Category Archives: Nursing Education

Presentation is key in antenatal information, research suggests

OBGYN_Nursing_Occupational MedicineThe font type of written text and how easy it is to read can be influential when it comes to engaging people with important health information and recruiting them for potentially beneficial programmes, new research by The University of Manchester and Leeds Beckett University has found.Led by Dr Andrew Manley, a Chartered Sport and Exercise Psychologist and Senior Lecturer in Sport and Exercise Psychology at Leeds Beckett, the study – published in the latest issue of Patient Education and Counseling journal – assessed the extent to which the title and font of participant information sheets can influence a person’s perception of written information.Thirty-five pregnant women and 36 trainee midwives took part in the research and were randomly presented with one of four participant information sheets describing an antenatal programme.

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Community nurses urged to highlight dangers of female genital mutilation

NursesIn their trusted professional capacity, community nurses are well placed to develop effective collaboration with patients and families to tackle the harmful and illegal procedure of female genital mutilation, say academics.Nurses have an important role in preventing female genital mutilation and in providing sensitive care for women and girls who have undergone the procedure, authors writing in Primary Health Care journal warn.King’s College London lecturer in mental health Niall McCrae and lecturer in child health Sheena Bynoe have written about the growing number of girls and women affected by female genital mutilation (FGM).The authors state that although FGM has been illegal in the UK since 1985, healthcare services have lacked a ‘robust response’ until recent years.

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Ten measures to drive quality palliative and hospice care

Nurses-GeriatricsPatients with serious and life-threatening illnesses may be less likely to experience unnecessary physical and emotional suffering if they receive palliative or hospice care that meets 10 key quality indicators identified by the American Academy of Hospice and Palliative Medicine (AAHPM) and the Hospice and Palliative Nurses Association (HPNA). The findings and recommendations of the organizations’ consensus project, Measuring What Matters, were published online in the Journal of Pain and Symptom Management.Measuring What Matters was launched to ensure palliative and hospice care patients receive the highest quality care by identifying the 10 best existing indicators – measures – to gauge that care. The 10 measures range from a complete assessment (including physical, psychological, social, spiritual and functional needs) to a plan for managing pain and shortness of breath to having patients’ treatment preferences followed. They were selected from among 75 indicators largely based on what’s most important to patients and families.Palliative care improves quality of life for patients who are being treated for a serious illness by managing pain and other symptoms. Hospice is a specific type of palliative care for patients in their last year of life.The goal of the project was to select a set of measures that are scientifically rigorous, and that all palliative and hospice care providers should use to ensure they are giving the highest quality care and to eventually enable benchmarking in the field. Currently there is no consistency regarding which measures are required by various groups, from accrediting organizations to payers. As the population ages and the demand for this type of care grows, the ability to assess quality throughout the country and across care settings is increasingly important.

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Practicing nursing care in a virtual world

NursesOculus Rift, a gaming headset, can help teach nurses how to communicate better, researchers at the Norwegian University of Science and Technology have found.While Facebook wants to make the world’s best online games using the Oculus Rift headset, researchers at Norwegian University of Science and Technology (NTNU) are using the same set-up to help teach nurses how to communicate better.The Oculus Rift headset gives your body and your mind the powerful experience of being in a virtual world. Your body feels confused, the signals that your brain gets from your eyes don’t quite match with what the rest of your body is experiencing. Your heart rate jumps, and you might even feel nauseated. But many are intrigued – and consumed by the experience.”Forget Google glass. Now it’s Oculus Rift that’s big. Especially if you want to immerse yourself in another reality,” says Ekaterina Prasolova-Førland, an associate professor in NTNU’s Programme for Learning with ICT.

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Mode of delivery in childbirth associated with pain during or after sexual intercourse


Operative birth is associated with persisting pain during or after sexual intercourse, known as dyspareunia, suggests a new study published in BJOG: An International Journal of Obstetrics and Gynaecology (BJOG).

The study aimed to investigate the contribution of obstetric risk factors, including mode of delivery and perineal trauma to postpartum dyspareunia. It also examined the influences of other risk factors, including breastfeeding, maternal fatigue, maternal depression and intimate partner abuse.

A cohort of 1244 first time mothers across six maternity hospitals in Melbourne, Australia was used. Data were taken from baseline and postnatal questionnaires at 3, 6, 12 and 18 months. The mean gestational age of the study participants at the time of enrolment was 15 weeks.

Of the women sampled, 49% had a spontaneous vaginal birth, two thirds of whom sustained a sutured tear and/or episiotomy, 10.8% had an operative vaginal birth assisted by vacuum extraction and 10.7% gave birth assisted by forceps. Additionally, 9.7% were delivered by elective caesarean section and 19.9% were delivered by emergency caesarean section.

Results showed that 78% of the study population had resumed sexual intercourse by 3 months, 94% by 6 months, 97% by 12 months and 98% by 18 months postpartum.

With regards to dyspareunia following childbirth, most of the women (85.7%) who had resumed sex by 12 months postpartum experienced pain during first vaginal sex after childbirth. Dyspareunia was reported by 44.7% of women at 3 months postpartum, 43.4% at 6 months, 28.1% at 12 months and 23.4% at 18 months postpartum. Of the women who reported dyspareunia at 6 months postpartum, a third (32.7%) reported persisting dyspareunia at 18 months postpartum.

Compared to women who had a spontaneous vaginal delivery with intact perineum or unsutured tear, women who had an emergency caesarean section, vacuum extraction or elective caesarean section had double the risk of reporting dyspareunia at 18 months postpartum, adjusting for maternal age and other risk factors.

Other factors associated with dyspareunia at 18 months postpartum include pre-pregnancy dyspareunia, intimate partner abuse and maternal fatigue. One in six women (16%) in the study experienced abuse by an intimate partner in the first 12 months postpartum. One third of these women (32.4%) reported dyspareunia at 18 months postpartum, compared with 20.7% of women who did not experience intimate partner abuse. The authors of the study highlight that these results suggest that clinicians should be alert to the possibility that intimate partner abuse is a potential underlying factor in persisting dyspareunia.

The authors conclude that greater recognition and understanding of the role of mode of delivery and perineal trauma in contributing to postpartum maternal morbidities is needed. Additionally, ways to prevent postpartum dyspareunia should be explored.

Ellie McDonald from the Murdoch Childrens Research Institute, Victoria, Australia and co-author of the study said:

“Almost all women experience some pain during first sexual intercourse following childbirth.

“However, our findings show the extent to which women report persisting dyspareunia at 6 and 18 months postpartum is influenced by events during labour and birth, in particular caesarean section and vacuum extraction delivery.

“Not enough is known about the longer term impact of obstetric procedures on maternal health. The fact that dyspareunia is more common among women experiencing operative procedures points to the need for focusing clinical attention on ways to help women experiencing ongoing morbidity, and increased efforts to prevent postpartum morbidity where possible.”

Patrick Chien, BJOG Deputy Editor-in-chief added:

“This is the first study with detailed, frequent and long-term follow-up to assess associations of dyspareunia with obstetric risk factors.

“This study provides us with robust evidence about the extent and persistence of postpartum dyspareunia and associations with mode of delivery and perineal trauma. Future research could look into ways of preventing dyspareunia.”

Adapted by MNT from original media release


Mobility disabilities can contribute to complications during pregnancy


A new study indicates that women with mobility disabilities often experience problems during pregnancy related to their functional impairments.

The study included 8 women with spinal cord injuries, 4 with cerebral palsy, and 10 with other conditions. Impairment-related complications during pregnancy included falls, urinary tract and bladder problems, wheelchair fit and stability problems, significant shortness of breath, increased spasticity, bowel management difficulties, and skin integrity problems.

“Relatively little information is available about the pregnancy experiences of women with physical disabilities, which hampers preconception planning and helping women know what to expect as their pregnancies progress,” said Dr. Lisa Iezzoni, lead author of the Acta Obstetricia et Gynecologica Scandinavica article. “Our findings from 22 interviewees with physical disabilities who described their pregnancies provide insights, albeit preliminary, that could inform both women and their obstetrical practitioners about possible complications so they can plan ahead.”

Adapted by MNT from original media release


High fitness levels reduce hypertension risk


While being physically fit is beneficial in and of itself, researchers now report that people with high levels of fitness are less likely to develop high blood pressure – also referred to as hypertension – a risk factor for cardiovascular disease.

The study, published in the Journal of the American Heart Association, examined the association of fitness with hypertension among participants undergoing treadmill stress tests to rule out ischemia as a cause of chest pain or shortness of breath.

“If you’re exercising and you’re fit, your chances of developing hypertension are much less than someone else who has the same characteristics but isn’t fit,” says Dr. Mouaz H. Al-Mallah, senior author of the study.

Normal blood pressure is below 120/80 mm Hg – the first number (systolic measurement) represents peak pressure in the arteries and the second number (diastolic measurement) represents minimum pressure in the arteries. Blood pressure is considered to be high when it is greater than 140/90 mm Hg.

There are two types of hypertension. While secondary hypertension appears suddenly and is caused by underlying conditions such as kidney or thyroid problems, primary hypertension has no identifiable cause and develops gradually over the course of many years.

In the US, hypertension affects 1 in 3 adults. According to the American Heart Association (AHA), 78 million people in the country have been diagnosed with the condition.

“Hypertension is associated with a lot of other illnesses and adds significantly to health care costs,” explains Dr. Al-Mallah, “so we need to know how we can reduce it.”

Measuring physical fitness and high blood pressure

The researchers assessed 57,284 participants from the Henry Ford Exercise Testing (FIT) Project, from 1991-2009, taking treadmill stress tests. Of these, 35,175 participants had a history of hypertension.

The team measured the physical fitness of the participants by estimating how much oxygen their bodies used per kg ofbody weight per minute, and thus how much energy they burned in metabolic equivalents (METs).

With 1 MET representing the amount of energy expended by the body at rest, a large number of METs reflects a high-intensity workout.

The researchers observed that participants whose most intense exercise was less than 6 METs had more than a 70% likelihood of having hypertension at the start of the study. Conversely, participants whose maximal exercise output was 12 METs were less than 50% likely to have hypertension.

During the stress test, participants who managed to reach 12 METs or more were 20% less likely to develop hypertension compared with participants who reached less than 6 METs.

A total of 8,053 new cases of hypertension were reported in participants’ medical records and administrative claims during the study’s follow-up period. Of these new cases, 49% were among participants with the lowest fitness (less than 6 METs), and only 21% were among participants with the highest fitness (more than 12 METs).

Fitness: a ‘strong predictor’ of hypertension

Although the study uses a large and diverse population sample, the participants were all originally referred for a stress test, indicating that their initial cardiovascular disease risk would be greater than that of the general population, potentially hindering the generalizability of the findings. The study was also limited by a lack of measuring incidental hypertension in a clinical setting.

Dr. Al-Mallah states that further study is required in order to determine how increasing and decreasing fitness levels affect the risk of hypertension over time. Physical activity was not formally assessed in the study, and this could be addressed in future research as well.

Hypertension is a major risk factor for cardiovascular disease, the number one cause of premature mortality in the developed world. High levels of exercise have been associated with protecting the body from certain health conditions, and now this study suggests adding hypertension to the list.

“Fitness is a strong predictor of who develops hypertension and who does not,” says Dr. Al-Mallah. “This is a clear message to everyone: patients, physicians and lawmakers. It’s very important to be fit.”

Medical News Today also recently reported on a study suggesting that sugars may contribute more to hypertension risk than salt.

Written by James McIntosh


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