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Abstract
Objectives Supportive and palliative care include non-oncology settings where patients suffer from pain and quality of life-related concerns. Integrative medicine plays important roles in supportive care and symptom management, including Integrative Obstetric (IOb) programmes within peri-partum settings. Multidisciplinary approaches may help nurse-midwives and obstetricians improve patient care and associated outcomes. This study presents a national perspective on IOb programmes in Israel.
Methods A qualitative research methodology was codesigned by the Society for Complementary Medicine and Society of Maternal-Fetal Medicine, Israel Medical Association. A questionnaire with 17 open-ended questions was distributed throughout obstetrics and gynaecology departments across Israel. Respondent narratives were qualitatively analysed using ATLAS.Ti software for systematic coding.
Results 22 senior obstetricians and IOb directors across 11 centres with IOb programmes completed the questionnaire. Core themes considered essential for the design and operation of IOb programmes included (1) determining major goals and indications for referral, primarily pain and anxiety; (2) targeting patients most likely to benefit; (3) identifying barriers and enablers to implementation and communication with the obstetric team; (4) designing the referral process and (5) documenting outcomes and safety of the IOb intervention in electronic medical files.
Conclusions Designing and implementing IOb models of care that effectively support holistic symptom management within obstetric settings requires identifying barriers and enablers and establishing effective communication between obstetric and integrative medical teams. Further research should explore other multidisciplinary models of IOb care and structured referral development and testing while assessing risks and effectiveness.
- Integrative Medicine
- Complementary therapy
Data availability statement
Data are available upon request.
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Data availability statement
Data are available upon request.
Footnotes
X @BRosa_PhD
EB-A and TB-S contributed equally.
Contributors EB-A planned, designed and organised the trial as well as collected the data analysed and reported of the work in this manuscript. TB-S planned, designed and organised the trial. WER revised the manuscript. NS wrote the draft manuscript. OL collected the data analysed and reported of the work in this manuscript. YK analysed the qualitative data. SA collected the data analysed and reported of the work in this manuscript. OG collected the data analysed and reported of the work in this manuscript. RK collected the data analysed and reported of the work in this manuscript. AM collected the data analysed and reported of the work in this manuscript. RLA collected the data analysed and reported of the work in this manuscript. AL collected the data analysed and reported of the work in this manuscript. NA collected the data analysed and reported of the work in this manuscript. BBZ collected the data analysed and reported of the work in this manuscript. CFS collected the data analysed and reported of the work in this manuscript. IS collected the data analysed and reported of the work in this manuscript. HY collected the data analysed and reported of the work in this manuscript. GSM collected the data analysed and reported of the work in this manuscript. ML collected the data analysed and reported of the work in this manuscript. EM-S collected the data analysed and reported of the work in this manuscript. DKS collected the data analysed and reported of the work in this manuscript. GS collected the data analysed and reported of the work in this manuscript. RBZ collected the data analysed and reported of the work in this manuscript. MLS collected the data analysed and reported of the work in this manuscript. BZ collected the data analysed and reported of the work in this manuscript. SS collected the data analysed and reported of the work in this manuscript. ES planned, designed and organised the trial. All authors participated in the revision of the manuscript. EB-A is the guarantor.
Funding WER is partially supported by the NCI/NIH comprehensive cancer centre award P30 CA008748.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.
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