Pre-conception care for women with diabetes: A public health issue

Pre-conception care is recognised to be an effective strategy for addressing many health behaviours, particularly for women with diabetes, who carry a higher risk of morbidity and mortality. However, there is a lack of evidence of the most effective approaches for promoting pre-conception health and encouraging women to access services. This article explores this challenging issue and suggests a number of strategies that health professionals may consider in relation to promoting health in this area.

Exploring the needs, concerns and knowledge of women diagnosed with gestational diabetes: A qualitative study

Objective
To explore the concerns, needs and knowledge of women diagnosed with Gestational Diabetes Mellitus (GDM).
Design
A qualitative study of women with GDM or a history of GDM.
Methods
Nineteen women who were both pregnant and recently diagnosed with GDM or post- natal with a recent history of GDM were recruited from outpatient diabetes care clinics. This qualitative study utilised focus groups. Participants were asked a series of open-ended questions to explore 1) current knowledge of GDM; 2) anxiety when diagnosed with GDM, and whether this changed overtime; 3) understanding and managing GDM and 4) the future impact of GDM. The data were analysed using a conventional content analysis approach.
Findings
Women experience a steep learning curve when initially diagnosed and eventually become skilled at managing their disease effectively. The use of insulin is associated with fear and guilt. Diet advice was sometimes complex and not culturally appropriate. Women appear not to be fully aware of the short or long-term consequences of a diagnosis of GDM.
Conclusions
Midwives and other Health Care Professionals need to be cognisant of the impact of a diagnosis of GDM and give individual and culturally appropriate advice (especially with regards to diet). High quality, evidence based information resources need to be made available to this group of women. Future health risks and lifestyle changes need to be discussed at diagnosis to ensure women have the opportunity to improve their health.

Pregnancy Planning and Diabetes:A Qualitative Exploration of Women's Attitudes Toward Preconception Care

Introduction: Seeking preconception care is recognized as an important health behavior for women with preexisting diabetes. Yet many women with diabetes do not seek care or advice until after they are pregnant, and many enter pregnancy with suboptimal glycemic control. This study explored the attitudes about pregnancy and preconception care seeking in a group of nonpregnant women with type 1 diabetes mellitus. Methods: In-depth semistructured interviews were completed with 14 nonpregnant women with type 1 diabetes. Results: Analysis of the interview data revealed 4 main themes: 1) the emotional complexity of childbearing decisions, 2) preferences for information related to pregnancy, 3) the importance of being known by your health professional, and 4) frustrations with the medical model of care. Discussion: These findings raise questions about how preconception care should be provided to women with diabetes and highlight the pivotal importance of supportive, familiar relationships between health professionals and women with diabetes in the provision of individualized care and advice. By improving the quality of relationships and communication between health care providers and patients, we will be better able to provide care and advice that is perceived as relevant to the individual, whatever her stage of family planning. © 2012 by the American College of Nurse-Midwives.

Textbook: Maternal- Neonatal Care made Incredibly Easy!

This textbook is the perfect reference book for students new to midwifery and those studying for exams. The diagrams and explanations are simple and esay to follow

Perceptions of the role of the man in family planning, during pregnancy and childbirth : A qualitative study with fifteen Nepali men

Introduction: In Nepal, by tradition, family life and marriage are generally controlled by patriarchal norms, sanctions, values and gender differences. Women in Nepal have limited possibilities to make decisions regarding their sexual and reproductive health, as the husbands and other elders in the family make most of the decisions regarding family planning, pregnancy and childbirth. Aim: To describe the perceptions of Nepali men regarding the role of the man with respect to family planning, pregnancy and childbirth. Methods: A qualitative study was conducted with 15 Nepali men in both urban and rural areas. The material was analyzed through inductive content analysis. Findings: One main category and two generic categories were identified. One generic category contained six subcategories and the other five subcategories. The main category was labeled: “He leads – She follows” and the generic categories were labeled: “Supporting women in family planning, during pregnancy and childbirth” and “Withdrawal from supporting women in family planning, during pregnancy and childbirth”. Conclusion: The role of the Nepali men with respect to family planning, pregnancy and childbirth, was identified as a conflicted approach. This study highlights the importance of understanding the influence of culture and tradition when developing strategies for promoting sexual and reproductive health during family planning, pregnancy and childbirth among families in Nepal.

Acreditação da Idoneidade Formativa do Contextos de Prática Clínica na UCSP de Monforte

O Modelo de Desenvolvimento Profissional integra o Sistema de Certificação de Competências e o Sistema de Individualização das Especialidades. Na primeira alteração ao estatuto da Ordem dos Enfermeiros configura-se um novo Sistema de Certificação de Competências que contempla um período de Exercício Profissional Tutelado, para atribuição do título de enfermeiro, e um período de Desenvolvimento Profissional Tutelado, para atribuição do título de Enfermeiro Especialista. O Conselho de Enfermagem entende que esta Prática Tutelada deve acontecer em contexto de prática clínica de Idoneidade Formativa, reconhecida e acreditada pela Ordem dos Enfermeiros, e sob a supervisão de um Enfermeiro com certificação de competências, enquanto Supervisor Clínico. O estágio teve como finalidade verificar se estavam reunidas as condições para a candidatura a Acreditação de Idoneidade Formativa do Contextos de Prática Clínica, na UCSP de Monforte. Neste relatório, apresenta-se o trajeto percorrido, no levantamento das condições necessárias para a candidatura à Acreditação.

Acreditação da idoneidade formativa do contexto de prática clínica no S. de Urgência do CHMT – Abrantes

Num contexto de mudança dos estatutos da Ordem dos Enfermeiros, reconhece-se a importância de renovar um Sistema de Certificação de Competências, que é contemplado por um período de Exercício Profissional Tutelado, para a obtenção do título de Enfermeiro, e um período de Desenvolvimento Profissional Tutelado, para a atribuição do título de Enfermeiro Especialista. O Conselho de Enfermagem reconhece que para a obtenção destes títulos, esta Prática Tutelada deve acontecer num contexto de prática clinica de Idoneidade Formativa, reconhecida e acreditada pela Ordem dos Enfermeiros, e sob a supervisão de um Enfermeiro com certificação de competências, com a designação de Enfermeiro Supervisor. Serve então o presente relatório para verificar se, se encontram reunidas as condições para um eventual processo de candidatura a Acreditação de Idoneidade Formativa do Contexto de Prática Clinica, no Serviço de Urgência – Unidade de Abrantes – Centro Hospitalar Médio Tejo. Ao longo do relatório são descritas as fases de implementação e feito o levantamento das condições necessárias à candidatura para o processo de Acreditação

O processo de transição no enfermeiro português emigrante no Reino Unido

Apesar de Portugal sempre ter sido um país de emigrantes, atualmente este fenómeno atingiu dimensões nunca antes observadas, apresentando também características diferentes dos ciclos anteriores. Motivada por vários fatores, assiste-se a uma saída em massa de pessoas altamente qualificadas, nomeadamente os enfermeiros. O Reino Unido surge como o país de destino mais escolhido por este grupo profissional e, dados do Observatório de Emigração, revelam que, só em 2014, estavam inscritos no Nursing and Midwifery Council (NMC), o congénere da Ordem dos Enfermeiros no Reino Unido, 3.155 enfermeiros portugueses. Estes profissionais, na sua maioria, estão a vivenciar uma experiência inédita, a emigração, com consequentes alterações variadas e complexas nas suas vidas e que podem gerar instabilidade e vulnerabilidade. O presente estudo qualitativo, do tipo exploratório e descritivo, de cariz transversal, teve como objetivos: conhecer este grupo de enfermeiros portugueses, compreender o motivo que os leva a emigrar, compreender como estão a responder a este processo de transição, quais os fatores que facilitam e dificultam esse processo, que estratégias adotam para gerir as situações adversas e quais as implicações desta vivência no seu autocuidado, saúde e bem-estar. Este estudo assume particular relevância, na medida em que poderá representar um contributo a longo prazo, com vista à implementação de estratégias que se traduzam numa ajuda efetiva a estas pessoas, favorecendo a sua saúde e o seu bem-estar. Recorreu-se à entrevista semiestruturada, procurando auscultar, à luz da Teoria das Transições de Meleis, um grupo de onze enfermeiros que se encontrava emigrado no Reino Unido. Tratou-se de uma amostra jovem, maioritariamente do sexo feminino, solteiros e sem filhos, e com pouca experiência profissional. Os resultados apurados permitem-nos afirmar que a transição é gradual e morosa, ocorrendo em simultâneo com outras transições, do tipo situacional e desenvolvimental. Apenas um dos indivíduos alvo do estudo mostrou encontrar-se na fase final do processo, ou seja, na fase de mestria, que pressupõe o domínio da situação e o alcançar do equilíbrio e bem-estar. Os restantes encontravam-se ainda a vivenciar a transição migração. Os principais motivos que levaram este grupo de enfermeiros portugueses a emigrar foi o desemprego e a impossibilidade de progredir na carreira em Portugal, assim como a busca por melhores condições de vida. O conhecimento da língua inglesa e do país de destino, a estabilidade a nível de emprego, a melhoria da condição económica e o apoio por parte dos enfermeiros portugueses já presentes no Reino Unido, revelaram-se fatores fundamentais para uma transição saudável. Pelo contrário, o afastamento da família, as diferenças na prática da Enfermagem, e o facto de terem sido alvo de comportamentos considerados discriminatórios, por parte dos ingleses, desempenharam um papel dificultador no processo.

Use of an evidence-based care bundle by Thai emergency nurses.

 Implementation of a care bundle for nursing management of patients with severe traumatic brain injury was feasible in the Thai context. Use of an evidence-based care bundle increased emergency nurses’ knowledge regarding severe TBI management and improved the care delivered during the initial emergency nursing management of these patients.

Primary health care nurse perception and men’s expectation of the role of the primary health care nurse in providing men’s health services in the primary care setting in Victoria

 This study adds significantly to the current paucity of knowledge around men's health in Australian primary care and in particular stresses the need for men's health care education to be more reliable and systematic foundation for men's sexual health, mental health and health promotion.

Making a difference: the experiences of midwives working with women who use illicit drugs

AIM: This article describes the experiences of midwives who choose to work with pregnant womenwho use illicit drugs.BACKGROUND: Pregnant women who use illicit drugs present complex challenges for those whochoose to work with them. Society’s views on illicit drug use fluctuate from acceptance and harm minimizationto reprimand and retribution.METHOD: Qualitative interviews were conducted between June and August 2009 with 12 Australianmidwives. A thematic analysis method informed by hermeneutic phenomenology was applied to interpretthis data to explicate lived experiences and gain deeper understanding and meanings of this phenomenon.FINDINGS: Three major themes encapsulated the experience: making a difference, making partnerships,and learning to let go. The focus of this article, “making a difference,” included two subthemes of“working on the margins” and “transition and transformation.” The midwives were both rewarded andchallenged by the needs of women who use illicit drugs and by the systems in which they worked.CONCLUSIONS: The midwives acknowledged that their aspirations “to make a difference” was notalways sufficient when working with women who use illicit drugs. They also require the establishmentof maternity services that are compassionate and accessible, including woman–care provider partnershipsand continuity of the care environments.

Single rooms are 'hot property'

The article reports on an increase which has been seen in the number of Australian hospitals that have decreased the number of shared patient rooms and have opted for single patient rooms in their ward designs. A discussion of support for single occupancy rooms which has been voiced by clinicians and patients, and of the role that single occupancy rooms can play in infection control, is presented.

Recognising dying in acute care

The article reports on terminal care services which are offered to patients in Australia and discusses a terminal care program called the Liverpool Care Pathway which was implemented in Great Britain and is being tested in Australia. In the article the author offers her opinions on terminal care in Australia, on the Liverpool Care Pathway and on the education that Australian nurses receive the dying phase of the human life cycle.