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Article ; Online: ‘An extra level of kind of torment’

Rebecca Dennehy / Marita Hennessy / Jennifer Ui Dhubhgain / Con Lucey / Keelin O′Donoghue

Health Expectations, Vol 26, Iss 4, Pp 1768-

Views and experiences of recurrent miscarriage care during the initial phases of COVID‐19 in Ireland—A qualitative interview study

2023 Volume 1782

Abstract: Abstract Introduction Maternity services underwent much change during the COVID‐19 pandemic. Research on the impact on miscarriage care and experiences during this time is sparse. Within a national evaluation of recurrent miscarriage care, we ... ...

Abstract	Abstract Introduction Maternity services underwent much change during the COVID‐19 pandemic. Research on the impact on miscarriage care and experiences during this time is sparse. Within a national evaluation of recurrent miscarriage care, we qualitatively explored stakeholder views and experiences of recurrent miscarriage services in Ireland. This study describes the impact of the COVID‐19 pandemic on those experiences and perceptions of care. Methods People with professional and lived experience of recurrent miscarriage and service engagement were actively involved in this qualitative study from idea generation to analysis and reporting. We recruited women and men with two or more consecutive first‐trimester miscarriages, and people involved in the management/delivery of recurrent miscarriage services and supports. We used purposive sampling to ensure that perspectives across disciplinary or lived experience, geographical, and health service administrative areas, were included. We conducted semi‐structured interviews, virtually all due to COVID‐19 restrictions, between June 2020 and February 2021. These were audio‐recorded, and data were transcribed, and subsequently analyzed using reflexive thematic analysis. Results We interviewed 42 service providers and 13 women and 7 men with experience of recurrent miscarriage. We actively generated two central themes during data analysis. The first—‘Disconnected’—describes how many women navigated miscarriage diagnosis and management and care in subsequent pregnancies alone; many felt that this resulted in increased trauma. At the same time, men struggled with not being present to support their partners and described feeling disconnected. The second theme highlighted ‘The perceived dispensability of recurrent miscarriage services and supports’. Some service providers felt that service reduction and redeployment demonstrated a lack of value in the service. Virtual clinics facilitated access to services, but a preference for in‐person care was highlighted. Conclusion Our ...
Keywords	COVID‐19 ; maternity care ; miscarriage ; pregnancy loss ; qualitative ; recurrent miscarriage ; Medicine (General) ; R5-920 ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2023-08-01T00:00:00Z
Publisher	Wiley
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Factors that shape recurrent miscarriage care experiences

Caragh Flannery / Marita Hennessy / Rebecca Dennehy / Karen Matvienko-Sikar / Con Lucey / Jennifer Ui Dhubhgain / Keelin O’Donoghue

BMC Health Services Research, Vol 23, Iss 1, Pp 1-

findings from a national survey

2023 Volume 10

Abstract: Abstract Background Learning what matters to women/couples with recurrent miscarriage (RM) is essential to inform service improvement efforts and future RM care practices. Previous national and international surveys have examined inpatient stays, ... ...

Abstract	Abstract Background Learning what matters to women/couples with recurrent miscarriage (RM) is essential to inform service improvement efforts and future RM care practices. Previous national and international surveys have examined inpatient stays, maternity care, and care experiences around pregnancy loss, but there is little focus on RM care. We aimed to explore the experiences of women and men who have received RM care and identify patient-centred care items linked to overall RM care experience. Methods Between September and November 2021, we invited people who had experienced two or more consecutive first trimester miscarriages and received care for RM in Ireland in the ten-year period prior to participate in a cross-sectional web-based national survey. The survey was purposefully designed and administered via Qualtrics. It included questions on sociodemographics, pregnancy and pregnancy loss history, investigation and treatment for RM, overall RM care experience, and patient-centred care items at various stages of the RM care pathway such as respect for patients' preferences, information and support, the environment, and involvement of partners/family. We analysed data using Stata. Results We included 139 participants (97% women, n = 135) in our analysis. Of the 135 women, 79% were aged 35–44 years (n = 106), 24% rated their overall RM care experience as poor (n = 32), 36% said the care they received was much worse than expected (n = 48), and 60% stated health care professionals in different places did not work well together (n = 81). Women were more likely to rate a good care experience if they had a healthcare professional to talk to about their worries/fears for RM investigations (RRR 6.11 [95% CI: 1.41–26.41]), received a treatment plan (n = 70) (RRR 3.71 [95% CI: 1.28–10.71]), and received answers they could understand in a subsequent pregnancy (n = 97) (RRR 8 [95% CI: 0.95–67.13]). Conclusions While overall experience of RM care was poor, we identified areas that could potentially improve people’s RM ...
Keywords	Recurrent miscarriage ; Pregnancy loss ; Patient-centred care ; Patient experience ; Care quality ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Development of performance indicators for systems of urgent and emergency care in the Republic of Ireland. Update of a systematic review and consensus development exercise [version 2; peer review

Siobhan Boyle / Rebecca Dennehy / Orla Healy / John Browne

HRB Open Research, Vol

2 approved, 2 approved with reservations]

2019 Volume 1

Abstract: Objectives: To develop a set of performance indicators to monitor the performance of emergency and urgent care systems in the Republic of Ireland. Design: This study comprised of an update of a previously performed systematic review and a formal ... ...

Abstract	Objectives: To develop a set of performance indicators to monitor the performance of emergency and urgent care systems in the Republic of Ireland. Design: This study comprised of an update of a previously performed systematic review and a formal consensus development exercise. The literature search was conducted in PubMed and covered the period 2008 to 2014. The results of the review were used to inform a consensus group of 17 national experts on urgent and emergency care in Ireland. The consensus development exercise comprised an online survey followed by a face-to-face nominal group technique meeting. During this meeting participants had the opportunity to revise their preferences for different indicators after listening to the views of other group members. A final online survey was then used to confirm the preferences of participants. Results: Initial literature searches yielded 2339 article titles. After further searches, sixty items were identified for full-text review. Following this review, fifty-seven were excluded. Three articles were identified for inclusion in the systematic review. These papers produced 42 unique indicators for consideration during the consensus development exercise. In total, 17 indicators had a median of greater than 7 following the meeting and met our pre-specified criterion for acceptable consensus. Discussion: Using this systematic review and nominal group consensus development exercise, we have identified a set of 17 indicators, which a consensus of different experts regard as potentially good measures of the performance of urgent and emergency care systems in Ireland. Pragmatic implications are discussed with reference to three subsequently performed original studies which used some of the indicators
Keywords	Medicine ; R
Subject code	001
Language	English
Publishing date	2019-02-01T00:00:00Z
Publisher	F1000 Research Ltd
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Developing guideline-based key performance indicators for recurrent miscarriage care

Marita Hennessy / Laura Linehan / Rebecca Dennehy / Declan Devane / Rachel Rice / Sarah Meaney / Keelin O’Donoghue

Research Involvement and Engagement, Vol 8, Iss 1, Pp 1-

lessons from a multi-stage consensus process with a diverse stakeholder group

2022 Volume 18

Abstract: Plain English summary Women/couples who have recurrent/repeated miscarriages should receive care that meets their needs, through agreed care pathways. This is often not the case. Key performance indicators (KPIs) are measures of specific elements of care ...

Abstract	Plain English summary Women/couples who have recurrent/repeated miscarriages should receive care that meets their needs, through agreed care pathways. This is often not the case. Key performance indicators (KPIs) are measures of specific elements of care (structures, processes and/or outcomes), which can help us to judge the quality of care given. In this paper, we describe how we worked with women and men with lived experience, doctors, nurses, managers, and others, to develop and agree on a list KPIs for recurrent miscarriage care in Ireland. We will use these to check what services are doing across the country and what could be done better. Participants filled out surveys and took part in meetings to vote on and agree on what KPIs were important to include. They also shared their views and experiences of taking part in this work. Together, we developed 110 KPIs for recurrent miscarriage care. These include measures of how care is structured, counselling and supports, investigations and treatments provided, and health-related outcomes. Participants’ valued the different views that people brought to discussions and what they learned. They suggested ways that the process could be made more participant-friendly. For example, being up-front about the time it would take, explaining medical terms more, and cutting down on the number of items to be rated in surveys. It is important and possible to develop KPIs with different groups, particularly those with lived experience. Learning from our study may help others who want to do similar projects, such as develop KPIs or guidelines for care.
Keywords	Early pregnancy loss ; Care quality ; Quality indicators ; Quality improvement ; Delphi technique ; Patient and public involvement ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	360
Language	English
Publishing date	2022-05-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Publisher Correction to

Marita Hennessy / Laura Linehan / Rebecca Dennehy / Declan Devane / Rachel Rice / Sarah Meaney / Keelin O’Donoghue

Research Involvement and Engagement, Vol 8, Iss 1, Pp 1-

Developing guideline-based key performance indicators for recurrent miscarriage care: lessons from a multi-stage consensus process with a diverse stakeholder group

2022 Volume 2

Keywords	Medicine ; R ; Medicine (General) ; R5-920
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A protocol for a systematic review of clinical practice guidelines for recurrent miscarriage [version 3; peer review

Marita Hennessy / Rebecca Dennehy / Sarah Meaney / Declan Devane / Keelin O'Donoghue

HRB Open Research, Vol

2 approved, 2 approved with reservations]

2020 Volume 3

Abstract: Recurrent miscarriage (RM) was recently re-defined by the European Society of Human Reproduction and Embryology (ESHRE) as the loss of two or more consecutive pregnancies. Before this, and indeed still in some countries, RM was defined as three or more ... ...

Abstract	Recurrent miscarriage (RM) was recently re-defined by the European Society of Human Reproduction and Embryology (ESHRE) as the loss of two or more consecutive pregnancies. Before this, and indeed still in some countries, RM was defined as three or more consecutive pregnancy losses. While the incidence of RM depends on the definition employed and population studied, it is generally accepted to affect 1-6% of women of reproductive age. Clinical practice guidelines (CPGs) for RM have been published by some professional organisations. While there are CPGs on miscarriage in Ireland, there are none concerning RM specifically. The aim of this systematic review is to identify, appraise and describe published CPGs for the management, investigation and/or follow-up of RM within high-income countries. Electronic databases (MEDLINE (Ovid®; 1946), Embase® (Elsevier; 1980), CINAHL Complete (EBSCOhost; 1994), Web of Science™ (Thomson Reuters), Scopus (Elsevier; 2004), and Open Grey (INIST-CNRS; 2011)), selected guideline repositories, and the websites of professional societies will be searched to identify CPGs, published within the last 20 years, for potential inclusion. Two reviewers will review abstracts and full texts independently against the eligibility criteria. Characteristics and recommendations of included CPGs will be extracted by one reviewer and double-checked by another. Two reviewers will use the Appraisal of Guidelines for Research and Evaluation version 2 (AGREE II) instrument independently to assess the quality of the included CPGs. Narrative synthesis will be conducted to appraise and compare CPGs and their recommendations or guidance therein. The identification, appraisal and description of published CPGs in other high-income countries will be a valuable first step in informing efforts to promote the optimisation and standardisation of RM care.
Keywords	Medicine ; R
Subject code	070
Language	English
Publishing date	2020-10-01T00:00:00Z
Publisher	F1000 Research Ltd
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A protocol for a systematic review of clinical practice guidelines for recurrent miscarriage [version 2; peer review

Marita Hennessy / Rebecca Dennehy / Sarah Meaney / Declan Devane / Keelin O'Donoghue

HRB Open Research, Vol

2 approved, 2 approved with reservations]

2020 Volume 3

Abstract	Recurrent miscarriage (RM) was recently re-defined by the European Society of Human Reproduction and Embryology (ESHRE) as the loss of two or more consecutive pregnancies. Before this, and indeed still in some countries, RM was defined as three or more consecutive pregnancy losses. While the incidence of RM depends on the definition employed and population studied, it is generally accepted to affect 1-6% of women of reproductive age. Clinical practice guidelines (CPGs) for RM have been published by some professional organisations. While there are CPGs on miscarriage in Ireland, there are none concerning RM specifically. The aim of this systematic review is to identify, appraise and describe published CPGs for the management, investigation and/or follow-up of RM within high-income countries. Electronic databases (MEDLINE (Ovid®; 1946), Embase® (Elsevier; 1980), CINAHL Complete (EBSCOhost; 1994), Web of Science™ (Thomson Reuters), Scopus (Elsevier; 2004), and Open Grey (INIST-CNRS; 2011)), selected guideline repositories, and the websites of professional societies will be searched to identify CPGs, published within the last 20 years, for potential inclusion. Two reviewers will review abstracts and full texts independently against the eligibility criteria. Characteristics and recommendations of included CPGs will be extracted by one reviewer and double-checked by another. Two reviewers will use the Appraisal of Guidelines for Research and Evaluation version 2 (AGREE II) instrument independently to assess the quality of the included CPGs. Narrative synthesis will be conducted to appraise and compare CPGs and their recommendations or guidance therein. The identification, appraisal and description of published CPGs in other high-income countries will be a valuable first step in informing efforts to promote the optimisation and standardisation of RM care.
Keywords	Medicine ; R
Subject code	070
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	F1000 Research Ltd
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A protocol for a systematic review of clinical practice guidelines for recurrent miscarriage [version 1; peer review

Marita Hennessy / Rebecca Dennehy / Sarah Meaney / Declan Devane / Keelin O'Donoghue

HRB Open Research, Vol

2 approved, 2 approved with reservations]

2020 Volume 3

Abstract	Recurrent miscarriage (RM) was recently re-defined by the European Society of Human Reproduction and Embryology (ESHRE) as the loss of two or more consecutive pregnancies. Before this, and indeed still in some countries, RM was defined as three or more consecutive pregnancy losses. While the incidence of RM depends on the definition employed and population studied, it is generally accepted to affect 1-6% of women of reproductive age. Clinical practice guidelines (CPGs) for RM have been published by some professional organisations. While there are CPGs on miscarriage in Ireland, there are none concerning RM specifically. The aim of this systematic review is to identify, appraise and describe published CPGs for the management, investigation and/or follow-up of RM within high-income countries. Electronic databases (MEDLINE (Ovid®; 1946), Embase® (Elsevier; 1980), CINAHL Complete (EBSCOhost; 1994), Web of Science™ (Thomson Reuters), Scopus (Elsevier; 2004), and Open Grey (INIST-CNRS; 2011)), selected guideline repositories, and the websites of professional societies will be searched to identify CPGs, published within the last 20 years, for potential inclusion. Two reviewers will review abstracts and full texts independently against the eligibility criteria. Characteristics and recommendations of included CPGs will be extracted by one reviewer and double-checked by another. Two reviewers will use the Appraisal of Guidelines for Research and Evaluation version 2 (AGREE II) instrument independently to assess the quality of the included CPGs. Narrative synthesis will be conducted to appraise and compare CPGs and their recommendations or guidance therein. The identification, appraisal and description of published CPGs in other high-income countries will be a valuable first step in informing efforts to promote the optimisation and standardisation of RM care.
Keywords	Medicine ; R
Subject code	070
Language	English
Publishing date	2020-04-01T00:00:00Z
Publisher	F1000 Research Ltd
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Enhancing referral processes within an integrated fall prevention pathway for older people

Caragh Flannery / Sheena McHugh / Eoin Duggan / Patrick Barry / Finola Cronin / Eileen Moriarty / Spencer Turvey / Sarah-Jo Sinnott / Kieran O'Connor / Fiona Riordan / Rebecca Dennehy / Agnes Jonsson / Liz O’Sullivan / Éilis O'Reilly

BMJ Open, Vol 12, Iss

a mixed-methods study

2022 Volume 8

Abstract: Objectives Multifactorial interventions, which involve assessing an individual’s risk of falling and providing treatment or onward referral, require coordination across settings. Using a mixed-methods design, we aimed to develop a process map to examine ... ...

Abstract	Objectives Multifactorial interventions, which involve assessing an individual’s risk of falling and providing treatment or onward referral, require coordination across settings. Using a mixed-methods design, we aimed to develop a process map to examine onward referral pathways following falls risk assessment in primary care.Setting Primary care fall risk assessment clinics in the South of Ireland.Participants Focus groups using participatory mapping techniques with primary care staff (public health nurses (PHNs), physiotherapists (PT),and occupational therapists (OT)) were conducted to plot the processes and onward referral pathways at each clinic (n=5).Methods Focus groups were analysed in NVivo V.12 using inductive thematic analysis. Routine administrative data from January to March 2018 included details of client referrals, assessments and demographics sourced from referral and assessment forms. Data were analysed in Stata V.12 to estimate the number, origin and focus of onward referrals and whether older adults received follow-up interventions. Quantitative and qualitative data were analysed separately and integrated to produce a map of the service.Results Nine staff participated in three focus groups and one interview (PHN n=2; OT n=4; PT n=3). 85 assessments were completed at five clinics (female n=69, 81.2%, average age 77). The average number of risk factors was 5.4 out of a maximum of 10. Following assessment, clients received an average of three onward referrals. Only one-third of referrals (n=135/201, 33%) had data available on intervention receipt. Primary care staff identified variations in how formally onward referrals were managed and barriers, including a lack of client information, inappropriate referral and a lack of data management support.Conclusion Challenges to onward referral manifest early in an integrated care pathway, such as clients with multiple risk factors sent for initial assessment and the lack of an integrated IT system to share information across settings.
Keywords	Medicine ; R
Subject code	360
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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