{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T17:04:00Z","timestamp":1781802240921,"version":"3.54.5"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,11,6]],"date-time":"2017-11-06T00:00:00Z","timestamp":1509926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["#1024206"],"award-info":[{"award-number":["#1024206"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To study rheumatic heart disease health literacy and its impact on pregnancy, and to identify how health services could more effectively meet the needs of pregnant women with rheumatic heart disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Researchers observed and interviewed a small number of Aboriginal women and their families during pregnancy, childbirth and postpartum as they interacted with the health system. An Aboriginal Yarning method of relationship building over time, participant observations and interviews with Aboriginal women were used in the study. The settings were urban, island and remote communities across the Northern Territory. Women were followed interstate if they were transferred during pregnancy. The participants were pregnant women and their families. We relied on participants\u2019 abilities to tell their own experiences so that researchers could interpret their understanding and perspective of rheumatic heart disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Aboriginal women and their families rarely had rheumatic heart disease explained appropriately by health staff and therefore lacked understanding of the severity of their illness and its implications for childbearing. Health directives in written and spoken English with assumed biomedical knowledge were confusing and of limited use when delivered without interpreters or culturally appropriate health supports.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite previous studies documenting poor communication and culturally inadequate care, health systems did not meet the needs of pregnant Aboriginal women with rheumatic heart disease. Language\u2010appropriate health education that promotes a shared understanding should be relevant to the gender, life\u2010stage and social context of women with rheumatic heart disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12744","type":"journal-article","created":{"date-parts":[[2017,11,6]],"date-time":"2017-11-06T07:50:44Z","timestamp":1509954644000},"page":"425-431","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Rheumatic heart disease in pregnancy: How can health services adapt to the needs of Indigenous women? A qualitative study"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3418-2298","authenticated-orcid":false,"given":"Suzanne","family":"Belton","sequence":"first","affiliation":[{"name":"Rheumatic Heart Disease Menzies School of Health Research Global &amp; Tropical Health  Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Kruske","sequence":"additional","affiliation":[{"name":"Maternal and Child Health Institute for Urban Indigenous Health University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Jackson Pulver","sequence":"additional","affiliation":[{"name":"Pro\u2010Vice Chancellor Engagement and Aboriginal &amp; Torres Strait Islander Leadership Western Sydney University  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juanita","family":"Sherwood","sequence":"additional","affiliation":[{"name":"National Centre for Cultural Competence The University of Sydney  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kylie","family":"Tune","sequence":"additional","affiliation":[{"name":"Rheumatic Heart Disease Australia Menzies School of Health Research  Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Carapetis","sequence":"additional","affiliation":[{"name":"Telethon Kids Institute  Perth WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldine","family":"Vaughan","sequence":"additional","affiliation":[{"name":"Australasian Maternity Outcomes Surveillance System (AMOSS) Faculty of Health University of Technology Sydney  Ultimo NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Peek","sequence":"additional","affiliation":[{"name":"Australian National University and The Canberra Hospital  Canberra ACT Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"McLintock","sequence":"additional","affiliation":[{"name":"National Women's Health Auckland City Hospital  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Faculty of Health University of Technology Sydney  Ultimo, Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,6]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"RHDAustralia (ARF\/RHD writing group).The Australian Guideline for Prevention Diagnosis and Management of Acute Rheumatic Fever and Rheumatic Heart Disease.Casuarina NT:RHDAustralia National Heart Foundation and the Cardiac Society of Australia and New Zealand 2012."},{"key":"e_1_2_7_3_1","volume-title":"Rheumatic Heart Disease in Pregnancy in Australia: A Population Study","author":"On behalf of the AMOSS Investigators","year":"2016"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/1753-6405.12112"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61972-8"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.72.6.1155"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.3175"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja15.00139"},{"key":"e_1_2_7_9_1","first-page":"114","volume-title":"Experience of Married Women with Rheumatic Heart Disease","author":"Atnafe 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