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International Journal of Nursing Studies Sep 2023Perineal lacerations could lead to substantial morbidities for women. A reliable prediction model for perineal lacerations has the potential to guide the prevention....
BACKGROUND
Perineal lacerations could lead to substantial morbidities for women. A reliable prediction model for perineal lacerations has the potential to guide the prevention. Although several prediction models have been developed to estimate the risk of perineal lacerations, especially third- and fourth-degree perineal lacerations, the evidence about the model quality and clinical applicability is scarce.
OBJECTIVES
To systematically review and critically appraise the existing prediction models for perineal lacerations.
METHODS
Seven databases (PubMed, Embase, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, SinoMed, China National Knowledge Infrastructure, and Wanfang Data) were systematically searched from inception to July 2022. Studies that developed prediction models for perineal lacerations or performed external validation of existing models were considered eligible to include in the systematic review. Two reviewers independently conducted data extraction according to the Checklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies. The risk of bias and the applicability of the included models were assessed with the Prediction Model Risk of Bias Assessment Tool. A narrative synthesis was performed to summarize the characteristics, risk of bias, and performance of existing models.
RESULTS
Of 4345 retrieved studies, 14 studies with 22 prediction models for perineal lacerations were included. The included models mainly aimed to estimate the risk of third- and fourth-degree perineal lacerations. The top five predictors used were operative vaginal birth (72.7 %), parity/previous vaginal birth (63.6 %), race/ethnicity (59.1 %), maternal age (50.0 %), and episiotomy (40.1 %). Internal and external validation was performed in 12 (54.5 %) and seven (31.8 %) models, respectively. 13 studies (92.9 %) assessed model discrimination, with the c-index ranging from 0.636 to 0.830. Seven studies (50.0 %) evaluated the model calibration using the Hosmer-Lemeshow test, Brier score, or calibration curve. The results indicated that most of the models had fairly good calibration. All the included models were at higher risk of bias mainly due to unclear or inappropriate methods for handling missing data and continuous predictors, external validation, and model performance evaluation. Six models (27.3 %) showed low concerns about applicability.
CONCLUSIONS
The existing models for perineal lacerations were poorly validated and evaluated, among which only two have the potential for clinical use: one for women undergoing vaginal birth after cesarean delivery, and the other one for all women undergoing vaginal birth. Future studies should focus on robust external validation of existing models and the development of novel models for second-degree perineal laceration.
PROSPERO REGISTRATION NUMBER
CRD42022349786.
TWEETABLE ABSTRACT
The existing models for perineal lacerations during childbirth need external validation and updating. Tools are needed for second-degree perineal laceration.
Topics: Female; Humans; Pregnancy; Delivery, Obstetric; Episiotomy; Lacerations; Parity; Perineum; Risk Factors
PubMed: 37423201
DOI: 10.1016/j.ijnurstu.2023.104546 -
Journal of Midwifery & Women's Health Sep 2022We conducted a review of literature to examine the experiences of transgender men (transmen) seeking pregnancy care. Our review revealed that transmen and cisgender... (Review)
Review
We conducted a review of literature to examine the experiences of transgender men (transmen) seeking pregnancy care. Our review revealed that transmen and cisgender persons desire pregnancy at similar rates; however, transmen experience discrimination from health care systems and providers. Additionally, pregnant transmen may experience unique psychological needs and require support for postpartum contraception and lactation. Based on a synthesis of the available literature, we offer strategies for providing inclusive care for birthing transmen and resources for further professional development related to transgender health issues.
Topics: Breast Feeding; Female; Humans; Lactation; Male; Postpartum Period; Pregnancy; Transgender Persons; Transsexualism
PubMed: 35861269
DOI: 10.1111/jmwh.13397 -
MCN. the American Journal of Maternal... 2019
Topics: Female; Humans; Maternal Mortality; Obstetric Nursing; Pregnancy; Pregnancy Complications; Prenatal Care; Socioeconomic Factors; United States
PubMed: 31415266
DOI: 10.1097/NMC.0000000000000560 -
Worldviews on Evidence-based Nursing Dec 2021At least 40% of maternal deaths are attributable to failure to rescue (FTR) events. Nurses are positioned to prevent FTR events, but there is minimal understanding of... (Review)
Review
BACKGROUND
At least 40% of maternal deaths are attributable to failure to rescue (FTR) events. Nurses are positioned to prevent FTR events, but there is minimal understanding of systems-level factors affecting obstetric nurses when patients require rescue.
AIMS
To identify the nurse-specific contexts, mechanisms, and outcomes underlying obstetric FTR and the interventions designed to prevent these events.
METHODS
A realist review was conducted to meet the aims. This review included literature from 1999 to 2020 to understand the systems-level factors affecting obstetric nurses during FTR events using a human factors framework designed by the Systems Engineering Initiative for Patient Safety.
RESULTS
Existing interventions addressed the prevention of maternal death through education of clinicians, improved protocols for care and maternal transfer, and an emphasis on communication and teamwork.
LINKING EVIDENCE TO ACTION
Few researchers addressed task overload or connected employee and organizational outcomes with patient outcomes, and the physical environment was minimally considered. Future research is needed to understand how systems-level factors affect nurses during FTR events.
Topics: Communication; Humans; Patient Safety
PubMed: 34482602
DOI: 10.1111/wvn.12531 -
Revista Da Escola de Enfermagem Da U S P 2021to analyze the offering of the first graduate certificate program in nursing in the state of Minas Gerais, called "Graduate Certificate Course in Obstetrics" (Curso de...
OBJECTIVE
to analyze the offering of the first graduate certificate program in nursing in the state of Minas Gerais, called "Graduate Certificate Course in Obstetrics" (Curso de Pós-Graduação em Obstetrícia), by the Nursing School Carlos Chagas, in 1966, and its contribution to the professionalization of obstetric nursing.
METHOD
this is a documentary, socio-historical study, based on the Sociology of Professions by Freidson.
RESULTS
the data collected allowed the following thematic composition: academic organization of the graduate certificate program and differentials and discontinuities of the first graduate certificate program at the Nursing School Carlos Chagas, with two categories delineated: "Construction of specific knowledge for obstetric nursing" and "Enhancement of specialized knowledge for scientific notoriety".
CONCLUSION
The first offering of a graduate certificate program in nursing by the Nursing School Carlos Chagas at the Universidade Federal de Minas Gerais was a milestone in the history of nursing in Minas Gerais and of the institution itself for being groundbreaking and having attracted students from other states, with repercussions in Brazil. This protagonism supported the professionalization course in the state and in the country, contributing to the scientific notoriety of the institution and of the professional category.
Topics: Brazil; Female; Humans; Obstetric Nursing; Pregnancy; Schools, Nursing
PubMed: 34190896
DOI: 10.1590/S1980-220X2020014703762 -
Journal of Healthcare Engineering 2021Blockchain, as an emerging force transforming the Internet, has applications in finance, logistics, public services, and other fields. It will also have a huge impact on...
Blockchain, as an emerging force transforming the Internet, has applications in finance, logistics, public services, and other fields. It will also have a huge impact on the medical and health industry. The salient features of blockchain technology include guaranteeing information security and user privacy, decentralization, without the involvement of third-party trust institutions, and being able to establish a high-value input and output two-way system, which has a very important application space in obstetric care, medical, and health. The traditional medical and health system is far from being able to meet the information exchange between doctors and individuals. Therefore, building an interconnected obstetric care and health system based on blockchain technology is the direction of future obstetric care and medical development. This paper has conducted an in-depth study of the obstetric care medical health system, with the help of the Internet of Things, blockchain, and other technical means; the purpose is to realize the sharing and security of medical data and to break the limitations of traditional user information. This paper builds a medical electronic health record system model and a hybrid consensus model based on blockchain technology to realize the safety and transparency of patients' personal medical information data and achieve two-way communication and interconnection of information between doctors and patients. This paper analyzes the current status of domestic and foreign medical and health systems and the blockchain-based medical electronic health record system. It is concluded that the domestic investment in medical and health in 2018 was as high as 113.2 billion yuan, and the entire investment scale is continuously expanding. Pay attention to the health system. In the future, the obstetric care and medical health system based on blockchain technology will surely be realized and improved.
Topics: Blockchain; Electronic Health Records; Humans; Obstetrics; Privacy; Technology
PubMed: 33747416
DOI: 10.1155/2021/6631457 -
Nursing Outlook 2021Professional nursing bodies have had a well-established, collective history of advancing the nursing profession through career development, advocacy, and continuing... (Review)
Review
Professional nursing bodies have had a well-established, collective history of advancing the nursing profession through career development, advocacy, and continuing education. The purpose of this review paper is to provide a historical overview of these entities, leading up to the formation of specialty nursing associations and the emergence of the Association of Women's Health Obstetric and Neonatal Nurses (AWHONN). The Association of Women's Health Obstetric and Neonatal Nurses is a leader in research, education, and advocacy in the field of women's health, obstetric, and neonatal nursing that has focused on promoting the health and well-being of women, newborns, and their families for the past fifty years.
Topics: Female; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Infant, Newborn; Neonatal Nursing; Nurses, Neonatal; Obstetric Nursing; Pregnancy; Societies, Nursing; Specialties, Nursing; Women's Health
PubMed: 34334190
DOI: 10.1016/j.outlook.2021.05.012 -
The Journal of Nursing Education Dec 2021Whiteness is a systemic construct that functions to make itself invisible and prevent its racialization. Whiteness informs the nursing profession on all levels and...
BACKGROUND
Whiteness is a systemic construct that functions to make itself invisible and prevent its racialization. Whiteness informs the nursing profession on all levels and impacts how nurses learn, relate to, and perpetuate whiteness through structural, curricular, interpersonal, and ideological means. The aim of this study was to use an antiracist framework to analyze manifestations of whiteness in select prelicensure obstetric and pediatric clinical simulation scenarios at a large midwestern college of nursing.
METHODS
Nine prelicensure nursing simulations were analyzed for themes using qualitative content analysis.
RESULTS
Two themes related to whiteness emerged from the data-normalizing whiteness in assessment and othering.
CONCLUSION
Applying an antiracist framework in clinical nursing education can assist educators and students to see the embedded whiteness and racism in the curriculum and begin to address it. Additional analysis is needed to explore nurse educators and student perceptions of whiteness in simulations. .
Topics: Child; Curriculum; Education, Nursing; Faculty, Nursing; Humans; White People
PubMed: 34870503
DOI: 10.3928/01484834-20211102-01 -
Social Science & Medicine (1982) Jan 2023In Chicago, maternal morbidity and mortality is six times more likely among Black birthing people than white, despite policy initiatives to promote maternal health...
BACKGROUND
In Chicago, maternal morbidity and mortality is six times more likely among Black birthing people than white, despite policy initiatives to promote maternal health equity. Disparities in maternal morbidity and mortality reflect experiences of structural inequities - including limited quality obstetric care, implicit bias, and racism resulting patient mistrust in the health care system, inadequate social support, and financial insecurity. Although there is published literature on Black women's experiences with obstetric care, including experiences with individual and structural racism, little is known about the intersection of age and race and experiences with health care. The purpose of this study was to explore the maternal health and pregnancy experiences of young Black women utilizing an intersectional theoretical lens.
METHODS
In this study, we conducted two focus groups in a sample of 11 young Black pregnant people. We conducted a thematic analysis to identify codes, themes, and subthemes of the data.
RESULTS
We developed two overarching themes: obstetric racism and obstetric resistance. To elucidate how obstetric racism framed our participants' healthcare experiences, we identified sub-themes: intersectional identities as young Black women, medical mistrust, and pregnancy trauma. The second major theme describes ways in which participants protected themselves against obstetric racism to engender positive health experiences. These methods of resistance included identifying advocates and relying on trusted providers.
CONCLUSIONS
The current standard of obstetric care in the US is suboptimal due to individual and structural racism. This study provides unique data on the experiences with health care for young, Black pregnant individuals and delivers valuable insight into how individual and structural racism impacts obstetric care for young Black women.
Topics: Pregnancy; Female; Humans; Mothers; Trust; Black or African American; Black People; Parturition; Racism
PubMed: 36549014
DOI: 10.1016/j.socscimed.2022.115604 -
Creative Nursing Nov 2022A study involving 48 obstetric nurses explored the relationship between self-efficacy scores and demographic variables, and family-focused care during obstetrical...
A study involving 48 obstetric nurses explored the relationship between self-efficacy scores and demographic variables, and family-focused care during obstetrical emergencies. Obstetric Nursing Self-Efficacy Scale scores and demographic data were collected, and the Van Gelderen Family Care Rubric (VGFCR) was administered following simulation of obstetrical emergencies. Results: Two variables were found to influence the VGFCR scores. Nursing specialty certification and previous education in family-focused care. Improvements in the delivery of family-focused care can be achieved with simulation education and nursing specialty certification achievement.
Topics: Pregnancy; Female; Humans; Self Efficacy; Emergencies; Clinical Competence; Demography; Nurses
PubMed: 36411045
DOI: 10.1891/CN-2022-0050