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Results for “Anecdotes as Topic”

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At least 433 records · Page 24Linked to original sources

PubMed2002

Midwives' experience of the encounter with women and their pain during childbirth.

OBJECTIVE: to describe midwives' experience of the encounter with women and their pain during childbirth. DESIGN: qualitative study using a phenomenological approach. Data were collected via tape-recorded interviews. SETTING: Sahlgrenska University Hospital, Göteborg, and Karolinska Hospital, Stockholm, Sweden in 2000. PARTICIPANTS: nine experienced midwives between 12 and 28 years of midwifery practice. KEY FINDINGS: the essential structure was described as a striving to become an 'anchored companion'. 'To be a companion' was to be available to the woman, to listen to and see her situation mirrored in her body, and to share the responsibility of childbirth. To be 'anchored' was to show respect for the limits of the woman's ability as well as one's own professional limits. Five constituents can further describe the essential structure: listening to the woman; giving the woman an opportunity to participate and to be responsible; a trusting relationship; the body expresses the woman's situation; and to follow the woman through the process of childbirth. IMPLICATIONS FOR PRACTICE: the basis for maternity care should give an opportunity for midwives to be anchored companions. This could be done by emphasising listening to the woman, participation, responsibility, a trusting relationship and a clear understanding of the professional limits and the limits of the woman's ability.

Adaptation, Psychological↗

PubMed2002

A study of Swedish midwives' encounters with infibulated African women in Sweden.

OBJECTIVES: to investigate Swedish midwives' perceptions and attitudes towards infibulation and infibulated women, midwives' experiences of providing care for them and the training the midwives describe having received to enable them to care for and deliver infibulated women. DESIGN: a multi-stage sampling procedure was used. Open-ended questionnaires were distributed to midwives in labour wards with the purpose of identifying midwives to contact for interviews and focus group discussions. SETTING AND PARTICIPANTS: twenty-six midwives from three labour wards and two antenatal clinics situated in two towns in central Sweden participated in eight focus group discussions and three individual interviews. FINDINGS: there were three major themes: (a) emotions and communicational challenges entailed in the care of infibulated women, (b) knowledge and skills needed for caring and (c) the midwives' reliance on the Swedish law when dealing with the dilemmas they face in their interactions with the women and their families. The data indicate communication problems on different levels between midwives and the women and their families. There appear to be few or no guidelines in the units on how to provide good care for infibulated women and little or no co-ordination between antenatal care and the maternity wards. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the care of infibulated women during pregnancy and childbirth seems to be a marginalised issue in the areas where this study was performed. Early acknowledgement of female genital mutilation during pregnancy as well as improved communication between health care units may help professionals to offer culturally sensitive professional care to the women and their families.

Adult↗

PubMed2002

An Australian study of women's experiences of their first pregnancy.

OBJECTIVE: to describe women's experiences and perceptions of their first pregnancy. DESIGN, SETTING AND PARTICIPANTS: a qualitative study, using grounded theory. Data were obtained from 13 women whose interviews were tape-recorded and transcribed. Interviews were conducted in the women's homes on three occasions during pregnancy. FINDINGS: the women's experiences were varied and diverse. Most had difficulty coping with the physical and emotional symptoms of pregnancy. Loss of control caused anxiety. Need for support emerged as important. Antenatal education classes were favourably commented upon, however, the women wanted more information on breast feeding, baby feeding/sleeping patterns and behaviour, and self-care. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: midwives committed to a wellness, woman-centred model of care and willing to provide continuity of care should endeavour to implement this model in the hospital environment. Teaching in the ward or childbirth/parenting programmes should not be compromised by midwives who believe that pregnant women cannot learn. A comprehensive review of the philosophy, content, delivery and evaluation of current childbirth/parenthood programmes should be undertaken. Also, a review of the qualifications and aptitude of educators conducting the programmes.

Adult↗

PubMed2002

A comparative study in Stockholm, Sweden of labour outcome and women's perceptions of being referred in labour.

OBJECTIVE: to study the outcome of labour and women's perceptions of being referred after onset of labour. DESIGN: a comparative study carried out between October 1998 and April 1999. SETTING: prospective parents in Stockholm, Sweden are offered a choice of which of the five hospitals in which they want to give birth. In reality, there is a lack of maternity beds in Stockholm to implement this policy and therefore nearly 10% of labouring women are being referred during labour. PARTICIPANTS: the study population was selected from one of the five hospitals. Included in the study were 266 labouring women, with a 37-42 weeks uncomplicated pregnancy, fetus presenting by the vertex and spontaneous onset of labour. During pregnancy, all the women had chosen the same labour ward where they planned to deliver. However, at the onset of labour half of the women, case group I (n = 133) were referred to another maternity unit due to lack of space in the labour ward. For every referred woman a control woman matched for age, parity and date of delivery was selected, with the same inclusion criteria, except being referred, control group II (n = 133). METHODS: a questionnaire with closed and open questions was posted to the women after birth and used to collect quantitative and qualitative data on the outcome of labour and the women's perceptions of referral during labour. FINDINGS: routines such as epidural analgesia (EDA) (p<0.002), episiotomies (p<0.015) and morphine/pethidine during labour (p<0.023) were more common in the referred group. The women in the referred group considered to a higher extent that referral during labour had affected their emotional state (p<0.001). Women in both groups had been worried during pregnancy by the thought of having to be referred when labour had started and the referral had caused practical problems, stress and a feeling of not being welcome in the referral labour ward. KEY CONCLUSION AND IMPLICATIONS FOR PRACTICE: referral during established normal labour may affect labour outcome, and the possibility that they may be referred worries women during pregnancy. Maternity policies and practices should be organised so that caring goals, such as continuity of care and women's' participation in birth planning, can be met.

Adaptation, Psychological↗

PubMed2002

Women's experiences of smoking during and after pregnancy as ascertained two to three years after birth.

OBJECTIVE: to ascertain the significant factors that influence women to stop/not stop smoking during pregnancy and the postnatal period. DESIGN: Twenty-four women were interviewed two-three years after delivery with regard to their smoking habits during and after pregnancy. The material was analysed based on a phenomenological approach in order to provide an accurate description of lived experience. FINDINGS: women who still smoked at their first visit to the antenatal clinic often had an established smoking pattern. They had vague knowledge about the risks of smoking during pregnancy. All women interviewed stated that the midwife played an important role in their motivation to stop/reduce smoking during pregnancy. Many women, however, lacked the support from doctors, delivery and maternity ward staff and district nurses. CONCLUSION: during pregnancy midwives and doctors have a unique opportunity to influence and help women who smoke to give up smoking. It is necessary that the different personnel have a similar approach to counselling.

Adult↗

PubMed2002

What constitutes 'balanced' information in the practitioners' portrayals of Down's syndrome?

OBJECTIVE: to explore the information that practitioners perceive they give to pregnant women about the condition of Down's syndrome, and to look at some influences on the construction of this information. DESIGN: qualitative study incorporating semi-structured interviews with practitioners followed by multidisciplinary discussion groups led by a health-care ethicist. SETTING: inner-city teaching hospital and district general hospital situated in South East England. PARTICIPANTS: seventy practitioners whose work relates directly or indirectly to perinatal care. FINDINGS: although women were seen to vary in their knowledge about Down's syndrome, practitioners felt that many did not understand the basic features of the condition. Practitioners themselves rarely had any practical experience or knowledge of people with Down's syndrome. This led to a reliance on 'medical textbook' information, which tends to focus primarily on the potential problems of the condition. Due to lack of time, practitioners also relied on the use of information leaflets. However, much more space in these was devoted to explaining the actual screening process rather than the condition, and the very brief descriptions of Down's syndrome lacked any positive statements. IMPLICATIONS FOR PRACTICE: informed choice in antenatal screening must be based on balanced information about 'screened for' conditions. Education about conditions set within a broader context of disability awareness could help to avoid the 'checklist' type approach used by many respondents. Practitioners and maternity units as a whole should reflect critically on the origins of the information they are conveying to prospective parents about what it means to live with Down's syndrome. Midwives and others involved in prenatal screening need to be aware of their own feelings about screening and disability. Midwives should also be involved in the planning of any future antenatal screening developments within their workplaces, and it is essential that they prospectively highlight factors such as lack of time and knowledge, which they feel inhibits their ability to facilitate informed choice. Research is needed which explores the consequences of allocating substantial resources into ensuring that women are fully informed about an increasingly complex antenatal screening process.

Adult↗

PubMed2001

Pearls and pitfalls of ethical issues in neurology.

The growth of bioethics as a practical, meaningful player in the arena of health care has paralleled that of clinical neurology not only in time but also in interaction between the two disciplines. Almost every advance in neurology has spawned an ethical dilemma, the unraveling of which has brought new insights to both fields of endeavor. The myriad ways in which this parallel growth has touched one clinical neurologist, the persons with whom he has been privileged to work, and those for whom they have cared is offered in reflection on the meaning of ethics, the essence of concepts such as "brain death," the pain of truth telling, the complexity of informed consent, the societal dimension of the "vegetative state," and finally, even the business of medicine. Should readers not find any pearls of wisdom in this offering, the author can at least hope it will prevent them from falling into the same pits.

Anecdotes as Topic↗

PubMed2001

Teaching in the field: the model of a one-day trip to an outreach clinic.

A trip to an outreach clinic in a 15-passenger van is presented as part of the answer to the forces negatively affecting the practice of academic medicine today. Any subspecialist in a medical center can use the model if a community can be identified that has a hospital or clinic building able to host the university group. County- or state-funded facilities are well suited to a periodic clinic, and public health nurses are well trained in their management. The Muscular Dystrophy Association is a private supporter of clinics like this, allowing specialty doctor visits close to home for patients with disabling weakness who might otherwise be excluded from our increasingly restricted health care system.

Ambulatory Care Facilities↗

PubMed1994