Tools
Tools
Silverio, SA, De Backer, K, Brown, JM, Easter, A, Khazaezadeh, N, Rajasingam, D, Sandall, J and Magee, LA (2023) Reflective, pragmatic, and reactive decision-making by maternity service providers during the SARS-CoV-2 pandemic health system shock: a qualitative, grounded theory analysis. BMC Pregnancy and Childbirth, 23 (1). p. 368. ISSN 1471-2393
|
Text
Reflective, pragmatic, and reactive decision-making by maternity service providers during the SARS-CoV-2 pandemic health sys.pdf - Published Version Available under License Creative Commons Attribution. Download (1MB) | Preview |
Abstract
Background: Pregnant and postpartum women were identified as having particular vulnerability to severe symptomatology of SARS-CoV-2 infection, so maternity services significantly reconfigured their care provision. We examined the experiences and perceptions of maternity care staff who provided care during the pandemic in South London, United Kingdom – a region of high ethnic diversity with varied levels of social complexity. Methods: We conducted a qualitative interview study, as part of a service evaluation between August and November 2020, using in-depth, semi-structured interviews with a range of staff (N = 29) working in maternity services. Data were analysed using Grounded Theory analysis appropriate to cross-disciplinary health research. Analysis & findings: Maternity healthcare professionals provided their views, experiences, and perceptions of delivering care during the pandemic. Analysis rendered three emergent themes regarding decision-making during reconfigured maternity service provision, organised into pathways: 1) ‘Reflective decision-making’; 2) ‘Pragmatic decision-making’; and 3) ‘Reactive decision-making’. Whilst pragmatic decision-making was found to disrupt care, reactive-decision-making was perceived to devalue the care offered and provided. Alternatively, reflective decision-making, despite the difficult working conditions of the pandemic, was seen to benefit services, with regards to care of high-quality, sustainability of staff, and innovation within the service. Conclusions: Decision-making within maternity care was found to take three forms – where at best changes to services could be innovative, at worst they could cause devaluation in care being delivered, and more often than not, these changes were disruptive. With regard to positive changes, healthcare providers identified staff empowerment, flexible working patterns (both for themselves and collectively as teams), personalised care delivery, and change-making in general, as key areas to capitalise on current and ongoing innovations borne out of the pandemic. Key learnings included a focus on care-related, meaningful listening and engagement of staff at all levels, in order to drive forward high-quality care and avoid care disruption and devaluation.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Humans; Pregnancy; Qualitative Research; Maternal Health Services; Female; Pandemics; Grounded Theory; COVID-19; SARS-CoV-2; COVID-19; Decision-making; Health system shock; Healthcare professionals; Maternity care; SARS-CoV-2 pandemic; Service reconfiguration; Female; Pregnancy; Humans; Maternal Health Services; SARS-CoV-2; Grounded Theory; Pandemics; COVID-19; Qualitative Research; 1110 Nursing; 1114 Paediatrics and Reproductive Medicine; 1117 Public Health and Health Services; Obstetrics & Reproductive Medicine |
| Subjects: | B Philosophy. Psychology. Religion > BF Psychology R Medicine > RA Public aspects of medicine R Medicine > RG Gynecology and obstetrics |
| Divisions: | Psychology (from Sep 2019) |
| Publisher: | BioMed Central |
| SWORD Depositor: | A Symplectic |
| Date Deposited: | 12 Jun 2023 10:10 |
| Last Modified: | 12 Jun 2023 10:15 |
| DOI or ID number: | 10.1186/s12884-023-05641-2 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/19752 |
 |
View Item |