Background:Postpartum Care is a strategy to improve survival of women and newborns,especially in low-and middle-income countries.Early post-partum care can promote healthy behaviors and the identification of risk fact...Background:Postpartum Care is a strategy to improve survival of women and newborns,especially in low-and middle-income countries.Early post-partum care can promote healthy behaviors and the identification of risk factors associated with poorer pregnancy-related outcomes.The objective of this study was to assess the association of perceived social support with attendance to post-partum care in women from three Latin-American and Caribbean countries:Costa Rica,Dominican Republic and Honduras.Methods:Women aged 18+who completed a pregnancy in the past 5 years were interviewed in local healthcare and community settings in each country.Perceived social support(PSS)was the primary explanatory variable and the primary outcome was self-reported attendance to post-partum care.Odds Ratios(OR)with 95%confidence intervals derived from logistic regression documented the association between variables.Adjusted Odds Ratios(AOR)were calculated,controlling for social and pregnancy-related confounders.Hosmer–Lemeshow’s Goodnessof-Fit statistic was computed to assess model fit.Results:Our cohort of 1199 women across the three Latin-American and Caribbean countries showed relatively high attendance to post-partum care(82.6%,n=990).However,51.7%(n=581)of women reported lower levels of total PSS.Women were more likely to attend postpartum care if they had mean and higher levels of PSS Family subscale(OR:1.9,95%CI:1.4,2.7),Friends subscale(OR 1.3,95%CI:0.9,1.8),Significant Other subscale(OR 1.8,95%CI:1.3,2.4)and the Total PSS(OR 1.8,95%CI:1.3,2.5).All associations were statistically significant at p<0.05,with exception of the Friends subscale.Women with higher levels of total PSS were more likely to attend to post-partum care(AOR:1.40,0.97,1.92)even after controlling for confounders(education,country,and food insecurity).Conclusions:Women with higher perceived social support levels were more likely to attend to post-partum care.From all countries,women from Dominican Republic had lower perceived social support levels and this may influence attendance at post-partum care for this subgroup.Societal and geographic factors can act as determinants when evaluating perceived social support during pregnancy.展开更多
Background: To evaluate the care given using Roy’s Adaptation Model. Materials and Methods: A pretest-posttest experimental model with a control group. Study population comprised postpartum women (N = 134;65 in the e...Background: To evaluate the care given using Roy’s Adaptation Model. Materials and Methods: A pretest-posttest experimental model with a control group. Study population comprised postpartum women (N = 134;65 in the experimental group, 69 in the control group) who had caesarean full-term delivery in a Turkish maternity hospital between September 2009 and February 2011. Data were collected from the experimental group during seven home visits and from the control group at the end of the 6th week postpartum. Results: Percentage, chi-square, arithmetic mean, standard deviation, and the McNamer test were used to evaluate data establishing 36 nursing diagnoses: Physiological requirements (22), Self requirements (7), Role Function requirements (4), and Interdependence Mode requirements (3). It was determined that the care given during the postpartum period using Roy’s Adaptation Model resolved or prevented the majority of postpartum problems. The difference between most diagnoses was found to be statistically significant (p p < 0.001) during the last week of data collection. Conclusion: The care given in the postpartum period using Roy’s Adaptation Model resolved or prevented postpartum problems.展开更多
Background: Neonatal mortality is a real public health problem in the world and particularly in countries with limited resources. Essential care remains an effective means of reducing this mortality. Objective: To eva...Background: Neonatal mortality is a real public health problem in the world and particularly in countries with limited resources. Essential care remains an effective means of reducing this mortality. Objective: To evaluate the practice of administering of vitamin K1, ocular and cord care in maternity wards in the Kozah 1 municipality. Method: This is a cross-sectional study conducted from March 1st to June 30th, 2022 in all maternity wards in the Kozah 1 municipality. Socioprofessional aspects of providers and those related to the administration of vitamin K1, ocular and cord care were studied. Results: Eighty-five (85) maternity providers were included in this study. The average age of the providers was 36.2 years with extremes of 21 and 55 years. Providers were midwives (51.8%), childbirth attendants (35.3%), and matrons (12.9%). The average length of practice was 9.5 years with extremes of 1 and 28 years. For three out of four providers (75.3%), the postpartum period was defined as a period of 02 hours following delivery. The importance of cord, ocular care, and administration of vitamin K1 in postpartum was known respectively by 84.7%, 98.8%, and 92.9% of the providers. Chlorhexidine gel was used by 81.2% of providers for umbilical cord care. For ocular disinfection, more than half of the providers (52.9%) reported using half-diluted povidone iodine. No center had displayed care protocol. Conclusion: This study highlighted the level of knowledge and practice of three essential postpartum care practices. The products used for the different care practices are consistent with recommendations but vary according to the care providers.展开更多
Background: A cesarean section is a major obstetric surgical procedure performed for the purpose of delivering a live baby when vaginal delivery would put the mother and the baby at risk due to complications of pregna...Background: A cesarean section is a major obstetric surgical procedure performed for the purpose of delivering a live baby when vaginal delivery would put the mother and the baby at risk due to complications of pregnancy, labour and delivery. Although caesarean section is a life saving procedure, it is associated with a number of risks or problems in the postoperative period. The aim of the study was to understand the Midwives’ perspective on the care of postpartum mothers who had cesarean section at the University Teaching Hospital—Women and Newborn in Lusaka District. Methods: A descriptive cross sectional survey was conducted at the University Teaching Hospital—Women and Newborn in Lusaka. 51 Midwives working in postnatal wards were consecutively selected to participate in the study. Data was collected using a self administered questionnaire with a 4 point Likert scale and also some closed and open ended questions. SPSS version 20 statistical package was used to analyse data, expressed as descriptive summary measures. Results: All the 51 Midwives were female and they scored themselves highly on a 4 point Likert scale as always performing all the immediate post-operative care on the postpartum mothers who had a caesarean section while the score was much lower during the subsequent post-operative period. Staffing levels and medical-surgical materials were found to be low and affect care of Postpartum mothers (P-0.050). The majority (94.2%) of the Midwives also indicated that C-section mothers were not given any form of written materials or standardized instructions to take home as reference material during the Information, Education Communication sessions on discharge (P-0.001) and home/domiciliary visits to postpartum mothers who had C-sections on postpartum were not being undertaken. Conclusion: There was need to improve the care rendered to the postpartum women who had complicated labour and delivery including caesarean sections in order to promote good health and to prevent postpartum complications.展开更多
Objective: To assess a training approach in Emergency Obstetric and Neonatal Care (EmONC) to strengthen skills of healthcare providers and reduce maternal mortality. Materials and methods: The approach was based on th...Objective: To assess a training approach in Emergency Obstetric and Neonatal Care (EmONC) to strengthen skills of healthcare providers and reduce maternal mortality. Materials and methods: The approach was based on the skills training using the so-called “humanist” method and “life saving skills”. Simulated practice took place in the classroom through thirteen clinical stations summarizing the clinical skills on EmONC. The evaluation was done in all phases and the results were recorded in a database to document the progress of each learner. Results: We trained 432 providers in 10 months. The increase in technical achievements of each participant was documented through a database. The combination of training based on the model “learning by doing” has ensured learning and mastering all EmONC skills particularly postpartum haemorrhage management and reduced missed learning opportunities. Conclusion: The impact of training on postpartum haemorrhage management and maternal mortality is a major challenge in terms of prospects.展开更多
Background: Postpartum hemorrhage is one of the main causes of maternal mortality, mainly in underdeveloped countries. Deaths are mostly preventable, and are related to socioeconomic development, organization of healt...Background: Postpartum hemorrhage is one of the main causes of maternal mortality, mainly in underdeveloped countries. Deaths are mostly preventable, and are related to socioeconomic development, organization of health services and professional training. Objective: To systematize alerts for the prevention of postpartum hemorrhage. Method: This is a technical essay developed from reflections on previously produced and published texts about maternal mortality and has hemorrhage as the focus of this study. Results: It presents the concept, classification of hemorrhage, risk factors and their classification, prevention strategies, universal recommendations, pharmacological and non-pharmacological interventions when hemorrhage already exists, bleeding assessment techniques;clinical evaluation, by laboratory examination and by shock index. Conclusions: Hemorrhage is a preventable cause of maternal death through the accomplishment of multiple care. Hospital care must be conducted by qualified professionals and in adequate numbers. The risk diagnosis must be carried out during prenatal care with the recording of clinical data accessible in the health care network. All references studied are not specific to nursing, as hemorrhage prevention requires multidisciplinary action.展开更多
Objective To investigate the impact of childbirth on the sexual health of primiparous women in China and the prevalence of women's postpartum sexual problemsMethod In this cross-sectional study, obstetric records ...Objective To investigate the impact of childbirth on the sexual health of primiparous women in China and the prevalence of women's postpartum sexual problemsMethod In this cross-sectional study, obstetric records of 460 primiparous women delivering a live-birth at the First Affiliated Hospital of Chongqing University of Medical Sciences between November 1, 2000 and July 31, 2001 were analyzed together with the data collected from questionnaire survey conducted six months after delivery.Results Totally 460 women participated in the questionnaire survey. Though 94.74% of the subjects had resumed sexual activity within six months after birth, most of them had experienced postpartum sexual problems, among which dyspareunia was the most common type. There was no significant association between delivery types and women's sexual health status in six months after birth, including their satisfactory degree of sexual intercourse, sexual desire, sex active rate, the incidence of dyspareunia and pubococcygeal muscle strength (P>0.05). Only 20.80% of women had knowledge of sexual health and 8.02% of them had consulted for sexual problems. Conclusions Women's postpartum sexual health problems were very common, they deserve more attention. There was no significant association between delivery types and women's postpartum sexual problems at the 6th month after delivery.展开更多
In the immediate postpartum period, women need to be observed by the obstetric nurse so that measures can be taken to prevent hemorrhages and reduce its complications. Most maternal deaths from hemorrhage are preventa...In the immediate postpartum period, women need to be observed by the obstetric nurse so that measures can be taken to prevent hemorrhages and reduce its complications. Most maternal deaths from hemorrhage are preventable with support measures for clinical practice, such as: guiding protocols, training of professionals, organization and management of health services and provision of adequate conditions for the parturition process. Objective: To validate Rangel’s instrument with its application in the Maternity Ward of the General Hospital of Huambo, Angola. Methodology: This is a descriptive study with a quantitative approach. This is the sixth stage, called pre-test, of the Translation and Cultural Adaptation process. This instrument was sent for evaluation by the validators using the electronic data collection form named Google forms, with a seven-point Likert-type scale (from 7—totally agree to 1—totally disagree). The analysis was performed with the Cronbach’s Alpha coefficient index (>0.91) and the Content Validity Index (CVI > 0.98). Results: Of the 10 items of evaluation criteria of the instrument analyzed by the 20 validators, 100% of them obtained a Cronbach’s Alpha index rating of 0.91: clarity;coherence;scientific writing;relevance;sequence;uniqueness and updating. Coverage, item criticality and objectivity reached a Cronbach’s Alpha of 0.95. The Content Validity Index was 0.95 for coverage, coherence, item criticality, scientific writing, relevance and updating. Conclusion: Rangel’s instrument for nursing care aimed at preventing and controlling hemorrhage in the third period of birth, translated into Angolan Portuguese and validated by nurses, through the statistical results obtained in the validation, was considered reliable and necessary for clinical nursing practice in Huambo, Angola. .展开更多
基金funded by The National Institutes of Health/Fogarty International Center Grant#1 R25 TW 009697-01A1NIH National Center for Advancing Translational Sciences,“NRSA Training Core”(TL1 TR002000).
文摘Background:Postpartum Care is a strategy to improve survival of women and newborns,especially in low-and middle-income countries.Early post-partum care can promote healthy behaviors and the identification of risk factors associated with poorer pregnancy-related outcomes.The objective of this study was to assess the association of perceived social support with attendance to post-partum care in women from three Latin-American and Caribbean countries:Costa Rica,Dominican Republic and Honduras.Methods:Women aged 18+who completed a pregnancy in the past 5 years were interviewed in local healthcare and community settings in each country.Perceived social support(PSS)was the primary explanatory variable and the primary outcome was self-reported attendance to post-partum care.Odds Ratios(OR)with 95%confidence intervals derived from logistic regression documented the association between variables.Adjusted Odds Ratios(AOR)were calculated,controlling for social and pregnancy-related confounders.Hosmer–Lemeshow’s Goodnessof-Fit statistic was computed to assess model fit.Results:Our cohort of 1199 women across the three Latin-American and Caribbean countries showed relatively high attendance to post-partum care(82.6%,n=990).However,51.7%(n=581)of women reported lower levels of total PSS.Women were more likely to attend postpartum care if they had mean and higher levels of PSS Family subscale(OR:1.9,95%CI:1.4,2.7),Friends subscale(OR 1.3,95%CI:0.9,1.8),Significant Other subscale(OR 1.8,95%CI:1.3,2.4)and the Total PSS(OR 1.8,95%CI:1.3,2.5).All associations were statistically significant at p<0.05,with exception of the Friends subscale.Women with higher levels of total PSS were more likely to attend to post-partum care(AOR:1.40,0.97,1.92)even after controlling for confounders(education,country,and food insecurity).Conclusions:Women with higher perceived social support levels were more likely to attend to post-partum care.From all countries,women from Dominican Republic had lower perceived social support levels and this may influence attendance at post-partum care for this subgroup.Societal and geographic factors can act as determinants when evaluating perceived social support during pregnancy.
文摘Background: To evaluate the care given using Roy’s Adaptation Model. Materials and Methods: A pretest-posttest experimental model with a control group. Study population comprised postpartum women (N = 134;65 in the experimental group, 69 in the control group) who had caesarean full-term delivery in a Turkish maternity hospital between September 2009 and February 2011. Data were collected from the experimental group during seven home visits and from the control group at the end of the 6th week postpartum. Results: Percentage, chi-square, arithmetic mean, standard deviation, and the McNamer test were used to evaluate data establishing 36 nursing diagnoses: Physiological requirements (22), Self requirements (7), Role Function requirements (4), and Interdependence Mode requirements (3). It was determined that the care given during the postpartum period using Roy’s Adaptation Model resolved or prevented the majority of postpartum problems. The difference between most diagnoses was found to be statistically significant (p p < 0.001) during the last week of data collection. Conclusion: The care given in the postpartum period using Roy’s Adaptation Model resolved or prevented postpartum problems.
文摘Background: Neonatal mortality is a real public health problem in the world and particularly in countries with limited resources. Essential care remains an effective means of reducing this mortality. Objective: To evaluate the practice of administering of vitamin K1, ocular and cord care in maternity wards in the Kozah 1 municipality. Method: This is a cross-sectional study conducted from March 1st to June 30th, 2022 in all maternity wards in the Kozah 1 municipality. Socioprofessional aspects of providers and those related to the administration of vitamin K1, ocular and cord care were studied. Results: Eighty-five (85) maternity providers were included in this study. The average age of the providers was 36.2 years with extremes of 21 and 55 years. Providers were midwives (51.8%), childbirth attendants (35.3%), and matrons (12.9%). The average length of practice was 9.5 years with extremes of 1 and 28 years. For three out of four providers (75.3%), the postpartum period was defined as a period of 02 hours following delivery. The importance of cord, ocular care, and administration of vitamin K1 in postpartum was known respectively by 84.7%, 98.8%, and 92.9% of the providers. Chlorhexidine gel was used by 81.2% of providers for umbilical cord care. For ocular disinfection, more than half of the providers (52.9%) reported using half-diluted povidone iodine. No center had displayed care protocol. Conclusion: This study highlighted the level of knowledge and practice of three essential postpartum care practices. The products used for the different care practices are consistent with recommendations but vary according to the care providers.
文摘Background: A cesarean section is a major obstetric surgical procedure performed for the purpose of delivering a live baby when vaginal delivery would put the mother and the baby at risk due to complications of pregnancy, labour and delivery. Although caesarean section is a life saving procedure, it is associated with a number of risks or problems in the postoperative period. The aim of the study was to understand the Midwives’ perspective on the care of postpartum mothers who had cesarean section at the University Teaching Hospital—Women and Newborn in Lusaka District. Methods: A descriptive cross sectional survey was conducted at the University Teaching Hospital—Women and Newborn in Lusaka. 51 Midwives working in postnatal wards were consecutively selected to participate in the study. Data was collected using a self administered questionnaire with a 4 point Likert scale and also some closed and open ended questions. SPSS version 20 statistical package was used to analyse data, expressed as descriptive summary measures. Results: All the 51 Midwives were female and they scored themselves highly on a 4 point Likert scale as always performing all the immediate post-operative care on the postpartum mothers who had a caesarean section while the score was much lower during the subsequent post-operative period. Staffing levels and medical-surgical materials were found to be low and affect care of Postpartum mothers (P-0.050). The majority (94.2%) of the Midwives also indicated that C-section mothers were not given any form of written materials or standardized instructions to take home as reference material during the Information, Education Communication sessions on discharge (P-0.001) and home/domiciliary visits to postpartum mothers who had C-sections on postpartum were not being undertaken. Conclusion: There was need to improve the care rendered to the postpartum women who had complicated labour and delivery including caesarean sections in order to promote good health and to prevent postpartum complications.
文摘Objective: To assess a training approach in Emergency Obstetric and Neonatal Care (EmONC) to strengthen skills of healthcare providers and reduce maternal mortality. Materials and methods: The approach was based on the skills training using the so-called “humanist” method and “life saving skills”. Simulated practice took place in the classroom through thirteen clinical stations summarizing the clinical skills on EmONC. The evaluation was done in all phases and the results were recorded in a database to document the progress of each learner. Results: We trained 432 providers in 10 months. The increase in technical achievements of each participant was documented through a database. The combination of training based on the model “learning by doing” has ensured learning and mastering all EmONC skills particularly postpartum haemorrhage management and reduced missed learning opportunities. Conclusion: The impact of training on postpartum haemorrhage management and maternal mortality is a major challenge in terms of prospects.
文摘Background: Postpartum hemorrhage is one of the main causes of maternal mortality, mainly in underdeveloped countries. Deaths are mostly preventable, and are related to socioeconomic development, organization of health services and professional training. Objective: To systematize alerts for the prevention of postpartum hemorrhage. Method: This is a technical essay developed from reflections on previously produced and published texts about maternal mortality and has hemorrhage as the focus of this study. Results: It presents the concept, classification of hemorrhage, risk factors and their classification, prevention strategies, universal recommendations, pharmacological and non-pharmacological interventions when hemorrhage already exists, bleeding assessment techniques;clinical evaluation, by laboratory examination and by shock index. Conclusions: Hemorrhage is a preventable cause of maternal death through the accomplishment of multiple care. Hospital care must be conducted by qualified professionals and in adequate numbers. The risk diagnosis must be carried out during prenatal care with the recording of clinical data accessible in the health care network. All references studied are not specific to nursing, as hemorrhage prevention requires multidisciplinary action.
文摘Objective To investigate the impact of childbirth on the sexual health of primiparous women in China and the prevalence of women's postpartum sexual problemsMethod In this cross-sectional study, obstetric records of 460 primiparous women delivering a live-birth at the First Affiliated Hospital of Chongqing University of Medical Sciences between November 1, 2000 and July 31, 2001 were analyzed together with the data collected from questionnaire survey conducted six months after delivery.Results Totally 460 women participated in the questionnaire survey. Though 94.74% of the subjects had resumed sexual activity within six months after birth, most of them had experienced postpartum sexual problems, among which dyspareunia was the most common type. There was no significant association between delivery types and women's sexual health status in six months after birth, including their satisfactory degree of sexual intercourse, sexual desire, sex active rate, the incidence of dyspareunia and pubococcygeal muscle strength (P>0.05). Only 20.80% of women had knowledge of sexual health and 8.02% of them had consulted for sexual problems. Conclusions Women's postpartum sexual health problems were very common, they deserve more attention. There was no significant association between delivery types and women's postpartum sexual problems at the 6th month after delivery.
文摘In the immediate postpartum period, women need to be observed by the obstetric nurse so that measures can be taken to prevent hemorrhages and reduce its complications. Most maternal deaths from hemorrhage are preventable with support measures for clinical practice, such as: guiding protocols, training of professionals, organization and management of health services and provision of adequate conditions for the parturition process. Objective: To validate Rangel’s instrument with its application in the Maternity Ward of the General Hospital of Huambo, Angola. Methodology: This is a descriptive study with a quantitative approach. This is the sixth stage, called pre-test, of the Translation and Cultural Adaptation process. This instrument was sent for evaluation by the validators using the electronic data collection form named Google forms, with a seven-point Likert-type scale (from 7—totally agree to 1—totally disagree). The analysis was performed with the Cronbach’s Alpha coefficient index (>0.91) and the Content Validity Index (CVI > 0.98). Results: Of the 10 items of evaluation criteria of the instrument analyzed by the 20 validators, 100% of them obtained a Cronbach’s Alpha index rating of 0.91: clarity;coherence;scientific writing;relevance;sequence;uniqueness and updating. Coverage, item criticality and objectivity reached a Cronbach’s Alpha of 0.95. The Content Validity Index was 0.95 for coverage, coherence, item criticality, scientific writing, relevance and updating. Conclusion: Rangel’s instrument for nursing care aimed at preventing and controlling hemorrhage in the third period of birth, translated into Angolan Portuguese and validated by nurses, through the statistical results obtained in the validation, was considered reliable and necessary for clinical nursing practice in Huambo, Angola. .
