursing care contributes to improving the health outcomes of mothers and unborn babies. Some pregnant women in contexts of vulnerability experience prenatal nursing care in a positive way, while some do not. A better understanding of factors influencing this experience could help improve prenatal nursing care. The aim of this study was to describe factors influencing the prenatal primary nursing care experience of pregnant women in contexts of vulnerability. Methods Thorne’s qualitative interpretative descriptive approach was used. Twenty-four pregnant women in contexts of vulnerability were recruited in local community service centers in Quebec, Canada, using purposive and snowball samplings, to carry out a semi-structured interview. Participants were 16 years old and over, in their second or third trimester, or had given birth in the previous year, and received prenatal nursing care through community health services. Data collection methods included a logbook, sociodemographic questionnaire and semi-structured interview on vulnerable pregnant women’s experience with prenatal primary nursing care. The Qualitative Analysis Guide of Leuven guided the inductive thematic analysis, following a constant comparative iterative process. Results The women’s experience was initially influenced by the fulfillment of their needs and expectations. These stem from their previous or current pregnancy experiences, their motivation to receive prenatal care, their family concerns as well as their contexts of vulnerability. From the pregnant women’s perspective, the main factors that influenced their experience were the nurse’s approach, characteristics and interventions that all impact on their relationship with nurses, as well as the prenatal primary care organization, including the modalities of prenatal care (i.e. schedule, setting, duration, number and frequency of meetings), the continuity and the program’s prenatal care services, such as referral to a nutritionist, social worker or other services. Conclusions A conceptual framework is proposed to describe relationships among the factors distributed in three dimensions that influence the experience of pregnant women in contexts of vulnerability and to guide nurses in the improvement of prenatal primary care. Considering the complexity of this experience, a person-centered approach is mandatory to promote a positive experience, equity and a better use of services.

Flemish critical care nurses’ experiences regarding the influence of work-related demands on their health: A descriptive interpretive qualitative study

“…During this process, the same two researchers discussed and cross-checked the identi ed analytical and contextual concepts and sought to obtain a detailed understanding of the data [50]. This constant comparison process through inductive and interpretative reasoning allowed a withincase and across-case analysis to compare new concepts with earlier coded data so that similarities and differences in data could be identi ed and analysed [51][52][53]. Subsequently, the concepts were linked to relevant focus group fragments by using the QSR NVivo 12 software program.…”

Flemish critical care nurses’ experiences regarding the influence of work-related demands on their health: a descriptive interpretive qualitative study

“…During this process, the same two researchers discussed and cross-checked the identified analytical and contextual concepts and sought to obtain a detailed understanding of the data [ 50 ]. This constant comparison process through inductive and interpretative reasoning allowed a within-case and across-case analysis to compare new concepts with earlier coded data so that similarities and differences in data could be identified and analysed [ 51 – 53 ]. Subsequently, the concepts were linked to relevant focus group fragments by using the QSR NVivo 12 software program.…”