Background: Episiotomy is one of the most common interventions during the second stage of labour. Some studies have identified episiotomy as a risk factor for pain during sexual intercourse. Aims: The aim of this cross-sectional study was to establish the effect of episiotomy on the sexual function of women 2–5 years after a vaginal birth. Methods: Women with episiotomy were compared with four control groups: women with intact perineum, women with first-degree perineal tear, women with second-degree perineal tear and women with third- and fourth-degree perineal tear. Data were collected from 13 private gynaecological clinics in three regions in the Czech Republic during August–September 2013. The Female Sexual Function Index (FSFI) was used. Response rate was 41% (246/600 questionnaires); 35 questionnaires were excluded, so the final sample was 211 women. The Kruskal–Wallis test was performed on all women in the study (n = 211) and then again for only the primiparous women (n = 112). Findings: In all samples in women with second-degree perineal tears, lower score values were found in the domains of arousal and orgasm, and these women had a lower total FSFI score compared to those with first-degree perineal tears and women who received an episiotomy. However, in primiparous women only, there was no difference between these groups. Conclusions: Further research is required to establish the effect of episiotomy on women's sexual function.
Aim:The aim was to analyse the effect of antihypertensive therapy on incidence of sexual dysfunction in patients with arterial hypertension. Design: a review study. Methods: In the period from 2000 to 2015 we searched licensed and freely available electronic databases: CINAHL EBSCOhost, ProQuest, Pubmed and Medline for relevant recherches of Czech and foreign sources. We set the following criteria: a study of least 100 participants and a minimum six-month follow-up. We excluded experimental and vaguely defined studies. From a total of 123 searches, 45 articles met the criteria. A review includes a total of 15 studies, six studies with a control group of healthy individuals, two cohort studies, six randomized trials and one case study with a control group. Results: The study analysis showed that beta-blockers and thiazide diuretics are the most detrimental in terms of incidence of sexual dysfunction. Angiotensin II receptor antagonists and angiotensin-converting enzyme inhibitors have a neutral or beneficial effect. Conclusion: The review article deals with the issue of patients' sexuality, focusing on the potentially negative effect of antihypertensive therapy on sexual function. Current scientific findings suggest that antihypertensive therapy increases the risk of occurence of sexual dysfunction. Professional literature is more dedicated to the incidence of male sexual dysfunction, especially erectile dysfunction, than with female sexual dysfunction.
In the validation of nursing diagnoses, which has a superior position in the research in the field of the nursing diagnostics, there is an important role of a group of nurses-specialists. Validation studies cannot be performed without their cooperation. A consequent choice of a group of experts is an important step in the process of the validation of nursing diagnoses. Accurate criteria for the identification of experts were delimited by Fehring in 1994 (Fehring, 1994, p. 59), but they cannot be employed in any country to their whole extent. The authors of particular validation studies use their partial modifications depending on the type of the study and conditions of the particular country. The target of the contribution presented here is to propose criteria of the choice of experts for purposes of validation studies of nursing diagnoses in the Czech Republic and Slovak Republic. The method of the panel discussion was employed for the establishment of criteria, which was implemented in January 2010. The panel of experts included 10 university teachers-5 specialists from the Czech Republic and 5 specialists from the Slovak Republic. Fehring criteria were modified in such a way that they corresponded to the contemporary condition of the education of nurses in clinical practice. The criteria proposed are divided into the basic and supplementary ones. The basic classical criteria considered by the authors of the contribution are education in the branch nursing and clinical practice with at least one-year affiliation in the field adequate to the nursing diagnosis in question. The supplementing criteria are the specialty/certification in the field of the clinical practice with taking into account the relevant area of the nursing diagnosis, diploma, rigorous or dissertation theses in problems of nursing diagnostics and a published article (of research or theoretical nature) in the field of nursing diagnostics in a professional journal. Points were assigned to particular criteria from 1 to 3 provided that the expert is a nurse achieving the total number of 4 points. The criteria proposed can be achieved and are optimal for the choice of a group of experts in the field of validation of nursing diagnoses in the Czech Republic and Slovak Republic and they will be tested in validation studies of nursing diagnoses selected.
Aim: The aim of the study was to find a relationship between episiotomy and prevalence of urinary incontinence in women. The obtained results were compared with those in women who suffered 1st-or 2nd-degree perineal tears during childbirth and those with an intact perineum. Design: Cross sectional study. Methods: The sample was made up of 211 women, who were 2-5 years after a spontaneous term childbirth. The data were collected using the International Consultation on Incontinence Questionnaire -Short Form (ICIQ-SF). Results: No differences were found in the prevalence of urinary incontinence between women with episiotomy and those with spontaneous perineal tears or with an intact perineum. The prevalence of urinary incontinence is affected by a woman's BMI, parity and the presence of incontinence before childbirth. Conclusion: The study did not find episiotomy to either increase or decrease the prevalence of urinary incontinence at 2-5 years postpartum.
These trained Romany assistants are now working in the regions of the Czech Republic where inhabitants live in large Romany communities. The project evaluation was based on a questionnaire investigation of 170 clients living in Romany communities and on the statements of Romany health assistants. They found positive outcomes in several areas: obtaining information on health, motivation to healthy lifestyle, concrete changes in lifestyle and boosting trust towards doctors. Following the end of the project and its evaluation, an educational course will be accredited and certified, and the education of Romany assistants will be widespread across the whole country.
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