H:\Pregbedrest[1]

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Bedrest

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H:\Pregbedrest[1]

  1. 1. Pregnancy and bedrest Donna Adelsperger RN, M. Ed.
  2. 2. Effects of Pregnancy Bedrest <ul><li>Bodily activity and exercise is a means for release of psychologic tension and stress. </li></ul><ul><li>Some effects of bedrest include: </li></ul><ul><ul><li>feelings of isolation/ loneliness </li></ul></ul><ul><ul><li>confined </li></ul></ul><ul><ul><li>bored </li></ul></ul><ul><ul><li>depression </li></ul></ul><ul><ul><li>stress of waiting/ anxiety </li></ul></ul>
  3. 3. Effects of Bedrest <ul><li>Central to the problem of bedrest is </li></ul><ul><li>Activity restriction </li></ul><ul><li>Women perceive they receive little help in planning HOW to be on bedrest. </li></ul>
  4. 4. Effects of Bedrest <ul><li>Studies suggest stressors may be different between hospital & home </li></ul><ul><li>Bedrest at home - family relations may be less stressed </li></ul><ul><li>Bedrest at hospital - separation from family </li></ul><ul><li>Both groups - similar for mood swings, guilt and anger </li></ul>
  5. 5. Effects of Bedrest <ul><li>Women feel profound loss of control over their bodies and their pregnancies. </li></ul><ul><li>Medical technical procedures contribute to sense of loss & control. </li></ul><ul><li>This may cause distancing from fetus. </li></ul>
  6. 6. Effects of BR on Fathers <ul><li>Stressed - worried about mom & baby </li></ul><ul><li>may not share how they feel </li></ul><ul><li>begin to feel depressed </li></ul><ul><li>would like to trade places for a time </li></ul><ul><li>need support and counselling </li></ul>
  7. 7. Impact of BR on Family and Finances <ul><li>Fathers assuming multiple role while trying to handle own stress and worries. </li></ul><ul><li>Increased domestic activities </li></ul><ul><li>decrease in leisure activities </li></ul><ul><li>constant state of worry </li></ul>
  8. 8. Ways to Assist Families <ul><li>Gifts of food </li></ul><ul><li>assistance with child care </li></ul><ul><li>assistance with household chores </li></ul>
  9. 9. Effects of Bedrest <ul><li>Bedrest becomes self perpetuating and activity restriction becomes a cycle </li></ul><ul><li>Activity restriction leads to sensory & social isolation which leads to inactivity </li></ul><ul><li>Dulling of cortical processes eventually leads to self imposed activity restriction </li></ul>
  10. 10. Effects of BR on Postpartum <ul><li>Recovery takes longer </li></ul><ul><li>have difficuly with concentrating </li></ul><ul><li>experience feeling overwhelmed due to sensory deprivation </li></ul>
  11. 11. How to Avoid Bedrest <ul><li>Education </li></ul><ul><li>early detection of symptoms of complications </li></ul><ul><li>help women gain skills in knowing their bodies and to report worrisome symptoms </li></ul><ul><li>therapeutic relationship with nurses </li></ul><ul><li>collaborative research </li></ul>
  12. 12. Interventions for Assisting Women on Bedrest <ul><li>Unstructured support groups - </li></ul><ul><ul><li>after each introduces self they share: </li></ul></ul><ul><ul><ul><li>diagnoses </li></ul></ul></ul><ul><ul><ul><li>tell “their bedrest story </li></ul></ul></ul><ul><ul><li>leader - (needs facilitation skills) provides positive support & provide info when needed & redirect discussion as needed. </li></ul></ul><ul><ul><li>keeping discussion going </li></ul></ul>
  13. 13. Benefits of Support Groups <ul><li>Content analysis revealed most discussions about coping, including behaviors or mechanisms that helped women manage their perceived problems or maintain their current status on bedrest </li></ul><ul><li>I.e.how to arrange hospital room so things within reach, </li></ul><ul><li>I.e. plan activities </li></ul>
  14. 14. Interventions for Coping with “Time Passing Slowly” <ul><li>Provide diversional activities </li></ul><ul><li>set shot term goals for themselves I.e. weekly goals </li></ul>
  15. 15. Interventions for Coping with Boredom <ul><li>“ take it one day at a time” </li></ul><ul><li>“ focus on the prize” the baby </li></ul><ul><li>make a schedule each day (often around MD’s visits, hospital tests, meals, visitors, </li></ul><ul><li>Planned diversional activities help women cope and give them some sense of control. </li></ul>
  16. 16. Psychologic Effects of Bedrest cont’d <ul><li>Hostility </li></ul><ul><li>mood lability </li></ul><ul><li>guilt </li></ul><ul><li>loss of control /autonomy </li></ul><ul><li>stress on all members of family </li></ul><ul><li>financial stress </li></ul><ul><li>child care problems </li></ul><ul><li>financial difficulties </li></ul>

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