不同剂量骨水泥PKP联合雌激素对绝经后女性骨质疏松性腰椎体压缩性骨折患者的影响

目的探讨不同剂量骨水泥PKP联合雌激素对绝经后女性骨质疏松性腰椎体压缩性骨折患者的影响。方法选取2015年1月至2018年6月我院收治的120例老年女性骨质疏松性腰椎体压缩性骨折患者为研究对象,按行PKP手术治疗时骨水泥注入的剂量不同分为三组(A组2-4 mL、B组4-5 mL、C组5-6 mL),所有患者均随访1年,比较术后三组患者VAS评分、ODI评分、伤椎椎体前缘高度、椎体中部高度及并发症的发生率。结果三组患者相比,治疗前VAS评分、ODI评分组间比较差异无显著性(P0.05);术后3天及1年后随访时,三组患者各项指标均较治疗前显著改善,组内比较差异具有显著性(P0.05),组间比较差异无显著性(P0.05);治疗前伤椎椎体前缘高度及椎体中部高度组间比较差异无显著性(P0.05);术后3天及1年后随访时,三组患者治疗后椎体前缘、中间高度均较术前明显增加(P0.05),组间比较椎体前缘高度:C组B组A组,椎体中间高度:C组B组A组,且组间比较有统计学差异(P0.05); A组患者并发症的发生率(12.5%)明显低于B组(30.0%)、C组(41.0%),有统计学差异(P0.05)。结论 PKP术中注入小剂量骨水泥(2-4 mL)对于治疗老年女性OVCFs具有良好的治疗效果及较高的安全性。     

Validity and Reliability of the Modified Attitudes About Drug Use in Pregnancy Scale

ObjectiveTo contemporize the Attitudes About Drug Abuse in Pregnancy questionnaire, keep the length of the modified scale brief to promote use, and test the psychometric properties of the modified scale among perinatal nurses.DesignCross-sectional survey.SettingFour hospitals in the Midwestern United States.ParticipantsRegistered nurses who worked in perinatal units (N = 440).MethodsWe collected data from participants using survey methods. Seven experts in perinatal substance use research and clinical care informed scale modifications. We used a split-sample design involving maternal–newborn units (labor, postpartum) and newborn-focused units (NICU, pediatrics). We evaluated construct validity using factor analysis and reliability using Cronbach’s alpha. We tested for differences between units using analysis of variance and Tukey’s post hoc honest significant difference test of pairwise differences.ResultsThe final modified scale included 13 items that loaded on one factor and showed internal consistency reliability in both samples (α = .88?.91). We found a statistically significant difference in mean score between NICU and pediatric units; however, the absolute difference was small and likely not clinically significant.ConclusionsThe Modified Attitudes About Drug Use in Pregnancy scale has initial evidence for validity and reliability, was updated to reflect current terminology in the field, and is a pragmatic tool for use in research.     

Self‐objectification in the context of breastfeeding: A concept analysis

To increase the overall rate of breastfeeding initiation and duration, factors involved in a mother's decision to breastfeed must be identified. Self‐objectification in the context of breastfeeding was a concept selected for exploring factors associated with negative views of breastfeeding. A concept analysis following the eight‐step Walker & Avant method provides clarity and context to the concept of self‐objectification in the context of breastfeeding. The antecedents of self‐objectification in the context of breastfeeding include living in a culture of sexualization and objectification of women and the internalization of the values of objectification. Attributes of self‐objectification in the context of breastfeeding are a prioritization of physical appearance attributes of the breast over the health benefits of breastfeeding and a preoccupation with physical appearance. Consequences include negative views toward breastfeeding initiation, duration, and public breastfeeding. A concept analysis on self‐objectification in the context of breastfeeding will provide definition and clarity to this phenomenon, lend to theory and measurement, and add literature to the sociocultural factors impacting breastfeeding decisions.     

Literature Review of the Association Between Prenatal Education and Rates of Cesarean Birth Among Women at Low Risk

A review of the literature was performed to explore the association between prenatal education and rates of primary cesarean birth for women at low risk for cesarean birth. Most women who are nulliparous with a singleton fetus of term gestational age and in the vertex position are considered to be at low risk and favorable for a vaginal birth, yet the cesarean birth rate for women at low risk was 25.6% in 2019. It has been suggested that the rise in the cesarean birth rate among low-risk women may not be due to medical indications but, rather, to nonmedical factors, such as a provider’s or woman’s preference or lack of prenatal education. Evidence from this literature review supports the premise that prenatal education classes should be routinely incorporated into maternity care in an effort to reduce cesarean birth rates for the low-risk population.