scholarly journals A study of male friendly approach in obstetrics and gynaecology outpatient department

2017 ◽  
Vol 6 (3) ◽  
pp. 1113 ◽  
Author(s):  
Jalpa K. Bhatt ◽  
Malini R. Desai
Keyword(s):  
Decision Making ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Outpatient Department ◽  
Obstetrics And Gynecology ◽  
Reproductive Disorders ◽  
Obstetrics And Gynaecology ◽  
Paramedical Staff ◽  
Female Relative ◽  
Novel Concept

Background: Involvement of male relative in management of female reproductive disorders is low in many countries including India. Active participation of male relatives by establishing male friendly approach in Obstetrics and Gynecology (OBGY) outpatient department is a novel concept. This study explores the perceptions of male relatives accompanying the patients regarding male friendly approach which constitutes attitude of medical and paramedical staff towards them, involvement of male relatives in counseling and their role in decision making in obstetrics and gynecology outpatient department.Methods: This prospective study was carried out over three months in Obstetrics-Gynecology outpatient department of a tertiary care teaching hospital. Male relatives accompanying the patient were enrolled in the study. The participants were allowed to remain present at the time of history taking and post examination counseling. They were also asked to be part of the decision making whenever required. Feedback from the male relatives was obtained using a questionnaire.Results: Out of 450 patients attending the OBGY Outpatient Department (OPD) during the three months study period 100 were accompanied by male relatives. Participation in decision making was the commonest reason for accompanying the patient (36%). All the male relatives involved in this study were satisfied with the approach of doctor and paramedical staff and 85% were willing to accompany their female relative at every visit.Conclusions: Making health services for women more male friendly would increase participation of male relative in healthcare of female reproductive disorders. This can improve women’s health and eventually reduce maternal and neonatal morbidity and mortality.

Study of incidence of premature ovarian failure in patient attending outpatient department for infertility in a tertiary care centre

2019 ◽  
Vol 8 (10) ◽  
pp. 3926
Author(s):  
Qazi Jaweria Amber ◽  
Tushar Tatyaba Palve
Keyword(s):  
Premature Ovarian Failure ◽  
Wide Spectrum ◽  
Tertiary Care ◽  
Ovarian Failure ◽  
Outpatient Department ◽  
Obstetrics And Gynecology ◽  
Premature Menopause ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Presenting Symptoms

Background: To assess the incidence of premature ovarian failure in cases attending infertility outpatient Department of Obstetrics and Gynecology in a tertiary care centre. A total of 350 patients attending infertility opd were screened over period of 150 days from which authors observed premature menopause in 10 cases accounting for an incidence of 2.8%. POF affects approximately one in 10,000 women by age 20; one in 1,000 women by age 30; one in 100 women by age 40.  Premature ovarian failure is a common cause of infertility in women.Methods: Patient attending outpatient Department of Obstetrics and Gynecology with age less than 40 years and infertility, symptoms of menopause were enrolled for the study for duration of 150 days.Results: Present study authors found a total of 2.8% of patient presenting in our outpatient department for infertility had Premature ovarian failure.80% of them were symptomatic suffering with symptoms of hormonal deficiencies .100% of patient with infertility diagnosed as premature ovarian failure had low AMH and High FSH and LH levels indicating poor prognosis.Conclusions: Patient presenting with infertility and amenorrhoea can be cases of premature menopause. Here it is essential to investigate and treat the patient. Infertility might be one of the early presenting symptoms if not the first one. These patients if treated and diagnosed early can have a better living. Considering the wide spectrum of functional derangements in patient with early menopause and benefits of early hormone replacements these patients should be diagnosed and treated early.

Ultrasound in Africa: what can really be done?

2016 ◽  
Vol 44 (2) ◽  
Author(s):  
Labaran Dayyabu Aliyu ◽  
Asim Kurjak ◽  
Tuangsit Wataganara ◽  
Renato Augusto Moreira de Sá ◽  
Ritsuko Pooh ◽  
...  
Keyword(s):  
Health Care ◽  
Critical Role ◽  
Neonatal Morbidity ◽  
Obstetrics And Gynecology ◽  
Care Provision ◽  
Quality Health Care ◽  
Obstetrics And Gynaecology ◽  
The World ◽  
Quality Health ◽  
Heath Care

AbstractToday we are living in a globalized world in which information on what is happening in one part of the world is easily communicated to other parts of the world. This happens thanks to advancement in science and technology. One area where technology has made the greatest impact is heath care provision. Ultrasound technology is now playing a critical role in health care provision particularly in Obstetrics and Gynaecology. This has significantly assisted in provision of quality health care to pregnant women and their unborn infants and in reducing maternal and neonatal morbidity and mortality in the developed world. Africa the continent with greatest health care challenges and with the highest maternal and neonatal mortalities is yet to fully utilize this important technology. The need for this technology is great as the conditions requiring its application abound. The effective application of Ultrasound however faces serious challenges in Africa. To successfully entrench Ultrasound in quality Obstetrics and Gynaecology care various approaches must be adopted to overcome the challenges. The aim of this paper is to identify the benefits and the challenges inimical to the application Ultrasound in Obstetrics and Gynecology in Africa. It also examines what needs to be done to achieve better application of Ultrasound in Obstetrics and Gynecology.

scholarly journals Occupational Stress among Medical and Paramedical Staff in Tertiary Care Hospitals Based on Observational Study

2021 ◽  
Vol 10 (4) ◽  
pp. 231-241
Author(s):  
Muhammad-Maaz Arif ◽  
Abdul Qadir ◽  
Sajid Rashid Ahmad ◽  
Mujtaba Baqir ◽  
Muhammad Irfan
Keyword(s):  
Decision Making ◽  
Occupational Stress ◽  
Tertiary Care ◽  
Public Hospitals ◽  
Primary Data ◽  
Care Hospital ◽  
Duty Hours ◽  
Hospital Employees ◽  
Paramedical Staff ◽  
Tertiary Care Hospitals

Background: Occupational stress is a common concern among employees, particularly those working in tertiary care hospitals. In Pakistan, both medical and paramedical staffs face many stressors because of their high job demand, dealing with multiple patients, excessive duty hours, and strict rules and regulations. The objective of the study was to measure occupational stress among the tertiary care hospital employees of the Lahore District using different demographic and workplace determinants. Methods: It was a cross-sectional study. A total of 138 hospital employees recorded their responses, which included 71 medical staff/doctors and 67 paramedical staff members. Primary data was obtained through a detailed structured questionnaire based on the Likert scale with the stress level index ranging from 1-5. Results: In terms of the six staff designations, stress index from top to bottom was observed in house officers/ internees (3.47), medical officers/ postgraduate trainees (3.04), technicians (2.74), consultants/ specialists (2.73), emergency/ ward assistants (2.61) and nurses (2.46). Among all the employees, the most significant factors leading to stress bottom-down were justice/ fairness (3.30), tasks and roles (3.14), management (3.03), environment/ working conditions (3.01), decision-making autonomy (2.84), work schedule (2.62) and profession/ job entitlement (1.63). Analysis of demographic characteristics showed that males (2.99) faced greater stress than females (2.64) and people of young age group (? 30 years) showed the highest stress value (3.01) than other age groups. It was observed that moderately experienced (5-10 years) employees were more prone to occupational stress (3.03) than other groups. Furthermore, the employees of public hospitals (3.13) bear more stress than those of private hospitals (2.67). On the basis of locality, the locals showed slightly higher stress values (2.89) as compared to non-locals (2.77). Conclusion: The current study showed that occupational stress is a prevalent problem in hospitals, particularly among house officers and postgraduate residents. Several useful steps can be undertaken to improve the health and safety of hospital employees like alleviating duty hours, working in shifts, focusing on a single task, and motivating the employees in decision-making.

scholarly journals A retrospective study of urological injuries during obstetrics and gynecological procedures

2020 ◽  
Vol 9 (7) ◽  
pp. 2746
Author(s):  
Sunil Kumar Samal ◽  
Setu Rathod ◽  
Kalaivani Thangavel
Keyword(s):  
Clinical Presentation ◽  
Tertiary Care ◽  
Bladder Injury ◽  
Obstetrics And Gynecology ◽  
Management Option ◽  
Ureteric Injury ◽  
Obstetrics And Gynaecology ◽  
Bladder Injuries ◽  
High Degree ◽  
Urological Injuries

Background: Urological injury in obstetrics and gynaecology are not uncommon because there is a close anatomical association between reproductive and urological system. The objective of this study was to find out the incidence and types of urological injuries in obstetric and gynaecological procedures, clinical presentation and various management option in a tertiary care hospital.Methods: The study was a retrospective analysis of all obstetric and gynecological surgeries over a period of 6 years from January 2014 to December 2019. Cases with the documented urological injuries during these procedures were analyzed further.Results: Total 8595 patients had undergone different obstetrics and gynecology procedures, out of which 5429 were obstetrics and 3166 were gynecology surgeries.  Out of 3166 of gynecology procedures, there were 16 cases (0.5%) of bladder injuries and one case (0.03%) of ureteric injury. Out of 5429 cases of obstetric procedures there were 11 (0.2%) cases of bladder injury and one case (0.01%) of ureteric injury.Conclusions: The incidence urological injuries during obstetrics and gynecological procedures are rare but the morbidity associated these are significant. Therefor surgeons should be more cautious and high degree of suspicion can help in early diagnosis and avoid the sequel.

Quantifying the Risks and Benefits of Continuing Labor Induction: Data for Shared Decision-Making

2020 ◽  
Author(s):  
Elizabeth Nicole Teal ◽  
Adam K. Lewkowitz ◽  
Sarah L. P. Koser ◽  
Carol B. N. Tran ◽  
Stephanie L. Gaw
Keyword(s):  
Decision Making ◽  
Cesarean Delivery ◽  
Shared Decision Making ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Neonatal Morbidity ◽  
Labor Induction ◽  
Shared Decision ◽  
Risks And Benefits

Abstract Objective To quantify the relative maternal and fetal risks and benefits of continuing labor induction. Study Design This retrospective cohort study included nulliparous women with nonanomalous, singleton, vertex, term pregnancies undergoing labor induction with intact membranes at a tertiary-care academic hospital from January 2015 to April 2017. The primary outcome was mode of delivery. Secondary outcomes included hemorrhage, transfusion, infection, and composite neonatal morbidity. The data were analyzed using chi-square and Fisher's exact tests. Multivariable regression was used to control for potential confounders. Results A total of 955 patients met the inclusion criteria. The median induction duration was 32.3 hours (interquartile range: 20.4–41 hours) and the vaginal delivery rate was 70.5% (n = 673). The chance of vaginal delivery at 12, 24, 36, 48, 60, and ≥60 hours was 76, 83, 77, 74, 72, and 48%, respectively. After controlling for confounders, there was a 20% decrease in chance of vaginal delivery with induction ≥ 24 hours compared with induction < 24 hours. The adjusted relative risks of hemorrhage, transfusion, and infection with induction ≥ 24 hours compared with induction < 24 hours were 1.9, 2.2, and 2.7, respectively (95% confidence interval [CI] of 1.4–2.5, 1.1–3.9, and 1.8–4.0, respectively). The relative risk for these outcomes remained stable or decreased at each subsequent time point. The increasing risks of hemorrhage and infection were primarily among patients who underwent cesarean delivery. There was no association between induction duration and neonatal morbidity. Conclusion In this cohort, the chance of vaginal delivery remained nearly 50% even when induction extended beyond 60 hours. Risks of hemorrhage and maternal infection rose modestly over time, but primarily in patients who underwent cesarean delivery. There was no difference in the risk of transfusion beyond 24 hours and no association between induction duration and neonatal morbidity. These findings may be useful when engaging patients in shared decision-making during labor induction.

Decision making based on intuitionistic fuzzy preference relations with additive approximate consistency

2020 ◽  
Vol 39 (3) ◽  
pp. 4041-4058
Author(s):  
Fang Liu ◽  
Xu Tan ◽  
Hui Yang ◽  
Hui Zhao
Keyword(s):  
Decision Making ◽  
Decision Makers ◽  
Real Interval ◽  
Preference Relations ◽  
Intuitionistic Fuzzy ◽  
Proposed Model ◽  
Fuzzy Preference Relations ◽  
Novel Concept ◽  
Fuzzy Weights ◽  
Fuzzy Preference

Intuitionistic fuzzy preference relations (IFPRs) have the natural ability to reflect the positive, the negative and the non-determinative judgements of decision makers. A decision making model is proposed by considering the inherent property of IFPRs in this study, where the main novelty comes with the introduction of the concept of additive approximate consistency. First, the consistency definitions of IFPRs are reviewed and the underlying ideas are analyzed. Second, by considering the allocation of the non-determinacy degree of decision makers’ opinions, the novel concept of approximate consistency for IFPRs is proposed. Then the additive approximate consistency of IFPRs is defined and the properties are studied. Third, the priorities of alternatives are derived from IFPRs with additive approximate consistency by considering the effects of the permutations of alternatives and the allocation of the non-determinacy degree. The rankings of alternatives based on real, interval and intuitionistic fuzzy weights are investigated, respectively. Finally, some comparisons are reported by carrying out numerical examples to show the novelty and advantage of the proposed model. It is found that the proposed model can offer various decision schemes due to the allocation of the non-determinacy degree of IFPRs.

scholarly journals Perceptions of partial gland ablation for prostate cancer among men on active surveillance: a qualitative study

2021 ◽  
Vol 3 (1) ◽  
pp. e000068
Author(s):  
Sonia Hur ◽  
Michael Tzeng ◽  
Eliza Cricco-Lizza ◽  
Spyridon Basourakos ◽  
Miko Yu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Qualitative Study ◽  
Active Surveillance ◽  
Treatment Modality ◽  
Tertiary Care ◽  
Low Risk ◽  
Intermediate Risk ◽  
Perceptions And Attitudes ◽  
Partial Gland Ablation

ObjectivesPartial gland ablation (PGA) therapy is an emerging treatment modality that targets specific areas of biopsy-proven prostate cancer (PCa) to minimize treatment-related morbidity by sparing benign prostate. This qualitative study aims to explore and characterize perceptions and attitudes toward PGA in men with very-low-risk, low-risk, and favorable intermediate-risk PCa on active surveillance (AS).Design92 men diagnosed with very-low-risk, low-risk, and favorable intermediate-risk PCa on AS were invited to participate in semistructured telephone interviews on PGA.SettingSingle tertiary care center located in New York City.Participants20 men with very-low-risk, low-risk, and favorable intermediate-risk PCa on AS participated in the interviews.Main outcome measuresEmerging themes on perceptions and attitudes toward PGA were developed from transcripts inductively coded and analyzed under standardized methodology.ResultsFour themes were derived from 20 interviews that represent the primary considerations in treatment decision-making: (1) the feeling of psychological safety associated with low-risk disease; (2) preference for minimally invasive treatments; (3) the central role of the physician; (4) and the pursuit of treatment options that align with disease severity. Eleven men (55%) expressed interest in pursuing PGA only if their cancer were to progress, while nine men (45%) expressed interest at the current moment.ConclusionsAlthough an emerging treatment modality, patients were broadly accepting of PGA for PCa, with men primarily debating the risks versus benefits of proactively treating low-risk disease. Additional research on men’s preferences and attitudes toward PGA will further guide counseling and shared decision-making for PGA.

scholarly journals Improving Communications With Patients and Families in Geriatric Care. The How, When, and What

2021 ◽  
Vol 8 ◽  
pp. 237437352110340
Author(s):  
Shirley Chien-Chieh Huang ◽  
Alden Morgan ◽  
Vanessa Peck ◽  
Lara Khoury
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Family Caregivers ◽  
Health Care Providers ◽  
Tertiary Care ◽  
Care Providers ◽  
Telephone Interviews ◽  
Written Information ◽  
Geriatric Unit ◽  
Patient Health

There has been little published literature examining the unique communication challenges older adults pose for health care providers. Using an explanatory mixed-methods design, this study explored patients’ and their family/caregivers’ experiences communicating with health care providers on a Canadian tertiary care, inpatient Geriatric unit between March and September 2018. In part 1, the modified patient–health care provider communication scale was used and responses scored using a 5-point scale. In part 2, one-on-one telephone interviews were conducted and responses transcribed, coded, and thematically analyzed. Thirteen patients and 7 family/caregivers completed part 1. Both groups scored items pertaining to adequacy of information sharing and involvement in decision-making in the lowest 25th percentile. Two patients and 4 family/caregivers participated in telephone interviews in part 2. Interview transcript analysis resulted in key themes that fit into the “How, When, and What” framework outlining the aspects of communication most important to the participants. Patients and family/caregivers identified strategic use of written information and predischarge family meetings as potentially valuable tools to improve communication and shared decision-making.

End-of-life decision making in critical illness: Perspectives of Asian parents

2021 ◽  
pp. 1-10
Author(s):  
Kristy Xinghan Fu ◽  
Yee Keow Chiong ◽  
Nicola Ngiam
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Tertiary Care ◽  
Asian Population ◽  
Emergency Department Visits ◽  
Case Vignette ◽  
Healthcare Team ◽  
Care Hospital ◽  
Case Vignettes ◽  
End Of Life Decision

Abstract Objective To explore parents’ perspectives regarding end-of-life (EOL) decisions, factors and possible barriers that influence the EOL decision making process, and to understand parental preferences for communication about EOL care in an Asian population. Method A prospective questionnaire cohort study conducted in a university-based tertiary care hospital. 30 parents of children who had been admitted to general pediatric wards for acute ailments and/or were being followed up in general pediatric outpatient clinics after inpatient admissions or emergency department visits completed 30 interviewer-administered questionnaires. With the first 10 completed questionnaires, we sought feedback on the design of the four case vignettes and related questions. Responses to specific questions related to each case vignette were rated on a Likert scale. Results The majority of parents were able to comprehend and identify with the issues in the case vignettes, which allowed them to respond appropriately. Parents tended to avoid active withdrawal or withholding of life-sustaining treatment. The top three priorities for parents making EOL decisions for their children were: the chance of improvement, the presence of pain or discomfort, and information provided by healthcare staff. Parents reported that they would prefer to know immediately if their child is at risk of dying; they also preferred to get as much information as possible from the healthcare team and thought that meeting with the healthcare team before making EOL decisions was pivotal. Significance of results Parents place highest priorities on their child's likelihood of improvement, perception of their child's pain, and information provided by healthcare professionals in making EOL decisions.

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