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de Wit W, Frielink N, Roeg D, Embregts PJCM. Sexual support and education for adults with mild intellectual disabilities: a Delphi study on multiple perspectives. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024. [PMID: 39021295 DOI: 10.1111/jir.13172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Providing appropriate sexual support and education for adults with mild intellectual disabilities (IDs) is a source of considerable debate, resulting in diverse, non-funded and potentially adverse practices. This study aims to identify a consensus among experts regarding what conditions are conducive to successful sexual support and education for adults with mild IDs. METHODS A Delphi study was conducted with 13 experts, including experts-by-experience, relatives, support staff, psychologists and sexologists. Qualitative data on the conditions for sexual support and education were gathered in the first round and thematically analysed. In the following three quantitative rounds, consensus was achieved using Likert-type response scales and participants' feedback. RESULTS Round 1 resulted in 82 conditions on six themes: 'the necessary attitude', 'requirements', 'approach to delivering sexual support and education', 'appropriate providers', 'settings and timing' and 'effective collaboration with the network'. In the following three quantitative rounds, the experts reached consensus on 68 conditions distributed across the six themes. CONCLUSIONS The six themes highlight conducive conditions for successful sexual support and education for adults with mild IDs, emphasising the significance of a safe and supportive environment, comprehensive educational programmes, and the promotion of autonomy and protection. The consensus-based findings have distinct implications for practice and future research.
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Affiliation(s)
- W de Wit
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Zuidwester, Middelharnis, The Netherlands
| | - N Frielink
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - D Roeg
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Kwintes Supported Housing, Zeist, The Netherlands
| | - P J C M Embregts
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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Armitage L, Walter F. Differences observed in perceived sexual knowledge between people with intellectual disabilities, their parents and professionals. Evid Based Nurs 2024:ebnurs-2023-103871. [PMID: 38360067 DOI: 10.1136/ebnurs-2023-103871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 02/17/2024]
Affiliation(s)
- Leah Armitage
- School of Health Sciences, University of Manchester Institute of Science and Technology Department of Biomolecular Science, Manchester, UK
| | - Florian Walter
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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Gil-Llario MD, Fernández-García O, Flores-Buils R, Huedo-Medina TB, Morell-Mengual V, Ballester-Arnal R. People with intellectual disabilities' sexuality from three different perspectives: Parents, professionals, and themselves. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:1337-1344. [PMID: 37614095 DOI: 10.1111/jar.13154] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 05/22/2023] [Accepted: 08/13/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND A positive conception of sexuality among people with intellectual disabilities is crucial and relies on several social and interpersonal contexts. The goal of this study is to analyse the interaction and impact of three different contextual groups: individuals with intellectual disabilities, their parents, and professionals working with them. METHODS Survey data were collected from 330 people with intellectual disabilities attending occupational centres in eastern Spain, 330 parents, and 100 professionals. RESULTS Correlation and variance analyses of dyad-level data show significant differences among the three groups in all variables. Professionals perceived people with intellectual disabilities to have higher knowledge of socio-sexual norms than people with intellectual disabilities actually appear to be, but they are also more concerned about aspects related to this area of people with intellectual disabilities. Compared to people with intellectual disabilities and professionals, parents perceived people with intellectual disabilities to have lower sexual knowledge. CONCLUSIONS Our study demonstrates inconsistent perceived knowledge of people with intellectual disabilities' socio-sexual norms and sexual knowledge among the three groups, leading to disparate levels of concern regarding people with intellectual disabilities sexuality. Thus, the need to collect information from different perspectives for more accurate reporting and the critical need for sex education programs that involve the target population, but also parents and professionals who frequently interact with people with intellectual disabilities are highlighted.
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Affiliation(s)
- María Dolores Gil-Llario
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Olga Fernández-García
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Raquel Flores-Buils
- Department of Developmental, Educational and Social Psychology and Methodology, Faculty of Health Sciences, Jaume I University, Castellón de la Plana, Spain
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, USA
| | - Vicente Morell-Mengual
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Rafael Ballester-Arnal
- Department of Basic and Clinical Psychology and Psychobiology, Faculty of Health Sciences, Jaume I University, Castellón de la Plana, Spain
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Gil-Llario MD, Morell-Mengual V, Fernández-García O, Estruch-García V, Ballester-Arnal R. SALUDIVERSEX: A quality of life and sexual health intervention for adults with mild intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023:17446295231196258. [PMID: 37586786 DOI: 10.1177/17446295231196258] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Individuals with intellectual disabilities need an affective and sexual education adapted to their characteristics. There are few interventions that meet these objectives and offer empirical evidence of their efficacy. To respond to the limitations of existing interventions, an evidence-based affective-sexual educational intervention for adults with a mild degree of intellectual disability is proposed: SALUDIVERSEX. Participants will be randomly assigned to an intervention group that will receive the SALUDIVERSEX program or to a waiting list group. The intervention will be implemented by educators of occupational centers after a thorough training phase. Our main hypothesis is that the SALUDIVERSEX program will improve the sexual health and quality of life, through the joint action built into three components: the acquisition of basic information, the development of skills and strategies and the achievement of healthy attitudes towards the experience and expression of sexuality. The results of this approach could have important implications for optimizing the quality of life and self-determination of individuals with Intellectual disability by contributing to the development of healthy sexuality.
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Affiliation(s)
| | | | - Olga Fernández-García
- Department of Developmental and Educational Psychology, University of Valencia, Spain
| | | | - Rafael Ballester-Arnal
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Spain
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de Wit W, Roeg D, Embregts PJCM. Using Concept Mapping to Explore the Perspectives of People with Mild to Borderline Intellectual DisabilitiesToward Sexual Health. SEXUALITY AND DISABILITY 2023; 41:1-15. [PMID: 37362799 PMCID: PMC10169136 DOI: 10.1007/s11195-023-09796-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2023] [Indexed: 06/28/2023]
Abstract
People with mild to borderline intellectual disabilities face many barriers toward their sexual health. To promote sexual health and overcome these barriers, they need individualized forms of sexuality support and education. To align sexuality support and education insight is needed on their understanding of sexual health. The current paper aims to provide greater insight in what sexual health consists of according to people with mild to borderline intellectual disabilities. Nine people with a mild to borderline intellectual disability participated in a concept mapping procedure, consisting of brainstorming, sorting, and ranking the statements. The resulting clusters and concept map were interpreted by an expert group. Analysis resulted in five clusters which participants considered important for their sexual health. According to people with mild to borderline intellectual disability cluster pertaining to romantic relationships and sexual socialization were the most important. These were followed by clusters on sexual health and lastly sexual selfhood. These results have implications for the development of sexuality support and education, as well as further research. Supplementary Information The online version contains supplementary material available at 10.1007/s11195-023-09796-w.
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Affiliation(s)
- Wouter de Wit
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Postbus 90153, 5000 LE Tilburg, The Netherlands
- Zuidwester, Middelharnis, The Netherlands
| | - Diana Roeg
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Postbus 90153, 5000 LE Tilburg, The Netherlands
- Kwintes Supported Housing, Zeist, The Netherlands
| | - Petri J. C. M. Embregts
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Postbus 90153, 5000 LE Tilburg, The Netherlands
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Crehan ET, Rocha J, Sclar J, Ward O, Donaghue A. Topics and timing of sexuality and relationship education for autistic and non-autistic adults in the United States. Disabil Health J 2023:101466. [PMID: 37062650 DOI: 10.1016/j.dhjo.2023.101466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 03/16/2023] [Accepted: 03/16/2023] [Indexed: 04/05/2023]
Abstract
INTRODUCTION Sexuality and relationship education is a learning area that historically has been overlooked, especially for autistic individuals. To inform future programming, we are in need of evidence-based reasoning to guide program design, such as what to cover and when. In particular, the social aspects of sexuality and relationship education, which are less commonly addressed, need further scrutiny. OBJECTIVE To identify sexuality and relationship education priorities and timelines based on feedback from autistic and non-autistic adults. METHODS An online anonymous survey of adults in the United States posed questions about sexuality and relationship education, sexual and relationship experiences, and autistic traits. RESULTS Comparisons by diagnostic group (autistic and non-autistic) revealed no significant differences in the timing of sexual experiences. Autistic individuals were significantly more likely to indicate that they wanted to learn more about gender identity, sexual orientation, consent, and assertiveness than non-autistic peers. However, the majority of all participants across diagnostic groups wanted more information across all surveyed topics. CONCLUSIONS Lack of differences in timing of sexuality-related experiences highlights the importance of beginning sexuality and relationship education early for all learners. Important diagnostic group differences highlight critical areas of development for sexuality and relationship education programming. The importance of incorporating needs of autistic learners into program design is highlighted for future work. Overall findings support the idea that more sexuality and relationship education across the lifespan would best meet the learning needs of all people.
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de Alvarenga KAF, de Alcântara WL, de Miranda DM. What has been done to improve learning for intellectual disability? An umbrella review of published meta-analyses and systematic reviews. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:413-428. [PMID: 36760221 DOI: 10.1111/jar.13072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 01/02/2023] [Accepted: 01/04/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Intellectual disability (ID) affects 1%-3% of the paediatric population. Currently, there is no consensus as to the most effective strategies for improving the learning skills of children and adolescents with ID. This review aims to systematically gather information regarding interventions to promote and improve learning skills in children/adolescents with ID from previously published systematic reviews and meta-analyses. METHODS Systematic search strategies, including appropriate descriptors, were employed on Medline, Cochrane, Scopus, Web of Science, Lilacs, SciELO, ERIC, and PsycINFO databases. Quality assessment was conducted via the AMSTAR-2. RESULTS Fifty-nine studies were selected, subdivided by outcome domains and by the type of intervention. Interventions were related to caregiving, education, pharmaco-dietary, physical, and technology approaches. The overall low quality of the studies limited our recommendations.
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Affiliation(s)
- Kevin Augusto Farias de Alvarenga
- Laboratório de Neurociências, Faculdade de Medicina-Centro de Tecnologia em Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Wagner Lima de Alcântara
- Laboratório de Neurociências, Faculdade de Medicina-Centro de Tecnologia em Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Débora Marques de Miranda
- Laboratório de Neurociências, Faculdade de Medicina-Centro de Tecnologia em Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Departamento de Pediatria, Faculdade de Medicina, Centro de Tecnologia em Medicina Molecular-Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Baltar MMDS, Cavalcanti ACS, Silva LMPD, Luz Neto RGD, Almeida HCRD, Vieira SCM. Educação Sexual: Dificuldades dos Pais de Jovens com Síndrome de Down. PSICOLOGIA: CIÊNCIA E PROFISSÃO 2023. [DOI: 10.1590/1982-3703003249352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Resumo Com este estudo buscou-se conhecer as dificuldades e barreiras de pais na educação sexual de jovens com Síndrome de Down, a partir de uma pesquisa descritiva e de natureza qualitativa, utilizando-se o conceito das representações sociais como referencial teórico-metodológico. O estudo foi conduzido em uma Organização Não Governamental (ONG), localizada em Recife (PE), após aprovação do Comitê de Ética e Pesquisa, sob parecer consubstanciado 3.558.587. A amostra do estudo envolveu 11 pais de jovens com Síndrome de Down com idades entre 15 e 24 anos. A coleta de dados foi realizada por meio de entrevistas semiestruturadas. A abordagem escolhida para a interpretação desses dados foi a análise de conteúdo proposta por Bardin. Pode-se elencar como principais dificuldades enfrentadas pelos pais ao conversarem com seus filhos sobre sexualidade: a infantilização do jovem com Síndrome de Down, julgando-o incapaz de experienciar tais fenômenos e compreender a orientação que pudesse ser repassada; o medo em ultrapassar etapas e, de repente, “estimular” o filho a viver sua sexualidade de maneira “precoce”; e o fato de os pais também terem recebido pouca ou nenhuma orientação sexual por parte de suas famílias. Diante das narrativas dos pais, é possível perceber que ainda são muitos os mitos, tabus e preconceitos que permeiam a sexualidade dos jovens com Síndrome de Down, demonstrando que os responsáveis estão despreparados para dar as devidas orientações.
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Frawley P, Wilson N, David J, O’Shea A, Areskoug Josefsson K. Access to Sexual Health Services and Support for People with Intellectual and Developmental Disabilities: an Australian Cross-sector Survey. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2022; 19:1935-1943. [PMID: 35669627 PMCID: PMC9159772 DOI: 10.1007/s13178-022-00734-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION People with intellectual and developmental disabilities under the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) have the right to access sexual health services including information, education, and support. Little is known about the capacity of sexual health professionals to provide these services. METHODS Using an observational research design, this study utilised a descriptive survey tool (PASH-Ext) that also encompassed a standardised measure, with a cross-sectional purposive sample of 52 Australian sexual health professionals. Data was collected in 2020. RESULTS Just over half of the participants reported having received training in their preservice education to work with people with intellectual and developmental disabilities, of these 60% held the view that people with intellectual and developmental disabilities would not feel embarrassed receiving sexual health information and support. CONCLUSION The study found that training is both important to the professionals' preparedness to work with people with intellectual and developmental disabilities, and that these professionals advocate for the continuation of this training in pre-service courses and additional training in post service education for sexual health workers. POLICY IMPLICATIONS To progressively realise Article 25 of the UNCRPD signatory, countries need to ensure sexual health services are accessible to people with intellectual and developmental disabilities. This study recommends that sexual health policy addresses equity of access for people with intellectual and developmental disability by ensuring all staff are prepared and supported to provide these services.
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Affiliation(s)
- Patsie Frawley
- Faculty of Education, Te Kura Toi Tangata, University of Waikato New Zealand, Gate 1 Knighton Road, Hamilton, New Zealand
| | - N.J. Wilson
- School of Nursing and Midwifery, Western Sydney University, Hawkesbury Campus, Locked Bag 3, Richmond, NSW 2753 Australia
| | - Jennifer David
- Disability & Inclusion, School of Health & Social Development, Deakin University, Gheringhap St, Geelong, 3220 Australia
| | - Amie O’Shea
- Disability & Inclusion, School of Health & Social Development, Deakin University, Gheringhap St, Geelong, 3220 Australia
| | - K. Areskoug Josefsson
- VID Specialized University, Vågsgaten 40, 4306 Sandnes, Norway
- Oslo Metropolitan University, St Olavs Plass, Postboks 4, 0130 Oslo, Norway
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Paulauskaite L, Totsika V, Rivas C. Relationships and Sex Education outcomes for students with intellectual disability: protocol for development of a Core Outcome Set (Preprint). JMIR Res Protoc 2022; 11:e39921. [DOI: 10.2196/39921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 10/04/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022] Open
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Sexuality, Education and Support for People with Intellectual Disabilities: A Systematic Review of the Attitudes of Support Staff and Relatives. SEXUALITY AND DISABILITY 2022. [DOI: 10.1007/s11195-021-09724-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AbstractSupport staff and relatives are uncertain about multiple aspects of the sexuality of people with intellectual disabilities. Given that their attitudes embody positive and negative views, they can respectively support and restrict free sexual expression among people with intellectual disabilities and their potential for (intimate) relationships. A qualitative systematic literature review was conducted on the attitudes of support staff and relatives toward the sexuality of people with intellectual disabilities. A systematic search strategy was deployed across seven databases. The identified articles were screened on predetermined inclusion and exclusion criteria, and assessed on quality, which resulted in 31 included studies. A metasynthesis of these studies resulted in two major themes emerging, namely (a) attitudes toward the sexuality of people with intellectual disabilities, and (b) attitudes toward the sex education and support. Themes represented both positive and restrictive attitudes among support staff and relatives. The findings suggest that despite a general acceptance of the sexual rights of people with intellectual disabilities, certain forms of sexuality were approached more cautiously. Moreover, the sexual needs of some subgroups of people with intellectual disabilities received scarce attention. Those support staff and relatives holding rather restrictive attitudes appear to emphasize sexual risks. Finally, support staff and relatives stressed the importance of providing sex education and support for people with intellectual disabilities, while, simultaneously, expressing insecurity over the subject. The findings can help to improve the support provided to support staff and relatives to promote sexual health among people with intellectual disabilities.
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Kamaludin NN, Muhamad R, Mat Yudin Z, Zakaria R. Barriers and Concerns in Providing Sex Education among Children with Intellectual Disabilities: Experiences from Malay Mothers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031070. [PMID: 35162094 PMCID: PMC8834534 DOI: 10.3390/ijerph19031070] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 02/04/2023]
Abstract
Though sex education (SE) may benefit the sexual development and overall well-being of children with intellectual disabilities (IDs), obstacles to its implementation remain. This study highlights barriers and concerns of SE for children with IDs based on their mothers’ experiences. We employed a phenomenological approach and in-depth interviews with twenty Malay mothers of children with mild-to-moderate IDs or/and other neurodevelopmental disorders. Four primary hurdles to SE were discovered: (1) mother (2) children (3) family value, and (4) socio-cultural environment. Inadequate knowledge, mothers’ perceptions that SE is less necessary at this stage of their children’s development, and time constraints were among their main barriers. Another source of hardship was the communication barrier because children with ID have cognitive impairment in their capacity to understand the topic being addressed and more time should be spent throughout the discussion. Family value and socio-cultural elements also had an impact on mothers’ intention to deliver SE to their children. Our findings suggest that mothers recognize the importance of SE for their children’s well-being. However, the dynamic interaction between the barriers complicates SE. This study emphasizes the necessity for future interventions to overcome hurdles at each level to effectively implement the recommended strategies.
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Affiliation(s)
- Nawal Nabilah Kamaludin
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (N.N.K.); (R.Z.)
| | - Rosediani Muhamad
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (N.N.K.); (R.Z.)
- Correspondence:
| | - Zainab Mat Yudin
- School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia;
| | - Rosnani Zakaria
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (N.N.K.); (R.Z.)
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Bovbjerg ML, Pillai S. Current Resources for Evidence-Based Practice, May 2021. J Obstet Gynecol Neonatal Nurs 2021; 50:352-362. [PMID: 33865844 DOI: 10.1016/j.jogn.2021.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of the prenatal prediction of fetal macrosomia and commentaries on reviews focused on the effects of date palm and dill seed on labor outcomes and the current research available on SARS-CoV-2 and pregnancy outcomes.
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