Browsing by Author "Pumpure, Elizabete"

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    The impact of COVID–19 pandemic and restriction measures on sexual behaviour, couple relationship and psychological well-being in Latvia
    (2021-04-21) Briedīte, Ieva; Ķīvīte-Urtāne, Anda; Lazdāne, Gunta; Rezeberga, Dace; Kantāne, Ināra; Pumpure, Elizabete; Pitkevica, Ieva; Graviņa, Marta Laura; Mihailova, Darja; Rīga Stradiņš University
    Purpose: Since the beginning of COVID-19 restrictions, almost all domains of people’s lives have been affected, including couple and family relationships and sexual life. There are various factors that are likely to influence the partner availability, intimacy, emotional well-being, contraception access and interpersonal tension. Materials and methods: Behavioural cross-sectional online survey (I-SHARE) combined with structured interviews with the aim to determine the impact of COVID-19 social restriction measures on sexual health and psychological well-being and behaviour was conducted. Results and conclusions: Results showed increase of tension and its negative impact on frequency and satisfaction with sex life. Frequency of sexual intercourse decreased more for people who did not live with their partner. Increase of alcohol consumption and loss of job decreased satisfaction with sex life. Controversial data about contraception availability and intimate partner violence were obtained showing no impact in survey, but revealing contraception access restrictions and intimate partner violence increase during qualitative research interviews.
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    Importance of Quality of Maternal and Newborn Care in Childbirth : Findings over Time of the Imagine Euro Study on 40 WHO Standard-Based Quality Measures During the Covid-19 Pandemic in Latvia
    (2024-02-01) Knoka, Anna Regīna; Pumpure, Elizabete; Matroze, Asnate; Jakovicka, Dārta; Mariani, Ilaria; Vaska, Agnija; Covi, Benedetta; Valente, Emanuelle Pessa; Jansone-Šantare, Gita; Vilcāne, Katrīna Paula; Rezeberga, Dace; Lazzerini, Marzia; Department of Obstetrics and Gynaecology; Rīga Stradiņš University
    The objectives of the study were to investigate the quality of maternal and newborn care (QMNC) from the view of mothers who gave birth in a healthcare facility during the COVID-19 pandemic in Latvia. An online questionnaire survey was conducted in Latvia from 1 March 2020 to 28 October 2021, which was based on 40 World Health Organisation (WHO) Standard-based Quality measures. In addition, descriptive and multivariate quantile regression analyses were performed to compare the years 2020 and 2021. A total of 2079 women participated in the study, of whom 833 gave birth in 2020 — of them, 648 had a vaginal delivery, and 185 had a cesarean section, and 1205 women gave birth in 2021, 979 with a vaginal delivery, and 226 with a cesarean section. A lower QMNC during the COVID-19 pandemic was reported by 29.8% and 24.5% of respondents in 2020 and 2021. The total QMNC Index was notably higher in 2021 compared to 2020. This study showed essential gaps in the QMNC in Latvia perceived by mothers, while observing a slight increase in quality in 2021. Therefore, strategies to improve mothers' and newborns' health care should be introduced as soon as possible.
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    Individual and country-level variables associated with the medicalization of birth : Multilevel analyses of IMAgiNE EURO data from 15 countries in the WHO European region
    (2022-12) IMAgiNE EURO study group; Miani, Céline; Wandschneider, Lisa; Pumpure, Elizabete; Jakovicka, Dārta; Rezeberga, Dace; Department of Obstetrics and Gynaecology; Faculty of Medicine
    OBJECTIVE: To investigate potential associations between individual and country-level factors and medicalization of birth in 15 European countries during the COVID-19 pandemic. METHODS: Online anonymous survey of women who gave birth in 2020-2021. Multivariable multilevel logistic regression models estimating associations between indicators of medicalization (cesarean, instrumental vaginal birth [IVB], episiotomy, fundal pressure) and proxy variables related to care culture and contextual factors at the individual and country level. RESULTS: Among 27 173 women, 24.4% (n = 6650) had a cesarean and 8.8% (n = 2380) an IVB. Among women with IVB, 41.9% (n = 998) reported receiving fundal pressure. Among women with spontaneous vaginal births, 22.3% (n = 4048) had an episiotomy. Less respectful care, as perceived by the women, was associated with higher levels of medicalization. For example, women who reported having a cesarean, IVB, or episiotomy reported not feeling treated with dignity more frequently than women who did not have those interventions (odds ratio [OR] 1.37; OR 1.61; OR 1.51, respectively; all: P < 0.001). Country-level variables contributed to explaining some of the variance between countries. CONCLUSION: We recommend a greater emphasis in health policies on promotion of respectful and patient-centered care approaches to birth to enhance women's experiences of care, and the development of a European-level indicator to monitor medicalization of reproductive care.
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    Management of a primary malignant melanoma of uterine cervix stage IVA patient with radical surgery and adjuvant oncolytic virus Rigvir(R) therapy: A case report.
    (2020-05-22) Pumpure, Elizabete; Dručka, Eva; Kigitoviča, Dana; Meškauskas, Raimundas; Isajevs, Sergejs; Nemiro, Ineta; Rasa, Agnija; Olmane, Evija; Zablocka, Tatjana; Alberts, Pēteris; Doniņa, Simona
    Primary malignant melanoma of the uterine cervix is a rare disease with poor prognosis and high recurrence rate. We used Rigvir® as adjuvant therapy for a stage IVA patient. Tolerability, overall and progression-free survival are good.
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    Relationship between pregnant women and their partners during COVID-19 and the role of accompanying persons during childbirth
    (2021-06-07) Pumpure, Elizabete; Rezeberga, Dace; Lazdane, Gunta; Briedite, Ieva; Mihailova, Darja; Pitkevica, Ieva; Gravina, Laura Marta; Olsena, Solvita; Kantane, Inara; Ķīvīte-Urtāne, Anda; Institute of Public Health; Department of Obstetrics and Gynaecology
    Objective: Although the World Health Organization (WHO) recommends the presence of a support person, several hospitals in Latvia have restricted the presence of supporting persons due to COVID-19. This study was conducted to understand the importance of partnership and the role of the accompanying person in childbirth in the context of COVID-19 in Latvia.Methods: A mixed method study with sequential explanatory design was conducted from 26 July to 30 October 2020. The quantitative study consisted of a behavioral cross-sectional online survey with convenience sampling. The survey items, methods, and implementation were performed as part of the I-SHARE study carried out in 33 countries, with standardized survey instruments that were focused on sexual and reproductive health issues. In Latvia it was supported by the National Research Program to lessen the effects of COVID-19. Our study analyses only one part of all data. To answer the research question besides quantitative data the qualitative study that consisted of 7 semi-structured in-depth interviews and 11 focus group discussions was integrated.Results: 1,173 people of Latvia have participated in the I-SHARE online survey. The answers of 662 women of reproductive age and 70 pregnant women have been analyzed. Pregnant women had less tension with their partners and received higher partner emotional support before the COVID-19 pandemic than other women of reproductive age, and pregnant women were less frustrated during COVID-19 than non-pregnant women of reproductive age (p < .05). More than half (61.4%) of the pregnant women felt anxiety and depression due to COVID-19 restrictions. The qualitative part of the study revealed that having a partner during childbirth was an important aspect when choosing a facility to give birth in, as the lack of an accompanying person caused anxiety and additional stress.Conclusions: COVID-19 has increased anxiety and depression among pregnant women. Birth companions should not be considered third parties, and establishing a delivery unit visitor policy is necessary to balance the benefits and risks in an evidence-based and compassionate manner.
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    Socioeconomic Factors and Changes in Food Choice and Availability During COVID-19 Restrictions in Latvia
    (2022-02-01) Pitkēviča, Ieva; Pumpure, Elizabete; Graviņa, Marta Laura; Mihailova, Darja; Briedīte, Ieva; Rezeberga, Dace; Kantāne, Ināra; Ķīvīte-Urtāne, Anda; Lazdāne, Gunta; Rīga Stradiņš University
    The COVID-19 pandemic changed the life of many. The study aimed to identify fragile groups ofthe population regarding nutrition during the COVID-19 restriction period. An online survey wasconducted from 26 July to 3 September 2020. A total of 1173 answers were received from per-sons aged 18–68 years living in Latvia. The results showed that food availability mainly was notlimited, although for 15.3% responders restrictions caused increased worries about not havingenough food, and 12.2% noted a decrease in the ability to eat preferred food. Responders aged40–54 noted that they ate less, and that their food stocks were scarce in comparison with otherage groups. Almost 50% of responders increased food consumption. One-fifth of responders in-creased consumption of foods of low nutritional value, especially among 25–39 year old personsand in households where the economic situation became worse. Fragile groups regarding nutri-tion in times of COVID-19 restrictions included households whose economic situation becameworse during the COVID-19 restrictions, younger people who increased food consumption to-gether with consumption of food of low nutritional value, and persons aged 40–54 years. The datafrom the study serve as an indicator that more detailed research is needed to determine whethercrises such as the COVID-19 pandemic are changing dietary habits and food availability in thepopulation.
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    WHO Standards-based questionnaire to measure health workers' perspective on the quality of care around the time of childbirth in the WHO European region : development and mixed-methods validation in six countries
    (2022-04-08) Valente, Emanuelle Pessa; IMAgiNE EURO study group; Pumpure, Elizabete; Rezeberga, Dace; Vaska, Agnija; Jakovicka, Dārta; Rudzīte, Paula; Ērmane, Elīna; Vilcāne, Katrīna Paula; Department of Obstetrics and Gynaecology; Faculty of Medicine
    OBJECTIVES: Develop and validate a WHO Standards-based online questionnaire to measure the quality of maternal and newborn care (QMNC) around the time of childbirth from the health workers' perspective. DESIGN: Mixed-methods study. SETTING: Six countries of the WHO European Region. PARTICIPANTS AND METHODS: The questionnaire is based on lessons learnt in previous studies, and was developed in three sequential phases: (1) WHO Quality Measures were prioritised and content, construct and face validity were assessed through a Delphi involving a multidisciplinary board of experts from 11 countries of the WHO European Region; (2) translation/back translation of the English version was conducted following The Professional Society for Health Economics and Outcomes Research guidelines; (3) internal consistency, intrarater reliability and acceptability were assessed among 600 health workers in six countries. RESULTS: The questionnaire included 40 items based on WHO Standards Quality Measures, equally divided into four domains: provision of care, experience of care, availability of human and physical resources, organisational changes due to COVID-19; and its organised in six sections. It was translated/back translated in 12 languages: Bosnian, Croatian, French, German, Italian, Norwegian, Portuguese, Romanian, Russian, Slovenian, Spanish and Swedish. The Cronbach's alpha values were ≥0.70 for each questionnaire section where questions were hypothesised to be interrelated, indicating good internal consistence. Cohen K or Gwet's AC1 values were ≥0.60, suggesting good intrarater reliability, except for one question. Acceptability was good with only 1.70% of health workers requesting minimal changes in question wording. CONCLUSIONS: Findings suggest that the questionnaire has good content, construct, face validity, internal consistency, intrarater reliability and acceptability in six countries of the WHO European Region. Future studies may further explore the questionnaire's use in other countries, and how to translate evidence generated by this tool into policies to improve the QMNC. TRAIL REGISTRATION NUMBER: NCT04847336.
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    Women's perspectives on the quality of maternal and newborn care in childbirth during the COVID-19 pandemic in Latvia : Results from the IMAgiNE EURO study on 40 WHO standards-based quality measures
    (2022-12) Pumpure, Elizabete; Jakovicka, Dārta; Mariani, Ilaria; Vaska, Agnija; Covi, Benedetta; Valente, Emanuelle Pessa; Jansone-Šantare, Gita; Knoka, Anna Regīna; Vilcāne, Katrīna Paula; Rezeberga, Dace; Lazzerini, Marzia; IMAgiNE EURO study group; Department of Obstetrics and Gynaecology; Faculty of Medicine
    OBJECTIVE: To investigate women's perspectives on the quality of maternal and newborn care (QMNC) around the time of childbirth during the COVID-19 pandemic in Latvia, comparing the years 2020 and 2021, among women who went into labor or had a prelabor cesarean. METHODS: Women giving birth in healthcare facilities in Latvia from March 1, 2020, to October 28, 2021, answered an online questionnaire including 40 WHO standards-based quality measures. Descriptive and multivariate quantile regression analyses were performed to compare QMNC in 2020 and 2021. RESULTS: 2079 women were included in the analysis: 1860 women who went into labor (group 1) and 219 with prelabor cesarean (group 2). Among group 1, 66.4% (n = 99/149) of women received fundal pressure in an instrumental vaginal birth, 43.5% (n = 810) lacked involvement in choices, 17.4% (n = 317) reported suffering abuse, 32.7% (n = 609) reported inadequate breastfeeding support while 5.2% (n = 96) lack of early breastfeeding. A significant reduction in QMNC due to the COVID-19 pandemic was reported by 29.5% (n = 219) and 25.0% (n = 270) of respondents in 2020 and 2021, respectively (P = 0.045). Multivariate analyses highlighted a significantly lower QMNC index for 2020 compared with 2021 (P < 0.001). CONCLUSION: This first study investigating QMNC in Latvia showed significant gaps in QMNC perceived by respondents, with slightly better results in 2021. Appropriate healthcare strategies to improve health care for women and newborns in Latvia are required. CLINICALTRIALS: gov Identifier:NCT04847336.