Private Health Care Centers Research Articles

Pregnant women's preferences for mode of delivery questionnaire: Psychometric properties.

Introduction:The rate of caesarean delivery is increasing worldwide. Maternal beliefs may be influential on the mode of delivery. This study aimed to validate pregnant women's preferences for mode of delivery questionnaire among pregnant women.Materials and Methods:This was a cross-sectional study which was done in Ahvaz Public and Private Health Care Centers. A total of 342 low-risk pregnant women were included in a study conducted in spring 2011 in Ahvaz, Iran. After careful consideration and performing content and face validity, a 62-item measure was developed and subjects completed the questionnaire. Reliability was estimated using internal consistency and validity was assessed by performing face, content and structure and discriminate validity. Data were analyzed using explanatory factor analysis, t-test, and correlations in SPSS 16.Results:The findings of content and face validity showed almost perfect results for both content validity ratio = 1 and content validity index = 1. The explanatory factor analysis indicated a 7-subscale measure (Eigenvalue >1, factor loading >0.4), and discriminate validity revealed satisfying results P < 0.05 for 6 out of 7 subscales. Internal consistency as measured by the Cronbach's alpha coefficient was acceptable for subscales.Conclusions:In general, the findings suggest that this newly generated scale is a reliable and valid specific questionnaire for assessing pregnant women's preferences for mode of delivery. However, further studies are needed to establish stronger psychometric properties for the questionnaire.

Evaluation of antimicrobial susceptibility and integron carriage in Helicobacter pylori isolates from patients.

The purpose of this study was to determine the antibiotic susceptibility pattern and distribution of integron in H. pylori isolates collected from patients referred to private health care centers in Tehran, Iran. Antibiotic resistance is the main reason for failure of Helicobacter pylori therapy. Integrons as genetic reservoirs play main roles in the dissemination of antimicrobial resistance gene. During a 12-month cross-sectional study period, 65 H. pylori isolates were recovered from 124 biopsy specimens. Isolates were subjected to susceptibility testing using by Epsilometer test according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guideline. PCR was used to detect different types of integrons. Antimicrobial susceptibility testing revealed that 73.8% of isolates were resistant to metronidazole, 43.1% to clarithromycin, 29.2% to tetracycline, 27.7% to amoxicillin, 23.1% to rifampicin and 13.4% to levofloxacin. Frequency of multidrug resistance among H. pylori isolates was 26.1%. The most predominant resistance profiles among our isolates were included resistance to clarithromycin and metronidazole (20%). Class 1 and 2 integrons were detected in 8 (12.3%) and 15 (23.1%) of the isolates, respectively. The high prevalence of multidrug resistance and frequency of class 2 integron in this survey can be a warning for clinicians. Continuous surveillance is necessary for the development of new treatment protocols to prevent the treatment failures and also further spread of resistant isolates.

Local, national, and service component cost variations in the management of low back pain: Considerations for the clinician

In the past two decades, the cost associated with managing low back pain has increased significantly. Improved consciousness of how clinicians utilize resources when managing low back pain is necessary in the current economic climate. The goal of this review is to examine the component costs associated with managing low back pain and provide practical solutions for reducing healthcare costs. This is accomplished by utilizing examples from a major metropolitan area with several major academic institutions and private health care centers. It is clear that there is considerable local and national variation in the component costs of managing low back pain, including physician visits, imaging studies, medications, and therapy services. By being well informed about these variations in one's environment, clinicians and patients alike can make strides towards reducing the financial impact of low back pain. Investigation of the cost discrepancies for services within one's community of practice is important. Improved public access to both cost and outcomes data is needed.

Factors influencing first childbearing timing decisions among men: Path analysis

Factors that influence men's childbearing intentions have been relatively unexplored in the literature. This study aimed to determine the influencing factors about the first childbearing timing decisions of men. In this cross-sectional study, 300 men who were referred to private and governmental healthcare centers in Shahrood, Iran were randomly recruited from April to September 2014. Data were collected using a demographic questionnaire, the Quality of Life Questionnaire; ENRICH Marital Satisfaction Questionnaire, Synder's Hope Scale, and the Multidimensional Scale of Perceived Social Support. After removing the statistically insignificant paths, men's age at marriage had the highest direct effect (β=0.86) on their first childbearing decision. Marital satisfaction (β=-0.09), social support (β=0.06), economic status (β=0.06), and quality of life (β=-0.08) were other effective factors on men's first childbearing decisions. Moreover, marital satisfaction and social support had significant indirect effects on men's childbearing decisions (β=-0.04 and -0.01, respectively). Many factors, including personal factors (age at marriage and quality of life), family factors (marital satisfaction), and social factors (social support), can affect men's decision to have a child. Policymakers are hence required to develop strategies to promote the socioeconomic and family conditions of the couples and to encourage them to have as many children as they desire at an appropriate time.

Intravenous ferric carboxymaltose versus standard care in the management of postoperative anaemia: a prospective, open-label, randomised controlled trial

Despite increasing efforts in perioperative management, postoperative iron deficiency anaemia persists, and few data are available about the management of this condition. In this study, we aimed to determine whether giving postoperative intravenous iron (in the form of ferric carboxymaltose) improved iron stores, haemoglobin concentrations, and outcomes following surgery. We did a prospective, open-label, randomised, controlled study of patients at two centres (a general hospital and a private health-care centre) in Tasmania, Australia, undergoing elective surgery with functional iron deficiency anaemia (haemoglobin 70-120 g/L and ferritin ≤100 μg/L or iron saturation ≤20%), measured at day 1 postoperatively. Consecutive routine elective surgical patients who were having major orthopaedic surgery, abdominal, and genitourinary surgery, and other surgeries were recruited. Via computer-generated randomisation, patients were randomly assigned (1:1) to either a single dose of intravenous 1000 mg ferric carboxymaltose (intervention group) or standard care, consisting of observation (control group). The primary endpoints were changes in haemoglobin concentrations and iron stores at 4 weeks postoperatively, and the number of transfused units of blood required postoperatively until discharge. Analyses were done on an intention-to-treat basis. This trial is registered with the Australian New Zealand Clinical Trials Registry and the WHO International Clinical Trials Registry platform (number ACTRN12614001261606). Between Dec 17, 2014, and May 7, 2015, we recruited 201 eligible patients, assigning 103 to intravenous ferric carboxymaltose and 98 to standard care only. Baseline mean haemoglobin was 105·5 g/L (SD 13·8) in the standard care group versus 106·2 g/L (11·9) in the ferric carboxymaltose group, improving at 4 weeks to 121·5 g/L (SD 14·5) in the standard group and 130·1 g/L (11·3) in the ferric carboxymaltose group (mean difference of 7·84 g/L, 95% CI 3·79-11·9; p<0·0001 in favour of the ferric carboxymaltose group). Significant improvements in serum iron (5·36 μmol/L, 95% CI 3·62-7·09; p<0·0001), iron saturation (11·40%, 95% CI 8·33-14·50; p<0·0001), and serum ferritin concentrations (468 μg/L, 95% CI 355-582; p<0·0001) were also noted in the ferric carboxymaltose group at 4 weeks compared with standard care, although no differences were noted in transferrin concentrations (0·06 g/L, 95% CI -0·97 to 1·09; p=0·62). Fewer transfused blood units were given in the ferric carboxymaltose group (to one of 103 patients [<1%]) than in the standard care group (to five of 98 patients [5%]; incidence rate ratio 0·10; 95% CI 0·01-0·85; p=0·035). No adverse events were observed with ferric carboxymaltose treatment. Postoperative intravenous ferric carboxymaltose is a feasible and pragmatic management approach in surgical patients with functional iron deficiency anaemia. Our study suggests that patient blood management guidelines should be updated, incorporating the use of postoperative intravenous iron infusion to optimise patient outcomes. Further trials to assess our approach are warranted. Launceston General Hospital, Launceston, TAS, Australia, in affiliation with the University of Tasmania, TAS, Australia.

Evaluation of the associations between changes in intraocular pressure and metabolic syndrome parameters: a retrospective cohort study in Japan

ObjectiveThe contributions of highly correlated cardiovascular risk factors to intraocular pressure (IOP) are not clear due to underlying confounding problems. The present study aimed to determine which metabolic syndrome parameters...

Impact of Perceived Service Quality on Patient Satisfaction and Loyalty in Private Health Care Centres with special reference to Chennai City: A Structural Equation Modeling Approach

The goal of this study is to examine the impact of service quality on patient satisfaction and patient loyalty in the private health care industry in Chennai, Tamil Nadu, using the structural equation modeling approach. The service quality scale was developed based on the SERVQUAL instrument developed by Parasuraman and his colleagues; and was modified according to the healthcare industry. A survey instrument was developed to measure the influence of service quality on patient satisfaction and their loyalty in Chennai city. The stratified random sampling technique was used to select the samples from the selected private healthcare centres. Structured questionnaire was used to collect the primary data. The survey questionnaire was distributed among the patients who have undergone the treatment in the selected healthcare centres and who come for health review at regular intervals. The sample size of the survey is 562. Data were examined using IBM SPSS 23.0 and IBM AMOS 23.0. The results indicated in the proposed model are fitted and the dimensions of perceived service quality have a strong impact on patient satisfaction and loyalty.

Impact of Perceived Service Quality on Patient Satisfaction and Loyalty in Private Health Care Centres with special reference to Chennai City: A Structural Equation Modeling Approach

Impact of Perceived Service Quality on Patient Satisfaction and Loyalty in Private Health Care Centres with special reference to Chennai City: A Structural Equation Modeling Approach

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Background: The use of the Internet and social networks by patients seeking health-related information has grown in recent years. The application of these tools in the context of cardiovascular prevention in Argentina is unknown. Objectives: The aim of this study was to analyze the use of the Internet and social networks in patients evaluated in the context of cardiovascular prevention, determine the characteristics of subjects using them, analyze the reliability and usefulness perceived by patients and describe the potential behavioral impact. Methods: Patients over 18 years of age, consecutively attending 10 cardiology centers focusing on cardiovascular prevention of the City of Buenos Aires and suburban areas, were surveyed. In 97% of cases the surveys were completed by the patients. Participants’ demographic and clinical data were collected, excluding subjects with inability to read and interpret a questionnaire. Results: A total of 1,135 patients (age 49±17 years) were included in the study. Among them 68%, 65% and 52% used the Internet, email or social networks, respectively, and 58.2% searched health-related information. The most searched-for topics were food (48%), physical activity (35%), medication (32%), hypertension (26%) and obesity (25%). Information was considered reliable or very reliable in 54.6% of cases, and interest was perceived in using these tools to contact the physician or other patients. In 57.8% of cases, patients felt that the network could influence their behavior. Characteristics such as less than 50 years of age, attending private healthcare centers or higher education were independently associated with a greater possibility of seeking health information. Conclusions: In this population, the Internet was significantly used to explore about health information. Younger subjects, with higher education and those attending private healthcare centers were more likely to seek health-related information. The interest generated by these tools could be used for patient care.

Empowering the People: Public Responses to Welfare Policy Change

AbstractHow and when does welfare policy contribute to shape public opinion? This article departs from the policy feedback research tradition and seeks to contribute to the understanding of how policy influences public opinion (public responsiveness). The argument here suggests that personal experiences in terms of empowerment condition the dynamics between policy and opinion. The empirical case concerns the implementation of a consumer's choice model in Swedish primary health care, which resulted an intended increase in private health care centres. In this case, empowerment is assumed to be enhanced by increased exit options and freedom of choice. The specific question in the analysis is whether citizens who have empowering experiences, as a consequence of the reform, are more likely to be positive towards further privatization of welfare services. The results show few effects in general, but there seems to be a correlation between the experience of exiting and more positive attitudes towards privatization.

Detecção de rotavírus e norovírus na população idosa na cidade de Caxias do Sul, Rio Grande do Sul, Brasil, de 2010 a 2012

Aims: Rotavirus (RV) and norovirus (NoV) are the most common cause of diarrhea in children aged less than five years throughout the world. However, RV and NoV have frequently been overlooked as pathogens in elderly individuals. This study examined the frequency of RV and NoV among elderly patients with complaints of diarrhea in the city of Caxias do Sul, southern Brazil. Methods: Between 2010 and 2012, stool samples from patients aged 60 years or older with acute gastroenteritis treated at a private healthcare center were analyzed, seeking to identify RV and NoV. RV detection was performed by latex agglutination (LA) methods and polyacrylamide gel electrophoresis (PAGE). One third of the samples were further tested for NoV by reverse transcription polymerase chain reaction (RT-PCR). Results: A total of 145 stool samples from patients aged 60 to 105 years were analyzed. RV was detected in 6/145 (4.14%) and 5/125 (4.00%) of the samples by LA and PAGE, respectively. NoV was detected in 6/51 (11.76%). Mixed infection (RV and NoV) was detected in a single sample: 1/51 (1.96%). Conclusions: This study adds further evidence that viral agents are involved in the etiology of gastroenteritis in the elderly, contributing significantly to the understanding of RV and NoV infections in the mature population.

Compare the quality of life in fertile and infertile women attending public

Background and aim: Infertile women experience many problems in their life. Evaluation the quality of lifein infertile makes the healthcare provider aware of their needs for providing quality care. The aim of presentstudy was to compare the quality of life in fertile and infertile women attending public and private centers IIlam,Iran.Methods and material : In a cross - sectional study , quality of life of a group of infertile and fertilewomen attending to public and private health care centers of Ilam in 2013 was compared. Simple randomsampling method was used. Inclusion criteria consisted of: being married, age between 15-49 years , nonpregnantand non-lactating. Postmenopausal women with known physical and mental illness, or a history ofthem were excluded. Data were collected by the quality of life questionnaires SF-36 and demographicquestionnaire. Data were analyzed using SPSS software, chi-square test and t-test.Results: 450 women participated in the present study . Mean age in women of fertile group was 32.17± 3.09years and in infertile women 35.93± 8.07, respectively. The mean scores for physical functioning, rolelimitations due to physical problems, general health, vitality, social functioning, role limitations due toemotional problems and mental health were significantly different in fertile and infertile women. But thephysical pain scores were not significantly different in fertile and infertile women.Conclusion: The physical and mental dimensions of quality of life scores was lower in infertile women incomparison to fertile women group . Therefore it is important to provide support and education to improvequality of life in infertile women.Key words: Infertility, quality of life, SF-36

A Study of Socio-Economic Status (SES) Associated with Epidemiology of Tuberculosis in General Population of District Buner, Khyber Pakhtunkhwa (KPK), Pakistan

Objectives: Tuberculosis (TB) is endemic in Pakistan ranking fifth amongst the twenty two endemic countries. Historically, TB has been associated with poverty and low socioeconomic status (SES). This study focuses on the association of SES with prevalence of TB in general population of district Buner, Khyber Pakhtunkhwa, Pakistan. Material and Methods: A cross-sectional survey was conducted in Government and Private health care centers during 2010-2013 in district Buner, KPK. TB rates were calculated in relation to SES. Result: The data analysis resulted in 1079 positive cases consisting male (n = 445, 41.24%) and female n = (634); 58.8%. The highest occurrence of TB (306/1079: 28.4%) was observed in the group 15 - 45 years followed by the group below 15 years (85/1079:7.9%) in males. The female group in range of 15 - 45 years (251/1079: 23.3%) had maximum TB followed by the group above 45 years (235/1079: 21.8%). The male patients with no education were more in number (152/445: 34.16%) to TB infection as compared to patients with primary (124/445: 27.9%), secondary (111/445: 34.16%) and higher education (58/ 445: 13%). Likewise the highly qualified female patients suffered only 3.5% from TB where as those having no education had maximum infection (49%) followed by primary educated (37.85%) patients. The minimum number of patients (300/1079: 27.8%) suffering from TB were reported in high income family followed by middle (325/1079: 30%) and low income (454/1079: 42%) families. The maximum incidence of TB (320/1079: 28.7%) was found in 2010 followed by 2011 (289/1079: 26.8%), 2012 (268/1079: 24.7%) and 2013 (213/1079: 19.7%) respectively. Conclusions: This result shows that there is deep association between the TB infection and the SES among the public. High infection rates of TB in district Buner may reflect ignorance, no early medical care, poor hygiene, poor nutritional status, economic depressions, lack of proper health facility and knowledge regarding the treatment. Screening for TB (to diagnose latent TB infection), education and good SES remain the most important tools to reduce the risk of TB progression among the general populations in a region.

Swedish general practitioners' attitudes towards treatment guidelines - a qualitative study.

BackgroundDrug therapy in primary care is a challenge for general practitioners (GPs) and the prescribing decision is influenced by several factors. GPs obtain drug information in different ways, from evidence-based sources, their own or others’ experiences, or interactions with opinion makers, patients or colleagues. The need for objective drug information sources instead of drug industry-provided information has led to the establishment of local drug and therapeutic committees. They annually produce and implement local treatment guidelines in order to promote rational drug use. This study describes Swedish GPs’ attitudes towards locally developed evidence-based treatment guidelines.MethodsThree focus group interviews were performed with a total of 17 GPs working at both public and private primary health care centres in Skåne in southern Sweden. Transcripts were analysed by conventional content analysis. Codes, categories and themes were derived from data during the analysis.ResultsWe found two main themes: GP-related influencing factors and External influencing factors. The first theme emerged when we put together four main categories: Expectations and perceptions about existing local guidelines, Knowledge about evidence-based prescribing, Trust in development of guidelines, and Beliefs about adherence to guidelines. The second theme included the categories Patient-related aspects, Drug industry-related aspects, and Health economic aspects. The time-saving aspect, trust in evidence-based market-neutral guidelines and patient safety were described as key motivating factors for adherence. Patient safety was reported to be more important than adherence to guidelines or maintaining a good patient-doctor relationship. Cost containment was perceived both as a motivating factor and a barrier for adherence to guidelines. GPs expressed concerns about difficulties with adherence to guidelines when managing patients with drugs from other prescribers. GPs experienced a lack of time to self-inform and difficulties managing direct-to-consumer drug industry information.ConclusionsPatient safety, trust in development of evidence-based recommendations, the patient-doctor encounter and cost containment were found to be key factors in GPs’ prescribing. Future studies should explore the need for transparency in forming and implementing guidelines, which might potentially increase adherence to evidence-based treatment guidelines in primary care.

Management of pancreatic collections with a novel endoscopically placed fully covered self-expandable metal stent: a national experience (with videos)

Recent medical literature on novel lumen-apposing stents for the treatment of pancreatic fluid collections (PFCs) is limited by small numbers, solo operators, and single-center experience. To evaluate a recently developed lumen-apposing, fully covered self-expandable metal stent (FCSEMS) in the management of PFCs. Retrospective case series. Thirteen tertiary and private health care centers across Australia. Forty-seven patients (median age 51 years) who underwent endoscopic management of PFCs. Insertion of FCSEMS after PFC puncture under EUS guidance. A subgroup of 9 patients underwent direct endoscopic necrosectomy. Technical and clinical success rate, adverse event rate. The technical success rate was 53 of 54 patients (98.1%), and the initial clinical success rate was 36 of 47 (76.6%), which was sustained for more than 6 months in 34 of 36 (94.4%). Early adverse events included 4 cases (7.4%) of stent migration during direct endoscopic necrosectomy, 4 cases (7.4%) of sepsis, 1 case (1.9%) of bleeding, and 1 case (1.9%) of stent migration into the fistula tract. Late adverse events were6 (11.1%) spontaneous stent migrations, 3 (5.6%) recurrent stent occlusions, 3 (5.6%) tissue ingrowth/overgrowth, and 2 (3.7%) bleeding into PFC. The majority of stents inserted (48 of 54, 88.9%) and removed (31 of 35, 88.6%) in our study were described by the operator as superior to pigtail stents with regard to ease of use. Retrospective study. Although FCSEMSs are technically easier to insert and remove compared with traditional pigtail stents, there are significant limitations to the widespread use of FCSEMSs in the management of PFCs. These include cost, adverse events, and lower-than-expected resolution rates.

Leiomiomatosis parásita en Medellín, Colombia: reporte de un caso y revisión de la literatura

&lt;p&gt;&lt;strong&gt;Objetivo:&lt;/strong&gt; mostrar un caso de leiomiomatosis parásita que se presentó después de miomectomía laparoscópica y revisar la literatura disponible respecto a la histopatología, la fisiopatología, el diagnóstico y el tratamiento de la entidad.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materiales y métodos:&lt;/strong&gt; se presenta el caso de una paciente de 30 años con antecedente de miomectomía por laparoscopia, que consultó a la clínica las Americas (Medellín, Colombia), centro privado de atención, por sangrado uterino de un mes de evolución. Por ultrasonido pélvico se documentó la presencia de leiomiomas uterinos. Fue sometida a nueva laparoscopia que reveló cuatro miomas parásitos en la cavidad pélvica. Se realizó una búsqueda en las bases de datos Medline vía PubMed y SciELO con los términos MeSH: “leiomyomatosis parasitic”, “myomectomy”, “laparoscopic” y “myoma”, y los términos DeCS: “mioma”, “leiomiomatosis parásito” “miomectomía” y “laparoscopia”.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Resultados: &lt;/strong&gt;se seleccionaron 12 artículos de los cuales 10 son reporte de caso, una serie de casos y una revisión narrativa de la literatura.&lt;/p&gt;

10.5937/sjas11-6957 = Differences in motivation of health care professionals in public and private health care centers

It is very important to achieve client satisfaction in the health care sector, which is why the issue of motivation of health care professionals is always an interesting topic to explore. Having in mind the current situation in the private health care sector in Serbia, we have decided to examine the differences in satisfaction of motivational needs in health care professionals, with an emphasis on differences between health care professionals working in public and private health care centres. We have used Maslow and Herzberg’s motivation theories when designing the appropriate questionnaire. The results obtained have revealed differences between subsamples. Health care professionals working in the private sector are more satisfied with their salaries, working conditions, job certainty and opportunities for professional development.

Telaprevir- and boceprevir-based tritherapies in real practice for F3-F4 pretreated hepatitis C virus patients.

To assess, in a routine practice setting, the sustained virologic response (SVR) to telaprevir (TPV) or boceprevir (BOC) in hepatitis C virus (HCV) null-responders or relapsers with severe liver fibrosis. One hundred twenty-five patients were treated prospectively for 48 wk with TPV or BOC + pegylated-interferon (peg-INF) α2a + ribavirin (PR) according to standard treatment schedules without randomization. These patients were treated in routine practice settings in 10 public or private health care centers, and the data were prospectively collected. Only patients with severe liver fibrosis (Metavir scores of F3 or F4 upon liver biopsy or liver stiffness assessed by elastography), genotype 1 HCV and who were null-responders or relapsers to prior PR combination therapy were included in this study. The Metavir fibrosis scores were F3 in 35 (28%) and F4 in 90 (72%) of the patients. In total, 62.9% of the patients were null-responders and 37.1% relapsers to the previous PR therapy. The overall SVR rate at 24 wk post-treatment withdrawal was 59.8%. The SVR was 65.9% in the TPV group and 44.1% in the BOC group. Independent predictive factors of an SVR included a response to previous treatment, relapsers vs null-responders [OR = 3.9; (1.4, 10.6), P = 0.0084], a rapid virological response (RVR) [OR 6.9 (2.6, 18.2), P = 0.001] and liver stiffness lower than 21.3 kPa [OR = 8.2 (2.3, 29.5), P = 0.001]. During treatment, 63 patients (50.8%) had at least one severe adverse event (SAE) of grade 3 or 4. A multivariate analysis identified two factors associated with SAEs: female gender [OR = 2.4 (1.1, 5.6), P = 0.037] and a platelet count below 150 × 10(3)/ mm(3) [OR = 5.3 (2.3, 12.4), P ≤ 0.001]. More than half of these difficult-to-treat patients achieved an SVR and had SAEs in an actual practice setting. The SVR rate was influenced by the response to previous PR treatment, the RVR and liver stiffness.

Prevalence and risk factors for postpartum depressive symptoms in Argentina: a cross- sectional study

IntroductionPostpartum depression is a prevalent disorder with negative consequences for women, infants, and the family as a whole. Most studies of this disorder have been conducted in Western countries, and studies from developing countries are few. In this paper, we report the first – as far as we are aware – study of the prevalence and risk factors associated with postpartum depressive symptoms in Argentina.Materials and methodsThe study participants were 86 women attending 6 week checkups, (range 4–12 weeks) postpartum at a private health care center in the metropolitan area of Buenos Aires. The women completed the Edinburgh Postnatal Depression Scale (EPDS) and a questionnaire collecting demographic and obstetric data. Data were described as proportions (percentages). Differences between proportions were assessed with chi-squared tests. To control for possible confounders, we fitted bivariate logistic regression models in which the dependent variable was an EPDS sum score of <10 versus a score of ≥10.ResultsWe found a high prevalence of depressive symptoms. A total of 32 women (37.2%) had an EPDS score of ≥10, 16 (18.6%) had a score between 10 and 12, and 16 (18.6%) had a score of ≥13. In our sample, an EPDS score of ≥10 was significantly associated with multiparity (odds ratio [OR] =3.58; 95% confidence interval [CI]: 1.13–11.30; P=0.030), pregnancy complications (OR =3.40; 95% CI: 1.03–11.26; P=0.045), labor complications (OR =11.43; 95% CI: 1.71–76.61; P=0.012), cesarean section (OR =4.19; 95% CI: 1.10–16.01; P=0.036), and incomplete breast-feeding (OR =5.00; 95% CI: 1.42–17.54; P=0.012).ConclusionOur results indicate that postpartum depression may be prevalent in Argentina, and may be associated with incomplete breast-feeding, cesarean section, perinatal complications and multiparity. The prevalence and risk factors for postpartum depression has not been described previously and is a considerable health-related problem among women. Argentinian health professionals should be aware of the high prevalence rate and possible risk factors so that these women and families can be identified and receive adequate support and treatment.

Retrospective study of the implementation of the nursing process in a health area

To analyze when the nursing process began to be used in the public and private healthcare centers of Gipuzkoa (Basque Country), and when both NANDA-I nursing diagnoses and the NIC-NOC terminologies were incorporated into this process. A retrospective study was conducted, based on the analysis of nursing records that were used in the 158 studied centers. The specific data provided showed that in Gipuzkoa, the nursing process began to be used in the 1990s. As for NANDA-I nursing diagnoses, they have been used since 1996, and the NIC-NOC terminologies has been used since 2004. It was concluded that public centers are the ones which, generally speaking, first began with the nursing methodology, and that in comparison to the United States and Canada, the nursing process started to be used about 20 years later, NANDA-I nursing diagnoses around 15 years later, and the NIC-NOC terminologies, around six years later.