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AIM: To explore the experiences, expectations and needs of mothers from low-socioeconomic status at 1 month postpartum. DESIGN: Descriptive qualitative. METHODS: Mothers from low-socioeconomic status and irrespective of their parity were invited to participate in one-to-one interviews at 1 month postpartum. Semi-structured interviews were conducted until data saturation. Interviews were audio recorded, transcribed verbatim and analysed thematically. Written informed consent was obtained. RESULTS: Twenty mothers participated and six themes were identified: (1) No choice but to find meaning; (2) Father as a major pillar of support; (3) 'Kampung' Spirit; (4) Trials and Tribulations of Transition to Motherhood; (5) Shame, guilt and internalized stigma and (6) Reclaiming the power. CONCLUSION: This study reflected the unique struggles of mothers from low-socioeconomic status with pregnancy, childbirth and early postpartum and the wider health inequities within Singapore's maternal health system. To provide much-needed support and improved care, the stakeholders within government, healthcare providers and social organizations should consider the niche needs of this community. IMPLICATIONS FOR PATIENT CARE: Nurses need to reflect on their own biases and ensure consistent care delivery regardless of socioeconomic status. When delivering patient education, patient-centred and sincere advice rooted in personal experience can help to establish rapport. IMPACT: This study is the first to explore the experiences of mothers from low-socioeconomic status in the Singapore context. Low-socioeconomic status mothers experienced less autonomy over their health, the care they received and their childcare options. As mothers adjusted to their new roles, they struggled to cope. However, as they were wary of the stigma surrounding poverty and their guilt of not being a 'good mother', they preferred to seek informal support from their family, friends and self-help through learning from social media, as compared to formal, external help. REPORTING METHOD: COREQ checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
RESUMO
Exposure to trauma elevates the risk of illness in women, resulting in increased healthcare costs. The trauma-informed care approach seeks to enhance patient engagement and promote more effective recovery for those with a history of psychological trauma. This qualitative systematic review aims to synthesize evidence related to the experiences of women receiving trauma-informed care using Sandelowski and Barroso's two-step approach for qualitative research synthesis. A comprehensive search was conducted across 10 electronic databases from their inception until September 2023, coupled with an extensive bibliography search of relevant studies and reviews. In total, eleven studies meeting the inclusion criteria were selected: qualitative peer-reviewed and non-peer-reviewed studies in English with findings on the experiences of adult heterosexual women aged 19 to 64 years old who underwent various trauma-informed psychosocial interventions. From these studies, four main themes emerged, elucidating women's experiences as they engage with trauma-informed care: (a) Readiness to seek healing; (b) Healthcare providers: Extending the first hand; (c) An empowering paradigm shift; and (d) Better days ahead. Our major findings emphasize the importance of healthcare providers demonstrating sensitivity to trauma and culture, adopting a gender-sensitive approach, and taking a proactive stance in initiating discussions about trauma. Moreover, allocating more time for consultations, with an increased focus on building an initial rapport to ensure women's comfort, is also vital. The review further underscores the benefits of group sessions in aiding women's recovery from trauma. Ultimately, this review holds substantial implications for shaping future practices, emphasizing the critical necessity of personalized treatment plans.
