Management of hyperlactation using pseudoephedrine — a case report
- Authors: Russell, Judith , King, Rosemary
- Date: 2020
- Type: Text , Journal article
- Relation: Breastfeeding Review Vol. 28, no. 1 (2020), p. 33-38
- Full Text: false
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- Description: Hyperlactation refers to excessive breastmilk production over and above the infant’s needs. It may cause a range of distressing and uncomfortable symptoms for mother and infant, potentially affecting breastfeeding duration. The majority of cases will resolve through common, supportive management strategies that aim to reduce breastmilk supply through the negative feedback mechanism of milk production. Some herbal and pharmaceutical agents are considered to reduce breastmilk production and may be used to manage hyperlactation. One of these medications, pseudoephedrine, has been reported anecdotally to reduce breastmilk production, but there is a lack of evidence to support its use in this context. This case report details the use of pseudoephedrine as a ‘last resort’ treatment for a mother experiencing hyperlactation which had not responded to the usual management strategies. By titrating the dose according to her milk production, the mother was able to effectively self-manage hyperlactation and maintain an adequate breastmilk supply without any apparent adverse effects to herself or her baby. This suggests that pseudoephedrine has potential for use in the management of severe hyperlactation. However, pseudoephedrine should be used with caution and in conjunction with professional lactation support and supervision. © 2020, Australian Breastfeeding Association. All rights reserved.
Regional special care nursery environments : Navigating the role of mother
- Authors: Knox, Kate , Wellard, Sally , King, Rosemary
- Date: 2007
- Type: Text , Conference paper
- Relation: Paper presented at 9th National Rural Health Conference, Albury, New South Wales : 7th-10th March 2007
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- Description: Premature birth presents challenges for most mothers assuming a parenting role with their infant. Living in rural and regional areas provides additional hardship due to isolation, distances and limited support services. The predominant focus of research in the area of premature birth has been on the survival of infants. There has been limited investigation of the experiences of women with infants in special care nurseries (SCNs), in regional Australia. The ways in which mothers ‘navigate their way’, physically and emotionally, in SCN environments was the focus of this study. Using a qualitative interpretive design data were collected through in-depth interviews with mothers and analysed thematically. Women related a dislocation in their lives as a result of their infant’s hospitalisation. The nursery space and the various ways space was used to marginalise or sanction mothers was revealed and resulted in women adopting conflicting roles throughout this time. These findings provide direction for developing more supportive environments for parents relying on SCNs for the care of their infant. This study provides new insight into the experiences of women and their environmental sensitivity within SCN settings. Findings will increase regional midwives’ understanding of mothers’ interpretations of the neonatal nursery environment. Insights into maternal perspectives will assist in the provision of better family-centred care and improved outcomes for the vulnerable families of premature infants.
- Description: 2003005864
Juggling type 1 diabetes and pregnancy in rural Australia
- Authors: King, Rosemary , Wellard, Sally
- Date: 2009
- Type: Text , Journal article
- Relation: Midwifery Vol. 25, no. 2 (2009), p. 126-133
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- Description: Objective: to explore the experiences of women with type 1 diabetes, living in rural Australia, while preparing for pregnancy and childbirth. Additionally, we aimed to describe the women's engagement with, and expectations of, health-care providers during this period, and subsequently highlight potential service and informational gaps. Design: qualitative research using a collective case-study design; seven women with type 1 diabetes who had given birth within the previous 12 months participated in in-depth interviews about their experiences of pregnancy and birth. Data were analysed thematically. Setting: The experience of type 1 diabetes, preconception preparation and pregnancy among rural Australian women was explored, including interactions with health professionals. Participants: seven women aged between 26 and 35 years agreed to be interviewed. The woman had one or two children and had given birth within the past 12 months. Findings: rigid narrow control of blood glucose levels before conception and during pregnancy created unfamiliar body responses for women, with hypoglycaemic symptoms disappearing or changing. For example, some women mentioned developing tunnel vision or numbness and tingling around their lips and tongue as different symptoms of hypoglycaemia. Women needed information and support to differentiate between what might be normal or abnormal bodily processes associated with pregnancy, diabetes, or both. The women's preparation for conception and pregnancy was reliant on the level of available expertise and advice. Participants' experiences were coloured by their limited access and interactions with expert health professionals. Conclusion: women with type 1 diabetes experienced significant hardship during their pregnancy, including a higher incidence of hypoglycaemic episodes, a loss of hypoglycaemic symptom recognition and weight gain. These difficulties were compounded by a scarcity of available information to support the management of their pregnancy and a lack of availability of experienced health professionals. Implications for practice: national and international consensus guidelines emphasise the importance of preconception and pregnancy care for women with type 1 diabetes. Close clinical supervision and the development of closer co-operation and partnership between the women and health-care providers before conception and during pregnancy may improve outcomes for these women and their babies. Building confidence in professional care requires increased access to specialist services, increased levels of demonstrated knowledge and expertise and better general community access to information about preparation for pregnancy and birth among women who have type 1 diabetes. © 2007 Elsevier Ltd. All rights reserved.
Illness attributions and myocardial infarction : The influence of gender and socio-economic circumstances on illness beliefs
- Authors: King, Rosemary
- Date: 2002
- Type: Text , Journal article
- Relation: Journal of Advanced Nursing Vol. 37, no. 5 (2002), p. 431-438
- Full Text: false
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- Description: Aim. To present findings from a study conducted between 1996 and 1998 to investigate participants' perceptions of illness causation following a myocardial infarction. Rationale. The underlying assumption of many practitioners is that perceptions of illness causation will influence emotions and adjustment to illness. Design. Phenomenology was the research methodology used to examine perceptions of illness causation. A convenience sample was taken of 24 men and women who were admitted to a regional hospital in Victoria, Australia, with a provisional diagnosis of myocardial infarction. Participants were interviewed shortly after hospitalization, and interviews were taped, transcribed and thematically analysed. Findings. Stress was the most commonly cited cause of illness. Men and women demonstrated distinct differences in illness attribution. Participants who verbalized concerns about their loss of autonomy and their subsequent ability for self-management were predominantly female and uniformly members of the lowest socio-economic group. Conclusion. The article concludes with a discussion of implications of the findings for practice.
- Description: 2003000204
Researching maternal, neonatal and child health service use in pastoralist Ethopia: A key informant research approach
- Authors: King, Rosemary , Jackson, Ruth , Dietsch, Elaine
- Date: 2013
- Type: Text , Book chapter
- Relation: The Alfred Deakin Research Institute Working Papers- Series Two p. 1-21
- Full Text: false
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Barriers and enablers to women's access to services during childbearing in Timor-Leste
- Authors: King, Rosemary
- Date: 2019
- Type: Text , Thesis , PhD
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- Description: Background: In Timor-Leste the maternal mortality ratio (MMR) is one of the highest in Southeast Asia, in some districts only 15-25% of women birth in a facility with a skilled birth attendant (SBA). Care from SBA is the international benchmark for quality maternity care. Purpose: Determine the barriers and enablers to women's access to services during childbearing in Timor-Leste, including women’s expectations and needs. Methodology: Qualitative research using focused ethnography, data collection methods included semi-structured interviews, focus groups and participant observation. Seventeen stakeholders and thirty women from three districts in Timor-Leste participated. Thematic analysis and coding of data with triangulation of the findings between separate participant groups. Results: Barriers to woman’s access to SBA include poor roads, lack of transport, costs associated with accessing SBA, lack of availability and poor quality services. Lack of privacy, multiple care-givers and poor interpersonal communication from SBA were also noted. Stakeholders emphasise health promotion and antenatal care to counteract the influence of traditional beliefs and promote demand for SBA. Many women demonstrate their agency in health seeking behaviours and choices for care during pregnancy and childbirth. Discussion: Women understand that pregnancy and childbirth poses potential risks to their health. Rural women, women from low socio-economic and other marginalised groups have less access to services. Perceptions of poor quality services also reduce women’s demand. Conclusion: Barriers and enablers to woman’s access to services are identified using an amended AAAQ framework introducing the domain of Antecedents in addition to domains of Access, Availability, Acceptability and Quality (AAAQA). Further expenditure on health service infrastructure, staff training and community outreach will improve access and quality SBA. Culturally safe SBA services may also improve the uptake of SBA service in Timor-Leste. Key words: Timor-Leste, Skilled birth attendance, cultural safety, women’s agency, quality maternity care.
- Description: Doctor of Philosophy
Barriers and facilitators to accessing skilled birth attendants in Afar region, Ethiopia
- Authors: King, Rosemary , Jackson, Ruth , Dietsch, Elaine , Hailemariam, Asseffa
- Date: 2015
- Type: Text , Journal article
- Relation: Midwifery Vol. 31, no. 5 (2015), p. 540-546
- Full Text: false
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- Description: Objective: to explore barriers and facilitators that enable women to access skilled birth attendance in Afar Region, Ethiopia. Design: researchers used a Key Informant Research approach (KIR), whereby Health Extension Workers participated in an intensive training workshop and conducted interviews with Afar women in their communities. Data was also collected from health-care workers through questionnaires, interviews and focus groups. Participants: fourteen health extension workers were key informants and interviewers; 33 women and eight other health-care workers with a range of experience in caring for Afar childbearing women provided data as individuals and in focus groups. Findings: participants identified friendly service, female skilled birth attendants (SBA) and the introduction of the ambulance service as facilitators to SBA. There are many barriers to accessing SBA, including women's low status and restricted opportunities for decision making, lack of confidence in health-care facilities, long distances, cost, domestic workload, and traditional practices which include a preference for birthing at home with a traditional birth attendant. Key conclusions: many Afar men and women expressed a lack of confidence in the services provided at health-care facilities which impacts on skilled birth attendance utilisation. Implications for practice: ambulance services that are free of charge to women are effective as a means to transfer women to a hospital for emergency care if required and expansion of ambulance services would be a powerful facilitator to increasing institutional birth. Skilled birth attendants working in institutions need to ensure their practice is culturally, physically and emotionally safe if more Afar women are to accept their midwifery care. Adequate equipping and staffing of institutions providing emergency obstetric and newborn care will assist in improving community perceptions of these services. Most importantly, mutual respect and collaboration between traditional birth attendants (Afar women's preferred caregiver), health extension workers and skilled birth attendants will help ensure timely consultation and referral and reduce delay for women if they require emergency maternity care. © 2015 Elsevier Ltd.
Deteriorating patients : Global reach and impact of an e-simulation program
- Authors: Cooper, Simon J. , Hopmans, Ruben , Cant, Robyn , Bogossian, Fiona , Giannis, Anita , King, Rosemary
- Date: 2017
- Type: Text , Journal article
- Relation: Clinical Simulation in Nursing Vol. 13, no. 11 (2017), p. 562-572
- Full Text: false
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- Description: Background E-simulation may enable a feasible education solution to the management of deteriorating patients. Method The study involves a pre–post quasi-experimental evaluation of global data on educational outcomes from an e-simulation program. Results Qualified nurses (n = 1,229) and final year nursing students (n = 1,742) were among 5,511 participants from 20 countries who completed the program. Both groups’ knowledge and performance improved significantly (p = <.001) with no difference between groups. Regression analysis revealed predictors of performance were education level, knowledge, experience, and being female. Participants positively evaluated the program and mode of delivery. Conclusion E-simulation may enhance students’ preparation for practice and improve qualified nurses’ management of deteriorating patients. © 2017 International Nursing Association for Clinical Simulation and Learning
Key factors deterring women's engagement with skilled birth attendants in three districts of Timor-Leste. A qualitative descriptive study
- Authors: King, Rosemary , Jones, Linda
- Date: 2019
- Type: Text , Journal article
- Relation: Midwifery Vol. 79, no. (Dec 2019), p. 8
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- Description: Objective: To describe the barriers to women's access to maternity services in three districts of Timor-Leste. Research design/setting: Focused ethnography with data collection methods commensurate with a qualitative research design. Setting and participants: Data was collected in three districts in Timor-Leste. Participants included seventeen stakeholders, health professionals and managers providing skilled birth attendance (SBA) in Timor-Leste and thirty women who have given birth and are competent to give consent. Findings: Access to SBA services is seriously impeded by poor roads and lack of transportation, the poor condition and amenity of services, restricted hours of opening, the lack of availability of skilled SBA professionals and medical resources. Participants also commented upon the lack of privacy and multiple caregivers. Timorese patriarchal family structures, intergenerational decision-making and cultural attitudes towards reproductive health information and services potentially reduce women's access to reproductive health services. Conclusion: This data provides a comprehensive record of the multiple structural barriers to women's access to SBA services. The modified AAAQA framework provides categories and an organisational structure to these barriers to SBA services. Implications for practice: Maternity care in Timor-Leste is extremely poorly resourced. Midwives and other SBA will need to provide innovative low cost solutions if they are to consistently provide respectful culturally safe midwifery care. This includes the provision of privacy and a one to one midwifery relationship 'with woman'. In addition, many women are unable to access SBA, where possible the MoH can consider strategies to improve the provision of SBA services to women birthing in community. Crown Copyright (C) 2019 Published by Elsevier Ltd. All rights reserved.
Perceptions of people with Type 2 diabetes about self-management and the efficacy of community based services
- Authors: Wellard, Sally , Rennie, Sheree , King, Rosemary
- Date: 2008
- Type: Text , Journal article
- Relation: Contemporary nurse : a journal for the Australian nursing profession Vol. 29, no. 2 (2008), p. 218-226
- Full Text:
- Description: Self-management has become a key strategy for managing the health care of people with diabetes. This study explored issues people with type 2 diabetes experienced in their self-management practices and access to regional community based services. Using a qualitative interpretative design data was collected from four participants who were interviews about their perceptions of facilitators, barriers and issues they encountered in their diabetes care in a regional setting. The findings indicate difficulties participants experienced in gaining access to quality services in regional areas, including long waiting times, difficulties making appointments, and their perception that healthcare professionals fail to acknowledge patients self-management knowledge and practices. Additionally, participants reported food choices affected their family relationships and experience of social stigma. These issues compromised their self-management decisions. The findings support other studies that show a need for health professionals to develop strategies to improve community based services for people with type 2 diabetes and to increase public awareness of the scope of diabetes management.
Timorese women's experiences and expectations of skilled birth attendance in Timor-Leste : a qualitative inquiry
- Authors: King, Rosemary , Jones, Linda
- Date: 2022
- Type: Text , Journal article
- Relation: Sexual and Reproductive Healthcare Vol. 33, no. (2022), p.
- Full Text: false
- Reviewed:
- Description: Objective: The study explores women's experiences and expectations of maternity care in Timor-Leste. Method: Qualitative, descriptive research using focused ethnography. Thirty women and seventeen health professionals from three districts in Timor-Leste were interviewed and/or participated in focus groups. Results: Women's expectations of care include the provision of information, advice and clinical assessment from midwives who have the capacity to provide emergency obstetric care if required. Midwives’ access to technology (for example: the fetal doppler), increased the women's confidence in services. The women also identified poor experiences, including angry, busy midwives, poor communication, and lack of privacy in antenatal and birthing services. The lack of privacy inhibits women's communication with health professionals. An absence of covers and multiple staff present during labour and birth embarrass the women and their families. Many Timorese women live in poverty and have poor literacy skills. These women want knowledgeable, approachable, and clinically competent midwives who can support them through their pregnancies and childbirth. Poor communication, angry, busy midwives and lack of privacy cause discomfort and embarrassment and may discourage the women and their family's uptake of skilled birth attendant (SBA) services. Conclusion: Midwives have a critical primary role in the provision of advice, information and care of Timorese women during the childbirth continuum. Continuing education of midwives with an emphasis on communication and culturally congruent care will improve women's satisfaction and childbirth outcomes. Impoverished women are particularly vulnerable when birthing in health care services. Attention to the women's privacy and her additional needs can include a focus on the birthing space and the number of staff who have access to it. © 2022