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Biomedical subjects

P Slade

Publications and source records attributed to P Slade.

At least 19 recordsLinked to original sources
PubMed2005

Preoperative anxiety and postoperative satisfaction in women undergoing elective caesarean section.

BACKGROUND: The primary aim was to investigate whether preoperative anxiety in women undergoing elective caesarean section predicts postoperative maternal satisfaction with the process, perceptions of recovery, analgesic use or length of hospital stay. Other factors that might influence postoperative satisfaction were also explored. METHOD: In 85 women awaiting elective caesarean section, anxiety, social support and aspects of preparation were measured in the 24 hours preceding surgery. Maternal satisfaction and perceptions of recovery were assessed around the third postoperative day. Satisfaction with the preoperative information from the anaesthetist and postoperative pain relief were also measured at this time. Medical notes were used to gather information on analgesia use and length of hospital stay. RESULTS: Preoperative anxiety scores were comparable with those of general surgical/medical patients. Preoperative trait anxiety and state anxiety were inversely associated with postoperative maternal satisfaction. State anxiety was also inversely associated with better recovery. Preoperative anxiety was not associated with analgesic use or length of hospital stay. Linear regression analysis indicated the degree of satisfaction with information from the anaesthetist and perceived emotional support from the partner explained 52% of the variance in postoperative maternal satisfaction. CONCLUSION: Lower preoperative anxiety is associated with greater maternal satisfaction with elective caesarean section and better recovery. Information provided by anaesthetists and perceived emotional support are also of importance. It may be possible to identify women with high anxiety and facilitate satisfaction and recovery through providing additional supportive input.

Adult↗
PubMed2004

Abnormal eating attitudes and sexual abuse experiences in Turkish university women.

The aim of this study was to examine the direct and indirect relationship between abnormal eating attitudes and sexual abuse. The subject sample comprised 532 female Turkish undergraduate and nursing students in Istanbul. The Eating Attitudes Test (EAT), Sexual Abuse Questionnaire, the Setting Conditions for Anorexia Nervosa Scale, the Positive and Negative Perfectionism Scale and the Need for Control Scale (NCS) were the instruments of the study. The results showed that sexual abuse has a direct effect on EAT-Bulimia but not on EAT-Dieting. It also has some indirect effects on both of these through its effects on family functioning. Perfectionism, on the other hand, was independently linked with both EAT-Dieting and EAT-Bulimia but was not associated with sexual abuse.

Adolescent↗
PubMed2003

Individualised homeopathy as an adjunct in the treatment of childhood asthma: a randomised placebo controlled trial.

BACKGROUND: Homeopathy is frequently used to treat asthma in children. In the common classical form of homeopathy, prescriptions are individualised for each patient. There has been no rigorous investigation into this form of treatment for asthma. METHODS: In a randomised, double blind, placebo controlled trial the effects of individualised homeopathic remedies were compared with placebo medication in 96 children with mild to moderate asthma as an adjunct to conventional treatment. The main outcome measure was the active quality of living subscale of the Childhood Asthma Questionnaire administered at baseline and follow up at 12 months. Other outcome measures included other subscales of the same questionnaire, peak flow rates, use of medication, symptom scores, days off school, asthma events, global assessment of change, and adverse reactions. RESULTS: There were no clinically relevant or statistically significant changes in the active quality of life score. Other subscales, notably those measuring severity, indicated relative improvements but the sizes of the effects were small. There were no differences between the groups for other measures. CONCLUSIONS: This study provides no evidence that adjunctive homeopathic remedies, as prescribed by experienced homeopathic practitioners, are superior to placebo in improving the quality of life of children with mild to moderate asthma in addition to conventional treatment in primary care.

Administration, Inhalation↗
PubMed2003

Obstetric complications and anxiety during pregnancy: is there a relationship?

This review examines the contribution of recent research into the effects of anxiety during pregnancy. The focus of interest is upon the process of labor and delivery rather than its timing or the size of the baby. Therefore studies directed at areas of prematurity or low birthweight are specifically excluded as these have already been well evaluated in the literature. It is known that one proximal cause of obstetric complications is increased hormone levels in the uterus. It seems likely therefore that anxiety, a form of arousal, known to influence hormone levels, may be implicated as a distal determinant of obstetric complications. Attempts to evaluate this hypothesis have been hampered by methodological issues such as: poor definition and measurement of obstetric outcomes, in particular utilizing composite measures of diverse components; inappropriate measurements or over broad conceptualizations of anxiety; failure to account for confounding variables and inadequate sample sizes. On balance the evidence reviewed suggests that a general association between anxiety and obstetric complications per se does not exist, but specific types of anxiety, such as psychosocial stress, family functioning, or fear of childbirth may have associations with specific complications, such as prolonged labor or Cesarean section. Recent studies considering the effect of fear of childbirth, for example, on specific obstetric outcomes, such as type of delivery, have produced more clear-cut relationships. Recommendations for future research into the relationships between specific combinations of types of anxiety and individual obstetric complications are discussed.

Anxiety↗
PubMed2002

Assessing the assessment measures for menstrual cycle symptoms: a guide for researchers and clinicians.

A review of measures of menstrual cycle symptoms is provided. This will enable researchers and clinicians to make the appropriate choice of method for their study requirements. In recent years, these measures have taken the form of retrospective questionnaires (rating severity of symptoms from memory) and prospective diaries (daily checklists of symptoms). Many of these draw on aspects of the well-known retrospective questionnaires, the Menstrual Distress Questionnaire and Premenstrual Assessment Form, in their development and validation. Each measure will be briefly described, followed by comments on its development, psychometric properties and finally an evaluation of its strengths and weaknesses. It concludes with an examination of the implications arising from the review, and some recommendations that menstrual cycle researchers and clinicians may wish to consider, as they decide upon the most appropriate measure for their needs.

Female↗
PubMed2001

Termination of pregnancy: patients' perceptions of care.

BACKGROUND: Little is known about women's perceptions of care in termination of pregnancy (TOP). Developing an understanding of how care is experienced is crucial to improvements in services. METHOD: Two hundred and eight women undergoing either a medical or surgical TOP reported on their perspectives of the experience and the care received. A mix of questionnaire and open questions analysed by content analysis was used. Women reported on the aspects which were most stressful, helped them to feel more relaxed, were unexpected in some way, and also on the provision of information and on the quality of staff care. RESULTS: The most stressful aspects for the medical group related to the physical and emotional aspects of the process, whilst for the surgical group it concerned waiting in hospital for the operation. Whilst little was unexpected for the surgical group, many aspects came as a surprise to the medical group. Seeing the foetus was particularly difficult. All information provided was viewed as helpful, with greater information required about the phase following termination. Care from staff was rated positively, although areas for improvement in terms of opportunity to ask questions and ensuring concerns were dealt with were identified. Caring and non-judgemental staff attitudes were viewed as particularly important in helping women to feel as relaxed as possible in a potentially stressful situation. CONCLUSION: Surgical termination schedules should avoid a long waiting time once the woman has been admitted. More adequate preparation is required for those having medical termination so that they have realistic expectations of what will happen, including the possibility of seeing the foetus. More attention to information about the time following termination, including possible emotional responses, is needed. The importance of positive staff attitudes in the quality of care is emphasised.

Abortion, Legal↗
PubMed2000

Development of a questionnaire (OPQ) to assess patient's knowledge about osteoporosis.

OBJECTIVE: to develop a self-administered questionnaire (OPQ) to assess the patient's knowledge about osteoporosis. METHODS: An initial item pool of 71 questions was developed with input from clinicians involved in the management of patients with osteoporosis. It was piloted in ten patients for face validity and comprehension. The questionnaire was then administered to 50 first-time attendees at a specialist osteoporosis unit. After item analysis using index of difficulty and index of discrimination, 20 items were selected for the final questionnaire (OPQ). These were in the areas of general information (5), risk factors (7), consequences and treatment (four each). RESULTS: the average index of difficulty and index of discrimination (D) of the 20 items was 0.56 (>0.75 is suggestive of a poor discriminator) and 54.8% (D value of 50% is associated with highest level of item discrimination) respectively. This means that all the items actively discriminated between high and low scorers. The Flesch readability index was 74.3 (a score between 70 and 100 means a document is easily understood) and the reliability coefficient was 0.84 (acceptable range 0.8-0.9). Criterion validity (verification that the scale measures what it claims to measure) was confirmed by the method of contrasted groups where members of an osteoporosis awareness charity had a significantly higher score than the first time attendees (13.6 +/- 4.3 vs. 8.5 +/- 5.4; P=0.003). CONCLUSIONS: we have developed a self-report, 20-item questionnaire (OPQ) to assess the patient's knowledge about osteoporosis. Psychometric analysis has shown that the items have a satisfactory index of difficulty and discrimination. The OPQ is internally reliable, valid and easily understandable. It can be used to identify individuals in need of educational interventions as well as assess the effectiveness of education efforts as a part of management of osteoporosis.

Female↗
PubMed2000

Factor structure of the Eating Attitudes Test (EAT) in a Turkish university sample.

OBJECTIVE: The primary purpose of this study was to compare the factor structure of the Eating Attitudes Test (EAT) in a sample of Turkish university students with both that of the original Canadian study and that of a Turkish study conducted ten years earlier. METHOD: The EAT 40 was administered to a sample of 270 female undergraduates at the Bogazici and Marmara universities in Istanbul, Turkey. RESULTS: The factor structure produced more closely resembled the original than did that of the study conducted ten years ago. Of particular note was the presence of a bulimia factor which had not emerged in the previous Turkish study, together with a new factor labelled "Ambivalence about Eating". DISCUSSION: Comparison of the two Turkish studies highlights the emergence of a bulimia factor not present ten years ago. This reflects clinical experience. Moreover the new Ambivalence about Eating factor is discussed in terms of the transitional nature of Turkish society and the role of a culture clash between traditional and westernized attitudes towards food. It is therefore predicted that the prevalence of eating disorders in Turkish culture will dramatically increase in the foreseeable future.

Adult↗
PubMed2000

Fathers' coping style, antenatal preparation, and experiences of labor and the postpartum.

BACKGROUND: In recent years the trend for fathers in Western postindustrial countries to attend childbirth has increased. This study examined the interaction between fathers' information-seeking coping predispositions and their level of attendance at antenatal classes with respect to their experiences of attending childbirth. Associations between fathers' childbirth experiences, their relationship with their baby, and level of depressive symptomatology at 6 weeks postpartum were also examined. METHODS: A quantitative methodology was employed in which 78 fathers completed several questionnaires, some within 6 days of childbirth and others at 6 weeks postpartum. RESULTS: Fathers who were characterized as high blunters (avoiders) of threat information, from antenatal classes reported that experiencing childbirth was less fulfilling than fathers with similar coping styles who did not attend classes. Fathers' reports of fulfillment and delight while attending childbirth were negatively related to their level of depressive symptomatology at 6 weeks postpartum. Levels of distress were associated with subsequent depressive symptoms, but their effect was removed when preexisting depressive symptoms were partialled out. Fathers whose children were born by cesarean delivery used significantly more negative adjectives to describe their baby at 6 weeks postpartum compared with those born by vaginal delivery. More married fathers attended antenatal classes and reported lower levels of depressive symptomatology than unmarried fathers. CONCLUSIONS: Although fathers' attendance at antenatal classes may have positive consequences for them and their partner, for some fathers, attendance at classes may be associated with less positive reports of experiencing childbirth. The way in which men experience childbirth may have some influence on their subsequent emotional well-being.

Adaptation, Psychological↗
PubMed2000

Prevalence and predictors of post-traumatic stress symptoms following childbirth.

OBJECTIVES: To identify the prevalence and potential predictors of post-traumatic stress type symptoms following labour. DESIGN: A large sample, within-participants design with initial assessment and postal follow-up was utilized. METHOD: Two hundred and sixty-four women who had 'normal' births were assessed within 72 hours on potential predictive measures and at 6 weeks post-partum for levels of symptoms of intrusions, avoidance and hyperarousal on a questionnaire derived from DSM-IV (American Psychiatric Association, 1994) criteria. Symptoms of depression and anxiety were also assessed. RESULTS: Three per cent showed questionnaire responses suggesting clinically significant levels on all three post-traumatic stress dimensions and a further 24% on at least one of these dimensions. Forward stepwise regression analysis yielded models for predicting outcome variables. Perceptions of low levels of support from partner and staff, patterns of blame and low perceived control in labour were found to be particularly related to experience of post-traumatic stress symptoms. Personal vulnerability factors such as previous mental health difficulties and trait anxiety were also related to such symptoms as well as being relevant predictors for anxiety and depression. CONCLUSIONS: A proportion of women reports all three aspects of post-traumatic stress type symptoms following childbirth with many more reporting some components. A broader conceptualization of post-partum distress which takes account of the impact of labour is required. There may be opportunities for prevention through providing care in labour that enhances perceptions of control and support.

Adolescent↗
PubMed2000

The Eating Attitudes Test (EAT) in Turkish university students: relationship with sociodemographic, social and individual variables.

OBJECTIVE: The primary purpose of this study was to establish the frequency of abnormal eating attitudes and behaviours, as measured by the Eating Attitude Test (EAT 40) in a sample of Turkish university students and to examine the relationship of such abnormalities to socio economic status, social and individual variables. METHOD: The EAT 40, two other questionnaires and a personal data sheet were administered to a sample of 253 female undergraduates at Bogazici and Marmara Universities in Istanbul, Turkey. RESULTS: Using the EAT 40 cut-off score of 30 established by (16) 7.9% of subjects were classified as having abnormal eating attitudes and behaviours. This subgroup of subjects was then compared with the remainder on all the other measures. No group differences were found for any of the SES variables. However, both social and individual variables were found to distinguish between groups in the predicted directions. DISCUSSION: Abnormal eating attitudes and behaviours are now as common in Turkish students as they are in many other comparable western and, increasingly, non-western societies. In the current student sample these attitudes and behaviours were found to be related to social factors such as the perceived traditionality of parents as well as to individual risk factors such as negative perfectionism.

Adolescent↗
PubMed1999

Birdsong

Explore the source record for details and available documents.

Journal Article↗
PubMed1999

Strategies for coping with labour: does antenatal education translate into practice?

There is little evidence to associate attendance at antenatal classes with a reduction in psychological distress or increased satisfaction with the experience of labour. There may be several reasons for this, including failure to implement coping strategies. A within-subjects research design explored the use in labour of coping strategies taught in antenatal classes and the role of practice. Women's views about using these strategies and their expectations of their midwives and birth companions were also identified. Following Ethics Committee approval and providing informed consent, 121 nulliparous women completed a questionnaire at their final antenatal class. This included questions on confidence and the amount of effort required to use coping strategies, the involvement hoped for from birth companions and midwives in using coping strategies in labour and satisfaction with the amount of practice of coping strategies. Within 72 hours of delivery, women were interviewed to obtain a narrative of the events of labour and their use of the coping strategies (sighing-out-slowly breathing, Laura Mitchell relaxation and postural change). A questionnaire obtained information on the involvement of the midwife and birth companion. Women used the three coping strategies to different extents. Midwives were not involved to the extent that women had hoped for antenatally. Birth companions achieved a level of involvement closer to women's hopes than that achieved by midwives. A significant proportion of women expressed dissatisfaction with the amount of practice of coping strategies during antenatal classes. The findings of this study of a group of well-prepared women raise questions about the correct components of antenatal classes and how midwives and birth companions can be involved optimally in this aspect of a woman's labour. Further research is required to determine how women can best be helped to cope with the experience of labour.

Adaptation, Psychological↗
PubMed1999

A longitudinal comparison of the psychological impact on mothers of neonatal and 3 month repair of cleft lip.

PURPOSE: This study investigates whether the timing after birth of babies' cleft repairs influences the psychological status of mothers. METHODS: Mothers of infants born with a cleft lip completed psychological assessments and semistructured interviews at four time points: 2-3 weeks, 3 months and 6 months following the birth. In addition, a preoperative assessment and interview was completed within the first week of birth for those with infants undergoing neonatal repair and within the week before surgery for the 3 month repair group. RESULTS: There were no significant differences between mothers of infants with early (neonatal) and late (3 month) repairs on the emotional measures at any time point or preoperatively. Means of measures for anxiety and depressive symptoms and the Impact of Event Scale were within the normal range. Measures of interaction with the infant, perceived infant difficulty, bonding and parental competence failed to show any impact of timing of operation. Women's emotional status improved significantly over the 6 month period regardless of operation timing. Qualitative analysis of interview data indicated most mothers preferred their infant to receive neonatal repair. CONCLUSIONS: There was no evidence to support the idea that repair neonatally or at 3 months led to differential levels of anxiety or depressive symptoms or differences in attachment to the infant. Nevertheless mothers expressed a preference for and greater satisfaction with neonatal repair. In the absence of definitive evidence of differences in physical outcome, parental preferences should routinely be considered in deciding the timing of this procedure.

Age Factors↗
PubMed1999

Appraisal and coping in adults with cleft lip: associations with well-being and social anxiety.

The appraisal patterns and coping strategies of adults born with a cleft lip or cleft lip and palate were assessed in relation to measures of psychological well-being and social anxiety. A sample of 51 adults was recruited via the Cleft Lip and Palate Association. Data were collated using a questionnaire incorporating open questions and standardized measures. The focus was upon appraisal of the cleft, perceptions of consequences--both positive and negative--on personal and social dimensions, together with measurements of sense of coherence, psychological well-being, satisfaction with life and coping responses utilized in stressful situations. There was wide variability in the participants' reports of negative affect as a component of psychological well-being, suggesting that there may be small numbers of individuals with quite extreme responses. Seventy-five per cent reported difficulties which they attributed to their cleft. Perceiving positive gains as a result of the cleft and having a positive appraisal of facial appearance was associated with well-being. Patterns in coping strategies were also associated with emotional adjustment. Personal appraisals of both having a cleft and facial appearance may be more important in determining emotional well-being than the current medical emphasis on the aesthetics of surgical outcomes.

Adaptation, Psychological↗
PubMed1998

A comparison of medical and surgical termination of pregnancy: choice, emotional impact and satisfaction with care.

OBJECTIVE: To investigate whether women having medical or surgical terminations of pregnancy differ in their emotional distress before or after the procedure. To evaluate whether choice of procedure occurs, the factors influencing type of procedure and the effect of choice on emotional responses and satisfaction with care. DESIGN: A prospective comparative study. SETTING: A termination of pregnancy unit in a University Teaching Hospital. PARTICIPANTS: Two hundred and seventy-five women attending for medical or surgical first trimester termination of pregnancy. METHODS: Interviews concerning choice and measures of emotional status were completed prior to terminations. Four weeks after termination emotional functioning was reassessed together with satisfaction with care. RESULTS: Women having a surgical termination waited longer for the procedure and were at more advanced gestation than those having the medical termination. There were no differences in emotional responses related to type of procedure or gestation. One-quarter remained highly anxious at four weeks. Medical and surgical groups did not differ in emotional status prior to termination. Those having the medical procedure rated it as marginally more stressful and experienced more post-termination physical problems and disruption to life. Seeing the fetus was associated with more intrusive events (nightmares, flashbacks, unwanted thoughts related to the experience). One-quarter of the medical and 67% of the surgical group reported having no choice in type of procedure. Only 53% of the medical group would choose the same procedure again compared with 77% of the surgical group. CONCLUSIONS: Termination method did not influence emotional adjustment. Many women were not offered genuine choice of procedure. Having choice was considered very important but was unrelated to emotional distress or satisfaction with care.

Abortifacient Agents↗