Salutogenically focused outcomes in systematic reviews of intrapartum interventions: A systematic review of systematic reviews

• Introduction: Salutogenesis explores health systematically in terms of movement along the health continuum, thereby eliminating a distinct dichotomy of being in a state of health or being in a state of disease. Currently there is little understanding of what constitutes salutogenically focused outcomes in maternity care. In evaluating current maternity care intrapartum intervention-based research, a systematic review of reviews, to determine the type and number of salutogenically-focused reported outcomes, was performed. Aim: To present the findings of this systematic review of systematic reviews. Methodology: Systematic reviews of randomsied trials of intrapartum interventions were eligible for inclusion. Protocols for systematic reviews and systematic reviews that had been withdrawn were excluded. Issue 9, 2011 of the Cochrane Database of Systematic Reviews was searched for all reviews published by the Cochrane Pregnancy and Childbirth Group using the group filter “hm-preg”. At least two review authors independently reviewed each review for inclusion and extracted the data using a purposively designed data extraction form. Any disagreements were resolved through within pair discussions or deferral to the team for consensus. Unique lists of salutogenically-focused and non-salutogenically-focused outcome categories were identified. Ethical approval: Not applicable. Findings: A total of 102 reviews were included. 135 salutogenically-focused outcomes were identified and collapsed into 16 outcome categories. Examples include maternal satisfaction, spontaneous vaginal birth, maternal parenting confidence and breastfeeding. 1632 non-salutogenically-focused outcomes, collapsed into 49 outcome categories, were identified. Examples include preterm birth, instrumental birth and neonatal death. Conclusion: The findings of this review support the hypothesis that the effectiveness of intrapartum interventions is measured against adverse outcomes rather than increases in measures of health and wellbeing. Given the relative absence of salutogenically-focused reported outcomes identified in this systematic review of reviews, the development of a core dataset of salutogenic outcomes for reporting in maternity care research, is recommended.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Annan medicin och hälsovetenskap (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Other Medical and Health Sciences (hsv//eng)

Nyckelord

salutogenetic

systematic review

outcome

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