Objective: to analyze the influence of evidence-based nursing on labor time and satisfaction in obstetrics and gynecology nursing. Methods: 68 parturient women who were admitted to the department of obstetrics of our ...Objective: to analyze the influence of evidence-based nursing on labor time and satisfaction in obstetrics and gynecology nursing. Methods: 68 parturient women who were admitted to the department of obstetrics of our hospital from December 2020 to December 2021 were selected. According to nursing differences, 68 parturients were divided into two groups (routine and evidence-based), with 34 parturients in each group. Among them, the routine group of parturients used routine obstetrics and gynecology nursing;Evidence-based nursing was adopted in evidence-based group. The duration of labor, the incidence of maternal and child adverse outcomes and nursing satisfaction were recorded in the two groups, and negative emotions were investigated before and after nursing. Results: the first, second and third stages of labor in evidence-based group were all shorter than those in routine group (P < 0.05). The incidence of maternal and infant adverse outcomes in evidence-based group was lower than that in routine group (P < 0.05). The satisfaction degree of maternal care in routine group was lower than that in evidence-based group (P < 0.05). Before nursing, the SAS and SDS scores of the two groups were basically the same (P > 0.05). After nursing, the SAS and SDS scores of the two groups of parturients were improved, and the SAS and SDS scores of the evidence-based group were lower than those of the routine group (P < 0.05). Conclusion: the application of evidence-based nursing in obstetrics and gynecology nursing can effectively shorten the labor time, reduce the incidence of maternal and child adverse outcomes, improve the satisfaction of parturient and their families, and further reduce the occurrence of maternal negative emotions, which is worthy of clinical application.展开更多
Background and Objective: Although globally admitted as the most valuable tool to prevent prolongation of labor, the partogram has failed to be commonly used. This is due to its alleged complexity. Based on the simpli...Background and Objective: Although globally admitted as the most valuable tool to prevent prolongation of labor, the partogram has failed to be commonly used. This is due to its alleged complexity. Based on the simplified model proposed by Debdas, the so called paperless partogram, we aimed at evaluating the ability of only using the alert and action lines to prevent prolongation of labor. Methods: This was a cross-sectional study including labor records of women delivered at King Baudouin Hospital of Kinshasa (secondary level) from 01/01 till 31/12/2013. The study was approved by the Faculty Ethical Committee. Inclusion criteria were: 1) live singleton pregnancy, 2) cephalic fetal presentation, 3) lack of uterine scar, 4) monitoring in labor ward by 4 cm of cervical dilation, and 5) delivery at term. For every record, the expected time of delivery (ETD = 6 hours after 4 cm of cervical dilation) was considered “Alert EDT” to which 4 hours were added to obtain the “Action EDT”. Irrespective of other fetal and maternal features contained in the traditional partogram Alert and Action ETD were checked a posteriori on Debdas’s model to derive the appropriate outcome of labor. Results: The study included 357 participants, of which 219 primiparous and 138 multiparous. Vaginal delivery took place in 91% of cases. Full cervical dilation was achieved after 8 - 9 hours (9.5 ± 1.8 hours for primiparous and 8.4 ± 1.7 hours for multiparous women), namely 2 - 3 hours following Alert ETD). This duration is close to the Action ETD. For 32 cesarean sections (9%) final decision took place within the Alert ETD. Conclusion: Using only Alert and Action ETD was found convenient to derive appropriate measures for the outcome of labor. So, the paperless partogram is a simplified method to manage the active stage of labor that could prevent prolongation of labor in our setting.展开更多
BACKGROUND： Some research exists on the effect of non-pharmacological approaches for labor pain relief However, there is limited information about effectiveness of breathing exercises in pregnant women to reduce mate...BACKGROUND： Some research exists on the effect of non-pharmacological approaches for labor pain relief However, there is limited information about effectiveness of breathing exercises in pregnant women to reduce maternal pain during labor. OBJECTIVE： To determine whether breathing exercises for pregnant women during the second stage of labor have beneficial effects on maternal pain, duration of labor, and the first-minute Appearance, Pulse, Grimace, Activity and Respiration （APGAR） scores. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This randomized clinical trial involved 250 pregnant women, who were randomly divided into two groups： intervention group （IG; n = 125） and control group （CG; n = 125）. IG received one session breathing exercise training and performed breathing exercises during the second stage of labor versus the CG that did not receive any breathing exercise training. MAIN OUTCOME MEASURES： The effects of breathing exercises on maternal pain were determined by Visual Analogue Scale （VAS）, duration of the second stage of labor, and the first-minute APGAR scores. RESULTS： The mean age of the participants was （23.2 _＋ 4.2） （range： 18 to 42） years. Both IG and CG had similar baseline characteristics in terms of age, education level, occupation, and smoking （P 〉 0.05）. The mean VAS scores of IG and CG were （88.2 ＋_ 6.3） and （90.5 ＋_ 7.0）, respectively （P 〈 0.001）. The duration of the second stage of labor was （369.6 ＋ 92.0） s for IG and （440.7 ＋ 142.5） s for CG （P 〈 0.001 ）. The mean first-minute APGAR scores were （8.84 ＋ 0.50） for IG and （8.73 ＋ 0.89） for CG （P 〉 0.05）. CONCLUSION： Based on this study, breathing exercises with deep inhalation and exhalation in pregnant women are effective in reducing the perception of labor pain and shortening the duration of the second stage of delivery. Therefore, we recommend breathing exercises as an effective modality for labor pain management and shortening the duration of labor. TRIAL REGISTRATION： This study is registered on the website of ClinicalTrials.gov （www.clinicaltrials.gov） with the number of NCT03066973.展开更多
There is market equilibrium when the demand willingness is consistent with the supply willingness. From the individual preferences and budget constraints,Western Economics deduced demand curve,causing the traditional ...There is market equilibrium when the demand willingness is consistent with the supply willingness. From the individual preferences and budget constraints,Western Economics deduced demand curve,causing the traditional demand willingness to be built on the basis of subjective utility. From the relative labor time of economic entity,this paper discusses the relationship between labor time and price readiness,demand curve or supply curve,and establishes the market equilibrium model based on labor value. In a perfectly competitive environment,the equilibrium exchange price of the model is the ratio of labor value between two commodities,and combines demand and supply sides' recognition of commodity quantity of labor,reflecting the socially necessary labor time contained in commodities.展开更多
It is of crucial importance for professional women to strike a balance between childcare and work.Help from family can effectively reduce women's time spent on childcare.Based on relevant survey,this paper success...It is of crucial importance for professional women to strike a balance between childcare and work.Help from family can effectively reduce women's time spent on childcare.Based on relevant survey,this paper successively analyzes the time of mother,father and grandparents invested in childcare and explores how women are supported by their family in this duty.Infant and childcare can be as time-consuming as a full-time job.Mothers have always played a primary role in infant and childcare,while grandparents,offering a helping hand to effectively alleviate the mother's workload,can play an alternative role,which is of great significance.This is particularly true in early childhood,when more than 40% of Chinese children are under the care of grandparents,with relatively limited participation of their fathers.Childcare gap between mothers and fathers is even larger in rural China.It is quite common for a family to turn to nursery services when their child are three years old to significantly alleviate the mother's childcare burden.When it comes to the design of relevant public policies and projects,consideration should be given to the role of each family member in taking care of infants and children in different growth stages to explore more options for childcare.More specifically,in addition to motherhood,grandparents' support should be valued,and fatherhood should be enhanced.展开更多
Background: The timing of elective repeat cesarean delivery at 38 weeks versus 39 weeks is still a debatable subject, both regarding maternal and neonatal outcomes. In the Saudi context, there is lack of local data to...Background: The timing of elective repeat cesarean delivery at 38 weeks versus 39 weeks is still a debatable subject, both regarding maternal and neonatal outcomes. In the Saudi context, there is lack of local data to aid decision-making regarding the timing of elective repeat cesarean delivery. Objectives: To estimate the rate of spontaneous onset of labor before the planned gestational age for repeat cesarean section in women who were booked at gestational age of (39 0/7 - 39 6/7) weeks (W39) versus (38 0/7 - 38 6/7) weeks (W38) and to compare the rate of maternal composite outcome between these groups. Design: Retrospective cohort. Setting: This study was conducted at King Abdulaziz Medical City, Jeddah, KSA. Method: Delivery registry books were reviewed to identify all deliveries from 1 January 2014 to 31 December 2016 (3 years). All low-risk pregnant women who had 2 or more cesarean deliveries and who met the inclusion criteria were included. Results: A total of 440 women were included of whom 318 (72.3%) were planned for elective cesarean section at W38 gestational age and 122 women at W39 gestational age. Mothers planned at W39 had higher rate of emergency cesarean deliveries versus those planned at W38 (18.0% versus 10.4%, p = 0.030;RR = 13.06), most frequently due to early onset of contractions (16.4% versus 8.2%, p = 0.012;RR = 12.17) or cervical dilatation (11.6% versus 5.4%, p = 0.024, RR = 16.15). No difference in the incidence of individual or composite maternal complications was noted between the two groups. Mother’s age (OR 0.93, p = 0.018) and schedule date at W39 (OR = 1.94, p = 0.028) were independently associated with spontaneous onset of labor before the scheduled gestational age, while no association was found with parity, previous number of spontaneous vaginal deliveries, number of previous cesarean deliveries or interval from last cesarean delivery. Conclusion: Elective cesarean section scheduled at 39 weeks of gestation or beyond carries a higher risk of emergency cesarean section, with no significant increase in maternal complications. The identification of factors associated with spontaneous onset of labor before the planned gestational age should be carefully identified to determine the optimal timing.展开更多
文摘Objective: to analyze the influence of evidence-based nursing on labor time and satisfaction in obstetrics and gynecology nursing. Methods: 68 parturient women who were admitted to the department of obstetrics of our hospital from December 2020 to December 2021 were selected. According to nursing differences, 68 parturients were divided into two groups (routine and evidence-based), with 34 parturients in each group. Among them, the routine group of parturients used routine obstetrics and gynecology nursing;Evidence-based nursing was adopted in evidence-based group. The duration of labor, the incidence of maternal and child adverse outcomes and nursing satisfaction were recorded in the two groups, and negative emotions were investigated before and after nursing. Results: the first, second and third stages of labor in evidence-based group were all shorter than those in routine group (P < 0.05). The incidence of maternal and infant adverse outcomes in evidence-based group was lower than that in routine group (P < 0.05). The satisfaction degree of maternal care in routine group was lower than that in evidence-based group (P < 0.05). Before nursing, the SAS and SDS scores of the two groups were basically the same (P > 0.05). After nursing, the SAS and SDS scores of the two groups of parturients were improved, and the SAS and SDS scores of the evidence-based group were lower than those of the routine group (P < 0.05). Conclusion: the application of evidence-based nursing in obstetrics and gynecology nursing can effectively shorten the labor time, reduce the incidence of maternal and child adverse outcomes, improve the satisfaction of parturient and their families, and further reduce the occurrence of maternal negative emotions, which is worthy of clinical application.
文摘Background and Objective: Although globally admitted as the most valuable tool to prevent prolongation of labor, the partogram has failed to be commonly used. This is due to its alleged complexity. Based on the simplified model proposed by Debdas, the so called paperless partogram, we aimed at evaluating the ability of only using the alert and action lines to prevent prolongation of labor. Methods: This was a cross-sectional study including labor records of women delivered at King Baudouin Hospital of Kinshasa (secondary level) from 01/01 till 31/12/2013. The study was approved by the Faculty Ethical Committee. Inclusion criteria were: 1) live singleton pregnancy, 2) cephalic fetal presentation, 3) lack of uterine scar, 4) monitoring in labor ward by 4 cm of cervical dilation, and 5) delivery at term. For every record, the expected time of delivery (ETD = 6 hours after 4 cm of cervical dilation) was considered “Alert EDT” to which 4 hours were added to obtain the “Action EDT”. Irrespective of other fetal and maternal features contained in the traditional partogram Alert and Action ETD were checked a posteriori on Debdas’s model to derive the appropriate outcome of labor. Results: The study included 357 participants, of which 219 primiparous and 138 multiparous. Vaginal delivery took place in 91% of cases. Full cervical dilation was achieved after 8 - 9 hours (9.5 ± 1.8 hours for primiparous and 8.4 ± 1.7 hours for multiparous women), namely 2 - 3 hours following Alert ETD). This duration is close to the Action ETD. For 32 cesarean sections (9%) final decision took place within the Alert ETD. Conclusion: Using only Alert and Action ETD was found convenient to derive appropriate measures for the outcome of labor. So, the paperless partogram is a simplified method to manage the active stage of labor that could prevent prolongation of labor in our setting.
文摘BACKGROUND： Some research exists on the effect of non-pharmacological approaches for labor pain relief However, there is limited information about effectiveness of breathing exercises in pregnant women to reduce maternal pain during labor. OBJECTIVE： To determine whether breathing exercises for pregnant women during the second stage of labor have beneficial effects on maternal pain, duration of labor, and the first-minute Appearance, Pulse, Grimace, Activity and Respiration （APGAR） scores. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This randomized clinical trial involved 250 pregnant women, who were randomly divided into two groups： intervention group （IG; n = 125） and control group （CG; n = 125）. IG received one session breathing exercise training and performed breathing exercises during the second stage of labor versus the CG that did not receive any breathing exercise training. MAIN OUTCOME MEASURES： The effects of breathing exercises on maternal pain were determined by Visual Analogue Scale （VAS）, duration of the second stage of labor, and the first-minute APGAR scores. RESULTS： The mean age of the participants was （23.2 _＋ 4.2） （range： 18 to 42） years. Both IG and CG had similar baseline characteristics in terms of age, education level, occupation, and smoking （P 〉 0.05）. The mean VAS scores of IG and CG were （88.2 ＋_ 6.3） and （90.5 ＋_ 7.0）, respectively （P 〈 0.001）. The duration of the second stage of labor was （369.6 ＋ 92.0） s for IG and （440.7 ＋ 142.5） s for CG （P 〈 0.001 ）. The mean first-minute APGAR scores were （8.84 ＋ 0.50） for IG and （8.73 ＋ 0.89） for CG （P 〉 0.05）. CONCLUSION： Based on this study, breathing exercises with deep inhalation and exhalation in pregnant women are effective in reducing the perception of labor pain and shortening the duration of the second stage of delivery. Therefore, we recommend breathing exercises as an effective modality for labor pain management and shortening the duration of labor. TRIAL REGISTRATION： This study is registered on the website of ClinicalTrials.gov （www.clinicaltrials.gov） with the number of NCT03066973.
基金Supported by Fundamental Research Funds for Central Universities(SWU1409313)Business Management Cultivation Discipline of Rongchang Campus of Southwest University(RCQG207001)
文摘There is market equilibrium when the demand willingness is consistent with the supply willingness. From the individual preferences and budget constraints,Western Economics deduced demand curve,causing the traditional demand willingness to be built on the basis of subjective utility. From the relative labor time of economic entity,this paper discusses the relationship between labor time and price readiness,demand curve or supply curve,and establishes the market equilibrium model based on labor value. In a perfectly competitive environment,the equilibrium exchange price of the model is the ratio of labor value between two commodities,and combines demand and supply sides' recognition of commodity quantity of labor,reflecting the socially necessary labor time contained in commodities.
文摘It is of crucial importance for professional women to strike a balance between childcare and work.Help from family can effectively reduce women's time spent on childcare.Based on relevant survey,this paper successively analyzes the time of mother,father and grandparents invested in childcare and explores how women are supported by their family in this duty.Infant and childcare can be as time-consuming as a full-time job.Mothers have always played a primary role in infant and childcare,while grandparents,offering a helping hand to effectively alleviate the mother's workload,can play an alternative role,which is of great significance.This is particularly true in early childhood,when more than 40% of Chinese children are under the care of grandparents,with relatively limited participation of their fathers.Childcare gap between mothers and fathers is even larger in rural China.It is quite common for a family to turn to nursery services when their child are three years old to significantly alleviate the mother's childcare burden.When it comes to the design of relevant public policies and projects,consideration should be given to the role of each family member in taking care of infants and children in different growth stages to explore more options for childcare.More specifically,in addition to motherhood,grandparents' support should be valued,and fatherhood should be enhanced.
文摘Background: The timing of elective repeat cesarean delivery at 38 weeks versus 39 weeks is still a debatable subject, both regarding maternal and neonatal outcomes. In the Saudi context, there is lack of local data to aid decision-making regarding the timing of elective repeat cesarean delivery. Objectives: To estimate the rate of spontaneous onset of labor before the planned gestational age for repeat cesarean section in women who were booked at gestational age of (39 0/7 - 39 6/7) weeks (W39) versus (38 0/7 - 38 6/7) weeks (W38) and to compare the rate of maternal composite outcome between these groups. Design: Retrospective cohort. Setting: This study was conducted at King Abdulaziz Medical City, Jeddah, KSA. Method: Delivery registry books were reviewed to identify all deliveries from 1 January 2014 to 31 December 2016 (3 years). All low-risk pregnant women who had 2 or more cesarean deliveries and who met the inclusion criteria were included. Results: A total of 440 women were included of whom 318 (72.3%) were planned for elective cesarean section at W38 gestational age and 122 women at W39 gestational age. Mothers planned at W39 had higher rate of emergency cesarean deliveries versus those planned at W38 (18.0% versus 10.4%, p = 0.030;RR = 13.06), most frequently due to early onset of contractions (16.4% versus 8.2%, p = 0.012;RR = 12.17) or cervical dilatation (11.6% versus 5.4%, p = 0.024, RR = 16.15). No difference in the incidence of individual or composite maternal complications was noted between the two groups. Mother’s age (OR 0.93, p = 0.018) and schedule date at W39 (OR = 1.94, p = 0.028) were independently associated with spontaneous onset of labor before the scheduled gestational age, while no association was found with parity, previous number of spontaneous vaginal deliveries, number of previous cesarean deliveries or interval from last cesarean delivery. Conclusion: Elective cesarean section scheduled at 39 weeks of gestation or beyond carries a higher risk of emergency cesarean section, with no significant increase in maternal complications. The identification of factors associated with spontaneous onset of labor before the planned gestational age should be carefully identified to determine the optimal timing.
