Information-seeking barriers and strategies in maternity care: a framework analysis of nurses’ goals, plans, and actions

ABSTRACT

Background

There is limited understanding about informational barriers that nurses face when assessing obstetric patients and the strategies they use to obtain and elicit disclosure of potentially sensitive health information. Using framework analysis and goals-plans-actions theory, this study qualitatively explores the perspectives of nurses, nurse practitioners, and midwives on these processes and strategies.

Methods

This study utilizes framework analysis to analyze in-depth interviews with 22 nurses working in the field of obstetric and intrapartum care.

Results

Two overarching themes regarding barriers to disclosure and six themes regarding strategies to address these barriers emerged. Barriers included intentional self-concealment and unintentional omission of information. Strategies to overcome these barriers include education, rapport building, strategic questioning, creating a zone of privacy, seeking out information from other sources, and postnatal debriefing sessions.

Conclusion

This study provides greater insight into the types of barriers that may prevent pregnant people from disclosing their health information, as well as communicative strategies on how to elicit sensitive health information. Nurses’ responses highlight their reliance on patients, as well as on other sources of information when encountering patient reticence. Framework analysis points to four overarching strategic implications for communicative practices in health care settings: creating mutual understanding, creating rapport, creating privacy, and creating more empowered and informed patients.

KEYWORDS:

• Obstetric nursing
• nurse-patient relations
• information seeking behavior
• disclosure
• pregnancy
• self-concealment
• framework analysis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was supported by the MT-Internal Grant Opportunities award (MT-IGO) grant at Middle Tennessee State University, index no. 221724.

Notes on contributors

Elizabeth D. Dalton

Elizabeth D. Dalton, Ph.D., is an Assistant Professor at Middle Tennessee State University where she teaches in the Communication Studies department. Her research examines uncertainty, uncertainty management, and disclosure in the contexts of women’s health and nurse-patient communication. She also examines sexual scripts and refusal processes in emerging adults.

Laura E. Miller

Laura E. Miller, Ph.D., is an Associate Professor in the School of Communication Studies at the University of Tennessee. Her research examines interpersonal and health communication, focusing specifically on uncertainty management, disclosure, and family relationships in health contexts. Her recent research has been published in Communication Monographs, Health Communication, and the Journal of Social and Personal Relationships.

Ivanka Pjesivac

Ivanka Pjesivac, Ph.D., is an Associate Professor at the University of Georgia in the College of Journalism and Mass Communication. Her research focuses on international communication, media trust and credibility, and effects of digital content, including health outcomes. Her research has been published in major journalism and mass communication journals and presented at leading national and international conferences.

Scott A. Eldredge

Scott A. Eldredge, Ph.D., is an Associate Professor in the Communication Department at Western Carolina University. He conducts research in the areas of relationships and health and patient-provider interaction. Specifically, he examines issues involving intimacy, uncertainty, trust, and relational development and maintenance.