The facilitating factors and barriers encountered in the adoption of a humanized birth care approach in a highly specialized university affiliated hospital

<p>Abstract</p> <p>Background</p> <p>Considering the fact that a significant proportion of high-risk pregnancies are currently referred to tertiary level hospitals; and that a large proportion of low obstetric risk women still seek care in these hospitals, it is important to explore the factors that influence the childbirth experience in these hospitals, particularly, the concept of humanized birth care.</p> <p>The aim of this study was to explore the organizational and cultural factors, which act as barriers or facilitators in the provision of humanized obstetrical care in a highly specialized, university-affiliated hospital in Quebec province, in Canada.</p> <p>Methods</p> <p>A single case study design was chosen. The study sample included 17 professionals and administrators from different disciplines, and 157 women who gave birth in the hospital during the study. The data was collected through semi-structured interviews, field notes, participant observations, a self-administered questionnaire, documents, and archives. Both descriptive and qualitative deductive content analyses were performed and ethical considerations were respected.</p> <p>Results</p> <p>Both external and internal dimensions of a highly specialized hospital can facilitate or be a barrier to the humanization of birth care practices in such institutions, whether independently, or altogether. The greatest facilitating factors found were: caring and family- centered model of care, professionals' and administrators' ambient for the provision of humanized birth care besides the medical interventional care which is tailored to improve safety, assurance, and comfort for women and their children, facilities to provide a pain-free birth, companionship and visiting rules, dealing with the patients' spiritual and religious beliefs. The most cited barriers were: the shortage of health care professionals, the lack of sufficient communication among the professionals, the stakeholders' desire for specialization rather than humanization, over estimation of medical performance, finally the training environment of the hospital leading to the presence of too many health care professionals, and consequently, a lack of privacy and continuity of care.</p> <p>Conclusion</p> <p>The argument of medical intervention and technology at birth being an opposing factor to the humanization of birth was not seen to be an issue in the studied highly specialized university affiliated hospital.</p

Reduced dream-recall frequency in left-handed adolescents: A replication

The ability to recall a dream upon waking up in the morning has been linked to a broad variety of factors such as personality, creativity, sleep behaviour and cognitive function. There have been conflicting findings as to whether dream recall is related more to the right or to the left hemisphere, and conflicting findings regarding the relationship of dream-recall frequency to handedness. We have found previously that right- and mixed-handers report having more dreams than left-handers, a finding more pronounced among adolescents than adults. In the present sample of 3535 participants aged from 6 to 18 years, right-handedness and mixed/inconsistent handedness were associated with higher dream-recall frequency compared to that of left-handed persons, again especially in adolescents compared with children. Further research is required to uncover the reason for the lower frequency of dream recall by left-handers

Correspondence between REM dream reports and diary records as a function of time period.

<p>Mean correspondence scores (and Standard Deviations) between REM dream reports and diary records as a function of time period between diary day and dream. * p≤.05 (Wilcoxon test).</p

Example portion of a matrix used to record correspondence ratings (0–4) between dream reports and diary records.

<p>Example portion of a matrix used to record correspondence ratings (0–4) between dream reports and diary records.</p

Correspondence between N2 dream reports and diary records as a function of time period.

<p>Mean correspondence scores (and Standard Deviations) between N2 dream reports and diary records as a function of time period between diary day and dream. * p<.05 (Wilcoxon test).</p

Correspondence between N2 dream reports and diary records as a function of time.

<p>Mean correspondence scores (and Standard Deviations) between N2 dream reports and diary records as a function of time between diary day and dream.</p