Pregnancy is not a disease or illness, but requires clinical surveillance as life-threatening complications can develop. Preeclampsia, one such potentially serious complication, puts both mother and baby at risk. Self-monitoring blood pressure in the general population is well established, and its potential in pregnancy is currently being explored. In the context of self-monitoring, the information and guidance given to women regarding hypertension, and the literature they themselves seek out during pregnancy, are vital to perceptions of disease risk and subsequent responses to, and management of, any symptoms. Drawing on online, offline, official, and unofficial sources of information, discourses are examined to provide analysis of how self-responsibilization is reflected in contemporary information, advice, and guidance drawn from multiple sources. A paradox emerges between the paternalistic and lay discourses that seek to challenge and regain control. Findings are discussed in the context of Foucault’s governmentality and medical power.
Objective: To determine the accuracy of self-testing for proteinuria during pregnancy.
ObjectiveThis systematic review examines the qualitative literature on women’s experiences of self-managing chronic conditions in pregnancy.DesignSystematic review of qualitative literature. Searches were performed in PubMed and CINAHL from inception to February 2021. Critical interpretive synthesis informed the coding framework and the analysis of the data. The Burden of Treatment theory emerged during the initial analysis as having the most synergy with the included literature, themes were refined to consider key concepts from this theory.ParticipantsPregnant women who are self-managing a chronic condition.ResultsA total of 2695 articles were screened and 25 were reviewed in detail. All 16 included studies concerned diabetes self-management in pregnancy. Common themes coalesced around motivations for, and barriers to, self-management. Women self-managed primarily for the health of their baby. Barriers identified were anxiety, lack of understanding and a lack of support from families and healthcare professionals.ConclusionsPregnant women have different motivating factors for self-management than the general population and further research on a range of self-management of chronic conditions in pregnancy is needed.PROSPERO registration numberCRD42019136681.
Objective: Postural hypotension (PH), the drop in blood pressure (BP) on standing, is associated with falls, all-cause mortality and cognitive decline. PH diagnostic criteria require lying-to-standing BP measurements. PH is common, with prevalence estimated at 19% in older primary care patients, yet it is infrequently (<1%) recorded in routine English primary care data, suggesting PH testing and/or recording is under-utilised in this setting; reasons for such limited PH testing and/or recording have not yet been explored in detail. The aim of this study was to understand current PH measurement and management strategies in primary care practices across England. Design and method: Clinical Research Networks circulated an online survey to primary care staff involved in measurement of BP from 10th August until 8th December 2022. Responses were summarised as percentages and/or median (inter-quartile ranges (IQR)) and chi2 tests. Modelling is underway to explore response variations according to professional and practice characteristics. Final analyses will be presented at the conference. Results: Replies from 703 practitioners in 242 practices were received; predominantly from doctors (51%), nurses (28%) and healthcare assistants (HCAs; 11%), plus pharmacists, paramedics and other roles; median age 45 (IQR 38 to 53) years, 72% female. Overall, doctors (97%) and nurses (92%) reported checking for PH more often than HCAs (82%) or pharmacists (80%; p < 0.001). They all usually check when symptoms are present (97%). Other reasons for checking - patients aged over 80 years (24%); hypertension reviews (17%); medication reviews (12%) or diabetes reviews (11%) – were all more commonly undertaken by allied health professionals than by doctors (p < 0.001). Standing BP measurements are regarded as feasible, usually (77%) following sitting; only 22% use lying-to-standing measurements. 64% observe a rest period (median 5 (2 to 5) minutes) before sitting or lying measurements and 1 (IQR 1 to 2) standing BP measurements are made, usually (66%) within the first minute of standing. Conclusions: Findings suggest that most PH assessments in primary care do not meet current guideline criteria. Results from this survey will inform future national guidelines to support PH detection.
BackgroundPostural hypotension (PH), the drop in blood pressure (BP) on standing, is associated with falls, all-cause mortality and cognitive decline. PH diagnostic criteria require lying-to-standing BP measurements. PH Prevalence in older adults is 20%, however, it is infrequently recorded in primary care records, suggesting PH testing and/or recording is under-utilised in this setting.AimTo understand current PH measurement and management by primary care practitioners in England.MethodClinical Research Networks circulated an online survey to primary care clinicians involved in measurement of BP. Demographics and responses were summarised as percentages, or median and inter-quartile ranges (IQR), as appropriate. The survey remains open until 30 November 2022; full results will be presented at the conference.ResultsTo date, there are 669 replies (341 doctors, 179 nurses, 70 healthcare assistants, 23 pharmacists, 56 other roles); median age 45 (IQR 38 to 53), 72% female. Overall, 597 (89%) responders check for PH, predominantly when symptoms are present (98%). Less common reasons to check include patients being over 80 (24%), Parkinson’s disease (21%), hypertension reviews (18%), medication reviews (12%) or diabetes reviews (11%). Sitting-to-standing BP measurements are common (77%); only 22% use lying-to-standing. Only 64% ensure a rest period before sitting or lying BP measurement and only 1 (IQR 1 to 2) standing BP measurement is made, usually (66%) within the first minute of standing.ConclusionInterim findings suggest that most PH assessments in primary care do not meet current guideline criteria. Full findings from this survey are expected to inform and influence future national guidelines.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.