No description available.

No description available.

No description available.

No description available.

No description available.

Background: The childbearing years place socioeconomically disadvantaged African American women at increased risk for poor diet quality, excess weight gain, and cardiometabolic complications. Little is known about the attitudes, beliefs, values, and contextual constraints that shape these high risk mothers’ dietary and physical activity behaviors. Objective: The purpose of this study was to examine health perceptions of diet quality and physical activity among low-income African American women in the early postpartum period, and how these perceptions manifest as barriers or facilitators to health. Additionally, we examined how they may differ by known predictors of health, such as education, age, parity, and BMI. Methods: We conducted semi-structured, individual interviews with 20 women who were between 3-6 months postpartum. Mothers were approached and recruited in the waiting room of a university-affiliated, outpatient prenatal care clinic in Philadelphia, PA. Enrollment in the study was restricted to women who self-identified as African American, were at least 18 years old, and met the federal income guidelines to qualify for assistance (Medicaid, WIC). Individual interviews were audio recorded and transcribed verbatim, with transcripts verified by research staff. Thematic coding and content analysis were performed by 3 researchers using NVivo 10 software to assist with data management. Results: Barriers and facilitators of healthy eating and physical activity after childbirth fell into 4 major themes of mothers’ lives: 1) new structural reality in the postpartum period; 2) physiologic changes after delivery; 3) correct/incorrect perceptions of healthy eating and activity; and 4) social determinants influencing behaviors. Mothers described the transition from pregnancy to the early postpartum period as having a significant negative impact on their eating and activity behaviors due to heightened fatigue, time constraints, and the monotony of daily life with a newborn. We found more than double the number of perceived barriers to engaging in healthy eating than facilitators with regard to fluctuations in food supply, cost of food, and the built environment. Mothers with obesity and less education were more likely to have misperceptions; these misperceptions additionally served as strong barriers to making healthy lifestyle choices. Changes in mothers’ physical symptoms and health status (e.g., developing diabetes, hypertension), on the other hand, facilitated healthy behaviors. Conclusion: This research deepens our understanding of the primary drivers of health behaviors among low-income African American women in the postpartum period. We identified barriers which limit and facilitators which support these mothers’ ability to engage in healthy behaviors, though there were far fewer facilitators of healthy eating and physical activity. Interventions designed to overcome these barriers and capitalize on these facilitators have the potential to improve health outcomes for this population. / Urban Bioethics

A recurring theme in the literature is that simulation is a positive teaching strategy when compared to other methods of instruction and produces positive student outcomes (Jefferies, 2016). Simulation provides educators a way to reproduce a clinical teaching experience in a safe, supportive learning environment. The purpose of this quantitative research study was to determine whether an obstetrical simulation educational experience is an effective strategy for educating undergraduate nursing students in the management of a postpartum hemorrhage. A quasi-experimental study using a pre-test and post-test design was employed in a Women’s Health Course and Pediatrics course over one semester. A single convenience sample (N=81) of junior baccalaureate nursing students was used for this study. There were 41 students in the control group and 40 in the experimental group. Both the control and experimental groups received the traditional didactic session, case study, skills lab instruction, and clinical. In addition, the experimental group received the postpartum simulation. This simulation study tested the differences in knowledge, satisfaction, and confidence level between junior nursing students who did and did not participate in the simulation. There were three instruments used during this study; a pre-test/post-test for knowledge acquisition, the National League for Nursing (NLN) (2005) student satisfaction and confidence level survey, and the Creighton Competency Evaluation Instrument (C-CEI) (Todd, Manz, Hawkins, Parsons, & Hercinger, 2008). The pre-test/post-test measured the knowledge acquisition obtained from the didactic session. NLN (2005) student satisfaction and confidence level survey measured students’ satisfaction and confidence level from either the interactive skills lab sessions or the simulation. The C-CEI tool measured the students’ performance during the simulation. There were four categories: assessment, communication, clinical judgment, and patient safety that the researcher measured the students’ performance during the simulation. Data for the knowledge acquisition, revealed both the experimental and control groups significantly increased between the pre-test and the post-test. The post-test showed statistically significant differences between groups, with the control group outperforming the experimental group. As such, the data demonstrate that the simulation did not have a significant effect on knowledge. Data from the NLN (2005) student satisfaction and confidence level survey were analyzed using a two group MANOVA. Although the results of the MANOVA were not significant, as a follow up analysis, the individual questions were used as the dependent variables in a MANOVA. When the individual questions were used as the dependent variables in a MANOVA, the experimental group performed significantly better in two out of the five questions on student satisfaction and five out of the nine questions on student self-confidence. There was a strong positive correlation between satisfaction with current learning and self–confidence. Data for the students’ performance were analyzed using the C-CEI tool. A perfect score on the C-CEI instrument was 14 points, 100%. The overall group average was 8.1 points or 58%. Of the four sections in the C-CEI tool, the lowest mean was Communication (0.5185), followed by Patient Safety (mean = 0.5333). Although student groups were able to communicate with the patient effectively 67% of the time, none of the simulation groups provided an organized report to the healthcare provider with minimal prompting. During the postpartum simulation, 33% of the students administered medications safely. The wrong dosage and incorrect technique were seen in 67% of the simulations. Communication and safe medication practice are essential to ensuring patient safety; it is important that faculty prepare nursing graduates to provide safe care. Even though there were limitations to this study, a convenience sample at one public university, the findings are informative and have implications for future teaching and learning strategies. The results of this study add to the body of knowledge that supports the use of simulation as a teaching strategy in undergraduate nursing education. / Educational Leadership

Introduktion: Abdominell rektusmuskeldiastas (RD) är ett resultat av en fysiologisk process som uppstår hos gravida kvinnor och kännetecknas av utvidgning av bindväven i linea alba, vilket innebär att det uppstår ett ökat avstånd mellan rektusbukarna. Många kvinnor med RD har också ont i bäcken, rygg och buk med negativa hälsokonsekvenser. Att samma kvinnor har både RD och symtom har gjort att besvären ansetts vara relaterade, men detta är inte helt klarlagt. Området är inte tillräckligt beforskat och kliniska riktlinjer eller rekommendationer för prevention och behandling saknas. I dagsläget finns en kunskapslucka om hur RD påverkar smärta och funktion. Syfte: Hos kvinnor som upplever nedsatt funktion, smärta och ökad rektusdiastas efter graviditet och som av en fysioterapeut förskrivs anpassad bål- och bäckenbottenmuskelträning undersöka träningseffekt genom utfallsmåtten smärta och funktion. Metod: En SSED med A-B design där fem kvinnor deltog. Efter undersökning av fysioterapeut förskrevs egenträningen med bål- och bäckenbottenmuskel övningar. Träningen genomfördes under 5,5 veckor med 11 mättillfällen. Utfallsmåtten var Numeric raiting scale (NPRS) och Patientspecifik funktionell skala (PSFS). Analysmetoderna var celerationslinje, två standardavvikelse band samt binomialtest. Resultat: Analysmetoderna för NPRS visade olika resultat hos fyra deltagare. Hos en deltagare sågs ingen förbättring. Analysmetoderna för PSFS visade olika resultat hos fyra deltagare. Hos en deltagare sågs en förbättring i samtliga analysmetoder. Slutsats: Det går inte att dra några entydiga slutsatser utifrån de sammanlagda undersökningsresultaten.

This study examined pregnancy risk and protective factors for developing postpartum depression from a structural family theory lens. The purpose of this study was to (1) examine previously identified pregnancy stressors to learn which stressors put women more at risk for postpartum depression and (2) to identify possible buffers for women who are at risk for developing postpartum depression. In this paper, two analyses were proposed. Analysis I, uses a hierarchal regression analysis to examine the impact of couple related stress on postpartum depression. Analysis II uses moderated multiple regression to test factors during pregnancy which may protect at-risk women from postpartum depression symptoms. Three post-hoc exploratory analyses were conducted following the originally proposed analyses. Secondary data was used in this study. The data was collected in four large urban hospitals in Utah from 2005-2007 and included 1568 women. The results of these analyses illustrate the importance of conceptualizing postpartum depression from a family systems perceptive. Specifically, this study shows that a couple’s relationship, depending on the stress level experienced in the relationship, can be both a risk and protective factor for pregnant women. / Ph. D.

Introduktion: Mellan åtta och femton procent av nyförlösta kvinnor i Sverige drabbas av Postpartum depression (PPD). Många vet inte om att de är sjuka och söker inte vård. Hälso- och sjukvården ska tidigt uppmärksamma symtom, samt ha kunskap om vilka faktorer som kan bidra till PPD för att ge vård, hjälp och stöd. Syfte: Syftet var att utforska kvinnors upplevelse av förlossningsdepression samt stöd från vårdpersonal. Metod: En systematisk deskriptiv litteraturöversikt baserad på elva originalartiklar med kvalitativ design utfördes. Resultat: Resultatanalysen visade att kvinnorna upplevde fysiska och psykiska symtom, kände rädsla och hade svårigheter att prata om sina känslor vilket bidrog till isolering. En del kvinnor hade anknytningsproblem till barnet och vissa påverkades i sin relation till partnern. Kvinnor hade suicidtankar eller tankar på att skada sig själva eller sitt barn. Positiva eller negativa egenskaper hos vårdpersonalen var avgörande för mödrarnas önskan om stöd. När stödet i vården var bristande eller otillräckligt upplevdes fysisk aktivitet vara hjälpande faktorer. Slutsats: Kvinnor med PPD upplever ett onödigt lidande och känner skuld och skam. I många fall skulle dessa individer kunna upptäckas och få behandling tidigare genom att sjukvården arbetar proaktivt och ger kvinnor information i ett tidigt stadium. Det kan hjälpa kvinnor att uppmärksamma symtom själva och att söka vård i tid. Att göra information och vård lättillgängligt, att öka kunskapen i samhället och bland professionerna i vården samt att normalisera och bryta stigmat skulle kunna underlätta för många drabbade. / Introduction: Between eight and fifteen percent of women who have just given birth in Sweden suffer from postpartum depression (PPD). Many do not know that they are ill and do not seek treatment. The healthcare system must pay attention to symptoms early on, and have knowledge of which factors can contribute to PPD in order to provide care, help and support. Purpose: The purpose was to explore women's experience of postpartum depression and support provided by healthcare professionals. Method: A systematic descriptive literature review based on eleven original articles with a qualitative design was performed. Result: The results analysis showed that the women experienced physical and psychological symptoms, felt fear and had difficulty talking about their feelings, which contributed to isolation. Some women had attachment problems with the child and some were affected in their relationship with the partner. Women had suicidal thoughts or thoughts of harming themselves or their child. Positive or negative characteristics of the healthcare professionals were decisive for the mothers' desire for support. When support in care was lacking or insufficient, physical activity was perceived to be a helping factor. Conclusion: Women with PPD experience unnecessary suffering and feel guilt and shame. In many cases, these individuals could be detected and treated earlier by the healthcare system working proactively and providing women with information at an early stage. It can help women to notice symptoms themselves and to seek care in time. Making information and care easily accessible, increasing knowledge in society and among the healthcare professions, and normalizing and breaking the stigma could make things easier for many sufferers.