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Biomedical subjects

Margaret Comerford Freda

Publications and source records attributed to Margaret Comerford Freda.

At least 19 recordsLinked to original sources
PubMed2006

A surgical skills laboratory improves residents' knowledge and performance of episiotomy repair.

OBJECTIVE: This study was undertaken to assess whether a surgical skills laboratory improves residents' knowledge and performance of episiotomy repair. STUDY DESIGN: Twenty-four first- and second-year residents were randomly assigned to either a surgical skills laboratory on episiotomy repair or traditional teaching alone. Pre- and posttests assessed basic knowledge. Blinded attending physicians assessed performance, evaluating residents on second-degree laceration/episiotomy repairs in the clinical setting with 3 validated tools: a task-specific checklist, global rating scale, and a pass-fail grade. RESULTS: Postgraduate year 1 (PGY-1) residents participating in the laboratory scored significantly better on all 3 surgical assessment tools: the checklist, the global score, and the pass/fail analysis. All the residents who had the teaching laboratory demonstrated significant improvements on knowledge and the skills checklist. PGY-2 residents did not benefit as much as PGY-1 residents. CONCLUSION: A surgical skills laboratory improved residents' knowledge and performance in the clinical setting. Improvement was greatest for PGY-1 residents.

Clinical Competence↗
PubMed2006

The history of preconception care: evolving guidelines and standards.

This article explores the history of the preconception movement in the United States and the current status of professional practice guidelines and standards. Professionals with varying backgrounds (nurses, nurse practitioners, family practice physicians, pediatricians, nurse midwives, obstetricians/gynecologists) are in a position to provide preconception health services; standards and guidelines for numerous professional organizations, therefore, are explored. The professional nursing organization with the most highly developed preconception health standards is the American Academy of Nurse Midwives (ACNM); for physicians, it is the American College of Obstetricians and Gynecologists (ACOG). These guidelines and standards are discussed in detail.

Family Practice↗
PubMed2005

Nurse editors' views on the peer review process.

A growing body of research challenges the inter-rater reliability of peer reviewers and the value of reviewer training or blinding in improving the quality of manuscript reviews, but double-blinded peer review of papers remains a relatively unexamined standard for nursing journals. Using data from a larger emailed survey, the views of 88 nurse editors on peer review were analyzed using content analysis. The majority of nurse editors reported that blinding was important in peer review, to maintain objectivity and avoid negative personal or professional consequences. The minority who saw potential benefits of open review valued increased transparency in the reviewing and editorial decision-making process. An excellent review was viewed as containing specific instructions on how the deficits in a manuscript might be remedied. Common weaknesses of reviews were lack of specificity and inappropriate focus. Virtually all editors provided some form of preparation or guidance to reviewers. Peer review has an impact on nurses' workload and careers, and training in writing and critique should be included in nursing education.

Attitude↗
PubMed2005

An international survey of nurse editors' roles and practices.

PURPOSE: To describe the editorial practices of nurse editors, including proprietary arrangements, manuscript processing systems, and editorial review, and to ascertain editors' opinions on effective editorial practices. DESIGN: A descriptive study in which an author-designed 108-question survey was distributed and collected by e-mail. Of 177 international nursing editors identified, 164 e-mail addresses could be located, and 137 nurse editors expressed willingness to participate. Ninety journals were represented in the final purposive convenience sample, including 71 published in the US and 19 outside the US. Data were analyzed using descriptive statistics, t test, chi square, and content analysis. FINDINGS: Of the 90 journals, 78 were characterized by their editors as scholarly journals. Fifty-two were official journals of associations. The nurse editors' average age was 53, with over 20 years of experience in nursing and 8 years as editor. Although practices and compensation at U.S. and international journals did not differ significantly, scholarly journals and "other" publications such as magazines and newsletters were managed differently. Blinded peer review was in place at 98% of journals. Editors generally used manuscript reviewers as advisors rather than as voters; only 30% of editors thought their ultimate decision must agree with the majority of reviewers. Nurse editors often needed 3-5 years to feel comfortable in the role. Editors of association journals often reported struggling with the issue of editorial independence versus association control. Editors believed their role was influential in maintaining scholarly excellence and evidence-based practice, but many noted the constant pressure of deadlines and dealing with poor writing from authors as challenges of the work. CONCLUSIONS: The role of nurse editor is not part of the formal preparation of nurse scholars or clinicians; standards for nurse editors are not readily apparent, and nurse editors often work in isolation, lacking professional support. This survey included data by which nurse authors and readers of nursing journals can understand how nurse editors work and make decisions about manuscripts, ultimately influencing knowledge dissemination in nursing journals. Nurse editors can use this information to compare their practices with that of others, and advocate for adequate preparation, compensation, and assistance with production.

Adaptation, Psychological↗
PubMed2005

Ethical issues faced by nursing editors.

This study reports on ethical issues faced by editors of nursing journals, a topic which has not appeared in the nursing literature. A survey of nursing editors (n = 88)was conducted via e-mail; this article is the content analysis of survey questions about ethics. Eight categories of ethical issues emerged: problems with society/association/publisher; decisions about inflammatory submissions; informed consent or IRB issues; conflicts of interest; advertising pressures; duplicate publications and/or plagiarism; difficult interactions with authors; and authorship. Some issues were similar to those published about medical editors; however, others were unique. This study can assist authors to better understand some of the ethical issues in publishing, can help editors to view their issues in the context of what others experience, and can assist societies and publishers to work toward avoiding these ethical issues in the future. Professional discussions about ethics in nursing publications should be the subject of ongoing research and scientific inquiry.

Adult↗
PubMed2003

Screening for postpartum depression in an inner-city population.

OBJECTIVE: This study was undertaken to determine the prevalence of positive screens for postpartum depression by using the Edinburgh Postnatal Depression Scale (EPDS) in an inner-city population. STUDY DESIGN: At their postpartum visits, women who were seen in two inner-city practices between February 20 and April 30, 2002, self-administered the EPDS. A threshold of 10 or more points was selected as a positive screen for postpartum depression. If the patient responded that she had thoughts of harming herself or others, she was referred immediately for social work or psychiatric evaluation. Otherwise, providers were blinded to the results of the screen. RESULTS: Of the 443 patients who were scheduled for postpartum visits during this time period, 285 (64%) patients presented for their postpartum visit. One hundred twenty-one (42%) of these patients participated in the study and 1 patient did not complete the questionnaire. Twenty-seven (22%) of the 121 patients had a positive screen for postpartum depression. Eight patients (6.6%) reported experiencing suicidal ideation within the previous week. Without use of the screening tool, providers identified 16 (13%) patients who they thought were at risk for postpartum depression. Of those 16 patients, 14 had positive screens on the EPDS. Eight patients eventually had clinical depression diagnosed. There was a significant relationship between women with elevated scores on the EPDS and a personal history of depression (P <.0006), history of prior treatment for depression (P <.0001), and feeling depressed during the pregnancy (P <.0001). Providers failed to comment on the patient's mood in 34 (28%) of the 121 patients. CONCLUSION: A larger than expected number of women had a positive screen for postpartum depression in our population. This unexpected finding suggests the need for more resources to be directed toward the research, identification, and treatment of postpartum depression in inner-city populations.

Adolescent↗
PubMed2002

Interdisciplinary development of a preconception health curriculum for four medical specialties.

A group of obstetricians and gynecologists, along with physicians from three other medical specialties, nurses, and midwives, developed a curriculum on preconception health care for women. This curriculum was specifically aimed at residents in obstetrics and gynecology, internal medicine, pediatrics, and family medicine. The curriculum was designed to convince these physicians that they needed to participate in promotion of preconception health for many reasons, such as the need to teach women to take folic acid daily because it significantly decreases the incidence of neural tube defects. Because over 50% of all pregnancies are unplanned, it is imperative that all physicians think of themselves as preconception health providers. Our group then taught the curriculum to medical students, residents, fellows, and attending physicians in all specialties at four hospitals affiliated with the medical college. Evaluation of the curriculum in 171 physicians who participated revealed that only a small percentage of physicians took folic acid daily themselves. Almost 36% of the obstetricians did not currently provide preconception care for their patients. Most physicians in all specialties believed that the curriculum provided them with useful information for their practice. The March of Dimes is currently distributing this curriculum on its Web site.

Curriculum↗
PubMedDate not supplied

Issues in patient education.

Nurses and nurse midwives have historically considered patient education one of their most important responsibilities. Increasingly, however, appropriate and comprehensive patient education has become more difficult to accomplish. There are many reasons for this, including the huge influx of clients of varying cultures into virtually all health care systems across the United States, the lack of time available for patient education in tightly scheduled managed care visits, the dearth of educational materials written at appropriate readability levels and/or in languages other than English, and the lack of reimbursement for time spent on patient education. In addition, many providers might not have specific training in the provision of patient education or in the development of appropriate health educational materials for the population they serve. This article discusses these issues, suggesting also that there are ethical dilemmas inherent in the provision of some aspects of patient education.

Cultural Diversity↗
PubMedDate not supplied

The readability of American Academy of Pediatrics patient education brochures.

INTRODUCTION: The purpose of this study was to evaluate the readability of American Academy of Pediatrics (AAP) patient education brochures. METHOD: Seventy-four brochures were analyzed using two readability formulas. RESULTS: Mean readability for all 74 brochures was grade 7.94 using the Flesch-Kincaid formula, and grade 10.1 with SMOG formula (P = .001). Using the SMOG formula, no brochures were of acceptably low (< or =8th grade) readability levels (range 8.3 to 12.7). Using the Flesch-Kincaid formula, 41 of the 74 had acceptable readability levels (< or =8th grade). The SMOG formula routinely assessed brochures 2 to 3 grade levels higher than did the Flesch-Kincaid formula. DISCUSSION: Some AAP patient education brochures have acceptably low levels of readability, but at least half are written at higher than acceptable readability levels for the general public. This study also demonstrated statistically significant variability between the two different readability formulas; had only the SMOG formula been used, all of the brochures would have had unacceptably high readability levels. Readability is an essential concept for patient education materials. Professional associations that develop and market patient education materials should test for readability and publish those readability levels on each piece of patient education so health care providers will know if the materials are appropriate for their patients.

Comprehension↗
PubMedDate not supplied

Do you love nursing?

Explore the source record for details and available documents.

Anecdotes as Topic↗
PubMedDate not supplied

What others are saying.

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Economic Competition↗
PubMedDate not supplied

The lived experience of miscarriage after infertility.

PURPOSE: To describe women's experiences of miscarriage after infertility treatments. Published studies in which fertile women were interviewed after miscarriage have found that the women universally look to another pregnancy as the solution to their grief. However, for women undergoing infertility treatments, the possibility of another pregnancy is not a certainty. Despite this, little is known about the unique experience of this group of women. Appropriate interventions based on evidence require research to discover these women's needs. DESIGN: Phenomenology. METHOD: Eight women who had experienced miscarriage after infertility were interviewed. Interviews were audiotaped and transcribed verbatim. Data saturation guided the sample size. Colaizzi's methods for phenomenologic analysis were used. Analyzed data were brought back to the women for fact checking and to ensure trustworthiness and reliability of the data. RESULTS: Themes included : going back to "square one," an inner struggle between hope and hopelessness for future fertility, running out of time, anger/frustration, lack of understanding by others, guilty feelings, feeling alone/numb with their grief, and gaining strength from adversity. CLINICAL IMPLICATIONS: This study provides a first glimpse of women who miscarry after infertility treatments, and demonstrates that they feel profoundly alone, and grieve intensely. They worry that they caused the miscarriage, and find it difficult to hope that they will ever become pregnant again. Several women described being hospitalized for their miscarriage on postpartum units. This was unbearable for them, and should remind all of us in healthcare that this type of unthinking treatment of women who miscarry after infertility is not acceptable.

Abortion, Spontaneous↗