'n Evaluasie van pre-aborsie berading aan vroue met ongewenste swangerskappe in die Wes-Kaapse metropool : 'n verpleegkundige perspektief

Study project (BCur)--University of Stellenbosch, 2007.ENGLISH ABSTRACT: Problem statement: The abortion regulation was implemented in 1997 before the necessary infrastructure was in place. The shortage of educated healthcare providers in abortion facilities led to uninformed women. Aims for this research was exploratory-describing of nature and was aimed on pre-abortion counselling to women with unwanted pregnancies in the state facilities in the Western Cape metropole to be evaluated from a nursing perspective. Methodology: Two samplings was done namely a 50% randomized, proportional stratified sampling from the State Health facilities in the Western Cape Metropole which offer abortion care service, as well as the non-randomized convenient sampling of pregnant women that received pre-abortion counselling. Data was gathered with the help of self compiled questionnaires. Quantitative data was analyse with the help of Statistika 7 and qualitative data according to Tesch’s approach. Results: Of the respondents 79% was between the age 16 and 30 and 72% was single. Although the Department of Health strives that abortion care services should be offered by a level 1 health facility, only 43% have been counselled through a registered nurse. While 49% consider preabortion counselling as important, 39% of the respondents received no, or information in groups regarding the termination of the pregnancy, 77% received information with regarding to the procedure and 50% was informed when they could go forth with normal activities. Approximately 54% received no information regarding post-abortion complications and 59% did not received a follow-up date. Approximately 68% of the respondents received information regarding family planning. Conclusion: It seems that pre-abortion counselling is not done according to guidelines and there is many gaps in the existing counselling methods in the different health facilities. Recommendations: Counselling should be based on the WHO and the Department of Health’s guidelines for abortion care. Nurses should be more involved in education programs. Abortion care facility’s should promote the total spectrum of abortion care and counsellors should receive special training and annually be re-evaluated.AFRIKAANSE OPSOMMING: Probleemstelling: Die aborsiewetgewing is in 1997 geïmplementeer voordat die nodige infrastruktuur in plek was. Die tekort aan doeltreffend-opgeleide gesondheidswerkers in aborsiesorgdienste het tot gevolg gehad dat vroue oningelig is met betrekking tot aborsiesorgdienste. Doelwitte vir hierdie navorsing was ondersoekend-beskrywend van aard en daarop gerig om preaborsie berading aan vroue met ongewenste swangerskappe in staatsaangewysde fasiliteite in die Wes-Kaapse metropool te evalueer vanuit ‘n verpleegkundige perspektief. Metodologie: Twee steekproefnemings is gedoen, naamlik ‘n 50% ewekansige, proporsionele, gestratifiseerde steekproefneming van die staatsgesondheidsfasiliteite in die Wes-Kaapse metropool wat aborsiesorgdienste aanbied, sowel as ‘n nie-waarskynlike, gerieflikheidssteekproefneming van swanger vroue wat pre-aborsie berading ontvang. Data is met behulp van selfopgestelde vraelyste ingesamel. Kwantitatiewe data is ontleed met behulp van Statistica 7 en die kwalitatiewe data deur middel van Tesch se benadering. Resultate: Van die respondente was 79% tussen die ouderdom van 16 en 30 jaar en 72% was enkellopend. Alhoewel die Departement van Gesondheid strewe dat aborsiesorgdienste by ‘n vlak 1 gesondheidsfasiliteite aangebied word, het slegs 43% hul berading hier deur geregistreerde verpleegkundiges ontvang. Terwyl 94% pre-aborsie berading beskou as belangrik, het 39% óf geen, óf inligting in groepe ontvang betreffende die beëindiging van die swangerskappe, 77% het inligting ontvang met betrekking tot die prosedure en 50% was ingelig wanneer hul kon voortgaan met normale aktiwiteite. Sowat 54% het geen inligting ontvang betreffende post-aborsie komplikasies nie en 59% het nie ‘n opvolgdatum gekry nie. Sowat 68% van die respondente het wel inligting ontvang oor gesinsbeplanning. Slotsom: Dit blyk dus dat pre-aborsie berading nie volgens riglyne gedoen word nie en dat daar baie leemtes is in die bestaande beradingsmetodes in die verskillende gesondheidsfasiliteite. Aanbevelings: Berading moet gebaseer word op die WGO en die Departement van Gesondheid se riglyne vir aborsiesorg. Verpleegkundiges moet meer betrokke raak by voorligtingsprogramme. Aborsiesorgfasiliteite moet die totale spektrum van aborsiesorg kan behartig en aborsiesorgberaders moet spesiale opleiding ontvang en jaarliks her-evalueer word

Breastfeeding and maternal alcohol use: Prevalence and effects on child outcomes and fetal alcohol spectrum disorders

OBJECTIVE: Determine any effects that maternal alcohol consumption during the breastfeeding period has on child outcomes. METHODS: Population-based samples of children with fetal alcohol spectrum disorders (FASD), normally-developing children, and their mothers were analyzed for differences in child outcomes. RESULTS: Ninety percent (90%) of mothers breastfed for an average of 19.9 months. Of mothers who drank postpartum and breastfed (MDPB), 47% breastfed for 12 months or more. In case control analyses, children of MDPB were significantly lighter, had lower verbal IQ scores, and more anomalies in comparisons controlling for prenatal alcohol exposure and final FASD diagnosis. Utilizing a stepwise logistic regression model adjusting for nine confounders of prenatal drinking and other maternal risks, MDPB were 6.4 times more likely to have a child with FASD than breastfeeding mothers who abstained from alcohol while breastfeeding. CONCLUSIONS: Alcohol use during the period of breastfeeding was found to significantly compromise a child’s development

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes