Judith A Noronha

Maternal risk factors and anaemia in pregnancy: A prospective retrospective cohort study

Anaemia in pregnancy is still a concern during the reproductive period, as it is associated with increased maternal and perinatal mortality and morbidity. This study examined the maternal risk factors associated with increased prevalence of anaemia among antenatal and postnatal women. A prospective–retrospective cohort approach was carried out among 1,077 antenatal and 1,000 postnatal women. The haemoglobin was estimated using the cyanmethaemoglobin method. The maternal factors included were age, parity, education, socioeconomic status, spacing, history of bleeding, worm infestation, period of gestation, knowledge regarding anaemia in pregnancy, food selection ability and compliance to iron supplementation. Of the 1,077 antenatal women studied, 540 were anaemic. Among the 1,000 postnatal women, the prevalence was 537 (53.7%). The high prevalence was strongly associated with low socioeconomic status (OR 1.409 [1.048–1.899]; p < 0.023) which affected their knowledge and health seeking behaviour in both the groups. Hence it can be concluded that empowering women in terms of education and economic status is the key factor in combating anaemia in pregnancy to prevent the vicious cycle of associated problems.

Interventional study to strengthen the health promoting behaviours of pregnant women to prevent anaemia in southern India

OBJECTIVES to determine the effectiveness of a health information package in terms of empowering the pregnant women to modify their health-care behaviour and take appropriate action to combat anaemia in pregnancy. DESIGN the study was conceptualized based on Rosenstock and Beckers health belief model. A quasi-experimental pretest-posttest control group design was used. The sample consists of 225 anaemic pregnant women randomly allocated in experimental (n=75), control group A (n=75) and control group B (n=75). The health seeking behaviour outcome measure included knowledge regarding anaemia, food selection ability, increase in haemoglobin level and compliance to iron supplementation. Intervention was a validated planned educational programme with visual aids and iron supplementation. FINDINGS the results show the mean gain of knowledge scores of experimental group was comparatively higher and control groups A and B showed that F ratio was (F(2,190)=11.910, p<0.01) indicating that the pregnant women learned more about anaemia prevention than others. With regard to food selection ability scores of experimental, control groups A and B the F ratio was also significant (F(2,190)=20.92, p<0.01). Nearly 61.2% of the subjects in experimental group became non-anaemic after the intervention when compared to control group A. This indicated that inspite of iron supplementation received by the three groups health education contributed significantly in modifying their health seeking behaviour and their perception about significance of anaemia has a problem. CONCLUSION developing countries still face the critical problem of anaemia in pregnancy. These are the socio-cultural priority problems that demand immediate attention by the policy makers and health professionals. The national anaemia control programme focuses on iron supplementation, but nutritional education and supervision of iron supplementation has failed in different regions. The study implies that economic empowerment; strengthening health literacy through planned educational programs will definitely improve the health behaviour of individual and community at large.

Perinatal outcomes of intimate partner violence (IPV) during pregnancy: A systematic review protocol

Background: Pregnancy and childbirth is a crucial developmental phase in the life of a woman and her newborn(s). It becomes increasingly challenging if the pregnant woman is exposed to any Intimate Partner Violence (IPV) or domestic violence during this period. Neonatal outcomes depend largely on the mother’s health and wellbeing. Though IPV could be present even during pregnancy, it is not reported especially in a patriarchal culture. It also seems to be neglected in the perinatal health care by the health care professionals. It is pertinent for health care professionals to be aware of this during pregnancy, so that the mother and her newborn do not face any adverse outcomes.Objective: To identify the perinatal outcomes in pregnant women (who had experienced Intimate Partner Violence (IPV) during their pregnancy) and their newborns.Method: A comprehensive literature search will be made in the following databases: PubMed, MEDLINE, CINAHL, Google Scholar, Proquest, IndMed and ScienceDirect for retrieving the related studies. This systematic review will be conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta- nalyses (PRISMA) statement. A search strategy will be formulated. Data will be collected and analyzed according to the objective. Data extraction and data evaluation for its quality will be done. This review will include observational/analytical studies like cohort, case-control, cross-sectional studies and prevalence surveys. Narrative reviews, dissertations, case-reports, letters to the editor will be excluded.Conclusion: Though there is a growing evidence suggesting that IPV can cause serious consequences, it is unclear as to what are the specific perinatal outcomes that may affect a woman when she suffers from IPV during the period of her pregnancy. The proposed study would help in adding to the existing evidence.

Knowledge, Attitude and Risk Perception for diabetes among Pregnant Women with gestational diabetes Mellitus

Background: Gestational Diabetes Mellitus (GDM) has gained increasing attention as a predictor of future diabetes in women. Women with GDM are six times more likely to develop type 2 diabetes later in life than women without GDM. GDM has a recurrence rate of 35–80%, and risk of recurrent GDM is directly associated with previous pregnancies with GDM.Methods: Institutional based cross sectional survey design was used to collect data from the participants.Informed consent was obtained from all the participants. All pregnant women confirmed by an abnormal glucose challenge test as per the WHO criteria to have GDM were included. Pregnant women with Type 2 diabetes/preexisting diabetes were excluded. Data was collected from 100 mothers.Results: The mean age of the mothers was 26.7±3.7 years. The mothers were recruited for the study as early as 24 weeks to 39weeks with a mean POG of 31.75±4.3 weeks. Also there exists perfect positive correlation between knowledge and attitude(r =1,p=0.073).Seventy seven percent of the pregnant women with GDM perceived low risk of developing Type 2 diabetes in future.Conclusion: This study highlights the need for culturally accepted way of education and health promotion activities for women with GDM to prevent the early onset of Type 2 diabetes Mellitus

A Study to Assess Functional Assessment and Lived Experiences of Cervical Cancer Patients Admitted to a Tertiary Level Hospital of Udupi District, Karnataka-A Mixed Method Protocol

Aim: The aim of the study is to determine the quality of life by functional assessment, cancer related fatigue and describe the lived experiences of cervical cancer patients undergoing sensitization chemotherapy in a tertiary referral hospital. Background: Patients diagnosed with cancer at an advanced stage of the disease and receiving sensitization chemotherapy experience a variety of psychosocial problems in addition to their physical problems. Women with cervical cancer are more vulnerable to experience loss of functional wellbeing and thereby have poor quality of life. They also experience cancer related fatigue along with a variety of other physical symptoms and psychological problems when compared to other patients. Exploration of lived experiences of these women who have poor quality of life may help in providing a deeper understanding on the issues these women face day in and day out.Design: Mixed method; (Sequential exploratory design) Method: The study comprises of two phases: (i) Quantitative phase: to determine the functional assessment– quality of life and cancer related fatigue in women with cervical cancer who are currently receiving sensitization chemotherapy; (ii) Qualitative phase: will adopt a nested sampling technique, for choosing women with cervical cancer with poor quality of life. The objective will be to describe the lived experiences of women with cervical cancer on sensitization chemotherapy. Qualitative data will be collected using an unstructured interview guide.Conclusion: This study will help to provide information on the quality of life and cancer related fatigue of women with cervical cancer on sensitization chemotherapy. This study would further help in exploring the lived experiences of women with poor quality of life.

Nurses Perception of Factors Infuencing Clinical Decision Making

Introduction:Nurses are practicing in the era of ongoing advancement of research and technology. This change in health care environment needs nurses to improve competency in decision making to respond to clients requirement.Objective:To find out perceived factors affecting Clinical Decision Making (CDM) skills regarding Post-operative pain management among staff nurses.Methodology: A cross-sectional survey was carried out among 165 nurses in a selected hospital of Udupi district, Karnataka. A 36 item Questionnaire on Factors Affecting CDM regarding Post-operative pain management was used to assess the factors affecting CDM for caring for with post-operative pain.Results:Majority of the participants agreed that Self-esteem (General), education regarding decision making, situation, clinical nursing experience were the most influencing factors. Apart from the above factors, influence of Senior nurses in the clinical field (Modeling), cognitive process, relationship with ward in-charge, perception of CDM were the moderately influencing factors and the least influencing factors were locus of control and stress related to clinical decision making regarding Post-operative pain management Conclusion:Clinical decision making is an essential component of quality clinical nursing practice. Understanding the factors influencing decision making enables to strengthen the individual and external factors enabling appropriate decisions to be taken regarding patient care.

Practices of Smokeless Tobacco use (SLT) among married women

Background: Smokeless tobacco consumption is a common tradition especially common in south Asian origin. In spite of its global use and the serious health risks linked to it, the issue of using smokeless tobacco has not gained much a