A narrative review of interventions addressing the parental-fetal relationship

Background Expectant parents develop varying degrees of emotional affiliation with the unborn child. Interventions supporting this relationship may be beneficial given its link to maternal health behaviour during pregnancy, as well as the parental–infant bond after birth. Aim To identify and describe the effects of programmes and strategies that have addressed the parental–fetal relationship. Method English-language primary studies, published between 2005–2015, were identified and their methodological quality was assessed. Databases used included CINAHL, Cochrane Library, MEDLINE, PsycINFO and Web of Science. Key search terms included maternal/paternal–fetal attachment, prenatal bond, parental–fetal relationship and intervention. RCTs, non-RCTs, observational and non-comparative studies, before and after studies and case studies were included. Findings Twenty-seven papers were included. Studies evaluated the effects of various strategies, including ultrasound and screening procedures, fetal awareness interventions, social and psychological support techniques, educational programmes and relaxation strategies. Results are inconsistent due to the diversity of interventions and significant variation in methodological quality. Conclusion There is insufficient evidence to support definitive conclusions regarding the efficacy of any included intervention. A number of limitations, such as non-probability sampling, lack of blinding, and insufficient follow-up weaken the evidence. The inclusion of fathers in only three studies reflects the overall neglect of men in research regarding the prenatal relationship. Further in-depth study of the nature of the maternal/paternal–fetal relationship may be needed in order to allow for the identification of interventions that are consistently beneficial and worthwhile

The needs of Maltese families with dependent children : a focus group study among professionals

This article seeks to identify the needs of Maltese families with dependent children. The sociocultural context in which Maltese families are embedded will serve as a theoretical framework for this study. A series of six focus groups with experts in the area of family and children were moderated for the purpose of the study. These focus group sessions were audiotaped and transcribed and the results analysed using thematic analysis. This article draws on the findings of these focus groups and compares them to extant literature on Maltese families before making a number of policy recommendations. Three key themes were elicited: the need for more community work and early intervention; the need for education for life; and the need to support families achieve work-life balance. The main recommendations are: the set-up of family centres for community work and early intervention; the implementation of relationship education programmes; and more family-friendly working practices.peer-reviewe

Intimate partner violence : psychological and verbal abuse during pregnancy

AIM: To examine the association between sociodemographic, pregnancy related variables and psychological and verbal intimate partner abuse (PIPA), as well as determine which of these variables, are predictors of PIPA during pregnancy. BACKGROUND: Intimate partner violence is a significant health issue, with severe implications to both mother and foetus. However, much of the research to date focuses on the outcomes of physical abuse. This article addresses the dearth in literature by examining the association between sociodemographic, pregnancy related variables and PIPA during pregnancy. DESIGN: A survey research design was used. METHOD: Three hundred postnatal women were recruited by convenience, non-proportional quota sampling technique. The WHO Violence Against Women Instrument was self-administered by participants. Association between categorical variables was assessed using Pearson's Chi-square, strength of association using Cramer's V and the phi coefficient, and identification of predictor variables for psychological and verbal abuse using Logistic regression. RESULTS: Four predictors were identified for psychological abuse namely i.e., low education level in women, an unplanned pregnancy, experiencing two or more pregnancy related health problems and living with an unemployed partner. Whilst unemployment in women, an unplanned pregnancy, fear of partner, and a low education level of partner, were identified as predictors of verbal abuse. CONCLUSION: This study identified a number of variables which strongly predict PIPA during pregnancy; however, it extends the available literature by identifying a low standard of education in males, unemployment and fear of the intimate partner as significant predictors of PIPA

Oocyte and ovarian tissue cryopreservation in European countries : statutory background, practice, storage and use

STUDY QUESTION: What is known in Europe about the practice of oocyte cryopreservation (OoC), in terms of current statutory background, funding conditions, indications (medical and ‘non-medical’) and specific number of cycles? SUMMARY ANSWER: Laws and conditions for OoC vary in Europe, with just over half the responding countries providing this for medical reasons with state funding, and none providing funding for ‘non-medical’ OoC. WHAT IS ALREADY KNOWN: The practice of OoC is a well-established and increasing practice in some European countries, but data gathering on storage is not homogeneous, and still sparse for use. Ovarian tissue cryopreservation (OtC) is only practiced and registered in a few countries. STUDY DESIGN, SIZE, AND DURATION: A transversal collaborative survey on OoC and OtC, was designed, based on a country questionnaire containing information on statutory or professional background and practice, as well as available data on ovarian cell and tissue collection, storage and use. It was performed between January and September 2015. PARTICIPANTS/MATERIALS, SETTING AND METHODS: All ESHRE European IVF Monitoring (EIM) consortium national coordinators were contacted, as well as members of the ESHRE committee of national representatives, and sent a questionnaire. The form included national policy and practice details, whether through current existing law or code of practice, criteria for freezing (age, health status), availability of funding and the presence of a specific register. The questionnaire also included data on both the number of OoC cycles and cryopreserved oocytes per year between 2010 and 2014, specifically for egg donation, fertility preservation for medical disease, ‘other medical’ reasons as part of an ART cycle, as well as for ‘non-medical reasons’ or age-related fertility decline. Another question concerning data on freezing and use of ovarian tissue over 5 years was added and sent after receiving the initial questionnaire. MAIN RESULTS AND THE ROLE OF CHANCE: Out of 34 EIM members, we received answers regarding OoC regulations and funding conditions from 27, whilst 17 countries had recorded data for OoC, and 12 for OtC. The specific statutory framework for OoC and OtC varies from absent to a strict frame. A total of 34 705 OoC cycles were reported during the 5-year-period, with a continuous increase. However, the accurate description of numbers was concentrated on the year 2013 because it was the most complete. In 2013, a total of 9126 aspirations involving OoC were reported from 16 countries. Among the 8885 oocyte aspirations with fully available data, the majority or 5323 cycles (59.9%) was performed for egg donation, resulting in the highest yield per cycle, with an average of 10.4 oocytes frozen per cycle. OoC indication was ‘serious disease’ such as cancer in 10.9% of cycles, other medical indications as ‘part of an ART cycle’ in 16.1%, and a non-medical reason in 13.1%. With regard to the use of OoC, the number of specifically recorded frozen oocyte replacement (FOR) cycles performed in 2013 for all medical reasons was 14 times higher than the FOR for non-medical reasons, using, respectively, 8.0 and 8.4 oocytes per cycle. Finally, 12 countries recorded storage following OtC and only 7 recorded the number of grafted frozen/thawed tissues. LIMITATIONS, REASONS FOR CAUTION: Not all countries have data regarding OoC collection, and some data came from voluntary collaborating centres, rather than a national authority or register. Furthermore, the data related to use of OoC were not included for two major players in the field, Italy and Spain, where numbers were conflated for medical and non-medical reasons. Finally, the number of cycles started with no retrieval is not available. Data are even sparser for OtC. WIDER IMPLICATIONS OF THE FINDINGS: There is a need for ART authorities and professional bodies to record precise data for practice and use of OoC (and OtC), according to indications and usage, in order to reliably inform all stakeholders including women about the efficiency of both methods. Furthermore, professional societies should establish professional standards for access to and use of OoC and OtC, and give appropriate guidance to all involved. STUDY FUNDING/COMPETING INTEREST(S): The study was supported by ESHRE. There are no conflicts of interest.peer-reviewe

The experience of living with an ileoanal pouch : an interpretative phenomenological analysis

The purpose of this study was to explore the lived experiences of individuals living with an ileoanal pouch. A qualitative, phenomenological methodology was used to elicit detailed accounts of the impact of living with an ileoanal pouch. Ten individuals having an ileoanal pouch, formed as a consequence of ulcerative colitis, participated in the study. Semistructured interviews were conducted and analyzed using interpretative phenomenological analysis. The following 4 themes emerged from the analysis: "a flood of emotions"; "changed body image"; "changes in lifestyle"; and "intimacy and sexual relationships." Participants indicated that their quality of life after surgery has improved because they were no longer suffering from the devastating symptoms of ulcerative colitis. However, a considerable number of these participants disclosed that they are still living a restricted lifestyle and reported profound changes not only in their physical self but also in their social and sexual relationships. By acknowledging these experiences, healthcare professionals have the potential to improve the psychological, sexual, and social care that these individuals receive

The lived experience of adults with ulcerative colitis

AIMS AND OBJECTIVES: The purpose of this study was to explore the experiences of adults living with ulcerative colitis. BACKGROUND: Research to date has focused on the impact of inflammatory bowel disease, by analysing the responses of persons with ulcerative colitis and Crohn's disease collectively. This article addresses the dearth in literature by exploring the experiences of adults living with ulcerative colitis. DESIGN: An exploratory qualitative phenomenological design was used. METHOD: Semi-structured interviews were conducted with a purposive sample of 10 adults with ulcerative colitis. Verbatim transcripts were analysed using Interpretative Phenomenological Analysis. RESULTS: Three super-ordinate themes emerged from the analysis: 'living with physical discomfort', 'emotional turmoil in living the experience' and 'social interactions'. CONCLUSION: The participants described a fundamental change in their lifestyle, as a result of physical discomfort and emotional turmoil. Misconceptions held regarding the causes of their disease, further compounded their negative emotional experience. RELEVANCE TO CLINICAL PRACTICE: It is of importance that health care professionals understand and explore the unique perspectives of individuals with ulcerative colitis. These perspectives relate to both physical and psychosocial issues. The needs and concerns of persons with ulcerative colitis can then guide the formulation and development of an individualised care plan

Preparation for parenthood: a concept analysis

Objective: This article reviewed the literature and critically analysed the concept of preparation for parenthood. The analysis is mainly of a discursive nature with some theoretical underpinnings. Background: Preparation for parenthood is a concept that is generally used within psychology, sociology and health professional practice especially midwifery, in terms of preparation for birth and parenthood sessions. However, parents often report feeling unprepared during this period. In order to ensure appropriate delivery of support and education during this time it is important to fully understand what preparation for parenthood really means by unravelling its component elements and understanding its contemporary relevance. Methods: A number of sources were searched using the keywords ‘preparation’ and ‘parenthood’. The concept analysis framework put forward by Walker and Avant was used to develop appropriate cases to further illustrate and explore meaning. Results: The literature search confirmed limited evidence with regards to an in-depth exploration of the concept and the separate elements that are related to each other. This investigation is the first of its kind considering the full range of meanings with regards to the concept and the contemporary evidence available. Law, gender, culture and spirituality all influence the concept and thus antecedents and consequences cannot always be applied to contexts which are fundamentally different. Conclusion: Preparation for parenthood is multi-faceted and changing, thus further research with regards to this concept is warranted. This analysis provides the groundwork for the development of measures that may be used within clinical practice