Health professional's knowledge and use of the partograph in public health institutions in eastern Ethiopia: a cross-sectional study.

BACKGROUND: The partograph is a vital tool for health professionals who need to be able to identify pathological labor. It is used to recognize complications in childbirth on time and to take appropriate actions. We aimed to assess the knowledge and utilization of the partograph and associated factors among health professionals at public health institutions in eastern Ethiopia. METHODS: An institution based cross-sectional quantitative study was carried out among health professionals who were working in public health institutions. Multistage sampling with proportional to size allocation was used to recruit a total of 441 study participants. Self-administered questionnaire was used to collect data in this study. Eight midwives were recruited and trained to facilitate the data collection activities. Data were entered into Epi data software and exported into SPSS (22.0) for analysis. Descriptive statistics, bivariate and multiple logistic regression were computed to determine proportions and significant association with knowledge and use of the partograph among health professionals. RESULTS: More than half of health professionals, 232(53.7%) had a good level of knowledge about the partograph. However, only 196(45.4%) of health professionals had fair knowledge of partograph. Nevertheless, the proportion of the partograph utilization to follow labor progress by health professionals was 92.6%. Working in the health center [AOR = 0.31, 95% CI: 0.20, 0.48], being a midwife [AOR = 2.80, 95% CI: 1.60, 5.60] and in-service training [AOR = 2.0, 95% CI: 1.22, 3.42] were significantly associated with good level of knowledge. Health professionals who had in-service training about the partograph [AOR = 3.10, 95% CI: 1.35, 4.98] and who had positive attitude about the partograph [AOR = 2.90, 95% CI: 1.30, 6.30] were significantly associated with utilization of the partograph. CONCLUSION: Only less than half of health professionals had fair knowledge about the partograph. Having in-service obstetric care training, type of health institutions and profession were significantly associated with knowledge of the partograph. Health professionals who had positive attitude towards use of the partograph were significantly associated with the partograph utilization. We suggest regular in-service training of health professionals can enhance their knowledge and utilization of the partograph.

If you could see what we see, would it bother you?

OBJECTIVE: The purpose of our study was to determine whether the anatomic threshold for pelvic organ prolapse (POP) diagnosis and surgical success remains valid when the patient sees what we see on exam. METHODS: Two hundred participants were assigned, by computer-generated block randomization, to see one of four videos. Each video contained the same six clips representative of various degrees of anterior vaginal wall support. Participants were asked questions immediately after each clip. They were asked: "In your opinion, does this patient have a bulge or something falling out that she can see or feel in the vaginal area?" Similarly, they were asked to give their opinion on surgical outcome on a 4-point Likert scale. RESULTS: The proportion of participants who identified the presence of a vaginal bulge increased substantially at the level of early stage 2 prolapse (1 cm above the hymen), with 67 % answering yes to the question regarding bulge. The proportion of participants who felt that surgical outcome was less desirable also increased substantially at early stage 2 prolapse (1 cm above the hymen), with 52 % describing that outcome as "not at all" or "somewhat" successful. CONCLUSION: Early stage 2 POP (1 cm above the hymen) is the anatomic threshold at which women identify both a vaginal bulge and a less desirable surgical outcome when they see what we see on examination.

A consulta genecológica sob a ótica de adolescentes: uma análise compreensiva / Gynecological consultation from the point of view of adolescents: comprehensive analysis / La consulta ginecológica desde la perspectiva de adolescentes: un análisis comprensivo

Este estudo teve por objetivo compreender o significado atribuído pelas adolescentes à consulta ginecológica. Para isso, utilizei-me da abordagem fenomenológica, à luz das concepções de Merleau-Ponty. Para a coleta de dados utilizei a entrevista aberta. Os discursos das adolescentes permitiram construir três categorias: "Expressão de Sentimentos", "Cuidado com a Saúde" e "Relação com o Profissional de Saúde", que apontam que fazer a consulta causa constrangimento, pois é preciso falar sobre a intimidade e expor o corpo ao exame. Mas, elas superam tais sentimentos, pois reconhecem que é importante cuidar da saúde.

The purpose of this study was to understand the meaning given by adolescents to a gynecological consultation. I have used a phenomenological approach, according to the concepts of Merleau-Ponty. Data was collected using an open interview. The discourse of the teenagers allowed me to construct three categories: "Expression of Feelings", "Health Care" and "Relation to the health care professional", which show that the consultation brings about embarrassment for them, because they have to talk about their intimacy and expose their bodies for examination, but they manage to overcome these feelings because they recognize it is important to care for their health.

El objetivo de este estudio es comprender el significado atribuido por las adolescentes a la consulta ginecológica. Para ello se ha empleado la fenomenología con los conceptos de Merleau-Ponty y, para la recopilación de datos, la entrevista abierta. Las respuestas de las adolescentes permitieron construir tres (3) categorías: "Expresión de sentimientos", "Cuidado con la Salud" y "Relación con el Profesional de Salud"; señalan que la consulta les da vergüenza pues deben hablar sobre su intimidad y exponer el cuerpo para el examen. Sin embargo, las adolescentes superan tales sentimientos ya que reconocen que es importante cuidar la salud.

[Smear test from the point of view of women who undergo it]. / O exame colpocitológico sob a ótica da mulher que o vivencia.

This research is the result of my experience with women in cervical cancer prevention at the Gynecology and Obstetrics National Health Clinic of the Federal University of Minas Gerais. I tried to understand what it means to women who are submitted to a smear test. To achieve this, I have used a qualitative research, in a phenomenological approach. I gathered the data from interviews about the main subject. The analysis of those eleven interviews have helped me to build three analytical categories that are the located structure of the phenomenon, as follows: A--The preventive cervical cancer examination: a woman as a human being conscious of the world; B--Facing the smear test: manifestation of the existence; C--Working with the health professional during the examination: as interfaces of the attendance.

O exame colpocitológico sob a ótica da mulher que o vivencia / El examen colpocitológico desde la óptica de la mujer que lo vivencia / The smear test under the point of view of the woman who has experienced it in her life

Esta pesquisa é fruto de minha experiência com mulheres no Programa de Prevenção do Câncer Cérvico-uterino do Ambulatório de Ginecologia e Obstetrícia do Hospital das Clínicas da UFMG. Busquei compreender o que significa para as mulheres se submeterem ao exame colpocitológico. Para tal, utilizei-me da pesquisa qualitativa, numa abordagem fenomenológica. Para coletar os dados foi utilizada uma entrevista aberta. A análise dos discursos das onze mulheres entrevistadas possibilitou-me construir três categorias analíticas: A- Prevenindo o câncer cérvico-uterino: a mulher como ser-consciente-no-mundo; B- Enfrentando o exame colpocitológico: manifestações do existir; C- Interagindo com o profissional de saúde durante o exame: as interfaces da assistência.

This research is the result of my experience with women in cervical cancer prevention at the Gynecology and Obstetrics National Health Clinic of the Federal University of Minas Gerais. I tried to understand what it means to women who are submitted to a smear test. To achieve this, I have used a qualitative research, in a phenomenological approach. I gathered the data from interviews about the main subject. The analysis of those eleven interviews have helped me to build three analytical categories that are the located structure of the phenomenon, as follows: A- The preventive cervical cancer examination: a woman as a human being conscious of the world; B- Facing the smear test: manifestation of the existence; C- Working with the health professional during the examination: as interfaces of the attendance.

Esta investigación es fruto de mi experiencia con mujeres en el Programa de Prevención de Cáncer Cérvico-uterino del Consultorio externo de Ginecología y Obstetricia del Hospital de Clinicas de la UFMG. Quería comprender lo que significa para las mujeres someterse al examen colpocitológico. Para tal fin, utilicé el método de investigación cualitativo con abordaje fenomenológico. Para la recolección de datos fue utilizada la entrevista con preguntas abiertas. El análisis de los discursos de once mujeres entrevistadas me permitió construir tres categorías analíticas: A- Previniendo el cáncer cérvico-uterino: la mujer como ser conciente del mundo; B- Enfrentando el examen colpocitológico: manifestaciones del existir; C- Interactuando con el profesional de salud durante el examen: las interfases de la asistencia.

Anxiety and feelings of medical students conducting their first gynecological examination.

We examined the anxiety of medical students when they conduct their first gynecological examination. The students (226) from two universities completed anonymous questionnaires providing measures of state and trait anxiety and anxiety and confidence feelings, before and after conducting their first bimanual and speculum examination. This took place during a structured, self-directed learning session and involved examination of a professional patient. Students state anxiety was significantly elevated immediately before and fell to below baseline levels after the examination (p < 0.001). Students' reported feelings of increased confidence during the examination (p < 0.001). Students who had personally had a Pap smear test were most anxious before (p < 0.003) but during the examination, students who had experienced a gynecological exam felt less anxious (p < 0.002). The students experiencing the greatest decreases (before to after) in state anxiety were those who had never experienced sexual intercourse (p < 0.005). Most students (96%), particularly those who were more anxious during the examination (p < 0.001) and who experienced a greater decrease in anxiety from before to after the examination (p < 0.008) would recommend this method of learning to other students. In summary, medical students are anxious when they conduct their first gynecological examination, appear to be influenced by their personal experiences and appreciate methods of learning that reduce their anxiety.

Simulators for intimate examination training in the developing world.

CONTEXT: Family planning clinic in urban India. OBJECTIVE: To assess the usefulness of a pelvic simulator for intimate examination and intrauterine device insertion training, and for enhancing reproductive education for women. DESIGN: Observational study using evaluation forms completed by staff, and focus group interviews with women and girls participating in sexual health education. Content analysis of interview material. RESULTS: Staff being trained in intimate examination found the simulator to be useful in increasing their level of skill. Participants in sexual health education reported an improved range and depth of knowledge following demonstrations with the simulator. CONCLUSION: Where working and training conditions are crowded and lacking in privacy, inappropriate examination practices are likely to be propagated. Training for intimate examinations can be enhanced by the use of pelvic simulators.

How to perform a pelvic exam for the sexually active adolescent.

The pelvic examination is a necessary health screening for sexually active female adolescents. This article describes how to perform a pelvic examination, including collecting specimens for sexually transmitted infections, wet mount evaluation, and the Papanicolaou test. Additional sections cover abnormal findings and special considerations.