A Qualitative Study Exploring How the Aims, Language and Actions of Yoga for Pregnancy Teachers May Impact Upon Women's Self-efficacy for Labour and Birth

As women's anxiety and the rate of medical intervention in labour and birth continue to increase, it is important to identify how antenatal education can increase women's confidence and their ability to manage the intense sensations of labour. To report a grounded theory study of how the aims, language and actions of yoga for pregnancy teachers may impact upon women's self-efficacy for labour and birth. Yoga for pregnancy classes in three locations were filmed. Semi-structured interviews were undertaken with the teachers to explore what they were trying to achieve in their classes, and how. Interviews and classes were transcribed and analysed using grounded theory. There was considerable consistency in the teachers’ aims, the language they used in classes and in their thinking about class structure. Four main themes emerged: creating a sisterhood, modelling labour, building confidence and enhancing learning. Teachers see yoga for pregnancy as a multi-faceted, non-prescriptive intervention that enhances women's physical, emotional and social readiness for labour and birth, and supports women to make their own decisions across the transition to parenthood. Women's self-efficacy for labour is complex and multi-factorial. This study offers insights into the factors which may be involved in increasing it. These include not only traditional elements of yoga such as postures, breathing and meditation, but also the creation of safe, women-only groups where anxieties, experiences and stories can be shared, and pain-coping techniques for labour learned and practised

Turning evidence into recommendations: Protocol of a study guideline development groups

<p>Abstract</p> <p>Background</p> <p>Health care practice based on research evidence requires that evidence is synthesised, and that recommendations based on this evidence are implemented. It also requires an intermediate step: translating synthesised evidence into practice recommendations. There is considerable literature on evidence synthesis and implementation, but little on how guideline development groups (GDGs) produce recommendations. This is a complex process, with many influences on communication and decision-making, <it>e.g</it>., the quality of evidence, methods of presentation, practical/resource constraints, individual values, professional and scientific interests, social and psychological processes. To make this process more transparent and potentially effective, we need to understand these influences. Psychological theories of decision-making and social influence provide a framework for this understanding.</p> <p>Objectives</p> <p>This study aims to investigate the processes by which GDGs formulate recommendations, drawing on psychological theories of decision-making and social influence. The findings will potentially inform the further evolution of GDG methods, such as choice of members and procedures for presenting evidence, conducting discussion and formulating recommendations.</p> <p>Methods</p> <p>Longitudinal observation of the meetings of three National Institute of Health and Clinical Excellence (NICE) GDGs, one from each of acute, mental health and public health, will be tape recorded and transcribed. Interviews with a sample of GDG members at the beginning, middle, and end of the GDG's work will be recorded and transcribed. Site documents including relevant e-mail interchanges, GDG meeting minutes, and stakeholders' responses to the drafts of the recommendations will be collected. Data will be selected for analysis if they refer to either evidence or recommendations; the focus is on "hot spots", <it>e.g</it>., dilemmas, conflicts, and uncertainty. Data will be analysed thematically and by content analysis, drawing on psychological theories of decision-making and social influence.</p

Where There is a Will: encouraging policymakers to value unpaid labour

Unpaid labour, notably caring labour, is one of the most important and productive sectors of our society. Its inherent and measurable value has been stressed by scholars and practitioners, feminists and those doing unpaid work for generations. Yet policymakers continue to sideline it. This article describes the improvements that would flow from recognising and responding to the importance of unpaid labour, the values and cultural narratives that help explain the lack of policymaking will, and the potential for counters to these narratives

A review of enablers and barriers to physical activity participation among older people of New Zealand and international populations

The objective of the present study was to review international evidence on common motivators and barriers to physical activity for older people. Data sources:Authors searched Pubmed, PsychINFO, EBSCOhost, Scopus, CINAHL, PsycARTICLES, Google Scholar, Ausportmed, and SPORTDiscus, plus additional hand searches. Relevant terms included: 1) physical activity, sport, exercise, sedentary, inactivity; 2) older people, older adults, aged, elderly; and 3) barriers, facilitators, enablers, motivators. The search was limited to English language publications from 2003 to 2010. Study section:Article titles (n = 504) were reviewed for potential relevance by two authors, then full-text articles were retrieved for all potentially relevant articles. Twenty-seven English language articles, reports, or abstracts published from 2003 to 2010, addressing motivators or barriers to physical activity in people over the age of 65 years were included. Data extraction: Two authors extracted data on motivators and barriers. Data Synthesis: Based on frequency, the most common barriers and motivators to physical activity (PA) participation, categorised at the personal, social, and environmental levels were identified. Common PA motivators included positive outcome expectations, feeling healthy, social support, easy access to facilities or affordable community-based programmes, guidance or encouragement from health professionals, and institutional encouragement. Common PA barriers included health problems, lack of support, cultural/social norms, functional ability, and the fear of falling and injury. Conclusions:For both New Zealand and international populations, common personal, social, and environmental barriers and motivators were identified that could be targeted through public health programmes, which should be culturally appropriate for each ethnic group

A Literature Review of Evidence on Physical Activity for Older People and a Review of Existing Physical Activity Guidelines for Older People

Consistent with worldwide trends, the population of New Zealand is ageing. Based on the 2006 Census data, the New Zealand population aged over 65 years at the end of 2006 was 519,940 (12% of the total population) (Ministry of Social Development 2007). It has been estimated that the older adult cohort is projected to increase to 25% of the total population by 2051 (Dunstan et al 2006). Along with the ageing population come challenges in maintaining health and wellbeing. An important key to healthy ageing is the maintenance of a physically active lifestyle. Physical inactivity has both direct and indirect costs to the health of a population, with evidence showing graded health benefits of physical activity for reducing of a range of non-communicable diseases (US Surgeon General 1996). The phrase „older people‟, as used in this report, refers to people over the age of 65 years. This report examines the evidence since 2004 on the benefits and risks of physical activity, as well as the risks of inactivity. It draws conclusions from the evidence as to what the most effective types of physical activity are for older people and does this from the perspective of both preventing the onset of chronic conditions and also the management of those conditions. The report addresses the enablers and barriers to participation in physical activity for older people; and examines specific issues (especially with regard to safety) and cultural considerations for New Zealand older people. It also examines the existing evidence from international guidelines and policies on physical activity for older people

Turning Evidence into Recommendations: protocol for a study of guideline development groups

Background: Health care practice based on research evidence requires that evidence is synthesised, and that recommendations based on this evidence are implemented. It also requires an intermediate step: translating synthesised evidence into practice recommendations. There is considerable literature on evidence synthesis and implementation, but little on how guideline development groups (GDGs) produce recommendations. This is a complex process, with many influences on communication and decision-making, e. g., the quality of evidence, methods of presentation, practical/resource constraints, individual values, professional and scientific interests, social and psychological processes. To make this process more transparent and potentially effective, we need to understand these influences. Psychological theories of decision-making and social influence provide a framework for this understanding.Objectives: This study aims to investigate the processes by which GDGs formulate recommendations, drawing on psychological theories of decision-making and social influence. The findings will potentially inform the further evolution of GDG methods, such as choice of members and procedures for presenting evidence, conducting discussion and formulating recommendations.Methods: Longitudinal observation of the meetings of three National Institute of Health and Clinical Excellence (NICE) GDGs, one from each of acute, mental health and public health, will be tape recorded and transcribed. Interviews with a sample of GDG members at the beginning, middle, and end of the GDG's work will be recorded and transcribed. Site documents including relevant e-mail interchanges, GDG meeting minutes, and stakeholders' responses to the drafts of the recommendations will be collected. Data will be selected for analysis if they refer to either evidence or recommendations; the focus is on "hot spots", e. g., dilemmas, conflicts, and uncertainty. Data will be analysed thematically and by content analysis, drawing on psychological theories of decision-making and social influence

The effects of counseling on fear of childbirth

ObjectiveTo investigate women's experiences of attending existing counseling programs for childbirth-related fear and the effect of this counseling over time. DesignA longitudinal survey. SettingThree hospitals in the central north of Sweden. SampleA selected sample of 936 women. Of these, 70 received counseling due to fear of childbirth (study-group). MethodsData were collected with questionnaires 2months and 1year after giving birth with background data collected during midpregnancy. Comparisons were made between women with or without counseling. Crude and adjusted odds ratios (OR) were calculated. Main outcome measuresSelf-reported childbirth fear, experience of counseling, birth experience and preferred mode of birth. ResultsWomen in the counseling group reported higher childbirth fear 1year after giving birth (OR 5.0, 95% confidence interval (95% CI) 2.6-9.3), they had a more negative birth experience that did not change over time (OR 2.1, 95% CI 1.2-3.9) and they preferred cesarean section to a greater extent (OR 12.0, 95% CI 5.1-28.1) in the case of another birth. Also, they were more often delivered by planned cesarean section (OR 4.7, 95% CI 2.4-9.1). However, 80% were satisfied with the given support. ConclusionAlthough women were satisfied with the treatment, this study shows that counseling had a minor effect on fear of childbirth, birth experiences or cesarean section rates. To help women with their fear of childbirth, more effective methods of treatment are needed