Thesis (M.A.)-- Brigham Young University. Dept. of English, 1998. / Includes bibliographical references (leaves 57-60).

M.A. / This study was conducted in light of several feminist texts that have critiqued the diagnostic criteria for posttraumatic stress disorder in the DSM-IV-TR. These texts have argued that the current criteria, particularly Criterion A, are gender-biased and exclude many of the kinds of life events that are unique to women. This study sought to conduct an in-depth exploration of life events that do not meet the DSM-IV-TR‟s Criterion A but that nevertheless precipitated all of the other manifestations of PTSD. For the purpose of this study, two gender-specific traumatic events were selected, namely childbirth and miscarriage or stillbirth. A feminist and phenomenological approach was taken and the study was formulated as a critique of the DSM-IV-TR diagnostic criteria of PTSD. The research question was formulated as follows: Should the Criterion A definition of a traumatic event be expanded to include any experience that an individual defines as traumatic? A semi-structured interview was conducted with three participants complying with the specific population criteria. The interviews were transcribed and analysed through qualitative data analysis processes. The research methodology and analysis processes needed to be adapted due to the phenomenological nature of the research study. A comparison between the symptoms presented by the participants and the diagnostic criteria of PTSD, revealed that all three participants complied with all the DSM-IV-TR criteria except for Criterion A(1) and therefore could not be formally diagnosed with PTSD. It was also revealed that the women‟s experiences and reactions to the traumatic events were very similar, especially the fear caused due to feeling out of control. Therefore it was concluded that the essence of the traumatic experience was loss of control. The research question was positively answered, because it was concluded that each individual experiences events differently due to internal perceptions and the individualised meanings which are allocated to the event. Therefore the Criterion A definition of a traumatic event should be expanded to include any experience that an individual defines as traumatic.

No description available.

An abortion, be it induced or spontaneous, can be a traumatic experience in the life of a woman and her family. Women can use abortion as a method of family planning or to end an unwanted pregnancy. On the contrary there are women who wish to have children of their own, but experience spontaneous abortion or recurrent abortion. When women go through an abortion they may experience different dimensions of side effects and symptoms. The women may experience physical symptoms such as blood loss, pain and sepsis as well as psychological symptoms such as despair, depression and grief. Studies indicate that women who have abortions do not receive the care that they require and are in need of high quality care. There is a need for a systematic synthesis of the best available evidence regarding interventions for nursing practitioners. This can be used to inform practice. This research study aim to critically review and synthesise best available evidence regarding the best nursing practices for women who have an abortion. This was done by conducting a thorough step-by-step systematic review with the following objectives: to critically review available research evidence on abortion care and to synthesise best practices for abortion care provided by nurses. This study can provide nursing practitioners with the necessary information about the best available evidence regarding abortion care provided by nurses. The information can be used to increase and improve the nursing practitioner’s knowledge and to promote and enhance future questions and research. Through the step-by-step use of the systematic review after a thorough search and screening of potentially relevant studies on nurses providing abortion care according to the inclusion and exclusion criteria, the critical appraisal and data extraction of nine final relevant studies could be used for data analysis and synthesis. Conclusion statements were drawn and later combined and synthesised, graded and evaluated to provide the current best available evidence. The research was evaluated, limitations identified and recommendations made for nursing practice, nursing education and nursing research. The overall conclusion that can be drawn is there is not enough sufficient evidence to demonstrate that abortion care such as contraceptive counselling and/or psychological follow-up care provided by nurses and/or midwives before and after an induced or spontaneous abortion is sufficient and effective in reducing recurrent abortions, reducing despair, depression and grief and improving psychological consequences and increasing contraceptive usage. More research must be done on abortion nursing care. / MCur, North-West University, Potchefstroom Campus, 2014

An abortion, be it induced or spontaneous, can be a traumatic experience in the life of a woman and her family. Women can use abortion as a method of family planning or to end an unwanted pregnancy. On the contrary there are women who wish to have children of their own, but experience spontaneous abortion or recurrent abortion. When women go through an abortion they may experience different dimensions of side effects and symptoms. The women may experience physical symptoms such as blood loss, pain and sepsis as well as psychological symptoms such as despair, depression and grief. Studies indicate that women who have abortions do not receive the care that they require and are in need of high quality care. There is a need for a systematic synthesis of the best available evidence regarding interventions for nursing practitioners. This can be used to inform practice. This research study aim to critically review and synthesise best available evidence regarding the best nursing practices for women who have an abortion. This was done by conducting a thorough step-by-step systematic review with the following objectives: to critically review available research evidence on abortion care and to synthesise best practices for abortion care provided by nurses. This study can provide nursing practitioners with the necessary information about the best available evidence regarding abortion care provided by nurses. The information can be used to increase and improve the nursing practitioner’s knowledge and to promote and enhance future questions and research. Through the step-by-step use of the systematic review after a thorough search and screening of potentially relevant studies on nurses providing abortion care according to the inclusion and exclusion criteria, the critical appraisal and data extraction of nine final relevant studies could be used for data analysis and synthesis. Conclusion statements were drawn and later combined and synthesised, graded and evaluated to provide the current best available evidence. The research was evaluated, limitations identified and recommendations made for nursing practice, nursing education and nursing research. The overall conclusion that can be drawn is there is not enough sufficient evidence to demonstrate that abortion care such as contraceptive counselling and/or psychological follow-up care provided by nurses and/or midwives before and after an induced or spontaneous abortion is sufficient and effective in reducing recurrent abortions, reducing despair, depression and grief and improving psychological consequences and increasing contraceptive usage. More research must be done on abortion nursing care. / MCur, North-West University, Potchefstroom Campus, 2014

Background: Miscarriage is also called spontaneous abortion and occurs in about 20 percent of all pregnancies. The majority of miscarriages occur before 12 weeks of pregnancy and the main causes are chromosomal abnormalities or damage to the fertilized egg. Aim: The purpose of this study was to describe women's experiences when they suffer a miscarriage and treatment from the medical staff during miscarriage. And to describe the data collection methods used in the included articles. Methods: A descriptive literature study based on 12 scientific articles with a qualitative approach. The CINAHL database was used for the article search and the keywords that was used were: Miscarriage and Experience. Main results: The result described the women who had suffered from a miscarriage experienced physical and mental pain.The miscarriage was described as a loss and crushed ambitions for the future. Emotions such as shame and guilt were common. Miscarriage was seen as a traumatic experience for the affected woman. Experiences as loneliness and omission were common, and that the women’s physical and mental pain was overlooked by the medical staff. Lack of empathy and compassion affected the women negatively. If themedical staff confirmed the grief it helped the women with their physical and emotional needs. Perceptions and feelings of security occurred when the women had a prior relationship to the obstetrician, who then knew their history and background. The data collection method used in all articles were individual audio recorded interviews. Conclusion: The conclusion to be drawn from this study is that the women who suffered miscarriages was affected both physically and mentally. The response and relevant information from the nursing staff has a major impact on how women perceive their situation when they have suffered a miscarriage. / Bakgrund: Missfall benämns även som spontan abort och inträffar i omkring 20 procent av alla graviditeter. Majoriteten av alla missfall sker innan graviditetsvecka 12 och de främsta orsakerna är kromosomavvikelser eller skador på det befruktade ägget. Syfte: Syftet med litteraturstudien var att beskriva kvinnors upplevelser när de drabbas av missfall och bemötandet från vårdpersonal vid missfall. Samt att beskriva vilka datainsamlingsmetoder som använts i de inkluderade artiklarna. Metod: En deskriptiv litteraturstudie som grundade sig på 12 vetenskapliga artiklar med kvalitativ ansats. Databasen Cinahl användes för artikelsökning med sökorden:Miscarriage och Experience. Huvudresultat: Resultatet beskriver hur kvinnor som drabbats av missfall upplever både fysisk och psykisk smärta. Missfallet beskrevs som en förlust och framtidsplaner som krossades. Känslor som skam och skuld var vanligt förekommande. Missfall sågs som en traumatisk upplevelse för den drabbade kvinnan. Upplevelser som ensamhet och utelämnande var vanligt förekommande, samt att kvinnornas fysiska och psykiska smärta förbisågs av vårdpersonalen. Brist på empati och medlidande påverkade kvinnorna negativt. Genom att vårdpersonalen bekräftade sorgen hjälpte det kvinnorna med deras fysiska och emotionella behov. Upplevelser av trygghet förekom när kvinnorna hade en tidigare relation till obstetrikern, som då kände till deras historia och bakgrund. Den datainsamlingsmetod som använts i samtliga artiklar var individuella ljudinspelade intervjuer. Slutsats: Slutsatsen som kan dras av denna litteraturstudie är att kvinnorna som drabbats av missfall påverkas både fysiskt och psykiskt. Bemötandet och relevant information från vårdpersonalen har en stor inverkan på hur kvinnorna upplever sin situation när de drabbats av missfall.

The first half of this thesis addressed the clinical question of whether the phenotype of peripheral immune cells is affected by the normal menstrual cycle and whether there are differences in women with recurrent unexplained miscarriage. In chapter 2, a mid-luteal type 1 shift was demonstrated in NK^dim and cytotoxic T cells in the menstrual cycle. In addition, women with recurrent miscarriage had increased numbers of type 1 (IL-18R+) cytotoxic lymphocytes and an increased number of NK^dim and NK^bright cells in the mid-luteal phase of the cycle. The shift to type 2 immunity seen in normal pregnancy has been previously identified from the second half of the first trimester. In chapter 3 this type 2 shift was seen in NK and T cells as early as 9 days post implantation. ST2L (the ligand for IL-33 and a marker of type 2 cells) was consistently up regulated at this very early stage post implantation in women who were pregnant. The second half of this thesis investigated IL-33 and ST2 in normal and pathological pregnancy. In chapter 4 it was shown that circulating IL-33 did not change over the course of pregnancy but that sST2 (the soluble decoy receptor) increased significantly in the 3rd trimester of normal pregnancy. Both IL-33 and ST2 were variably expressed by the pre-implantation human blastocyst, as well as by the 1st and 3rd trimester placenta. Finally, chapter 5 showed a potential role for ST2 in pre-eclampsia, an inflammatory disease of pregnancy. sST2 was significantly elevated in the third trimester in women who went on to develop pre-eclampsia even prior to the onset of disease. Using an in vitro model of placental perfusion, it was shown that sST2 can be secreted by the placenta, suggesting that sST2 may play a significant role in pregnancies complicated by this disease.

The Elegant Universe: Stories is a story collection featuring female characters unflinching in their self-appraisal, and wry in their humor, who explore the realities of their heterosexual relationships, particularly the weighty decision whether to have children or not in these dark and terrifying times. Sometimes funny, sometimes sad, the stories collected here explore the various, subtle modes of threat that are the palpable part of the experience of being a woman—not in society, or in the workplace, but primarily inside relationships with men. At the same time, the stories own that love can grow between men and women despite the near and present poison of misogyny. They own the miracle of motherhood while depicting the palpable fragility of new life and the proximity of mothers to unstoppable wreckage and ruin.

Background: Pregnancy is the fertilization and development of one or more offspring. It is a period of significant importance, during the time of which, health status of the mother could have profound impact on that of the fetus. Due to the one child policy in Mainland China, ensuring the baby’s health is of the utmost priority. In the past two years the incidence rate of miscarriage has been gradually increasing. It has an impact on mothers both physically and psychologically. Formaldehyde can be released for a long time from compound and furniture products in newly decorated houses and have become a chronic source of pollution. We are interested in whether there is any association between miscarriage and formaldehyde exposure. If the association exists, the evidence could be applied to support further research to identify the sources of formaldehyde and to support formulation of environmental public health policy to reduce formaldehyde exposure. Objectives: (1) To estimate whether the serum formaldehyde concentrations were different between miscarriage women and normal pregnant women at the same stage. (2) To investigate the normal serum formaldehyde concentration in pregnant women; and (3) to identify exposure factors in miscarriage patients. Setting：Guangzhou Women and Children’s Medical Centre Method: A case-control study was carried out to estimate the association between serum formaldehyde concentrations and miscarriage. 309 pregnant women who fulfilled the inclusion criteria participated in this study, 191 normal pregnant women at term delivery as the control group and 118 women who were diagnosed with miscarriage as the case group. The main outcome was miscarriage confirmed by ultrasound and physicians. The main exposure variable was serum formaldehyde concentration. Binary logistic regression was used to estimate the crude and adjusted odds ratios for a diagnosis of miscarriage for each independent variable. The odds ratio (OR) would be used to estimate the relative risk of the serum formaldehyde concentration in miscarriage women compared with those women who were not diagnosed miscarriage. We also categorized the values of formaldehyde into quartile, and put them into logistic regression as continuous variable to test the linear dose-response relationship. Then we tested whether there would be a significant linear trend that the increasing of serum formaldehyde concentration level leads to the increased risk of miscarriage. Chi-squared tests were performed to test the association between diagnosis of miscarriage and various independent variables. And Chi-squared tests for linear trend were also used for ordinal independent to study any dose-response relationship. Results：The mean serum formaldehyde concentration was 0.0944 in the case group and 0.0239 in the control group. The difference was statistically significant. All characteristics between case group and control group were quite similar. After adjusting for age, occupation，education level, household income, home decoration situation, the following factors remained having independent impact on the miscarriage. They were formaldehyde and second-hand smoke (crude ORs=7.87 [95%CI: 4.96, 12.49]; 3.20[95%CI: 1.86, 5.52] respectively, adjusted ORs=8.06 [95%CI: 4.96, 13.09]; 3.60[95%CI: 1.58, 8.20] respectively). Exposure to formaldehyde and second-hand smoke were significantly associated with higher risk of miscarriage. The liner dose response association between formaldehyde level and miscarriage was presented with P value for trend less than 0.001. Conclusions：Our study provided some evidence of the association between the serum formaldehyde level and miscarriage. A significant linear trend was found that the increasing of serum formaldehyde concentration level lead to the increase the risk of miscarriage. And we also found that second-hand smoking was contributive to miscarriage. This association did not confound by age, occupation, education level, household income, or home decoration situation. / published_or_final_version / Public Health / Master / Master of Public Health

Statistik visar att av alla kvinnor i Sverige som föder barn, har minst 21 % också genomgått missfall. Ett missfall väcker många olika känslor hos de par som berörs, såsom förlust, sorg, skuld, oro och existentiella funderingar. Missfall kan innebära en traumatisk upplevelse för alla berörda och sjuksköterskans roll att stödja och tillgodose parets behov är central för att säkra såväl fysisk som psykisk återhämtning. Sjuksköterskorna behöver identifiera det individuella behovet och vidta lämpliga omvårdnadsåtgärder för att hjälpa paret under denna tid. Litteraturstudiens syfte var att belysa sjuksköterskors omvårdnadsåtgärder i samband med missfall. I denna litteraturstudie av 13 vetenskapliga artiklar framkom följande begrepp enligt VIPS-modellen som kan användas: information/undervisning, stöd, skötsel, smärta/sinnesintryck, observation/övervakning, läkemedelshantering, psykosocialt och samordning. Ett annat bra redskap för sjuksköterskor är Swansons omvårdnadsteori, som ger insikt i optimala omvårdnadsåtgärder vid missfall och som kan integreras i VIPS-modellen. Sjuksköterskan behöver få ökad kunskap om missfall för att kunna möta parets behov av omvårdnad med ett holistiskt synsätt och säkra såväl fysisk som psykisk återhämtning.  Därför behövs vidare forskning för att utveckla sjuksköterskans omvårdnad vid missfall. / Statistics indicate that at least 21 % of all women in Sweden who give birth to a child also have experienced a miscarriage. A miscarriage evokes many different emotions for affected couples such as loss, grief, guilt, anxiety and existential reflections. Miscarriage can be a traumatic experience for all parties involved and the role of nurses in supporting these needs is pivotal in ensuring a physical and psychological recovery. Nurses are required to identify the needs of individuals and apply the appropriate nursing intervention to support families during this time. The purpose of the literature review was to illustrate the nursing interventions provided by nurses when women suffering of miscarriages. This literature review on 13 scientific articles illustrated the following concepts used in the VIPS-model to source appropriate information, referrals or assistance: information/education, support, care, pain/sensory impression, observation/supervision, medical management, psychosocial and coordination. Another useful tool for nurses is Swanson’s theory of caring which offers insight on optimal nursing practices during the event of a miscarriage which may be integrated in the VIPS-model. The nurses need to gain increased knowledge of miscarriage to be able to take a holistic approach to the care required to ensure recovery both physically and psychologically. Therefore more research is needed to develop nursing care when women suffering of miscarriage.