Biomedical subjects

E M Hillan

Publications and source records attributed to E M Hillan.

7 recordsLinked to original sources

PubMed1998

Women's perceptions of birth plans.

OBJECTIVE: To investigate the use and effects of birth plans and how women perceive them. DESIGN: Retrospective questionnaire survey. SETTING: A teaching hospital with approximately 3000 deliveries per annum in Dundee, Scotland. PARTICIPANTS: 143 primigravidae, six to 13 weeks following delivery. FINDINGS: The study achieved a 71% response rate. Ninety per cent of women had completed a birth plan. Most women thought the process of completion of the plan had been useful by allowing discussion of available options beforehand. Half said the birth plan did not make any difference to the amount of control they felt during labour, although many thought that not enough attention had been paid to what they had written. Most women said they would make another birth plan in a future pregnancy. CONCLUSIONS: The majority of women found completion of a birth plan was beneficial. IMPLICATIONS FOR PRACTICE: More attention should be paid to the birth plan by carers during labour.

Adult↗

PubMed1998

Computers in midwifery practice: a view from the labour ward.

Concern continues to exist about the lack of integration of research into clinical practice. One of the reasons which has been suggested for this, is that practitioners may either not know about, or understand, the research findings. The availability of a database which contains systematic reviews of research such as the Cochrane Pregnancy and Childbirth Database, should go some way to overcome such obstacles associated with the implementation of research into practice. As part of a national audit on Caesarean section, a computer with the Cochrane Database was installed in the labour ward of each consultant maternity unit in Scotland. The purpose of this study was to determine if midwives working in labour wards make use of this accessible source of research findings to inform their practice. Anecdotal evidence suggested that although midwives were keen to use the databases, they did not have the requisite computer skills to do so. This study examined the computer literacy of midwives and their perceived educational needs. A questionnaire was distributed to all labour ward midwives in 22 consultant maternity hospitals in Scotland (n = 850). This questionnaire considered issues such as the preparation of midwives to use computers, midwives' perceptions and use of computers and their perceived educational needs. The response rate was 74%. Following analysis of the questionnaire labour ward managers were interviewed by telephone to ascertain their views regarding the Cochrane Database and their perception of its effectiveness. The results highlighted that only 27% of midwives claimed to use the Cochrane Database on a regular basis. Overall midwives had a positive attitude towards information technology but claimed they did not have the requisite computer skills to use these tools. Managers agreed that there was a need for further instruction and support for midwives. The findings of this study have important implications for the future professional preparation and continuing education of midwives.

Adult↗

PubMed1995

Postoperative morbidity following Caesarean delivery.

The current study was designed to determine the postoperative morbidity associated with Caesarean section and to compare the morbidity with the timing of the operation: elective versus emergency Caesarean section; subgroups of women delivered by emergency Caesarean section; women delivered during the first stage of labour versus those delivered during the course of the second stage. A retrospective review was conducted of the obstetric case record and the midwifery notes of all women delivered by Caesarean section over a 1-year period in a university teaching hospital (n = 619). The variables used to measure postoperative morbidity included: wound infection, intrauterine infection, urinary tract infection, chest infection, pyrexia, urinary catherization and postnatal blood transfusion. Only 9.5% of the women had no recorded morbidity in the postnatal period. Women delivered by emergency Caesarean section experienced a greater number of postnatal problems, an increased incidence of febrile morbidity, more blood transfusions in the postnatal period and a higher proportion had a urinary catheter left in situ after surgery. The incidence of wound infection, intrauterine infection and chest infection was higher in the emergency group and this resulted in an increased proportion of the women requiring antibiotic therapy in the postnatal period. The study found that there was considerable postoperative morbidity associated with Caesarean delivery, particularly if the operation was carried out as an emergency procedure.

Antibiotic Prophylaxis↗

PubMed1993

Nursing dementing elderly people: ethical issues.

It has been estimated that up to 40% of people with moderate to severe dementia live in residential homes or long-stay hospital wards. This paper examines some of the ethical issues that arise in nursing people suffering from dementia within an institutional setting. The paper focuses first on the nursing profession and the recently published Strategy for Nursing. The fundamental patient/client values within the strategy recognize the uniqueness of the individual and the importance of providing nursing care which is tailored to meet individual needs. The next part of the paper will examine the difficulties associated with individualizing care for people suffering from dementia and highlight some of the ethical issues involved in looking after them. Finally, some of the general professional issues involved are examined and some tentative suggestions are put forward as to how some of the identified problems might be tackled.

Aged↗

PubMed1992

Issues in the delivery of midwifery care.

The current study was designed to further knowledge of the immediate, short and long-term effects of Caesarean delivery for both the woman and her baby. A study group of 50 low-risk primigravidae of normal stature delivered by emergency Caesarean section were compared with a closely matched control group of 50 primigravidae delivered vaginally. The study generated a large amount of both quantitative and qualitative data. From the analysis of the comments made by the women in both the study and control groups at the time of both the hospital and home interviews, it was apparent that there were a number of deficiencies in the care received. This paper examines some of the issues related to the delivery of midwifery care round the themes of lack of realistic preparation for labour, delivery and parenthood; lack of support and conflicting advice from midwives, especially in the postnatal wards; failure of communication between women and staff, and it was apparent that this occurred in all areas from antenatal care to the postnatal wards.

Cesarean Section↗

PubMed1992

Short-term morbidity associated with cesarean delivery.

This study describes the short-term morbidity associated with cesarean delivery and women's knowledge of the reasons it was performed. It was conducted in a university teaching hospital that delivers approximately 4000 women per year. During 1986, 619 women (16%) were delivered by cesarean, 588 of whom were sent a questionnaire three months after delivery. The response rate was 76 percent. General questions were asked about the women's recovery and health state after the birth, and whether they had experienced more specific types of morbidity, including infection, backache, and depression, and the reasons for the cesarean delivery. Women's answers were then compared with the obstetric case record. In their comprehension of why the cesarean was necessary, 87 percent of women were right or partially right, 35 percent believed they had still not fully recovered, and 28 percent felt less healthy than before the pregnancy. Women experienced a wide variety of postnatal morbidity, most commonly backache (55%), constipation (49%), and depression (38%). The study showed that considerable maternal morbidity is associated with cesarean delivery, and it can persist long after the woman is discharged from hospital. Much more information is necessary about the health of women after delivery, and research is urgently required to determine the comparative rates of morbidity associated with different delivery methods.

Adult↗

PubMed1991

Caesarean section: historical background.

Although caesarean section is probably one of the oldest operations in the history of medicine, its origins are rather obscure. Very few surgical procedures have been the subject of such bitter controversy, and, it is only in relatively recent times that its performance changed from a last minute attempt to save a child from an almost dead mother to a safe, often planned, operation.

Cesarean Section↗