PMID- 35141129
OWN - NLM
STAT- MEDLINE
DCOM- 20220228
LR  - 20240404
IS  - 2211-8179 (Electronic)
IS  - 2211-8160 (Print)
IS  - 2211-8160 (Linking)
VI  - 16
IP  - 1
DP  - 2021
TI  - Caring for Pregnant Women with Rheumatic Heart Disease: A Qualitative Study of 
      Health Service Provider Perspectives.
PG  - 88
LID - 10.5334/gh.1086 [doi]
LID - 88
AB  - BACKGROUND: Rheumatic heart disease (RHD) persists in low-middle-income countries 
      and in high-income countries where there are health inequities. RHD in pregnancy 
      (RHD-P) is associated with poorer maternal and perinatal outcomes. Our study 
      examines models of care for women with RHD-P from the perspectives of health care 
      providers. METHODS: A descriptive qualitative study exploring Australian health 
      professionals' perspectives of care pathways for women with RHD-P. Thematic 
      analysis of semi-structured interviews with nineteen participants from maternal 
      health and other clinical and non-clinical domains related to RHD-P. RESULTS: A 
      constellation of factors challenged the provision of integrated women-centred 
      care, related to health systems, workforces and culture. Themes that impacted on 
      the provision of quality woman-centred care included conduits of care - helping 
      to break down silos of information, processes and access; 'layers on layers' - 
      reflecting the complexity of care issues; and shared understandings - factors 
      that contributed to improved understandings of disease and informed 
      decision-making. CONCLUSIONS: Pregnancy for women with RHD provides an 
      opportunity to strengthen health system responses, improve care pathways and 
      address whole-of-life health. To respond effectively, structural and cultural 
      changes are required including enhanced investment in education and capacity 
      building - particularly in maternal health - to support a better informed and 
      skilled workforce. Aboriginal Mothers and Babies programs provide useful 
      exemplars to guide respectful effective models of care for women with RHD, with 
      relevance for non-Indigenous women in high-risk RHD communities.For key goals to 
      be met in the context of RHD, maternal health must be better integrated into RHD 
      strategies and RHD better addressed in maternal health.
CI  - Copyright: (c) 2021 The Author(s).
FAU - Vaughan, Geraldine
AU  - Vaughan G
AD  - Central Queensland University, College of Science and Sustainability, Sydney 
      campus, AU.
FAU - Dawson, Angela
AU  - Dawson A
AD  - University of Technology Sydney, Faculty of Health, Sydney, AU.
FAU - Peek, Michael
AU  - Peek M
AD  - The Australian National University, College of Health and Medicine, Canberra, AU.
FAU - Carapetis, Jonathan
AU  - Carapetis J
AD  - Telethon Kids Institute, University of Western Australia, and Perth Children's 
      Hospital, Nedlands WA, AU.
FAU - Wade, Vicki
AU  - Wade V
AD  - Menzies School of Health Research, NT, AU.
FAU - Sullivan, Elizabeth
AU  - Sullivan E
AD  - The University of Newcastle, Faculty of Health and Medicine, Newcastle, AU.
LA  - eng
PT  - Journal Article
DEP - 20211222
PL  - England
TA  - Glob Heart
JT  - Global heart
JID - 101584391
SB  - IM
MH  - Australia/epidemiology
MH  - Female
MH  - Health Services
MH  - Humans
MH  - Infant
MH  - Pregnancy
MH  - Pregnant Women
MH  - Qualitative Research
MH  - *Rheumatic Heart Disease/epidemiology/therapy
PMC - PMC8698228
OTO - NOTNLM
OT  - Rheumatic Heart Disease
OT  - health services
OT  - pregnancy
COIS- The authors have no competing interests to declare.
EDAT- 2022/02/11 06:00
MHDA- 2022/03/01 06:00
PMCR- 2021/12/22
CRDT- 2022/02/10 05:38
PHST- 2021/11/18 00:00 [received]
PHST- 2021/11/15 00:00 [accepted]
PHST- 2022/02/10 05:38 [entrez]
PHST- 2022/02/11 06:00 [pubmed]
PHST- 2022/03/01 06:00 [medline]
PHST- 2021/12/22 00:00 [pmc-release]
AID - 10.5334/gh.1086 [doi]
PST - epublish
SO  - Glob Heart. 2021 Dec 22;16(1):88. doi: 10.5334/gh.1086. eCollection 2021.