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      Mothers’ and fathers’ sense of security in the context of pregnancy, childbirth and the postnatal period: an integrative literature review

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          Abstract

          Background

          From the individual perspective, security, which is essential to life quality, is characterised as an elementary human need that requires fulfilment. During the transition to parenthood, mothers and fathers are confronted with changes in physical and psychosocial processes that are accompanied by uncertainty and insecurity. Feelings of insecurity may have consequences affecting their pregnancy and childbirth experiences as well as their adaption to the parental role in the first weeks following childbirth. In this context, it is important to understand how parents express and interpret their sense of security to effectively support their security needs. This integrative review aimed to provide a critical synthesis of existing research on parents’ experiences of their sense of security associated with pregnancy, childbirth and the postnatal period.

          Methods

          A literature search of the PubMed, CINAHL, PsycINFO and GESIS Sowiport databases was performed. Peer-reviewed papers that were published in English or German between 1990 and 2017 focusing on mothers’ and fathers’ experiences of sense of security in the context of maternity care were included. A thematic analysis was performed to organise and describe the findings.

          Results

          Eleven research-based papers met the inclusion criteria. Four key themes among the data were analysed: the meaning and manifestation of sense of security, sense of security in relation to confidence and control, lack of feeling secure and coping strategies, and factors influencing sense of security.

          Conclusions

          The findings revealed a complex profile of the perception of security associated with pregnancy, childbirth and the postnatal period. Sense of security can depend on multiple internal and external factors, which can differ between mothers and fathers. Research on the experiences and perceptions associated with fathers’ sense of security is lacking. Further research focused on the experiences of security from the parents’ perspective is necessary. Midwives and other involved health professionals should be aware of their role in creating a sense of security among parents. Based on a local specific understanding of security experiences, professional caregivers have the opportunity to support parents more effectively with regard to their specific security needs.

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          Most cited references73

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          The integrative review: updated methodology.

          The aim of this paper is to distinguish the integrative review method from other review methods and to propose methodological strategies specific to the integrative review method to enhance the rigour of the process. Recent evidence-based practice initiatives have increased the need for and the production of all types of reviews of the literature (integrative reviews, systematic reviews, meta-analyses, and qualitative reviews). The integrative review method is the only approach that allows for the combination of diverse methodologies (for example, experimental and non-experimental research), and has the potential to play a greater role in evidence-based practice for nursing. With respect to the integrative review method, strategies to enhance data collection and extraction have been developed; however, methods of analysis, synthesis, and conclusion drawing remain poorly formulated. A modified framework for research reviews is presented to address issues specific to the integrative review method. Issues related to specifying the review purpose, searching the literature, evaluating data from primary sources, analysing data, and presenting the results are discussed. Data analysis methods of qualitative research are proposed as strategies that enhance the rigour of combining diverse methodologies as well as empirical and theoretical sources in an integrative review. An updated integrative review method has the potential to allow for diverse primary research methods to become a greater part of evidence-based practice initiatives.
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            Towards an International Classification for Patient Safety: key concepts and terms

            Background Understanding the patient safety literature has been compromised by the inconsistent use of language. Objectives To identify key concepts of relevance to the International Patient Safety Classification (ICPS) proposed by the World Alliance For Patient Safety of the World Health Organization (WHO), and agree on definitions and preferred terms. Methods Six principles were agreed upon—that the concepts and terms should: be applicable across the full spectrum of healthcare; be consistent with concepts from other WHO Classifications; have meanings as close as possible to those in colloquial use; convey the appropriate meanings with respect to patient safety; be brief and clear, without unnecessary or redundant qualifiers; be fit-for-purpose for the ICPS. Results Definitions and preferred terms were agreed for 48 concepts of relevance to the ICPS; these were described and the relationships between them and the ICPS were outlined. Conclusions The consistent use of key concepts, definitions and preferred terms should pave the way for better understanding, for comparisons between facilities and jurisdictions, and for trends to be tracked over time. Changes and improvements, translation into other languages and alignment with other sets of patient safety definitions will be necessary. This work represents the start of an ongoing process of progressively improving a common international understanding of terms and concepts relevant to patient safety.
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              Antenatal fear of childbirth and its association with subsequent caesarean section and experience of childbirth.

              To investigate the prevalence of fear of childbirth in a nationwide sample and its association with subsequent rates of caesarean section and overall experience of childbirth. A prospective study using between-group comparisons. About 600 antenatal clinics in Sweden. A total of 2,662 women recruited at their first visit to an antenatal clinic during three predetermined weeks spread over 1 year. Postal questionnaires at 16 weeks of gestation (mean) and 2 months postpartum. Women with fear of childbirth, defined as 'very negative' feelings when thinking about the delivery in second trimester and/or having undergone counselling because of fear of childbirth later in pregnancy, were compared with those in the reference group without these characteristics. Elective and emergency caesarean section and overall childbirth experience. In total 97 women (3.6%) had very negative feelings and about half of them subsequently underwent counselling. In addition, 193 women (7.2%) who initially had more positive feelings underwent counselling later in pregnancy. In women who underwent counselling, fear of childbirth was associated with a three to six times higher rate of elective caesarean sections but not with higher rates of emergency caesarean section or negative childbirth experience. Very negative feelings without counselling were not associated with an increased caesarean section rate but were associated with a negative birth experience. At least 10% of pregnant women in Sweden suffer from fear of childbirth. Fear of childbirth in combination with counselling may increase the rate of elective caesarean sections, whereas fear without treatment may have a negative impact on the subsequent experience of childbirth.
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                Author and article information

                Contributors
                Therese.Werner-Bierwisch@uni-wh.de
                c.pinkert@hs-osnabrueck.de
                k.niessen@hs-osnabrueck.de
                Sabine.Metzing@uni-wh.de
                c.hellmers@hs-osnabrueck.de
                Journal
                BMC Pregnancy Childbirth
                BMC Pregnancy Childbirth
                BMC Pregnancy and Childbirth
                BioMed Central (London )
                1471-2393
                4 December 2018
                4 December 2018
                2018
                : 18
                : 473
                Affiliations
                [1 ]ISNI 0000 0000 9024 6397, GRID grid.412581.b, Faculty of Health, Department of Nursing Science, , Witten/Herdecke University, ; Stockumer Strasse 12, 58453 Witten, Germany
                [2 ]Research Group `FamiLe – Family Health in Life Course`, Witten and Osnabrück, Germany
                [3 ]ISNI 0000 0001 1864 9826, GRID grid.434095.f, Faculty of Business Management and Social Sciences, Osnabrück, , Osnabrück University of Applied Sciences, ; Germany, P.O. Box: 1940, 49009 Osnabrück, Germany
                Author information
                http://orcid.org/0000-0002-6240-9114
                Article
                2096
                10.1186/s12884-018-2096-3
                6278054
                30509217
                fc3b3400-42a9-4c46-a29f-b2714afdb80c
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 27 April 2018
                : 19 November 2018
                Funding
                Funded by: German Federal Ministry of Education and Research
                Award ID: FKZ: 01KX1113A and FKZ: 01KX1113B
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Obstetrics & Gynecology
                sense of security,mothers,fathers,pregnancy,childbirth,postnatal period,literature review

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