Background: Given the sudden and unexpected nature of an emergency caesarean section (EmCS) coupled with an increased risk of psychological distress, it is particularly important to understand the psychosocial outcomes for women. The aim of this systematic literature review was to identify, collate and examine the evidence surrounding women’s psychosocial outcomes of EmCS worldwide. Methods: The electronic databases of EMBASE, PubMed, Scopus, and PsycINFO were searched between November 2017 and March 2018. To ensure articles were reflective of original and recently published research, the search criteria included peer-reviewed research articles published within the last 20 years (1998 to 2018). All study designs were included if they incorporated an examination of women’s psychosocial outcomes after EmCS. Due to inherent heterogeneity of study data, extraction and synthesis of both qualitative and quantitative data pertaining to key psychosocial outcomes were organised into coherent themes and analysis was attempted. Results: In total 17,189 articles were identified. Of these, 208 full text articles were assessed for eligibility. One hundred forty-nine articles were further excluded, resulting in the inclusion of 66 articles in the current systematic literature review. While meta-analyses were not possible due to the nature of the heterogeneity, key psychosocial outcomes identified that were negatively impacted by EmCS included post-traumatic stress, health-related quality of life, experiences, infant-feeding, satisfaction, and self-esteem. Post-traumatic stress was one of the most commonly examined psychosocial outcomes, with a strong consensus that EmCS contributes to both symptoms and diagnosis. Conclusions: EmCS was found to negatively impact several psychosocial outcomes for women in particular post-traumatic stress. While investment in technologies and clinical practice to minimise the number of EmCSs is crucial, further investigations are needed to develop effective strategies to prepare and support women who experience this type of birth.
The National Health Service (NHS) in England plans to increase accessibility to evidence-based, trauma-informed psychological care for women in the perinatal period. Therefore, this systematic review aimed to 1) synthesise current guidance from clinical guidelines, policy documents, and care standards on trauma-informed approaches to care in maternal mental health settings within the context of pregnancy-related trauma and 2) to offer recommendations informing the implementation and evaluation of this type of care. Nine electronic databases were searched and screened. Data were extracted and analysed using narrative synthesis. Included records were quality-assessed. After screening 1095 identified records, 11 records were included. The findings were synthesised into eight recommendations: 1) screening for trauma, 2) access to care, 3) clear and sensitive communication, 4) consistency and continuity of care, 5) offering individualised care whilst recognising diversity, 6) collaboration between women, families, and services, 7) care provider training to enhance skills and knowledge, and 8) supervision and peer support for care providers. The findings of this review are highly relevant given the current development, delivery, and evaluation of specific maternal mental health services, particularly in the United Kingdom, but also with the increase in perinatal mental health provision more globally.
Background: The global prevalence of gestational diabetes mellitus (GDM) is increasing, and it can significantly impact women’s psychosocial outcomes in the perinatal period. The aim of this study was to explore the psychosocial impacts including experiences of support for women with GDM in the antenatal and postnatal period. Methods: Semi-structured individual interviews were conducted with women (n = 33) living in the UK, who were either pregnant and recently diagnosed with GDM or had a previous GDM diagnosis within the past three years. Interviews were recorded, transcribed, and analysed using reflexive thematic analysis. Findings: Analysis revealed six themes: 1. Diagnostic related frustration; 2. Impact on mental health; 3. The medicalisation of eating; 4. Losing agency to gain control; 5. Sourcing networks of support; 6. Current pregnancy; and future reproductive health. Each theme provides a unique insight into the experiences and psychological strain associated with GDM. From confusion and frustration at diagnosis, to the profound knock-on impact a diagnosis, associated lifestyle changes and medical appointments had on women’s mental health, and the perceived medicalisation of their eating behaviours and patterns. Conclusion: Given the increasing prevalence of GDM and its wide-ranging psychosocial impacts, this study emphasises the need for healthcare professionals to consider the potential implications of GDM on women’s psychosocial outcome, and to consider alternative support options outside of the medical system, such as peer support.
30 April 2019 in The Australian Journal of Indigenous Education
Aboriginal and Torres Strait Islander peoples remain significantly under-represented in higher education systems. There are significant disparities in university completion rates for Aboriginal and Torres Strait Islander students compared with their non-Indigenous counterparts. The poor-retention and high-attrition rates among Aboriginal and Torres Strait Islander students come at significant financial and personal cost for the individual, families, community, universities and governments. Existing evidence in relation to attrition has identified complex and multifaceted reasons including ill health, family and community responsibilities, financial difficulties, lack of social support, academic disadvantage and issues surrounding personal well-being. The current study aimed to add to evidence of the academic, financial, social support and well-being factors affecting Aboriginal and Torres Strait Islander student's decision to continue or withdraw from their university studies. Contrary to expectation, students' decision to withdraw was not related to academic and social factors. It was found that students between 22 and 25 years old strongly agreed they were likely to withdraw from studies. There was a significant association between withdrawal and type of enrolment. This study provided important insights into the factors that contribute to a students' decision to withdraw from their university studies, with implications for future educational interventions.
Aims: To explore perspectives and experiences of healthcare professionals in the identification and support provision of mental health problems in adults living with type 1 diabetes.Methods: Using a qualitative research design, 15 healthcare professionals working in the United Kingdom were individually interviewed using a semi‐structured interview schedule. Data were analysed using reflexive inductive thematic analysis.Results: Four themes were identified relating to barriers: time, knowledge, relationship between services and stigma. Three themes were identified relating to facilitators: education, communication and appropriate tools and services.Conclusions: This research emphasises the need for educational tools to improve the skills and competency of healthcare professionals in identifying mental health problems in people with type 1 diabetes, highlighting practical and theoretical implications for healthcare improvements and the necessity for additional research to design care pathways that better support this population, in which all healthcare professionals are aware of.
Background: Low health literacy can present significant risks throughout pregnancy, impacting both maternal and fetal health outcomes. Those who do not speak the main language of their country of residence are more likely to have lower health literacy. Considering the heightened challenges faced by this demographic in accessing, understanding, and engaging with health information and services, designing and implementing tailored interventions is crucial to mitigate health disparities. This review aims to identify and examine health literacy interventions developed for pregnant women whose first language differs from the language predominantly spoken in their residing country. Methods: Electronic databases of Embase and Medline were searched using relevant search terms from their inception to July 2023. Data were extracted and analysed using narrative synthesis. Results: Of the 1964 identified records, three were included. The studies were conducted in Australia and Denmark, and ranged in design, including: a cluster randomised controlled trial, mixed methods design; and qualitative design. Health literacy intervention modalities included midwifery education combined with a smartphone application and leaflet, culturally adapted group classes, and informative videos. The interventions were translated into various languages to cater to the target populations. Two studies used the Health Literacy Questionnaire to assess the intervention effectiveness, yielding contrasting results: one showed no improvement, while the other reported increased post-intervention health literacy scores. The third had not yet evaluated intervention effectiveness. Conclusions: This review identifies a significant scarcity in health literacy interventions for pregnant women whose first language differs to the predominant language of the country they live in, despite their greater need for support. While few studies were found, their diversity suggests multiple strategies for enhancing health literacy. Bridging this health literacy gap for linguistically diverse pregnant populations could reduce disparities in maternal and fetal outcomes, underscoring the need for targeted, evaluated interventions that actively engage affected women and their support networks. Trial registration: Registered with PROSPERO: CRD42023475511. Date of registration: 10.11.23.