ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90011-5

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTThe purpose of this study was to determine how accurately clinicians can identify the uppermost border of the uterine fundus when they obtain fundal height measurements. Clinicians were instructed to identify the uppermost border of the uterine fundus in their usual manner and make a small pen mark on the maternal abdomen at that point. Real‐time ultrasonography was then used to locate the actual level of the fundus and measure the distance between the clinician's assessment and the actual level of the fundus. Measurements were obtained from 126 women. Six clinicians participated in the study, and the differences between the clinicians' errors were not statistically significant (F = 1.26; d.f. = 5,120;P= .2873). For the entire series, the mean error was ‐ .45 cm (SD = 1.99 cm), the mean absolute error was 1.25 cm, the maximal error was 8.6 cm, the percentage of errors that exceeded 1 cm was 42.1 %, and the percentage of errors that exceeded 2 cm was 20.6%. Examiner error was not associated with factors such as maternal height, prepregnancy weight, present weight, prepregnancy body mass index, parity, gestational weeks, the amount of fat on the anterior abdominal wall, or the presence of the placenta or fetal parts in the fundus. Examiner error was influenced by thickness of the uterine wall and fetal presentation. These findings indicate that clinicians make errors in identifying the uterine fundus in a significant number of cases and that the methods used by clinicians to identify the uterine fundus need to be evaluated and impro

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90012-6

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTPublished reports of the effectiveness of preterm birth prevention programs have produced mixed results. Many larger observational studies suggest benefit. The randomized trials, however, suggest no effect on reducing rates of preterm birth in high‐risk populations. This article reviews and critiques these reports and suggests areas for further researc

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90013-7

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTThe use of warm water immersion (WI) by women for relaxation during labor is being used around the world; however, there is little available research as to the effects of WI. We conducted this prospective, randomized, and controlled study to determine the safety and effect of WI on the woman in labor. We studied 93 subjects between 36 and 41 weeks' gestation, in active labor, with intact membranes, and without major medical or obstetric complications. Subjects in the WI group utilized a tub in labor along with other pain relief measures such as ambulation, rest, showers, and analgesics. Subjects in the no‐WI group could use all available methods of pain relief except WI. Water immersion did not alter the rate of cervical dilation, change the contraction pattern, change the length of labor, or alter the use of analgesia. The rates of chorloamnionitis and endometritis were not allered by WI. Although we did not demonstrate an improvement in progression of labor by WI, there was no evidence of increased maternal, neonatal, or infectious morbidit

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90014-8

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTTo identify selected research trends, 69 research reports were analyzed from a sample of feature articles that were published in theJournal of Nurse‐Midwiferybetween 1987 and 1992. Systematic appraisal was performed to classify these articles according to topic, design, sampling methodology, sample size, and funding. The largest proportion of studies were conducted on clinical topics (83%). Descriptive study designs were utilized most frequently (67%). Nonprobability sampling (81%) far exceeded probability sampling (19%); however, in 1992, probability sampling increased to 75%. With the exception of 1988, funding steadily increased over the study period. These results suggest that research has primarily focused upon clinical issues and has utilized descriptive designs and nonprobability samplin

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90015-9

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTCertified nurse‐midwives (CNMs) are specialists in normal obstetrics and women's health care. In this capacity, CNMs have been actively involved in the education of nurses and student nurse‐midwives. Nurse‐midwives also have been consultants and mentors for medical students and residents during their clinical experiences. However, the nurse‐midwife's contribution to the formal medical education process has not received the appropriate formal recognition that it deserves, nor has this contribution been utilized to its maximum potential. This article describes the development, philosophy, and implementation of an educational program utilizing nurse‐midwives as the primary clinical preceptor for the obstetric rotation for third‐year medical students. The long‐range impact of this educational experience on the nurse‐midwife/physician relationship i

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90016-A

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTJapan's infant mortality rate in 1991 was four per 1,000, the lowest in the world. Contributing factors are the universal use of theBoshi Kenko Techo(maternal–child health handbook) and universal access to care. Most births occur to women aged 25–29 years and there are few unmarried mothers. Ninety‐nine and seven‐tenths percent of births are attended by qualified professionals either in hospitals or private clinics, with an average stay of one week postpartum. Abortion is available when contraceptives fail. There are government subsidies for medical, obstetric, and pediatric complications. Japanese citizens are highly literate and seek out medical advice, and their society is organized to support children. Efficient systems of community support, public health education, and excellent medical care encompass events from conception to sch

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90017-B

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTDistance‐learning has greatly expanded the number of students admitted to a nurse‐midwifery education program. This article describes the Community‐Based Nurse‐Midwifery Education Program (CNEP) of the Frontier School of Midwifery and Family Nursing. The organizational structure and curriculum of the CNEP combines apprenticeship learning with academic rigor, permitting students who cannot relocate to the university to pursue graduate education. New technology, such as an interactive electronic bulletin board, networks students and faculty. The program emphasizes theories of independent, adult learning. There is a master's completion option available through the affiliation with Case Western Reserve Uni

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90018-C

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTHigher education is seen as a step in the right direction for credentialing health care providers. The difficulty lies in the continuation of nurse‐midwifery certificate programs to increase the number of practicing certified nurse‐midwives while maintaining high‐quality care. The author offers some pragmatic solutions to this di

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90019-D

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90022-9

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY