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SAGE Open Medicine 2024There are few studies that have evaluated the provision of compassionate care in Ethiopian contexts. One probable factor could be a lack of validated tools for assessing...
BACKGROUND
There are few studies that have evaluated the provision of compassionate care in Ethiopian contexts. One probable factor could be a lack of validated tools for assessing compassionate care in Ethiopia.
OBJECTIVE
To adapt the Compassionate Care Assessment Tool into the Amharic version and to assess its reliability and validity for application in obstetric services of the Ethiopian context.
METHOD
Four hundred ten mothers who gave birth at the four referral hospitals in North West Amhara participated in this study. Using SPSS version 23.0 and SPSS Amos 26 and by applying principal axial factoring, the Compassionate Care Assessment Tool was assessed for structural reliability and validity. Cronbach's alpha was used to evaluate internal consistency and reliability. Factor loadings, composite reliability, average variance extracted and square root of the average variance extracted were used to test convergent and discriminant validity.
RESULTS
Three factors with thirteen items were identified that explained 69.87% of the variation in the Compassionate Care Assessment Tool. Cronbach's alpha was 0.917. In the confirmatory factor analysis, all items had factor loadings more than 0.6, and the average variance extracted was greater than 0.5. Composite reliability values were above 0.7, and the square root of the average variance extracted for each element was greater than the correlation of each factor with other factors in the model.
CONCLUSION
The three factors and the thirteen items of the tool have shown internal consistency in the exploratory factor analysis. The factor loadings and the average variance extracted confirmed the convergent validity of the tool, while composite reliability and the square root of the average variance extracted values confirmed discriminant validity. Thus, the Amharic version of the Compassionate Care Assessment Tool was found to have excellent internal consistency as well as adequate structural, convergent, and discriminant validity among obstetric service users in Ethiopia.
PubMed: 38813096
DOI: 10.1177/20503121241254992 -
Ethiopian Journal of Health Sciences Sep 2023Good communication is necessary for safety and quality of health. This study aims to determine the effect of ISBAR communication on nurses' perception of communication...
Effect of ISBAR Clinical Handover Application on Nurses' Perception of Communication and Attitudes toward Patient Safety at Emirates Maternity Hospital in Gaza Strip, Palestine.
BACKGROUND
Good communication is necessary for safety and quality of health. This study aims to determine the effect of ISBAR communication on nurses' perception of communication and attitudes toward patient safety in the Emirates Maternity Hospital in the Gaza Strip, Palestine.
METHOD
A single-group hospital-based intervention study (pre and posttest) was conducted. A census sample was used Participants opinions about the effect of ISBAR were gathered using two tools established by Shortell, Rousseau, Sexton, and Helmreich to assess the communication awareness and nurses' attitudes towards safety, respectively, before and after the use of the ISBAR program.
RESULTS
After the ISBAR application, nurses' perception of communication demonstrated a positive and significant increase in the three sub-items (openness, accuracy and understanding, and shift communication) in the nurse-nurse communication. Moreover, in four sub-items (openness, accuracy, and understanding, timeliness, and satisfaction) in nurse-doctor communication, (p < 0.05). Further, the nurses' attitudes toward patient safety showed a significant and positive increase in teamwork climate (p<0.001), safety climate (p = 0.007), job satisfaction and working condition (p<0.001), stress recognition (p= 0.008), and perception of management (p = 0.001).
CONCLUSION
The results provide significant evidence of the positive effects of the ISBAR program in improving nurses' perceptions of communication and attitudes toward patient safety. It is recommended that healthcare providers use ISBAR communication in their practice. Moreover, periodic training programs are required for effective ISBAR communication among the healthcare team.
Topics: Humans; Attitude of Health Personnel; Female; Patient Safety; Adult; Communication; Hospitals, Maternity; Patient Handoff; Nursing Staff, Hospital; Middle East; Male; United Arab Emirates; Nurses; Young Adult
PubMed: 38784516
DOI: 10.4314/ejhs.v33i5.7 -
Cureus Apr 2024Cholestasis of pregnancy (CP), or intrahepatic CP (ICP), represents a condition peculiar to pregnancy, marked by impaired bile acid flow and consequent accumulation in... (Review)
Review
Cholestasis of pregnancy (CP), or intrahepatic CP (ICP), represents a condition peculiar to pregnancy, marked by impaired bile acid flow and consequent accumulation in the maternal bloodstream. Primarily emerging in the third trimester, CP is linked with considerable risks to both the mother and fetus, including heightened incidences of preterm birth, fetal distress, and stillbirth, alongside maternal complications such as intense pruritus and liver dysfunction. Despite its clinical significance, the etiology of CP, which involves genetic, hormonal, and environmental factors, remains partially understood. This comprehensive review delves into the physiology and pathophysiology of CP, outlines its clinical manifestations and diagnostic criteria, and discusses the associated maternal and fetal complications. Furthermore, it evaluates current management strategies, prognostic implications, and potential long-term effects on maternal and child health. It also explores future research directions, emphasizing the need for advancements in understanding the pathophysiology of CP, developing novel therapeutic interventions, and improving risk stratification models. By offering a thorough overview of CP, this review aims to enhance clinical awareness, guide management practices, and identify areas requiring further investigation, ultimately contributing to better health outcomes for affected women and their babies.
PubMed: 38779244
DOI: 10.7759/cureus.58699 -
Health Science Reports May 2024The promotion of rational use of antibiotics among pregnant women is eminent not only for the risk of teratogenicity in the developing fetus but also the risk of drug...
BACKGROUND AND AIMS
The promotion of rational use of antibiotics among pregnant women is eminent not only for the risk of teratogenicity in the developing fetus but also the risk of drug resistance with its concomitant high cost of health care. Studies on antibiotic self-medication among pregnant women in Northern Ghana are rare. Improving the knowledge and awareness among the vulnerable groups about the appropriate use of antibiotics can help in limiting the antibiotic resistance menace. We, therefore, conducted this study to assess the knowledge, attitude, and practice (KAP) toward antibiotic use among pregnant women attending an antenatal clinic at a primary health care in Tolon, Northern Region, Ghana.
METHOD
We conducted a cross-sectional study using an interviewer-administered questionnaire to assess the KAP of 702 pregnant women on antibiotic use. This study was conducted in the Tolon Health Center (THC) from March 2021 and ended in October 2021.
RESULTS
In this study, 55.6% of pregnant women had good knowledge and 45.3% of them had engaged in self-medication with antibiotics while pregnant. There were statistically significant associations between participants' background and obstetric characteristics and knowledge of antibiotic use and antibiotic resistance, except for age, marital status, and parity. Also, there was a significant association between pregnant women's knowledge and self-medication or over-the-counter purchase of antibiotics.
CONCLUSION
We concluded that higher education level, monthly income, good practice, and good knowledge were significantly associated with a reduced likelihood of self-medication with antibiotics. A well-structured education that could be easily accepted and understood by pregnant women on the risks of antibiotic self-medication should be included in the routine education at the antenatal clinics.
PubMed: 38779221
DOI: 10.1002/hsr2.2111 -
BMC Pregnancy and Childbirth May 2024We sought to investigate the impact of individualized exercise guidance during pregnancy on the incidence of macrosomia and the mediating effect of gestational weight... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
We sought to investigate the impact of individualized exercise guidance during pregnancy on the incidence of macrosomia and the mediating effect of gestational weight gain (GWG).
DESIGN
A prospective randomized clinical trial.
SETTING
A Hospital in Xingtai District, Hebei Province.
POPULATION
Older than 20 years of age, mid-pregnancy, and singleton pregnant women without contraindications to exercise during pregnancy.
METHODS
A randomized clinical trial was conducted from December 2021 to September 2022 to compare the effects of standard prenatal care with individualized exercise guidance on the incidence of macrosomia.
MAIN OUTCOME MEASURE
Incidence of macrosomia.
RESULTS
In all, 312 singleton women were randomized into an intervention group (N = 162) or a control group (N = 150). Participants who received individualized exercise guidance had a significantly lower incidence of macrosomia (3.73% vs. 13.61%, P = 0.002) and infants large for gestational age (9.94% vs. 19.73%, P = 0.015). However, no differences were observed in the rate of preterm birth (1.86% vs. 3.40%, P = 0.397) or the average gestational age at birth (39.14 ± 1.51 vs. 38.69 ± 1.85, P = 0.258). Mediation analysis revealed that GWG mediated the effect of exercise on reducing the incidence of macrosomia.
CONCLUSION
Individualized exercise guidance may be a preventive tool for macrosomia, and GWG mediates the effect of exercise on reducing the incidence of macrosomia. However, evidence does not show that exercise increases the rate of preterm birth or affects the average gestational age at birth.
TRIAL REGISTRATION
The trial is registered at www.clinicaltrails.gov [registration number: NCT05760768; registration date: 08/03/2023 (retrospectively registered)].
Topics: Humans; Female; Fetal Macrosomia; Pregnancy; Gestational Weight Gain; Adult; Prenatal Care; Prospective Studies; Exercise; Incidence; China; Infant, Newborn
PubMed: 38778289
DOI: 10.1186/s12884-024-06527-7 -
BMC Health Services Research May 2024Research on disaster preparedness in public hospitals is limited, and specialised units such as obstetric departments need to be even more prepared when rendering health...
BACKGROUND
Research on disaster preparedness in public hospitals is limited, and specialised units such as obstetric departments need to be even more prepared when rendering health care to vulnerable populations. Disasters can be natural, such as floods due to human interventions, sinkholes due to mining, or pandemic occurrences, such as the recent COVID-19 pandemic. Research on disaster preparedness is limited, and even more so in specialised units such as obstetrics and evacuating a ward of maternal and neonatal patients present unique challenges. Being prepared for any disaster is the only assurance of effective patient healthcare during a disaster. This study explored and described nurses' knowledge and attitudes regarding preparedness for a disaster in an obstetric unit in a public institution. The study aimed to make recommendations to improve disaster preparedness in an obstetric ward based on the nurses' knowledge and attitudes.
METHODS
This study utilised an exploratory, descriptive qualitative design within a contextual approach. The data were acquired through individual interviews that were done using a semi-structured interview schedule. An observational walkabout was performed with the unit manager to validate interviewee responses. The study employed purposive sampling with a sample size of 17 nurses (N = 32, n = 17) and a response rate of 53%. The interviews were transcribed verbatim, and later, the data underwent analysis using theme analysis and a co-coder.
RESULTS
The results indicate that the participants demonstrate an awareness of disaster terminology but need more assertiveness in executing the institutional disaster policy. The results illustrate that more frequent training, disaster rehearsals, and simulations should be implemented to improve disaster readiness. Strategies are recommended to enhance preparedness for a disaster in the obstetric unit.
CONCLUSION
The study findings recommend more education and training opportunities that should be regularly instilled as a practice within the obstetric ward. More disaster drills and simulation exercises should be performed to ensure confidence in disaster preparedness. Obstetric staff of all levels should be involved with policymaking and disaster plan development.
Topics: Humans; Female; Disaster Planning; Hospitals, District; Adult; COVID-19; Pregnancy; Qualitative Research; Health Knowledge, Attitudes, Practice; Attitude of Health Personnel; Obstetrics and Gynecology Department, Hospital; Male; Nursing Staff, Hospital; SARS-CoV-2
PubMed: 38773494
DOI: 10.1186/s12913-024-11104-x -
BMC Pregnancy and Childbirth May 2024Globally, disrespectful, and abusive childbirth practices negatively impact women's health, create barriers to accessing health facilities, and contribute to poor birth...
BACKGROUND
Globally, disrespectful, and abusive childbirth practices negatively impact women's health, create barriers to accessing health facilities, and contribute to poor birth experiences and adverse outcomes for both mothers and newborns. However, the degree to which disrespectful maternity care is associated with complications during childbirth is poorly understood, particularly in Ethiopia.
AIM
To determine the extent to which disrespectful maternity care is associated with maternal and neonatal-related complications in central Ethiopia.
METHODS
A multicentre cross-sectional study was conducted in the West Shewa Zone of Oromia, Ethiopia. The sample size was determined using the single population proportion formula. Participants (n = 440) were selected with a simple random sampling technique using computer-generated random numbers. Data were collected through face-to-face interviews with a pretested questionnaire and were entered into Epidata and subsequently exported to STATA version 17 for the final analysis. Analyses included descriptive statistics and binary logistic regression, with a 95% confidence interval (CI) and an odds ratio (OR) of 0.05. Co-founders were controlled by adjusting for maternal sociodemographic characteristics. The primary exposure was disrespectful maternity care; the main outcomes were maternal and neonatal-related complications.
RESULTS
Disrespectful maternity care was reported by 344 women (78.2%) [95% CI: 74-82]. Complications were recorded in one-third of mothers (33.4%) and neonates (30%). Disrespectful maternity care was significantly associated with maternal (AOR = 2.22, 95% CI: 1.29, 3.8) and neonatal-related complications (AOR = 2.78, 95% CI: 1.54, 5.04).
CONCLUSION
The World Health Organization advocates respectful maternal care during facility-based childbirth to improve the quality of care and outcomes. However, the findings of this study indicated high mistreatment and abuse during childbirth in central Ethiopia and a significant association between such mistreatment and the occurrence of both maternal and neonatal complications during childbirth. Therefore, healthcare professionals ought to prioritise respectful maternity care to achieve improved birth outcomes and alleviate mistreatment and abuse within the healthcare sector.
Topics: Humans; Female; Ethiopia; Cross-Sectional Studies; Adult; Pregnancy; Maternal Health Services; Young Adult; Professional-Patient Relations; Parturition; Attitude of Health Personnel; Infant, Newborn; Delivery, Obstetric; Obstetric Labor Complications; Surveys and Questionnaires; Quality of Health Care
PubMed: 38773395
DOI: 10.1186/s12884-024-06574-0 -
PLOS Global Public Health 2024Maternal morbidity and mortality has remained a major public health concern worldwide. Basic emergency obstetric care is the primary intervention to prevent obstetric...
INTRODUCTION
Maternal morbidity and mortality has remained a major public health concern worldwide. Basic emergency obstetric care is the primary intervention to prevent obstetric complications and maternal death. Episiotomy is one of the basic obstetrical procedures used to facilitate vaginal delivery, shorten the second stage of labor and prevent complications. However, there is a paucity of evidence on the prevalence and factors associated with episiotomy among women who gave birth in eastern Ethiopia.
OBJECTIVE
This study aimed to determine the prevalence of episiotomy and its associated factors among women who gave birth at public health facilities in Jigjiga town, eastern Ethiopia.
METHODS
A facility-based cross-sectional study was conducted among women who gave birth vaginally from May 1 to June 30, 2022. A total of 422 study participants were recruited using systematic random sampling. Data were collected using structured questionnaires through a face-to-face interview supported with standard observational checklist and reviewing medical records. A logistic regression analysis was carried out to examine the association between explanatory variables and episiotomy. An adjusted odds ratio (AOR) at a 95% confidence interval (CI) at a P-value <0.05 was used to declare significant association.
RESULTS
The prevalence of episiotomy among women was 52.6% (95% CI: 47.8%, 57.0%). Obstetric complications during current pregnancy (AOR:3.92, 95% CI: 1.59, 9.68), birth weight ≥4000 gm (AOR: 4.30, 95% CI: 1.53, 12.04), induction of labor (AOR: 3.10, 95% CI: 1.62, 5.93), meconium-stained amniotic fluid (AOR:2.10, 95% CI: 1.14, 3.88), duration of the second stage of labor ≥90 minutes (AOR:3.09, 95% CI: 1.53, 6.23), instrumental delivery (AOR: 2.69, 95%, CI: 1.39, 5.19), and female genital mutilation (AOR: 2.91, 95% CI: 1.83, 4.64) were factors significantly associated with episiotomy.
CONCLUSION
Slightly more than half of the women who gave birth at public health facilities in the study area underwent episiotomies. In addition to the common obstetric factors, having a female genital mutilation scar increased the risk of women's experiencing episiotomies. Therefore, intervention should be tailored to address the identified obstetric risk factors and avoid female genital mutilation in the community to reduce women's experiences of episiotomies in the future.
PubMed: 38768152
DOI: 10.1371/journal.pgph.0003216 -
PLOS Global Public Health 2024Over 98% of stillbirths and neonatal deaths occur in Low- and Middle-Income Countries, such as Tanzania. Despite the profound burden of perinatal loss in these regions,...
Over 98% of stillbirths and neonatal deaths occur in Low- and Middle-Income Countries, such as Tanzania. Despite the profound burden of perinatal loss in these regions, access to facility or community-based palliative and psychosocial care is poor and understudied. In this study we explore perinatal loss through the lens of front-line healthcare providers, to better understand the knowledge and beliefs that guide their engagement with bereaved families. A Knowledge Attitudes and Practices survey addressing perinatal loss in Tanzania was developed, translated into Swahili, and administered over a 4-month period to healthcare professionals working at the Kilimanjaro Christian Medical Center (KCMC). Results were entered into REDCap and analyzed in R Studio. 74 providers completed the survey. Pediatric providers saw a yearly average of 5 stillbirths and 32.7 neonatal deaths. Obstetric providers saw an average of 11.5 stillbirths and 13.12 neonatal deaths. Most providers would provide resuscitation beginning at 28 weeks gestational age. Respondents estimated that a 50% chance of survival for a newborn occurred at 28 weeks both nationally and at KCMC. Most providers felt that stillbirth and neonatal mortality were not the mother's fault (78.4% and 81.1%). However, nearly half (44.6%) felt that stillbirth reflects negatively on the woman and 62.2% agreed that women are at higher risk of abuse or abandonment after stillbirth. A majority perceived that women wanted hold their child after stillbirth (63.0%) or neonatal death (70.3%). Overall, this study found that providers at KCMC perceived that women are at greater risk of psychosocial or physical harm following perinatal loss. How women can best be supported by both the health system and their community remains unclear. More research on perinatal loss and bereavement in LMICs is needed to inform patient-level and health-systems interventions addressing care gaps unique to resource-limited or non-western settings.
PubMed: 38768103
DOI: 10.1371/journal.pgph.0003227 -
Revista Brasileira de Ginecologia E... 2024Despite the literature on dydrogesterone, studies on dydrogesterone utilization patterns are largely lacking in Indian patients. (Observational Study)
Observational Study
OBJECTIVE
Despite the literature on dydrogesterone, studies on dydrogesterone utilization patterns are largely lacking in Indian patients.
METHODS
This was a multi-center, retrospective, observational, cross-sectional, and descriptive study across 817 centers in India. Data of patients who received dydrogesterone in past and provided consent for future use of their medical record for research purpose was were retrieved and analyzed.
RESULTS
Data of 7287 subjects (aged 29.55±4.84 years) was analyzed. Threatened abortion was the most common indication for which the subjects received dydrogesterone (46.9%) followed by recurrent pregnancy loss. Polycystic ovary syndrome (PCOS), thyroid disorders and anemia were the most common comorbid conditions and prior pregnancy loss, advanced maternal age and obesity were the most common risk factors seen in subjects who received dydrogesterone. Total 27.5% of subjects received a loading dose of dydrogesterone, and majority (64%) received 40 mg as loading dose. 10 mg dose was used as maintenance or regular dose in 81.4% of the subjects. Twice daily (BID) was the most common dosing frequency (66.6%). The most common concomitant medications being taken by the subjects on dydrogesterone included folic acid (45.1%), iron supplements (30.3%) and calcium and vitamin D3 supplements (25.5%). Another progesterone preparation (oral, injection, vaginal, tubal) other than dydrogesterone was used concurrently in 7.8% of subjects.
CONCLUSION
The study helped to identify the patient population that is benefitted by dydrogesterone and the preferred indications, risk factors, comorbid conditions and concomitant medication used in this patient population at real-life scenario.
Topics: Humans; Female; Retrospective Studies; India; Dydrogesterone; Adult; Cross-Sectional Studies; Pregnancy; Progestins; Young Adult; Abortion, Threatened; Abortion, Habitual
PubMed: 38765536
DOI: 10.61622/rbgo/2024AO18