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Volume 2, Problème 2 (2013)

article de recherche

Fathers' Feelings and Experiences during Pregnancy and Childbirth: A Qualitative Study

Anette Eksträm, Kristina Arvidsson, Malin Falkensträm and Stina Thorstensson

Background: Fathers feel excluded and insecure during childbirth and professional support for fathers can be inadequate. Therefore it is important to further understand fathers experience in order to develop professional support and to create a positive childbirth experience for both fathers and their partners.

Aim: The aim of this study was to explore fathers’ feelings and experiences during pregnancy and childbirth.

Materials and Methods: A qualitative method was used, with written interviews which were analyzed using a qualitative content analysis. Participants were eight fathers who wrote answers to two open questions.

Results: The theme “Fathers have strong, mixed feeling while striving to become prepared and to participate during pregnancy and childbirth” crossed over into all the four categories: Being prepared gave security, Feeling needed, Feeling strong, mixed feelings during pregnancy, and Feeling strong, mixed feelings during childbirth. Fathers’ previous experiences from childbirth facilitated being prepared and increased sense of security.

Conclusion: It was important for fathers to be prepared and to feel needed and to witness the birth of their baby was fantastic. Overall, the fathers were faced with handling their strong but mixed feelings while striving to prepare for and participate in pregnancy and childbirth.

Implications: Healthcare professionals need to acknowledge that fathers have needs of their own during pregnancy and childbirth. Fathers also worry about the woman and the baby so they need explanations about normal changes as well as possible complications.

article de recherche

Physical Restraints in Critical Care Units: Impact of a Training Program on Nurses' Knowledge and Practice and on Patients' Outcomes

Nadia M Taha and Zeinab H Ali

The use of physical restraints is a common practice in various clinical settings, especially in intensive care units (ICUs). The aim of this study was to improve nurses’ knowledge and practice regarding physical restraining, with the ultimate goal of reducing the number of consequent complications among ICU patients. A quasi-experimental design with pre-post assessment was used on 38 nurses working in the ICUs and Critical Care Medicine at the Zagazig University Hospitals and 100 patients under their care. A self-administered questionnaire was used to assess nurses’ knowledge, an observation checklist for their practice, and a physical assessment sheet for patients. The researcher developed a training intervention based on analysis of assessment data and using pertinent literature to teach nurses guidelines for dealing with restrained patients. This was delivered to nurses in 7 sessions. Evaluation was done immediately (post-test), and two months after implementation (follow-up), along with evaluation of the patients. The results showed marked deficiencies in nurses’ knowledge and practices before the program, with significant improvements at the post and follow-up evaluations. Additionally, statistically significant improvements were revealed in patients’ signs and physical findings, with much less complications. Therefore, a relatively short-term in-service training in guidelines can significantly improve nurses’ knowledge and practice concerning physical restraining of ICU patients, with subsequent reductions in the frequency of related complications among these patients. Therefore, these guidelines should be adopted and its booklet should be available in each department using restraint in the hospital.

article de recherche

Health-Related Problems after the Great East Japan Earthquake: An Evaluation Based on the Annual Health Examination

Kazumi Kubota, Akiomi Inoue, Yoichi Shimizu, Satoko Kagata, Roseline Yong,Yoshiaki Hirama, Masaru Shiga, Takashi Kawazoe

Background: Study on the medium- to long-term effect of a great earthquake on health among the victims is limited. The purpose of the present study was to investigate the medium-term (i.e., three months) effect of the Great East Japan Earthquake (occurred on March 11, 2011) on health conditions (i.e., blood pressure, hemoglobin A1c [HbA1c], blood sugar, triglyceride, and total cholesterol) among the victims, by comparing with the control population.

Methods: In June 2011, taking blood pressure and blood tests were conducted for a total of 159 victims who had stayed in the shelter located in the Tohoku region since the Great East Japan Earthquake. The same tests were conducted for a total of 1,048 control participants in Tokyo from October 2010 to December 2011. Analyses of covariance and multiple logistic regression analyses were conducted.

Results: Compared with the control group, the victim group had significantly higher systolic and diastolic blood pressure; lower HbA1c, blood sugar, triglyceride, and total cholesterol, after adjusting for age and sex. In a similar way, the victim group had a significantly higher prevalence odds ratio of hypertension; lower prevalence odds ratios of diabetes mellitus, high blood sugar, high triglyceride, and high total cholesterol than control group.

Conclusions: The present study revealed that the prevalence of hypertension is higher among the victims of the Great East Japan Earthquake. Lower prevalence of diabetes mellitus, high blood sugar, high triglyceride, and high total cholesterol among the victims may be explained by the continued inadequate diet issues after the earthquake.

article de recherche

Predictors of Health Related Quality of Life for Adults Ages 40-64

Stefany H Almaden

Background: This study focused on access to care for adults 40 to 64 with the purpose of identifying predictors of health-related quality of life (HR-QoL). The literature had inconsistencies and gaps in experimental methoods in determining HR-QoL predictors.

Methods: Using Becker’s HBM as its theoretical framework as well as Quality Metric instrument SF 12 vs 2™ for measuring HR-QoL, this explorative correlational study examined under insurance, continued health coverage, and health behavior in relation to HR-QoL while controlling for personal attributes like age, gender, race/ethnicity, and level of income and education. Multivariate regression analyses were conducted with a sample N = 165.

Results: The study focused on three research question with three Null and Alternate hypotheses in search of predictors of HR-QoL. Although no significant relations were observed when linking the three predictors to HR-QoL, significant positive association between health seeking behavior and continuity of health coverage was observed.

Conclusion: Continuity of health coverage had a significant relation to health seeking behavior with implications for positive social change. An understanding of factors that contribute to health behavior and engaging patients to seek health services are key factors to improving health status.

Article de révision

Engaging Clinicians in Research: Issues to Consider

Trisha Dunning AM

The beginning of nursing research is attributed to Florence Nightingale whose research during the Crimean War in the 1850s ultimately shaped health care, including nursing practice. Modern research, like clinical care, is influenced by technological, societal, organisational and environmental changes. However, ‘nursing research’ is a simple term that may not encompass complex inter-related concepts and practices and various research methods: quantitative, qualitative, implementation science, evaluation and audit. All research methods follow a similar basic ‘research process,’ but the way the process is applied and rigor is demonstrated differs among the methods. All nurses must engage in research on some level, given they practice in a climate of evidence-based care and are expected to adhere to evidence-based protocols and guidelines. In addition, they need to be able to implement evidence-based best practice and use clinical judgement to treat each person as an individual.

article de recherche

Relationships Among Health Locus of Control, Coping Methods, and Dysmenorrhea of Korean Adolescence in Middle School

Nam Hyun Cha and Sohyune R Sok

Background: Recently, sexual issues in youth have become more severe, and sexual education is given to youth almost forcefully and involuntarily. Then, it is necessary to help the youth cultivate accurate information on their own menstruation as the most basic health knowledge.

Objective: This study aimed to examine the correlations and degrees of health locus of control, coping methods, and dysmenorrhea; and the factors influencing the dysmenorrhea of Korean adolescence in middle school.

Design: This was a cross-sectional descriptive design.

Participants: Subjects were 572 female students in middle schools in Seoul, South Korea.

Measurements and findings: Measures were a demographic form, revised MDQ (Menstrual distress Questionnaire), questionnaire for coping methods of dysmenorrhea, and scale for health locus of control. The mean of dysmenorrhea was 77.71 scores indicating lower dysmenorrhea. Physical psychological control in the coping methods of dysmenorrhrea was effectively the most using as the highest score (27.20). Internal health locus of control was the most as 79.2%. The analyses showed that the prediction model was significant (F=20.457, p<.001). The value of the adjusted R2 was 0.235, which corresponds to the explanatory power of 23.5%. The factor found to have the most influence on the dysmenorrhea of Korean adolescence in middle school were the negative coping (β=0.369), followed by chance health locus of control (β=0.244), conversion in coping method (β=-0.159), dependence health locus of control (β=-0.100), posture therapy in coping method (β=0.091).

Conclusions/Implications for practice: Nursing intervention programs should be explored to reduce their negative coping, to apply conversion and posture therapy in coping methods.

article de recherche

A Dialogical Trial for Understanding a Mother and a Child with Autism Spectrum Disorder: Preliminary Implication for Nursing and Care

Mami Yamamoto, Midori Asano and Naoki Nomura

The objective of this study is to demonstrate the change in qualitative levels of the context (evolution of context) in communication between a mother and a child with autism spectrum disorder (ASD).

In order to realize this objective, we focus on the relationship between contexts, and describe dynamic change inside mother-child communication. The data were collected thorough fieldwork by interview to the mother and participant observation. We analyzed about qualitative level of a context by qualitative analysis.

When the mother and the child with ASD experience repeated cycles of conflict and trial and error, the qualitative levels of the shared context of communication become comprehensive. The subject, which is the change in communication, is a context that arises in the parent and child’s whole unit. Synchronously, the context about how to understand the communication between the parent and child becomes comprehensive. We propose that the dialogic partner’s context and mother-child’s context evolves in synchrony. When the object of nursing becomes a unit, including the nursing care provider, nursing can be asserted as a change of relationship in the interaction between the nursing care provider and the mother and child.

article de recherche

Scoping the Assessment Needs of Young Carers of Adults with a Long Term Condition

Lioba Howatson-Jones and Esther Coren

The numbers of people living with a long term condition are increasing. People with long term conditions appear in a variety of health settings. Many of these may have young families and be reliant on them for help. The United Kingdom government policy recognises the contribution of carers and the need for assessment in their own right. The aim of this research was to bridge the gap between adult and child services by developing an assessment tool for adult nurses to use when working with a family where a young person is involved in the care of an adult with a long term condition. The study utilised a qualitative approach gathering data by means of three focus groups and developing results from thematic analysis to formulate an assessment tool. The findings identified that health professionals did not always know about young carers in their catchment or case load area, services were usually focused on the person cared for and explanations about the long term condition needed to be clearer and age specific. Cross-cultural applicability of the assessment tool has also been considered in terms of adaptability to other settings. The conclusions reached were that using an assessment tool to assess young carer input and needs when the person cared for comes into contact with acute services could help to create greater awareness of young carers and their needs.

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