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Biomedical subjects

L Tulman

Publications and source records attributed to L Tulman.

29 records · Page 2Linked to original sources
PubMedDate not supplied

Postnatal care in low-income urban African American women: relationship to level of prenatal care sought.

OBJECTIVE: This study examined the relationship between level of prenatal care utilization and postnatal patterns of health care behavior among high-risk minority women. The primary hypothesis was that prenatal care utilization predicts subsequent levels of both the maternal and child health services used in the postnatal period. METHODS: The study population consisted of 297 low-income African American women who were recruited at delivery at an urban tertiary medical center in the Mid-Atlantic region. They were followed monthly for 1 year using telephone interviews to determine their use of maternal and child health services. Four levels of prenatal care were identified retrospectively based on reviews of health records and screening interviews using the Kessner Index. Data regarding pregnancy outcomes, maternal postnatal visits, and well-child and acute care child visits were collected. RESULTS: Women who sought inadequate or no prenatal care had greater infant morbidity and mortality in the postnatal period and significantly lower levels of attendance at maternal postnatal visits, well-child visits, immunization completions, and acute care visits. CONCLUSION: This study confirms that the level of prenatal care is indicative of the level of postnatal care women seek for themselves and their children in the first year after delivery.

Adolescent↗
PubMedDate not supplied

Recovery from childbirth: looking back 6 months after delivery.

Women's perceptions of their recovery from childbirth were investigated by open-ended interviews of 96 mothers of health, full-term infants 6 months after delivery. Data included factors affecting physical, mental, and emotional recovery; sources of help and hindrance; ideas of what each women would do differently after the delivery of another child; and overall evaluation of how the months after delivery compared with expectations. Content analysis of the data revealed that 25% of the women did not feel physically recovered from childbirth at 6 months postpartum. Husbands and other family members were major sources of help. Prolonged labor and cesarean delivery were the major hindrances to recovery. More household and child-care help was desired after delivery of another child. Almost half of the women found the first 6 months after delivery more difficult than anticipated. The findings suggest that pregnant women need more information about lifestyle adjustments after childbirth.

Adaptation, Psychological↗
PubMedDate not supplied

Responses to vaginal birth after cesarean section.

OBJECTIVES: To compare women's reactions to their experiences of vaginal birth after cesarean (VBAC) with their reactions to their previous cesarean birth experiences, to identify the factors that influenced the women's decision to attempt VBAC, and to describe the causes the women ascribed to the outcome of their birth experiences. DESIGN: An exploratory descriptive study derived from the Roy Adaptation Model of Nursing. SETTING: Hospital postpartum unit. PARTICIPANTS: Thirty-two women who had experienced a VBAC. MAIN OUTCOME MEASURES: The Perception of the Birth Scale and an investigator-developed questionnaire. RESULTS: The women reported moderately positive perceptions of the VBAC experience. However, the mean score was lower than previously reported means for vaginally delivered women. A statistically significant association (X2 = 22.70, p < 0.0005) was found between type of delivery and adaptive and ineffective responses within the Roy Adaptation Model modes, with a greater proportion of adaptive responses to the VBAC than the previous cesarean. Information from obstetricians, nurses, family members, and print media influenced women's decisions to attempt the vaginal birth. Most causes ascribed to the successful VBAC came from external sources, were particular to a given pregnancy, and were beyond the woman's control. CONCLUSIONS: The women reported both positive and negative aspects of childbearing, regardless of mode of delivery. The results indicate a need for a high quality of nursing and obstetric care for all women, with an emphasis on relief of pain and the provision of support and information.

Adaptation, Psychological↗
PubMedDate not supplied

Prepregnant weight and weight gain during pregnancy: relationship to functional status, symptoms, and energy.

OBJECTIVE: To examine the relationship of prepregnancy weight and pregnancy weight gain to functional status, physical symptoms, and physical energy. DESIGN: Longitudinal panel, with data collected at the end of each trimester. Functional status was measured by the Inventory of Functional Status-Antepartum Period; physical symptoms, by the Symptoms Checklist; and physical energy, by a one-item question. Self-reported weight and height were used to calculate body mass index (BMI), using the formula weight[kg]/height[m2]. SETTING: Women's homes. PARTICIPANTS: Two hundred twenty-two women, whose pregnancies were low-risk, drawn from a larger study. RESULTS: Women were classified by prepregnancy BMI as underweight (BMI < 19.8), normal weight (BMI = 19.8-26.0), or overweight (BMI > 26.0). The groups did not differ in weight gain by trimester, for an average total weight gain of 30.56 lb (SD = 10.18, range = 1-64) (p > .05), with overweight women therefore gaining less weight on a percentage basis (M = 16.87%) than women who were of normal weight (M = 23.58%) or were underweight (M = 26.02%) (p < .00005). The groups did not differ in functional status, physical energy, or number or type of physical symptoms. Women who gained more than the recommended amount of weight for their prepregnant weight group had a lower level of 3rd trimester functional status than those who did not. CONCLUSIONS: Individual counseling of women regarding food intake and excessive weight gain during pregnancy needs to be reconsidered in light of these findings.

Adult↗
PubMedDate not supplied

Three sides of the same coin: the analysis of paired data from dyads.

Three types of research questions are commonly asked about data from dyads: (1) What are the overall group differences between the two sets of measurements? (2) What is the association between paired data? and (3) What is the agreement between pairs? These three types of questions about the same dyad dataset lead to different analyses, and the answer to one question does not necessarily help in answering the other questions. The purpose of this article is to highlight the differences among these questions and their respective methods of data analysis. The intent is to stress the necessity for congruence between research questions and the analysis, rather than to present a review of all possible methods of analysis of paired data.

Bias↗
PubMedDate not supplied

The computer as a classroom participant in teaching statistics.

The versatility, speed, and portability of the personal computer make it a great partner in the classroom for teaching statistics. The computer display from the monitor can be shown as a clear image on a large screen by a projection panel. Commercially available software, easy-to-use and relatively inexpensive, enables an instructor to carry out many classroom demonstrations of basic statistical ideas. The graphics capabilities of the personal computer for plotting and animated effects capture students' interest and promote learning.

Biometry↗
PubMedDate not supplied

Changes in functional status after childbirth.

Changes in functional status after childbirth were examined over a 6-month postdelivery period in 97 women who had delivered healthy full-term infants. Functional status was defined as the woman's readiness to assume infant care responsibilities and resume her usual activities. Functional status was found to improve steadily from 3 weeks to 3 months postpartum, but no statistically significant changes were found between 3 and 6 months. However, by 6 months postpartum 6% of the women had not yet fully assumed the desired or required level of infant care responsibilities, nearly 20% had not yet fully resumed usual levels of household activities, 30% had not fully resumed usual levels of social and community activities, and more than 80% had not yet fully resumed usual self-care activities. Of the 57 women who had returned to work or school by 6 months postpartum, over 60% had not fully resumed their usual level of occupational activities. Canonical analysis revealed that different sets of health, psychosocial, family, and demographic variables were associated with functional status at each data collection point.

Activities of Daily Living↗
PubMedDate not supplied

Return of functional ability after childbirth.

Recovery of functional ability after childbirth was examined in a sample of 30 women who had vaginal deliveries and 40 who had cesarean births. Recovery of functional ability after childbirth was defined as the resumption of household, social and community, and occupational activities and assumption of infant care responsibilities. Only 51% of the women reported they had regained their usual level of energy by the end of the 6-week postpartum period; 72% of the vaginally delivered women reported regaining their physical energy within this period, but only 34% of the cesarean delivered women had done so. Differences were also noted between cesarean- and vaginally delivered women in the interval until assumption of infant care responsibilities and resumption of certain household tasks, socializing with friends, and participation in religious organizations. Recovery of functional ability was also found to be affected by maternal and neonatal complications, and their presence was associated with postponed return to employment. Findings suggest that the traditional 6-week recovery period from childbirth needs to be reconsidered, particularly for women experiencing cesarean deliveries or maternal or neonatal postdelivery complications.

Adult↗