Assuntos
Mães/psicologia , Parto Normal/psicologia , Complicações do Trabalho de Parto/psicologia , Posicionamento do Paciente/psicologia , Versão Fetal/psicologia , Feminino , Humanos , Recém-Nascido , Segunda Fase do Trabalho de Parto , Tocologia/métodos , Parto Normal/enfermagem , Papel do Profissional de Enfermagem , Complicações do Trabalho de Parto/enfermagem , Posicionamento do Paciente/enfermagem , Gravidez , Versão Fetal/enfermagemRESUMO
Injured children are in pain, anxious, scared, and intimidated by the emergency room environment and parents often compound this anxiety by their own fears. During minor surgical procedures, a child held in the "humane position" by the parent is helpful. The child is positioned on the parent's lap so that the affected extremity is drawn out and placed on the side of the parent. The surgeon and instruments are positioned behind the parent's back out of the child's and parent's field of vision especially if the wound is bleeding actively. Physical intimacy with the parent is capitalized upon; this makes the child feel secure, comfortable, relaxed, and reassured during the procedure.
Assuntos
Procedimentos Cirúrgicos Ambulatórios/psicologia , Ansiedade/prevenção & controle , Ansiedade/psicologia , Traumatismos da Mão/psicologia , Traumatismos da Mão/cirurgia , Posicionamento do Paciente/psicologia , Procedimentos Cirúrgicos Ambulatórios/efeitos adversos , Anestesia Local , Ansiedade/etiologia , Criança , Pré-Escolar , Feminino , Humanos , Cuidados Intraoperatórios/métodos , Cuidados Intraoperatórios/psicologia , Masculino , Posicionamento do Paciente/efeitos adversos , Posicionamento do Paciente/métodos , Psicologia da CriançaAssuntos
Conscientização , Idoso Fragilizado , Assistência de Longa Duração/psicologia , Limitação da Mobilidade , Estimulação Física , Terapia de Relaxamento/enfermagem , Descanso , Atividades Cotidianas/classificação , Atividades Cotidianas/psicologia , Idoso , Idoso de 80 Anos ou mais , Idoso Fragilizado/psicologia , Alemanha , Humanos , Comunicação não Verbal/psicologia , Posicionamento do Paciente/enfermagem , Posicionamento do Paciente/psicologia , Terapia de Relaxamento/psicologia , Meio SocialRESUMO
OBJECTIVE: to explore whether choices in birthing positions contributes to women's sense of control during birth. DESIGN: survey using a self-report questionnaire. Multiple regression analyses were used to investigate which factors associated with choices in birthing positions affected women's sense of control. SETTING: midwifery practices in the Netherlands. PARTICIPANTS: 1030 women with a physiological pregnancy and birth from 54 midwifery practices. FINDINGS: in the total group of women (n=1030) significant predictors for sense of control were: influence on birthing positions (self or self together with others), attendance of antenatal classes, feelings towards birth in pregnancy and pain in second stage of labour. For women who preferred other than supine birthing positions (n=204) significant predictors were: influence on birthing positions (self or self together with others), feelings towards birth in pregnancy, pain in second stage of labour and having a home birth. For these women, influence on birthing positions in combination with others had a greater effect on their sense of control than having an influence on their birthing positions just by themselves. KEY CONCLUSIONS: women felt more in control during birth if they experienced an influence on birthing positions. For women preferring other than supine positions, home birth and shared decision-making had added value. IMPLICATIONS FOR PRACTICE: midwives can play an important role in supporting women in their use of different birthing positions and help them find the positions they feel most comfortable in. Thus, contributing to women's positive experience of birth.
Assuntos
Segunda Fase do Trabalho de Parto/psicologia , Tocologia/métodos , Parto Normal/enfermagem , Posicionamento do Paciente , Gestantes/psicologia , Adulto , Comportamento de Escolha , Tomada de Decisões , Feminino , Humanos , Países Baixos , Relações Enfermeiro-Paciente , Posicionamento do Paciente/métodos , Posicionamento do Paciente/psicologia , Preferência do Paciente , Gravidez , Inquéritos e QuestionáriosRESUMO
Having choices and being involved in decision making contributes to women's positive childbirth experiences. During a physiological birth, women's preferences can play a leading role in the choice of birthing positions. In this study, we explored women's preferences with regard to birthing positions during second stage of labor, with a special focus on women who preferred positions other than common supine positions. A questionnaire survey was conducted among women in 54 Dutch midwifery practices. Of the 1154 women in the study, 58.9% preferred supine positions, 19.6% preferred other positions (e.g. sitting or standing), and 21.5% had no distinct preference. Women who preferred supine positions gave birth in these positions more often than women with preferences for other positions. Among the women having a preference for other positions, the actual fulfillment of their preference was related to longer duration of second stage of labor, higher levels of education, the strength of the preference, and giving birth at home. These results demonstrate differences in women's use of preferred positions during childbirth. Midwives can contribute to women-centered care by proactively exploring women's preferences for birthing positions throughout pregnancy and birth, supporting women in developing well-informed choices and facilitating these choices where possible.
Assuntos
Comportamento de Escolha , Segunda Fase do Trabalho de Parto/psicologia , Parto/psicologia , Posicionamento do Paciente/psicologia , Satisfação do Paciente , Adulto , Feminino , Humanos , Tocologia , Gravidez , Inquéritos e Questionários , MulheresRESUMO
OBJECTIVES: To determine the difference between the estimated and measured values of the left lateral decubitus (LLD) angle in the positioning of patients for scheduled cesarean section; to determine whether the accuracy of estimates differs between staff anesthesiologists and residents; and to assess the angle estimates of midwives and surgical nurses as well as their level of knowledge with respect to the utility of the LLD position. METHODS: This was a prospective, observational, double-blind study comparing staff anesthesiologists working in obstetrics to residents in their second, third, or fourth-year of training. We also presented a task and questions to midwives and surgical nurses who assisted during categories 3 and 4 cesarean sections (elective and scheduled procedures) according to the classification system of he National Institute of Clinical Excellence. The anesthesiologist was asked to place the patient in LLD position after onset of anesthesia and to estimate the LLD angle. A second anesthesiologist measured the angle. The midwives and nurses were asked to place a vacant surgical table at approximately 15 degrees; the angle was then measured. Patient variables (weight, height, anesthetic technique) and staff variables (position, understanding of the purpose of the maneuver, estimated DLL angle, and measured angle) were recorded. RESULTS: Of 55 women who underwent cesarean sections (98.18% under regional anesthesia), 25 were assessed by staff anesthesiologists and 30 by residents. A total of 14 midwives and 10 surgical nurses participated in the surgical table positioning task and answered questions. The mean (SD) DLL angle estimate of the anesthesiologists was 12.4 degrees (3.4 degrees); the mean measured angle was 7.8 degrees (3.1 degrees). The estimates of staff anesthesiologists were significantly more accurate (P < .001). All the midwives understood the reason for using the DLL position in cesarean section, while only 1 nurse (10%) did (P < .05). CONCLUSION: The DLL position angle is overestimated by resident anesthesiologists and midwives. It seems that the use and understanding of DLL positioning could be improved.