Browsing by Author "Watts, K."
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Item Open Access The association between treatment adherence to nicotine patches and smoking cessation in pregnancy: A secondary analysis of a randomized controlled trial(Oxford Academic, 2016-10-01) Vaz, L R; Aveyard, P; Cooper, S; Leonardi-Bee, J; Coleman, T; Watts, K.Introduction: In nonpregnant “quitters,” adherence to nicotine replacement therapy (NRT) increases smoking cessation. We investigated relationships between adherence to placebo or NRT patches and cessation in pregnancy, including an assessment of reverse causation and whether any adherence: cessation relationship is moderated when using nicotine or placebo patches. Methods: Using data from 1050 pregnant trial participants, regression models investigated associations between maternal characteristics, adherence and smoking cessation. Results: Adherence during the first month was associated with lower baseline cotinine concentrations (β −0.08, 95% confidence interval [CI] −0.15 to −0.01) and randomization to NRT (β 2.59, 95% CI 1.50 to 3.68). Adherence during both treatment months was associated with being randomized to NRT (β 0.51, 95% CI 0.29 to 0.72) and inversely associated with higher nicotine dependence. Adherence with either NRT or placebo was associated with cessation at 1 month (odds ratio [ OR ] 1.11, 95% CI 1.08 to 1.13) and delivery ( OR 1.06, 95% CI 1.03 to 1.09), but no such association was observed in the subgroup where reverse causation was not possible. Amongst all women, greater adherence to nicotine patches was associated with increased cessation ( OR 2.47, 95% CI 1.32 to 4.63) but greater adherence to placebo was not ( OR 0.98, 95% CI: 0.44 to 2.18). Conclusion: Women who were more adherent to NRT were more likely to achieve abstinence; more nicotine dependent women probably showed lower adherence to NRT because they relapsed to smoking more quickly. The interaction between nicotine-containing patches and adherence for cessation suggests that the association between adherence with nicotine patches and cessation may be partly causal.Item Metadata only Changes in maternal self-efficacy, postnatal depression symptoms and social support among Chinese primiparous women during the initial postpartum period: A longitudinal study(Elsevier, 2018-04-11) Zheng, X.; Morrell, J.; Watts, K.Background: There are many parenting problems during infancy for Chinese primiparous women. As an important determinant of good parenting, maternal self-efficacy (MSE) should be paid more attention by researchers. At present, the limitations of previous research examining MSE during infancy are that most studies were conducted with a homogeneous sample and there were few studies with Chinese women. Secondly, the trajectory of change in MSE, postnatal depression symptoms and social support for Chinese primiparous women was not clear during the initial postpartum period in earlier studies. Objectives: This study aimed to describe changes in MSE, postnatal depression symptoms and social support among Chinese primiparous women in the first three months postnatally . Design: A quantitative longitudinal study using questionnaires was conducted. Setting: Obstetric wards at three hospitals in Xiamen City, South-East China. Participants: In total, 420 Chinese primiparous women were recruited. Methods: Initial baseline questionnaires to measure socio-demographic and clinical characteristics at three days postnatally were distributed to participants face-to-face by the researcher on the postnatal ward. Follow-up ques- tionnaires at six and 12 weeks postnatally were sent via e-mail by the researcher to participants, including the Self-efficacy in Infant Care Scale (SICS), the Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Social Support Scale (PSSS) to measure MSE, postnatal depression symptoms and social support, respectively. These were returned by participants via e-mail. Quantitative data were analysed using SPSS. Results: The mean MSE score at six weeks postnatally was 74.92 (SD = 11.05), and increased to 77.78 (SD = 11.13) at 12 weeks postnatally. The mean social support scores at six and 12 weeks postnatally were 40.99 (SD = 9.31) and 43.00 (SD = 9.55). The mean EPDS scores decreased from 9.09 (SD = 4.33) at six weeks postnatally to 8.63 (SD = 4.40) at 12 weeks postnatally; the proportion of women with an EPDS score of ten or more and 13 or more at the two time points declined from 47.4% to 38.3%, and from 21.4% to 18.2%, respectively. Conclusions: In this study, Chinese primiparous women had a moderate level of MSE and received a moderate level of social support at six and 12 weeks postnatally, and a higher proportion of Chinese women had postnatal depression symptoms than did women in Western countries. From six to 12 weeks postnatally, the mean MSE scores and social support scores had a statistically significant increase; the mean EPDS scores had a statistically significant decreaseItem Open Access Chinese primiparous women’s experiences of the traditional postnatal practice of Doing the month: A descriptive method study(Wiley, 2018-07-08) Zheng, X.; Morrell, J.; Watts, K.Aim: “Doing the month” has been a traditionally postnatal practice that women follow for one full month after giving birth. The aim of this study was to explore Chinese primiparous women’s experience of “Doing the month” and why Chinese women felt satisfied or dissatisfied with the experience. Methods: This was a descriptive survey using open and closed questions. In total, 420 Chinese primiparous women were recruited in obstetric wards at three hospitals in Xiamen City, China. Baseline questionnaires were distributed to the participants face-to-face by the researcher on the postnatal ward at 3 days’ postnatally. Follow-up questionnaires of “Doing the month” were sent via email by the researcher to the participants at 6 weeks’ postnatally and were returned by the participants via email. The quantitative data were analyzed with SPSS and the qualitative data were analyzed by using a thematic text analysis. Results: Most of the women thought that “Doing the month” after childbirth was necessary. Some women felt satisfied with “Doing the month” because their family helped them to have a good rest, they felt a sense of achievement when taking care of their baby, and that having an appreciative attitude helped them to get along with the older generations. In contrast, some women felt dissatisfied with “Doing the month” because of being tired of following taboos, having conflicts with their mother-in-law, the lack of family help and care, and undue expectations of “Doing the month.” Conclusions: In order to improve postnatal care for Chinese primiparous women, health professionals could be more aware of how health care needs to be customized to fit the special tradition of “Doing the month.”Item Open Access Experiences and impact of mistreatment and obstetric violence on women during childbearing: a systematic review protocol(2017-03-01) McGarry, J.; Hinsliff-Smith, K.; Watts, K.; McClouskey, P.; Evans, C.The aim of this review is to synthesize the best available evidence on the experiences of mistreatment and/or obstetric violence in women. Specifically, the objective is to explore, from a woman's point of view, the impacts and consequences of mistreatment and/or obstetric violence during childbearing. The review question is: “What are the experiences and impact of mistreatment and obstetric violence on women during the active period of childbearing?”Item Open Access Exploring primary care responses to domestic violence and abuse (DVA): Operationalisation of a national initiative in one area of the United Kingdom(Emerald, 2019-03-28) McGarry, J.; Hussain, B.; Watts, K.Purpose In the UK, the Identification and Referral to Improve Safety (IRIS) initiative has been developed for use within primary care to support women survivors of domestic violence and abuse (DVA). However, while evaluated nationally, less is known regarding impact of implementation at a local level. The purpose of this paper is to explore the effectiveness of IRIS within one locality in the UK. Design/methodology/approach A qualitative study using interviews/focus groups with primary care teams and women who had experienced DVA in one primary care setting in the UK. Interviews with 18 participants from five professional categories including: general practitioners, practice nurses, practice managers, assistant practice managers and practice receptionists. Focus group discussion/interview with seven women who had accessed IRIS. Data were collected between November 2016 and March 2017. Findings Five main themes were identified for professionals: Team role approach to training, Professional confidence, Clear pathway for referral and support, Focussed support, Somewhere to meet that is a “safe haven”. For women the following themes were identified: Longevity of DVA; Lifeline; Face to face talking to someone; Support and understood where I was coming from; A place of safety. Practical implications IRIS played a significant role in helping primary care professionals to respond effectively. For women IRIS was more proactive and holistic than traditional approaches. Originality/value This study was designed to assess the impact that a local level implementation of the national IRIS initiative had on both providers and users of the service simultaneously. The study identifies that a “whole team approach” in the primary care setting is critical to the effectiveness of DVA initiatives.Item Embargo The mental health and wellbeing of midwifery students: An integrative review(Elsevier, 2019-02-14) Oates, J.; Topping, A.; Arias, T.; Charles, P.; Hunter, C.; Watts, K.Item Open Access A quantitative longitudinal study to explore factors which influence maternal self-efficacy among Chinese primiparous women during the initial postpartum period(Elsevier, 2017-12-21) Zheng, X.; Morrell, J.; Watts, K.Background: parenting during infancy is highly problematic for Chinese primiparous women. As an important determinant of good parenting, maternal self-efficacy (MSE) should be paid more attention by researchers. At present, the limitations of previous research about MSE during infancy are that the factors which influence MSE remained poorly explored, there were few studies with Chinese women, and the studies did not consider the effect of different cultures. Objectives: to explore factors which influence MSE in primiparous women in China in the first three months postnatally. Methods: a quantitative longitudinal study using questionnaires was conducted. In total, 420 Chinese primiparous women were recruited in obstetric wards at three hospitals in Xiamen City, Fujian Province of China. Initial baseline questionnaires to measure socio-demographic and clinical characteristics were distributed to participants face-to-face by the researcher on the postnatal ward at three days postnatally. Follow-up questionnaires at six and 12 weeks postnatally were sent via e-mail by the researcher to participants, including the Self-efficacy in Infant Care Scale (SICS), the Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Social Support Scale (PSSS) to measure MSE, postnatal depression symptoms and social support, respectively. These were returned by participants via e-mail. Quantitative data were analysed using SPSS. Results: the variables: social support, women's satisfaction with ‘Doing the month’, postnatal depression, maternal education, baby health, and maternal occupation had an influence on MSE at six weeks postnatally (Adjusted R2 = 0.510, F = 46.084, P < 0.01); and the variables: postnatal depression, social support, baby health, women's satisfaction with ‘Doing the month’, and baby fussiness were the factors influencing MSE at 12 weeks postnatally (Adjusted R2 = 0.485, F = 41.082, P < 0.01). Conclusions: obstetric nurses and women's family members need to be aware of the significant contribution of social support, women's satisfaction with ‘Doing the month’ in positively influencing primiparous women's MSE, and the significant effect of postnatal depression symptoms in negatively impacting on first-time mothers’ MSE; they should pay more attention to primiparous women with less education, unemployed mothers, women with unskilled occupations, women with an unhealthy baby, and women with a baby with a difficult temperament to improve their comparatively lower MSE levels during the initial postnatal period.Item Open Access ‘The rollercoaster’: a qualitative study of midwifery students’ experiences affecting their mental wellbeing.(Elsevier, 2020-05-15) Oates, J.; Topping, A.; Watts, K.; Charles, P.; Hunter, C.; Arias, T.Objective: midwifery student mental wellbeing is an important consideration for the sus-tainability of the profession, however it has seldom been the subject of empirical research. Previous studies of the lived experience of midwifery students have focused on the impact of transition experiences and student satisfaction, rather than specifically on mental health and students’ views on support for their mental wellbeing. Design: a qualitative descriptive study using semi-structured interviews. Setting: a midwifery undergraduate programme in one university in the South of England. Participants: 20 BSc midwifery students. Findings: two inductive themes were developed from our analysis. The theme of ‘the rollercoaster’ encapsulated students’ experience over the length of the course, characterised by multiple culture shocks of being in different worlds, from one clinical placement to the next, from university to clinical placement. This experience was emotionally taxing. The theme of ‘being noticed, feeling connected’ encapsulated midwifery students’ views on what could help them enjoy their training. They wanted to be seen as individuals by at least one educator, they wanted opportunities to connect with their peers and they wanted the support available to them to be consistent. Conclusions: listening to students’ insights into the lived experience of being a midwifery student can enable midwifery educators to improve the way courses are designed and support structures are put in place. The importance of having consistent contact with peers and educators cannot be underestimated. Implications for practice: The emotional demands of midwifery training must be acknowledged. Educators should identify ways in which they can provide students with consistent individualised support and regular opportunities to meet with their peers.Item Open Access The SNAP trial: a randomised placebo-controlled trial of nicotine replacement therapy in pregnancy; effectiveness and safety until 2 years after delivery, the economic evaluation(HTA, 2014-08-26) Lewis, S.; Thornton, J. G.; Marlow, N.; Watts, K.; Britton, J.; Grainge, M. J.; Tagger, J.; Essex, H.; Parrott, S.; Dickson, A.; Whitemore, R.; Coleman, T.; Cooper, S.