Patty,
Interesting approach to use the word "optimality", if it is indeed an
English word, but it is a noun and not an adjective. Women can be healthy
or unhealthy, and care can aim to maintain or even improve health, but
women cannot be defined as "optimised", though in French the word
"optimalisation" means augmentation of labour in the context of pregnancy.
A bit confusing.
In the context of my own research, I preferred to used the terms "healthy"
or "suitable for midwifery led care" rather than "low risk". But there is
no way that I could define a woman as "optimised". Ii have to admit that
these women were identified through a series of exclusion criteria so that
women who could not be said to be suitable for exclusive midwifery care
were excluded from the study. I am sure that defining inclusion criteria
would be much more difficult, and to comment on a question from Soo,
interpretations would probably vary substantially, but I have not had time
to check this out, so it is just a personal opinion.
Marianne Mead
At 15:15 15-01-03 -0500, you wrote:
>The problem with useing the concept "healthy" is that if you do not have it
>you are "unhealthy" or "pathological". We used the concept developed in
>Holland - optimality. It sounds a bit crazy but it avoids the whole notion
>of pathology around birth.
>Patty
>----- Original Message -----
>From: "Soo Downe" <[log in to unmask]>
>To: <[log in to unmask]>
>Sent: Tuesday, January 14, 2003 4:45 PM
>Subject: Re: Fw: Outcome data
>
>
>> rosalee, this is of interest to us in the light of some work that a number
>of us are trying to do both in the context of outcome measures, and of
>minimum data sets to measure 'normal birth' (whatever that is). Do you think
>that the term 'healthy' is interpreted in a common manner, both between
>midwives, and between midwives, obstetricans and women? some of the work i
>am involved in suggests that womens interpretation of wellbeing may well be
>very different from that of professional groups. This may affect the kinds
>of outcomes used to measure 'health'. did you find anything which may chime
>with these findings?
>>
>> all the best
>>
>> Soo
>>
>> Dr Soo Downe
>> Director
>> Research in Childbearing and Health (ReaCH) group
>> Midwifery Studies Research Unit
>> University of Central Lancashire
>> Preston PR1 2HE
>> Lancs
>> England
>>
>> tel: 01772 893815
>>
>> >>> [log in to unmask] 12/17/02 10:38pm >>>
>> Jane, my doctoral work was looking at midwifery indicators and outcomes.
>> Although the work is yet unfinished, I would be happy to discuss it
>further.
>>
>> There is a deal of difficulty in differentiating between medical and
>midwifery outcomes, and I found that for both of these groups the ultimate
>outcome is "healthy mother, healthy baby" and the indicators linked to this.
>> The main difference between midwifery and medicine is not in the ultimate
>aim, but in the process, and so I am finding that process indicators are
>much more relevant, e.g. the use of chemical pain management is one example.
>>
>> Happy to discuss this further if its useful.
>> Rosalee
>>
>> >>> [log in to unmask] 12/17/02 06:33PM >>>
>> I have forwarded this message on behalf of a query to ICM. Please send
>replies to list and I will collate, and return to the list and the original
>sender.
>> Jane Sandall - list moderator
>>
>> -----Original Message-----
>>
>>
>> Pam McQuide and I are working on a paper re: nursing and midwifery
>outcomes. Do you have any recommendations regarding literature of midwifery
>outcomes or cost comparisons across different types of care providers.
>Finding good conclusive studies in the literature has been difficult.
>>
>> Any suggestions would be welcome. Thanks for your help. Judy
>
>
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