Edwards, Susan Letitia (2016) Bringing together the 'threads of care' in possible miscarriage for women, their partners and nurses in non-metropolitan emergency departments. PhD thesis, James Cook University.

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Abstract

Pregnancy is usually a significant event in a woman's life: a time of great expectation and attachment to the possibilities and dreams placed on the new life growing inside her. Complications in early pregnancy can be physically and psychologically traumatic experiences that generate high levels of anxiety. For some women and their partners, the fear of possible miscarriage is so overwhelming and unexpected that the emergency department seems the most appropriate healthcare service to attend. Women who seek emergency care often consider or anticipate the possible loss of their pregnancy when presenting for urgent medical care. Vaginal bleeding occurs in about 25% of all pregnancies, and of these roughly one in six (15–20%) end in miscarriage. Symptomatic first-trimester pregnancies are a common presentation in an Australian emergency department, yet research has shown that women often feel dissatisfied with the care provided in this setting.

In Australia, emergency departments play an important role in the provision of healthcare, especially in regional, rural and remote areas. Unfortunately, access to and quality of healthcare has been strained in recent times because of the unique challenges associated with the delivery of health in these locations. The aim of this study is to examine and explain current approaches to care provided to women who present to nonmetropolitan emergency departments with first-trimester bleeding and possible miscarriage. Using a grounded theory methodology, three participant groups were included in this study: women who presented to an emergency department, their partners, and the nursing staff who provided care in these settings. The multiple participant views informed the development of a grounded theory, titled 'threads of care'. This theory enhances the understanding of what constitutes optimal and effective care for women and their partners when presenting to regional, rural and remote emergency departments with possible miscarriage.

Item ID:	48974
Item Type:	Thesis (PhD)
Keywords:	EDs; emergency care; emergency departments; first trimester bleeding; health care; healthcare; hospital treatment; miscarriage; nurses; nursing staff; pregnancy complications; pregnancy; regional cities; remote communities; rural towns; women
Related URLs:	https://researchonline.jcu.edu.au/43884/ https://researchonline.jcu.edu.au/51231/
Additional Information:	This is a thesis by publication. One published article included in chapters 2 has been redacted from the thesis due to copyright restrictions. The full thesis may either be requested via document delivery at your local library or viewed in the Eddie Koiki Mabo Library at JCU, Townsville. Two publications arising from this thesis are stored in ResearchOnline@JCU, at the time of processing. Please see the Related URLs. The publications are: Chapter 2: Edwards, Susan, Birks, Melanie, Chapman, Ysanne, and Yates, Karen (2016) Miscarriage in Australia: the geographical inequity of healthcare services. Australasian Emergency Nursing Journal, 19 (2). pp. 106-111. Chapter 5: Edwards, Susan, Birks, Melanie, Chapman, Ysanne, and Yates, Karen (2018) Bringing together the 'Threads of Care' in possible miscarriage for women, their partners and nurses in non-metropolitan EDs. Collegian, 25 (3). pp. 293-301.
Date Deposited:	24 May 2017 02:49
FoR Codes:	11 MEDICAL AND HEALTH SCIENCES > 1110 Nursing > 111003 Clinical Nursing: Secondary (Acute Care) @ 100%
SEO Codes:	92 HEALTH > 9202 Health and Support Services > 920210 Nursing @ 34% 92 HEALTH > 9202 Health and Support Services > 920206 Health Policy Economic Outcomes @ 33% 92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920506 Rural Health @ 33%
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