Models of health care in the management of women with psychiatric disorders in pregnancy

2006 ◽  
pp. 277-292
Author(s):  
Louise Howard
Keyword(s):  
Health Care ◽  
Psychiatric Disorders ◽  
In Pregnancy

scholarly journals Web Resources that Address Psychiatric Disorders in Pregnancy

2003 ◽  
Vol 12 (3) ◽  
pp. 50-52
Author(s):  
Mary Lou Montgomery
Keyword(s):  
Health Care ◽  
Pregnant Woman ◽  
Psychiatric Disorders ◽  
Health Care Providers ◽  
Life Stage ◽  
Care Providers ◽  
Web Resources ◽  
In Pregnancy

Psychiatric disorders occur at every life stage, including pregnancy. This resource column highlights several Web resources that may be useful to childbirth educators and other health care providers who may care for pregnant woman experiencing one of these conditions.

scholarly journals Oral Misoprostol alone versus oral misoprostol followed by oxytocin for labour induction in women with hypertension in pregnancy (MOLI): protocol for a randomised controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hillary Bracken ◽  
Kate Lightly ◽  
Shuchita Mundle ◽  
Robbie Kerr ◽  
Brian Faragher ◽  
...  
Keyword(s):  
Health Care ◽  
Low Dose ◽  
Oral Medication ◽  
Labour Induction ◽  
Care Providers ◽  
Hypertensive Disease ◽  
Membrane Rupture ◽  
Oral Misoprostol ◽  
Active Labour ◽  
In Pregnancy

Abstract Background Every year approximately 30,000 women die from hypertensive disease in pregnancy. Magnesium sulphate and anti-hypertensives reduce morbidity, but delivery is the only cure. Low dose oral misoprostol, a prostaglandin E1 analogue, is a highly effective method for labour induction. Usually, once active labour has commenced, the misoprostol is replaced with an intravenous oxytocin infusion if ongoing stimulation is required. However, some studies have shown that oral misoprostol can be continued into active labour, a simpler and potentially more acceptable protocol for women. To date, these two protocols have never been directly compared. Methods This pragmatic, open-label, randomised trial will compare a misoprostol alone labour induction protocol with the standard misoprostol plus oxytocin protocol in three Indian hospitals. The study will recruit 520 pregnant women being induced for hypertensive disease in pregnancy and requiring augmentation after membrane rupture. Participants will be randomised to receive either further oral misoprostol 25mcg every 2 h, or titrated intravenous oxytocin. The primary outcome will be caesarean birth. Secondary outcomes will assess the efficacy of the induction process, maternal and fetal/neonatal complications and patient acceptability. This protocol (version 1.04) adheres to the SPIRIT checklist. A cost-effectiveness analysis, situational analysis and formal qualitative assessment of women’s experience are also planned. Discussion Avoiding oxytocin and continuing low dose misoprostol into active labour may have a number of benefits for both women and the health care system. Misoprostol is heat stable, oral medication and thus easy to store, transport and administer; qualities particularly desirable in low resource settings. An oral medication protocol requires less equipment (e.g. electronic infusion pumps) and may free up health care providers to assist with other aspects of the woman’s care. The simplicity of the protocol may also help to reduce human errors associated with the delivery of intravenous infusions. Finally, women may prefer to be mobile during labour and not restricted by an intravenous infusion. There is a need, therefore, to assess whether augmentation using oral misoprostol is superior clinically and economically to the standard protocol of intravenous oxytocin. Trial registration Clinical Trials.gov, NCT03749902, registered on 21st Nov 2018.

Prevalence of Psychiatric Diagnoses and Psychiatric Consultation Service Utilization on Inpatient Medical Units

2021 ◽  
pp. 107839032110055
Author(s):  
Bianca Reis ◽  
Jenny Hsin-Chun Tsai
Keyword(s):  
Health Care ◽  
Psychiatric Disorders ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Adult Patients ◽  
Psychiatric Diagnoses ◽  
Psychiatric Consultation ◽  
Consultation Service ◽  
Icd 10 ◽  
Delivery Models

OBJECTIVE This practice improvement project sought to determine the prevalence of psychiatric diagnoses among patients admitted to a community hospital’s inpatient medical units and which diagnoses were serviced by the hospital’s psychiatric consultation service. METHOD Electronic medical record data on adult patients of five medical units admitted with a psychiatric condition between October 1, 2019, and December 31, 2019, were used. Psychiatric ICD-10 ( International Classification of Diseases, 10th Revision) codes and diagnosis names extracted were categorized into seven major diagnostic groups. A total of 687 adult patients with 82 psychiatric ICD-10 codes were analyzed using descriptive statistics. RESULTS Substance-related and addictive disorders were the most prevalent psychiatric diagnoses. Ninety-six percent ( n = 658) of patients residing on medical floors with psychiatric disorders were hospitalized for a principal medical problem. Seventy-three cases received psychiatric consultations during their stay. Sixty percent ( n = 44) of those cases had psychiatric disorders from two or more diagnostic categories. CONCLUSIONS Multidisciplinary, team-based health care delivery models that include a psychiatric nurse can provide an effective approach to treat patients in community hospitals with multiple psychiatric and medical comorbidities. Hospitals could take a significant role in providing substance use disorder treatment and equipping medical nurses with training to competently care for patients with psychiatric disorders on medical units. Further research into the prevalence and impact of patients with co-occurring and multiple psychiatric diagnoses in community hospitals is needed to implement effective health care delivery models and provide appropriate treatment options in the community.

scholarly journals Community pharmacy as a setting for public health nutrition action: Australian nutritionists’ perspectives

2014 ◽  
Vol 18 (10) ◽  
pp. 1864-1872 ◽  
Author(s):  
Judith H Maher ◽  
John Lowe ◽  
Roger Hughes
Keyword(s):  
Public Health ◽  
Health Care ◽  
Community Pharmacy ◽  
Qualitative Data ◽  
Infant Nutrition ◽  
Public Health Nutrition ◽  
Structured Interviews ◽  
Nutrient Supplementation ◽  
Practice Experience ◽  
In Pregnancy

AbstractObjectiveTo explore public health nutritionists’ perceptions of nutrition and its place in community pharmacy (CP) presently and into the future; and to explore perceived opportunities, feasibility and scope of public health nutrition (PHN) interventions in CP, with a focus on maternal and infant nutrition.DesignQualitative data were gathered through semi-structured interviews and drew on hermeneutics as the theoretical framework for analysis and interpretation.SettingQueensland, Australia.SubjectsPublic health nutritionists, identified through purposive, criterion sampling, were chosen due to (i) their role as potential stakeholders, (ii) their knowledge and emphasis on nutrition and (iii) their practice experience.ResultsOpportunities for PHN action focused primarily on actions relating to early nutrient supplementation in pregnancy and breast-feeding protection and promotion. Opportunities in CP were constrained by practitioners’ perception of (i) conflict between health care and commercial interests in CP, (ii) problematic practices in CP and (iii) values and motivations of practitioners and other stakeholders in the CP sector. Strategies were suggested to improve practices and enhance the setting from a PHN perspective. Participants suggested both collaborative and regulatory approaches to achieve settings-based changes, identifying the need for these to coexist for effective outcomes.ConclusionsPublic health nutritionists suggest that opportunities for PHN action are constrained by perceived conflicted interests and that consumers need to be adequately protected from the influence of commercial interests. PHN action in this setting needs adequate reflection on evidence as well as ethics ensuring that practices are ‘for the good’ of mothers and infants.

scholarly journals Asthma knowledge, care, and outcome during pregnancy: The QAKCOP study

2018 ◽  
Vol 16 ◽  
pp. 147997231876771 ◽  
Author(s):  
Wanis H Ibrahim ◽  
Fatima Rasul ◽  
Mushtaq Ahmad ◽  
Abeer S Bajwa ◽  
Laith I Alamlih ◽  
...  
Keyword(s):  
Health Care ◽  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Medical Condition ◽  
Action Plan ◽  
Well Being ◽  
Chronic Medical Condition ◽  
Uncontrolled Asthma ◽  
Asthma Care ◽  
In Pregnancy

Asthma is the most common chronic medical condition affecting pregnancy. Optimizing asthma management in pregnancy is paramount for the well-being of both the mother and the baby. The primary objectives of this study were to assess patient’s knowledge about asthma, the level of asthma care, and fetal and maternal outcomes among pregnant asthmatic women in this wealthy country with tremendous improvement in maternal and fetal health care. The secondary objective was to identify barriers to asthma control. This was a cross-sectional, face-to-face, prospective study of 80 pregnant women with physician-diagnosed asthma. About 56% of patients reported worsening of their asthma control during pregnancy, of which 52.3% felt this worsening in the third trimester. About 65% of patients had uncontrolled asthma during their pregnancy, and inhaler technique was incorrect in 64.4%. Only 38% of patients knew the difference between controller and reliever asthma medications, 12.7% of patients had received written asthma action plan, 17% had a spirometry done in the previous 5 years, and 3.8% had peak expiratory flow meter at home. The main reasons for uncontrolled asthma were lack of knowledge about right asthma medications in 30% and fear of side effects of inhaled corticosteroids in 19% of patients. No financial reason was reported. Significant associations between total number of pregnancies, poor perception of asthma medications, asthma exacerbation during delivery and poor asthma control were observed. Preeclampsia and congenital anomalies occurred at higher rates than previously reported among general population in this country. The tremendous improvements in maternal health care and socioeconomic status do not seem to be a barrier to the globally recognized poor asthma care in pregnancy. Important strategies are much needed.

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