Midwifery care of non-vaccinating families - Insights from the Byron Shire.


Journal

Women and birth : journal of the Australian College of Midwives
ISSN: 1878-1799
Titre abrégé: Women Birth
Pays: Netherlands
ID NLM: 101266131

Informations de publication

Date de publication:
Jul 2021
Historique:
received: 04 06 2020
revised: 20 08 2020
accepted: 22 08 2020
pubmed: 15 9 2020
medline: 25 6 2021
entrez: 14 9 2020
Statut: ppublish

Résumé

Midwives may feel ill-equipped to manage clinical encounters with non-vaccinating parents. Pregnancy is a peak time in the formation of parents' vaccination views and intention. Midwives are central to maternity care in Australia. While most midwives will have infrequent contact with families who intend not to vaccinate, when they do, they must feel equipped to communicate with them in a manner which fulfils their professional responsibilities, acknowledges parental autonomy and facilitates continued engagement. To understand how midwives can most effectively communicate with non-vaccinating parents. We conducted in-depth interviews with 32 non-vaccinating parents and six key informant health professionals, and a focus group of six midwives. Data collection occurred in the Byron Shire of New South Wales, where childhood vaccination rates are persistently lower than national averages. This study explores four central codes. The first, 'hold on…I'm not sure about this' providing insights into moments of doubt preceding parents' decisions not to vaccinate. The second 'Pregnancy: a decision-making focal point' reinforces the importance of effective vaccination recommendations in the antenatal period. 'Manipulation and ambivalence' examines why overzealous or unclear recommendations about vaccination are unhelpful, and the fourth central code 'engage, inform and encourage' summarise recommendations from health professionals who are experienced in communicating, apparently effectively, with non-vaccinating families. Insights from this study are used to recommend practical strategies which may be employed by midwives and maternity units to successfully and professionally manage clinical encounters with non-vaccinating parents. Midwives are well positioned to provide clear recommendations to parents regarding childhood vaccination whilst maintaining engagement and meeting the goals of woman-centred care.

Sections du résumé

PROBLEM OBJECTIVE
Midwives may feel ill-equipped to manage clinical encounters with non-vaccinating parents.
BACKGROUND BACKGROUND
Pregnancy is a peak time in the formation of parents' vaccination views and intention. Midwives are central to maternity care in Australia. While most midwives will have infrequent contact with families who intend not to vaccinate, when they do, they must feel equipped to communicate with them in a manner which fulfils their professional responsibilities, acknowledges parental autonomy and facilitates continued engagement.
AIM OBJECTIVE
To understand how midwives can most effectively communicate with non-vaccinating parents.
METHODS METHODS
We conducted in-depth interviews with 32 non-vaccinating parents and six key informant health professionals, and a focus group of six midwives. Data collection occurred in the Byron Shire of New South Wales, where childhood vaccination rates are persistently lower than national averages.
FINDINGS RESULTS
This study explores four central codes. The first, 'hold on…I'm not sure about this' providing insights into moments of doubt preceding parents' decisions not to vaccinate. The second 'Pregnancy: a decision-making focal point' reinforces the importance of effective vaccination recommendations in the antenatal period. 'Manipulation and ambivalence' examines why overzealous or unclear recommendations about vaccination are unhelpful, and the fourth central code 'engage, inform and encourage' summarise recommendations from health professionals who are experienced in communicating, apparently effectively, with non-vaccinating families.
DISCUSSION CONCLUSIONS
Insights from this study are used to recommend practical strategies which may be employed by midwives and maternity units to successfully and professionally manage clinical encounters with non-vaccinating parents.
CONCLUSION CONCLUSIONS
Midwives are well positioned to provide clear recommendations to parents regarding childhood vaccination whilst maintaining engagement and meeting the goals of woman-centred care.

Identifiants

pubmed: 32921599
pii: S1871-5192(20)30312-7
doi: 10.1016/j.wombi.2020.08.007
pii:
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e416-e425

Informations de copyright

Copyright © 2020 Australian College of Midwives. All rights reserved.

Auteurs

Catherine Helps (C)

University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia. Electronic address: chel0445@uni.sydney.edu.au.

Lesley Barclay (L)

University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia.

Stacy M Carter (SM)

Australian Centre for Health Engagement, Evidence and Values (ACHEEV), School of Health and Society, University of Wollongong, NSW, 2522, Australia.

Julie Leask (J)

Sydney Nursing School, The University of Sydney, Sydney, New South Wales, Australia; School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.

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