Experiences of women with cardiac disease in pregnancy: a systematic review and metasynthesis
dc.contributor.author | Dawson, Angela | |
dc.contributor.author | Krastev, Yordanka | |
dc.contributor.author | Parsonage, William | |
dc.contributor.author | Peek, Michael | |
dc.contributor.author | Lust, Karin | |
dc.contributor.author | Sullivan, Elizabeth | |
dc.date.accessioned | 2019-12-16T03:43:34Z | |
dc.date.available | 2019-12-16T03:43:34Z | |
dc.date.issued | 2018-09-28 | |
dc.date.updated | 2019-07-28T08:19:51Z | |
dc.description.abstract | OBJECTIVE: Cardiac disease in pregnancy is a leading cause of maternal death in high-income countries. Evidence-based guidelines to assist in planning and managing the healthcare of affected women is lacking. The objective of this research was to produce the first qualitative metasynthesis of the experiences of pregnant women with existing or acquired cardiac disease to inform improved healthcare services. METHOD: We conducted a systematic search of peer-reviewed publications in five databases to investigate the decision-making processes, supportive strategies and healthcare experiences of pregnant women with existing or acquired cardiac disease, or of affected women contemplating pregnancy. Identified publications were screened for duplication and eligibility against selection criteria, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We then undertook a thematic analysis of the data relating to women's experiences extracted from each publication to inform new healthcare practices and communication. RESULTS: Eleven studies from six countries were included in our meta-synthesis. Four themes were revealed. Women with congenital and acquired heart disease identified situations where they had either taken charge of decision-making, lacked control or experienced emotional uncertainty when making decisions. Some women were risk aware and determined to take care of themselves in pregnancy while others downplayed the risks. Women with heart disease acknowledged the importance of specific social support measures during pregnancy and after child birth, and reported a spectrum of healthcare experiences. CONCLUSIONS: There is a lack of integrated and tailored healthcare services and information for women with cardiac disease in pregnancy. The experiences of women synthesised in this research has the potential to inform new evidence-based guidelines to support the decision-making needs of women with cardiac disease in pregnancy. Shared decision-making must consider communication across the clinical team. However, coordinated care is challenging due to the different specialists involved and the limited clinical evidence concerning effective approaches to managing such complex care. | en_AU |
dc.format.mimetype | application/pdf | en_AU |
dc.identifier.citation | Dawson AJ, Krastev Y, Parsonage WA, et al. Experiences of women with cardiac disease in pregnancy: a systematic review and metasynthesis. BMJ Open 2018;8:e022755. doi:10.1136/ bmjopen-2018-022755 | en_AU |
dc.identifier.issn | 2044-6055 | en_AU |
dc.identifier.uri | http://hdl.handle.net/1885/195408 | |
dc.language.iso | en_AU | en_AU |
dc.provenance | This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. | en_AU |
dc.publisher | BMJ Publishing Group | en_AU |
dc.rights | © 2018 Author(s) (or their employer(s)) | en_AU |
dc.rights.license | Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) | en_AU |
dc.rights.uri | https://creativecommons.org/licenses/by-nc/4.0/ | en_AU |
dc.source | BMJ Open | en_AU |
dc.title | Experiences of women with cardiac disease in pregnancy: a systematic review and metasynthesis | en_AU |
dc.type | Journal article | en_AU |
dcterms.accessRights | Open Access | en_AU |
dcterms.dateAccepted | 2018-08-09 | |
local.bibliographicCitation.issue | 9 | en_AU |
local.bibliographicCitation.lastpage | 12 | en_AU |
local.bibliographicCitation.startpage | 1 | en_AU |
local.contributor.affiliation | Dawson, Angela, University of Technology, Sydney | en_AU |
local.contributor.affiliation | Krastev, Yordanka, University of Technology Sydney | en_AU |
local.contributor.affiliation | Parsonage, William, Royal Brisbane and Women's Hospital | en_AU |
local.contributor.affiliation | Peek, Michael, College of Health and Medicine, ANU | en_AU |
local.contributor.affiliation | Lust, Karin, Royal Brisbane and Women's Hospital | en_AU |
local.contributor.affiliation | Sullivan, Elizabeth, University of Technology Sydney | en_AU |
local.contributor.authoremail | u1005089@anu.edu.au | en_AU |
local.contributor.authoruid | Peek, Michael, u1005089 | en_AU |
local.description.notes | Imported from ARIES | en_AU |
local.identifier.absfor | 110201 - Cardiology (incl. Cardiovascular Diseases) | en_AU |
local.identifier.absfor | 111402 - Obstetrics and Gynaecology | en_AU |
local.identifier.absseo | 920507 - Women's Health | en_AU |
local.identifier.ariespublication | u4485658xPUB1318 | en_AU |
local.identifier.citationvolume | 8 | en_AU |
local.identifier.doi | 10.1136/bmjopen-2018-022755 | en_AU |
local.identifier.scopusID | 2-s2.0-85054435071 | |
local.identifier.uidSubmittedBy | u4485658 | en_AU |
local.publisher.url | https://bmjopen.bmj.com | en_AU |
local.type.status | Published Version | en_AU |
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