Objectives: Infants delivered at ≥37 weeks’ gestation are considered full term, but research has demonstrated those born at 37 to 38 weeks (early term) have a higher risk for poor birth outcomes than deliveries at 39 to 41 weeks (full term). Despite this, many deliveries occur electively (scheduled, no medical indication) before 39 weeks. This study examined the risks of elective early-term delivery in a disadvantaged, rural sample and compared these results with national findings. Methods: Data were available for 638 rural women, recruited prenatally from three counties in rural southern Appalachia, who delivered electively at ≥37 weeks. Results: Compared with electively delivered full-term infants, those delivered electively at early term were 7.7 times more likely to be low birth weight, 4.4 times more likely to have a neonatal intensive care unit admission, and 2.5 times more likely to develop jaundice. Those living furthest from the hospital were most likely to deliver electively at <39 weeks. Although rates of elective deliveries <39 weeks were no higher than national rates, adjusted odds ratios (aOR) of associated admission to a neonatal intensive care unit doubled (aOR 4.4 vs aOR 2.2). Conclusions: Results demonstrate that initiatives targeting early-term elective deliveries are needed in rural, disadvantaged regions.

Bakgrund: Den kraftiga omorganiseringen som skedde inom hälso- och sjukvården på grund av covid-19 orsakade bland annat att operationspersonal förflyttades till andra avdelningar. Patienter som väntade på att genomgå elektiv operation drabbades då dessa ställdes in eller flyttades fram. Någon sammanställning av dessa patienters erfarenheter identifierades inte varpå en vetenskaplig kunskapslucka existerade. Syfte: Beskriva patienters erfarenheter av att få sin elektiva operation inställd eller framflyttad på grund av covid-19 pandemin. Metod: En integrativ litteraturöversikt med engelsk vetenskaplig litteratur som eftersöktes i databaserna PubMed, Scopus och CINAHL. Datan analyserades enligt en integrativ analysprocess som bestod av fyra steg. 13 artiklar inkluderades. Resultat: Analysen resulterade i tre huvudteman “Komplicerad tid där livet påverkas och influeras av acceptans”, “Informationen från sjukvården påverkar erfarenheten” och “Förvärrade symtom och oro för långsiktiga konsekvenser” med totalt nio underteman. Slutsats: Erfarenheterna som framkom påverkades av mängden adekvat kommunikation och information från hälso- och sjukvården samt om denna var direkt eller indirekt. Patienternas bakomliggande sjukdom eller tillstånd var även avgörande för erfarenheterna. Bibehållen kontakt med patienter under förseningen var primärt då föreliggande studie visade att detta kunde minska oro och förbättra erfarenheten. / Background: The major reorganization that took place in healthcare due to covid-19 caused, among other things, the transfer of operating personnel to other departments. Patients waiting to undergo elective operation were affected when these were canceled or postponed. No compilation of these patients’ experiences was identified, therefore a scientific knowledge gap existed. Aim: Describe patients experiences of having their elective operation canceled or postponed due to the covid-19 pandemic. Method: An integrative literature review with English science literature were searched for in PubMed, Scopus and CINAHL databases. The data was analyzed according to an integrative analysis process consisted of four steps. 13 articles were included. Result: The analysis resulted in three main themes: “Complicated time where life is affected and influenced by acceptance”, “Information from healthcare affects the experience” and “Deteriorated symptoms and concern for long-term consequences” with a total of nine sub-themes. Conclusion: The experiences that emerged were influenced by the amount of adequate communication and information from healthcare and whether this was direct or indirect. The patients’ underlying illness or condition was also decisive for the experiences. Maintaining contact with the patients during the delay was primary as the present study showed that this could reduce anxiety and improve the experience.

Background: Pre-operative anxiety remains a serious problem affecting surgical patients. The prevalence rate ranges between 60% to 80% percent among western surgical patients. Nothing is known about the prevalence of pre-operative anxiety among Nigerian Hausa speaking elective surgical patients. It is also not known what non-pharmaceutical pre-operative anxiety reduction interventions are preferable in reducing their anxiety before they undergo elective surgery. Participants: Thirty adult patients scheduled to undergo elective surgery in a tertiary health facility in north eastern Nigeria. Design/procedure: The study consists of three phases: Phase 1- translating and cross-cultural validation of Amsterdam Pre-operative Anxiety and Information Scale (APAIS) into Nigerian Hausa Language. Phase 2- administering the translated scale to assess the prevalence of pre-operative anxiety among the study participants. Phase 3 - finding out which non-pharmaceutical pre-operative anxiety reduction interventions would the Hausa speaking elective surgical patients prefer in reducing their anxiety before they undergo elective surgery. Results: The translated Hausa and validated version of the scale (APAIS-H) has shown a good psychometric property with Cronbach's alpha of 0.82 for anxiety related to surgery subscale and 0.71 for information desire subscale respectively. The finding of phase 2 revealed that there is high prevalence of pre-operative anxiety among the Hausa speaking elective surgical patients. The patients' anxiety continues to increase in intensity as they approach their time of operation. Results of phase 3 shows that the Hausa speaking elective surgical patients have high preference for counselling services, information and education, video-film intervention and low preference for music therapy. Conclusion: There is high prevalence of pre-operative anxiety among the Hausa speaking elective surgical patients. It is therefore recommended that, before undergoing elective surgery, clinicians should assess the Hausa patients' pre-operative anxiety so as to provide them with their preferred pre-operative anxiety reduction interventions proportionate to their level of anxiety. The thesis argued that the translated and validated APAIS-H is be a good measure of assessment particularly of those Hausa patients who could not read and understand the English Language version of assessment tool. / Yobe State University

Den information som operationssjuksköterskan förmedlar till patienten före, under och efter en elektiv kirurgisk operation kan minska patientens oro och risken för operativa komplikationer. Rätt information kan även minska antalet inställda elektiva kirurgiska ingrepp, förkorta patientens vårdtid samt minska antalet vårdskador och användningen av smärtmedicinering. Ändå är forskningen om vilken information som patienterna önskar i samband med elektiv kirurgi otillräcklig. Syftet med denna studie var därför att sammanställa kunskap om vilken information patienter som skall genomgå elektiv kirurgi har behov av. För att tillmötesgå syftet genomfördes en integrativ litteraturstudie utifrån 15 vetenskapliga artiklar baserade på kvalitativ och kvantitativ metod. Den integrativa litteraturstudien analyserades utifrån kvalitativ metod och strukturerades efter två huvudteman som benämndes heltäckande information samt Personcentrerad information. Resultatet visade att operationsteam och operationssjuksköterskor försökte tillmötesgå patienternas varierade och individuella behov av skriftlig och muntlig information under den preoperativa, operativa och postoperativa perioden i omsorgsvårdsprocessen. Under den preoperativa perioden ville patienterna främst få individualiserade verbala eller skriftliga svar på sina frågor. Under den postoperativa perioden ville patienterna få mer omfattande information än vad som i praktiken gavs. Patienterna ville få en så heltäckande, varierad och individanpassad verbal eller skriftlig information som möjligt. Emellertid förekom skillnader mellan operationsteamets och patienternas önskemål och sätt att tolka information. Patienterna ville få en mer personcentrerad och empatisk förståelse samt fullständig information om operationens långsiktiga resultat. När sådan information inte gavs fullt ut kunde patienterna känna sig otrygga inför operationen och ovissa i egenvården efter operationen. Slutsatsen blev därför att operationssjuksköterskan behöver ge information som tar mer hänsyn till patienternas varierade individuella informationsbehov och mer hänsyn till patienternas behov av psykologisk trygghet före/efter operationen. / The information the surgical nurse communicates to the patient before, during and after an elective surgical operation can reduce the patient's concern and the risk of operative complications. Correct information can also reduce the number of elective surgical procedures canceled, shorten the patient's care time, and reduce the number of medical injuries and the use of pain medication. Nevertheless, there is lacking research on what information patients want in conjunction with elective surgery. The purpose of this study was therefore to compile knowledge about what information patients who are to undergo elective surgery need. To meet the purpose, an integrative literature study was conducted on the basis of 15 scientific articles based on qualitative and quantitative method. The integrative literature study was analyzed using a qualitative method and structured according to two main themes called comprehensive information and person-centered information. The result showed that surgery teams and surgery nurses tried to meet patients' varied and individual needs for written and oral information during the preoperative, operative and postoperative period of the careprocess. During the preoperative period, patients primarily wanted more individualised verbal or written answers to their questions. During the postoperative period, patients wanted more comprehensive information than was provided in practice, and patients wanted as comprehensive, varied and individualized verbal or written information as possible. However, there were differences between the surgical team's and the patients' information preferences, where the patients could want a more person-centered and empathetic understanding as well as complete information about the long-term results of the operation. When such person-centered information was not fully provided, patients could feel insecure before the operation and uncertain in self-care after the operation. The conclusion was therefore that the surgical nurse needs to provide information that takes more account of the patients’ varied individual information needs and more consideration of the patients' sense of psychological security before/after the operation.

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Information on the overall health risk behaviors of college students is limited and it is unknown if being enrolled in an elective or a required health course affects behavior change among the students. There are mixed reports on whether or not health education courses affect behavior change. Factors that may affect change are self-efficacy and the constructs that build the Health Belief Model (i.e. perceived susceptibility and perceived barriers). A sample of convenience was gathered for the current study using two universities in the state of Virginia. Virginia Tech students within the sample were enrolled in an elective health course (n = 375) and James Madison University students within the sample were enrolled in a required health course (n = 202). The National College Health Risk Behavior Survey (NCHRBS) and the Self-Efficacy Scale survey were used to gather information on overall health risk behaviors, health behavior changes, and self-efficacy levels of the students. To acquire health behavior change data, the NCHRBS was administered at the beginning of the Fall 2003 semester and again at the end of the semester. The results of the study indicated that, overall, the type of course a student was enrolled in and self-efficacy did not have a significant effect on health behavior change. However, possible trends were identified with alcohol use, tobacco use, and dietary behaviors, indicating that further research should be performed to analyze underlying factors, not analyzed in this study, which may be affecting health risk behaviors. / Ph. D.

Yes / For patients to be treated, decisions about their care must be made before treatment begins. In case of pre-operative anxiety, it is currently unknown how clinicians and patients discuss information about the issue, and it is also not known whether clinicians consider (or are ready to consider) their patients’ preferences of non-pharmaceutical pre-operative anxiety reduction interventions. At present no study has been conducted to find information on surgical patients’ preferences of, and their involvement in decisions about non-pharmaceutical interventions for reducing their pre-operative anxiety. This paper investigates elective surgical patients’ involvement in treatment decisions with the aim of finding out their preferred non-pharmaceutical pre-operative anxiety reduction interventions before they undergo elective surgery. Method: A survey method was used to collect data on patients’ preference of non-pharmaceutical preoperative anxiety reduction interventions at a tertiary health facility in Nigeria. Participants: A sample of 30 participants-17 male and 13 female, schedule to undergo surgical operations was selected using a convenient sampling method. Their ages range between 17 to 70 years (mean age = 41.03 and standard deviation = 16.09). Study design/procedure: To elicit preference of interventions, the study participants were presented with cards that contain picture of surgical patient receiving one of the non-pharmaceutical interventions used in reducing pre-operative anxiety. The pictures were presented one at a time for 30-40 seconds. The researcher then gives the participants a sheet of paper with the different interventions boldly written for the participants to rank order them according to the degree of their preferences. Through this process, data was collected from all the 30 participants. Results: The results obtained were entered into SPSS for analysis. Descriptive statistics, at 95 % confidence was calculated to estimate the percentage, mean, standard deviation and confidence intervals based on the participants’ preference of the interventions. Discussions: The findings were discussed alongside the existing literature and recommendations were offered for clinical practice and further research.

Background: Rapid repeat pregnancy (RRP), a pregnancy occurring less than 24 months from a prior birth, and unintended pregnancy-related induced abortions can be prevented with family planning. However, few studies have adequately addressed the role of male partners in reproductive decision-making. Objectives: The goal of this research is to understand the interrelationships between couple pregnancy intention, intimate partner violence (IPV), reproductive health and behaviors. Specifically, this project aims to: (1) examine the extent to which couple pregnancy intentions are associated with RRP and (2) induced abortions among women in the U.S., and (3) examine the extent to which IPV around the time of pregnancy is associated with postpartum birth control use by race/ethnicity and receipt of prenatal contraceptive counseling among U.S. women with live births. Methods: This project uses data from the 2006-2010 National Survey on Family Growth (NSFG), and the 2004-2008 national Pregnancy Risk Assessment Monitoring System (PRAMS). RRP and induced abortion of first pregnancy were self-reported in the NSFG. Couple pregnancy intentions were categorized as: both intended (M+P+), both unintended (M-P-), maternal intended and paternal unintended (M+P-), maternal unintended and paternal intended (M-P+). Multiple logistic regression analysis was used to assess the relationships between couple pregnancy intentions and RRP and induced abortion. Data on IPV and postpartum contraceptive use came from PRAMS. Stratified analyses were conducted to assess differences in the association by race/ethnicity and receipt of prenatal contraceptive counseling. Results: Compared to couples where pregnancy was intended by both, those with discordant pregnancy intentions and both unintended pregnancy had greater odds of induced abortion. The odds of RRP was higher for M-P+ couples and lower for M+P- couples. Abused women were significantly less likely to report postpartum contraceptive use. This was particularly true for Hispanic women who reported no prenatal birth control counseling and all other racial/ethnic groups who received birth control counseling. Conclusion: Health providers may need to consider the interpersonal dynamics of couple-based decision-making and behaviors to prevent RRP and induced abortions due to unintended pregnancy. Providers should discuss contraceptive options that are not partner-dependent within the context of abusive relationships.