The use of theory or model in studies on postpartum care: A narrative review.

PURPOSE: It is aimed to raise awareness about the science of nursing for women's health and the use of nursing theories and models in research by reviewing the studies using theories or models in postpartum care. DATA SOURCES: The data of the study were obtained by searching YÖK National Thesis Center, EBSCOhost, PubMed, Web of Science, Cochrane, and ScienceDirect databases. Reviewed studies were analyzed in terms of the type of research, sample characteristics, purpose, the field of use of theory and model in the research, and research results. CONCLUSIONS: As a result of the review, it was noted that in the studies, Orem's Self-Care Deficit Nursing Theory/Model (n = 9), Roy's Adaptation Theory (n = 7), and Kolcaba's Theory of Comfort (n = 7) were the most used theories, theories and models were not used in a systematic structure at every stage of the research, and positive outcomes were obtained with the theory and model-based nursing interventions. IMPLICATIONS FOR NURSING PRACTICE: The application of theory and model in postpartum care can be chosen by nurses as it improves patient outcomes. Furthermore, the use of theories and models in research to develop nursing knowledge will benefit nursing science while increasing professional autonomy.

Women's reproductive behaviour and perspectives on fertility, and their modifying factors, in a Turkish province with a high fertility rate.

OBJECTIVES: Population growth is an important public health problem with economic, social, cultural and political consequences. The aim of the study was to determine the reproductive behaviour and perspectives on fertility of women in Sanliurfa, the city with the highest fertility rate in Turkey. METHODS: The quantitative dimension of the study was carried out using a mixed methods approach in which 300 women were interviewed and a questionnaire was completed; the qualitative dimension was carried out through in-depth individual interviews with 14 women, using a semi-structured interview form. Analysis of the qualitative data was done using a content analysis technique. RESULTS: The median number of children was three (range 0-10). Women with no or a low level of education tended to have a greater number of children. Preference for a particular sex of child was one reason behind the higher number of children. These two factors were main causes of an increased number of children. Women with no or a low level of education (odds ratio [OR] 9.1) and women who expressed a preference for a male child (OR 5.9) had more children compared with other women. Participants regarded a male child as more valuable than a female child and that having many children strengthened the family. Parents regarded their sons as insurance for their old age. Having an induced abortion was perceived as a sin. CONCLUSION: The results showed that cultural norms and values significantly affected fertility rates.

Developing a Web-Based Smoking Cessation Program and Evaluating Its Effectiveness.

This study, which is based on the Stages of Change Model, aimed to develop a Web-based smoking cessation program and to evaluate its effectiveness. An interventional study with 1 group was conducted with college students from Afyon Kocatepe University. First, the Web-Based Smoking Cessation Program was set up (www.sbp.aku.edu.tr). The sample in this study was composed of the 433 students who were site members. The appropriate stages of the program were then sent to members' e-mail addresses at monthly intervals over a period of 6 months. Second, the effectiveness of the program was evaluated at the baseline, the third, and the sixth months of the study. The study was completed with 314 students. The data were evaluated using descriptive statistics, 1-way analysis of variance, and analysis of variance for repeated measures. There were significant developments in the self-efficacy, cognitive, and behavioral processes of students in the third and sixth months of the study. Students (2.5%) had quit smoking by the third month and 4.5% by the sixth month. These results reveal that the program was able to help students quit smoking, increase their self-efficacy, and develop the process of change regarding smoking cessation.

Persistent Organic Chlorinated Compound Residues in the Breast Milk of Female Seasonal Agricultural Workers.

OBJECTIVE: This retrospective descriptive study aimed to investigate organochlorine compounds in women who breastfeed and work as a seasonal agricultural worker (SAW). METHODS: It was carried out on 100 woman working as SAW. Data were collected with a questionnaire by face-to-face interview and analyzed the residues of 27 items of organochlorine pesticides, dichlorodiphenyltrichloroethane (DDT) metabolites and polychlorinated biphenyls, from persistent organic pollutants in mothers' 50 mL breast milk. Descriptive statistics, Chi-square test, and correlation analysis were used to evaluate data. RESULTS: Polychlorinated biphenyl (PCB)28 component was determined in almost all women's milk and more than half of collected milk contained beta-hexachlorocyclohexane (HCH), PCB52, pp'-dichlorodiphenyldichloroethylene (DDE), hexachlorobenzene (HCB), PCB70, pp'- dichlorodiphenyltrichloroethane (DDT) ve Gamma HCH, respectively. CONCLUSION: It was recommended that necessary legal regulations and public information policy about that subject should exist.

Educational needs of nurses to provide genetic services in prenatal care: A cross-sectional study from Turkey.

The latest advances in genetics/genomics have significantly impacted prenatal screening and diagnostic tests. This cross-sectional descriptive study was conducted in inpatient and outpatient obstetric clinics in 24 hospitals in Turkey to determine knowledge of genetics related to prenatal care and the educational needs of perinatal nurses. A total of 116 nurses working in these clinics agreed to participate. The results included the level of knowledge among nurses was not affected by sociodemographic factors. Also, there is a lack of knowledge and interest in genetics among prenatal nurses and in clinical practice to provide education and counseling related to genetics in prenatal settings as a part of prenatal care.

An Example from the Rural Areas of Turkey: Women Breast Cancer Risk Levels and Application and Knowledge Regarding Early Diagnosis-Scan of Breast Cancer.

OBJECTIVE: This research has been conducted for the purpose of determining the cancer risk levels of women living in a small village of in Saraycik village of Ankara and their knowledge and application of breast cancer early diagnose-scan methods. MATERIALS AND METHODS: 317 women were taken as examples for the study. Data were collected by giving survey forms to women and conducting face-to-face interviews. In determining breast cancer risk, "the form to determine the breast cancer risk" has been used. For breast cancer informational questions, one point has been given for each correct answer. In evaluating the data, number, percentage calculations, average and standard deviation, Mann-Whitney U (MU), Kruskal-Wallis (KW), One-way analysis of variance (F) independent sample T (t) tests have been used. RESULTS: It has been found that breast cancer risk is low, the knowledge level about cancer early recognition methods are medium among the women. It has been determined that 74.4% women didn't perform breast self-examination. 89.6% of women don't have mammography taken and 88.6% don't have their breast examined by health personnel. CONCLUSION: In our study, it has been found that the risk levels of women are low, their knowledge about early diagnosis and cure are at a medium level and their use of these methods are inadequate. For this reason, we suggest that responsibility of healthcare professionals have to be increased in determining breast cancer risk among women and education and advisory services for this subject to be offered.

Women's knowledge and use of prenatal screening tests.

AIMS AND OBJECTIVES: The aim of the study was to determine the rate of use of prenatal screening tests and the factors affecting the decision to have a prenatal screening test in pregnant women in Turkey. BACKGROUND: Prenatal genetic screening as an optional service is commonly used to determine a level of risk for genetic conditions in the foetus. DESIGN: A quantitative cross-sectional survey. METHODS: Pregnant women (n = 274) who sought prenatal care from one hospital in Turkey were recruited and asked to complete questionnaires that were developed by the researchers. Descriptive and inferential statistics were used to analyse the data. RESULTS: Almost half (44·2) % of the women were primiparas, and the majority (97·8%) were in the third trimester of pregnancy. Only 36·1% of the women reported that they had prenatal screening by either the double test or triple test. Women had a low level of knowledge regarding prenatal screening: the mean knowledge score was 3·43 ± 3·21 of a possible score of 10. Having consanguineous marriage, a history of spontaneous abortion, a child with genetic disorder, multiparity or a longer marriage duration were positively correlated with accepting a prenatal screening test. CONCLUSIONS: This study has provided baseline data on the uptake and reasons for accepting or declining a prenatal screening in a cohort of Turkish women. There is evidence to suggest that more education is needed to improve knowledge and provide comprehensive nursing care to promote informed consent in this context. RELEVANCE TO CLINICAL PRACTICE: Perinatal nurses are ideally situated to inform pregnant women about prenatal screening tests to improve access to healthcare services and to ensure informed decisions are made by pregnant women and their partners.

The effect of transtheoretical model-based individual counseling, training, and a 6-month follow-up on smoking cessation in adult women: a randomized controlled trial.

BACKGROUND/AIM: This study was conducted to determine the effect of transtheoretical model (TTM)-based individual counseling, training, and a 6-month follow-up on smoking cessation in adult women. MATERIALS AND METHODS: We carried out this randomized controlled trial in Konya, Turkey. Female subjects were randomly assigned into groups in a 1:1 ratio using block randomization, block size 3 × 3, divided by stages (precontemplation, contemplation, and preparation) and age (20-29, 30-39, and 40-49 years). The study was completed with 77 women (an intervention group containing 38 participants and a control group of 39 participants). The intervention group was interviewed 5 times (baseline and 1, 1.5, 2, and 6 months). Counseling and training were given to the intervention group at the first 3 interviews. The TTM scales were assessed for both groups at baseline and at 2 and 6 months. RESULTS: In the 6-month follow-up, the rate of smoking cessation and the rate of progress were higher in the intervention group than in the control group. All the TTM variables had differences except the cognitive processes in the intervention group over time. Analysis of variance related to time × groups indicated that all variables had significantly changed except the cognitive processes and the pros of change. CONCLUSION: Results suggest that the TTM may be useful in understanding the stages individuals are at and in deciding on the appropriate treatment for smoking cessation.

Sacral region massage as an alternative to the urinary catheter used to prevent urinary retention after cesarean delivery.

OBJECTIVE: The aim of the study was to determine the effect of massage to the sacral region after cesarean delivery instead of employing a urinary catheter for the prevention of urinary retention. STUDY DESIGN: Cross sectional study. MATERIAL AND METHODS: This interventional study population consisted of 60 women who were divided into two intervention groups and one control group. For the first intervention group, the sacral region was massaged every hour 10-15 minutes after cesarean delivery and every 30 minutes after a voiding sensation for the second intervention group. No interventions were made in the control group, although routine hospital services were provided. Socio-demographic data were collected using a questionnaire developed by the researchers. Other data were collected via observation. RESULTS: Fifteen percent (15%) of the women in the first intervention group needed to void 2 hours after cesarean delivery, 35% after 3 hours, and the mean time to void after delivery was 3.4±0.8 hours. Forty percent (40%) of the women in the second intervention group needed to void after 5 hours, and the mean time to void after delivery was 5.5±0.8 hours. Sixty percent (60%) of the women in the control group needed to void 6 hours later, and the mean time to void after delivery was 6.2±0.7 hours. Urinary retention was not observed in the first intervention group. Our statistical analysis showed a significant difference between the three groups in terms of mean times to void after cesarean delivery (p<0.05). CONCLUSION: In order to facilitate voiding and to prevent urinary retention, which is seen as a post-cesarean complication, massaging the sacral region could be recommended instead of urinary catheter insertion. Additional studies with larger groups are also recommended.

Role of pelvic floor muscle exercises in the prevention of stress urinary incontinence during pregnancy and the postpartum period.

OBJECTIVE: The aim of this study was to determine the role of pelvic floor muscle exercises (PFME) in the prevention of stress urinary incontinence (SUI) during pregnancy and the postpartum period. METHODS: A total of 102 women was included in the study. Data, collected through forms, included characteristics of the women, follow-up data during the pregnancy and postpartum period and a three-day urinary diary. Both groups were evaluated in terms of SUI at the 14th-20th, 28th and 32nd weeks of gestation and at 12 weeks postpartum. RESULTS: As shown by the pad test, SUI developed in 5.8, 17.3 and 1.9% of the subjects in the intervention group at the 28th and 32nd gestational week and the 12th postpartum week, respectively. The relevant ratios in the control group were 30, 48 and 18%, respectively. A statistically significant difference was found between the intervention and control groups in terms of SUI development at the 28th and 32nd weeks of gestation and the 12th postpartum week (p < 0.05). CONCLUSION: PFME are effective for prevention of SUI development during pregnancy and in the postpartum period. Health care providers are therefore recommended to provide education and counseling to pregnant women about SUI prevention.

Investigation of the sexual behavior of pregnant women residing in squatter neighborhoods in southwestern Turkey: a qualitative study.

The authors designed this study in order to understand changes in sexual behavior during pregnancy. The sample comprised 26 healthy women who were in at least their 37th week of pregnancy. The authors collected data through in-depth individual interviews. Participants reported the following most common reasons for ceasing sexual intercourse in the final stages of pregnancy: (a) physical discomfort during sex, (b) belief that it could be physically harmful to the fetus, (c) belief that it is sinful according to Islamic injunctions, (d) belief that the baby will be born "stained" because of the misperception of vernix caseosa as sperm, and (e) changes in sexual life at the recommendation of health professionals.

The use of lactational amenorrhea as a method of family planning in eastern Turkey and influential factors.

Although the lactational amenorrhea method (LAM) is commonly used for contraception, it frequently fails and pregnancy ensues. This descriptive study was conducted to determine the status of the use of breastfeeding as a method of family planning and the influential factors that may have contributed to the success or failure of LAM. The research sample was comprised of 188 women with 6-month-old infants in eastern Turkey. A semistructured interview form was used for data collection in face-to-face meetings with the women during visits in their homes. In this study, 34% of the women used LAM to prevent pregnancy after childbirth. However, it was observed that only 17.2% of women using LAM fulfilled the LAM criteria with success, and 82.8% did not fulfill one or more of the LAM criteria. The pregnancy rate of women using this method was 32.8%. Two of the three basic criteria necessary for LAM to be effective were not met by the women: having menses (43.8%) and starting supplemental feeding (70.3%). Prenatal and postnatal counseling services need to be integrated and include information and education about the criteria that are necessary for LAM to be used effectively. These services should be given to women who choose to use LAM for contraception.

Comparison of efficacy and complications of IUD insertion in immediate postplacental/early postpartum period with interval period: 1 year follow-up.

OBJECTIVE: This study aimed to compare immediate postplacental (IPP) and early postpartum (EP) intrauterine device (IUD) insertions with interval (INT) IUD insertions with respect to efficacy and complications. METHODS: The study group consisted of 268 women in whom the following TCu 380A IUD insertions were performed: 84 IPP (less than 10 min), 46 EP (10 min to 72 h) and 138 INT (more than 6 weeks). The women were followed up 8 weeks, 6 months and 12 months after insertion. Complications and pregnancies encountered at the end of 1 year following IPP, EP and INT insertions were compared. The chi-square test and Fisher's Exact Test were used for the evaluation of the data. RESULTS: Complications developed in 40.4% of the women in the IPP group, in 74.4% of the women in the EP group and in 19.2% of the women in the INT group (p<.001). Although no statistically significant difference was found between the groups for uterine perforation and infection (p>.001), there was a statistically significant difference between the groups in the incidence of complete and partial expulsion according to the time of IUD insertion. The overall cumulative pregnancy rate and frequency of pregnancy were found to be higher (p>.05 for both), which are both insignificant for the EP group (2 of 43 women), as compared with the INT (4 of 130 women) and IPP groups (2 of 84 women), and pregnancy rates at 1 year for all groups was 3.1% (8 of 257 women). CONCLUSION: IPP and EP insertion of the TCu 380A IUD is an effective and convenient procedure, and expulsion rates in these groups are higher than in the INT group. Further studies are necessary to determine the cause of the higher expulsion rates and to find ways to reduce such rates.

The effect of education and counseling services on compliance to therapy of women taking hormone therapy for the first time.

OBJECTIVE: The purpose of this experimental research was to examine the effect of hormone therapy (HT)-related education and counseling on compliance. DESIGN: The 119 women in both the experimental and the control group were being seen in a referral maternity and women's health teaching hospital's menopause outpatient clinic. Similarity between experimental and control groups was ensured using one-to-one pairing. The data were collected using a questionnaire and a follow-up form. The experimental group was given group education and an educational booklet on the first day they began therapy and counseling in the third and sixth months of therapy. The control group was not given counseling or education. Chi-square was used in data evaluation. RESULTS: There was no difference between the groups at the third month for those who were continuing HT (P > 0.05), but at the sixth month a significant difference was found (P < 0.05). The primary reason for stopping HT at the third month in the experimental group was fear of cancer and in the control group it was the side effects of HT. At 6 months, the primary reason for stopping HT in the experimental group was, again, fear of cancer but in the control group it was the woman's desire not to continue. There was no significant difference in the groups at either 3 or 6 months in experiencing benefits or side effects from HT (P > 0.05). CONCLUSION: Education and counseling services given by nurses or other health care personnel have an effect on long-term compliance with HT.

Effects of episiotomy on bonding and mothers' health.

BACKGROUND: Historically, episiotomy has been carried out during labour to facilitate delivery, shorten the duration of the second stage and prevent spontaneous lacerations. However, recent studies of episiotomy have recommended that it be carried out only when necessary. In Turkey, midwives are authorized to perform episiotomy. AIM: To analyse the effects of episiotomy on mothers' health and mother-infant bonding. DESIGN: A cohort study of 100 women who gave birth by normal vaginal delivery in a Turkish hospital between 15 March 1999 and 6 April 2000. METHODS: Participants were divided into episiotomy (n = 50) and control (n = 50) groups. Data on biographical characteristics and the process of labour were collected in hospital, and follow-up was conducted at home 1, 3 and 12 weeks after labour. RESULTS: Mean duration of the second stage was longer in the episiotomy group than the control group, but the difference was not significant. The number of spontaneous lacerations was significantly lower in the episiotomy group. Mean time from delivery to maternal rest and time taken to bond with the infant were significantly longer in the episiotomy group. There were significantly higher scores for overall incidence and severity of pain on the first day, and pain incidence and severity at 1 week in the episiotomy group. Significantly fewer women in the episiotomy group were able to do chores and to sit/stand up comfortably in the first postpartum week CONCLUSION: Episiotomy should not be used unless indicated. Measures should be taken to avoid perineal trauma during labour, establish bonding between mother and infant as soon as possible, and minimize perineal discomfort after delivery.