Preferences and factors determining preferences for mode of delivery among primigravida mothers.

Background: Childbirth is a beautiful life event, a unique personal experience for each woman. The study aimed to assess the preferences and factors determining preference for mode of delivery among primigravida mothers. Materials and Methods: A descriptive exploratory design was applied to explore the factors for preferring the mode of delivery among 250 antenatal mothers, selected by convenient sampling technique. A self-structured dichotomous questionnaire on preference and factors influencing preference for mode of delivery was used. Descriptive and inferential statistical analysis was done using SPSS 20 software. Results: The majority of participants (98.4%) preferred vaginal delivery over elective cesarean section as a mode of delivery. The significant factor influencing preferences was speedy recovery after delivery (89.8%). However, significant factors for preferring the cesarean mode of delivery were the obstetrician's advice and the baby's safety (100%). Conclusion: The majority of women preferred a vaginal mode of delivery; they still undergo cesarean mode of delivery. Considering factors, there is a need to develop a positive attitude toward NVD and actions to create awareness toward a safe mode of delivery by building a mutual trust environment and increasing effective dissemination of correct and neutral delivery option advice.

Factors Influencing Compliance With Personal Protective Equipment (PPE) Use Among Healthcare Workers.

Introduction Accurate and appropriate use of personal protective equipment (PPE) is an integral component in infection prevention and control policy to ensure healthcare workers' safety. Poor compliance with personal protective behaviours and inconsistent use of PPE has been identified as the main cause of transmission of nosocomial infections in healthcare settings and this reduced compliance is linked to many individual, environmental, and organizational factors. Therefore, the current study was carried out to identify various factors influencing PPE use among healthcare workers.  Materials and methods A descriptive cross-sectional survey has been carried out among healthcare workers selected from two selected tertiary care hospitals in central India. Data on compliance with PPE and factors influencing compliance were collected using a three-point rating scale and structured questionnaire. Quantile regression was performed to identify the factors associated with adherence to PPE use among healthcare workers. Results The median score for compliance with PPE use among healthcare workers was found to be 22 with an interquartile range (IQR) of 16-24. The multiple quantile regression found that variables such as occupation (p<0.001), institutional policy (p=0.003), quality of PPE (p=0.002), availability of PPE (p<0.001), and improper size (p=0.042) were significantly associated with PPE compliance by healthcare workers. Conclusion The current study highlights the importance of taking adequate measures by the government and healthcare organizations to eliminate various factors hindering PPE compliance levels among healthcare workers to ensure consistent use of PPE by healthcare workers to safeguard themselves and patients.

Embracing Motherhood: Impact of Nurse Led Fear and Apprehension Related to Labour or Childbirth Improving Intervention (FALCI) in Reducing Childbirth Fear Among Pregnant Women.

Objective: Childbirth is a complex process with various dimensions including physical, psychological, emotional, social, and cultural aspects. The study intended to assess the effectiveness of Nurse led FALCI (Fear and Apprehension related to Labour or Childbirth Improving) Intervention in reducing childbirth fear among pregnant women. Materials and methods: A quasi-experimental study was conducted among 115 pregnant women (selected through purposive sampling) at antenatal OPD of tertiary care hospital of Bhopal. Data was collected using Wijma Delivery Expectancy Questionnaire (DEQ) and self-structured questionnaire on socio-demographic and clinical variables. The intervention (FALCI) was carried out in two phases, each lasting for 30 minutes conducted at week 3-4 and week 5-6 and information booklet was provided for reinforcement. The data was analysed using two-way repeated measures mixed ANOVA (within group and between groups). Results: Findings revealed that most of the pregnant women in both experimental (68.5%) and control (90.2%) group had high level of childbirth fear. Post-intervention data revealed mean of pretest, posttest 1 and posttest 2 were 73.85, 46.94 and 37.90 in experimental group and the mean of pretest, posttest 1 and posttest 2 were 75.49, 72.59 and 72.67 in control group respectively and found that there is significant difference in childbirth fear (within group, F value=114.69, p<0.001 in experimental group and F =0.575, p=0.564 in control group) and between groups (F value= 81.52, p value <0.001). However, no significant association was found between childbirth fear and sociodemographic/clinical variables. Conclusion: The study findings revealed that Nurse led FALCI intervention was effective in reducing childbirth fear among the pregnant women and it is recommended that such intervention must be planned at all levels and implemented as routine protocol in maternity services.

Physiological Hazard Assessment While Wielding Personal Protective Equipment (PPE) Among Health Care Workers.

Introduction Accurate use of personal protective equipment (PPE) is an essential part of infection prevention and control measures to protect health care workers and patients from various hazardous conditions. Health care workers caring for patients with potentially infectious health conditions are using PPE for long periods of time. However, long-term use of PPE can cause many physiological health hazards among health care workers. So, the current study was carried out to assess the general health problems and dermatological problems experienced by health care workers with PPE use. Materials and methods A descriptive cross-sectional survey has been carried out in two selected tertiary care hospitals in central India by recruiting 301 health care workers. Non-probability convenient sampling technique was used to select participants for the study. Sociodemographic Performa and structured questionnaires were used to collect data on demographic characteristics of the participants and various health problems experienced by health care workers with PPE use. Collected data were analyzed using appropriate descriptive and inferential statistics. Results The current study reported excessive sweating (86.4%), difficulty in reading (85%), dry mouth (80.7%), and breathing difficulty (74.1%) as the most common problem associated with PPE use. In addition to this, adverse reactions like headache, restlessness, and dizziness were reported by 70.1%, 64.5%, and 50.8%. Indentation and pain on the back of the ears (76.1%), skin soaking (67.1%), and excessive sweating (76.1%) were identified as the most common problems related to N-95 masks, gloves, and coverall use.  Conclusion The current study revealed a higher incidence of various health problems with PPE use among health care workers. The findings of the study highlight the importance of developing various guidelines to reduce the negative impact of PPE use and implementing preventive measures to decrease health problems associated with PPE use.

Handling the pandemic our way: A qualitative content analysis of the guidelines issued by Apex Institutes of National Importance (INIs) of India to combat COVID-19 crisis.

INTRODUCTION: The Coronavirus disease 2019 (COVID-19) pandemic created havoc within a few weeks of its outbreak affecting over 100 countries. The rapid increase in the established cases urged for the prevention and control of COVID-19 belligerently on both national and worldwide fronts to prevent the healthcare systems from collapsing. For the sake of successfully preventing and restricting a fatal pandemic outbreak such as COVID-19, it requires the apex health institutions to have a uniform, urgent, flexible and effective policy response framework ensuring strict adherence too. In this regard, the Apex Institutes of National Importance in India (INIs) have released a series of documents on COVID-19 prevention and management. METHODS: Documents regarding COVID-19 preparedness and management were retrieved from the official websites of the INIs in India. The general population and healthcare workers' guidelines, standard operating procedures (SOPs) on COVID-19 prevention and management, action and response plans were included in the study. The full text of each document was analysed in detail and themes and subthemes were derived through content analysis. RESULTS: A total of 68 documents was included in the study. Five major themes and 12 subthemes were formulated after content analysis. A major similarity was found across all INIs on screening and testing and infection prevention control measures. The INIs formulated guidelines adhering to the World Health Organization, Indian Council of Medical Research and Ministry of Health and Family Welfare Recommendations. CONCLUSION: Common measures like quarantine, social distancing, travel bans and mass gathering restrictions were adopted to prevent the spread of COVID-19 during the initial period. The INIs have developed policies and standard operating protocols on COVID-19 management based on the Government of India guidelines. Better understanding of these guidelines will help in effective implementation of the nationwide pandemic management.