Knowledge, attitudes, and practices towards COVID-19 and COVID-19 vaccines among Obstetrician-Gynaecologists.

INTRODUCTION AND OBJECTIVE: The article assesses the knowledge, attitudes, and practices of Obstetrician-Gynaecologists (OB/GYNs) in Israel regarding COVID-19, its impact on fertility, pregnancy and childbirth, and their positions on COVID-19 vaccines. MATERIAL AND METHODS: A cross-sectional anonymous survey was employed, and the data analyzed using logistic regression models. RESULTS: A total of 172 OB/GYN participants aged 44.9 years, primarily female (59.7%), mostly attending physicians (60.4%), had a mean knowledge score of 75.62%, with 81.1% having sufficient knowledge about general COVID-19 information, 11.9% having specific knowledge about pregnancy, birth, and breastfeeding, and 40.3% having knowledge about COVID-19 vaccination. Notably, only 27% of participants correctly identified the increased risk of preeclampsia in pregnant women with COVID-19. Nevertheless, all OB/GYN participants recommended the COVID-19 vaccination during pregnancy. The majority (65.1%) recommended vaccination across all trimesters, while a smaller percentage recommended it only in the second (25%) or third (6%) trimesters, and very few in the first trimester (4%). The study found that attitudes towards vaccination were influenced by workplace, role, religion, religious observance, and marital status. CONCLUSIONS: The study showed a good level of knowledge regarding COVID-19 vaccines which contributed to OB/GYNs' recommendations to their patients. These findings can be valuable for designing future COVID-19 vaccination campaigns.

Global Elimination of HCV-Why Is Poland Still So Far from the Goal?

INTRODUCTION: Eradication of HCV in the global population remains one of the greatest challenges faced by the WHO. An insufficient level of knowledge and the lack of a national screening test strategy are obstacles to HCV eradication. AIM: This work aimed to summarize surveys assessing risk factors and awareness of the respondents regarding the prevention and course of HCV infection. The summary also includes the most important European and global attempts at eliminating HCV. MATERIALS AND METHODS: A cross-sectional, population-based study was conducted in the Mazowieckie district in Poland using anonymous surveys and conducted on people who willingly reported for a test. RESULTS: In the study cohort of n = 7397 adults, there were 5412 women (73.16%). The analysis of the quota sample (n = 1303) reflected the actual proportions in the population of the Mazowieckie Voivodeship. CONCLUSIONS: Insufficient knowledge about HCV decreases the probability of higher detection of infections, fast diagnostics, and treatment. According to the WHO model, assuming a 90% detection rate and treatment of 80% of infected by 2030, and taking into account 120-150 thousand infected persons in Poland, the number of detections of HCV should be increased 4-5 times and all diagnosed persons should be offered antiviral treatment.

Challenges in Job Seeking and the Integration of Ukrainian War Refugee Healthcare Workers Into the Polish Healthcare System: Facebook Content Analysis.

Objectives: The full-scale Russian invasion of Ukraine resulted in a refugee crisis. The terms of employment of Ukrainian Refugee background Medical Professionals (UKR-MPs) in the Polish healthcare system were liberalised. The aim of the study was to identify challenges in job seeking and the integration of Ukrainian war refugee healthcare workers into the Polish healthcare system. Methods: A qualitative, descriptive study based on content thematic analysis of Facebook content. We analyzed 1,700 posts published on two public Facebook groups intended for UKR-MPs. Results: The most common problems encountered by UKR-MPs were: 1) lack of easy-to-understand information about the list of documents necessary to apply for a work permit, 2) lack of feedback from those responsible for handling individual cases, and 3) long waiting time for the decision issued by the Ministry of Health. Conclusion: Despite the promptly implemented solutions enabling access to the job market by UKR-MPs, the refugees have encountered considerable administrative difficulties, as well as those arising from insufficient knowledge of the regulations on working as medical professionals in Poland under the EU law.

Validation Study of the Revised Spirituality and Spiritual Care Rating Scale (SSCRS): A Cross-Sectional Survey in Poland.

Introduction: The use of a validated scale, Spirituality and Spiritual Care Rating Scale (SSCRS) to measure nurses' perceptions of spirituality and spiritual care. Aim: The purpose of this study was to analyse selected psychometric properties of the Polish version of the SSCRS, among them the applicability of the dimensions of spiritual care in nursing, ie, spirituality, spiritual care, religiosity and personalized care, to Polish conditions. Methods: Poland-wide multicentre study with a cross-sectional validation design. The study was conducted between March and June 2019. Seven Polish Nursing Faculties accepted the invitation to participate in the study. A representative sample of 853 nurses enrolled in MSc (postgraduate) programs in nursing participated. After translation and cultural adaption of the SSCRS, the instrument underwent a full psychometric evaluation of its construct validity using (exploratory and confirmatory factor analysis), internal consistency (Cronbach's alpha and correlation analysis), reliability (test-retest analysis), known-group validity (Student's t-test) analysis. Results: The exploratory and confirmatory factor analysis demonstrated that the Polish version of the SSCRS was a three-factor model with "Activity-centred spiritual care" (9 items), "Emotional support-centred spiritual care" (5 items) and "Religiosity" (3 items) domains. The Cronbach's alpha coefficient for the whole scale was 0.902, and the alpha values for the individual domains were 0.898, 0.873 and 0.563, respectively. The three domains mentioned above seemed to provide a comprehensive understanding of spiritual care perceived subjectively by Polish MSc in nursing students. Conclusion: This study demonstrated a substantial degree of similarity in the selected psychometric characteristics of the Polish version of SSCRS and the original scale.

Social media literacy among nursing students during the COVID-19 pandemic - does year of study matter? A nationwide cross-sectional study.

INTRODUCTION AND OBJECTIVE: Research to date indicates that student competencies in various dimensions of social media use vary depending on, for example, the field of study or stage of education. The aim of the study was assessment of social media literacy in a group of undergraduate nursing students, based on the year of study. MATERIAL AND METHODS: Respondents: 679 nursing students from 11 Polish medical universities who began or continued their education during the COVID-19 pandemic. First-year students (N = 397, 58.73%) and women (N = 589, 87.13%) constituted the largest group. The Perceived Social Media Literacy Scale was used. Statistical analysis used the Kruskal-Wallis one-way analysis-of-variance-by-ranks to analyse differences in PSML scores, and Dunn's test to analyse differences in PSML scores between individual years of study (α= 0.05). RESULTS: The level of social media literacy between students differed significantly (p < 0.001). Students rated their technical competency the highest (H = 29.722, p < 0.001), social relationships (H = 20.946, p < 0.001) and informational awareness (H = 21.054, p < 0.001) the lowest. The lowest scores in the self-assessment of social media literacy were noted among first-year students (M = 55.85, Max = 70.0; p < 0.001), and the highest among second-year students (M = 60.99, Max = 70.0; p < 0.001). CONCLUSIONS: Nursing students rated their competency lowest in the sphere related to verifying the content of messages appearing on social media, which may have a significant impact on their professional competencies. Differences in the level of social media literacy among students of different years of study should be taken into account when designing training in this field.

THE IMPORTANCE OF REMOTE COUNSELING IN COSMETOLOGY AND COSMETIC DERMATOLOGY.

Remote consultations are used for diagnosis, treatment recommendations, patient monitoring and health education. The aim of the study was to collect, assess and summarise data regarding remote consultations in cosmetology and cosmetic dermatology. The study is an introduction to the authors' research into the importance of remote counseling in cosmetology. A review of the literature available on PubMed; a diagnostic survey was carried out among those declared and qualified for the study; the author's preliminary unpublished results are reported (JMB). A total of 490 publications were identified in a search of 20 October 2021. A summary of ten research papers was produced in the narrative form. In addition, an analysis of an unpublished diagnostic survey was carried out (JMB research, 2021, respondents n=95, full survey completed n=46). The analysed research papers discussed: telephone counseling (n=2), e-counseling (n=3), e-learning (n=2), automatic counseling (n=2), and mobile health applications (n=1). The aim of each of the research papers analysed in this review was to educate patients in the field of skin care and to con¬solidate proper skin care and photo-protection behaviours. The diagnostic survey, as well as the literature review, confirmed the importance of and need for remote counseling in cosmetology and cosmetic dermatology as regards education, motivation and prophylaxis.

How Psychological Variables Maybe Correlated with Willingness to Get COVID-19 Vaccine: A Nationwide Cross-Sectional Study of Polish Novice Nurses.

INTRODUCTION: Nurses became the largest medical group exposed to direct contact with the SARS-CoV-2 virus. In this study, we aimed to assess the readiness and motivation for vaccination, as well as the use of sources of information and attitudes toward vaccination depending on the psychological profile. MATERIAL AND METHODS: A cross-sectional online survey study was conducted. The study included 145 novice nurses from 8 medical universities who completed 3-year undergraduate studies. Women constituted 97.2% of the respondents (N = 141). The Generalized Anxiety Disorder 7-Item Scale, General Self-Efficacy Scale, Brief Resilient Coping Scale, and an original questionnaire were used. Variables were analyzed with descriptive statistics methods. A p-value of <0.05 was considered statistically significant. RESULTS: Among the participants, 73.1% had already been vaccinated against COVID-19 (N = 106). The participants were divided into two groups: G1 (N = 98), characterized by a lower level of anxiety with higher self-efficacy and resilient coping, and G2 (N = 47), with a higher level of anxiety with poorer self-efficacy and resilient coping. The analysis of the potential correlation of psychological pattern with the decision to vaccinate was not statistically significant (p = 0.166). CONCLUSION: Psychological variables may be correlating with motivation, attitudes toward vaccination, and the choice of reliable sources of information about vaccination. Our study demonstrates the key role of two psychological variables, self-efficacy and resilient coping, in this context.

A Review of Humoral and Cellular Immune Responses to SARS-CoV-2 Vaccination Following Solid Organ Transplantation.

The introduction of vaccines preventing a severe course of COVID-19 disease is particularly important in immunocompromised patients, among whom organ recipients and patients awaiting transplantation constitute a large group. The article is a critical review of 68 recent publications on the impact of the SARS-CoV-2 pandemic on transplantology worldwide. The study discusses research results concerning various aspects of SARS-CoV-2 vaccination in transplant patients; it also lists important factors influencing vaccination effectiveness. A suboptimal immune response to 2 doses of vaccine in this group of patients is a major challenge prompting further research. Therefore, this review aims to provide an update on the humoral and cellular immune responses to SARS-CoV-2 vaccination following solid organ transplantation.

Caring Ability and Professional Values of Polish Nursing Students-A Cross-Sectional Study.

Caring ability and professional values developed and shaped during nursing university studies are often recognised as fundamental components of education and professional nursing attitudes. The aim of this study was to analyse the relationship between caring ability and professional values among nursing students and their correlation with selected sociodemographic variables. A cross-sectional study was conducted among a convenience sample of 379 nursing students. During the research, the Polish versions of the Caring Ability Inventory and the Professional Values Scale were used. The overall result in the Professional Values Scale was 108.78 (SD = 16.17)-which is considered average, and in the Caring Ability Inventory 189.55 (SD = 18.77)-which is considered low. Age correlated negatively with the professional values of students in total and in the subscale "care"; in contrast, "gender", "place of residence" and "financial situation" did not show any correlation with the level of students' professional values and caring ability. The professional values and caring abilities of nursing students depended on the year and mode of study and the type of university. The results of the study revealed that the caring ability and professional values of nursing students undergo changes during their education.

The role of life skills in developing an authentic leadership attitude in public health students: a multicenter cross-sectional study in Poland.

BACKGROUND: Decision-making skills are considered crucial life skills that condition proper social functioning within groups (i.e., support authentic leadership skills and increasing one's chances of success and wellbeing in life). Nonetheless, the number of scientific papers addressing the role of life skills in developing authentic leadership skills in public health students is limited. The aim of the present study was to develop a theoretical model to determine the role of selected life skills in developing authentic leadership skills in public health students. METHODS: The study was conducted from January 16 through February 28, 2018. In total, 653 students undertaking in-service training in Master's degree programs qualified for the study, and complete data sets were obtained from 329 students (response rate 50.38%). The data were collected by means of a paper questionnaire. Four research tools were used in the study: The Authentic Leadership Self-Assessment Questionnaire, The Moral Foundations Questionnaire, The General Self-Efficacy Scale, and The Youth Leadership Life Skills Development Scale. RESULTS: Two subgroups were identified among the public health students in the study: 1) the extra life skills training group (N = 113) and 2) the no extra life skills training group (N = 216). Both groups of study participants did not differ significantly in terms of age (M (SD): 25.0 (3.89) vs. 25.0 (3.66); t = 0.068, P = 0.946). On the other hand, clear differences were observed in the case of the respondents' participation in voluntary service. The respondents from the extra life skills training group declared participation in voluntary activities less frequently than the respondents from the second identified group (48.7 vs. 31.9%). CONCLUSIONS: A verified theoretical model showed that course aimed at strengthening authentic leadership competences should be modular, should focus on self-improvement and critical reflection, and should be spread over time to enable and encourage each participant to grow and flourish at their own pace.

Attitudes toward COVID-19 Vaccination on Social Media: A Cross-Platform Analysis.

During the COVID-19 pandemic, social media content analysis allowed for tracking attitudes toward newly introduced vaccines. However, current evidence is limited to single social media platforms. Our objective was to compare arguments used by anti-vaxxers in the context of COVID-19 vaccines across Facebook, Twitter, Instagram, and TikTok. We obtained the data set of 53,671 comments regarding COVID-19 vaccination published between August 2021 and February 2022. After that, we established categories of anti-vaccine content, manually classified comments, and compared the frequency of occurrence of the categories between social media platforms. We found that anti-vaxxers on social media use 14 categories of arguments against COVID-19 vaccines. The frequency of these categories varies across different social media platforms. The anti-vaxxers' activity on Facebook and Twitter is similar, focusing mainly on distrust of government and allegations regarding vaccination safety and effectiveness. Anti-vaxxers on TikTok mainly focus on personal freedom, while Instagram users encouraging vaccination often face criticism suggesting that vaccination is a private matter that should not be shared. Due to the differences in vaccine sentiment among users of different social media platforms, future research and educational campaigns should consider these distinctions, focusing more on the platforms popular among adolescents (i.e., Instagram and TikTok).

Women's views and preferences regarding the mode of birth after cesarean section: Polish cross-sectional web-based survey.

OBJECTIVE: Currently, the most common indication for cesarean section is a previous cesarean section. Some of them are performed for no medical reasons. Therefore, it is crucial to recognize the preferences and expectations of women concerning birth after cesarean section. This study's main aim was to understand the women's points of view on the mode of birth after cesarean. STUDY DESIGN: A cross-sectional study was conducted, and data was collected using an original structured online questionnaire. The study group consisted of 733 pregnant Polish women who had previously undergone a cesarean birth. RESULTS: Women more often preferred vaginal birth after cesarean section (73.26%) and less frequently (23.33%) chose elective cesarean section. Women preferring VBAC when making decisions were guided by the benefits, opportunities, and risks associated with each mode of birth. For women preferring elective cesarean section the only highly significant factor was the experience of previous deliveries. Women mainly use Internet sources and the support of other women giving birth after cesarean section. More than half of the women did not talk about the mode of birth with their midwife, and every fifth did not talk about it with the obstetrician. CONCLUSION: Obstetric history and personal beliefs about birth after cesarean section, motivations, and concerns about childbirth affect women's preferences regarding the mode of birth. It is necessary to educate women, in particular, talks about the opportunities and risks associated with cesarean birth carried out by the medical staff at an early stage of pregnancy.

Bleeding during pregnancy as a reason for interventions by emergency medical services teams in Poland.

INTRODUCTION AND OBJECTIVE: Vaginal bleeding during pregnancy is associated with risks to the health and life of the woman and/or the foetus. Moreover, it is usually unanticipated, which requires on-site care to be provided to the woman. Such care is handled by emergency medical services (EMS) teams until specialist obstetric care can be provided. The purpose of study was to analyze the characteristics of EMS team responses to calls regarding pregnant women with vaginal bleeding, considering the location of call: urban vs. rural area. MATERIAL AND METHODS: The study was based on a retrospective analysis of 5,487 EMS team interventions due to vaginal bleeding in pregnant women in Poland. The data analyzed included the period January 2018-December 2019, obtained from the National Monitoring Centre of Emergency Medical Services. RESULTS: The teams were more commonly dispatched to pregnant women in rural areas, who were more likely to be older and in the course of a second (27.52% vs. 26.88%) or subsequent pregnancy (34.00% vs. 27.49%), to have had one (28.22% vs. 26.75%) or more previous births (28.87% vs. 22.87%), and to have antepartum bleeding (23.91% vs. 20.36%) than those from urban areas. The mean time between receipt of the call and patient hand-over at the hospital by the EMS team was longer in rural areas (50.00 vs. 37.23 minutes). CONCLUSIONS: EMS teams responding to calls from rural areas regarding pregnant women with vaginal bleeding were most commonly dispatched in the summer, and the mean time between the receipt of the call and patient hand-over at the hospital was longer than in the calls from urban areas. Compared to patients calling from urban areas, those from rural areas were also more likely to be pregnant for the second or subsequent time, to have antepartum bleeding, and to have given birth before.

The Trend of Authentic Leadership Skills in Nursing Education: The Key Role of Perfectionism and Self-Efficacy.

(1) Background: Shaping leadership skills is a complex process, which may be modified by psychological factors such as self-efficacy and perfectionism. The aim of the study was to determine whether perfectionism can be a mediator between self-efficacy, and authentic leadership skills in nursing students; (2) Methods: The cross-sectional study included 615 Polish nursing students (women = 96.3%) was carried out at Medical University of Warsaw in 2019. The following research tools were used: Authentic Leadership Questionnaire, Almost Perfect Scale-Revised (APS-R), and General Self-Efficacy Scale (GSES); (3) Results: The level of perfectionism is a significant mediator of relations between self-efficacy as measured by the GSES and the level of authentic leadership (Sobel test: t = 6.958; p < 0.000). The relation, without a mediating factor, is positive, and the standardized beta coefficient for the feeling of self-efficacy totals beta = 0.470 (p < 0.000), while in the presence of a mediator the strength of the correlation is smaller and amounts to beta = 0.366 (p < 0.000); (4) Conclusions: Personality factors such as self-efficacy and perfectionism play an important role in shaping AL skills of nursing students. Therefore, academic teachers should pay special attention to strengthening students' self-efficacy and adaptive perfectionism. In this context, adequate feedback and reflection may be important.

Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models.

Liver transplantation (LTx) is the best treatment for patients with early-stage hepatocellular carcinoma (HCC). The Milan criteria positively influenced results of liver transplantation and were adopted by the majority of cancer centers, becoming the criterion standard treatment for early-stage HCC. Despite the use of restrictive criteria, recurrence is still high, affecting between 8% and 20% of cases, and is a significant predictor of survival after LTx. The diagnosis of both micro-and macro-invasion of vessels, which are significant factors in determining the frequency of recurrence and overall survival, significantly decreases the success of transplantation, causing an increase in mortality of 50% in comparison to recipients with no vascular invasion. The risk of recurrence depends on several factors, which are discussed in this review. The authors also discuss the clinical presentation and treatment methods of recurrence and its prognosis. In addition, the role of different models developed to identify groups of patients with high versus low risk of recurrence is discussed, enabling the planning of recommendations and screening protocols after transplantation to help early diagnosis and guide effective treatment. In the era of an increasing numbers of liver transplants due to HCC, the need to create robust screening tools is urgent.

Impact of Anxiety on Readiness for COVID-19 Vaccination among Polish Nursing Undergraduate Students: Nationwide Cross-Sectional Study.

The COVID-19 pandemic had a huge impact on the mental health of people around the world, and it increased the level of fear of infection and anxiety about the consequences of the disease caused by the SARS-CoV-2 virus. We examined the relationship between the level of anxiety among nursing students and their knowledge about COVID-19 vaccination. In addition, we explored the correlations among the level of anxiety, knowledge about vaccination, and the willingness to vaccinate against COVID-19. A total of 790 undergraduate nursing students participated in the study. The results demonstrated that the level of anxiety among the surveyed nursing students was low; 40% of the study participants did not report any anxiety at all, 30% reported mild anxiety, 20% reported moderate anxiety, and 9% reported severe anxiety. At the time of the study, 77.2% of the participants were already vaccinated against COVID-19. Student knowledge about vaccination against COVID-19 was high and anxiety levels were low, with no direct correlation between the knowledge of vaccination and the severity of anxiety.

Perceiving the Role of Communication Skills as a Bridge between the Perception of Spiritual Care and Acceptance of Evidence-Based Nursing Practice-Empirical Model.

Decision making using evidence-based practice (EBP) is generally universally accepted by nurses. Such acceptance may affect the personnel's behaviour towards patients, which is also demonstrated by taking into consideration the patient's preferences, including the patient's spiritual needs, in the care plan. The provision of such care requires the development of an attitude of approval and an adequate level of communicative competence, which will enable the actual implementation of the EBP. The purpose of our study was to assess the perception of spirituality and the nurse's role in providing spiritual care, as well as the perception of the significance of communication skills in the approval of EBP in professional practice. A multi-centre cross-section study was conducted on a population of 1176 participants (459 undergraduate (bachelor's programme, BP) and 717 postgraduate students (master's programme, MP)) from 10 medical universities in Poland. Three tools were used in the study to evaluate the participants' approach: Evidence-Based Practice Competence Questionnaire (EBP-COQ), The Spirituality and Spiritual Care Rating Scale (SSCRS), and Communication Skills Attitude Scale (CSAS). Structural equation modelling was used for the analysis. An analysis of structural equations revealed the presence of positive relationships of the attitude to spiritual care and the role of communicative competences with the approach to EBP regardless of the cohort. A significant difference was found related to the influence of age on the attitude towards learning communicative competences. The approval in this respect was observed to decrease with age in the MP group. Increasing approval of EBP requires strengthening the approach to activity-centred spiritual care, with the simultaneous development of a positive attitude towards learning communicative competences. The model reveals the need to integrate a humanistic approach with EBP, which can be achieved by planning different interventions in different groups of recipients: nurses, academic teachers and students.

Polish Medical Air Rescue Interventions Concerning Pregnant Women in Poland: A 10-year Retrospective Analysis.

BACKGROUND Even in the normal course of pregnancy, alarming symptoms and obstetric complications can occur, necessitating appropriate care. Medical rescue and Helicopter Emergency Medical Services (HEMS) teams are responsible for responding to emergencies and performing medical emergency procedures on scene and during patient transport to hospital. The purpose of our study was to present the characteristics of HEMS and Emergency Medical Service (EMS) interventions concerning pregnant women in Poland. MATERIAL AND METHODS The study involved a retrospective analysis of missions by HEMS and EMS crews of the Polish Medical Air Rescue concerning pregnant women in Poland. The analysis included all HEMS and EMS flights to cases of accidents and other emergencies and air transport missions where medical assistance had been provided to pregnant women between January 2011 and December 2020. RESULTS Polish Medical Air Rescue teams were most commonly dispatched to urban areas (79.46%) and for inter-hospital transport (75.85%). The mean patient age was 29.72 years, and the most common diagnosis, in accordance with the International Statistical Classification of Diseases and Related Health Problems (ICD-10), was premature labor (24.38%). CONCLUSIONS Pregnant patients aged 30 and older and those receiving HEMS and EMS assistance in urban areas were found to have a higher odds ratio for premature labor. A correlation was identified between the diagnosis associated with the Polish Medical Air Rescue intervention and the pregnant woman's age and location of call.

Women's experiences of dysmenorrhoea - preliminary study.

INTRODUCTION: Dysmenorrhoea is a significant interdisciplinary problem that requires intensified activities of specialists, mainly in the fields of health sciences, gynaecology, and pharmacology. AIM OF THE STUDY: The aim of the study is to learn about women's experiences of dysmenorrhoea. MATERIAL AND METHODS: The study was conducted between January and March, 2020 using a diagnostic research questionnaire developed for the purpose of the study. Based on the inclusion criteria, a total of 166 out of 192 completed questionnaires were analysed. The analysis of collected data was performed with the aid of Microsoft Office Excel 2007 and Statistica 13.1. RESULTS: Most of the respondents, during menstruation, experienced severe pain. Among the study participants, 86.14% used pharmacological methods to relieve menstrual pain, and non-pharmacological methods were popular among 74.10% of women. Almost half of the study participants reported that the occurrence of menstrual pain involved the reorganization of previous arrangements. Most women cancelled classes/appointments and gave up sports because of menstrual pain. CONCLUSIONS: In most cases, the symptoms of dysmenorrhoea lead to changes in daily functioning, which can have a negative impact on the academic, professional, and social lives of affected women. The early diagnosis of dysmenorrhoea is of key importance. Therefore, women who have menstrual pain and other accompanying symptoms during menstruations should be referred to experienced gynaecologists for differential diagnosis.

Women's views of birth after cesarean section.

BACKGROUND: Vaginal birth is a safe mode of childbirth for the majority of women after cesarean section (CS). However, data show that women who have undergone a CS are more likely to have an elective CS (ECS) than a vaginal birth after CS (VBAC) in many areas of the world. AIM: This study aimed to review the literature about women's mode of birth preferences and attitudes and the underlying reasons for, and factors associated with, their preferences. METHODS: This is narrative literature review. PubMed/MEDLINE and Scopus databases were searched, limiting the results to non-interventional studies published between 1990 and 2020. Twenty-one articles were included in the analysis. RESULTS: The review found 34 different factors that influence women's preferences. Five factors influenced both VBAC and ECS preference, depending on the study. The most common factors having a dualistic effect on preference were: medical staff recommendation, doctor's opinion, and fear of pain. The most common factors were: desire to experience natural childbirth, faster/easier recovery, support from doctor's, and midwife's opinion. Among the factors influencing the preference for ECS, two were particularly prominent: predictability, controllability and comfortability of CS and the belief that CS is safer for the baby and/or mother. CONCLUSIONS: Our review showed that there are a variety of factors that influence women's preference for the mode of delivery after CS. Some of these have a dualistic effect according to the study. The key to making an informed decision regarding the mode of delivery is communication with medical professionals.