Nursing for Women''s Health最新文献

Objective: To explore Thai health care providers' perceptions of screening for intimate partner violence (IPV).

Design: This study used a qualitative approach to explore Thai health care providers' perceptions of IPV screening.

Setting: Four focus groups of health care providers working in secondary and tertiary hospitals in northeast Thailand.

Participants: Thirty-two health care providers (30 nurses and 2 social workers) experienced in women's health care and working in hospitals in northeast Thailand.

Results: Findings reflected four categories: The Importance of Screening for IPV, Factors Related to IPV Screening, Barriers to IPV Screening, and Strategies to Promote IPV Screening.

Conclusion: Our results highlight the significance of IPV screening in connecting survivors to help; challenges faced by providers, such as cultural norms and lack of training; and recommendations for policymakers to enhance IPV screening in Thailand.

Clinical practice manuscripts present current evidence-based information for nurses that can be incorporated into practice.

Objective: To assess the impact of a pharmacist-mediated education program on menstrual hygiene among adolescent girls in and around Balagangadaranatha (BG) Nagara, India.

Design: Pre- and postintervention study conducted over 6 months.

Setting/local problem: Adolescent girls in India, especially in rural areas, may lack proper knowledge and a supportive atmosphere to deal with menstruation-related concerns. Many myths and taboos also make it difficult or impossible to find accurate information about menstruation and menstrual hygiene.

Participants: The sample included 585 female high school students who had begun menstruation and lived in and around BG Nagara, India.

Intervention: An educational training session provided information about the menstrual cycle, sanitary products, proper disposal practices, and menstrual disorders. Information addressed the psychological and social dimensions of menstruation to mitigate stigma. Educational leaflets about personal menstruation hygiene practices were also provided.

Results: Pre- and posttests were administered to assess participants' knowledge of and practices regarding menstrual hygiene. Pretest scores indicated that 43.8% (n = 164) of participants had good knowledge of menstruation, 86% (n = 503) used sanitary pads, and 73.2% (n = 428) thought that increasing nutritious food was necessary during menstruation. Posttest scores indicated an increase in all areas (p < .001).

Conclusion: Health education was associated with an improvement in female high school students' knowledge of and practices related to menstrual hygiene. More menstrual health education strategies and awareness programs are needed to improve the knowledge and health of adolescent girls.

Objective: To explore the experience of pregnancy among adolescent girls ages 16 to 19 years in Jordan.

Design: Descriptive exploratory qualitative design.

Setting: Participants were recruited from antenatal clinics and postpartum wards in Ministry of Health primary health care clinics and hospitals across Jordan. This included a wide geographic area in Jordan that covered several cities: Amman, Zarqa, Irbid, As-Salt, and others.

Participants: The total number of participants was 13. Most participants were primiparous, and three were multiparous. Five participants were recruited during the postpartum period, seven in the second and third trimester, and one during the first trimester.

Measurements: Data were collected using semistructured and audio-recorded interviews and analyzed concurrently. Thematic analysis was used. A total of 13 interviews were conducted.

Results: Two core themes emerged from the study: Navigating the Change and Reflecting on the Experience of Pregnancy. The first theme included four subthemes: Making Adjustments, Seeking Support, Searching for Information, and Feeling the Responsibility.

Conclusion: Considering the impact of pregnancy on adolescent girls and their fetuses, early marriages should be reconsidered in legal and health policies in Jordan and worldwide. Adolescents expressed a need for more information about pregnancy. Age-appropriate comprehensive sexual education that includes discussion of gender issues and women's empowerment is needed. Online sources of pregnancy information targeting the needs of adolescents are also recommended. More research is needed to explore the needs of pregnant adolescents in different social and cultural contexts.

Objective: To increase patients' knowledge and access to genetic carrier screening (GCS) in a gynecologic setting by implementing a protocol to universally offer GCS education and screening to reproductive-age women during the preconception period at gynecologic-related visits.

Design: The model for improvement quality improvement process model was used to guide this initiative.

Local problem/setting: Screening for genetic disease has been a part of preconception and genetic care for the past 50 years. Despite its longstanding presence and better accessibility and affordability of testing, there are no established protocols to universally offer screening to reproductive-age women during preconception care in the United States. The project was implemented at an outpatient gynecology clinic in Phoenix, Arizona.

Participants: Fifty-one women ages 18 to 51 years.

Intervention/measurements: A protocol was implemented to universally offer expanded GCS and health education to reproductive-age women during the preconception period at gynecologic-related visits. Women's responses to being offered GCS and the rationale for their response was documented on a spreadsheet.

Results: All 51 participants were offered GCS during their visit. None of those 51 participants had any previous knowledge of GCS. All 51 participants declined GCS; reasons included the following: would consider it once closer to childbearing (53%), did not have any childbearing plans (31.3%), did not have any further childbearing plans (9.8%), or were not worried about the possibility of genetic disease (5.8%). None cited cost as a reason for declining GCS. After project completion, 3 of the 51 participants returned to the clinic to undergo GCS, and the clinic has adopted the intervention described here as its standard of care for patients who meet criteria for GCS.

Conclusion: It is imperative to provide health education about GCS to women during preconception care so that they can make informed choices about family planning.

The principles of trauma-informed care-safety, compassion, collaboration, communication, autonomy, and empowerment-are also the domains most vulnerable to implicit bias and most cited in adverse outcomes in maternal health. Perinatal nurses can practice trauma-informed care universally and thereby foster and advance person-centered care for all individuals with respect to race, ethnicity, religion, or lived experiences. In this article, we present evidence-based nursing interventions, collectively called REVIVE, that are known to promote principles of trauma-informed care. Taken together, the REVIVE interventions may improve health outcomes and reduce disparities in maternal health outcomes because they are proactive nursing interventions independent of implicit bias. REVIVE is described here and intended for use by individual nurses or health care teams to implement and evaluate in different maternity settings.

Objective: To evaluate the enhanced recovery after surgery (ERAS) protocols used and amount of opioids administered during hospitalization for cesarean birth after the ERAS protocols were implemented.

Data sources: A search was conducted in CINAHL Complete, Scopus, and PubMed for sources published in English between January 2018 and December 2023. Search terms were cesarean AND opioid∗ AND eras OR erac OR enhanced recovery.

Study selection: Eligible studies were conducted in the United States, used key pain management components from the ERAS guidelines, and reported results for in-patient postsurgical opioid use.

Data extraction: Data obtained were for post-ERAS implementation only and included authors, date, sample size, study location, participant inclusion and exclusion criteria, methods, interventions used (ERAS guideline components), and morphine milligram equivalents (MME) used during the hospital stay.

Data synthesis: Weighted averages were calculated for results reported as means and percentages. Descriptive summaries were used for the remainder of the results.

Results: Twenty-six studies were found, accounting for 19,961 individuals' post-ERAS experiences. Although 30% of participants experienced a scheduled cesarean birth, 70% experienced all types of cesarean births, including scheduled, urgent, or emergent. There was substantial heterogeneity of the data reported, especially for how opioid use was measured and analyzed and time frames for opioid use. In 11 studies that reported MME as means, the weighted average for in-patient opioid use was 54 MME per stay. In only 17 studies, researchers reported the number of women who experienced an opioid-free recovery, which averaged 40% of the women.

Conclusion: While implementation of key components of the ERAS protocol is associated with reduced opioid exposure for women experiencing scheduled and nonscheduled cesarean births, a benchmark for the amount of in-patient opioid use was not established. Still, this review offers evidence regarding best practices, lessons learned, and outcome analysis strategies. These findings can support perinatal teams who are considering implementing ERAS for cesarean birth, or those looking for further improvements.

A certified nurse-midwife describes how the TeamBirth approach has helped open up lines of communication between birthing families and care teams.