Definitions, measurements and prevalence of fear of childbirth: a systematic review.

BACKGROUND: Fear of Childbirth (FOC) is a common problem affecting women's health and wellbeing, and a common reason for requesting caesarean section. The aims of this review were to summarise published research on prevalence of FOC in childbearing women and how it is defined and measured during pregnancy and postpartum, and to search for useful measures of FOC, for research as well as for clinical settings. METHODS: Five bibliographic databases in March 2015 were searched for published research on FOC, using a protocol agreed a priori. The quality of selected studies was assessed independently by pairs of authors. Prevalence data, definitions and methods of measurement were extracted independently from each included study by pairs of authors. Finally, some of the country rates were combined and compared. RESULTS: In total, 12,188 citations were identified and screened by title and abstract; 11,698 were excluded and full-text of 490 assessed for analysis. Of these, 466 were excluded leaving 24 papers included in the review, presenting prevalence of FOC from nine countries in Europe, Australia, Canada and the United States. Various definitions and measurements of FOC were used. The most frequently-used scale was the W-DEQ with various cut-off points describing moderate, severe/intense and extreme/phobic fear. Different 3-, 4-, and 5/6 point scales and visual analogue scales were also used. Country rates (as measured by seven studies using W-DEQ with ≥85 cut-off point) varied from 6.3 to 14.8%, a significant difference (chi-square = 104.44, d.f. = 6, p < 0.0001). CONCLUSIONS: Rates of severe FOC, measured in the same way, varied in different countries. Reasons why FOC might differ are unknown, and further research is necessary. Future studies on FOC should use the W-DEQ tool with a cut-off point of ≥85, or a more thoroughly tested version of the FOBS scale, or a three-point scale measurement of FOC using a single question as 'Are you afraid about the birth?' In this way, valid comparisons in research can be made. Moreover, validation of a clinical tool that is more focussed on FOC alone, and easier than the longer W-DEQ, for women to fill in and clinicians to administer, is required.

Adolescents' experiences of Help Overcoming Pain Early-A school based person-centred intervention for adolescents with chronic pain.

To illuminate adolescents' experiences of Help Overcoming Pain Early (HOPE), a person-centred intervention delivered in a school setting by school nurses. Twenty-one adolescents with chronic pain recruited from secondary school, who had completed the HOPE intervention, were included in the interview study. The HOPE intervention was built on person-centred ethics and consisted of four meetings between school nurses and adolescents on the subject of stress and pain management. A qualitative method using content analysis with an inductive approach was employed. In the interviews, the adolescents describe how they reclaim their lives with the help of HOPE. They use different strategies and parts of the intervention to move on with their lives. A trustful relationship, as that with the school nurse, was essential to dare to change. The overarching theme summarizes in Becoming myself again and is built up by three sub-themes: Trust a pillar for growth, Making sense of my life with pain, and Putting myself into the world again. A person-centred intervention such as HOPE applied in a school context is promising for promoting confidence in adolescents with chronic pain. A trust-building process emerged, in terms of both the adolescents' trust in the healthcare staff they meet and their confidence in their own ability to handle and influence their situation, which in the long term can promote trust in themselves as a person.

[Use of paraformaldehyde tablets for bacterial count reduction, disinfection, cold sterilization, and sterile preservation of medical instruments. 3: On the use of paraformaldehyde tablets in medical institutions]. / Untersuchungen über den einsatz von paraformaldehydtabletten zur Keimzahlverminderung, Desinfektion, Kaltsterilisation und Sterilaufbewahrung von ärztlichem Instrumentarium.

Paraformaldehyde tablets are very effective against a wide spectrum of organisms. They may be recommended for targeted degerming measures in medical practice. Their utilization requires the observance of the conditions necessary for their efficient use. The tablets should be employed only in containers which are as tight-fitting as possible (preferentially instrument cabinets, Heynemann cabinets, catheter boxes and plastic bags). Paraformaldehyde tablets are well suited for the reduction of the bacterial population and the storage of nonwrapped sterilized instruments. For this purpose, 1 tablet/dm3 is needed. The exposure time required for bacterial count reduction is no less than 3 h. Despite certain limitations, paraformaldehyde tablets may be used for disinfecting. The objects to be disinfected should be neither too contaminated nor too soiled. The minimum period of exposure is 5 h, and 10 tablets/dm3 are necessary. Cold sterilization requires 10 tablets/dm3, too; but the exposure time ranges from 15 to 24 h. This method (which must be considered an expedient) should be employed only if the respective device or instrument cannot be sterilized by other sterilizing techniques. In any case, 80% relative air humidity is a must in the devices in which paraformaldehyde tablets are used.

[Chlorhexidine as a vaginal antiseptic in obstetrics]. / Chlorhexidin als Antiseptikum bei der vaginalen Untersuchung in der Geburtshilfe.

The antimicrobial efficiency of a chlorhexidine containing emulsion which is used as gliding or antiseptic remedy is examined. The killer-time for germs within the suspension test as well as the testing in clinical use confirm the efficiency known from literature. The use of chlorhexidine containing emulsions serving as antiseptic gliding remedy is recommended.