A novel care model: maternity care experiences of pregnant individuals who use substances
| dc.contributor.author | Gulbransen, Kristen | |
| dc.contributor.examiningcommittee | Gregory, Patricia (Nursing) | |
| dc.contributor.examiningcommittee | Mignone, Javier (Community Health Sciences) | |
| dc.contributor.examiningcommittee | Phillips-Beck, Wanda (Nursing) | |
| dc.contributor.examiningcommittee | Pauly, Bernie (University of Victoria) | |
| dc.contributor.guestmembers | Watson, Heather (Medicine) | |
| dc.contributor.supervisor | Thiessen, Kellie | |
| dc.date.accessioned | 2023-12-21T16:22:02Z | |
| dc.date.available | 2023-12-21T16:22:02Z | |
| dc.date.issued | 2023-12-17 | |
| dc.date.submitted | 2023-12-18T06:06:02Z | en_US |
| dc.date.submitted | 2023-12-21T02:16:54Z | en_US |
| dc.degree.discipline | Nursing | en_US |
| dc.degree.level | Doctor of Philosophy (Ph.D.) | |
| dc.description.abstract | Background: The overall incidence of substance use for individuals during childbearing years is rising. Pregnant individuals who use substances commonly have complex circumstances and face barriers such as systemic racism and judgment when health care services are accessed. Interprofessional care models and provider approaches driven by patient perspectives is a necessity in effort to provide best practice. Purpose: The purpose of this thesis was to critically examine interprofessional maternity care models among pregnant individuals and women who use substances. A sequential research study was undertaken. Phase 1 involved a scoping review of the literature. This led to Phase 2 an exploratory, qualitative design informed by the five processes of appreciative inquiry. Patient participants who received perinatal care from an interprofessional care team (midwife, obstetrician, and psychiatrist) participated in one-on-one semi-structured interviews. Data analysis was guided by thematic analysis along with on-going consultation provided by Knowledge Carrier and Grandmother Shingoose. Methods: The scoping review was conducted to systematically search for articles from seven health-related databases. Eleven articles met full inclusion criteria and were summarized. Optimal care models for pregnant individuals who use substances exist and reported improved maternal and neonatal outcomes. Interprofessional care teams all included a maternity provider along with other various care providers and aimed to provide continuity of care from prenatal through postpartum. A few care provider characteristics that were identified on the interprofessional care teams included: nonjudgmental, trustworthy, respectful, and relational. The qualitative research took place in a clinic setting that offered interprofessional care for pregnant individuals who use substances. There were 14 participants who participated in semi-structured interviews and shared their insights and experiences regarding an interprofessional maternity care model and team. Participants provided detailed descriptions of actionable ways for care providers to provide safe, compassionate, dignified, and connected care. The care approaches were detailed and nuanced on how to provide care that does not judge, provides reassurance, fosters a peaceful relationship, incorporates harm reduction, is kind, demonstrates listening, shows acceptance, honors natural supports, and is trusting. Areas to improve the interprofessional maternity care approach were also explored. Participants suggested that increased integration of cultural programming, further partnering with other specialists, and individualized pain approaches during birth and postpartum could be improved. | |
| dc.description.note | February 2024 | |
| dc.description.sponsorship | Manitoba Center for Nursing Research Scholarship, Celeste Waldman Nursing Research Scholarship, Christina Gow Community Health Nursing Scholarship, Joanne Greene Memorial Scholarship, Dr Wanda Phillips Beck Chair Award, Alberta Association for Registered Nurse Education Trust Fund, Margaruite Schumacher Award, and Red Deer Polytech Extended Funding | |
| dc.identifier.uri | http://hdl.handle.net/1993/37887 | |
| dc.language.iso | eng | |
| dc.rights | open access | en_US |
| dc.subject | Perinatal | |
| dc.subject | Substance Use | |
| dc.subject | Interprofessional Care | |
| dc.title | A novel care model: maternity care experiences of pregnant individuals who use substances | |
| dc.type | doctoral thesis | en_US |
| local.subject.manitoba | yes | |
| oaire.awardNumber | https://doi.org/10.13039/100010318 | |
| oaire.awardTitle | Research Manitoba PhD Studentship | |
| oaire.awardURI | https://researchmanitoba.ca/funding/programs/phd-research-studentship/ | |
| project.funder.identifier | Research Manitoba | |
| project.funder.name | Research Manitoba |