Back Pain/Discomfort in Pregnancy: Invisible and Forgotten

This paper is a comprehensive literature review of original research on the nature of back pain/discomfort in pregnancy. The causes of back pain/discomfort in pregnancy are reviewed and discussed, and the clinical manifestations and implications are explored. This analysis revealed that approximately 50% of pregnant women experience back pain/discomfort with little or no intervention from their health care providers. Thus, back pain/discomfort in pregnancy seems to be invisible and forgotten in contemporary antenatal care. Evidence-based guidelines are provided for both women and health professionals as a way of increasing attention to the prevention of unnecessary back pain/discomfort during pregnancy

Eat, Drink, and Be Labouring?

The practice of restricting oral intake during labour has been and remains controversial. Overall, the nutritional needs of labouring women are poorly understood. This literature review reveals that little evidence exists to support the general restriction of oral intake for all labouring women. Education of health professionals and pregnant women regarding intake in labour is required to encourage collaboration in the development and institution of appropriate policies in keeping with the available evidence for best practice

Taking a chance: the experience of lung volume reduction procedures for chronic obstructive pulmonary disease

Objectives: Lung Volume Reduction Surgery and Endo-Bronchial ValveTM insertion have expanded the thera-peutic choices for chronic obstructive pulmonary disease (COPD). Controversy over efficacy, costs and risks limits access to these therapies. There are no published findings to guide our understanding of the patient’s experience of surgery. The aim of this study is to understand the experience of palliative surgery for COPD. Methods: Merleau-Ponty’s philosophy provided a framework for this Heideggerian phenomenological inquiry. Fifty-eight semi-structured interviews were conducted with 15 patients undergoing lung volume reduction procedures and 14 family members. Results: Patients and families felt they had no option but to ‘take a chance ’ on surgery. Interventions frequently led to regaining lost tasks or easier completion of existing tasks. Where patients did not perceive an increase in things they could ‘do’, surgery allowed some to reclaim their sense of self. Regardless of the outcome, most did not regret their decision for surgery. Discussion: Meanings of surgery are not always tied to the visible, objective measurements of outsiders but may relate to regaining of self. Despite the concerns of some clinicians, patients and families are more likely to accept the risk of morbidity and mortality from surgery than has previously been realized