A Pilot Randomized Controlled Trial of a Breastfeeding Self‐Efficacy Intervention With Primiparous Mothers

ObjectivesTo pilot test a newly developed breastfeeding self‐efficacy interventionDesignPilot randomized controlled trial (RCT).SettingAn acute care hospital located in Northwestern Ontario that is the sole provider of maternity care for the city and referral center for the regionParticipantsOne‐hundred‐and‐fifty primiparous women intending to breastfeed their healthy, term, singleton infantInterventionA standardized, individualized nursing intervention protocol was designed and administered to increase mothers' breastfeeding self‐efficacy. Participants were randomly allocated to the intervention group or control group using sealed, opaque envelopes. Participants in the intervention group received three individualized, self‐efficacy enhancing sessions with the researcher: two in‐hospital and one by telephone. Participants in the control group received standard in‐hospital and community careMain Outcome MeasuresFeasibility, compliance, and the acceptability of the breastfeeding self‐efficacy intervention. Other outcomes assessed were breastfeeding self‐efficacy, duration, and exclusivityResultsFindings suggest that the intervention was feasible; there was a high degree of protocol compliance, and the majority of mothers reported that the intervention was beneficial. Mothers in the intervention group had higher rates of breastfeeding self‐efficacy, duration, and exclusivity at 4 and 8 weeks postpartum. However, the differences between groups were not statistically significantConclusionThe pilot RCT provided valuable information in examining the feasibility of the trial design and intervention     

The Sexual Function Questionnaire's Medical Impact Scale (SFQ‐MIS): Validation Among a Sample of First‐time Mothers

IntroductionChanges in sexual function can be difficult to capture, especially when an attempt is made to assess the effects of pregnancy or childbirth on the sexual function of first‐time mothers. Commonly used sexual function measures are limited and fail to account for pregnancy or birth in assessment of function.AimsThe purpose of this study was to explore the utility of the Sexual Function Questionnaire Medical Impact Scale (SFQ‐MIS) in assessing impact of childbirth on sexual function among first‐time mothers with infants aged one year or younger.MethodsA total of 255 women completed a cross‐sectional, web‐based survey. Exploratory factor analysis was utilized to assess the factor structure of the SFQ‐MIS scores in this sample. Variations in SFQ‐MIS scores based upon participant characteristics were conducted to further evaluate the SFQ‐MIS scores.Main Outcome MeasuresSFQ‐MIS score was the primary measure of interest. Factors related to pregnancy and childbirth, such as mode of delivery, infant date of birth, last menstrual period, need for an episiotomy or perineal stitches, breastfeeding status, and score on the Perceived Stress Scale, were also assessed in order to further evaluate the validity and predictive capacity of the SFQ‐MIS.ResultsResults indicated one factor that accounted for 58.27% of the variance in impact on sexual function due to childbirth. Cronbach's α coefficient for all five items was acceptable (0.82). Women who were breastfeeding (P < 0.05), those who had received perineal stitches after a vaginal delivery (P < 0.05), and those who reported no sexual activity in the past month (P < 0.001) experienced significantly greater impact than those who were not breastfeeding, those who had not required stitches, and those who had been sexually active in the past month.ConclusionThe SFQ‐MIS appears to be a useful and valid indicator of changes in sexual function following childbirth, such as those related to arousal, desire, and orgasm. Jawed‐Wessel S, Schick V, and Herbenick D. The Sexual Function Questionnaire's Medical Impact Scale (SFQ‐MIS): Validation among a sample of first‐time mothers. J Sex Med 2013;10:2715–2722.     

Assessment of the Psychometric Properties of the Short‐Form Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ‐12) following Surgical Placement of Prolift+M: A Transvaginal Partially Absorbable Mesh System for the Treatment of Pelvic Organ Prolapse

IntroductionImpairment of sexual function is a significant problem among women suffering from pelvic organ prolapse (POP). Because anatomical measures of POP do not always correspond with patients' subjective reports of their condition, patient‐reported outcome measures may provide additional valuable information regarding the experiences of women who have undergone surgery. The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ‐12) is a validated, widely used condition‐specific questionnaire focused on sexual function among patients with POP or urinary incontinence.AimThis study aims to report sexual function outcomes as measured by PISQ‐12 and to evaluate the psychometric characteristics of the questionnaire following surgical mesh implant for the treatment of POP.Main Outcome MeasuresThe PISQ‐12 was used to measure sexual function, while a set of other measures, namely, Pelvic Organ Prolapse Quantification, Patient Global Impression of Change, Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire, and Surgical Satisfaction Questionnaire, was used for validation.MethodsData for the study were collected from a prospective multicenter, single‐arm study of surgical POP repair via the transvaginal placement of a partially absorbable mesh system. For baseline, month 3, and month 12 following POP surgery, several psychometric properties of the PISQ‐12 were evaluated, including internal consistency (Cronbach's alpha), concurrent validity, discriminant validity, and responsiveness.ResultsAs measured by the PISQ‐12 questionnaire, statistically significant improvements were observed in the composite summary score as well as all three subscale scores at 1 year. The PISQ‐12 generally demonstrated good psychometric properties including internal consistency reliability, validity, and responsiveness. The PISQ‐12 items had good distributional properties at baseline, with substantial ceiling effects at follow‐up visits reflecting improvements experienced by the patients.ConclusionThe PISQ‐12 is a valid measure of sexual function in studies involving patients with POP. Roy S, Mohandas A, Coyne K, Gelhorn H, Gauld J, Sikirica V, and Milani AL. Assessment of the psychometric properties of the short‐form prolapse/urinary incontinence sexual questionnaire (PISQ‐12) following surgical placement of prolift+M: A transvaginal partially absorbable mesh system for the treatment of pelvic organ prolapse. J Sex Med 12;9:1190–1199.     

The Self‐Estimation Index of Erectile Function‐No Sexual Intercourse (SIEF‐NS): A Multidimensional Scale to Assess Erectile Dysfunction in the Absence of Sexual Intercourse

IntroductionA new concept of Erectile Dysfunction with No Sexual Intercourse (ED‐NS) is proposed to acknowledge the subpopulation of patients who are unable to achieve or sustain an erection in the absence of sexual intercourse. Since the commonly used ED diagnostic tool, International Index of Erectile Function Questionnaire is not able to adequately assess the erectile function (EF) in the absence of intercourse, the researchers developed a new 10‐item questionnaire to better evaluate the EF in this special patient subpopulation: Self‐Estimation Index of Erectile Function‐No Sexual Intercourse (SIEF‐NS).AimTo validate the reliability, sensitivity and specificity of SIEF‐NS.MethodsThe study was carried out in three phases. Phase one applied component analysis to 126 ED‐NS patients to search for the primary factors and Cronbach's alpha standardized statistic values for SIEF‐NS. Phase two applied discriminant analysis to participants' (212 ED‐NS patients and 193 normal controls) scores on each question item, each factor and the overall 10‐item questionnaire. Phase three investigated SIEF‐NS's capability of evaluating treatment effect on 41 ED‐NS patients.Main Outcome MeasuresReliability, sensitivity and specificity were defined and used to evaluate the performance of SIEF‐NS.ResultsEF by autonomic response (factor 1) and EF with potential sexual partners (factor 2) are the two primary factors with eigenvalues greater than 1.0. High degree of internal consistency was observed for the two factors and the 10‐item questionnaire (Cronbach's alpha values: 0.871 for 10 items, 0.84 for factor 1, and 0.823 for factor 2). SIEF‐NS demonstrated adequate construct validity, high sensitivity (0.925) and specificity (0.829) to diagnose ED‐NS. The EF scores of ED‐NS patients post treatment showed significant improvement (P < 0.05).ConclusionSIEF‐NS can be used to identify ED‐NS patients and detect treatment‐related EF changes in ED‐NS patients. Yuan Y, Zhang Z, Gao B, Peng J, Cui W, Song W, Xin Z, and Guo Y. The Self‐Estimation Index of Erectile Function‐No Sexual Intercourse (SIEF‐NS): A multidimensional scale to assess erectile dysfunction in the absence of sexual intercourse. J Sex Med 2014;11:1201–1207.     

The Rates of Any Breastfeeding at the Time of Postpartum Hospital Discharge for Early Term (370–386 Weeks) Versus Full Term (390–416 Weeks) Infants

ObjectiveThis study sought to compare the rates of any breastfeeding between early term (37⁰–38⁶ weeks) and full term (39⁰–41⁶ weeks) infants at the time of postpartum hospital discharge.MethodsA retrospective cohort study of women with live, singleton pregnancies who were delivered in St. John's, Newfoundland and Labrador, between April 2001 and March 2018 was completed. The primary outcome was any breastfeeding at the time of postpartum hospital discharge. Secondary analyses included a comparison of breastfeeding by week of gestational age at term and by maternal and neonatal demographics and outcomes of pregnancy. Univariate and multiple logistic regression analyses were performed.ResultsA total of 34 511 women were included. Early term infants were less likely to be breastfed than were full-term infants (67.9 vs. 70.4%) (adjusted odds ratio [aOR] 0.91; 95% confidence interval [CI] 0.86–0.97). Multiple logistic regression analysis also showed a significant effect of maternal age (aOR 1.07; 95% CI 1.05–1.09), partner status (aOR 1.56; 95% CI 1.20–2.03), smoking (aOR 0.32; 95% CI 0.26–0.41), prenatal education (aOR 2.43; 95% CI 1.99–2.97), pre-pregnancy body mass index (kg/m²) (aOR 0.97; 95% CI 0.96–0.98), and cesarean section (aOR 0.72; 95% CI 0.60–0.88). When compared by week of gestational age at term, the likelihood of breastfeeding significantly increased with each successive week (aOR 1.08; 95% CI 1.007–1.16).ConclusionEarly term delivery is an independent risk factor for not breastfeeding at the time of postpartum hospital discharge. It is important to target and support these women to increase breastfeeding rates. Additionally, these findings further validate recommendations to avoid non–medically indicated early term deliveries because of the increased risks of adverse outcomes.