Research News within Nursing and Midwifery
Study seeks male perspective on traumatic childbirth
Mums’ traumatic childbirth experiences have been well studied in the past, now a new study is looking at the impact on male partners.
The research by the University of Western Sydney’s School of Nursing and Midwifery(opens in new window)
will explore men’s experiences of labour and birth where their partners have experienced complications, required emergency intervention or the birth was traumatic in other ways.
Of all life events, the childbirth experience is consistently described as a significant life event of powerful psychological importance in a couples lives, says principal researcher Dr Rakime Elmir(opens in new window).
“Although birth is a normal physiological process, it can be associated with certain risks to health and in a rare event may pose a threat to survival of the woman and her infant,” says Dr Elmir.
“This has the potential to impact significantly on the physical and emotional health and well-being of the woman, her partner and the family unit.”
Dr Elmir says traumatic birth experiences and the effects on women have been researched by several scholars; however, little is known about the effects traumatic birth experiences can have on men where their partner has experienced complications or emergency interventions during the labour and birth.
“Distress following a traumatic childbirth has the potential to impact on a large number of Australian men.”
The participants will also be invited to take part in a focus group, involving other men who have had similar experiences.
“The research results will add knowledge and provide additional insights to the current body of literature on men’s experiences of birth trauma,” says Dr Elmir.
“It’s hoped the findings of this study will help create greater awareness among health professionals - particularly midwives and child and family health nurses - of the support needed for men following traumatic birth.”
The study findings also aim to direct and inform future research on men’s health.
For information on the study or to participate please contact principal researcher Dr Rakime Elmir on (02) 4620 3372 or r.elmir@uws.edu.au
This study has been approved by the University of Western Sydney Human Research Ethics Committee. The approval number is H9966.
Ends
3 January 2012
A spoonful of sugar: Sweet taste comforts babies during injections
Fictional character Mary Poppins may have been correct when she sang “a spoonful of sugar helps the medicine go down” at least when it comes to injections for babies, according to a new systematic review published this week in the international Cochrane Library.
The researchers found the sweet taste of sugar may provide some comfort for babies during immunisations.
One of the authors of the study, Dr Jann Foster(opens in new window), from the University of Western Sydney’s School of Nursing and Midwifery says the systematic review of 14 published clinical studies found babies did not cry for as long if they were given drops of sugar solution before injections.
“In the first 18 months of their lives, babies may have as many as 15 injections,” says Dr Foster.
“Current medical science is unable to say for certain whether babies feel pain in the same way as older children and adults, or whether they are simply unable to express it. However, there’s no denying injections and other medical procedures that puncture the skin cause discomfort and can make babies cry.”
Dr Foster says one simple alternative that is now widely used is the use of a syringe or dropper to put a few drops of a sugary solution in a child’s mouth.
“Sugar may trigger the release of pain-relieving chemicals in the body that have an analgesic effect.”
The researchers reviewed data involving a total of 1551 infants aged between one month and a year. Most studies compared sucrose, given two minutes before immunisation, with water.
Overall, babies given the sugary solution cried for a shorter time than those given water. However, individual studies used different pain measures, making it difficult to conclude that sugar solutions actually reduced pain.
Lead researcher, Manal Kassab of the Department of Maternal and Child Health at the Jordan University of Science and Technology in Irbid, Jordan says: “Giving babies something sweet to taste before injections may stop them from crying for as long.”
“Although we can’t confidently say that sugary solutions reduce needle pain, these results do look promising.”
Dr Foster says an earlier Cochrane review showed that sugar reduces the effect of painful procedures in newborn babies.
The latest results have encouraged the researchers to now examine whether a more concentrated dose of sugar could reduce the discomfort in older and larger babies aged 6 to 12 months.
“We need to know what is the most effective concentration of sugar to have a similar comforting effect on older babies who can receive up to three injections in a single visit,” says Dr Foster.
“Vaccinations can be stressful for parents. Anything reduces the discomfort for both babies and parents is a good thing.”
The study was a collaboration involving Jordan University of Science and Technology, UWS and University of Technology, Sydney.
Full citation:
Kassab M, Foster JP, Foureur M, Fowler C. Sweet-tasting solutions for needle-related procedural pain in infants one month to one year of age. Cochrane Database of Systematic Reviews 2012, Issue 12. Art. No.: CD008411. DOI: 10.1002/14651858.CD008411.pub2.
Ends
January 2013
New research reveals strong links between diabetes and mental illness
New research just published in a Special Issue of the Journal of Affective Disorders shows that the prevalence of both type 1 and type 2 diabetes was consistently higher for Australian people aged 25 years or older with psychological distress (or taking medications for depression or anxiety) from 2001 to 2008. Senior Research Fellow Dr Evan Atlantis (opens in new window) from the School of Nursing and Midwifery at the University of Western Sydney analysed data obtained from the 2001, 2004-05 and 2007-Australian National Health Surveys conducted by the Australian Bureau of Statistics. He found that the prevalence of type 1 diabetes remained stable at 0.6% whereas the prevalence of type 2 diabetes increased by 36% (from 3.7 to 5.0%) over the eight-year period. On average, the prevalence of both type 1 and type 2 diabetes was 1.3 to 2.4-fold higher for people with psychological distress from 2001 to 2008. However, the strength of these associations was partially explained by lifestyle risk factors, particularly for type 2 diabetes.
In another novel study published in the same Special Issue, Dr Atlantis led an international collaboration with colleagues from the VU University Medical Center, Amsterdam, The Netherlands to determine the incidence of diabetes and pattern of explanatory factors associated with depressive or anxiety disorders in 2,460 adults from The Netherlands over a two year period. They found that the relative odds of developing diabetes within two years was about 10-fold higher for people with current depressive and/or anxiety disorders in comparison to those without either of these disorders. They also found that this strong association was partially explained by lifestyle risk factors.
Dr Atlantis asserts that diabetes is a rising health and economic burden in Australia, frequently associated with common mental disorders and unhealthy lifestyle behaviours. In a recently published editorial in the journal Obesity Research & Clinical Practice, he explains how unhealthy sleeping and eating behaviours and consequent obesity partially explain the link between diabetes and depression or anxiety.
He concludes that clinicians should consider routinely screening patients with diabetes for depression or anxiety and vice versa, as well as lifestyle risk factors, to inform practice for more effective management and prevention planning.
Ends
October 2012
Private hospitals drive surge in caesareans, inductions
A new study led by the University of Western Sydney has found low risk women giving birth in private hospitals in New South Wales are much more likely to have obstetric interventions such as inductions and caesareans compared to low risk women giving birth in public hospitals.
The study, published online today in the British Medical Journal Open (opens in a new window), found women having their first baby in a private hospital had a 20 percent lower normal vaginal birth rate, and 15 percent lower rate if it was a subsequent baby.
Associate Professor Hannah Dahlen (opens in new window), from the UWS School of Nursing and Midwifery’s Family and Community Health Research Group (opens in new window), studied over 650,000 births in New South Wales over eight years (2000-2008).
The study allowed researchers to determine if taking a matched low risk population would result in different levels of obstetric intervention for women giving birth in private and public hospitals.
It also repeated a study undertaken a decade ago, providing a clear indication of current trends in childbirth.
Associate Professor Dahlen’s findings show low-risk women giving birth to their first baby in a private hospital compared to a public hospital had:
- Higher rates of induction (31 percent vs 23 percent)
- Higher rates of instrumental birth (29 percent vs 18 percent)
- Higher rates of caesarean section (27 precent vs 18 percent)
- Higher rates of epidural (53 percent vs 32 precent)
- Higher rates of episiotomy (28 percent vs 12 percent)
- Lower rates of vaginal births (44 percent vs 64 percent)
“The results stunned us,” says Professor Dahlen. “Ten yeas ago we were concerned at what came out, but today there is no conceivable explanation for such high rates of intervention in the private sector. When only 15 out of 100 low risk, healthy young women have a normal vaginal birth without intervention for their first baby in a private hospital, then questions need to be asked.”
Over the past decade the rate of caesarean amongst low risk women has risen by 5 percent in the public sector and double that in the private sector (10 precent).
“If we were saving more babies then we would accept this as necessary for safety, but we are not,” says Associate Professor Dahlen.
“The argument that is often used by private obstetricians is women are older and sicker now and therefore the rates of intervention are higher, but we have controlled for that and included the same low risk criteria used a decade ago (20-34 years of age, no medical or obstetric complications, term babies and babies with good birth weights), and the intervention rate is only going one way, and that is up and up.
“The cost to the public purse of such high levels of intervention is not insignificant, not to mention the impact on women’s health and the short and long-term health of children. With emerging evidence of links between caesarean section and diabetes, asthma, obesity and other immunological disorders in children, it is time to take a serious look at this issue,” says Professor Dahlen.
The paper, titled: Rates of intervention among low risk women giving birth in private and public hospitals in NSW: A population-based descriptive study, can be obtained free online from the BMJ Open.
Ends
7 September 2012
Read the story on ABC Online (opens in a new window), Australian Doctor (opens in a new window), and Canberra Times (opens in a new window) online
