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Biomedical subjects

S Chandler

Publications and source records attributed to S Chandler.

48 records · Page 3Linked to original sources
PubMedDate not supplied

Becoming a father. First-time fathers' experience of labor and delivery.

In this study, ethnographic interviews were used to identify first-time fathers' experiences of the birth of their first child. Fourteen fathers were interviewed, and prenatal expectations of the experience are compared with the fathers' perceptions after the birth. Although the fathers expected to be treated as part of a laboring couple, they found that they were relegated to a supporting role. Initially the fathers were confident of their ability to support their wives, but they found that labor was more work than they had anticipated. They became fearful of the outcome, but hid these fears from their partners. Later, they found that their focus moved from their wives to their babies at the time of birth. The men all completed the experience with an enhanced respect for their wives. Fathers should be included in labor management plans and need support for their role as coach, particularly when their wives experience pain. They also need to be encouraged to eat and take a break from their wives' labor when appropriate.

Adult↗
PubMedDate not supplied

Nebulized opioids to treat dyspnea.

Breathlessness secondary to cancer and nonmalignant disease is very distressing and exhausting to patients and families. Patient quality of life and functionality can be greatly improved with effective management. The pathophysiology and treatment of dyspnea are where the science of pain management was 20 years ago. While the optimal therapy for dyspnea would be to treat the underlying cause, this is frequently not possible. Research results evaluating dosages and effectiveness of nebulized morphine are conflicting. Some researchers have reported dramatic benefit to patients in relieving the symptoms of dyspnea, increasing exercise endurance, and improving function. Other studies have reported no significant differences between nebulized morphine and saline with or without oxygen. Studies that administer single predetermined doses that are not titrated to relief in patients that do not have end-stage lung or cardiac disease may report false-negative results. Other factors such as the placebo effect of saline and oxygen, if not controlled, may cause false-positive results. The dramatic positive benefits documented warrant further investigation on the appropriate patient selection criteria and therapeutic potential. Clearly, large scale randomized trials on opioid nebulized treatments for patients with severe dyspnea need to be published to reach a clear consensus outlining efficacy and administration parameters. Until that time, we must rely on anecdotal reports for treatment options. Such reports of the effectiveness of nebulized morphine as an alternative to hospital or hospice admission are encouraging for patients and family members managing severe dyspnea in the home.

Administration, Inhalation↗