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Biomedical subjects

D G Froberg

Publications and source records attributed to D G Froberg.

18 recordsLinked to original sources
PubMed1993

Changes in women's physical health during the first postpartum year.

OBJECTIVE: To examine changes in women's physical health during the first postpartum year. DESIGN: Participants completed surveys at 1, 3, 6, 9, and 12 months post partum. PARTICIPANTS AND SETTING: Four hundred thirty-six first-time mothers who gave birth at one of two St Paul, Minn, hospitals during a 12-month period and who met the criteria for the study. MAIN OUTCOME MEASURES: Physical symptoms and number of illness days experienced within the previous 2 weeks. RESULTS: Physical problems seen at a higher prevalence at 1 month post partum included breast symptoms, vaginal discomfort, fatigue, hemorrhoids, poor appetite, constipation, increased sweating, acne, hand numbness or tingling, dizziness, hot flashes, and illness days. Several of these disorders--hemorrhoids, dizziness, fatigue, and constipation--persisted beyond 1 month and were joined by other "late" problems, including respiratory symptoms, sexual concerns, and hair loss. Women who returned to the work force noted more symptoms of respiratory infections, and women with vaginal deliveries had a higher prevalence of hemorrhoids, vaginal discomfort, pain with intercourse, difficulty reaching orgasm, sinus problems, and acne. CONCLUSIONS: Recovery from childbirth often requires more than the 6 weeks traditionally allotted, and postpartum health appears to be affected by delivery type and work status.

Adult↗
PubMed1992

The parental leave debate: implications for policy relevant research.

Legislative activity regarding parental and family medical leave has been intense, with heated debate, in both national and state political arenas. Proponents of legislation report that policy is needed because of women's increasing rate of labor force participation and the concomitant shortage of substitute infant care. Benefits of policy are presumed to include women's health and parent-child bonding. However, no direct empirical evidence exists to support these assumptions. Opponents of legislation say that the cost of policy is burdensome to employers. However, the General Accounting Office reports that the only measurable net costs to employers associated with the federal bill will be to cover the leave takers' health insurance premiums. This literature review examines the above issues and identifies a policy relevant research agenda, crucial to the development of rational and humane policy.

Child Day Care Centers↗
PubMed1991

The measure of health in new mothers: a factor analysis of physical and mental health variables.

This factor analysis study was conducted to determine the components of health in new mothers. The 286 participants included three groups of married women: 63 first-time biological mothers, 104 first-time adoptive mothers, and 119 controls (women without children). Results for the entire participant group showed four health status factors--mental health, use of health services, work readiness, and activity--and these four factors yielded a cumulative variance of 62.8%. While three of the factors--mental health, use of health services, and work readiness--were represented in the factor structures of each of the three groups, there were noteworthy differences in the constituents of factors between groups. The current change in roles and responsibilities of new mothers calls for a careful look at the health of this group of women; the health factors identified in this study may provide useful tools for further research involving these important members of our society.

Adoption↗
PubMed1991

The effects of social support on women's health during pregnancy, labor and delivery, and the postpartum period.

This review of the literature on social support and its relationship to maternal health indicates that emotional, tangible, and informational support are positively related to mothers' mental and physical health around the time of childbirth. The importance of various types of support changes with the changing needs of women as they move from pregnancy to labor and delivery, and then to the postpartum period. During pregnancy, emotional and tangible support provided by the spouse and others is related to the expectant mother's mental well-being. In addition, informational support in the form of prenatal classes is related to decreased maternal physical complications during labor and delivery, and to improved physical and mental health postpartum. Mothers who have the support of a companion during labor and delivery experience fewer childbirth complications and less postpartum depression. Mothers' postpartum mental health is related to both the emotional support and practical help (eg, housework and child care activities) provided by the husband and others. Health care providers are in a unique position to educate prospective parents about the importance of social support around the time of childbirth and may play a critical role in mobilizing support systems for new mothers.

Delivery, Obstetric↗
PubMed1991

Changes in women's mental and physical health from pregnancy through six months postpartum.

A longitudinal study was conducted to investigate changes in women's mental and physical health around the time of childbirth, and to determine whether health was related to length of maternity leave. Thirty-seven married, employed first-time mothers completed questionnaires during pregnancy, and again at 6 weeks, 3 months, and 6 months postpartum. Results showed that, from pregnancy to the 6th postpartum month, the number of days that mothers were ill because of infections steadily increased. In addition, depressive symptoms for new mothers rose from pregnancy to the 6th week postpartum, and declined thereafter. For women who did not return to work during the period of the study, a significant decline in depressive symptoms was observed from the prenatal period through the 6th postpartum month. These findings demonstrate significant changes in mental and physical health for this group of first-time mothers.

Adult↗
PubMed1991

The fourth stage of labor: the health of birth mothers and adoptive mothers at six-weeks postpartum.

This study was conducted to determine the frequency of various health problems in new adoptive and biological mothers six weeks after they adopted or delivered their infants. Participants included 108 married first-time adoptive mothers, 72 married first-time biological mothers, and 133 controls (married women without children), each of whom completed a mailed questionnaire. Compared to controls, adoptive and biological mothers reported more fatigue, less readiness to work at a job, and less activity with household chores and recreational or social functions. In addition, biological mothers complained of more breast and genitourinary problems than did adoptive mothers or controls. Apart from their fatigue and hesitation to work at a job, adoptive mothers reported relatively good health, with the best mental health outcomes and the fewest acute physical problems of the three groups. These findings suggest that, for both adoptive and birth mothers, some aspects of postpartum recovery may continue up to and beyond the sixth postpartum week.

Adoption↗
PubMed1990

A causal model describing the relationship of women's postpartum health to social support, length of leave, and complications of childbirth.

Recovery from childbirth is a complex process that may involve not only the gynecological organs, but also the cardiovascular, respiratory, musculo-skeletal, urologic, gastrointestinal, endocrine, and nervous systems. The process of postpartum recovery may span several months and is related to a variety of personal, family, and social variables. This paper presents a model that describes changes in women's health over the first postpartum year and the relationship between health changes and other variables. The model's dependent variables--mothers' mental and physical health--have a reciprocal effect on one another. The independent variables within the model include length of maternity leave, social support, complications of childbirth, baby's health, mother's use of cigarettes and alcohol, and demographic characteristics. This model is proposed as a research tool for future investigations in postpartum health, and as a conceptual framework to enhance our understanding of the relationship between postpartum health and other important variables.

Adult↗
PubMed1989

Methodology for measuring health-state preferences--IV: Progress and a research agenda.

Remaining questions relative to the measurement of health-state preferences are outlined and applications discussed. We recommend more widespread use of functional measurement to better understand preference structures. Further research should be conducted on the reliability and validity of preference values produced by different scaling methods, including careful examination of the content validity of health-state descriptions. Construct validation studies using the multitrait-multimethod matrix would be useful as well as comparisons of stated preferences with revealed preferences. Despite the many unanswered measurement questions, preference values are currently being used in decision making at both the individual and societal levels. Several global health status measures incorporate preference values, and preferences are increasingly being used in cost-effectiveness studies. If preferences are to be used effectively, research on their measurement must accelerate to keep pace with the urgency for application.

Epidemiologic Methods↗
PubMed1989

Methodology for measuring health-state preferences--I: Measurement strategies.

Values play a critical part in decision making at both the individual and policy levels. Numerous methodologies for determining the preferences of individuals and groups have been proposed, but agreement has not been reached regarding their scientific adequacy and feasibility. This is the first of a four-part series of papers that analyzes and critiques the state-of-the-art in measuring preferences, particularly the measurement of health-state preferences. In this first paper we discuss the selection of relevant attributes to comprise the health-state descriptions, and the relative merits of three measurement strategies: holistic, explicitly decomposed, and statistically inferred decomposed. The functional measurement approach, a statistically inferred decomposed strategy, is recommended because it simultaneously validates the process by which judges combine attributes, the scale values they assign to health states, and the interval property of the scale.

Attitude to Health↗
PubMed1989

Methodology for measuring health-state preferences--II: Scaling methods.

This paper begins with a discussion of measurement principles relevant to determining health-state preferences. Six scaling methods are described and evaluated on the basis of their reliability, validity, and feasibility. They are the standard gamble, time trade-off, rating scale, magnitude estimation, equivalence, and willingness-to-pay methods. Reliability coefficients for most methods are acceptable although the low coefficients for measurements taken a year apart suggest that preferences change over time. Convergent validity among methods has been supported in some but not all studies, and there are limited data supporting hypothetical relationships between preferences and other variables. The category ratings method is easiest to administer and appears to yield valid scale values; thus, it is recommended for large-sample studies. However, decision-oriented methods, particularly the time trade-off and standard gamble, may be more effective in small-scale investigations and individual decision making.

Attitude to Death↗
PubMed1989

Methodology for measuring health-state preferences--III: Population and context effects.

In addition to the scaling method, there are many other aspects of the measurement process that may affect rater judgments of the relative desirability of health states. Although we find little compelling evidence of population differences in preferences due to demographic characteristics, there is some evidence suggesting that medical knowledge and/or experience with illness may influence raters' valuations of health states. Other aspects of the rating process that affect rater judgments can be classified as one of two types: inconsistencies due to limitations in human judgment, and inconsistencies due to situation-specific variables. When inconsistencies are due to limitations in human judgment, such as framing effects, a reasonable solution is to help the rater to see and correct the inconsistency. When inconsistencies are due to situation-specific variables, such as the way the health state is defined and presented, investigators should attempt to standardize conditions across studies.

Age Factors↗
PubMed1987

The effect of decreased caffeine consumption on benign proliferative breast disease: a randomized clinical trial.

A single-blind, randomized clinical trial of 56 female subjects was conducted to determine whether decreased consumption of caffeine decreases breast pain/tenderness or nodularity in patients with suspected benign proliferative breast disease. The subjects were randomly assigned to one of three groups--a control group (no dietary restrictions), a placebo group (cholesterol-free diet), and an experimental group (caffeine-free diet). At the initial examination, the subjects reported on the presence of breast pain, the degree to which pain affects daily activities, the frequency of pain, the degree of pain associated with breast examinations, and the degree of pain associated with close-fitting clothing. Subjects were then examined and the four quadrants of each breast were rated on a scale of 0 to 3 (0 = normal, fatty tissue, 1 = little seedy bumps or fine nodularity, 2 = discrete nodules or ropy tissue, 3 = confluent areas, hard or soft masses). Subjects in all three groups returned for 2- and 4-month follow-up examinations. Total nodularity scores, degree of pain/tenderness, and compliance with dietary restrictions were analyzed. The data showed that decreased caffeine consumption did not result in a significant reduction of palpable breast nodules or in a lessening of breast pain/tenderness.

Adult↗
PubMed1984

User-centered evaluation.

Much has been written on graduate medical education and its evaluation. Seldom, however, are mentioned the uses made or the benefits of such evaluations. Drawing on current models for increasing the use of information from external evaluations, the authors offer a user-centered approach for increasing the use of results from internal evaluations, the more typical form of evaluation in graduate medical education. The over-riding emphasis of the user-centered approach to evaluation is the utility of the resultant data. Three features characterize user-centered evaluation: an ordered set of steps with usefulness as the primary concern at each step; delineation of evaluator and decision-maker roles; and attention to the general communication aspects of evaluation. This article describes these three characteristics, concluding with two fundamental points: (1) A user-centered approach to evaluation will help evaluation do what it is supposed to do: provide information that gets used to increase the effectiveness of everyday decisions. (2) A user-centered evaluation accomplishes this, first, by having a pervasive attitude of utility and, second, by carefully attending to the three characteristic features of this approach to evaluation.

Education, Medical, Graduate↗
PubMed1984

A continuity model for research consultation in family medicine.

This paper describes a model of individualized research consultation designed to assist family physician faculty members to develop research skills. The consultative relationship described here is a one-to-one helping relationship between a client (a family physician researcher) and a research consultant that is directed toward enabling the client to complete a research project and ultimately to function as an independent researcher. The continuity model stresses a relatively longterm, intensive relationship--a departure from the typical consultation in which the consultant renders advice and then exits. Within this continuity model, the consultant is involved at regular intervals throughout the duration of the research project and is committed to its completion. The principal role of the consultant is that of educator, within which the consultant may at various times act as reflective listener, agent of change, role model, "linker" to resources, and informational expert.

Consultants↗
PubMed1982

A systematic approach to faculty development for family practice faculty.

Although faculty developers often employ a systems approach to instruction when responding to individual faculty members' requests for assistance, they are seldom in a position to use this approach to conduct a unified faculty development program for an entire faculty with hundreds of members. This paper describes a two-year faculty development program in family medicine that used a systems approach to meet identified faculty needs through a series of integrated training efforts. Following this systematic framework involved several steps: using a needs assessment to identify faculty needs and preferred learning strategies, selecting instructors from local and national experts to conduct workshops and seminars, evaluating the program by examining participants' gains on the workshop/seminar objectives using a one-group repeated measures design employing self-assessments, and using evaluation results to revise faculty training programs to better meet their needs.

Education, Medical, Graduate↗
PubMedDate not supplied

A study of federally funded faculty development in family medicine from 1978-1981.

From 1978 to 1982 the federal government invested $13.6 million in family medicine faculty development projects. To synthesize and disseminate the collective experience of these projects, we surveyed directors of the 30 projects funded and begun in 1978. The study's purpose was twofold. First, we wanted to capture the lessons these experienced project directors learned. To accomplish this we asked directors to describe and then evaluate specific approaches they used for eight aspects of their projects: project staff, needs assessment, participant recruitment, project participants, goals and objectives, instructional formats, instructional strategies, and project evaluation methods. We also sought information on additional effects of the projects, present status of faculty participants, and future directions for faculty development in family medicine. The results revealed useful suggestions for designing and conducting faculty development and a consensus on the priority areas for future faculty development efforts: research skills, clinical teaching, academic vitality, and curriculum development.

Faculty, Medical↗