Suzanne C Smeltzer1, Monika Mitra2, Linda Long-Bellil3, Lisa I Iezzoni4, Lauren D Smith5. 1. Center for Nursing Research, Villanova University College of Nursing, 800 Lancaster Avenue, Villanova, PA 190895, USA. Electronic address: Suzanne.smeltzer@villanova.edu. 2. The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, 15 South Street, Waltham, MA 02453, USA. Electronic address: mmitra@brandeis.edu. 3. Center for Health Policy and Research, University of Massachusetts Medical School, 333 South Street, Shrewsbury, MA 01545, USA. Electronic address: linda.long@umassmed.edu. 4. Harvard Medical School, The Mongan Institute for Health Policy, Massachusetts General Hospital, 50 Staniford Street, Room 901B, Boston, MA 02114, USA. Electronic address: liezzoni@partners.org. 5. The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, 15 South Street, Waltham, MA 02453, USA. Electronic address: smithL@brandeis.edu.
Abstract
BACKGROUND: Women with physical disabilities (WPD) experience major barriers to care during pregnancy. Lack of education about disability in health professionals' education is a pervasive barrier to quality care. In an effort to explore this issue, this study examined the issue from the perspective of obstetric clinicians who provide care to WPD. OBJECTIVE: This qualitative descriptive study explored perspectives of obstetric clinicians who provide perinatal care for WPD to inform the educational preparation of clinicians to care for women with disabilities. METHOD: We contacted 33 obstetric clinicians who care for pregnant WPD. Thirteen obstetricians and one nurse midwife participated in semi-structured telephone interviews. Interview transcriptions were content analyzed to identify initial themes. Investigators discussed and revised the themes as additional transcripts were reviewed and new themes were identified. RESULTS: Themes identified from transcript analyses included: lack of education at any level including during postgraduate residency and fellowship on care of pregnant WPD, unplanned career pathway, educating other clinicians, and positive and negative experiences providing obstetrical care to women with physical disability. Several clinicians provided this care because of requests from other clinicians and did not begin their careers with the goal of providing obstetric care to women with physical disabilities. None had received formal education or training including during their residencies or fellowships. The clinicians described very rewarding experiences caring for WPD. CONCLUSIONS: The experiences reported by this study's participants suggest the need to include disability in undergraduate and postgraduate education and training to improve obstetric care to WPD.
BACKGROUND:Women with physical disabilities (WPD) experience major barriers to care during pregnancy. Lack of education about disability in health professionals' education is a pervasive barrier to quality care. In an effort to explore this issue, this study examined the issue from the perspective of obstetric clinicians who provide care to WPD. OBJECTIVE: This qualitative descriptive study explored perspectives of obstetric clinicians who provide perinatal care for WPD to inform the educational preparation of clinicians to care for women with disabilities. METHOD: We contacted 33 obstetric clinicians who care for pregnant WPD. Thirteen obstetricians and one nurse midwife participated in semi-structured telephone interviews. Interview transcriptions were content analyzed to identify initial themes. Investigators discussed and revised the themes as additional transcripts were reviewed and new themes were identified. RESULTS: Themes identified from transcript analyses included: lack of education at any level including during postgraduate residency and fellowship on care of pregnant WPD, unplanned career pathway, educating other clinicians, and positive and negative experiences providing obstetrical care to women with physical disability. Several clinicians provided this care because of requests from other clinicians and did not begin their careers with the goal of providing obstetric care to women with physical disabilities. None had received formal education or training including during their residencies or fellowships. The clinicians described very rewarding experiences caring for WPD. CONCLUSIONS: The experiences reported by this study's participants suggest the need to include disability in undergraduate and postgraduate education and training to improve obstetric care to WPD.
Authors: Monika Mitra; Karen M Clements; Jianying Zhang; Lisa I Iezzoni; Suzanne C Smeltzer; Linda M Long-Bellil Journal: Med Care Date: 2015-12 Impact factor: 2.983
Authors: Monika Mitra; Linda M Long-Bellil; Lisa I Iezzoni; Suzanne C Smeltzer; Lauren D Smith Journal: Disabil Health J Date: 2016-01-02 Impact factor: 2.554
Authors: Claire Z Kalpakjian; Jodi M Kreschmer; Mary D Slavin; Pamela A Kisala; Elisabeth H Quint; Nancy D Chiaravalloti; Natalie Jenkins; Tamara Bushnik; Dagmar Amtmann; David S Tulsky; Roxanne Madrid; Rebecca Parten; Michael Evitts; Carolyn L Grawi Journal: J Womens Health (Larchmt) Date: 2020-05-19 Impact factor: 2.681
Authors: Lisa I Iezzoni; Sowmya R Rao; Julie Ressalam; Dragana Bolcic-Jankovic; Karen Donelan; Nicole Agaronnik; Tara Lagu; Eric G Campbell Journal: Jt Comm J Qual Patient Saf Date: 2021-06-23