Patients' experiences and perceived causes of persisting discomfort following day surgery

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to describe patients' experiences and perceived causes of persisting discomfort following day surgery. Earlier research has mainly covered symptoms and signs during a recovery period of up to one month, and not dealt with patients' perceptions of what causes persisting, longer-term discomfort.</p> <p>Methods</p> <p>This study is a part from a study carried out during the period May 2006 to May 2007 with a total of 298 day surgery patients. Answers were completed by 118 patients at 48 hours, 110 at seven days and 46 at three months to one open-ended question related to discomfort after day surgery constructed as follows: <it>If you are still experiencing discomfort related to the surgery, what is the reason, in your opinion</it>? Data was processed, quantitatively and qualitatively. Descriptive, inferential, correlation and content analyses were performed.</p> <p>Results</p> <p>The results suggest that patients suffer from remaining discomfort e.g. pain and wound problem, with effects on daily life following day surgery up to three months. Among patients' perceptions of <it>factors leading to discomfort </it>may be <it>wrongful or suboptimal treatment</it>, <it>type of surgery </it>or <it>insufficient access to provider/information.</it></p> <p>Conclusions</p> <p>The results have important implications for preventing and managing discomfort at home following day surgery, and for nursing interventions to help patients handle the recovery period better.</p

Fear causes tears - Perineal injuries in home birth settings. A Swedish interview study

<p>Abstract</p> <p>Background</p> <p>Perineal injury is a serious complication of vaginal delivery that has a severe impact on the quality of life of healthy women. The prevalence of perineal injuries among women who give birth in hospital has increased over the last decade, while it is lower among women who give birth at home. The aim of this study was to describe the practice of midwives in home birth settings with the focus on the occurrence of perineal injuries.</p> <p>Methods</p> <p>Twenty midwives who had assisted home births for between one and 29 years were interviewed using an interview guide. The midwives also had experience of working in a hospital delivery ward. All the interviews were tape-recorded and transcribed. Content analysis was used.</p> <p>Results</p> <p>The overall theme was "No rushing and tearing about", describing the midwives' focus on the natural process taking its time. The subcategories 1) preparing for the birth; 2) going along with the physiological process; 3) creating a sense of security; 4) the critical moment and 5) midwifery skills illuminate the management of labor as experienced by the midwives when assisting births at home.</p> <p>Conclusions</p> <p>Midwives who assist women who give birth at home take many things into account in order to minimize the risk of complications during birth. Protection of the woman's perineum is an act of awareness that is not limited to the actual moment of the pushing phase but starts earlier, along with the communication between the midwife and the woman.</p

Medical students’ knowledge, attitudes and perceptions towards contraceptive use and counselling: a cross-sectional survey

Medical students&apos; knowledge, attitudes, and perceptions on contraceptive use and counselling: a cross-sectional survey in Maharashtra, India. Setting: Considerable global maternal mortality and morbidity could be avoided through the use of effective contraception. In India, contraception services are frequently unavailable or there are obstacles to obtaining modern, reversible contraceptives. Participants: A cross-sectional descriptive study using a self-administered questionnaire was conducted among 1996 medical students in their fifth year of study at 27 medical colleges in the state of Maharashtra, India. Descriptive and analytical statistics interpreted the survey instrument and significant results were presented with 95% CI. Results: Respondents expressed a desire to provide contraceptive services. A few students had experienced training in abortion care. There were misconceptions about modern contraceptive methods and the impact of sex education. Attitudes towards contraception were mainly positive, premarital counselling was supported and the influence of traditional values and negative provider attitudes on services was recognised. Gender, area of upbringing and type of medical college did not change the results. Conclusions: Despite mostly positive attitudes towards modern contraceptives, sex education and family planning counselling, medical students in Maharashtra have misconceptions about modern methods of contraception. Preservice and in-service training in contraceptive counselling should be implemented in order to increase women&apos;s access to evidence-based maternal healthcare services

Characteristics of Finnish and Swedish intensive care nursing narratives: a comparative analysis to support the development of clinical language technologies

Abstract Background Free text is helpful for entering information into electronic health records, but reusing it is a challenge. The need for language technology for processing Finnish and Swedish healthcare text is therefore evident; however, Finnish and Swedish are linguistically very dissimilar. In this paper we present a comparison of characteristics in Finnish and Swedish free-text nursing narratives from intensive care. This creates a framework for characterising and comparing clinical text and lays the groundwork for developing clinical language technologies. Methods Our material included daily nursing narratives from one intensive care unit in Finland and one in Sweden. Inclusion criteria for patients were an inpatient period of least five days and an age of at least 16 years. We performed a comparative analysis as part of a collaborative effort between Finnish- and Swedish-speaking healthcare and language technology professionals that included both qualitative and quantitative aspects. The qualitative analysis addressed the content and structure of three average-sized health records from each country. In the quantitative analysis 514 Finnish and 379 Swedish health records were studied using various language technology tools. Results Although the two languages are not closely related, nursing narratives in Finland and Sweden had many properties in common. Both made use of specialised jargon and their content was very similar. However, many of these characteristics were challenging regarding development of language technology to support producing and using clinical documentation. Conclusions The way Finnish and Swedish intensive care nursing was documented, was not country or language dependent, but shared a common context, principles and structural features and even similar vocabulary elements. Technology solutions are therefore likely to be applicable to a wider range of natural languages, but they need linguistic tailoring. Availability The Finnish and Swedish data can be found at: http://www.dsv.su.se/hexanord/data/.© 2011 Allvin et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Confident but not theoretically grounded &ndash; experienced simulation educators&rsquo; perceptions of their own professional development

Ren&eacute;e Allvin,1 Magnus Berndtzon,2 Liisa Carlzon,3 Samuel Edelbring,4,5 H&aring;kan Hult,6 Magnus Hultin,7 Klas Karlgren,5,8 Italo Masiello,9 Marie-Louise S&ouml;dersved K&auml;llestedt,10 &Eacute;va Tam&aacute;s,11 1Clinical Skills Centre, Faculty of Medicine and Health, School of Medical Sciences, &Ouml;rebro University, &Ouml;rebro, 2Metodikum &ndash; Skill Centre of Medical Simulation Region County J&ouml;nk&ouml;ping, J&ouml;nk&ouml;ping, 3Simulation Centre West, Department of Research, Education and Development, Sahlgrenska University Hospital, Gothenburg, 4Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Link&ouml;ping University, Link&ouml;ping, 5Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, 6Institute of Medicine and Health, Medical Faculty, Link&ouml;ping University, Link&ouml;ping, 7Department of Surgical and Perioperative Sciences, Anaesthesiology and Intensive Care, Medical Faculty, Ume&aring; University, Ume&aring;, 8Department of Research, Education and Development and Innovation, S&ouml;dersjukhuset Hospital, Stockholm, 9Department of Clinical Science and Education, Karolinska Institutet, S&ouml;dersjukhuset Hospital, Stockholm, 10Clinical Skills Centre, Centre for Clinical Research, Uppsala University, V&auml;ster&aring;s, 11Department of Cardiovascular Diseases, Institute of Medicine and Health, Medical Faculty, University of Link&ouml;ping, Link&ouml;ping, Sweden Background: Medical simulation enables the design of learning activities for competency areas (eg, communication and leadership) identified as crucial for future health care professionals. Simulation educators and medical teachers follow different career paths, and their education backgrounds and teaching contexts may be very different in a simulation setting. Although they have a key role in facilitating learning, information on the continuing professional development (pedagogical development) of simulation educators is not available in the literature. Objectives: To explore changes in experienced simulation educators&rsquo; perceptions of their own teaching skills, practices, and understanding of teaching over time. Methods: A qualitative exploratory study. Fourteen experienced simulation educators participated in individual open-ended interviews focusing on their development as simulation educators. Data were analyzed using an inductive thematic analysis. Results: Marked educator development was discerned over time, expressed mainly in an altered way of thinking and acting. Five themes were identified: shifting focus, from following to utilizing a structure, setting goals, application of technology, and alignment with profession. Being confident in the role as an instructor seemed to constitute a foundation for the instructor&rsquo;s pedagogical development. Conclusion: Experienced simulation educators&rsquo; pedagogical development was based on self-confidence in the educator role, and not on a deeper theoretical understanding of teaching and learning. This is the first clue to gain increased understanding regarding educational level and possible education needs among simulation educators, and it might generate several lines of research for further studies. Keywords: continuing professional development, interviews, medical simulation, pedagogical development, simulation educato