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Hindrances and facilitators in humanitarian migrants' maternity care in Finland: qualitative study applying the three delays model framework.

https://arctichealth.org/en/permalink/ahliterature309472
Source
Scand J Caring Sci. 2020 Mar; 34(1):148-156
Publication Type
Journal Article
Date
Mar-2020
Author
Satu Leppälä
Reeta Lamminpää
Mika Gissler
Katri Vehviläinen-Julkunen
Author Affiliation
Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
Source
Scand J Caring Sci. 2020 Mar; 34(1):148-156
Date
Mar-2020
Language
English
Publication Type
Journal Article
Keywords
Altruism
Emigration and Immigration
Female
Finland
Humans
Maternal Health Services - organization & administration
Models, Theoretical
Pregnancy
Qualitative Research
Abstract
Humanitarian migration to Finland nearly ten-folded in 2015-2016 from 3 326 asylum seekers' yearly average to 32 476. Earlier research shows that humanitarian migrants sustain suboptimal maternal health in high-income countries, even though care facilities are available.
This study aimed to investigate what factors do maternity care professionals identify as hindrances and facilitators in humanitarian migrants' maternity care process in Finland.
Study employed qualitative design. Eighteen midwives and maternity care public health nurses participated in semi-structured qualitative interviews that were audio-recorded and transcribed verbatim. Qualitative content analysis of the interview data produced meaning units, codes and categories.
Research plan was reviewed and approved by the ethics committee of the local hospital district. Participants signed an informed consent prior the interviews.
Hindrances and facilitators for care were organised in theoretical framework of Three Delays Model. Participants described multiple hindrances for caring process, of which language barrier constantly raised as a significant obstacle for seeking and receiving care, and for perceived quality of care. Correspondingly, interpreters facilitated the caring process at all of its phases. Rural location of asylum centres, long distances and lacking transportation to care hindered reaching the health facility. Complicated bureaucracy was described to affect negatively in receiving adequate care. Refugee and asylum centre workers facilitated decision to seek care, and reaching of health facilities.
Interpreters can influence in the caring process in more versatile ways than we might have acknowledged this far. We recommend further research on interpreters' role in the caring process of pregnant humanitarian migrants.
PubMed ID
31149746 View in PubMed
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Humanitarian migrant women's experiences of maternity care in Nordic countries: A systematic integrative review of qualitative research.

https://arctichealth.org/en/permalink/ahliterature308128
Source
Midwifery. 2020 Jan; 80:102572
Publication Type
Systematic Review
Date
Jan-2020
Author
Satu Leppälä
Reeta Lamminpää
Mika Gissler
Katri Vehviläinen-Julkunen
Author Affiliation
Department of Nursing Science, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland. Electronic address: satulep@student.uef.fi.
Source
Midwifery. 2020 Jan; 80:102572
Date
Jan-2020
Language
English
Publication Type
Systematic Review
Keywords
Culturally Competent Care - ethnology
Female
Finland
Focus Groups
Humans
Interviews as Topic
Maternal Health Services - standards
Norway
Pregnancy
Pregnant Women - ethnology
Qualitative Research
Refugees - psychology
Social Discrimination - ethnology
Standard of Care
Sweden
Transients and Migrants - psychology
Abstract
Maternal morbidity and sub-optimal maternity care are more common in humanitarian migrants in comparison to country-born population in the Nordic countries. Statistical reviews on the issue are plenty, whereas little synthesis on humanitarian migrants' lived experiences exists.
This systematic integrative literature review investigated humanitarian migrant women's experiences on maternity care in Nordic countries, aiming to address possible hindrances for optimal care.
Electronic search in PubMed, CINAHL, SocIndex, Scopus, PsycINFO and Web of Science yielded 474 papers. PICoS inclusion and exclusion criteria were used. Critical appraisal was conducted utilising 32-item COREQ tool. The findings of the review articles were synthesised through thematic analysis.
Ten qualitative studies were included in the review. Altogether 198 women in Sweden, Norway and Finland had participated interviews or focus group discussions. Analysis of the women's reported experiences of care emerged three themes: Diminished negotiation power on care, Sense of insecurity, and Experienced care-related discrimination.
Humanitarian migrant women's maternal morbidity and sub-optimal care has multiple potential explanations, and their experiences of care reflect those earlier reported.
Recommendations for tackling the addressed hindrances are: (1) enabling humanitarian migrant women's negotiation power by acknowledging their vulnerability but also competency, (2) increasing the sense of security, and (3) improving care providers' cultural competence.
PubMed ID
31739182 View in PubMed
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Manual handling of burdens as a predictor of birth outcome-a Finnish Birth Register Study.

https://arctichealth.org/en/permalink/ahliterature300200
Source
Eur J Public Health. 2018 12 01; 28(6):1122-1126
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
12-01-2018
Author
Emma Kwegyir-Afful
Reeta Lamminpää
Tuomas Selander
Mika Gissler
Katri Vehviläinen-Julkunen
Seppo Heinonen
Markku Sallmen
Kimmo Räsänen
Author Affiliation
Faculty of Health Sciences, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
Source
Eur J Public Health. 2018 12 01; 28(6):1122-1126
Date
12-01-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Female
Finland
Humans
Lifting
Logistic Models
Male
Occupational Exposure
Pregnancy
Pregnancy outcome
Registries
Young Adult
Abstract
Negative effects of manual handling of burdens on pregnancy outcomes are not elucidated in Finland. This study examines the association between perinatal outcomes and occupational exposure to manual handling of burdens.
The study cohort was identified from the Finnish Medical Birth Register (MBR, 1997-2014) and information on exposure from the Finnish job-exposure matrix (FINJEM) 1997-2009. The cohort included all singleton births of mothers who were classified as 'service and care workers' representing the exposure group (n=74 286) and 'clerks' as the reference (n=13 873). Study outcomes were preterm birth (PTB) (
PubMed ID
29757389 View in PubMed
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Preeclampsia complicated by advanced maternal age: a registry-based study on primiparous women in Finland 1997-2008.

https://arctichealth.org/en/permalink/ahliterature123563
Source
BMC Pregnancy Childbirth. 2012;12:47
Publication Type
Article
Date
2012
Author
Reeta Lamminpää
Katri Vehviläinen-Julkunen
Mika Gissler
Seppo Heinonen
Author Affiliation
Department of Nursing Science, University of Eastern Finland, PO, Box, 1627, Kuopio, 70211, Finland. reeta.lampinen@uef.fi
Source
BMC Pregnancy Childbirth. 2012;12:47
Date
2012
Language
English
Publication Type
Article
Keywords
Adult
Apgar score
Asphyxia Neonatorum - epidemiology
Body mass index
Body Weight
Female
Finland - epidemiology
Humans
Infant, Newborn
Logistic Models
Maternal Age
Multivariate Analysis
Pre-Eclampsia - epidemiology
Pregnancy
Pregnancy outcome
Premature Birth - epidemiology
Registries
Reproductive Techniques, Assisted
Risk factors
Abstract
Preeclampsia is a frequent syndrome and its cause has been linked to multiple factors, making prevention of the syndrome a continuous challenge. One of the suggested risk factors for preeclampsia is advanced maternal age. In the Western countries, maternal age at first delivery has been steadily increasing, yet few studies have examined women of advanced maternal age with preeclampsia. The purpose of this registry-based study was to compare the obstetric outcomes in primiparous and preeclamptic women younger and older than 35 years.
The registry-based study used data from three Finnish health registries: Finnish Medical Birth Register, Finnish Hospital Discharge Register and Register of Congenital Malformations. The sample contained women under 35 years of age (N?=?15,437) compared with those 35 and over (N?=?2,387) who were diagnosed with preeclampsia and had their first singleton birth in Finland between 1997 and 2008. In multivariate modeling, the main outcome measures were Preterm delivery (before 34 and 37 weeks), low Apgar score (5 min.), small-for-gestational-age, fetal death, asphyxia, Cesarean delivery, induction, blood transfusion and admission to a Neonatal Intensive Care Unit.
Women of advanced maternal age (AMA) exhibited more preeclampsia (9.4%) than younger women (6.4%). They had more prior terminations (25 (
Notes
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PubMed ID
22687260 View in PubMed
Less detail

Pregnancy outcomes in women aged 35 years or older with gestational diabetes - a registry-based study in Finland.

https://arctichealth.org/en/permalink/ahliterature276431
Source
J Matern Fetal Neonatal Med. 2016;29(1):55-9
Publication Type
Article
Date
2016

Pregnancy outcomes of overweight and obese women aged 35 years or older - A registry-based study in Finland.

https://arctichealth.org/en/permalink/ahliterature286962
Source
Obes Res Clin Pract. 2016 Mar-Apr;10(2):133-42
Publication Type
Article
Author
Reeta Lamminpää
Katri Vehviläinen-Julkunen
Mika Gissler
Tuomas Selander
Seppo Heinonen
Source
Obes Res Clin Pract. 2016 Mar-Apr;10(2):133-42
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Apgar score
Body mass index
Cesarean Section
Female
Fetal Development
Finland
Humans
Infant, Newborn
Infant, Small for Gestational Age
Maternal Age
Obesity - complications
Overweight
Pre-Eclampsia - etiology
Pregnancy
Pregnancy outcome
Premature Birth - etiology
Registries
Risk factors
Stillbirth
Young Adult
Abstract
To compare pregnancy outcomes of overweight and obese pregnant women aged 35 years or older to women aged less than 35 years old.
A registry-based study covering years 2004-2008 including data on women =35 years (N=45,718) compared to those
PubMed ID
26054598 View in PubMed
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Smoking among older childbearing women - a marker of risky health behaviour a registry-based study in Finland.

https://arctichealth.org/en/permalink/ahliterature105720
Source
BMC Public Health. 2013;13:1179
Publication Type
Article
Date
2013
Author
Reeta Lamminpää
Katri Vehviläinen-Julkunen
Mika Gissler
Seppo Heinonen
Author Affiliation
Department of Nursing Science, University of Eastern Finland, P,O,Box, 1627, 70211 Kuopio, Finland. reeta.lampinen@uef.fi.
Source
BMC Public Health. 2013;13:1179
Date
2013
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Apgar score
Female
Fetal Death - epidemiology - etiology
Finland - epidemiology
Humans
Infant, Low Birth Weight
Infant, Small for Gestational Age
Logistic Models
Pre-Eclampsia - epidemiology - etiology
Pregnancy
Pregnancy Complications - epidemiology - psychology
Pregnancy Outcome - epidemiology
Premature Birth - epidemiology - etiology
Registries - statistics & numerical data
Smoking - adverse effects - epidemiology
Abstract
Smoking during pregnancy is known to negatively affect pregnancy outcomes and it has been associated with numerous complications during pregnancy. Smoking is more common in younger pregnant women, but previous research has shown that adverse pregnancy outcomes related to older maternal age and smoking are even more harmful than with younger smokers. The aim of this study was to compare pregnancy outcomes among smoking and non-smoking pregnant women aged
Notes
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PubMed ID
24330715 View in PubMed
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A systematic review of dietary interventions for gestational weight gain and gestational diabetes in overweight and obese pregnant women.

https://arctichealth.org/en/permalink/ahliterature296691
Source
Eur J Nutr. 2018 Aug; 57(5):1721-1736
Publication Type
Journal Article
Systematic Review
Date
Aug-2018
Author
Reeta Lamminpää
Katri Vehviläinen-Julkunen
Ursula Schwab
Author Affiliation
Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, P.O. BOX 1627, 70211, Kuopio, Finland. reeta.lampinen@uef.fi.
Source
Eur J Nutr. 2018 Aug; 57(5):1721-1736
Date
Aug-2018
Language
English
Publication Type
Journal Article
Systematic Review
Keywords
Adult
Australia
Denmark
Diabetes, Gestational - diet therapy - prevention & control
Diet, Reducing
Female
Humans
Obesity - diet therapy
Obesity, Morbid - diet therapy
Overweight - diet therapy
Pregnancy
Treatment Outcome
Weight Gain
Abstract
The number of overweight and obese women is increasing in the obstetric population. The aim of this study was to review studies that reported results related to the efficacy of dietary interventions on gestational weight gain (GWG) or the prevention of gestational diabetes (GDM) in overweight and obese women.
The search was performed using the CINAHL, PubMed, Scopus and Medic electronic databases and limited to the years between 2000 and March 2016. This systematic review includes 15 research articles of which 12 were randomized controlled trials, and three were controlled trials. Three main categories emerged as follows: (1) the types of interventions, (2) the contents of the interventions and (3) the efficacy of the intervention on GWG and the prevention of GDM. The quality of the selected studies was evaluated using the AHRQ Methods Reference Guide for Effectiveness and Comparative Effectiveness Reviews.
Of the selected 15 studies, eight included a specified diet with limited amounts of nutrients or energy, and the others included a dietary component along with other components. Ten studies reported significant differences in the measured outcomes regarding GWG or the prevention of GDM between the intervention and the control groups.
This review confirms the variability in the strategies used to deliver dietary interventions in studies aiming to limit GWG and prevent GDM in overweight and obese women. Inconsistency in the provider as well as the content of the dietary interventions leaves the difficulty of summarizing the components of effective dietary interventions.
PubMed ID
29128995 View in PubMed
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Utilization of Large Data Sets in Maternal Health in Finland: A Case for Global Health Research.

https://arctichealth.org/en/permalink/ahliterature291735
Source
J Perinat Neonatal Nurs. 2017 Jul/Sep; 31(3):236-243
Publication Type
Journal Article
Author
Reeta Lamminpää
Mika Gissler
Katri Vehviläinen-Julkunen
Author Affiliation
Department of Nursing Science, University of Eastern Finland, Kuopio, Finland (Drs Lamminpää and Vehviläinen-Julkunen); Information Services Department, THL National Institute for Health and Welfare, Helsinki, Finland (Dr Gissler); Research Centre for Child Psychiatry, University of Turku, Turku, Finland (Dr Gissler); Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institute, Stockholm, Sweden (Dr Gissler); Kuopio University Hospital, Kuopio Finland (Dr Vehviläinen-Julkunen).
Source
J Perinat Neonatal Nurs. 2017 Jul/Sep; 31(3):236-243
Language
English
Publication Type
Journal Article
Keywords
Birth Certificates
Data Collection - methods - trends
Databases, Factual - utilization
Electronic Health Records - statistics & numerical data - utilization
Female
Finland
Global health
Humans
Maternal Health - statistics & numerical data
Maternal Health Services - statistics & numerical data
Nursing Research - methods - trends
Pregnancy
Abstract
In recent years, the use of large data sets, such as electronic health records, has increased. These large data sets are often referred to as "Big Data," which have various definitions. The purpose of this article was to summarize and review the utilization, strengths, and challenges of register data, which means a written record containing regular entries of items or details, and Big Data, especially in maternal nursing, using 4 examples of studies from the Finnish Medical Birth Register data and relate these to other international databases and data sets. Using large health register data is crucial when studying and understanding outcomes of maternity care. This type of data enables comparisons on a population level and can be utilized in research related to maternal health, with important issues and implications for future research and clinical practice. Although there are challenges connected with register data and Big Data, these large data sets offer the opportunity for timely insight into population-based information on relevant research topics in maternal health. Nurse researchers need to understand the possibilities and limitations of using existing register data in maternity research. Maternal child nurse researchers can be leaders of the movement to utilize Big Data to improve global maternal health.
PubMed ID
28737544 View in PubMed
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9 records – page 1 of 1.