Biomedical subjects
Publications and source records attributed to D Oakley.
Applying research methods and techniques developed in a dominant culture to other cultures can threaten the validity and generalizability of research conducted with other cultures. Guidelines are proposed for increasing the cultural sensitivity of research, and a case example is discussed.
We explored perimenstrual symptoms among 16 Chinese women in an urban area of southeastern China using a retrospective questionnaire, the Menstrual Distress Questionnaire (MDQ), and a prospective daily symptom diary, the Daily Health Diary (DHD), modified for cultural relevance. Mean scores on the DHD were significantly (p < .03) higher during the perimenstrual phase for the symptoms fatigue, increased sensitivity to cold, increased sleeping, abdominal pain/discomfort, painful or tender breasts, and decreased sexual desire. The women who reported higher DHD physical symptom scores prospectively were more likely to recall more severe physical symptoms retrospectively on the MDQ. However, there were remarkable discrepancies between the DHD and MDQ regarding psychoemotional symptoms. By retrospective MDQ, the percentages of women who experienced severe mood swings and irritability ranged from 13% to 25% during the premenstrual and menstrual phases; on the DHDs, however, these emotional symptoms were not statistically associated with the menstrual cycle. The failure of prospective charting to confirm the retrospective reports of cyclic psychoemotional symptoms agrees with findings of studies of U.S. samples. We conclude that perimenstrual distress in Chinese women may be affected by the data collection methods.
The ways in which contraceptive methods are actually used is of increasing interest to researchers, clinicians, and policy makers. Although contraceptive "use" has multiple dimensions, existing indicators measure only one aspect of use or combine unidimensional measures to produce a questionable pastiche. This study uses a subsample of 612 respondents from a larger study of first-time patients at a public-health-department family planning clinic to develop a new measure. Psychometric properties of this measure are examined and discussed.
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OBJECTIVE: To describe reported patterns of postpartum physical activity and to identify benefits or risks associated with postpartum physical activity at 6 weeks postpartum. DESIGN: Secondary analysis of longitudinal data collected prenatally and postpartum in a study of obstetric outcomes at a midwestern tertiary-care center and its ambulatory satellite and hospital clinics. PARTICIPANTS: One thousand three women completed a questionnaire at the 6-week postpartum clinic visit. Mean age was 29.7 years, and mean education level was 15.3 years. VARIABLES OF INTEREST: Participation in vigorous exercise, change in postpartum activity level, postpartum weight retention, infant feeding method, maternal postpartum adaptation, and participation in activities for fun. RESULTS: Nearly 35% reported doing vigorous exercise with a modal frequency of three times per week. More active women had retained significantly less weight (8.6 lb [3.9 kg]) than their less active counterparts (11.3 lb [5.1 kg]). Vigorous exercisers demonstrated a consistent pattern of better scores on measures of postpartum adaptation and were more likely than nonexercisers to participate in fun activities, such as socializing, hobbies, and entertainment. Breastfeeding was not adversely affected by vigorous exercise. CONCLUSIONS: These exploratory results indicate that physical and psychologic benefits may accrue to postpartum women who are able to exercise vigorously and avoid decreasing their usual level of activity. A prospective randomized test of this relationship is warranted. Although positive outcomes of physical activity have been demonstrated in the population at large, exercise has rarely been an element in postpartum care plans. Nurses who care for women after childbirth should assess women's exercise goals and support them in their desired activities.
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Despite the explosive growth in nurse-managed centers (NMC) in the past 20 years, most have been unable to achieve financial self-sufficiency, and many have closed. Combining costing techniques with outcome measures provides essential information needed by NMC for making operating decisions and for marketing NMC performance. These outcome data can be persuasive to policy makers and institutional decision makers and are crucial for NMC to improve their competitiveness in the health care market place.
A retrospective study of 1,311 women making initial family planning visits to metropolitan-area health department clinics found that many women switch methods or discontinue use in the first year following the clinic visits. Among a subgroup of women, most of whom selected the pill as their primary method and who used the pill for at least one of the months in the study period, almost half either changed methods or used no method at some point during a follow-up period averaging eight months. This includes 13 percent of women who made two or more changes. In addition, only 42 percent said they took a pill every day, and only half of these said they always took their pill at about the same time every day. Despite such irregularities, pill users were approximately one-third as likely to get pregnant during the study period as women making an initial family planning visit to a health department clinic who did not use the pill at all.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The future viability of nursing research depends on federal funding decisions, which in turn depend upon national and local action by researchers and other advocates of nursing research. Since successful action is facilitated by familiarity with national policy-making, the legislative process is reviewed and a plan for action at the state and local level is offered. Basic actions are suggested to organize, arouse public support, build coalitions, and gain access to legislators. All these must follow a developed work plan. Ideas for specific implementing steps are provided, but each local area requires specially designed activities appropriate for their own needs and resources. The goal is to build a grass roots system to support national lobbying to stabilize and increase federal funding for nursing research.
OBJECTIVE: To examine the effects of infertility treatment on women's ability to adapt to pregnancy and motherhood. METHODS: Fecund (n = 261) and subfecund (n = 103) primiparous women receiving obstetrical care in southeastern Michigan participated in this descriptive, correlational, prospective study. The subjects completed Lederman's Pre-Natal Self-Evaluation questionnaire during the third trimester of pregnancy and Lederman's Postpartum Self-Evaluation questionnaire during the first postpartum appointment. FINDINGS: Mean scores showed that the two groups of women were not significantly different with either adaptation to pregnancy or motherhood. CONCLUSIONS & IMPLICATIONS FOR NURSING: Although subfecund women may experience stress in order to achieve a pregnancy, there do not appear to be any latent effects of this stress on their ability to adapt to pregnancy or motherhood.
Irregular use of the pill compromises the effectiveness of this highly reliable method. The consistency of pill-taking has traditionally been estimated through women's own reports of their patterns of pill use. In this study, self-reported data on pill-taking were compared with data from an electronic device measuring compliance among 103 women attending university health services and publicly funded family planning clinics. In three months of pill use, the electronic and self-reported data agreed on the number of days when pills were missed only 45% of the time; the level of agreement dropped from 55% in the first month to 38% in the third month. In each month, the proportion of women reporting no missed pills was much higher than the proportion recorded electronically (53-59% compared with 19-33%), and the proportion missing at least three pills according to the electronic data was triple that derived from the women's reports (30-51% vs. 10-14%). In addition, the electronic data recorded substantially more episodes in which women missed pills on two or more consecutive days (88 vs. 30).
A three-month prospective study of 103 women initiating oral contraceptive use examined how consistently the women took their pills and whether those who missed pills employed other means to avoid pregnancy. The results showed that 52% took each active pill or never missed more than one pill at a time after the first week of the initial cycle, according to electronic devices that recorded the date and time each pill was removed from the blister pack. Another 21% were protected by behaviors that reduce the risk of pregnancy when two or more consecutive pills have been missed: avoiding coitus for the next seven days (18%) or using backup contraception during that period (3%). The remaining 27% were at increased risk of pregnancy. Predictors of increased risk were receiving low partner support for effective pill use, being unmarried and not considering it especially important to avoid pregnancy. Increased risk was most likely during the first seven days and during the third cycle of pill use.
CONTEXT: An understanding of determinants of inconsistent pill-taking could be useful to service providers who are trying to help women prevent unwanted pregnancy. This article explores the predictors of inconsistent use in a nationally representative sample of U.S. women aged 15-44. METHODS: Data on 1,485 pill users participating in the 1995 National Survey of Family Growth are used to describe users' characteristics, and logistic regression analyses are conducted to identify factors that predict inconsistent use (defined as missing two or more pills in a three-month period) among both users of the pill only and dual method users. RESULTS: While 85% of pill users rely solely on the pill, 15% also use another method. Overall, 16% of users are inconsistent in their pill-taking (16% of those using the pill alone and 20% of dual method users). Among users of the pill only, Hispanic and non-Hispanic black women have a significantly increased likelihood of inconsistent use (odds ratios, 2.5 and 2.1, respectively), as do those who recently began use (2.7) and those who have had an unintended pregnancy (1.6). For dual method users, the odds are significantly elevated among women whose income is less than 250% of the federal poverty level (4.3) and among new users (4.5). CONCLUSION: Service providers may need to better address consistency of pill-taking among women who have characteristics associated with inconsistent use.