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Biomedical subjects

C M Sampselle

Publications and source records attributed to C M Sampselle.

At least 19 recordsLinked to original sources
PubMed2001

Posttraumatic stress disorder and pregnancy complications.

OBJECTIVE: To assess the associations between specific pregnancy complications and posttraumatic stress disorder based on neurobiologic and behavioral characteristics, using Michigan Medicaid claims data from 1994-1996. METHODS: Two thousand, two hundred nineteen female recipients of Michigan Medicaid who were of childbearing age had posttraumatic stress disorder on the basis of International Classification of Diseases, 9th Revision (ICD-9) codes. Twenty percent (n = 455) of those recipients and 30% of randomly selected comparison women with no mental health diagnostic codes (n = 638; P <.001) had ICD-9 diagnostic codes for pregnancy complications. We used multiple logistic regression to investigate associations between specific pregnancy complications and posttraumatic stress disorder, controlling for demographic and psychosocial variables. Obstetric complications were hypothesized based on high-risk behaviors and neurobiologic alterations in stress axis function in posttraumatic stress disorder. RESULTS: After controlling for demographic and psychosocial factors, women with posttraumatic stress disorder had higher odds ratios (ORs) for ectopic pregnancy (OR 1.7, 95% confidence interval [CI] 1.1, 2.8), spontaneous abortion (OR 1.9, 95% CI 1.3, 2.9), hyperemesis (OR 3.9, 95% CI 2.0, 7.4), preterm contractions (OR 1.4, 95% CI 1.1, 1.9), and excessive fetal growth (OR 1.5, 95% CI 1.0, 2.2). Hypothesized labor differences were not confirmed and no differences were found for complications not thought to be related to traumatic stress. CONCLUSIONS: Pregnant women with posttraumatic stress disorder might be at higher risk for certain conditions, and assessment and treatment for undiagnosed posttraumatic stress might be warranted for women with those obstetric complications. Prospective studies are needed to confirm present findings and to determine potential biologic mechanisms. Treatment of traumatic stress symptoms might improve pregnancy morbidity and maternal mental health.

Adult↗
PubMed1999

Comfort in labor and midwifery art.

PURPOSE: To examine the phenomenon of comfort in the context of childbirth. Enhancement of comfort for laboring women is a valued outcome of nursing and midwifery care. Interventions that increase comfort during labor support a woman's effort to participate more fully in the birth thereby keeping her more aware of her body, emotions, and experience. ORGANIZING CONSTRUCT: The concept of comfort is analyzed and defined in the context of laboring women. Comfort studied from a feminist perspective is suggested. SOURCES: A literature review of nursing, midwifery, and medical texts from the 1920s to 1998 provides information about labor, pain in labor, and goals of providers caring for laboring women. Research articles focusing on comfort are identified as they relate to the concept of comfort in labor. Writings of contemporary feminist authors provided the ideas for designing the study of comfort from a feminist perspective. METHODS: To develop a theory of comfort during labor, early nursing and midwifery texts were searched to identify goals of care. The meaning of comfort was analyzed from the early 1920s to the present by concept analysis. Validation of findings was sought from publications on comfort research. FINDINGS: Comfort can exist in spite of great pain and nurses and midwives may be able to assist laboring women to achieve a level of comfort during labor. Intervening to promote the comfort of laboring women can empower these women during birthing. CONCLUSIONS: For clinicians caring for birthing women, particularly midwives, promotion of comfort is a high priority. Increasing comfort can redefine the meaning of pain in childbirth. Increasing comfort may create a decreased need for medical interventions and lower costs.

Clinical Nursing Research↗
PubMed1999

Continence for women: evidence-based practice.

Approximately 20% of women ages 25-64 years experience urinary incontinence. The symptoms increase during perimenopause, when 31% of women report that they experience incontinent episodes at least once per month. Bladder training and pelvic muscle exercise are the recommended initial treatment and can be taught effectively in the ambulatory care setting. Bladder training enables women to accommodate greater volumes of urine and extend between-voiding intervals. Pelvic muscle exercise increases muscle strength and reduces unwanted urine leakage. Accumulated research results provide evidence-based guidelines for nursing practice. The Association of Women's Health, Obstetric and Neonatal Nurses has identified continence for women as the focus of its third research utilization project. This article presents the rationale, evidence base, and educational strategies compiled by the Research Utilization 3 Nurse Scientist Team. Nurses can enable women to incorporate these noninvasive techniques into self-care.

Adult↗
PubMed1998

Effect of pelvic muscle exercise on transient incontinence during pregnancy and after birth.

OBJECTIVE: To test the effect of pelvic muscle exercise on postpartum symptoms of stress urinary incontinence and pelvic muscle strength in primigravidas during pregnancy and postpartum. METHODS: A prospective trial randomized women into treatment (standardized instruction in pelvic muscle exercise) or control (routine care with no systematic pelvic muscle exercise instruction). Urinary incontinence symptoms were measured by questionnaire. Pelvic muscle strength was quantified by an instrumented gynecologic speculum. Time points were 20 and 35 weeks' gestation and 6 weeks, 6 months, and 12 months postpartum. RESULTS: Outcomes are reported for 46 women with vaginal or cesarean birth and for a subsample of 37 women with vaginal birth. Longitudinal analyses are reported for cases with complete data across time points. Diminished urinary incontinence symptoms were seen in the treatment group, with significant treatment effects demonstrated at 35 weeks' gestation (F [1,43] = 4.36, P = .043), 6 weeks postpartum (F [1,43] = 4.94, P = .032), and 6 months postpartum (F [1,43] = 4.29, P = .044). A repeated measures analysis of variance showed a significant interaction between time and treatment for urinary incontinence (F [4, 41] = 2.83, P = .037). A significant effect of initial pelvic muscle strength was demonstrated; ie, pelvic muscle strength at 20 weeks' gestation predicted significantly 12-months postpartum strength (F [1, 13] = 8.12, P = .014). Group differences in pelvic muscle strength were observed (the treatment group had greater strength at 6 weeks and at 6 months postpartum than did controls), but these differences were not statistically significant. CONCLUSION: Practice of pelvic muscle exercise by primiparas results in fewer urinary incontinence symptoms during late pregnancy and postpartum.

Adult↗
PubMed1998

Anatomy of female continence.

Various muscle, connective tissue, and neurologic structures within the pelvic floor play critical roles in the maintenance of both urinary and fecal continence. Recent advances in technology, combined with greater precision during anatomic study, have expanded our understanding of the role played by the pelvic floor in maintaining continence. The goal of this article is to summarize recent research on female pelvic anatomy, with a particular emphasis on the evidence base related to urinary incontinence. The content is organized to accomplish three aims: (1) identify, within the context of pelvic floor anatomy, the structures that comprise the urinary continence system, (2) Describe the functional dynamics of urinary continence, including factors in resting urethral pressure and pressure transmission, and (3) Present the rationale, technique, and interpretation of various methods of measuring pelvic floor function.

Female↗
PubMed1993

Using a stopwatch to assess pelvic muscle strength in the urine stream interruption test.

Pelvic muscle strength is important in maintaining urinary continence. The urine stream interruption test provides a simple measure of pelvic muscle strength. This study evaluated the accuracy of the test as adapted for clinical use. Women (n = 75) were tested according to standardized protocol. The test was simultaneously timed using a uroflowmeter (for research purposes) and a stopwatch (a technique more feasible in the practice setting). The stopwatch-timed urine stream interruption test was consistent with the uroflowmeter score (r = 0.90, p < 0.00) and demonstrated adequate repeatability (r = -0.69, p < 0.00). The stopwatch test was related to a digital measure of pelvic muscle strength (r = -0.49, p = 0.00), i.e., women with greater pelvic muscle strength were able to interrupt the stream of urine more quickly. Significantly less involuntary urine loss was seen in women whose stopwatch test score was two seconds or less as compared with those whose scores were greater than two seconds (t = -4.83, p = < 0.00, df = 73). Clinicians can use the urine stream interruption test as a baseline measure and as a tool to assess changes in pelvic muscle strength.

Adolescent↗
PubMed1993

Kegel dyspareunia: levator ani myalgia caused by overexertion.

BACKGROUND: The onset of unexplained dyspareunia with a normal pelvic examination requires a careful evaluation to search for an etiology. CASES: The initiation of Kegel exercises led to dyspareunia in several patients whose pain could be localized to the levator ani muscles. Elimination of the muscular overexertion led to resolution of the dyspareunia in all cases. CONCLUSION: Dyspareunia associated with the initiation of Kegel exercises may be due to levator ani myalgia. Once recognized as a potential source of dyspareunia, levator myalgia is easy to diagnose and treat.

Adult↗
PubMed1990

The influence of feminist philosophy on nursing practice.

This paper describes how feminist beliefs and values should influence nursing practice. Traditionally held patriarchal values are challenged, and the feminist tenets of gender equity, the basis for value to society and personal sovereignty are discussed. Drawing on experience as a nurse practitioner this writer gives examples of nursing practice that are grounded in feminist philosophy.

Female↗
PubMed1988

The Child Care Activities Scale and Parental Role Preference Scale.

The Child Care Activities Scale (CCAS) and Parental Role Preference Scale (PRPS) were developed to measure parental involvement in four domains of child care: direct care, indirect care, amount of sole responsibility, and play. The CCAS measures level of involvement of each parent in 21 child care activities. The 12-item PRPS is intended to discriminate among how much parents ideally would like to participate, and how much they actually do participate in child care. The psychometric properties of both scales are presented using data from two studies. Recommendations for the future use of the scales are given.

Adult↗
PubMedDate not supplied

Pelvic muscle relaxation. Assessment and management.

Strong pelvic musculature is important to the health of women because of the role it plays in maintaining urinary continence and in providing support to the pelvic organs. Therefore, assessment for pelvic muscle relaxation and strategies for preventive and therapeutic management are necessary elements of care. This paper discusses several assessment techniques that were tested in research settings but that are readily transferable to clinical care. Research-based recommendations for nurse-midwifery management, with emphasis on effective teaching of pelvic muscle exercise, are made. Pelvic muscle exercise is a noninvasive technique that should be used as the initial treatment of urinary incontinence, before a surgical alternative is tried. Moreover, women with weaker pelvic musculature, who are identified early, can begin a program of preventive exercise that may help to avoid incontinence in later life.

Exercise↗
PubMedDate not supplied

Prevalence of abuse among pregnant women choosing certified nurse-midwife or physician providers.

Despite the fact that violence against women is a widespread problem in the United States, many providers do not routinely screen for it, particularly if the woman is not from a lower socioeconomic group. This was a secondary analysis of survey data from 940 antenatal women in private CNM and MD practices. Median annual income was $40,000 to $49,000 and mean schooling completed was 15 years. It was found that 91 (9.7%) had a history of previous abuse and eight (0.9%) were currently in an abusive relationship. Women with a previous history of abuse were found in the CNM caseloads at higher than expected levels. Annual income was predictive of women currently being abused, but not for women with past history. Abused women had on average less education than nonabused, with the most marked difference seen in women reporting current abuse. These results provide further evidence that the problem of abuse is not restricted to women of lower socioeconomic status. The finding that women with history of abuse were more likely to appear in CNM caseloads adds further support to the need for routine screening.

Female↗
PubMedDate not supplied

Spontaneous pushing during birth. Relationship to perineal outcomes.

Vaginal birth is a recognized factor in perineal tissue damage and postpartum perineal pain. This study examined outcomes of 39 primiparous women who had spontaneous vaginal births. In a retrospective survey, women were asked to describe the type of pushing used to give birth and what the level of pain had been in the perineal (or vaginal) area during the first week postpartum. Labor and delivery chart data documented extent of episiotomy and/or laceration sustained. Eleven (28%) women reported using spontaneous bearing down efforts, and the remaining 28 (72%) were directed. Women who used spontaneous pushing were more likely to have intact perineums postpartum and less likely to have episiotomies, and second or third degree lacerations (chi 2 [3, N = 39] = 8.1, P = .043). Other variables, such as maternal age, infant birth weight, length of second stage, provider type, and use of epidural, did not demonstrate a significant difference in perineal outcome. Further analysis showed a significant relationship between the extent of perineal disruption and pain (F [3,30] = 5.08, P = .005).

Adult↗
PubMedDate not supplied

Behavioral intervention for urinary incontinence in women: evidence for practice.

In the past, clinicians have relied heavily on pharmacologic and surgical interventions for urinary incontinence in women. However, evidence now exists that less invasive, behavioral therapies can be extremely effective in helping women become continent; thus, strategies that involve bladder and pelvic floor muscle training should generally be the first line of treatment. Before behavioral intervention is initiated, it is important to assess for any medical or associated conditions that should be treated first. Bladder training enables women to accommodate increasingly greater volumes of urine in the bladder and gradually to extend the interval between voiding. Pelvic floor muscle training increases awareness of function and strengthens these voluntary muscles, promoting continence.

Behavior Therapy↗
PubMedDate not supplied

Changes in pelvic muscle strength and stress urinary incontinence associated with childbirth.

Pelvic muscle strength and stress urinary incontinence were studied in 20 nulliparous women at 32 to 36 antepartum weeks and 6 postpartum weeks. Measures used included a digital muscle strength score, observed incontinence, and urine flow interruption. Pelvic muscle strength declined from the antepartum to postpartum periods in women with vaginal births; however, women with greater antepartal pelvic muscle strength tended to preserve a higher level of strength during the postpartum period. In general, less pelvic muscle strength was found in women who demonstrated stress urinary incontinence.

Adult↗
PubMedDate not supplied

The role of nursing in preventing violence against women.

Violence against women is a significant problem at every age. While nurses have increased their role in identifying and managing cases of women who have experienced physical and sexual abuse, they have been less active in preventing violence. Effective prevention requires an understanding of the prevalence and seriousness of the problem, awareness of the societal forces that foster and sustain it, and application of feminist principles to counteract those forces. The incidence of rape and battery in contemporary society is highlighted, and the societal forces of devaluation of women, power inequity, and treatment of women as property that maintain this destructive behavior are outlined. Preventive nursing actions derived from feminist philosophy that are applicable in clinical practice are discussed.

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