Abstract:Background: As a normative theory, care ethics has become widely theorized and accepted. However, there remains a lack of clarity in relation to its use in practice, and a care ethics framework for practice. Maternity care is fraught with ethical issues and care ethics may provide an avenue to enhance ethical sensitivity. Aim: The purpose of this scoping review is to determine how care ethics is used amongst health professions, and to collate the information in data charts to create a care ethics framework an… Show more
“…Using a care ethics lens [20,[28][29][30][31] to interpret these findings identifies an endemic lack of concern in maternity settings for genuine ethical care. Although technology can be useful in contributing to an overall clinical picture, it is not a replacement for attentive, human caring.…”
Section: Discussionmentioning
confidence: 99%
“…We propose that the perspectives of care ethics [20,28,30,31] and technological mediation [32] can equally be applied to fetal monitoring in the context of caring for women and birthing people during labour. By this, we mean that midwives and other health professionals should not simply comply with the demands of the fetal monitoring technology by midwifing the monitor instead of the person, which arguably increases the risk of physical and emotional harm.…”
Qualitative research about women and birthing people’s experiences of fetal monitoring during labour and birth is scant. Labour and birth is often impacted by wearable or invasive monitoring devices, however, most published research about fetal monitoring is focused on the wellbeing of the fetus. This manuscript is derived from a larger mixed methods study, ‘WOmen’s Experiences of Monitoring Baby (The WOMB Study)’, aiming to increase understanding of the experiences of women and birthing people in Australia, of being monitored; and about the information they received about fetal monitoring devices during pregnancy. We constructed a national cross-sectional survey that was distributed via social media in May and June, 2022. Responses were received from 861 participants. As far as we are aware, this is the first survey of the experiences of women and birthing people of intrapartum fetal monitoring conducted in Australia. This paper comprises the analysis of the free text survey responses, using qualitative and inductive content analysis. Two categories were constructed, Tending to the machine, which explores participants’ perceptions of the way in which clinicians interacted with fetal monitoring technologies; and Impressions of the machine, which explores the direct impact of fetal monitoring devices upon the labour and birth experience of women and birthing people. The findings suggest that some clinicians need to reflect upon the information they provide to women and birthing people about monitoring. For example, freedom of movement is an important aspect of supporting the physiology of labour and managing pain. If freedom of movement is important, the physical restriction created by a wired cardiotocograph is inappropriate. Many participants noticed that clinicians focused their attention primarily on the technology. Prioritising the individual needs of the woman or birthing person is key to providing high quality woman-centred intrapartum care. Women should be provided with adequate information regarding the risks and benefits of different forms of fetal monitoring including how the form of monitoring might impact her labour experience.
“…Using a care ethics lens [20,[28][29][30][31] to interpret these findings identifies an endemic lack of concern in maternity settings for genuine ethical care. Although technology can be useful in contributing to an overall clinical picture, it is not a replacement for attentive, human caring.…”
Section: Discussionmentioning
confidence: 99%
“…We propose that the perspectives of care ethics [20,28,30,31] and technological mediation [32] can equally be applied to fetal monitoring in the context of caring for women and birthing people during labour. By this, we mean that midwives and other health professionals should not simply comply with the demands of the fetal monitoring technology by midwifing the monitor instead of the person, which arguably increases the risk of physical and emotional harm.…”
Qualitative research about women and birthing people’s experiences of fetal monitoring during labour and birth is scant. Labour and birth is often impacted by wearable or invasive monitoring devices, however, most published research about fetal monitoring is focused on the wellbeing of the fetus. This manuscript is derived from a larger mixed methods study, ‘WOmen’s Experiences of Monitoring Baby (The WOMB Study)’, aiming to increase understanding of the experiences of women and birthing people in Australia, of being monitored; and about the information they received about fetal monitoring devices during pregnancy. We constructed a national cross-sectional survey that was distributed via social media in May and June, 2022. Responses were received from 861 participants. As far as we are aware, this is the first survey of the experiences of women and birthing people of intrapartum fetal monitoring conducted in Australia. This paper comprises the analysis of the free text survey responses, using qualitative and inductive content analysis. Two categories were constructed, Tending to the machine, which explores participants’ perceptions of the way in which clinicians interacted with fetal monitoring technologies; and Impressions of the machine, which explores the direct impact of fetal monitoring devices upon the labour and birth experience of women and birthing people. The findings suggest that some clinicians need to reflect upon the information they provide to women and birthing people about monitoring. For example, freedom of movement is an important aspect of supporting the physiology of labour and managing pain. If freedom of movement is important, the physical restriction created by a wired cardiotocograph is inappropriate. Many participants noticed that clinicians focused their attention primarily on the technology. Prioritising the individual needs of the woman or birthing person is key to providing high quality woman-centred intrapartum care. Women should be provided with adequate information regarding the risks and benefits of different forms of fetal monitoring including how the form of monitoring might impact her labour experience.
“… COVID-19’s impact on primary care and related mitigation strategies: A scoping review [ 22 ]. Care ethics framework for midwifery practice: A scoping review [ 23 ]. …”
This article, the seventh in a series aiming to provide practical guidance for qualitative research in primary care, introduces qualitative synthesis research for addressing health themes in primary care research. Qualitative synthesis combines rigorous processes and authorial judgement to present the collective meaning of research outputs; the findings of qualitative studies – and sometimes mixed-methods and quantitative research – are pooled. We describe three exemplary designs: the scoping review, the meta-ethnography and the rapid realist review. Scoping reviews aim to provide an overview of the evidence/knowledge or to answer questions regarding the nature and diversity of the evidence/knowledge available. Meta-ethnographies intend to systematically compare data from primary qualitative studies to identify and develop new overarching concepts, theories, and models. Rapid realist reviews aim to provide a knowledge synthesis by looking at complex questions while responding to time-sensitive and emerging issues. It addresses the question, ‘what works, for whom, in what circumstances, and how?’
We discuss these three designs’ context, what, why, when and how. We provide examples of published studies and sources for further reading, including manuals and guidelines for conducting and reporting these studies. Finally, we discuss attention points for the research team concerning the involvement of necessary experts and stakeholders and choices to be made during the research process.
“…This speaks to the situational, relational and holistic view of care and ethics. In a recent scoping review of how healthcare professionals use care ethics in practice, Buchanan et al [13] presented a definition for healthcare practice:Care ethics recognizes that care is a universal human experience. Care ethics is founded on relationship, based on presence, trust and respect, forged on knowing the person at the centre of care.…”
BackgroundIntroducing new technologies into healthcare practices may challenge professionals' traditional care cultures. The aim of this review was to map how the ‘ethics of care’ theoretical framework informs empirical studies of technology‐mediated healthcare.MethodA scoping review was performed using eight electronic databases: CINAHL with full text, Academic Search Premier, MEDLINE, the Philosopher's Index, SocINDEX with Full Text, SCOPUS, APA PsycInfo and Web of Science. This was followed by citation tracking, and articles were assessed against the inclusion criteria.ResultsOf the 443 initial articles, 18 met the criteria and were included. We found that nine of the articles used the concept of ‘ethics of care’ (herein used interchangeably with the terms ‘feminist ethics’ or ‘relational ethics’) insubstantially. The remaining nine articles deployed care ethics (or its equivalent) substantially as an integrated theoretical framework and analytical tool. We found that several articles suggested an expansion of ethics of care to encompass technologies as part of contemporary care. Furthermore, ethics of care contributed to the empirical research by recognising both new relationships between patients and healthcare professionals as well as new ethical challenges.ConclusionEthics of care is sparsely used as a theoretical framework in empirical studies of technology‐mediated healthcare practices. The use of ethics of care in technology‐mediated care brings new dilemmas, relational tensions and vulnerabilities to the foreground. For ethics of care to be used more explicit in empirical studies, it is important that it is recognised by research community as an adequate, universal ethical theory.
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