Biomedical subjects

Jo Alexander

Publications and source records attributed to Jo Alexander.

3 recordsLinked to original sources

PubMed2003

An evaluation of a support group for breast-feeding women in Salisbury, UK.

OBJECTIVE: To evaluate a newly set-up breast-feeding support group. SETTING, PARTICIPANTS, DESIGN AND ANALYSIS: Lay 'Bosom Buddies' were trained, and ran a weekly drop-in group with a breast-feeding counsellor and a midwife in a socio-economically disadvantaged housing estate. During the first 31 weeks, 53 breast-feeding women attended and consent was sought to send an anonymous postal questionnaire six weeks after their first attendance. Content analysis and descriptive statistics have been used. FINDINGS: The response rate to the questionnaire was 87% (45/52) with 76% of respondents (34/45) reporting that they were still breast feeding. Only four women had discontinued for the reason for which they had initially attended the group. While the greatest value of the group was considered by the women to relate to its function in supporting breast feeding, 46% (141/305) of the aspects identified by them as being 'good' related to issues of a predominantly psychosocial nature. Of the women sent questionnaires 38% (20/52) came from areas with high or medium unemployment. KEY CONCLUSIONS: This group appears to be highly successful in supporting women to continue to breast feed for at least six weeks following their first attendance. It also appears to provide psycho-social benefits.

Adolescent↗

PubMed2002

Postnatal vaginal bleeding problems and General Practice.

OBJECTIVES: to investigate women's experiences of problems with vaginal loss from 28 days to three months postnatally and to describe the treatment and referral patterns for women who consult their GP about such problems during the first three months postnatally. DESIGN: a longitudinal questionnaire study of consecutively delivered postnatal women and a report-card survey of GP consultations by women with problems with postnatal vaginal loss. SETTING: two health districts in the south of England. PARTICIPANTS: women delivering in the two health districts during specified recruitment periods in 1995 and 1996. For the GP study, with her consent, the GP returned an anonymous registration card for each woman presenting. FINDINGS: in the survey of women, 20% (64/325) reported problems with postnatal loss occurring between 28 days and three months after the birth. Around a half of these consulted a GP. The GP study was disappointing in that only 26% (30/115) of practices agreed to take part and 16% (18/115) returned notification cards. Forty-eight women were included from 18 practices. The most common presenting symptoms were excessive bleeding (29/48; 60%) and prolonged bleeding (26/48; 54%). The commonest form of treatment was antibiotics alone (15/48; 31%) but 12 women (25%) were neither treated nor referred. Referral (n=19) was for hospital admission, out-patient appointment or direct referral for an ultrasound scan. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: morbidity related to abnormalities of postnatal vaginal fluid loss (lochia) has been shown to be significant, yet nothing was known about the outcome of related GP consultations during the first three months postnatally. A variety of treatment and referral patterns were revealed, highlighting the need for a systematic review of the literature on the management of secondary postpartum haemorrhage. Health care workers need to be aware of the significant morbidity experienced by postnatal women in relation to their lochial loss.

Adolescent↗

PubMed2002

An evaluation by focus group and survey of a course for Midwifery Ventouse Practitioners.

OBJECTIVE: to evaluate the Midwifery Ventouse Practitioners' (MVPs) Course and the MVPs' perception of its effect on their practice. DESIGN: qualitative and quantitative. PARTICIPANTS: 18 midwives who had completed the MVP course at Bournemouth University 1998-2000. DATA COLLECTION: focus group (n=8) and postal questionnaire (n=18). FINDINGS: important issues were identified by the focus group and informed the development of the questionnaire which achieved a 100% response rate. The mean length of full-time experience as a midwife was 18.6 years (SD 6.8; range 9-33); 11 midwives were based in community maternity units and seven in consultant units. Seventeen of the MVPs had been called to assist 505 women in this capacity; 366 (72%) had an MVP ventouse-assisted birth, 129 (26%) a normal birth and 10 women (2%) needed obstetric assistance. In this regard, there were considerable differences between individual MVPs. The midwives gave high priority to woman-centred values and to the very judicious use of intervention. They felt that the course had increased their confidence in relation to their midwifery practice, in general, and their ability to define fetal position and station, in particular. They reported a high level of confidence when undertaking their first ventouse birth after completing the course. KEY CONCLUSIONS AND IMPLICATIONS: midwives who have undertaken this course do not appear to expand their role to the detriment of normal midwifery, as had been feared. Even highly experienced midwives value increasing their confidence in relation to vaginal and abdominal examination. Ambulance transfer in the second stage of labour was prevented for at least 109 women. A long-term clinical evaluation of the births to which an MVP has been called is needed.

Adult↗