factors that affect women speaking up about early warning signs and symptoms of Pre-eclampsia and responses of health care staff
Critical appraisal of a qualitative paper on the narrative synthesis of factors that affect women speaking up about early warning signs and symptoms of Pre-eclampsia and responses of health care staff
The focus of the paper chosen for this critique is based on factors affecting patients speaking up about early warning signs and of pre-eclampsia and responses of healthcare staff. The title of the research paper is self-explanatory, precise, and easy to understand. The subject matter of the paper has a direct relation to the practice of nursing. Information about the authors of the article is provided at the end of the article. Author credentials are provided at the end of the article. The authors also identify themselves as a clinical research nurse at King’s College, London, faculty of life sciences, faculty of nursing, and midwifery. The article has an abstract at the beginning, which offers a precise overview of the issue under study. The study elements for the research are briefly discussed in a manner that gives readers an accurate presentation of content. The features of research that have been included in the article are background, aim, methods, discussion, limitation of the study, and conclusion. The abstract has a shortlist of keywords. Each inclusion section of the article provides a lengthy discussion of the subject matter. The abstract contains an accurate presentation of the information of the article.
Problem and purpose of the study
The article provides a clear statement of the problem within the introductory part of the article. Pre-eclampsia is a major obstetric problem that affects 2-8% of pregnancies and is the leading global cause of maternal and perinatal mortality and morbidity. Pre-eclampsia is a pregnancy-specific disease that is characterized by de-novo development of concurrent proteinuria and hypertension. The major challenges in treating pre-eclampsia and preventing further deterioration are determining how best to enhance early detection. The authors additionally define the problem by stating that if pregnant women and their partners are in a position to speak up about early warning signs and symptoms of pre-eclampsia, they may be in a position to receive the appropriate preventive intervention (Carter et al., 2017). Currently there are limited numbers of strategies that service users use to identify and seek help concerning sudden health deterioration. The purpose of this research is to improve the understanding of factors affecting the ability of women to recognize signs and symptoms of pre-eclampsia and seek appropriate medical help. The study also identifies factors that affect healthcare professionals’ responses to women and their families who speak up about their early presenting signs and symptoms of pre-eclampsia.
Literature review
The literature review for the article relates to the topic of the study, factors affecting women speaking up about early warning signs and symptoms of pre-eclampsia and responses of healthcare staff. The literature has been included in the background section of the article. The focus of the literature review section is divided into two sections. Factors affecting women and their families’ ability to speak up about their early warning signs of pre-eclampsia and factors affecting health care professionals’ ability to respond to women and their families’ speaking up about their early warning signs and symptoms. Research gap identified in the article is the availability of limited research on concerning pregnant and childbearing women’ involvement in the promotion of their safety (Carter et al., 2017). This gap is a presentation of unknown aspects about the level of knowledge that women have concerning the health status during pregnancy. The researchers provided specific sources of data that were used for the research. The authors have used current sources for citing the article.
Most sources are current ranging from 2001 to 2015. The authors used paraphrases instead of quotes in referencing to information borrowed from other scholars. The literature review section has clear organization and lays foundation for the overall research study. The literature used in the article is relevant to the study problem and purpose of the study. The literature identifies major challenges that both patients and healthcare professionals encounter in identifying and responding to early warning signs and symptoms of pre-eclampsia. One of the significant challenges for the prevention and treatment of pre-eclampsia is the determination of the most effective way to enable early detection. If women and their families can raise alert about early warning signs and symptoms of pre-eclampsia during pregnancy, childbirth, and the postnatal period, they may be in a position to receive effective healthcare intervention to prevent further development of the condition (Kascak et al., 2017).
The NICE postnatal care quality standard recommends that all women should be provided with information concerning signs and symptoms of serious health conditions within 24 hours of delivery. The other problem identified by the report is that women and their families do not feel listened to by the healthcare providers. The literature review provided an indication that the level of care that patients received was limited by women and their families’ knowledge about the Pre-eclampsia presenting conditions and that the healthcare professionals were reluctant to respond to women speaking up about their conditions.
Conceptual framework
A conceptual framework for this study attempts to map out direction for the study and link the research findings to nursing practice. The concept presented in this article is based on the presumption that early communication by pregnant women and their families about the presenting signs and symptoms of pre-eclampsia helps healthcare professionals to provide effective preventive intervention to avoid further deterioration of their health condition. The authors, however mentioned the use of the SPICE (Setting, Perspective, Intervention, Comparison, Evaluation) framework for the study in the article to develop a focused research question which include women’s clinicians’, and families’ perspectives about the problem. The study uses a narrative synthesis approach to expand further its discussion on the factors that affect women speaking up about early warning signs and symptoms of pre-eclampsia and the responses of healthcare staff. The researchers aim at enhancing the practice of nursing through identifying problems faced by both patients and healthcare professionals in addressing early warning signs and symptoms of pre-eclampsia to help in improving the provision of quality care for patients.
Methods
The research study used a narrative synthesis design. The research was listed in the abstract part of the article. The research design performs a systematic review and synthesis of research finding from various studies. With a narrative synthesis, the researcher relies primarily on words and texts to summarize and explains research findings. in regards to this study, the authors examined the factors that affect women and their partners’ ability to speak up about early signs and symptoms of pre-eclampsia and the response of healthcare professionals. The examination primarily relied on studies and findings of other scholars and data from health institutions such as World Health Organization (WHO) and UK National Perinatal Epidemiology (NPEU). In answering the research question, the authors searched electronic databases for qualitative studies that had met the inclusion criteria from January 1980 to April 2016. The databases included CINAHL, BNI, ASSIA, Medline, HMIC, Embase, Scopus, PsycINFO, Maternity and infant care, JBI, IBSS, Web of Science, Google Scholar, and Cochrane through the support of Information Service Consultant (Carter et al., 2017). The research question for the review was; what are the factors that affect women and their families speaking up with early warning signs and symptoms of pre-eclampsia, and what are the factors affecting health professionals’ response?
Results
The authors present the results of the study in a clear and easy to read and understand manner. The language for interpretation of the results is also simple and easy to understand. Out of the 2395 records, abstracts, and tiles screened for inclusion review, only 10n articles met the inclusion criteria (Kascak et al., 2017). Thematic analysis was effective for this study since data collection was primarily based on research conducted by other scholars. The results were categorized into themes and subthemes. The first theme focused on information about women’s understanding and knowledge of pre-eclampsia. This theme had three subthemes, knowledge, absence, or lack of recognition of signs and symptoms of pre-eclampsia and the range of information needs.
The second theme discussed information concerning factors affecting help-seeking behavior from women and their families’ perspectives. The authors divided this theme into two subthemes. The subthemes included emotions affecting women seeking help and social, cultural, and economic disparities affecting women and families seeking help. The third theme focused on factors affecting staff response to women speaking up about early signs and symptoms of pre-eclampsia. This was also divided into three subthemes, practitioner-client relationships and communication, women not being taken seriously, and social networks that influenced women’s help-seeking behavior. The authors performed an analysis of the identified themes and subthemes since the study lacked comparison variables (Carter et al., 2017).
The results of the study indicated that women suffered from a widespread lack of knowledge and understanding of the early signs and symptoms of pre-eclampsia among women, their partners, and families. The authors also identified that there were cases where women with signs and symptoms of pre-eclampsia viewed them as normal and result of pregnancy changes. The results of the study provide an indication of in-depth analysis of articles by the authors. The thematic analysis performed by the authors took into consideration instances of duplication and missing data from some of the identified articles that met the inclusion criteria. The analysis also took into consideration the social, economic, and cultural aspects of the factors that affected women’s’ ability to speak up about initial signs and symptoms of pre-eclampsia. The authors indicated in the research that social, economic, and cultural factors had a significant effect on the help-seeking behavior of women.
Discussion
Key factors identified in the discussion part of the article are a discussion of the results obtained from the collected data. The authors focus their discussion on the findings of the study that women lacked considerable knowledge concerning the presenting signs and symptoms of pre-eclampsia while others are unable to distinguish these signs from normal pregnancy changes. The aspect of significant lack of knowledge among women had a considerable influence on their ability to speak up about the early warning signs and symptoms of pre-eclampsia and the health professionals’ ability to provide preventive intervention measures. Many women needed information on signs and symptoms of the health condition. Most women also encountered conflicting information provided by health professionals as they considered the information as disempowering. Additionally, women experienced difficulty in distinguishing the signs and symptoms of pre-eclampsia from normal pregnancy changes. This affected their ability to seek help in time.
The authors also identified that healthcare providers experienced significant difficulties in distinguishing women’s presenting situations as critical and those requiring urgent care. Even though the research identified that some lacked immediate healthcare respondents in some situations, the health-seeking behavior of some women were greatly affected by their attitudes and behaviors. Emotions such as fear to speak up, frustration, being scared, and anxiety hindered the ability of women to speak up about their early signs and symptoms of pre-eclampsia. As such, clinicians encountered difficulties in getting the women to seek medical advice and respond effectively to their respective health conditions. Besides, the authors identified that the behavior of health care workers had a significant influence on women’s ability to speak up (Carter et al., 2017).
The discussion portion highlighted the limited amount of research for the study focus of this research. The authors also indicated that the scope of the study was limited by insufficient evidence about health care professionals’ perspectives about women reporting early signs and symptoms of pre-eclampsia. the authors reported the scarcity of research in this area that had a wide range of methodologies and goals limited the synthesis process and the final results of the study. The authors also cited lack of demographic and geographic restrictions for the selected studies made it difficult for them to compare the results. To address these limitations, the authors made recommendations for future research. The authors suggested that future research should narrow down the synthesis by analysis free text to capture the staff and user voice (Kascak et al., 2017).
Relevance
The analysis of factors that affect women speaking up about early warning signs and symptoms of pre-eclampsia and responses of health care staff is considered to have a positive influence on the quality of health provided to women during pregnancy, birth, and postnatal. As such, it is considerable that health care providers perform an evaluation of all possible measures that can be put in place to enhance positive outcome for women. Barriers to providing effective care to women with signs and symptoms of pre-eclampsia arise from lack of knowledge about the health condition and health care providers’ attitudes and behaviors towards patients. Healthcare providers should work towards creating a receptive and accommodative environment for women and their families to discuss freely with the clinicians the signs and symptoms of pre-eclampsia and provide timely preventive interventions.
Conclusion
The research presents an issue of concern that has been widely neglected in the nursing field. Research on factors that affect women speaking up about early warning signs and symptoms of pre-eclampsia and responses of healthcare staff aims at identifying ways to improve the provision of preventive care to patients to avoid escalation of pre-eclampsia. The provision of adequate information to women, their partners, and families are critical to ensure that they stay informed of their health conditions. besides, clinicians should be proactive in responding to women speaking about their health conditions.
References
Carter, W., Bick, D., Mackintosh, N., & Sandall, J. (2017). A narrative synthesis of factors that affect women speaking up about early warning signs and symptoms of pre-eclampsia and responses of healthcare staff. BMC pregnancy and childbirth, 17(1), 63.
Kascak, P., Paskala, M., Antal, P., & Gajdosik, R. (2017). Recurrent HELLP Syndrome at 22 Weeks of Gestation. Case reports in obstetrics and gynecology, 2017.