Exploring Contributing Factors to Psychological Traumatic Childbirth from the Perspective of Midwives: A Qualitative Study

PURPOSE: As midwives witness and attend the whole process of childbirth, they have a better understanding of which factors may cause traumatic childbirth. However, because most of the studies paid their attention on mothers, little is known about psychological birth trauma from the perspective of midwives. This study aims to gain a full understanding of which factors may contribute to psychological traumatic childbirth from the perspective of midwives.METHODS: A qualitative research was conducted using in-depth interviews, which involved fourteen midwives from the maternal ward of a tertiary hospital. The interviews were recorded and transcribed, and then, Colaizzi's method was used to analyze the contents of the interviews.RESULTS: We proposed four themes and eight subthemes on the influencing factors of psychological traumatic childbirth from the perspective of midwives: low perceived social support (lack of support from family and lack of support from medical staff), hard times (protracted labor in the first stage and futile efforts during the second stage), poor birth outcomes (poor birth outcomes of the mother and poor birth outcomes of the baby), and excruciating pain (unbearable pain of uterine contraction and labor pain was incongruent with the mother's expectations).CONCLUSION: Medical staff should pay attention to psychological traumatic childbirth and its effects, and emphasis on the screening and assessment of birthing women with negative feelings so that their psychological traumatic childbirth can be prevented and decreased.

Neutrophilic Granule Protein Is a Novel Murine LPS Antagonist

Neutrophilic granule protein (NGP) was previously reported as a granular protein of neutrophils in mouse, but the function has not been known clearly. We found the presence of the possible signal peptide in NGP and validated this protein is circulating in the bloodstream. In our findings, NGP is being modified post-translationally in Golgi apparatus and endoplasmic reticulum, which is a universal character of secretory molecules with a signal peptide. The secreted NGP protein could be detected both in vitro and in vivo. NGP has sequence similarity with an antimicrobial protein cathelicidin, and we observed the aspect of inflammation of NGP. Interestingly, NGP interacts with the complex of LPS and LPS binding protein (LBP). This interaction blocks the binding of the complex of LPS and LBP to TLR4 and the downstream inflammatory signals. Furthermore, the inhibitory function of NGP against the inflammatory effect of LPS could be observed in both in vitro and in vivo. With these findings, we report NGP is a novel secretory protein to mask LPS and inhibit its function.

Preference of Chinese general public and healthcare providers for a good death.

OBJECTIVES: The aim of this study is to find and compare the current situation between common people and healthcare providers' preferences for a good death in the context of Chinese culture. METHODS: A cross-sectional anonymous questionnaire survey covering 190 ordinary Chinese people and 323 healthcare providers was conducted. An inventory of the good death was translated and the subjects were surveyed about their attitude toward it. ETHICAL CONSIDERATIONS: Permission to conduct the study was granted by department chiefs, nurse managers and the participants themselves. The participants were informed that they took part on a voluntary and anonymous basis, that they could withdraw at any time, that they had the right to ignore questions they did not wish to answer, and that whatever they chose to do would not jeopardize their employment conditions. RESULTS: The attributes that were perceived as important by major respondents for a good death were maintaining hope and pleasure, good relationship with medical staff, good relationship with family, independence, environment comfort, being respected as an individual, preparation for death, physical and psychological comfort, dying in a favorite place, and not being a burden to others. And some relatively less important characteristics were life completion, receiving enough treatment, natural death, controlling over the future, unawareness of death, pride and beauty, feeling that one's life is worth living, and religious and spiritual comfort. We also found that healthcare providers were more likely than general out-patients to perceive "physical and psychological comfort," "dying in a favorite place," "good relationship with medical staff," and "natural death" as important for a good death. CONCLUSION: This study offers healthcare providers in China a fundamental understanding of the normal expectations of the general public for a good death. It is believed that these findings in our study are valuable to improve palliative care in China. We compared the attitudes of Chinese and Westerners and found some differences, which suggested that cultural difference should be an important consideration to achieve a good death in China. We also found that healthcare providers see good death differently from general public, indicating that the criteria for good death warrant further study.

Health professionals' attitude towards information disclosure to cancer patients in China.

A self-designed questionnaire was given to 634 health professionals in a large teaching hospital in Hubei Province in mainland China, to clarify the participants' attitude towards information disclosure to cancer patients. Statistic description was used to analyze the data. The item 'inappropriate information about cancer easily leads to medical disputes' scored highest at 3.86, while the scores of such items as 'advantages of fully informing patients outweigh disadvantages', 'if their family members demand nondisclosure, you will find it difficult to cooperate in good faith with patients', and 'telling white lies to patients disturbs you a lot' were less than 3. The health care staff placed a high value on both the desire and priority of patients to know the truth, though most of them did not think that patients had received enough information about their disease. In order to improve cancer patients' current state of knowledge, health professionals should learn more about informed consent, and special methods and guidelines compatible with Chinese culture are urgently required in China.