• The consequences of pregnancy and birth for the pelvic floor

      Steen, Mary; Roberts, Taniya; University of Chester (Mark Allen, 2011-11-02)
      This article discusses the anatomy and physiology of the pelvic floor and the important role it plays during childbirth. It will also consider damage that can be caused to the pelvic floor and in the genital/rectal region. Urinary and faecal incontinence, perineal injury (naturally occurring or surgically induced) and haemorrhoids can cause a lot of distress and pain for many women following childbirth. Alleviating the distress and pain associated with these problems is vitally important and will be explored.
    • Effectiveness of cooling gel pads and ice packs on perineal pain

      Navviba, Shahin; Abedian, Zahra; Steen, Mary; Zahedan University of Medical Science Nursing & Midwifery, Mashhad Iran ; Faculty of Health & Social Care, University of Chester (Mark Allen, 2009-11-01)
      The purpose of this paper is to report the findings of a randomised controlled trial undertaken at the Hazrat Ommolbanin University Maternity Hospital in Mashhad, Iran which investigated the effectiveness of localised cooling treatments to alleviate perineal trauma. From October 2005 to February 2006, 121 primiparous women who were at term and had an episiotomy were randomly recruited to one of three treatment groups (Group 1 - no localised cooling, Group 2 - Ice pack, Group 3 - cooling gel pad). The intensity of pain, wound healing and women’s satisfaction levels were the main outcomes measured. The intensity of pain was measured by a (Numeric Rating Scale (NRS) (0-10) and wound healing was evaluated by the REEDA scale within 4 hours of episiotomy repair, at Day 1, Day 2, Day 5 and finally at Day 10. The usage of oral analgesia (acetaminophen) was measured at Day 10. Women’s satisfaction levels with oral analgesia and localised cooling treatments were also assessed at Day 10 by a NRS (0-10). There was evidence that localised cooling treatments are effective at alleviating perineal pain which was in favour of the cooling gel pad group. A statistical significant difference was reported at 4 hours (p=0.003) Day 2 (p=0.004) and at Day 10 (p=0.044). At Day 1 and Day 5 there was evidence of a reduction in the intensity of pain but this did not reach a statistical significant difference. A reduction in the usage of oral analgesia (acetaminophen) was reported in favour of the cooling gel pad group (p<0.001). Women’s satisfaction levels with oral analgesia were similar within the three treatment groups but a higher level of satisfaction when assessing localised treatment was reported by the cooling gel pad group (p<0.001). Wound healing rates were also reported to be better in the cooling gel pad group when compared to the other two groups(p<0.001). In conclusion, treatments to alleviate perineal pain without any adverse affects on wound healing and women’s views are important aspects of midwifery care. This trial has demonstrated evidence that localised cooling of the perineum reduces the intensity of pain, women were more satisfied when applying cooling gel pads and this treatment appeared to assist in wound healing.
    • The future of nursing: Career choices in potential student nurses

      Whitehead, Elizabeth; Mason, Tom; Ellis, Jackie; University of Chester (Mark Allen, 2007-04-01)
      Young people leaving schools and sixth-form colleges have the opportunity to choose a career path from an increasing number of courses in colleges of further and higher education. Nursing studies are now competing with a range of health-related disciplines such as health studies, psychology and complementary therapy. Compared with nursing studies, many of these courses appear more exciting and appealing to studnets who are in the process of choosing a career or programme of study. while the increased choice is a positive move for students it may contribute to the shortage of students currently entering some areas of nursing. Indeed, some specialities in nursing, including mental health and learning disabilities, are so depleted in students that they are reaching a point of crisis. There is also concern that recruitment into nursing remains predominantly female and White British. Given the diversity of the UK population and the reliance on school leavers as a potential source of supply, it is important to understand why male students and those from multiracial and multicultural environments choose, or do not choose, nursing studies. This research study involved a sample of 106 16-year old students from three secondary schools in the North-West and South-East of England. The questionnaire results, collected in schools, revealed that students held tradtional views or knew very little about the nursing profession.
    • I can't sit down - easing genital tract trauma

      Steen, Mary; Leeds Teaching Hospitals NHS Trust, (Mark Allen, 2005-05-01)
      This article discusses the high prevalence of genital tract trauma and its many negative consequences for women, such as being unable to sit down comfortably. Its highlights how suture technique and suture material can significantly contribute to the severity of perineal pain and discomfort and the importance of asking women about their ‘pain experience’. Treatments to alleviate the pain and discomfort are then reviewed. In conclusion, it would appear that a combination of systemic and localised treatments is necessary to achieve adequate pain relief which will meet individual women’s needs.