We analyzed baseline and 12-month follow-up interview data from 98 women who had volunteered to use an experimental intracervical device (ICD) and from 155 women who had been randomly assigned to two control groups, the levonorgestrel-releasing intrauterine device (LNG-IUD; N = 86) and the copper Nova-T IUD (N = 69). All participants were clinic patients in Helsinki, Finland. Initial analysis of 12-month discontinuation data indicated that a significantly higher percent of ICD users (22.4) discontinued their device than did either LNG-IUD (7.0) or Nova-T (8.7) users. However, we were no longer able to detect significant differences in discontinuation after controlling for baseline variables that assessed predisposition to be dissatisfied with contraception in general. Adjusted probabilities of discontinuing the ICD, LNG-IUD, and Nova-T were 11.8%, 6.2% and 7.9%, respectively. These data indicate that the ICD is likely to be acceptable to Helsinki clinic patients; moreover, they suggest a definite place for hormonal intrauterine devices in the contraceptive armamentarium. Most importantly, the methodology used here can be generalized to acceptability studies of other contraceptive devices and drugs undergoing Phase I and early Phase II clinical trials (in situations where randomization may not be feasible) in order to identify and control for the bias introduced by nonrandom assignment procedures.
Six cereal/legume mixtures were developed with the aid of computer-assisted optimization software from cereal and legume staples indigenous to the West African sub-region. The mixtures had 45-50% maize, 35-40% decorticated cowpeas and either blanched peanuts or decorticated soybeans as a source of lipid and complementary amino acids. Three processing schemes involving roasting, amylase digestion and extrusion cooking were employed. The proportion of ingredients in each cereal/legume blend was based on meeting the nutrient requirement of the 0.5-0.9-year-old infant and cost considerations. Nutrient composition of the blends (proximate, amino acid, mineral and vitamin composition) indicated that these formulations were adequate nutritionally as weaning supplements (Mensa-Wilmot et al, 2000a,2000b). These formulations were evaluated by mothers of weanling children based on their preferences with respect to color, flavor, texture and willingness to purchase the product assessed. A total of 133 one-on-one interviews and 23 group discussions were conducted (involving 6-12 respondents) with selected Ghanaian women. The mothers found the convenience of a weaning food made from local staples that could be processed on village/market scale very attractive.
In the opinion of the public, accessibility is probably one of the most important features of general practice. More than 3,500 patients in North Norway answered a questionnaire asking for their opinions on waiting time for consultation, the time spent in consultation and the possibility of the doctor visiting them at home. 80% thought that a waiting time of more than one week was too long. The actual waiting times differ considerably, but only a few practices serving less than 900 inhabitants per physician managed to satisfy their patients. On the other hand, about 80% found the time allocated for the consultation to be adequate. Almost half the patients who expressed an opinion thought it too difficult to get a doctor to visit them at home. Less than 10% considered a long distance to travel to a doctor to be an obstacle. Not surprisingly, young people were most demanding as regards quick service. Men were somewhat more satisfied than women, as were patients in rural areas compared with patients in the towns. In our opinion, some of the patients' causes of dissatisfaction can be removed by better routines. However, it seems that the resources available within general practice, are inadequate to meet all the patients' wishes, either now or in the future.
Accessible support programs can improve health outcomes for family caregivers of older relatives with a chronic condition. Over the course of 6 months, 27 experienced family caregivers provided weekly support via the telephone to 66 individuals, either new family caregivers of seniors recently diagnosed with stroke or newly vulnerable family caregivers (i.e., facing increasing demands from the deterioration of their senior relative's condition) of seniors with Alzheimer's disease. Qualitative data documented the perceived impact of the intervention, including increased satisfaction with support, coping skills, caregiving competence and confidence, and decreased caregiver burden and loneliness. Caregivers identified varied support processes that overcame support deficits in their social networks. These processes can facilitate replication in future research and inform practice, programs, and policies.
This study aimed to (1) explore whether quality of life (QOL) is more associated with satisfaction with social participation (SP) than with level of accomplishment in SP and (2) examine respective correlates of accomplishment level and satisfaction with SP.
A cross-sectional design was used with a convenience sample of 155 older adults (mean age=73.7; 60% women) having various levels of activity limitations. Accomplishment level and satisfaction with SP (dependent variables) were estimated with the social roles items of the assessment of life habits. Potential correlates were human functioning components.
Correlations between QOL and accomplishment level and satisfaction with SP did not differ (P=0.71). However, best correlates of accomplishment level and satisfaction with SP were different. Higher accomplishment level of SP was best explained by younger age, activity level perceived as stable, no recent stressing event, better well-being, higher activity level, and fewer obstacles in "Physical environment and accessibility" (R2=0.79). Greater satisfaction with SP was best explained by activity level perceived as stable, better self-perceived health, better well-being, higher activity level, and more facilitators in "Social support and attitudes" (R2=0.51).
With some exceptions, these best correlates may be positively modified and thus warrant special attention in rehabilitation interventions.
Cites: Disabil Rehabil. 2004 Oct 21;26(20):1206-1315371021
Cites: Can J Occup Ther. 2007;74 Spec No.:233-4217844978
Cites: Health Place. 2004 Dec;10(4):383-9115491897
Cites: ANS Adv Nurs Sci. 1985 Oct;8(1):15-243933411
The aim of this study was to test a new method for continuous monitoring of the Danish contact person concept and to evaluate the impact of the concept on the mothers' perception of nursing care and on their self-efficacy.
This is a descriptive study, carried out at a neonatal unit forming part of a department of paediatrics. Using an electronic questionnaire, the mothers were asked if they had been given a contact nurse and how they assessed the quality of the care and their own self-efficacy. The correlation between their experience of being given a contact person and having high scores of nursing care and of self-efficacy was analyzed by logistic regression.
A total of 300 (81%) of the mothers answered the questionnaire. Among the mothers who acknowledged having had a contact nurse compared with those who did not, odds ratios were > 1 in 10/11 questions concerning assessment of nursing care. Concerning the mothers' assessment of their self-efficacy, the odds ratios were > 1 in 7/11 questions. None of these were statistically significant.
The study showed a tendency towards a positive impact on nursing care when contact persons were allocated to the mothers who were admitted to a neonatal ward. The findings were statistically significant in 2/11 questions.
Rehabilitation of the majority of hearing handicapped in Sweden consists of hearing aid fitting, provision of technical devices and information during about four visits to a Hearing Centre. Generally there is no structured guidance of the hearing handicapped on how to proceed with the hearing aid at home between appointments. A programme of active fitting (AF) of hearing aids, with a task-oriented diary, 'Try Your Hearing Aid' as a basic part, was therefore developed. We conducted a series of studies from 1985 to 1988 with the aim of investigating the benefit and applicability of the programme. A total of 128 new hearing aid candidates participated in three studies at the Sahlgrens hospital and at four other hearing centres in smaller Swedish towns. In a controlled study the AF group was more positive to their hearing aids and to the fitting period after 10 months. They used their hearing aids more frequently and felt psychologically more secure with them. It was established that the AF programme could well be applied in the clinical routine for a majority of new hearing aid patients. Old age per se was not found to be a relevant exclusion criterion. The positive outcome of the AF programme has stimulated the Swedish Institute of the Handicapped to print 'Try Your Hearing Aid' with a manual, and to introduce it to all hearing centres in Sweden.