COVID-19 ; Child ; Humans ; Internship and Residency ; Obstetrics/education* ; SARS-CoV-2 ; Singapore

PURPOSE: This study was conducted to develop an empowering education program for Maternal-Fetal Intensive Care Unit (MFICU) nurses who provide intensive care to high-risk mother and fetus at hospitals, to test effects of the education program on nursing care confidence and nursing knowledge, and to examine program satisfaction. METHODS: This study comprised of 2 phases: program development and evaluation. First, we have followed a process of program development to develop and refine an empowering education program for MFICU nurses through collaborative works among clinical obstetrics and gynecology doctors and nurses and academic nursing professors. Second, the empowering education program was provided to 49 nurses and evaluated from July 5 to 6, 2019. Levels of MFICU nursing care confidence and knowledge were measured. RESULTS: The empowering education program included 18 hours of lectures, discussion, and Q & A, which continued for 2 days. This program significantly improved high-risk maternal-fetal nursing care confidence and knowledge of nurses. The program was well met with nurses' education need and goals, and found to be highly satisfactory. CONCLUSION: The empowering education program was observed to be effective in terms of improve nursing care confidence and knowledge of nurses in MFICU. It is proposed that this program should be open regularly for nurses to obtain and improve their clinical knowledge, confidence, and competency. Further study is needed to develop and run 2-levels of education such as basic and advanced levels based on nurses' clinical background and competency.
Critical Care ; Education ; Fetus ; Gynecology ; Humans ; Intensive Care Units ; Lectures ; Mothers ; Nursing ; Nursing Care ; Obstetrics ; Pregnancy, High-Risk ; Program Development

OBJECTIVE: The aim of this study is to assess the prevalence and determinants of folic acid supplementation among women referred to community health centers. METHODS: This was a cross-sectional study conducted in 325 women referred to community health centers. The subjects were selected from 8 community health centers, using a stratified sampling technique. Data regarding demographics, socioeconomic status, obstetrics, folic acid supplementation status, and household food security status were obtained via questionnaires. The data was analyzed in SPSS v22. RESULTS: The prevalence of folic acid supplementation both before and during pregnancy was 54.5%. The results of the study showed that folic acid supplementation had a significant positive association with education level (odds ratio [OR],0 .441; 95% confidence interval [CI], 0.199–0.977; P<0.05), being employed (OR, 0.353; 95% CI, 0.148–0.840; P<0.05), and planned pregnancy (OR, 18.113; 95% CI, 7.371–44.51; P<0.001). However, other variables, including age, husband's age, husband's education and employment status, the number of prior pregnancies, economic satisfaction, and household food security, were nonsignificant factors affecting folic acid supplementation. CONCLUSION: Women with lower socioeconomic status are less likely to take folic acid supplements, and more effort should be made to increase their awareness of the importance of supplementation. Unplanned pregnancy is another strong risk factor for not supplementing with folic acid, and thus should be avoided.
Community Health Centers ; Contraception ; Cross-Sectional Studies ; Demography ; Education ; Employment ; Family Characteristics ; Family Planning Services ; Female ; Folic Acid ; Food Supply ; Humans ; Obstetrics ; Pregnancy ; Pregnancy, Unplanned ; Prevalence ; Referral and Consultation ; Risk Factors ; Social Class

OBJECTIVE: The Japan Society of Gynecologic Oncology (JSGO) initiated a nation-wide training system for the education and certification for gynecologic oncologists in 2005. To assess the impact of the quality of the JSGO-accredited institutions, JSGO undertook an analysis of the Uterine Cervical Cancer Registry of the Japan Society of Obstetrics and Gynecology (JSOG) to determine the effectiveness of the JSGO-accredited institutions on the treatment and survival of women with cervical cancer. METHODS: The effectiveness of 119 JSGO-accredited institutions and 125 non-JSGO-accredited institutions on the treatment and survival of women with cervical cancer were compared by analyzing the tumor characteristics, treatment patterns, and survival outcomes of women with stage T1B–T4 cervical cancer utilizing the data in the JSOG nation-wide registry for cervical cancer (2006–2009). RESULTS: A total of 14,185 eligible women were identified: 10,920 (77.0%) cases for 119 JSGO-accredited institutions and 3,265 (23.0%) cases for 125 non-accredited institutions. A multivariate analysis showed that age, stage, histology type, and treatment pattern were independently associated with mortality. Moreover, women who received treatment at the JSGO-accredited institutions had a significantly decreased mortality risk compared to non-accredited institutions (adjusted hazard ratio [aHR]=0.843; 95% confidence interval [CI]=0.784–0.905). Similar findings on multivariate analysis were seen among subset of women who received surgery alone (aHR=0.552; 95% CI=0.393–0.775) and among women who received radiotherapy (aHR=0.845; 95% CI=0.766–0.931). CONCLUSION: Successful implementation of gynecologic oncology accrediting institution was associated with improved survival outcome of women with cervical cancer in Japan.
Accreditation* ; Certification ; Education ; Female ; Gynecology ; Humans ; Japan* ; Mortality ; Multivariate Analysis ; Obstetrics ; Radiotherapy ; Surgical Procedures, Operative ; Uterine Cervical Neoplasms*

BACKGROUND: Red blood cell (RBC) transfusion is an essential practice during surgery to accommodate for bleeding. As such, there are efforts being made to allow for a safe and appropriate transfusion due to shortages of blood components and to minimize transfusion-related adverse reactions. However, a conventional transfusion decision with relatively high hemoglobin (Hb) threshold is still performed in clinical setting. In this study, we investigated the threshold of Hblevel and appropriateness of RBC transfusion in patients receiving perioperative RBC transfusion in surgical departments. METHODS: We investigated the pre-transfusion Hb level of 1,379 patients (2,170 episodes) receiving perioperative RBC transfusion in five surgical departments, including cardiothoracic surgery (CS), general surgery (GS), neurosurgery (NS), obstetrics and gynecology (OBGY), and orthopedics (OS), between June 2017 and March 2018. The appropriateness of transfusion was evaluated with two criteria: 1) pretransfusion Hb level ≤10 g/dL and 2) posttransfusion Hb level ≤10 g/dL. RESULTS: The median pretransfusion Hb level was 8.5 g/dL (interquartile range 7.7~9.4); that of each department was as follows: 8.6 g/dL (7.9~9.2) in CS, 7.9 g/dL (7.3~8.6) in GS, 9.1 g/dL (8.5~9.8) in NS, 8.5 g/dL (7.7~9.8) in OBGY, and 8.7 g/dL (7.9~9.7) in OS. With a criteria of pretransfusion of Hb level ≤10 g/dL, 85.4% of total episodes were appropriate. With criteria of post-transfusion of Hb level ≤10 g/dL, 44.7% were appropriate. CONCLUSION: This study presents a fundamental data observing the trend of RBC transfusion in a single institution. A significant proportion of inappropriate RBC transfusion are still being conducted in surgical setting. Continuous and effective education of clinicians and implementation of monitoring systems to assess the appropriateness of RBC transfusion may be necessary.
Education ; Erythrocyte Transfusion ; Erythrocytes ; Gynecology ; Hemorrhage ; Humans ; Neurosurgery ; Obstetrics ; Orthopedics

OBJECTIVE: The objective of this study was to assess the association between women with endometriosis and risk of preterm birth. METHODS: Two reviewers independently determined all prospective cohort study, retrospective cohort study, large population based cohort study, retrospective secondary analysis, and double blinded, multicentric, observational and cohort study, placebo-controlled, randomized clinical trial published using PubMed, Medline, Korea Education and Research Information Service, and Scopus from March 1994 through February 2016 without language restrictions comparing obstetric outcomes women with endometriosis and women without endometriosis. The meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Six studies met inclusion criteria, including 50,472 women. Among 50,472 pregnancies, 39,659 had endometriosis and 10,813 had no endometriosis. Meta-analyses were estimated with odds ratios and 95% confidence intervals using random effect analysis according to heterogeneity of studies. RESULTS: Data from six effect sizes from six studies involving 50,472 patients were enrolled. These meta-analyses showed women with endometriosis have an increased risk of preterm birth (odds ratio, 1.473; 95% confidence interval, 1.216 to 1.785). CONCLUSION: These meta-analyses demonstrate women with endometriosis at pregnancy have an increased risk of preterm birth. Therefore, it is worthy for obstetrics to increase the careful inspection in women with endometriosis during pregnancy.
Cohort Studies ; Education ; Endometriosis* ; Female ; Humans ; Information Services ; Korea ; Obstetrics ; Odds Ratio ; Population Characteristics ; Pregnancy ; Premature Birth* ; Prospective Studies ; Retrospective Studies

PURPOSE: This study aimed to investigate the safe medication utilization and the education demands during pregnancy and it further reported the development of educational materials for pregnant women. METHODS: A survey was conducted in two tertiary care university hospitals and one community hospital specialized in obstetrics and gynecology from July 2 to 29 2014. The survey questionnaires included the usage of medications and the unmet needs on medication use during pregnancy. Ad ditionally, pregnant women's requests regarding to medication use were collected through group interviewing of community pharmacists. Based on these results, educational materials were de veloped and implemented. After implementing the education sessions, the satisfaction was evaluated. RESULTS: A total of 152 pregnant women answered completely the questionnaire. Among them, 130 participants (42.8%) were given the medication information from their physicians. Exposure to a teratogenic drug during pregnancy was a major concern for most pregnant women (79.6%). The majority (90.1%) of subjects reported a necessity of medication-related education during their pregnancy. The interview with 48 pharmacists indicated that the most commonly used OTC drugs in pregnancy were vitamins (25.2%), iron supplements (23.7%), and the most frequently used prescription drugs were antiinflammatory-analgesics (25.3%), followed by antibiotics (20.9 %). Based on the results, booklets of drug therapy during pregnancy, leaflet of pregnancy category index were made. Also, on-line flash and presentation materials for instructors were prepared. Through the trial education with the developed materials, it was confirmed that the contents of education materials were well understood and satisfied by the pregnant women. CONCLUSIONS: This study showed the need of the medication-related education for the pregnant women. The developed education materials would be helpful sources to provide accurate and reliable medication-related information to health professionals and pregnant women.
Anti-Bacterial Agents ; Drug Therapy ; Education ; Female ; Gynecology ; Health Occupations ; Hospitals, Community ; Hospitals, University ; Humans ; Interviews as Topic ; Iron ; Nonprescription Drugs ; Obstetrics ; Pamphlets ; Pharmacists ; Pregnancy* ; Pregnant Women ; Prescription Drugs ; Tertiary Healthcare ; Vitamins

There are four principles of medical ethics; Beneficence, Respect for autonomy, Non-maleficence, and Justice. It is not easy to apply to principles of medical ethics in the special circumstances of obstetrics and gynecology. Student doctors must learn to be familiar with principles of medical ethics tailored to the special circumstances while the obstetrics and gynecology practice.
Beneficence ; Education, Medical* ; Ethics* ; Ethics, Medical ; Gynecology* ; Humans ; Obstetrics* ; Social Justice

The medical environment of obstetric field has been deteriorated seriously, which is caused by sharply declined birth rates and several other causes in Korea. Inversely, the prevalence of high risk pregnancy is continuously going to explode, and human resources and facilities in delivery unit are still in shortage. It is greatly needed to be reinforced, but rather diminished substantively. Finally, maternal death rate of Korea has been extremely increased. It is time that the policies for treatment of high risk maternity in national level, no more leave the situation unchanged. The integrated care system which treats high risk maternity and neonate sequentially is very important in their disease characteristics. It is sure that the integrated management of high risk pregnancy and neonate can make an important role in the improvement of perinatal and maternal death rate and maternal-neonatal health care. Therefore, Ministry of Health and Welfare made a policy that establishes 'Integrated Care Center for High Risk Pregnancy and Neonate' for high risk maternity and neonate. It is supposed to start from four centers as a demonstration project in 2014, and will finally establish 17 centers in 11 broad territories of the country in 2017. It will accomplish a task of emergency center, and carry out treatment and emergency operation at all times. In addition, it will take the roll of emergency transfer system, data collection and analysis, and preventive management service through public education and relations. In the future, Integrated Care Center will play an important role in improving maternal health care as well as obstetric infrastructure.
Birth Rate ; Delivery of Health Care ; Education ; Emergencies ; Humans ; Infant, Newborn* ; Information Systems ; Korea ; Maternal Death ; Maternal Health ; Obstetrics* ; Pregnancy, High-Risk* ; Prevalence

PURPOSE: Problem-based learning is an established method of teaching and learning in medical education. However, its impact on students' achievement on examinations is varied and inconsistent. We compared the levels of achievement on the Bachelor of Medicine, Bachelor of Surgery/Chirurgery (MB ChB) Part I and II licensing examination of students in problem-based learning, community-based education and service (PBL/COBES), and conventional curricula. METHODS: In 2014, we analyzed the MB ChB Final Part I and II licensing examination results of students in three classes (2004, 2005, and 2006) of the School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana. Ninety-three students in the 2004 and 2005 cohorts followed a conventional curriculum, and 82 students in the 2006 cohort followed a PBL/COBES curriculum. Using appropriate statistical tools, the analysis compared individual discipline scores and the proportions of students who received distinction/credit/pass grades among the classes. RESULTS: The PBL students had significantly higher mean and median scores than the conventional students in Obstetrics and Gynecology, Internal Medicine, Community Health and Family Medicine, Surgery, and Psychiatry, but not in Child Health and Pediatrics. Also, a significantly (P=0.0010) higher percentage, 95.1% (n=78), of the PBL students passed all the disciplines, compared to 79.6% (n=74) of the conventional students. CONCLUSION: The PBL students significantly performed better in all the disciplines except child health and pediatrics, where the conventional students scored higher. These findings demonstrate that the benefits of the PBL/COBES curriculum are tangible and should be fostered.
Child ; Child Health ; Cohort Studies ; Curriculum* ; Education* ; Education, Medical ; Educational Measurement ; Educational Status ; Ghana* ; Gynecology ; Humans ; Internal Medicine ; Learning ; Licensure* ; Obstetrics ; Pediatrics ; Problem-Based Learning*