ABSTRACT
OBJECTIVE: to evaluate the efficacy of an intervention combining videoconferencing and telephone contact compared to standard post partum care of recent mothers attending health centres in Catalonia were recorded. DESIGN: multicentre, randomised parallel controlled clinical trial. PARTICIPANTS AND SETTING: 1598 post partum women with Internet access attending eight 'Attention to Sexual and Reproductive Health' (Catalan acronym ASSIR) units at Primary Health Care centres, in Catalonia (Spain). INTERVENTION: at each of the eight ASSIR units, 100 women were randomly assigned to the intervention group (IG) and 100 to the control group (CG). Women in the IG could consult midwives by videoconference or telephone and could also receive standard care. Women in the control group received standard care from midwives at their health centres or at home. MEASURES: number and type of visits, reasons for consultation, type of feeding at six weeks and women's satisfaction with the intervention on a scale of 1 to 5. FINDINGS: 1401 women were studied (80.9% of the initial sample), 683 in the IG and 718 in the CG. Two hundred and seventy-six women (40.4%) used videoconferencing or telephone in the IG. The mean total visits, virtual and face-to-face, was higher in IG women than in controls (2.74 versus 1.22). IG women made fewer visits to the health centre (mean=1) than CG women (mean=1.17). Both differences were statistically significant, with p<0.001 and p=0.002 respectively. The prevalence of breast feeding was similar in the two groups (IG 64.5%, and CG 65.4%). The mean overall satisfaction of women with midwife care was very high in both groups (IG 4.77, CG 4.76). CONCLUSIONS AND IMPLICATIONS FOR THE PRACTICE: virtual care via videoconferencing is effective for post partum women. It reduces the number of health centre visits and allows mothers to consult health staff immediately and from their own home.
Subject(s)
Postnatal Care/methods , Telemedicine , Telephone , Videoconferencing , Adult , Female , Humans , Infant, Newborn , Midwifery , Pregnancy , Primary Health Care , SpainABSTRACT
Objetivo: Averiguar el consumo de tabaco y las modificaciones del hábito durante la gestación, y observar las recaídas después del parto. Personas y método: Estudio descriptivo transversal, realizado en el PASSIR «Casagemas», Badalona, desde febrero de 2006 a septiembre de 2007. Se incluyó a 115 gestantes que acudieron a la consulta de control prenatal en el tercer trimestre de gestación, y se excluyeron las que no fumaban al inicio de la gestación. Se recogieron variables sociodemográficas y las relacionadas con el hábito tabáquico a través de un cuestionario en la gestación y otro en el posparto. Resultados: Dejaron de fumar el 26% (30) de las gestantes, y las que continuaron fumando redujeron el consumo de una media de 19,2 (DE= 6,7) a 7,2 (DE= 6) cigarrillos/día. Se observaron diferencias en el abandono del tabaco en aquellas que fumaban un menor número de cigarrillos (p <0,001), en las que iniciaron el tabaquismo más tarde y en las de mayor edad (p= 0,013). Al año del parto, seguían fumando el 73% (70) de las mujeres, y habían recaído en el hábito el 39,2% (11) de las que lo habían abandonado en la gestación. Las mujeres que no fumaban lactaron a sus hijos un 76,9% (20), mientras que las que fumaban lo hicieron un 57,1% (40). La duración media de la lactancia fue inferior en las mujeres que fumaron en el posparto (2,81 meses [DE= 3,4]) en relación con las que no lo hicieron (4,96 meses [DE= 4,1]; p= 0,01). Conclusiones: La tasa de abandono del tabaco durante el embarazo es aún muy baja, y el índice de recaída del hábito tabáquico en el posparto, elevada (AU)
Objective: To find out more about tobacco consumption and the changes in the habit during pregnancy, and to observe the relapses after the delivery. Subjects and method: A cross-sectional descriptive study, carried out in the PASSIR (sexual and reproductive healthcare services) of Casagemas, Badalona, between February 2006 and September 2007. It included 115 pregnant women who attended the third trimester prenatal check-up, and those women who did not smoke at the start of the pregnancy were excluded. Socio-demographic variables as well as variables related to the tobacco habit were collected by means of a questionnaire during the pregnancy and another during the postpartum period. Results: Of the pregnant women 26% (30) stopped smoking, and those who continued to smoke reduced the consumption from an average of 19.2 (DE=6.7) to 7.2 (DE=6) cigarettes/day. Differences were observed in tobacco cessation among those who smoked a smaller number of cigarettes (p <0.001), those who started tobacco smoking later and among older pregnant women (p= 0.013). One year after giving birth, 73% (70) of the women continued to smoke, and 39.2% (11) of those who had stopped smoking during pregnancy had relapsed to smoking. Of the women who didnt smoke 76.9% (20) Breastfed their babies, while among those who smoked 57.1% (40) breastfedtheir babies. The average duration of the breastfeeding was smaller in the case of the women who smoked during the postpartum period, 2.81 months (DE= 3.4), compared to 4.96 months (DE= 4.1) in the case of those who didnt smoke; (p= 0.01). Conclusions: The rate of tobacco cessation during pregnancy is still very low, and the rate of relapse to tobacco smoking during the postpartum period is high (AU)
Subject(s)
Female , Humans , Pregnancy , Tobacco Use/epidemiology , Smoking , Smoking Cessation , Pregnancy , Postpartum Period , Epidemiological Monitoring/trends , Health Education , Health Promotion , Midwifery , Professional Competence , Spain/epidemiologyABSTRACT
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