Reconceptualising risk: Perceptions of risk in rural and remote maternity service planning.

Barclay, L; Kornelsen, J; Longman, J; Robin, S; Kruske, S; Kildea, S; Pilcher, J; Martin, T; Grzybowski, S; Donoghue, D; Rolfe, M; Morgan, G

Reconceptualising risk: Perceptions of risk in rural and remote maternity service planning.

Barclay, L

Kornelsen, J Longman, J Robin, S Kruske, S

Kildea, S Pilcher, J Martin, T Grzybowski, S Donoghue, D Rolfe, M Morgan, G

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Publisher:: ELSEVIER SCI LTD
Publication Type:: Journal Article
Citation:: Midwifery, 2016, 38, pp. 63-70
Issue Date:: 2016-07

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Field	Value	Language
dc.contributor.author	Barclay, L https://orcid.org/0000-0002-9345-3468
dc.contributor.author	Kornelsen, J
dc.contributor.author	Longman, J
dc.contributor.author	Robin, S
dc.contributor.author	Kruske, S https://orcid.org/0000-0002-2317-3954
dc.contributor.author	Kildea, S
dc.contributor.author	Pilcher, J
dc.contributor.author	Martin, T
dc.contributor.author	Grzybowski, S
dc.contributor.author	Donoghue, D
dc.contributor.author	Rolfe, M
dc.contributor.author	Morgan, G
dc.date.accessioned	2022-08-16T21:02:26Z
dc.date.available	2016-04-15
dc.date.available	2022-08-16T21:02:26Z
dc.date.issued	2016-07
dc.identifier.citation	Midwifery, 2016, 38, pp. 63-70
dc.identifier.issn	0266-6138
dc.identifier.issn	1532-3099
dc.identifier.uri	http://hdl.handle.net/10453/160383
dc.description.abstract	OBJECTIVE: to explore perceptions and examples of risk related to pregnancy and childbirth in rural and remote Australia and how these influence the planning of maternity services. DESIGN: data collection in this qualitative component of a mixed methods study included 88 semi-structured individual and group interviews (n=102), three focus groups (n=22) and one group information session (n=17). Researchers identified two categories of risk for exploration: health services risk (including clinical and corporate risks) and social risk (including cultural, emotional and financial risks). Data were aggregated and thematically analysed to identify perceptions and examples of risk related to each category. SETTING: fieldwork was conducted in four jurisdictions at nine sites in rural (n=3) and remote (n=6) Australia. PARTICIPANTS: 117 health service employees and 24 consumers. MEASUREMENTS AND FINDINGS: examples and perceptions relating to each category of risk were identified from the data. Most medical practitioners and health service managers perceived clinical risks related to rural birthing services without access to caesarean section. Consumer participants were more likely to emphasise social risks arising from a lack of local birthing services. KEY CONCLUSIONS: our analysis demonstrated that the closure of services adds social risk, which exacerbates clinical risk. Analysis also highlighted that perceptions of clinical risk are privileged over social risk in decisions about rural and remote maternity service planning. IMPLICATIONS FOR PRACTICE: a comprehensive analysis of risk that identifies how social and other forms of risk contribute to adverse clinical outcomes would benefit rural and remote people and their health services. Formal risk analyses should consider the risks associated with failure to provide birthing services in rural and remote communities as well as the risks of maintaining services.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	ELSEVIER SCI LTD
dc.relation.ispartof	Midwifery
dc.relation.isbasedon	10.1016/j.midw.2016.04.007
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1110 Nursing, 1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services
dc.subject.classification	Nursing
dc.subject.mesh	Australia
dc.subject.mesh	Birthing Centers
dc.subject.mesh	Cesarean Section
dc.subject.mesh	Cultural Competency
dc.subject.mesh	Female
dc.subject.mesh	Focus Groups
dc.subject.mesh	Health Facility Closure
dc.subject.mesh	Health Knowledge, Attitudes, Practice
dc.subject.mesh	Health Planning
dc.subject.mesh	Health Services Accessibility
dc.subject.mesh	Humans
dc.subject.mesh	Interviews as Topic
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Patient Safety
dc.subject.mesh	Pregnancy
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Risk Assessment
dc.subject.mesh	Rural Health Services
dc.subject.mesh	Rural Population
dc.subject.mesh	Humans
dc.subject.mesh	Cesarean Section
dc.subject.mesh	Focus Groups
dc.subject.mesh	Risk Assessment
dc.subject.mesh	Health Knowledge, Attitudes, Practice
dc.subject.mesh	Pregnancy
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Rural Population
dc.subject.mesh	Birthing Centers
dc.subject.mesh	Health Facility Closure
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Rural Health Services
dc.subject.mesh	Health Planning
dc.subject.mesh	Health Services Accessibility
dc.subject.mesh	Australia
dc.subject.mesh	Female
dc.subject.mesh	Interviews as Topic
dc.subject.mesh	Cultural Competency
dc.subject.mesh	Patient Safety
dc.title	Reconceptualising risk: Perceptions of risk in rural and remote maternity service planning.
dc.type	Journal Article
utslib.citation.volume	38
utslib.location.activity	Scotland
utslib.for	1110 Nursing
utslib.for	1114 Paediatrics and Reproductive Medicine
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	open_access	*
dc.date.updated	2022-08-16T21:02:24Z
pubs.publication-status	Published
pubs.volume	38

Abstract:

OBJECTIVE: to explore perceptions and examples of risk related to pregnancy and childbirth in rural and remote Australia and how these influence the planning of maternity services. DESIGN: data collection in this qualitative component of a mixed methods study included 88 semi-structured individual and group interviews (n=102), three focus groups (n=22) and one group information session (n=17). Researchers identified two categories of risk for exploration: health services risk (including clinical and corporate risks) and social risk (including cultural, emotional and financial risks). Data were aggregated and thematically analysed to identify perceptions and examples of risk related to each category. SETTING: fieldwork was conducted in four jurisdictions at nine sites in rural (n=3) and remote (n=6) Australia. PARTICIPANTS: 117 health service employees and 24 consumers. MEASUREMENTS AND FINDINGS: examples and perceptions relating to each category of risk were identified from the data. Most medical practitioners and health service managers perceived clinical risks related to rural birthing services without access to caesarean section. Consumer participants were more likely to emphasise social risks arising from a lack of local birthing services. KEY CONCLUSIONS: our analysis demonstrated that the closure of services adds social risk, which exacerbates clinical risk. Analysis also highlighted that perceptions of clinical risk are privileged over social risk in decisions about rural and remote maternity service planning. IMPLICATIONS FOR PRACTICE: a comprehensive analysis of risk that identifies how social and other forms of risk contribute to adverse clinical outcomes would benefit rural and remote people and their health services. Formal risk analyses should consider the risks associated with failure to provide birthing services in rural and remote communities as well as the risks of maintaining services.

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http://hdl.handle.net/10453/160383