Sairaanhoitajan antama tuki perheelle lapsen joutuessa tehohoitoon : Kirjallisuuskatsaus

Kriittinen sairaus ilmestyy tyypillisesti varoittamatta jättäen perheen kokemaan avuttomuutta ja epätietoisuutta koskien sairastuneen perheenjäsenen toipumista. On tärkeää, että perhe saa riittävästi tukea jaksaakseen vaikeassa tilanteessa. Sairaanhoitajat työskentelevät hyvin tiiviisti yhteistyössä lapsen ja hänen perheensä kanssa. Siksi on tärkeä ymmärtää, mitä tarpeita perheellä on, jotta niihin voidaan vastata. Sairaanhoitajan tärkeänä tehtävänä on antaa tukea kaikille perheenjäsenille, niin vanhemmille kuin sisaruksille. Opinnäytetyö toteutettiin kuvailevana kirjallisuuskatsauksena, jonka tarkoituksena oli kuvata perheen näkökulmasta, millaista tukea he tarvitsevat sairaanhoitajalta, kun heidän lapsensa on tehohoidossa. Tavoitteena oli tuottaa tietoa siitä, millaisiin asioihin sairaanhoitajien tulisi kiinnittää huomiota perheitä kohdatessaan lasten teho-osastoilla ja lisätä perhehoitotyön näkökulmaa hoitotyössä. Opinnäytetyön aineisto koostuu kansainvälisistä hoitotieteellisistä alkuperäistutkimuksista. Aineiston analyysissä käytettiin sisällönanalyysin periaatteita. Kirjallisuuskatsaukseen valikoitui lopulta yhdeksän alkuperäisartikkelia, jotka vastasivat tutkimuskysymykseen ja läpäisivät sisäänottokriteerit. Aineiston analyysi toteutettiin induktiivisella sisällönanalyysilla. Sisällönanalyysi tuotti kuusi perheen tarpeisiin koskevaa pääluokkaa. Nämä olivat sairaan-hoitajien läsnäolo, lapsen vierellä olon mahdollistaminen, vanhemmuuteen tukeminen, lapsen voinnista tiedottaminen perheelle, sairaanhoitajien hyvät kommunikaatiotaidot ja empatia sekä muut tarpeet. Opinnäytetyö auttaa ymmärtämään, miten vanhemmat kokivat lapsensa joutumisen tehohoitoon ja mitä tarpeita heillä oli lapsensa tehohoitojakson aikana.Critical illness typically appears without warning, leaving the family feeling helpless and uncertain about the recovery of the affected family member. It is important for the family to get enough support in a difficult situation. Nurses work very closely together with the child and her family. It is therefore important to understand what needs the family require to be able to respond them. An important task for nurses is to provide support to all family members, parents and siblings. The thesis was conducted as a descriptive literature review aimed at describing from the perspective of the family what kind of support they need from a nurse when their child is in intensive care. The aim is to provide information on what kind of issues nurses should pay attention to when dealing with families in child care departments and increase the perspective of family care in nursing. The material of the thesis consists of international scientific studies. The analysis of the material used the principles of content analysis. The final literature review comprised 9 original research articles that answered the research question and met the selection criteria. The data was analysed by using inductive content analysis. The analysis of the material was carried out with inductive content analysis. Content analysis produced six categories for family needs. These were the attendance of nurses, the advent of the child, the support of parenthood, the communication of the child with the family, the good communication skills of the nurses, and empathy and other needs. The thesis helps to understand how parents felt that their children were in intensive care and what their needs were during their child's intensive care period

Breaking the myth : the association between the increasing incidence of labour induction and the rate of caesarean delivery in Finland - a nationwide Medical Birth Register study

Objectives To determine the association between the rate of labour induction and caesarean delivery. Design Medical Birth Register-based study. We used data from the nationwide Medical Birth Register collecting data on delivery outcomes on all births from 22+0 weeks and/or birth weight of at least 500 g. Setting Finland. Participants 663 024 live births in Finland from 2008 to 2019. Main outcome measures The rates of labour induction and caesarean delivery. Results The rate of labour induction increased from 17.8% to 30.3%; p Conclusions The 70% increase in the rate of labour induction in Finland has not led to a significant increase in the rate of caesarean delivery, which has remained one of the lowest in the world. Pregnant women in Finland are more frequently obese, older and diagnosed with gestational diabetes, which may partly explain the increase in the rate of labour induction.Peer reviewe

Comparison of delivery outcomes in low-dose and high-dose oxytocin regimens for induction of labor following cervical ripening with a balloon catheter : A retrospective observational cohort study

A variety of oxytocin regimens are used for labor induction and augmentation. Considering the increasing rates of labor induction, it is important to assess the most optimal oxytocin regimen without compromising maternal and fetal safety. The aim of this study was to compare delivery outcomes of low-dose and high-dose oxytocin induction protocols. This retrospective cohort study of 487 women comparing low-dose oxytocin protocol (n = 280) and high-dose oxytocin protocol (n = 207) in labor induction following cervical ripening by balloon catheter was performed in Helsinki University Hospital after implementation of a new oxytocin induction protocol. The study included two six-month cohorts from 2016 and 2019. Women with vital singleton pregnancies >= 37 gestational weeks, cephalic presentation, and intact amniotic membranes were included. The primary outcome was the rate of vaginal delivery. The secondary outcomes were the rates of maternal and neonatal infections, postpartum hemorrhage, umbilical artery blood pH-value, admission to neonatal intensive care, and induction-to-delivery interval. Statistical analyses were performed by using IBM SPSS Statistics for Windows (Armonk, NY, USA). The rate of vaginal delivery was higher [69.9% (n = 144) vs. 47.9% (n = 134); pPeer reviewe

Future risk of metabolic syndrome in women with a previous LGA delivery stratified by gestational glucose tolerance : a prospective cohort study

Background: Whether the delivery of a large-for-gestational-age (LGA) infant predicts future maternal metabolic syndrome (MetS) is not known. To this aim, we investigated the incidence of MetS and its components in women with or without a history of gestational diabetes mellitus (GDM) with a view to the birth weight of the offspring. Methods: Eight hundred seventy six women treated for their pregnancies in Kuopio University Hospital in 19892009 underwent a follow-up study (mean follow-up time 7.3 (SD 5.1) years), of whom 489 women with GDM and 385 normoglycemic controls. The women were stratified into two groups according to the newborn's birth weight: 10-90th percentile (appropriate-for-gestational-age; AGA) (n = 662) and > 90th percentile (LGA) (n = 116). MetS and its components were evaluated in the follow-up study according to the International Diabetes Federation criteria. Results: LGA vs. AGA delivery was associated with a higher incidence of MetS at follow-up in women with a background of GDM (54.4% vs. 43.6%), but not in women without GDM. Conclusion: An LGA delivery in women with GDM is associated with a higher risk of future MetS and this group is optimal to study preventive measures for MetS. In contrast, an LGA delivery after a normoglycemic pregnancy was not associated with an increased future maternal MetS risk.Peer reviewe

Success of trial of labor in women with a history of previous cesarean section for failed labor induction or labor dystocia : a retrospective cohort study

BackgroundThe rates of cesarean section (CS) are increasing worldwide leading to an increased risk for maternal and neonatal complications in the subsequent pregnancy and labor. Previous studies have demonstrated that successful trial of labor after cesarean (TOLAC) is associated with the least maternal morbidity, but the risks of unsuccessful TOLAC exceed the risks of scheduled repeat CS. However, prediction of successful TOLAC is difficult, and only limited data on TOLAC in women with previous failed labor induction or labor dystocia exists. Our aim was to evaluate the success of TOLAC in women with a history of failed labor induction or labor dystocia, to compare the delivery outcomes according to stage of labor at time of previous CS, and to assess the risk factors for recurrent failed labor induction or labor dystocia.MethodsThis retrospective cohort study of 660 women with a prior CS for failed labor induction or labor dystocia undergoing TOLAC was carried out in Helsinki University Hospital, Finland, between 2013 and 2015. Data on the study population was obtained from the hospital database and analyzed using SPSS.ResultsThe rate of vaginal delivery was 72.9% and the rate of repeat CS for failed induction or labor dystocia was 17.7%. The rate of successful TOLAC was 75.6% in women with a history of labor arrest in the first stage of labor, 73.1% in women with a history of labor arrest in the second stage of labor, and 59.0% in women with previous failed induction. The adjusted risk factors for recurrent failed induction or labor dystocia were maternal heightPeer reviewe

Delivery of an LGA infant and the maternal risk of diabetes: A prospective cohort study

Aims: Was to determine whether the birth weight of the infant predicts prediabetes (impaired fasting glucose, impaired glucose tolerance, or both) and type 2 diabetes (T2DM) during long-term follow-up of women with or without gestational diabetes mellitus (GDM). Methods: The women with or without GDM during their pregnancies in Kuopio University Hospital in 1989-2009 (n=876) were contacted and invited for an evaluation. They were stratified into two groups according to the newborn's birth weight: 10-90th percentile (appropriate-for-gestational-age; AGA) (n = 662) and >90th percentile (large-for-gestational-age; LGA) (n = 116). Glucose tolerance was investigated with an oral glucose tolerance test after a mean follow-up time of 7.3 (SD 5.1) years. Results: The incidence of T2DM was 11.8% and 0% in the women with and without GDM, respectively, after an LGA delivery. The incidence of prediabetes increased with offspring birth weight categories in the women with and without GDM: from 46.3% and 26.2% (AGA) to 52.9% and 29.2% (LGA), respectively. Conclusions: GDM women with LGA infants are at an increased risk for subsequent development of T2DM and therefore represent a target group for intervention to delay or prevent T2DM development. In contrast, an LGA delivery without GDM does not increase T2DM risk. (C) 2018 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Childbirth experience in induced labor: A prospective study using a validated childbirth experience questionnaire (CEQ) with a focus on the first birth

Peer reviewe

Prenatal predictors of objectively measured appetite regulation in low-income toddlers and preschool-age children

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152019/1/ijpo12554_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/152019/2/ijpo12554.pd