자연주의적 탐구조사(Naturalistic Inquiry)

This article presents an introduction to the Health Belief Model (HBM). The HBM states that the perception of a personal health behavior threat is influenced by at least three factors: general health values, interest and concern about health; specific beliefs about vulnerability to a particular health threat; and beliefs about the consequences of the health problem. Once an individual perceives a threat to his health and is simultaneously cued to action, if his perceived benefits outweighs his perceived costs, then the individual is most likely to undertake the recommended preventive health action. Key words: health promotion, health belief model, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy. Content available only in Romanian.

Health Belief Model

Childbirth is regarded as an important life event for women, and growing numbers of them are making the choice to give birth by Caesarean Delivery. The aim of this study was to identify the factors influencing the decision that women make on their mode of delivery, underpinned by the Health Belief Model. This was a cross-sectional study. Hong Kong Chinese women aged 18–45, who were pregnant or had given birth within the last three years were recruited. The participants were asked to complete a structured self-administered questionnaire consisting of 62 questions. A total of 319 women were recruited, of whom 73 (22.9%) preferred to have a cesarean section delivery (CD). The results showed that women preferred CD because they were concerned about being pregnant at an advanced age, were worried about labor pain and perineum tearing, wanted to have a better plan for maternity leave, had chosen an auspicious date to deliver, and perceived that CD is a more convenience way to deliver. The perceived benefits and severity of a vaginal birth (VB), and the perceived benefits, severity, and cues to action of CD, affected the decision to undergo either a VB or CD. The data indicated that the constructs of the Health Belief Model – perceived benefits, perceived severity, and cues to action – affect the decision that women make on their mode of delivery. This research indicates that there is value in designing educational programs for pregnant women to educate them on the benefits, risks, and severity of the two different modes of birth based on the constructs of HBM. This will enable women to be active participants in choosing the mode of birth that they believe is right for them.

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Factors influencing the decision that women make on their mode of delivery: the Health Belief Model

The birth of a first child is an important event in a woman’s life Delivery psychological impacts vary depending on whether delivery has been positively or negatively experienced Delivery experience determinants have been identified but the understanding of their expression according to the mode of delivery is poorly documented The purpose of the study was to determine important elements associated with women’s first delivery experience according to the mode of delivery: vaginal or caesarean section Qualitative approach using thematic content analysis of in-depth interviews conducted between 4 and 6 weeks’ postpartum, in 24 primiparous women who delivered at Geneva University Hospital in 2012 Perceived control, emotions, and the first moments with the newborn are important elements for the experience of childbirth Depending on the mode of delivery these are perceived differently, with a negative connotation in the case of caesarean section Other elements influencing the delivery experience were identified among all participants, irrespective of the mode of delivery They included representations, as well as the relationship with caregivers and the father in the delivery room, privacy, unexpected sensory experiences, and ownership of the maternal role Women’s and health professionals’ representations sometimes led to a hierarchy based on the mode of delivery and use of analgesia The mode of delivery directly impacts on certain key delivery experience determinants as perceived control, emotions, and the first moments with the newborn The ability/inability of the woman to imagine a second pregnancy is a good indicator of the birth experience Certain health professional gestures or attitudes can promote a positive delivery experience We recommend to better prepare women during prenatal classes for the eventuality of a caesarean section delivery and to offer all women and, possibly, their partners, the opportunity to talk about the experience of childbirth during the postpartum period The results of this study suggest that further research is required on the social representations of women and health professionals regarding the existence of a hierarchy associated with the mode of delivery

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Impact of mode of delivery on the birth experience in first-time mothers: a qualitative study.

How does delivery method influence factors that contribute to women's childbirth experiences?

We sought to describe maternal satisfaction with childbirth among women planning either cesarean or vaginal birth. We enrolled primiparous women planning cesarean birth and a comparison group planning vaginal birth. After delivery, the maternal subjective experience was assessed with a visual analogue satisfaction scale and the Salmon questionnaire, with scale scores for these aspects of the maternal experience of birth: fulfillment, distress, and difficulty. The sample included 160 women planning vaginal birth and 44 women planning cesarean. Eight weeks postpartum, women planning cesarean reported higher satisfaction ratings ( P = 0.023), higher scores for fulfillment ( P = 0.017), lower scores for distress ( P = 0.010), and lower scores for difficulty ( P < 0.001). The least favorable scores were associated with unplanned cesarean ( N = 48). Women planning cesarean reported a more favorable birth experience than women planning vaginal birth, due in part to low satisfaction associated with unplanned cesarean. Maternal satisfaction with childbirth may be improved by efforts to reduce unplanned cesarean, but also by support for maternal-choice cesarean.

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Mothers' satisfaction with planned vaginal and planned cesarean birth.

Mothers satisfaction with planned vaginal and planned cesarean birth

Background and purpose
College years are a time young adults examine high-risk sexual behaviors, increasing their risk for sexually transmitted diseases (STDs). Fraternity/sorority membership has been identified as one factor contributing to increased risky sexual behavior in college students. This study measured the effectiveness of an educational intervention targeting STD prevention in fraternity and sorority members, and examined relationships between STD knowledge, attitudes, and demographics.

Methods
A descriptive, correlational design was used. Pre- and posttest data were collected from fraternity and sorority members (N = 132). Instruments measured demographic characteristics, STD knowledge, and attitudes toward safe sex behaviors.

Conclusions
There was a significant increase in STD knowledge from baseline (M = 13.03, SD = 6.5) to 1 week (M = 20.27, SD = 4.9) t (131) = −13.53, p = .000. Males were more likely to report attitudes toward risky sexual behavior rs(132) = .323, p = .000, and as knowledge increased, attitudes became more favorable to safe sex behaviors (pre-STD knowledge and preintervention attitudes, r(132) = −.249, p = .004; post-STD knowledge and postintervention attitudes, rs(132) = −.307, p = .000).

Implications for practice
Results support that brief STD educational interventions can increase STD knowledge. College health centers must aim to provide sexual health education to all students at every visit.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/2327-6924.12353

Assessing the effects of a sexually transmitted disease educational intervention on fraternity and sorority members' knowledge and attitudes toward safe sex behaviors.

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Understanding the Health Beliefs of First Time Mothers Who Request Elective Cesarean Versus Mothers who Request Vaginal Delivery

In certain health care settings, most notably in rehabilitation and palliative care, patients are expected and encouraged to articulate treatment goals and desired outcomes. In obstetrics, patients may voice their preferences via birth plans.1 Birth plans are currently used by women planning both vaginal and cesarean deliveries but have been most often discussed in the context of labor and vaginal delivery.

Maternal preferences are important considerations in the management of childbirth, and therefore caregivers should seek information about the values and expectations of obstetric patients. This is particularly important as obstetric providers grapple with an apparent increase in planned cesarean birth.2 Pregnant women strongly prefer a delivery that is safest for their babies and themselves.3 Studies indicate that some women widely perceive cesarean delivery to be as safe as or safer than vaginal birth.4–7 Indeed, some mothers request or agree to cesarean birth because of this belief.4 However, other than an expectation of a safe birth experience, very little is known about what women who request cesarean value regarding the birth experience. In particular, it is not known whether maternal goals for childbirth differ among women who anticipate cesarean versus vaginal birth.

We previously described maternal satisfaction with childbirth among women planning either cesarean or vaginal birth.8 In this study, we sought to describe maternal wishes, goals, and expectations for childbirth among women planning cesarean birth compared with a group of women planning vaginal birth. In contrast with other studies exploring women’s reasons for choosing primary cesarean,4–7 our focus was on goals for childbirth among women who had already selected cesarean as a mode of delivery. Our objectives were (1) to develop a framework for describing maternal goals for childbirth, (2) to contrast the goals articulated by women planning vaginal birth with those planning cesarean birth, (3) to investigate goal achievement in both groups, and (4) to investigate the relationship between goal achievement and satisfaction. To our knowledge, there are no current studies comparing maternal goals between planned vaginal and cesarean delivery. Our aim was to investigate whether choice of delivery route would be strongly associated with the type of goals expressed. We also investigated whether goal achievement would be associated with satisfaction with the birth experience in both groups.

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Deborah Macmillan

Papers

Mothers' satisfaction with planned vaginal and planned cesarean birth.

Mothers satisfaction with planned vaginal and planned cesarean birth

Assessing the effects of a sexually transmitted disease educational intervention on fraternity and sorority members' knowledge and attitudes toward safe sex behaviors.

Understanding the Health Beliefs of First Time Mothers Who Request Elective Cesarean Versus Mothers who Request Vaginal Delivery

Maternal goals for childbirth associated with planned vaginal and planned cesarean birth.