28 research outputs found

    Theoretical and practical development of the TOPSY self-management intervention for women who use a vaginal pessary for pelvic organ prolapse

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    Background: Pelvic organ prolapse (POP) is a common condition in women, where the downward descent of pelvic organs into the vagina causes symptoms which impacts quality of life. Vaginal pessaries offer an effective alternative to surgery for the management of POP. However, the need for regular follow-up can be burdensome for women and requires significant healthcare resources. The TOPSY study is a randomised controlled trial which aims to determine the clinical and cost-effectiveness of self-management of vaginal pessaries. This paper describes the theoretical and practical development of the self-management intervention. Methods: The intervention was developed using the MRC complex intervention framework, normalisation process theory (NPT) and self-management theory. The intervention aims to boost perceived self-efficacy in accordance with Bandura’s social cognitive theory and is guided by the tasks and skills Lorig and Hollman describe as necessary to self-manage a health condition. Results: The TOPSY intervention was designed to support women to undertake the medical management, role management and emotional management of their pessary. The six self-management skills described by Lorig and Hollman: problem-solving, decision-making, resource utilisation, formation of a patient-provider partnership role, action planning and self-tailoring, are discussed in detail, including how women were supported to achieve each task within the context of pessary self-management. The TOPSY intervention includes a self-management support session with a pessary practitioner trained in intervention delivery, a follow-up phone call 2 weeks later and ongoing telephone or face-to-face support as required by the woman initiated by contacting a member of the research team. Conclusions: The TOPSY study intervention was developed utilising the findings from a prior service development project, intervention development and self-efficacy theory, relevant literature, clinician experience and feedback from pessary using women and members of the public. In 2022, the findings of the TOPSY study will provide further evidence to inform this important aspect of pessary management. Trial registration: ISRCTN Registry ISRCTN62510577. Registered on June 10, 2017

    Comparative study of public libraries in Mauritius and Trinidad

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    Thesis (BA) University of the West Indies, 1977PhotocopyIDRC supported. Comparative analysis of public library development in Mauritius and Trinidad and Tobago - discusses the history and prospects of library information services; includes bibliography

    Relación entre peso estimado fetal por ecografía y el peso del recién nacido en gestantes a término en el Centro Materno Infantil Juan Pablo II – Los Olivos enero a diciembre 2017.

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    El objetivo es determinar la correlación entre el peso estimado fetal por ecografía y el peso del recién nacido en gestantes a término, en el Centro Materno Infantil Juan Pablo II – Los Olivos, enero a diciembre de 2017. Metodología: el presente estudio fue de enfoque cuantitativo, descriptivo-correlacional, de corte transversal. la muestra estuvo conformada por 203 gestantes a término cuyo parto fue atendido en el centro materno infantil juan pablo. el instrumento utilizado para la recolección de datos fue una ficha de recolección de datos, la cual consta de características sociodemográficas, estimación del peso fetal por ecografía y peso del recién nacido. Resultados: la mayor cantidad de pacientes se encuentra en el intervalo de 18 a 29 años de edad (87,2%). el análisis de la variable nivel educativo, dio como resultado que 130 pacientes (64,0%) tienen secundaria completa. el 55,7% de las pacientes encuestadas es de condición multípara (tuvo más de una gestación). los pacientes que ocupan la categoría “normopeso” en la estimación del peso fetal por ecografía fueron 155 (76,35%). los pacientes que ocupan la categoría “normopeso” en la evaluación del peso del recién nacido fueron 140 (73,89%). Conclusiones: se determinó que existe correlación significativa entre las variables de la investigación
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