A comparison of termination of pregnancy procedures: Patient choice,emotional impact and satisfaction with care

ObjectivesTo investigate: (1) whether women self-report an ability to choose their preferred termination of pregnancy (TOP) procedure, (2) what factors influence this choice, and (3) what effect this choice has on emotional responses and satisfaction with care.Study designA mixed-method prospective comparative study in which women requesting a TOP between five and eighteen weeks gestation for social reasons (as opposed to medical indications), were invited to complete a semi-structured pre-TOP interview and questionnaire, and a post-TOP questionnaire four weeks after the procedure.Main outcome measuresQuantitative data was collected using the Patient Health Questionnaire, Generalised Anxiety Disorder Scale, Positive and Negative Affect Scale, Impact of Event Scale – Revised, and Client Satisfaction Questionnaire.ResultsPre-TOP emotion-based factors did not differ between groups. Most women felt that they were able to choose their preferred method of TOP. Their decisions were based on factors categorised as procedure-related, lifestyle or social circumstance-related, emotional, or other factors. When no choice was perceived, common reasons reported were that: (1) gestation was too far along for there to be another option, or (2) an appointment was not available within the required timeframe. When women felt that the method of TOP performed was not their choice they found the procedure more stressful. All women reported high satisfaction with care.ConclusionA better understanding of the patient experience can inform service development, enabling staff to ensure that the services provided meet women’s needs. The perception that one is able to choose their preferred TOP procedure is important for reducing procedure-related stress and ensuring high satisfaction with care.     

Incorporating peer-to-peer facilitation with a mid-level fidelity student led simulation experience for undergraduate nurses

BackgroundThe aim of this study was to evaluate peer-to-peer facilitated student led mid-level fidelity simulation experiences.MethodsSecond and third year nursing students (N = 637) were invited to complete a 16-item 6-point Likert scale questionnaire after the simulation experience.ResultsStudents reported high self-confidence in their nursing skills (M = 4.14, SD = 0.92) and a high level of satisfaction in the learning they received during the peer-to-peer facilitated student led simulation experience (M = 4.42, SD = 0.93).ConclusionUsing peer-to-peer teaching strategies during student led simulation experience is an effective approach for ensuring active engagement of all learners during midlevel fidelity group-based simulations and has the potential for broad applicability.     

支气管肺泡灌洗术（ＢＡＬ）用于难治性肺部 感染的疗效分析

探讨支气管肺泡灌洗术（ＢＡＬ）用于难治性肺部感染的治疗效果。方法　选取２０１２年１月— ２０１４年１月入我院就诊的难治性肺部感染患者１６０例，随机分为观察组和对照组，各８０例，对照组采取常规抗 菌、雾化吸入、体位引流等治疗，观察者在此基础上进行支气管肺泡灌洗术。分析比较两组患者治疗效果以及患 者满意度情况。结果　观察组患者治疗效果明显优于对照组（９７５％ ＞６５０％），两组相比较差别具有统计学 意义（Ｐ＜００５）；观察组患者满意度为９６３％，对照组为５６３％，两组相比较差别具有统计学意义（Ｐ＜００５）。 结论　通过研究可知，支气管肺泡灌洗术用于难治性肺部感染效果显著，明显改善患者病情，提高满意度，值得 临床推荐应用。     

Self-Focused Reasons for Having Sex: Associations Between Sexual Goals and Women's Pain and Sexual and Psychological Well-being for Couples Coping With Provoked Vestibulodynia

BackgroundFor couples coping with provoked vestibulodynia (PVD), interpersonal sexual goals are associated with sexual and psychological functioning as well as women’s pain during intercourse, however, self-focused sexual goals (eg, having sex for personal pleasure, having sex to avoid feeling bad about oneself) have not been studied in this clinical population.AimThe purpose of this study was to examine the associations between self-focused approach and avoidance sexual goals and women's pain during intercourse and sexual satisfaction and depressive symptoms for both women and their partners.MethodsWomen diagnosed with PVD (N = 69) and their partners completed measures of self-focused sexual goals, sexual satisfaction, and depressive symptoms. Women also reported on pain experienced during sexual intercourse.OutcomesOutcomes included the Global Measure of Sexual Satisfaction, the Beck Depression Inventory-II, and a Numerical Rating Scale of pain during sexual intercourse.ResultsWhen women reported higher self-focused approach sexual goals, they also reported lower pain intensity. Women's higher self-focused avoidance sexual goals were associated with their own higher depressive symptoms, whereas men's higher self-focused approach goals were associated with their own higher depressive symptoms. When controlling for frequency of sexual intercourse, there were no significant associations between women or partners' sexual goals and sexual satisfaction.Clinical ImplicationsWithin a clinical context where many interpersonal pressures for sex exist, interventions should target self-focused sexual goals alongside interpersonal sexual goals to improve pain and psychological adjustment.Strengths & LimitationsThis is the first study to examine self-focused sexual goals among women with PVD and their partners. This study is cross-sectional, and the direction of associations cannot be inferred. Couples were in mixed-sex relationships, and results may not generalize to same-sex couples.ConclusionFindings suggest that self-focused goals are relevant to the psychological adjustment of women with PVD and their male partners and for women's pain.Corsini-Munt S, Bergeron S, Rosen NO. Self-Focused Reasons for Having Sex: Associations Between Sexual Goals and Women's Pain and Sexual and Psychological Well-being for Couples Coping With Provoked Vestibulodynia. J Sex Med 2020;17:975–984.