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2009 Canadian Hypertension Education Program recommendations: the scientific summary--an annual update.

https://arctichealth.org/en/permalink/ahliterature151166
Source
Can J Cardiol. 2009 May;25(5):271-7
Publication Type
Article
Date
May-2009
Author
Norman R C Campbell
Nadia A Khan
Michael D Hill
Guy Tremblay
Marcel Lebel
Janusz Kaczorowski
Finlay A McAlister
Richard Z Lewanczuk
Sheldon Tobe
Author Affiliation
Department of Medicine, University of Calgary, Calgary, Canada. ncampbel@ucalgary.ca
Source
Can J Cardiol. 2009 May;25(5):271-7
Date
May-2009
Language
English
Publication Type
Article
Keywords
Antihypertensive Agents - therapeutic use
Attitude to Health
Blood Pressure Determination
Canada
Combined Modality Therapy
Diet, Sodium-Restricted
Female
Health Knowledge, Attitudes, Practice
Health Promotion - organization & administration
Humans
Hypertension - diagnosis - therapy
Life Style
Male
Patient Education as Topic
Program Evaluation
Randomized Controlled Trials as Topic
Severity of Illness Index
Abstract
The present report highlights the key messages of the 2009 Canadian Hypertension Education Program (CHEP) recommendations for the management of hypertension and the supporting clinical evidence. In 2009, the CHEP emphasizes the need to improve the control of hypertension in people with diabetes. Intensive reduction in blood pressure (to less than 130/80 mmHg) in people with diabetes leads to significant reductions in mortality rates, disability rates and overall health care system costs, and may lead to improved quality of life. The CHEP recommendations continue to emphasize the important role of patient self-efficacy by promoting lifestyle changes to prevent and control hypertension, and encouraging home measurement of blood pressure. Unfortunately, most Canadians make only minor changes in lifestyle after a diagnosis of hypertension. Routine blood pressure measurement at all appropriate visits, and screening for and management of all cardiovascular risks are key to blood pressure management. Many young hypertensive Canadians with multiple cardiovascular risks are not treated with antihypertensive drugs. This is despite the evidence that individuals with multiple cardiovascular risks and hypertension should be strongly considered for antihypertensive drug therapy regardless of age. In 2009, the CHEP specifically recommends not to combine an angiotensin-converting enzyme inhibitor with an angiotensin receptor blocker in people with uncomplicated hypertension, diabetes (without micro- or macroalbuminuria), chronic kidney disease (without nephropathy [micro- or overt proteinuria]) or ischemic heart disease (without heart failure).
Notes
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PubMed ID
19417857 View in PubMed
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2010 Canadian Hypertension Education Program (CHEP) recommendations: the scientific summary - an update of the 2010 theme and the science behind new CHEP recommendations.

https://arctichealth.org/en/permalink/ahliterature143446
Source
Can J Cardiol. 2010 May;26(5):236-40
Publication Type
Article
Date
May-2010
Author
Norman R C Campbell
Janusz Kaczorowski
Richard Z Lewanczuk
Ross Feldman
Luc Poirier
Margaret Moy Kwong
Marcel Lebel
Finlay A McAlister
Sheldon W Tobe
Author Affiliation
Department of Medicine, University of Calgary, Alberta. ncampbel@ucalgary.ca
Source
Can J Cardiol. 2010 May;26(5):236-40
Date
May-2010
Language
English
Publication Type
Article
Keywords
Antihypertensive Agents - administration & dosage
Canada
Diet, Sodium-Restricted
Female
Health promotion
Humans
Hypertension - prevention & control - therapy
Life Style
Male
Patient Education as Topic
Practice Guidelines as Topic
Randomized Controlled Trials as Topic
Risk Reduction Behavior
Abstract
The present article is a summary of the theme, the key recommendations for management of hypertension and the supporting clinical evidence of the 2010 Canadian Hypertension Education Program (CHEP). In 2010, CHEP emphasizes the need for health care professionals to stay informed about hypertension through automated updates at www.htnupdate.ca. A new interactive Internet-based lecture series will be available in 2010 and a program to train community hypertension leaders will be expanded. Patients can also sign up to receive regular updates in a pilot program at www.myBPsite.ca. In 2010, the new recommendations include consideration for using automated office blood pressure monitors, new targets for dietary sodium for the prevention and treatment of hypertension that are aligned with the national adequate intake values, and recommendations for considering treatment of selected hypertensive patients at high risk with calcium channel blocker/angiotensin-converting enzyme inhibitor combinations and the use of angiotensin receptor blockers.
Notes
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Cites: Can J Cardiol. 2005 May 15;21(7):589-9315940357
PubMed ID
20485687 View in PubMed
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The 2012 Canadian hypertension education program recommendations for the management of hypertension: blood pressure measurement, diagnosis, assessment of risk, and therapy.

https://arctichealth.org/en/permalink/ahliterature124290
Source
Can J Cardiol. 2012 May;28(3):270-87
Publication Type
Article
Date
May-2012
Author
Stella S Daskalopoulou
Nadia A Khan
Robert R Quinn
Marcel Ruzicka
Donald W McKay
Daniel G Hackam
Simon W Rabkin
Doreen M Rabi
Richard E Gilbert
Raj S Padwal
Martin Dawes
Rhian M Touyz
Tavis S Campbell
Lyne Cloutier
Steven Grover
George Honos
Robert J Herman
Ernesto L Schiffrin
Peter Bolli
Thomas Wilson
Ross D Feldman
M Patrice Lindsay
Brenda R Hemmelgarn
Michael D Hill
Mark Gelfer
Kevin D Burns
Michel Vallée
G V Ramesh Prasad
Marcel Lebel
Donna McLean
J Malcolm O Arnold
Gordon W Moe
Jonathan G Howlett
Jean-Martin Boulanger
Pierre Larochelle
Lawrence A Leiter
Charlotte Jones
Richard I Ogilvie
Vincent Woo
Janusz Kaczorowski
Luc Trudeau
Simon L Bacon
Robert J Petrella
Alain Milot
James A Stone
Denis Drouin
Maxime Lamarre-Cliché
Marshall Godwin
Guy Tremblay
Pavel Hamet
George Fodor
S George Carruthers
George Pylypchuk
Ellen Burgess
Richard Lewanczuk
George K Dresser
Brian Penner
Robert A Hegele
Philip A McFarlane
Mukul Sharma
Norman R C Campbell
Debra Reid
Luc Poirier
Sheldon W Tobe
Author Affiliation
Division of General Internal Medicine, McGill University, Montreal, Québec, Canada. stella.daskalopoulou@mcgill.ca
Source
Can J Cardiol. 2012 May;28(3):270-87
Date
May-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - therapeutic use
Blood Pressure Determination - methods
Canada
Cardiovascular Diseases - etiology - prevention & control
Education, Medical, Continuing - standards
Evidence-Based Medicine - standards
Female
Health Education - standards
Humans
Hypertension - complications - diagnosis - therapy
Male
Middle Aged
Monitoring, Physiologic - methods
Practice Guidelines as Topic - standards
Prognosis
Risk assessment
Treatment Outcome
Abstract
We updated the evidence-based recommendations for the diagnosis, assessment, prevention, and treatment of hypertension in adults for 2012. The new recommendations are: (1) use of home blood pressure monitoring to confirm a diagnosis of white coat syndrome; (2) mineralocorticoid receptor antagonists may be used in selected patients with hypertension and systolic heart failure; (3) a history of atrial fibrillation in patients with hypertension should not be a factor in deciding to prescribe an angiotensin-receptor blocker for the treatment of hypertension; and (4) the blood pressure target for patients with nondiabetic chronic kidney disease has now been changed to
PubMed ID
22595447 View in PubMed
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The 2013 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension.

https://arctichealth.org/en/permalink/ahliterature115112
Source
Can J Cardiol. 2013 May;29(5):528-42
Publication Type
Article
Date
May-2013
Author
Daniel G Hackam
Robert R Quinn
Pietro Ravani
Doreen M Rabi
Kaberi Dasgupta
Stella S Daskalopoulou
Nadia A Khan
Robert J Herman
Simon L Bacon
Lyne Cloutier
Martin Dawes
Simon W Rabkin
Richard E Gilbert
Marcel Ruzicka
Donald W McKay
Tavis S Campbell
Steven Grover
George Honos
Ernesto L Schiffrin
Peter Bolli
Thomas W Wilson
Ross D Feldman
Patrice Lindsay
Michael D Hill
Mark Gelfer
Kevin D Burns
Michel Vallée
G V Ramesh Prasad
Marcel Lebel
Donna McLean
J Malcolm O Arnold
Gordon W Moe
Jonathan G Howlett
Jean-Martin Boulanger
Pierre Larochelle
Lawrence A Leiter
Charlotte Jones
Richard I Ogilvie
Vincent Woo
Janusz Kaczorowski
Luc Trudeau
Robert J Petrella
Alain Milot
James A Stone
Denis Drouin
Kim L Lavoie
Maxime Lamarre-Cliche
Marshall Godwin
Guy Tremblay
Pavel Hamet
George Fodor
S George Carruthers
George B Pylypchuk
Ellen Burgess
Richard Lewanczuk
George K Dresser
S Brian Penner
Robert A Hegele
Philip A McFarlane
Mukul Sharma
Debra J Reid
Sheldon W Tobe
Luc Poirier
Raj S Padwal
Author Affiliation
Division of Clinical Pharmacology, Department of Medicine, Western University, London, Ontario, Canada. dhackam@uwo.ca
Source
Can J Cardiol. 2013 May;29(5):528-42
Date
May-2013
Language
English
Publication Type
Article
Keywords
Adult
Aging - physiology
Antihypertensive Agents - therapeutic use
Blood Pressure - physiology
Blood Pressure Determination
Canada
Cardiovascular Diseases - prevention & control
Exercise - physiology
Health education
Humans
Hypertension - diagnosis - drug therapy
Risk assessment
Abstract
We updated the evidence-based recommendations for the diagnosis, assessment, prevention, and treatment of hypertension in adults for 2013. This year's update includes 2 new recommendations. First, among nonhypertensive or stage 1 hypertensive individuals, the use of resistance or weight training exercise does not adversely influence blood pressure (BP) (Grade D). Thus, such patients need not avoid this type of exercise for fear of increasing BP. Second, and separately, for very elderly patients with isolated systolic hypertension (age 80 years or older), the target for systolic BP should be
PubMed ID
23541660 View in PubMed
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The 2014 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension.

https://arctichealth.org/en/permalink/ahliterature104360
Source
Can J Cardiol. 2014 May;30(5):485-501
Publication Type
Article
Date
May-2014
Author
Kaberi Dasgupta
Robert R Quinn
Kelly B Zarnke
Doreen M Rabi
Pietro Ravani
Stella S Daskalopoulou
Simon W Rabkin
Luc Trudeau
Ross D Feldman
Lyne Cloutier
Ally Prebtani
Robert J Herman
Simon L Bacon
Richard E Gilbert
Marcel Ruzicka
Donald W McKay
Tavis S Campbell
Steven Grover
George Honos
Ernesto L Schiffrin
Peter Bolli
Thomas W Wilson
Patrice Lindsay
Michael D Hill
Shelagh B Coutts
Gord Gubitz
Mark Gelfer
Michel Vallée
G V Ramesh Prasad
Marcel Lebel
Donna McLean
J Malcolm O Arnold
Gordon W Moe
Jonathan G Howlett
Jean-Martin Boulanger
Pierre Larochelle
Lawrence A Leiter
Charlotte Jones
Richard I Ogilvie
Vincent Woo
Janusz Kaczorowski
Kevin D Burns
Robert J Petrella
Swapnil Hiremath
Alain Milot
James A Stone
Denis Drouin
Kim L Lavoie
Maxime Lamarre-Cliche
Guy Tremblay
Pavel Hamet
George Fodor
S George Carruthers
George B Pylypchuk
Ellen Burgess
Richard Lewanczuk
George K Dresser
S Brian Penner
Robert A Hegele
Philip A McFarlane
Milan Khara
Andrew Pipe
Paul Oh
Peter Selby
Mukul Sharma
Debra J Reid
Sheldon W Tobe
Raj S Padwal
Luc Poirier
Author Affiliation
Divisions of General Internal Medicine, Clinical Epidemiology and Endocrinology, Department of Medicine, McGill University, McGill University Health Centre, Montreal, Québec, Canada. Electronic address: kaberi.dasgupta@mcgill.ca.
Source
Can J Cardiol. 2014 May;30(5):485-501
Date
May-2014
Language
English
Publication Type
Article
Keywords
Antihypertensive Agents - therapeutic use
Blood pressure
Blood Pressure Determination - standards
Canada
Health Promotion - organization & administration
Humans
Hypertension - diagnosis - drug therapy - prevention & control
Life Style
Patient Education as Topic
Practice Guidelines as Topic
Prognosis
Program Evaluation
Abstract
Herein, updated evidence-based recommendations for the diagnosis, assessment, prevention, and treatment of hypertension in Canadian adults are detailed. For 2014, 3 existing recommendations were modified and 2 new recommendations were added. The following recommendations were modified: (1) the recommended sodium intake threshold was changed from = 1500 mg (3.75 g of salt) to approximately 2000 mg (5 g of salt) per day; (2) a pharmacotherapy treatment initiation systolic blood pressure threshold of = 160 mm Hg was added in very elderly (age = 80 years) patients who do not have diabetes or target organ damage (systolic blood pressure target in this population remains at
PubMed ID
24786438 View in PubMed
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Acceptability of reminder letters for Papanicolaou tests: a survey of women from 23 Family Health Networks in Ontario.

https://arctichealth.org/en/permalink/ahliterature160995
Source
J Obstet Gynaecol Can. 2007 Oct;29(10):829-34
Publication Type
Article
Date
Oct-2007
Author
Tina Karwalajtys
Janusz Kaczorowski
Lynne Lohfeld
Stephanie Laryea
Kelly Anderson
Stefanie Roder
Rolf J Sebaldt
Author Affiliation
Department of Family Medicine, McMaster University, Hamilton ON.
Source
J Obstet Gynaecol Can. 2007 Oct;29(10):829-34
Date
Oct-2007
Language
English
Publication Type
Article
Keywords
Adult
Aged
Female
Health Care Surveys
Health Promotion - methods
Humans
Middle Aged
Ontario
Papanicolaou test
Patient compliance
Reminder Systems
Vaginal Smears
Women's health
Abstract
To explore women's perspectives on the acceptability and content of reminder letters from the family physician for Papanicolaou (Pap) test screening and the effect of reminder letters on compliance with screening recommendations.
A population-based survey was conducted in 23 Family Health Networks and Primary Care Networks participating in a demonstration project to increase the delivery of preventive services in Ontario. Questionnaires were mailed to randomly selected women aged 35 to 69 years who had received a reminder letter for a Pap test from their family physician within the previous six months. Two focus groups were conducted with a volunteer sample of respondents.
The usable response rate was 54.3% (406/748). Two-thirds (65.8%, 267/406) of women who completed the survey recalled receiving the reminder letter. Overall, 52.3% (212/405) reported having a Pap test in the past six months. Among women who recalled the reminder letter and scheduled or had a Pap test, 71.4% (125/175) reported that the letter influenced their decision to be screened. The majority of respondents (80.8%, 328/406) wanted to continue to receive reminder letters for Pap tests from their physician, and 34.5% (140/406) wanted to receive additional information about cervical screening. Focus group interviews indicated that women who have had a Pap test may still be unsure about screening recommendations, what the test detects, and the rationale for follow-up procedures.
Reminder letters in family practice were viewed as useful and influenced women's decisions to undergo Pap test screening. Women who have had a Pap test may still need additional information about the test.
PubMed ID
17915066 View in PubMed
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Access to web-based personalized antenatal health records for pregnant women: a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature159321
Source
J Obstet Gynaecol Can. 2008 Jan;30(1):38-43
Publication Type
Article
Date
Jan-2008
Author
Elizabeth Shaw
Michelle Howard
David Chan
Heather Waters
Janusz Kaczorowski
David Price
Joyce Zazulak
Author Affiliation
Department of Family Medicine, McMaster University, Hamilton ON.
Source
J Obstet Gynaecol Can. 2008 Jan;30(1):38-43
Date
Jan-2008
Language
English
Publication Type
Article
Keywords
Adult
Canada
Female
Gestational Age
Humans
Internet
Medical Records
Patient Access to Records
Patient satisfaction
Pregnancy
Prenatal Care
Single-Blind Method
Abstract
During pregnancy, the information needs of patients are high and effective information sharing between patients and health care providers is of particular importance. We conducted a randomized controlled trial to evaluate the effect of providing pregnant women with secure access to their antenatal health records on their uptake of, and satisfaction with, relevant information.
Women presenting to a primary care maternity centre before 28 weeks' gestation were randomized to receive access either to a secure website with links to general pregnancy health information alone (GI group) or to the same website with access to their own antenatal health record (PI group). Primary outcomes included frequency of use, and satisfaction with and perceived usefulness of the web-based information.
We approached 199 women regarding participation in the study; 193 agreed to participate, and 97 were randomized to the PI group and 96 to the GI group. The mean number of log-ins to the website in the PI group subsequently was almost six times the number of log-ins in the GI group (10.4 +/- 17.8 vs. 1.8 +/- 1.4; P
PubMed ID
18198066 View in PubMed
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Antihypertensive medication use, adherence, stops, and starts in Canadians with hypertension.

https://arctichealth.org/en/permalink/ahliterature125049
Source
Can J Cardiol. 2012 May;28(3):383-9
Publication Type
Article
Date
May-2012
Author
Marianne E Gee
Norm R C Campbell
Femida Gwadry-Sridhar
Robert P Nolan
Janusz Kaczorowski
Asako Bienek
Cynthia Robitaille
Michel Joffres
Sulan Dai
Robin L Walker
Author Affiliation
Public Health Agency of Canada, Ottawa, Ontario, Canada.
Source
Can J Cardiol. 2012 May;28(3):383-9
Date
May-2012
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Antihypertensive Agents - administration & dosage
Attitude to Health
Blood Pressure Determination - methods
Canada
Confidence Intervals
Dose-Response Relationship, Drug
Drug Administration Schedule
Educational Status
Female
Follow-Up Studies
Health Surveys
Humans
Hypertension - diagnosis - drug therapy - epidemiology
Incidence
Male
Middle Aged
Patient Compliance - statistics & numerical data
Patient Dropouts - statistics & numerical data
Risk assessment
Rural Population
Severity of Illness Index
Sex Factors
Socioeconomic Factors
Treatment Outcome
Urban Population
Young Adult
Abstract
Some of the greatest barriers to achieving blood pressure control are perceived to be failure to prescribe antihypertensive medication and lack of adherence to medication prescriptions.
Self-reported data from 6017 Canadians with diagnosed hypertension who responded to the 2008 Canadian Community Health Survey and the 2009 Survey on Living with Chronic Diseases in Canada were examined.
The majority (82%) of individuals with diagnosed hypertension reported using antihypertensive medications. The main reasons for not taking medications were either that they were not prescribed (42%) or that blood pressure had been controlled without medications (45%). Of those not taking antihypertensive medications in 2008 (n = 963), 18% had started antihypertensive medications by 2009, and of those initially taking medications (n = 5058), 5% had stopped. Of those taking medications in 2009, 89% indicated they took the medication as prescribed, and 10% indicated they occasionally missed a dose. Participants who were recently diagnosed, not measuring blood pressure at home, not having a plan to control blood pressure, or not receiving instructions on how to take medications were less likely to be taking antihypertensive medications; similar factors tended to be associated with stopping antihypertensive medication use.
Compatible with high rates of hypertension control, most Canadians diagnosed with hypertension take antihypertensive medications and report adherence. Widespread implementation of self-management strategies for blood pressure control and standardized instructions on antihypertensive medication may further optimize drug treatment.
PubMed ID
22522073 View in PubMed
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The attitudes of Canadian maternity care practitioners towards labour and birth: many differences but important similarities.

https://arctichealth.org/en/permalink/ahliterature147135
Source
J Obstet Gynaecol Can. 2009 Sep;31(9):827-40
Publication Type
Article
Date
Sep-2009
Author
Michael C Klein
Janusz Kaczorowski
Wendy A Hall
William Fraser
Robert M Liston
Sahba Eftekhary
Rollin Brant
Louise C Mâsse
Jessica Rosinski
Azar Mehrabadi
Nazli Baradaran
Jocelyn Tomkinson
Sharon Dore
Patricia C McNiven
Lee Saxell
Kathie Lindstrom
Jalana Grant
Aoife Chamberlaine
Author Affiliation
Developmental Neuroscience and Child Health, Child and Family Research Institute, University of British Columbia, Vancouver BC.
Source
J Obstet Gynaecol Can. 2009 Sep;31(9):827-40
Date
Sep-2009
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Canada
Cross-Sectional Studies
Female
Health Personnel - statistics & numerical data
Humans
Labor, Obstetric
Male
Middle Aged
Parturition
Pregnancy
Questionnaires
Abstract
Collaborative, interdisciplinary care models have the potential to improve maternity care. Differing attitudes of maternity care providers may impede this process. We sought to examine the attitudes of Canadian maternity care practitioners towards labour and birth.
We performed a cross-sectional web- and paper-based survey of 549 obstetricians, 897 family physicians (400 antepartum only, 497 intrapartum), 545 nurses, 400 midwives, and 192 doulas.
Participants responded to 43 Likert-type attitudinal questions. Nine themes were identified: electronic fetal monitoring, epidural analgesia, episiotomy, doula roles, Caesarean section benefits, factors decreasing Caesarean section rates, maternal choice, fear of vaginal birth, and safety of birth mode and place. Obstetrician scores reflected positive attitudes towards use of technology, in contrast to midwives' and doulas' scores. Family physicians providing only antenatal care had attitudinal scores similar to obstetricians; family physicians practising intrapartum care and nurses had intermediate scores on technology. Obstetricians' scores indicated that they had the least positive attitudes towards home birth, women's roles in their own births, and doula care, and they were the most concerned about the consequences of vaginal birth. Midwives' and doulas' scores reflected opposing views on these issues. Although 71% of obstetricians supported regulated midwifery, 88.9% were against home birth. Substantial numbers of each group held attitudes similar to dominant attitudes from other disciplines.
To develop effective team practice, efforts to reconcile differing attitudes towards labour and birth are needed. However, the overlap in attitudes between disciplines holds promise for a basis upon which to begin shared problem solving and collaboration.
PubMed ID
19941707 View in PubMed
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Birth technology and maternal roles in birth: knowledge and attitudes of canadian women approaching childbirth for the first time.

https://arctichealth.org/en/permalink/ahliterature132112
Source
J Obstet Gynaecol Can. 2011 Jun;33(6):598-608
Publication Type
Article
Date
Jun-2011
Author
Michael C Klein
Janusz Kaczorowski
Stephen J C Hearps
Jocelyn Tomkinson
Nazli Baradaran
Wendy A Hall
Patricia McNiven
Rollin Brant
Jalana Grant
Sharon Dore
Anne Brasset-Latulippe
William D Fraser
Author Affiliation
Developmental Neuroscience and Child Health, Child and Family Research Institute, University of British Columbia, Vancouver BC, Canada.
Source
J Obstet Gynaecol Can. 2011 Jun;33(6):598-608
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Adult
Canada
Cesarean Section - psychology
Delivery, Obstetric - methods
Family Practice
Female
Health Knowledge, Attitudes, Practice
Humans
Midwifery
Obstetrics
Parity
Parturition - psychology
Pregnancy
Prenatal Care
Questionnaires
Abstract
To describe Canadian nulliparous women's attitudes to birth technology and their roles in childbirth.
A large convenience sample of low-risk women expecting their first birth was recruited by posters in laboratories, at the offices of obstetricians, family physicians, and midwives, at prenatal classes, and through web-based advertising and invited to complete a paper or web-based questionnaire.
Of the 1318 women completing the questionnaire, 95% did so via the web-based method; 13.2% of respondents were in the first trimester, 39.8% were in the second trimester, and 47.0% in the third. Overall, 42.6% were under the care of an obstetrician, 29.3% a family physician, and 28.1% a registered midwife. The sample included mainly well-educated, middle-class women. The planned place of giving birth ranged from home to hospital, and from rural centres to large city hospitals. Eighteen percent planned to engage a doula. Women attending obstetricians reported attitudes more favourable to the use of birth technology and less supportive of women's roles in their own delivery, regardless of the trimester in which the survey was completed. Those women attending midwives reported attitudes less favourable to the use of technology at delivery and more supportive of women's roles. Family practice patients' opinions fell between the other two groups. For eight of the questions, "I don't know" (IDK) responses exceeded 15%. These IDK responses were most frequent for questions regarding risks and benefits of epidural analgesia, Caesarean section, and episiotomy. Women in the care of midwives consistently used IDK options less frequently than those cared for by physicians.
Regardless of the type of care provider they attended, many women reported uncertainty about the benefits and risks of common procedures used at childbirth. When grouped by the type of care provider, in all trimesters, women held different views across a range of childbirth issues, suggesting that the three groups of providers were caring for different populations with different attitudes and expectations.
PubMed ID
21846449 View in PubMed
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