Pain is a complex perceptual experience that is profoundly influenced by a number of variables, differing in quality as well as in intensity. Therefore we need to understand the actual experience of multiparous women in order to provide basic information for nursing care. The purpose of the study is to explore the experience of labor pain. The data are collected through in-depth interviews of 17 multiparous women in city of Pusan from October 1998 to March 1999. The interviews were conducted 1-2 days after delivery in the admission room. Each interview lasted about 45 minutes on average. Subjects were interviewed one at a time. The interviews were recorded with the consent of the subject. Data were analyzed by means of Giorgi's Phenomenological analysis methods and categorized according to the similarities of its contents. The investigator read the data repeatedly to identify themes and categories. Six categories that were identified were : 1) pain 2) regret 3) acceptance 4) maturity 5) accomplishment 6) newness. Under these categories there were seventeen themes. I. Pain: 1) too dependent on others 2) too painful 3) fear or anxiety from previous painful experience 4) avoidance of pain 5) couldn't control the pain II. Regret : 1) spouse's absence 2) unprofessional attitude of the staff 3) ignorance of other's towards their pain III. Acceptance : 1) took the pain for granted 2) accepted the pain as fate 3) endured the pain IV. Maturity : 1) appreciated the value of life 2) apprehension of parent V. Accomplishment : 1)is over sense of accomplishment 2) grateful the pain VI. Newness : 1) experienced a new feeling 2) quickly forgot the pain. The results of the study will provide basic data for labor pain management.
Zoure, Abdou Azaque;Bambara, Aboubacar Hierrhum;Sawadogo, Alexis Yobi;Ouattara, Abdoul Karim;Ouedraogo, Marie;Traore, Si Simon;Bakri, Youssef;Simpore, Jacques
Asian Pacific Journal of Cancer Prevention
/
v.17
no.12
/
pp.5095-5099
/
2016
The relative lack of information on breast cancer etiology in Burkina Faso led us to undertake the present work to highlight risk factors. This prospective study was conducted using a questionnaire between January 2015 and February 2016 on women admitted to Yalgado OUEDRAOGO hospital, for consultation or supervision. The characteristics of multiparous breast cancer patients (n = 44) were compared with their non-multiparous counterparts (n = 36). The study found that increased risk of breast cancer among non-multiparous cases was related to body mass index (BMI) (p <0.001), age at menopause (p <0.004) and use of oral contraception (p <0.021) while abortion (p <0.002) was a risk factor among multiparous cases. These results suggest that even if multiparity is associated with a decreased risk in some women, avoidance of abortion during reproductive life should be recommended. The results provide preliminary information, which now need to be supplemented by survey of a larger sample in the national territory.
This study was undertaken to evaluate the prevalence of significant cervical pathology among women who are high-risk human papillomavirus (HR-HPV)-positive/cytology negative, the most common combination of positive co-tests. The records of 244 women HR-HPV-positive/cytology-negative who had undergone colposcopy at Srinagarind Hospital, Khon Kaen University during January 2010 and April 2014 were reviewed. Mean age was 46.4 years. Of these 224 women, 75 were positive for HPV types 16/18 (33.5%) and 123 were positive for non-16/18 types (54.9%). HR-HPV was not genotyped in the remaining 26 women (11.6%). Prevalence of significant lesions for the entire cohort was 2.4%, and 2.6% and 3.3%, respectively, for those with HPV 16/18 and other oncogenic HPV types. One woman with HPV 16/18 (1.3%) had invasive cervical cancer. Multiparous women were more likely to be infected with HPV 16/18 compared to nulliparous women (36.3% versus 17.6%, respectively). In conclusion, the prevalence of significant cervical lesion among our study population was 2.4%. Multiparous women were more likely to be infected with HPV 16/18 compared to nulliparous women.
Purpose: Coronavirus disease 2019 (COVID-19) has spread widely throughout the world, causing psychological problems such as fear, anxiety, and stress. During the COVID-19 pandemic, pregnant women have been concerned about both their own health and the health of their fetuses, and these concerns could negatively affect maternal-fetal attachment. Thus, this study aimed to explore the level of COVID-19 stress, resilience, and maternal-fetal attachment among pregnant women during the COVID-19 pandemic, and to identify factors influencing maternal-fetal attachment. Methods: In total, 118 pregnant women past 20 weeks gestation were recruited from two maternity clinics in Daegu, Korea, to participate in this descriptive correlational study during COVID-19. The factors influencing maternal-fetal attachment were analyzed using hierarchical multiple regression analysis. Results: The mean scores for COVID-19 stress, resilience, and maternal-fetal attachment were 57.18±10.32 out of 84, 67.32±15.09 out of 100, and 77.23±9.00 out of 96, respectively. Nulliparous pregnant women reported greater maternal-fetal attachment than multiparous pregnant women (p=.003). Religious pregnant women also reported greater maternal-fetal attachment than non-religious pregnant women (p=.039). Resilience (β=.29, p=.002), COVID-19 stress (β=.20, p=.030) and parity (β=-.17, p=.047) were factors influencing maternal-fetal attachment, and these factors explained 26.4% of the variance in maternal-fetal attachment (F=10.12, p<.001). Conclusion: Converse to common sense, COVID-19 stress exerted a positive influence on maternal-fetal attachment in pregnant women during the COVID-19 pandemic. Healthcare providers need to recognize the positive influence of COVID-19 stress and implement intervention strategies to strengthen resilience in pregnant women to improve maternal-fetal attachment.
In view of funding crunches and inadequate manpower in cytology in developing countries like India, single lifetime screening for cervical cancer has been suggested. In this study, an attempt was made to cscreening to make it more effective for early detection. Cytological data were derived from the ongoing routine cervical cytology screening program for women attending Gynaecology Out Patient Department of Queen Mary's Hospital of K.G.Medical University, Lucknow, India during a span of 35 years (April 1971 - December 2005). Cervical smears in a total of 38,256 women were cytologically evaluated. The frequencies of squamous intraepithelial lesions of cervix (SIL) and carcinoma cervix were found to be 7.0% and 0.6%, respectively, in the series. Predisposing factors related to cervical carcinogenesis were analyzed in detail to establish the most vulnerable groups of women for single life time screening. The incidence of SIL and carcinoma cervix was found to be maximal in women above the age of 40 years irrespective of parity and in multiparous women (with three or more children) irrespective of age. The incidence of cervical cytopathologies was significantly higher in symptomatic women, the frequency of SIL being alarmingly higher in women complaining of contact bleeding and that of carcinoma cervix in older women with postmenopausal bleeding. It is consequently felt that single life time screening must include the three groups of women delineated above. Such selective screening appears to be the most economical, cost effective and feasible approach to affordably control the menace of cervical cancer in developing countries like India.
This study was conducted to assess the attitude of pregnant women toward delivery method, understanding of the reason for determining her own delivery method, participation in decision-making process and satisfaction with delivery method after labor. Study subjects were 693 pregnant women who had visited obstetric clinic for prenatal care in the last month of pregnancy in one general hospital and one obstetrics-gynecology specialty hospital in Taegu city from February 1 to March 31 in 1998. A questionnaire was administered before and after labor and a telephone interview was done one month after labor. Proportion of women who had health education and/or counselling about delivery method during prenatal care was 24.0% and this proportion was higher for women who had previous c-section(35.5%) than others. Women thought vaginal delivery is better than c-section for both maternal and baby's health regardless of previous delivery method. About 90% of primipara and multiparous women who had previous vaginal delivery wanted vaginal delivery for the index birth, while 85.6% of multiparous women who had previous c-section wanted repeat c-section. Reasons for choosing c-section in pregnant women who preferred vaginal delivery before labor were recommendation of doctors(81.9%), recommendation of husband (0.8%), agreement between doctor and pregnant woman(4.7%), and mother's demand (12.6%). Reasons for choosing vaginal delivery were mother's demand(30.6%) and no indication for c-section(67.2%). Reasons for choosing c-section in pregnant women who preferred c-section before labor were recommendation of doctors(76.2%), mother's demand(20.0%), recommendation of husband(1.3%), and agreement between doctor and pregnant woman(2.5%). Of the pregnant women who had c-section, by doctor's recommendation, the proportion of women who had heard detailed explanation about reason for c-section by doctor was 55.1%. Mother's statement about the reason for c-section was consistent with the medical record in 75.9% . However, over 5% points disparities were shown between mother's statement and medical record in cases of the repeat c-section and mother's demand. In primipara and multiparous women who had previous vaginal delivery, the delivery method for index birth had statistically significant association with the preference of delivery method before labor(p<0.05). All of the women who had previous c-section had delivered the index baby by c-section. Among mothers who had delivered the index baby vaginally, 84.9% of them were satisfied with their delivery method immediately after labor and 85.1% at 1 month after labor. However, mothers who had c-section stated that they are satisfied with c-section in 44.6% immediately after labor and 42.0% at 1 month after labor. Preferred delivery method for the next birth had statistically significant association with delivery method for the index birth both immediately after labor and in 1 month after labor. The proportion of mothers who prefer vaginal delivery for the next birth increased with the degree of satisfaction with the vaginal delivery for the index birth but the proportion of mothers who prefer c-section for the next birth was high and they did not change significantly with the degree of satisfaction with the c-section for the index birth. These results suggest that the current high technology-based, physician-centered prenatal and partritional cares need to be reoriented to the basic preventive and promotive technology-based, and mother-fetus-centered care. It is also suggested that active involvement of pregnant woman in decision-making process for the delivery method will increase the rate of vaginal birth after c-section and decrease c-section rate and improve the degree of maternal satisfaction after delivery.
The purposes of this study were to predict newborn birthweight by use of gestational period and fundal height and to identify growth curve of fundal height according to gestational period and growth curve of newborn birthweight according to fundal height. The subjects for the study were 802 women who delivered the normal newborn babies at Seoul National University Hospital from Sep. 1, 1981 to Aug.31, 1986. The data were collected bit chart review and analyzed nth SPSS program. The results of study were as follows : 1. The multiple regression equation ($R^2$=0.416) used for the prediction of newborn birthweight was y=(newborn birthweight, kg)=-4.421+0.075$x_1$(fundal height, cm)+0.053$x_2$(gestational period, weeks)+0.016$x_3$(abdominal girth, cm)+0.010$x_4$(maternal height, cm) 2. The growth curve of fundal height according to gestational period was obtained by polynomial regression. The regression equation was Y(fundal height, cm)=-36.78+18.58$log_ex$(gestational period, weeks) The growth curve of newborn birth weight according to fundal height was obtained by polynomial regression. The regression equation was Y(newborn birthweight, kg)=-8.09+3.27$log_ex$ (Fundal Height, cm) 3. In the following subgroups no significant difference was found in fundal height : engaged vs. nonengaged presentation, and nulliparous vs. multiparous women.
Objectives: To evaluate the frequency of cytohistologic discrepancy of high-grade squamous intraepithelial lesions (HSILs) in Pap smears and associated factors. Methods: Medical records of 223 women with HSIL Pap smears who were treated at Thammasat University Hospital were reviewed. Data on age, parity, menopausal status, contraceptive use and colposcopic directed biopsy and loop electrosurgical excision procedure (LEEP) pathology results were recorded. Results: Mean (SD) age of patients was 38.0 (9.4) years. The majority were premenopausal (86.5%) and multiparous (83.9%). Cytohistologic discrepancy between the Pap test and colposcopic-directed biopsy histology was 45.7% and that between the Pap test and LEEP histology was 29.5%. Fifty-four (24.2%) women had no high-grade CIN on both colposcopic directed biopsy and LEEP. Nulliparity, postmenopausal status and having no oral contraceptive pills use were factors associated with cytohistologic discrepancy. Conclusion: The exact cytohistologic discrepancy rate was relatively high (24.2%). Factors associated with cytohistologic discrepancy were nulliparity and postmenopausal status and having no oral contraceptive pill use.
Purpose: This study was conducted to evaluate the construct validity, reliability, measurement invariance, and latent mean differences in the Breastfeeding Adaptation Scale-Short Form (BFAS-SF) for use with mothers at 2 weeks postpartum. Methods: This methodological study was designed to evaluate the validity, reliability, and measurement invariance of the BFAS-SF at 2 weeks postpartum, with data collected from 431 breastfeeding mothers. Confirmatory factor analysis and multi-group confirmatory factor analysis were conducted to assess the factor structure and the measurement invariance across employment status, delivery mode, parity, and previous breastfeeding experience, and the latent mean differences were then examined. Results: The goodness of fit of the six-factor model at 2 weeks postpartum was acceptable. Multi-group confirmatory factor analysis supported strict invariance of the BFAS-SF across employment status and delivery mode. Full configural invariance, full metric invariance, and partial scalar invariance across parity and full configural invariance and full metric invariance across previous breastfeeding experience were supported, respectively. The results for latent mean differences suggested that mothers who were employed showed significantly higher scores for breastfeeding confidence. Mothers who had a vaginal delivery showed significantly higher scores for sufficient breast milk and baby's feeding capability. Multiparous mothers showed significantly higher scores for baby's feeding capability and baby's satisfaction with breastfeeding. Conclusion: The validity and reliability of the BFAS-SF at 2 weeks postpartum are acceptable. It can be used to compare mean scores of breastfeeding adaptation according to employment status, delivery mode, and parity.
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