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Prevalence of unintended pregnancy and associated factors among pregnant women attending antenatal clinics 在产前诊所就诊的孕妇中意外怀孕的发生率及其相关因素
Pub Date : 2021-01-06 DOI: 10.5430/CNS.V9N1P29
Eman H. Elshrqawy, Amina M. Elnemr
Objective: Unintended pregnancy is an important worldwide public health problem and one of the important factors contributing to high level of maternal and child morbidity and mortality. The study was aimed to assess the prevalence and associated factors of unintended pregnancy among pregnant women attending antenatal clinics. Methods: The study followed a descriptive cross-sectional design on 1,254 pregnant women who were chosen by convenient sample technique. The study was done at governmental hospitals in EL-Mansoura City, Egypt including: The antenatal clinics of Obstetric and Gynecological specialty Center at EL-Mansoura University Hospitals, Old General Hospital and Mansoura International Hospital. Two tools were utilized for data collection (The Urdu version of pregnancy intention scale (LMUP) and structured Interviewing Questionnaire. Results: The prevalence of unintended pregnancy among studied women was (29.1%), of which 229 (18.3%) were mistimed and 136 (10.8%) were unwanted. Age, higher family size, lower family income, gravidity, parity, increased number of children and birth spacing were significantly associated with unintended pregnancy. Conclusions: The study concluded that the prevalence of unintended pregnancy was high in El-Mansoura city. It is recommended to develop educational programs and campaigns especially for rural areas to improve awareness regarding family planning and other co-factors associated with unintended pregnancy.
目的:意外怀孕是世界范围内一个重要的公共卫生问题,也是造成孕产妇和儿童高发病率和高死亡率的重要因素之一。该研究旨在评估在产前诊所就诊的孕妇中意外怀孕的患病率及其相关因素。方法:采用描述性横断面设计,采用方便抽样法对1254名孕妇进行研究。这项研究是在埃及曼苏拉市的政府医院进行的,包括:曼苏拉大学医院产科和妇科专科中心的产前诊所、老综合医院和曼苏拉国际医院。数据收集采用乌尔都语版妊娠意向量表(LMUP)和结构化访谈问卷两种工具。结果:研究对象意外妊娠发生率为29.1%,其中不合时宜妊娠229例(18.3%),意外妊娠136例(10.8%)。年龄、家庭规模较大、家庭收入较低、妊娠、胎次、子女数量增加和生育间隔与意外怀孕显著相关。结论:研究表明,El-Mansoura市意外怀孕的发生率较高。建议制定教育方案和宣传活动,特别是针对农村地区,以提高人们对计划生育和与意外怀孕有关的其他辅助因素的认识。
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引用次数: 1
Effect of utilizing developed gestational diabetes mellitus guideline on pregnancy and childbirth outcomes 应用已制定的妊娠期糖尿病指南对妊娠和分娩结果的影响
Pub Date : 2020-12-15 DOI: 10.5430/cns.v9n1p15
E. Elbeltagy, N. Khedr, N. Abd-Ella
Background: Gestational Diabetes Mellitus (GDM) is one of the most common medical health problems that may happen during pregnancy and may lead to a range of short and long-term maternal, fetal as well as neonatal complications. However, effective management and education on GDM self-care measures improve pregnancy outcomes for both women and their neonates.Aim: The study was carried out to evaluate the effect of utilizing developed gestational diabetes mellitus guideline on pregnancy and childbirth outcomes.Methods: A quasi-experimental research design was used at Antenatal Clinic of Obstetric and Gynecological Specialty Center at Mansoura University Hospitals, Mansoura city. A purposive sample of 126 pregnant women diagnosed with GDM, assigned to the intervention group (n = 63) who utilized the Gestational Diabetes Mellitus Guideline (GDMG) of care in addition to routine antenatal care and control group (n = 63) who followed routine antenatal care only. Tools: Three tools were used to collect data from participants as A structured interview schedule, maternal assessment record and fetal & neonatal assessment record.Results: The current study findings indicated that, there was a highly statistical significant reduction of body mass index and the mean random blood glucose levels at 34 & 37 weeks’ of pregnancy after intervention in the GDMG group than control groups (p < .001). Also, there was a statistical significant reduction in the occurrence of maternal complications as gestational hypertension, preeclampsia, preterm labor and polyhydramnios in the GDMG group .Similarly, the neonates of the GDMG group had better Apgar scores after birth & lower incidence for developing neonatal complications as prematurity, respiratory distress syndrome and NICU admission.Conclusions and Recommendations: This study showed that, pregnant women with GDM who utilized the GDMG had better maternal & neonatal outcomes than those who did not utilize it. It is recommended to provide a manual GDMG to all pregnant women with GDM for better lifestyle changes & maintaining self-management regimen as well as better pregnancy outcomes.
背景:妊娠期糖尿病(GDM)是妊娠期最常见的医学健康问题之一,可导致一系列短期和长期的母体、胎儿和新生儿并发症。然而,GDM自我保健措施的有效管理和教育可以改善妇女及其新生儿的妊娠结局。目的:探讨应用妊娠期糖尿病指南对妊娠及分娩结局的影响。方法:采用准实验研究设计,在曼苏拉市曼苏拉大学附属医院妇产科专科中心产前门诊进行研究。126名确诊为GDM的孕妇,分为干预组(n = 63)和对照组(n = 63),干预组在常规产前护理的基础上采用妊娠糖尿病指南(GDMG)进行护理,对照组仅采用常规产前护理。工具:使用三种工具收集参与者的数据:结构化访谈时间表、孕产妇评估记录和胎儿及新生儿评估记录。结果:目前的研究结果显示,GDMG组干预后体重指数和妊娠34、37周平均随机血糖水平较对照组有高度统计学意义的降低(p < 0.001)。GDMG组妊娠期高血压、子痫前期、早产、羊水过多等孕产妇并发症发生率均有统计学意义的降低。GDMG组新生儿出生后Apgar评分较高,早产、呼吸窘迫综合征、入住新生儿重症监护病房等新生儿并发症发生率较低。结论和建议:本研究显示,GDM孕妇使用GDMG比未使用GDMG有更好的孕产妇和新生儿结局。建议对所有妊娠期糖尿病孕妇进行手工GDMG,以更好地改变生活方式和维持自我管理方案,并获得更好的妊娠结局。
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引用次数: 0
Situational awareness in the identification of abuse – Out-of-hospital emergency care providers’ experiences 识别虐待的情境意识——院外急救提供者的经验
Pub Date : 2020-11-19 DOI: 10.5430/cns.v8n4p69
Mari Salminen-Tuomaala, J. Tiainen, E. Paavilainen
This qualitative study describes out-of-hospital emergency care providers’ experiences and views of situational awareness (SA) in the identification of abuse, including observations that led them to suspect abuse. Nine prehospital emergency care providers and three community paramedics were interviewed based on preselected themes. The data was analyzed using inductive content analysis. According to the results, emergency care providers’ self-defined situational awareness consisted of cognitive competence (logical reasoning and detection of cause-effect relationships); emotional competence (empathy and emotional intelligence); social competence (interaction skills and assessment of family dynamics), and experiential knowledge. Indicators of abuse involved the overall situation; the client’s physical condition; the client’s mental condition; the context and circumstances, and the logic in client reports. Although situational awareness develops with work experience, it is advisable for educators to include a wide range of cognitive, emotional and social skills in the initial and continuing education of emergency care professionals. These skills can be practiced using multi-professional simulation-based education.
本定性研究描述了院外急救提供者在识别虐待方面的经验和对情境感知(SA)的看法,包括导致他们怀疑虐待的观察结果。根据预先选定的主题对9名院前急救提供者和3名社区护理人员进行了访谈。采用归纳内容分析法对数据进行分析。结果显示,急救人员自我定义的情境意识包括认知能力(逻辑推理和因果关系的检测);情绪能力(共情和情商);社会能力(互动技巧和家庭动态评估)和经验知识。虐待的指标涉及总体情况;客户的身体状况;当事人的精神状况;上下文和环境,以及客户报告中的逻辑。虽然情景意识随着工作经验的发展而发展,但教育工作者在急救专业人员的初始和继续教育中应包括广泛的认知、情感和社交技能。这些技能可以通过基于多专业模拟的教育来练习。
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引用次数: 3
Ambulation of hospitalized patients: Knowledge, values, and barriers of direct care providers 住院患者的救护:直接护理提供者的知识、价值观和障碍
Pub Date : 2020-11-12 DOI: 10.5430/cns.v8n4p60
Melissa Tomassy, A. Moore, Ashley Peacock, Justin M. Wright, P. Ward-smith
The desire to ambulate hospitalized patients is tempered by their risk of falling. Research articulates the health-related benefits of ambulation, yet routinely providing this intervention is challenging. This descriptive survey-design study obtained data from consented licensed and unlicensed direct-care providers, which assessed their knowledge, values, and perceived barriers associated with routine ambulation of patients receiving care in a hospital setting. Analyses of these data conclude that the subjects were knowledgeable about and value ambulating patients. The most frequently cited barrier to routine ambulation was an inadequate staff number, followed closely by an unexpected rise in volume and patient acuity. Interventions aimed at improving the ambulation of patients should include the results of this study.
住院病人走路的欲望因其跌倒的风险而减弱。研究阐明了步行对健康的益处,但常规提供这种干预措施具有挑战性。这项描述性调查设计研究从同意的有执照和无执照的直接护理提供者那里获得了数据,这些提供者评估了他们的知识、价值观和与在医院接受护理的患者的日常行走相关的感知障碍。对这些数据的分析得出结论,受试者了解并重视移动患者。最常被提及的常规步行障碍是工作人员数量不足,其次是容量和患者敏锐度的意外上升。旨在改善患者行走的干预措施应包括本研究的结果。
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引用次数: 0
Sheltering in place swings door open wide to food insecurity during COVID-19 pandemic 新冠肺炎大流行期间,就地避难打开了粮食不安全的大门
Pub Date : 2020-10-23 DOI: 10.5430/cns.v9n1p11
A. Alakaam, S. Gudmundson
The COVID-19 pandemic is causing economic devastation and health system instability around the world. It has been reported that virus pandemics result in food crises even before the appearance of health impacts of the virus in the community. Addressing the consequences of food insecurity is critical during public health crises such as the COVID-19 pandemic. Currently, there is no evidence for the best module or practice used to reduce food insecurity during COVID-19 pandemic. However, a previously adapted tool can be used to address and measure community needs as well as expand access to food. The purpose of this report is to introduce the impact of the COVID-19 pandemic on food insecurity among the low-income population of the United States and to provide a suggestion to intervene on the impact. Using a validated tool to identify food insecurity, coupled with urgent immediate policy change, may diminish consequences of food insecurity and protect the health of those most fragile during a pandemic crisis in rural and low-income communities.
COVID-19大流行正在世界各地造成经济破坏和卫生系统不稳定。据报道,病毒大流行甚至在病毒对社区健康产生影响之前就已造成粮食危机。在2019冠状病毒病大流行等公共卫生危机期间,解决粮食不安全的后果至关重要。目前,没有证据表明在2019冠状病毒病大流行期间用于减少粮食不安全的最佳模块或做法。但是,可以使用先前经过调整的工具来解决和衡量社区需求,并扩大获得粮食的机会。本报告的目的是介绍COVID-19大流行对美国低收入人口粮食不安全的影响,并提供干预影响的建议。使用一种有效的工具来确定粮食不安全,再加上立即紧急改变政策,可能会减少粮食不安全的后果,并在大流行危机期间保护农村和低收入社区中最脆弱群体的健康。
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引用次数: 0
Relationship between patient-perceived quality of nurse caring attitudes and behaviours and quality of life of haemodialysis patients in Switzerland 瑞士血液透析患者护理态度和行为感知质量与生活质量的关系
Pub Date : 2020-10-23 DOI: 10.5430/cns.v9n1p1
P. Delmas, Matteo Antonini, T. Bellier-Teichmann, Evelyne Boillat, Vanessa Brandalesi, L. O’reilly, Chantal Cara, Sylvain Brousseau, Delphine Roulet-Schwab, Isabelle Ledoux, J. Pasquier
Background: Chronic kidney disease (CKD) is a fast-growing cause of morbidity and mortality worldwide. Patients suffering from CKD almost always develop end-stage renal disease (ESRD) that is often treated with haemodialysis (HD). In this context, the quality of the nurse-patient relationship (NPR) plays a major role in supporting the quality of life (QoL) of HD patients. This study examined the relationship between quality of nurse behaviours and attitudes as perceived by HD patients and QoL of these patients. Methods: The study used a cross-sectional correlational design. The sample consisted of 140 patients recruited in 10 HD units in French-speaking Switzerland. The Caring Nurse-Patient Interaction Scale (CNPI-70) was used to assess the NPR, and the French version of the WHOQOL-Bref was used to evaluate different dimensions of QoL. Random-intercept linear regressions adjusted for sociodemographic characteristics were used to study the relationship between patient-perceived quality of nurse caring attitudes and behaviours and patient QoL. Results: Patients reported a high frequency of caring attitudes and behaviours from their attending nurses, except relative to the dimension of spirituality. All the dimensions of patient QoL were positively influenced by the caring factor composing the CNPI-70. In particular, nurse attention to patient dignity when providing support for basic human needs seemed to be a major factor in patient QoL. Conclusions: Quality of NPR is essential to improving patient QoL. Interventions need to be developed to support quality of NPR.
背景:慢性肾脏疾病(CKD)是世界范围内发病率和死亡率快速增长的原因。患有CKD的患者几乎总是发展为终末期肾脏疾病(ESRD),通常采用血液透析(HD)治疗。在这种情况下,护患关系(NPR)的质量在支持HD患者的生活质量(QoL)中起着重要作用。本研究考察了HD患者所感知的护士行为质量和态度与患者生活质量的关系。方法:采用横断面相关设计。样本包括在瑞士法语区的10个HD单位招募的140名患者。采用护理护患互动量表(CNPI-70)评估护理护患关系,采用法文WHOQOL-Bref评估护理护患关系各维度。采用随机截距线性回归对社会人口学特征进行校正,研究患者感知护士护理态度和行为质量与患者生活质量之间的关系。结果:除精神维度外,患者报告的护理态度和行为频率较高。组成CNPI-70的关怀因子对患者生活质量的各维度均有正向影响。特别是,护士在提供基本人类需求支持时对患者尊严的关注似乎是影响患者生活质量的主要因素。结论:NPR质量对提高患者生活质量至关重要。需要制定干预措施以支持公共卫生的质量。
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引用次数: 2
Organizational justice and workplace spirituality: Their relation to organizational silence behavior among nurses 组织公正、工作场所灵性与护士组织沉默行为的关系
Pub Date : 2020-10-20 DOI: 10.5430/cns.v8n4p45
G. Diab, Sohair Mabrouk Mohamed
Background: Justice and its implementation are one of the fundamental and innate needs of the human. Employees’ exhibit higher levels of performance, loyalty, act more than their job descriptions when they are treated fairly at the workplace. Organizational injustice negatively affects organizational silence in the workplace and using the workplace spirituality technique decreases this negative effect. Aim: To assess the relation of organizational justice and workplace spirituality with organizational silence behavior among nurses. Methods: Design: A descriptive correlational research design. Setting: The study was conducted at the University Hospital of Menoufia Governorate, Egypt. Subjects: A simple random sample consisted of 372 nurses. Tools: Data were collected by using an organizational justice questionnaire, workplace spirituality questionnaire, and organizational silence behavior scale. Results: the highest percent of the studied nurses had a moderate perception level toward organizational justice, and the mean score of the organizational justice variable was 39.37 ± 6.73. The highest mean score was the interactional justice 18.41 ± 3.16, procedural justice 11.67 ± 2.56, and then the distributive justice dimension 9.51 ± 2.21, respectively. Two-third of the studied nurses had a moderate perception level toward workplace spirituality and the highest the mean score was 27.18 ± 1.68 related to the sense of community dimension. The highest percent of the studied nurses had a high level toward organizational silence behavior and the mean score of the organizational silence variable was 38.24 ± 6.73. Also, the most type of organizational silence behavior was prosocial silence, and the most common cause of nurses silent was “supervisor support for silence factor”. Conclusions: There was a highly statistically significant positive correlation between organizational justice and workplace spirituality and there was a negative correlation between organizational justice, workplace spirituality, and organizational silence behavior among nurses. Recommendations: Nursing Managers have to respect to rights and duties of nurses in making decisions and conducted periodically meeting with their nurses to discuss and solve work problems and have to create a transparent environment in which nurses express their ideas and views to minimize the reasons that push them to remain silent.
背景:正义及其实施是人类与生俱来的基本需求之一。当员工在工作场所受到公平对待时,他们表现出更高的绩效、忠诚度,表现得比他们的工作描述更出色。组织不公正对工作场所的组织沉默产生了负面影响,而使用工作场所精神技巧可以减少这种负面影响。目的:探讨护士组织公平、工作场所精神与组织沉默行为的关系。方法:设计:描述性相关研究设计。背景:该研究在埃及梅努菲亚省的大学医院进行。受试者:一个简单的随机样本由372名护士组成。工具:使用组织公正问卷、工作场所精神问卷和组织沉默行为量表收集数据。结果:最高百分比的研究护士对组织公正具有中等感知水平,组织公正变量的平均得分为39.37±6.73。平均得分最高的是互动公正18.41±3.16,程序公正11.67±2.56,然后是分配公正9.51±2.21。三分之二的受试护士对工作场所精神的感知水平中等,与社区维度感相关的平均得分最高,为27.18±1.68。最高百分比的研究护士对组织沉默行为具有较高水平,组织沉默变量的平均得分为38.24±6.73。组织沉默行为类型以亲社会沉默为主,护士沉默最常见的原因是“主管对沉默因素的支持”。结论:护士的组织公正与工作场所精神状态呈正相关,组织公正、工作场所精神和组织沉默行为呈负相关。建议:护理经理在做出决定时必须尊重护士的权利和义务,定期与护士会面讨论和解决工作问题,并必须创造一个透明的环境,让护士表达自己的想法和观点,以尽量减少迫使他们保持沉默的原因。
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引用次数: 0
Efficacy of a preventive instructional module on mothers’ knowledge regarding shaken baby syndrome 预防性教学模块对母亲摇晃婴儿综合征知识的有效性
Pub Date : 2020-10-18 DOI: 10.5430/cns.v8n4p35
S. Hashem, B. Mohammed, G. Ahmed, Eman A. Fadel
Objective: Shaken baby syndrome (SBS) is a shocking phenomenon that is recognized as one of the most severe forms of child abuse with very high rates of morbidity and mortality among infant less than one year of age. Although of its high mortality and morbidity, it is a highly preventable health problem. So, there is an essential need for a strategy to prevent it through education by nurses and physicians to new mothers. This study aimed to evaluate the efficacy of a preventive instructional module on mothers’ knowledge regarding SBS. Methods: A quasi-experimental design was carried out on eighty mothers who had delivered full-term infants and hospitalized on labour and delivery unit affiliated to Mansoura University Hospital, Mansoura City, Egypt. Data were collected through using of a structured interview questionnaire sheet (pre and post-test format) for assessing mothers’ knowledge about SBS and infant’s crying. Results: The total mean knowledge scores improved post implementation of a preventive instructional module regarding SBS compared to pre-implementation (0.86 ± 0.19 versus 0.35 ± 0.39 respectively). Conclusions: The study hypothesis was accepted. There were highly significant improvement in the studied women’s knowledge regarding SBS and infant crying. Indicating that the developed preventive instructional module was an effective tool for the enrichment of mothers’ knowledge regarding SBS and infant’s crying. Recommendation: Implementation of antenatal classes for improving mothers’ knowledge regarding SBS and infant crying.
目的:摇晃婴儿综合症(SBS)是一种令人震惊的现象,被认为是最严重的儿童虐待形式之一,在一岁以下的婴儿中发病率和死亡率非常高。虽然它的死亡率和发病率很高,但它是一个高度可预防的健康问题。因此,有必要制定一项策略,通过护士和医生对新妈妈的教育来预防它。本研究旨在评估预防性教学模块对母亲SBS知识的影响。方法:采用准实验设计,对埃及曼苏拉市曼苏拉大学附属医院产房分娩的80例足月产妇进行研究。采用结构化访谈问卷(测试前和测试后格式)评估母亲对SBS和婴儿哭闹的认知。结果:与实施前相比,实施SBS预防教学模块后的总平均知识得分有所提高(分别为0.86±0.19和0.35±0.39)。结论:接受研究假设。被研究女性对SBS和婴儿哭闹的认知有显著提高。说明所开发的预防教学模块是丰富母亲关于SBS和婴儿哭闹知识的有效工具。建议:开办产前班,提高母亲对SBS及婴儿啼哭的认识。
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引用次数: 1
Comparing the differences in health of body, mental and spirit among Schedule I and II controlled drugs users with Schedule III and IV controlled drugs users 比较附表一和附表二受管制吸毒者与附表三和附表四受管制吸毒者在身体、心理和精神健康方面的差异
Pub Date : 2020-09-30 DOI: 10.5430/CNS.V8N4P26
Hui-Man Huang, A. Long, F. Sun, Chu-Yun Lu, YuChun Yao
Objective: To compare the differences in physical, mental, and spiritual health among Schedule I and II with III and IV controlled drugs users. Methods: A cross-sectional comparison design was used. A convenience sample of 479 drugs users was recruited in Taiwan. Results: The results showed that Schedule I and II drug-users had less perceptions of their overall body-mental-spirit health than Schedule III and IV drug-users (52.72 vs. 55.40, t = -3.00, p < .01). Conclusions: The health professionals could design drug rehabilitation programs for all Schedules of drug-users, especially for Schedule I and II drug-users.
目的:比较一类和二类管制药物使用者与三类和四级管制药物使用者在生理、心理和精神健康方面的差异。方法:采用横断面比较设计。在台湾招募了479名吸毒者作为方便样本。结果:一级和二级吸毒者对自身整体身心健康状况的感知低于三级和四级吸毒者(52.72比55.40,t = -3.00, p < 0.01)。结论:卫生专业人员可以为所有级别的吸毒者设计戒毒方案,特别是针对第一和第二级别的吸毒者。
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引用次数: 0
Towards more authentic simulation-based learning – Nursing students’ experiences 走向更真实的基于模拟的学习——护理学生的经验
Pub Date : 2020-09-24 DOI: 10.5430/CNS.V8N4P18
Mari Salminen-Tuomaala, Elina Leppäkangs, Sami Perälä
Background: Nursing students need opportunities for authentic learning in contexts that strongly resemble real-life clinical settings. Objective: This qualitative study describes final year nursing students’ experiences of simulation authenticity and presents development needs proposed by the students. The study aimed at producing knowledge that can be used by educators and technology specialists to develop simulation pedagogy for acute nursing. Methods: Eleven final-year nursing students specializing in acute nursing (intensive care and in- and out-of-hospital emergency care) responded to a questionnaire with four open questions in December 2019. Inductive content analysis was used to analyze the data. Results: The students stressed the importance of their own preparations and living into the nursing role with proper briefing from an expert teacher, supported by a realistic representation of the setting using real equipment, actors, visualization and other multisensory cues. Conclusions: Students’ subjective experience of authenticity depends on many factors; preparation, awareness of objectives, support from the facilitator and the level of environmental fidelity. Simulations, which reach a reasonable degree of authenticity in the students’ experience, can be considered an effective form of authentic learning.
背景:护理专业的学生需要在与现实生活非常相似的临床环境中进行真实学习的机会。目的:本定性研究描述护生对模拟真实性的体验,并提出学生的发展需求。该研究旨在为教育工作者和技术专家提供知识,以开发急性护理模拟教学法。方法:2019年12月,11名急症护理专业(重症监护和院内外急救)的大四护生填写了一份包含4个开放性问题的问卷。采用归纳内容分析法对数据进行分析。结果:学生们强调了自己的准备和融入护理角色的重要性,并由专家老师进行了适当的介绍,并使用真实的设备、演员、可视化和其他多感官线索进行了逼真的再现。结论:学生的真实性主观体验受多种因素的影响;准备,目标意识,引导者的支持和环境保真度。模拟在学生的体验中达到了合理的真实程度,可以被认为是真实学习的一种有效形式。
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引用次数: 0
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Clinical nursing studies
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