Healthcare providers' perspectives of disrespect and abuse in maternity care facilities in Nigeria: a qualitative study.

OBJECTIVES: To explore healthcare providers' perspectives of disrespect and abuse in maternity care and the impact on women's health and well-being. METHODS: Qualitative interpretive approach using in-depth semi-structured interviews with sixteen healthcare providers in two public health facilities in Nigeria. Interviews were audio-recorded, transcribed, and analysed thematically. RESULTS: Healthcare providers' accounts revealed awareness of what respectful maternity care encompassed in accordance with the existing guidelines. They considered disrespectful and abusive practices perpetrated or witnessed as violation of human rights, while highlighting women's expectations of care as the basis for subjectivity of experiences. They perceived some practices as well-intended to ensure safety of mother and baby. Views reflected underlying gender-related notions and societal perceptions of women being considered weaker than men. There was recognition about adverse effects of disrespect and abuse including its impact on women, babies, and providers' job satisfaction. CONCLUSIONS: Healthcare providers need training on how to incorporate elements of respectful maternity care into practice including skills for rapport building and counselling. Women and family members should be educated about right to respectful care empowering them to report disrespectful practices.

"Coaching and Peer-Assisted Learning" (C-PAL) - The mental health nursing student experience: A qualitative evaluation.

WHAT IS KNOWN ON THE SUBJECT?: There is increasing demand for clinical placements for pre-registration nursing students. New models of mentorship have been developed to meet the demand for clinical placements by increasing the number of students within each placement. At present there are no published research studies into the effectiveness of team mentorship utilized by pre-registration nursing students within in-patient mental health settings. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This paper reports findings from a study that explored the experiences of mental health students within the social world of their clinical placement, adopting a new approach to practice learning where students support each other's learning. Students found their engagement in the pilot project as valuable as being exposed to the new team mentorship model which introduced them to peer-assisted learning. The learning that arose from peer-assisted learning within team mentorship appeared to provide learning opportunities that enabled students' to develop greater self-awareness and confidence. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Peer-assisted learning where students support the learning of each other, can lead to a wider range of learning opportunities for, as well as between, nursing students. In order for students to participate in care and become a "learning team," suitable in-patient mental health wards need to be identified that can support this new approach to the supervision, assessment and support of students. The establishment of team mentorship within mental health in-patient settings is dependent on the support provided by practice educators and university link lecturers to nurse mentors and coaches which in turn, determines the quality of the student experience. ABSTRACT: Introduction This paper presents findings from a study that evaluated mental health nursing students' experience of a team mentoring model called Coaching and peer-assisted learning (C-PAL). At present there are no published research studies into the effectiveness of team mentorship utilized by nursing students within in-patient mental health settings. Aim The study utilized an interpretivist methodology where the focus was on individuals in their social world. Method Two focus groups were held with fifteen students who had experienced C-PAL in four in-patient wards. Findings Students' overall experience of piloting C-PAL was positive. Learning opportunities (Theme 3) appeared to be dependent on the quality of peer support (Theme 5) which in turn, enhanced the learner experience and increased the level of student confidence (Theme 6). Less positive experiences included inadequate preparation (Theme 1), poor understanding of the model and competition for learning experiences. Implications for practice We tentatively suggest that team mentorship models such as C-PAL may be suitable for acute in-patient mental health settings. The success of C-PAL depends upon the preparation of nursing staff, mentors (Theme 4), coaches and students in relation to role expectations, shift rostering (Theme 2) and the implementation of "huddling" to promote opportunistic learning.

Women's experiences of disrespect and abuse in maternity care facilities in Benue State, Nigeria.

BACKGROUND: Disrespect and abuse (D&A) of women in health facilities continues to be a prevailing public health issue in many countries. Studies have reported significantly high prevalence of D&A among women during pregnancy and childbirth in Nigeria, but little is known about women's perceptions and experiences of D&A during maternity care in the country. The aim of this study was to explore: 1) how women perceived their experiences of D&A during pregnancy, childbirth, and in the postnatal period in Benue State, Nigeria; and 2) how women viewed the impact of D&A on the future use of health facilities for maternity care. METHOD: Five focus group discussions with a sample of 32 women were conducted as part of a qualitative phenomenological study. All the women received maternity care in health facilities in Benue State, Nigeria and had experienced at least one incident of disrespect and abuse. Audio-recorded discussions were transcribed and analysed using a six-stage thematic analysis using NVivo11. RESULTS: The participants perceived incidents such as being shouted at and the use of abusive language as a common practice. Women described these incidents as devaluing and dehumanising to their sense of dignity. Some women perceived that professionals did not intend to cause harm by such behaviours. Emerged themes included: (1) 'normative' practice; (2) dehumanisation of women; (3) 'no harm intended' and (4) intentions about the use of maternity services in future. The women highlighted the importance of accessing health facilities for safe childbirth and expressed that the experiences of D&A may not impact their intended use of health facilities. However, the accounts reflected their perceptions about the inherent lack of choice and an underlying sense of helplessness. CONCLUSION: Incidents of D&A that were perceived as commonplace carry substantial implications for the provision of respectful maternity care in Nigeria and other similar settings. As a country with one of the highest rates of maternal deaths, the findings point to the need for policy and practice to address the issue urgently through implementing preventive measures, including empowering women to reinforce their right to be treated with dignity and respect, and sensitising health care professionals.

The increasing use of reiki as a complementary therapy in specialist palliative care.

Palliative medicine and complementary therapies (CTs) have developed within the NHS as parallel philosophies of care. As a result, the last decade has seen an increase in the integration and usage of CTs, as adjunct therapies to conventional medical treatment. Documented benefits of relaxation, decreased perception of pain, reduced anxiety and improved sense of wellbeing have been shown to enable an enhanced quality of life, where curative treatment is no longer an option. Reiki is a more recent addition to the range of CTs available to cancer patients. As an energy-healing intervention it has gained in popularity as a non-invasive and non-pharmacological approach. Anecdotal evidence suggests that the profound relaxation effect has a positive impact on alleviating anxiety, stress, perception of pain and promotes a feeling of wellbeing particularly relating to the nature of psychospiritual wellbeing. However, there is very little evidence to support its application within clinical practice, and none within the specific field of specialist palliative care (SPC). This article will consider the position of reiki as an emerging CT within SPC. The function of the hospice movement, the role of CTs together with an understanding of energy healing will also be explored. Within this context, the rise in popularity of reiki and its potential benefits for SPC patients will be discussed. These considerations will then form the basis of the justification for further research in SPC.