Dataset Information

Impact of animated instruction on tablets and hands-on training in applying bimanual perineal support on episiotomy rates: an intervention study.

ABSTRACT:

Introduction and hypothesis

In Palestine, episiotomy is frequently used among primiparous women.This study assesses the effect of training birth attendants in applying bimanual perineal support during delivery by either animated instruction on tablets or hands-on training on episiotomy rates among primiparous women.

Methods

An interventional cohort study was performed from 15 October 2015 to 31 January 2017, including all primiparous women with singletons and noninstrumental vaginal deliveries at six Palestinian hospitals. Intervention 1 (animated instructions on tablets) was conducted in Hospitals 1, 2, 3, and 4. Intervention 2 (bedside hands-on training) was applied in Hospitals 1 and 2 only. Hospitals 5 and 6 did not receive interventions. Differences in episiotomy rates in intervention and nonintervention hospitals were assessed before and after the interventions and presented as p values using chi-square test, and odds ratios (OR) with 95% confidence intervals (CI). Differences in the demographic and obstetric characteristics were presented as p values using the Kruskal-Wallis test.

Results

Of 46,709 women, 12,841 were included. The overall episiotomy rate in the intervention hospitals did not change significantly after intervention 1, from 63.1 to 62.1% (OR?=?0.96, 95% CI 0.84-1.08), but did so after intervention 2, from 61.1 to 38.1% (OR?=?0.39, 95% CI 0.33-0.47). Rates after Intervention 2 changed from 65.0 to 47.3% (OR?=?0.52, 95% CI 0.40-0.67) in Hospital 1 and from 39.4 to 25.1% (OR?=?0.49, 95% CI 0.35-0.68) in Hospital 2.

Conclusions

Hands-on training of bimanual perineal support during delivery of primiparous women was significantly more effective in reducing episiotomy rates than animated instruction videos alone.

SUBMITTER: Zimmo KM

PROVIDER: S-EPMC6647226 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Publications

Impact of animated instruction on tablets and hands-on training in applying bimanual perineal support on episiotomy rates: an intervention study.

Zimmo Kaled Mikki KM Laine Katariina K Fosse Erik E Zimmo Mohammed M Ali-Masri Hadil H Böttcher Bettina B Zucknick Manuela M Vikanes Åse Å Hassan Sahar S

International urogynecology journal 20180714 8

<h4>Introduction and hypothesis</h4>In Palestine, episiotomy is frequently used among primiparous women.This study assesses the effect of training birth attendants in applying bimanual perineal support during delivery by either animated instruction on tablets or hands-on training on episiotomy rates among primiparous women.<h4>Methods</h4>An interventional cohort study was performed from 15 October 2015 to 31 January 2017, including all primiparous women with singletons and noninstrumental vagin ...[more]

PMID: 30008080

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Project description:BackgroundWomen who undergo perineal episiotomy can be affected by several complications such as bleeding, infection, perineal pain, dyspareunia, reduction of sexual desire, as well as urinary and anal incontinence. Perineal pain related to episiotomy has been reported to interfere with women's daily activities postpartum and can prevent proper breastfeeding, proper rooming-in, and maternal-infant bonding. The purpose of this study was to determine the effect of dry heat application on perineal pain and episiotomy wound Healing among primipara women.MethodA quasi-experimental, two-group, pre-post-test research study was conducted at the postnatal inpatient ward and the outpatient clinic of the El-Shatby Maternity University Hospital in Alexandria. A sample of 100 parturient women was divided into the following two groups at random: dry heat and moist (control) heat. Women in the moist heat group were advised to sit in a basin (tub) of warm water for 10 minutes, while those in the dry heat group were instructed to set an infrared light (230 volts) at a distance of 45 cm from the perineum after 12 hours post episiotomy. Both interventions were applied twice a day for ten consecutive days. They evaluated the severity of their perineal pain at baseline and repeated it on the 5th and 10th days after obtaining the interventions while the episiotomy wound healing was assessed on the 5th and 10th days.ResultsIt was discovered that the dry heat group had a significantly improved episiotomy wound healing as regards perineal redness, edema of the perineal area, ecchymosis, wound discharge, and approximation of wound edges on the 5th (P < 0.001, P < 0.001, P < 0.007, P < 0.003, and P < 0.001, respectively) and 10th day after intervention (P < 0.001, P < 0.001, P < 0.001, P < 0.005, and P < 0.001, respectively) than the moist heat group. The primipara women had significantly lower perineal pain intensity in the dry heat group on the 5th and 10th days after intervention than in the moist heat group (MH P < 0.001 for the dry heat group and MH P = 0.004 for the moist heat group).ConclusionThe application of dry heat promoted episiotomy wound healing among primipara women and reduced their perineal pain during early postpartum days than moist heat.

Project description:How music training and expertise influence non-musical abilities is a widely researched topic. Most studies focus on the differences between adult professional musicians and non-musicians, or examine the effects of intensive instrumental training in childhood. However, the impact of music programs developed in regular school contexts for children from low-income communities is poorly explored. We conducted a longitudinal training study in such communities to examine if collective (Orff-based) music training enhances fine motor abilities, when compared to a homologous training program in sports (basketball), and to no specific training. The training programs in music and sports had the same duration, 24 weeks, and were homologous in structure. A pre-test, training, post-test and follow-up design was adopted. Children attending the 3rd grade (n = 74, 40 girls; mean age 8.31 years) were pseudorandomly divided into three groups, music, sports and control that were matched on demographic and intellectual characteristics. Fine motor abilities were assessed with the Purdue pegboard test (eye-hand coordination and motor speed, both subsumed under manual dexterity, and bimanual coordination) and with the Grooved pegboard (manipulative dexterity) test. All groups improved in manipulative dexterity that was not affected by type of training. On bimanual coordination and manual dexterity, however, a robust and stable advantage of music training emerged. At the end of training (post-test), children from the music group significantly outperformed children from the sports and control groups, an advantage that persisted at follow-up 4 months after training at the start of the following school year. Also, at follow-up none of the children from the music group were performing below the 20th percentile in the Purdue pegboard subtests and more than half were performing at the high end level (>80th percentile). Children from the sports group also improved significantly from pre- to post-test but their performance was not significantly different from that of the control group. These results show that an affordable, collective-based music practice impacts positively on fine-motor abilities, a finding that is relevant for a better understanding of the impact of music in childhood development, and that may have implications for education at the primary grade.

Dataset Information

Impact of animated instruction on tablets and hands-on training in applying bimanual perineal support on episiotomy rates: an intervention study.

Introduction and hypothesis

Methods

Results

Conclusions

Publications

Impact of animated instruction on tablets and hands-on training in applying bimanual perineal support on episiotomy rates: an intervention study.

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