Women's views on the impact of operative delivery in the second stage of labour: qualitative interview study.
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OBJECTIVE: To obtain the views of women on the impact of operative delivery in the second stage of labour. DESIGN: Qualitative interview study. SETTING: Two urban teaching hospitals in the United Kingdom. PARTICIPANTS: Purposive sample of 27 women who had undergone operative delivery in the second stage of labour between January 2000 and January 2002. KEY THEMES: Preparation for birth, understandings of the indications for operative delivery, and explanation or debriefing after birth. RESULTS: The women felt unprepared for operative delivery and thought that their birth plan or antenatal classes had not catered adequately for this event. They emphasised the importance of maintaining an open mind about the management of labour. They had difficulty understanding the need for operative delivery despite a review by medical and midwifery staff before discharge. Operative delivery had a noticeable impact on women's views about future pregnancy and delivery. CONCLUSIONS: Women consider postnatal debriefing and medical review important deficiencies in current care. Those who experienced operative delivery in the second stage of labour would welcome the opportunity to have a later review of their intrapartum care, physical recovery, and management of future pregnancies. (+info)
Patient acceptance and the psychological effects of women experiencing telecolposcopy and colposcopy.
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BACKGROUND: The purpose of the study was to assess patient acceptance and psychological effects in women experiencing telecolposcopy compared with colposcopy. METHODS: Convenience samples of 150 and 263 women scheduled for colposcopy or telecolposcopy, respectively, completed questionnaires assessing anxiety (Prime MD), depression [Center for Epidemiologic Studies/Depressed Mood Scale (CES-D)], health beliefs and concerns, coping style (Miller Behavioral Style Score) and examination acceptance and satisfaction. Test scores and subject responses were compared using the t test and Wilcoxon rank sum test. RESULTS: Mean scores representing mild anxiety (1.3 and 1.2, P =.7) and mild depression (35.4 and 36.3, P =.4) were reported for the telecolposcopy and colposcopy groups, respectively. The telecolposcopy group indicated significantly greater mean scores for the examination, saving them time and money compared with the colposcopy group. Women in both groups were highly satisfied with their examinations and care. CONCLUSIONS: In general, women reported very high levels of satisfaction with telecolposcopy and colposcopy. Potential savings of time and money and improved health care were considered of particular value to women examined by telecolposcopy. Telecolposcopy seems to be well accepted by rural women. (+info)
Using peer recruitment and OraSure to increase HIV testing.
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We describe a community-based pilot study to boost HIV testing in a minority community through social network recruitment and a noninvasive HIV testing methodology. Over an 11-month period, the number of test takers at the intervention site increased by 71.7%, and the proportions of test takers with risk factors similar to those of peer recruiters (heterosexual sex and multiple partners) increased by 24.2% and 19.5%, respectively. At a comparison site, testing remained stable, while the proportion of test takers reporting heterosexual sex and multiple partners decreased by 42.5% and 21.8%, respectively. The use of a social network recruitment strategy in combination with an oral HIV test shows promise in increasing testing and in targeting populations. (+info)
Influence of HRT on prognostic factors for breast cancer: a systematic review after the Women's Health Initiative trial.
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INTRODUCTION: Mortality due to breast cancer has been reported to be the same or even lower in HRT users than in non-users. This has been attributed to earlier diagnosis and to better prognosis. Nevertheless, more advanced disease in HRT users was reported recently by the Women's Health Initiative (WHI) study. The objective of this study was to assess, using a systematic review of current literature, whether the data of the WHI study are in contradiction to observational data. METHODS: We selected 25 studies, for which we evaluated the methodology, the characteristics of the studied populations, confounding breast cancer risk factors and prognostic indicators. RESULTS: The WHI study, showing a worsening of some prognostic parameters, is in contradiction to most published observational studies. Most observational studies are retrospective, not well matched and did not consider most confounding factors. Their methodology and selection criteria varied considerably and the number of patients was often small. No differences in the distributions of histology, grade or steroid receptors were observed in the WHI trial, while this was the case in some of the observational studies. Other parameters (S phase, protein Neu, Bcl-2 gene, protein p53 and E-cadherin, cathepsin D) were not reported in the WHI trial. CONCLUSIONS: In view of these data, the current clinical message to patients should be changed: one can no longer declare that breast cancers developed while using HRT are of better prognosis. (+info)
Women's perceptions of support from partners, family members and close friends for smoking cessation during pregnancy--combining quantitative and qualitative findings.
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This article reports on data collected as part of a four-phase study initiated to strengthen practice in the field of smoking cessation during pregnancy. It focuses on the perceived support pregnant smokers would receive for quitting smoking and how this support could be effectively used by incorporating the education of partners/family in smoking cessation intervention strategies. Both quantitative and qualitative methods were employed, and data were collected from pregnant smokers through semistructured interviews and self-completed questionnaires. From the questionnaire data, the women reported that they would receive considerable support from their partners if they decided to stop smoking. The interviews, however, revealed that this support was 'potential' rather than 'real' and that the partners mostly made 'token gestures' such as smoking outside. None of the interviewed respondents reported receiving help in educating their partner/family about the risks of active and passive smoking, thus reducing the potential positive role they could play in smoking cessation. Whilst health professionals are aware of the important role the partner/family may play in successful smoking cessation interventions, these significant others are generally not involved. This study highlights the need for consideration to be given to providing opportunities for couples to be fully involved in smoking cessation interventions outside the antenatal environment. (+info)
Attitudes of married individuals towards oral contraceptives: a qualitative study in Istanbul, Turkey.
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OBJECTIVE: To determine positive and negative attitudes of married Turkish women and men regarding the use of oral contraceptives (OCs). METHODS: Twenty focus group discussions were conducted during the period October 1998-March 1999 in Umraniye, which is one of the densely populated districts of Istanbul. RESULTS: Most of the negative attitudes relating to OCs stemmed from concerns over side effects, particularly in the male focus groups. Health care professionals' behaviour, lack of concern or bias, and their reluctance to prescribe also limited the uptake of OCs. The female groups had very positive attitudes towards OCs compared to those of the male groups. It was identified that although OCs are largely provided free of charge in Turkey, beliefs and attitudes towards them are the important factors which affect the uptake of the method. CONCLUSION: Special efforts may be needed to educate these groups and also to teach the health professionals about family planning counselling. (+info)
Epidemiology of measles in the United States, 1997-2001.
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Of the 540 measles cases (annual incidence, less than 1/million population) reported during 1997-2001 in the United States, 362 (67%) were associated with international importation: 196 imported cases, 138 cases epidemiologically linked to imported cases, and 28 cases associated with an imported measles virus genotype. The remaining 178 (33%) "unknown-source" cases were analyzed as potential evidence of endemic measles transmission. A total of 83 counties (2.6% of the 3140 US counties) in 27 states reported unknown-source cases; 49 counties reported only 1 unknown-source case, and the maximum reported by any county was 10. Nationally, unknown-source cases were reported in 103 of the 260 weeks. The largest unknown-source outbreak included 13 cases and lasted 5 weeks. The rarity of unknown-source cases, wide gaps in geographic and temporal distribution, and the short duration of the longest unknown-source outbreak indicate that endemic transmission of measles was not sustained in the United States during this period. (+info)
Unraveling women's perceptions of risk for breast cancer.
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Inconsistent reports of the prevalence of risk perception accuracy may be related to the use of different classification strategies. The purpose of this study was to compare two approaches for assessing the accuracy of women's breast cancer risk perceptions. A telephone survey was conducted with an age-stratified random sample of British Columbian women 20-79 years of age without a breast cancer diagnosis (n = 761). A comparison of two methods employed to determine perception accuracy revealed substantial differences between the methods with regard to the classification of women as under- and over-estimators. The study highlights the need for researchers to consider the method used to determine the accuracy of risk perceptions and the implications of using different strategies to assess risk perception accuracy when such information is used in research or to guide interventions. (+info)