An evaluation of multidisciplinary intervention governed by functional independence measure (FIMSM) in incontinent stroke patients.

Patients with acute hemispheric stroke and ensuring urinary incontinence were randomly allocated to a ward using conventional methods of rehabilitation (n = 13) or to a ward practicing rehabilitation governed by Functional Independence Measure (FIM) (n = 21). All patients were assessed on admission and on discharge using the Katz activities of daily living (ADL) index, the psychological general well-being index, item G of the FIM index (FIM-G), and a mobility score. Patients admitted to the ward utilizing FIM were additionally evaluated using the total FIM on admission, repeatedly during the rehabilitation period and on discharge. An individual rehabilitation programme based on the latest FIM score was used throughout rehabilitation. There were no differences on admission between groups regarding clinical and demographic characteristics, ADL, mobility and mood. Twenty patients in the intervention group regained continence before discharge compared to 3 (p < 0.01) in the control group. There was also a greater improvement in well-being in the intervention group compared to the control group (p < 0.01). This study has indicated that rehabilitation governed by the use of FIM reduced urinary incontinence and enhanced well-being better than conventional methods of rehabilitation. The results warrant a larger study to further investigate rehabilitation of incontinent stroke patients using FIM.

Fathers' experience of childbirth and its relation to crying in his infant.

As part of a research project exploring ways through which we can understand the crying infant and its family, this study focuses on the experiences of fathers during labour and delivery of their infant. In a previous part of the project it was shown that fathers' negative experiences during the childbirth were correlated with the amount of crying in the infant during the first months after birth. The aim of the present study was to explore and interpret the experiences that fathers reported in an interview when the infant was between six months and one year of age. A hundred and nine fathers were interviewed. The interviews, which took place in the families' homes and with both parents present, were carried out in dialogue form with open-ended questions. The results reveal that complications during the delivery were significantly correlated with the amount of crying in the infant. Feelings of helplessness, of guilt and that staff behaviour had been negative were more common in the group of fathers who experienced the delivery as a negative event. 'Locus of control' seems to be the most relevant concept.

Nurses' advice to parents with a crying infant.

Child-Health Centres (CHC) in Sweden have a very good reputation. Despite the non-obligatory status of the CHC, most families visit these centres. With the purpose of studying nurses' work in general and especially in relation to their dealing with crying infants, an interview study was carried out at eight CHCs in a district in Stockholm. The results were analysed with focus on nurse-parent relationships, paternalism, and nursing subculture. The findings of this study suggest that nurses at CHC work purposefully to develop a favourable relationship with parents, though sometimes they adopt a paternalistic approach. Their knowledge of research in pediatrics in general and in child health care in particular is good, but a degree of wariness of research findings is evident.

Urinary excretion of catecholamines during the first months after delivery.

The urinary excretion of free catecholamines was assessed in 17 women 3 times after delivery; after 3 weeks, 6 weeks and 6 months, respectively. Relatively high levels were found both for adrenaline and noradrenaline excretion, on the first and third occasions, with significantly lowered levels on the second one. Mothers who had had a negative experience of their delivery (according to interview) as well as mothers who felt tired during the mid-phase of the follow-up (according to diaries) had very small variations in catecholamine excretion and did not show increased levels 6 months after delivery. Whether the mother experienced her infant as crying or not had no significant association with catecholamine output.