RESUMO
Considering the increasing number of cesarean cases and to identify the effective factors in choosing such surgery, this study was performed to evaluate the attitudes of medical specialists and gynecological assistants toward the type of delivery and the reasons for increasing rates of cesarean. Data were gathered through a semi-structured interview and analyzed using a content-analysis method. Finally, 11 physicians and assistants were participated in the study. The participants were selected through purposeful sampling. The first two participants were selected through accessible sampling, while the others by previous participants to consider the variety of physicians' experiences and attitudes. Data were analyzed using the Cheevakumjon method. After reviewing the data, key sentences and concepts were derived and finally categorized. Fear of the delivery pain was one of the most important reasons that made women to select the cesarean, while having a good delivery experience was one of the most important reasons for choosing the vaginal delivery. Four categories of factors, some facilitators for choosing the cesarean and the others for vaginal delivery, affecting the choice of delivery were related to patient, culture, delivery conditions and also the outcomes. Several factors should be considered in choosing a delivery method. Furthermore, preparing a woman for a painless and pleasant delivery and also changing the attitudes toward the type of delivery are very important
RESUMO
Background: Trauma is the leading cause of mortality and its unfavorable outcomes among the population under 50 years. This study was conducted to assess the outcome of traumatic brain injuries and its related factors among the patients hospitalized in intensive care unit [ICU]
Materials and Methods: This descriptive study was carried out on 95 patients hospitalized with traumatic brain injuries in ICU wards of Kashan hospitals. A check-list was used for data gathering, consisted of demographic and clinical data [e.g. characteristics of accident, trauma outcome and the level of consciousness]. The level of consciousness was evaluated using Glasgow Coma Score [GCS] on admission and 6 hours post-admission in ICU
Results: The average age of patients was 27.6+/-13.9 years. The average length of hospitalization in ICU [12.3+/-13.9 days] showed a significant relationship with GCS. Sixtypercent of patients showed desirable outcomes with a mortality of 23.2%. The severity of head trauma on admission and 6 hours post-admission had a significant relation to trauma outcome [P=0.0001]. Logistic regression showed that GCS evaluation 6 hours postadmission could identify the outcome of trauma [P=0.007]
Conclusion: The evaluation of GCS 6 hours post-admission to ICU was among the most important variables in identifying outcomes after head trauma. To evaluate and predict the outcomes of head trauma, the data related to the GCS of the ICU patients should be recorded carefully