research and studiesRelationship Between Weight Change and Diaphragm Size Change
Section snippets
LITERATURE REVIEW
The vaginal diaphragm as a barrier method of contraception was developed in Germany by Mensinga (1882).2 The method was popularized in the United States by Sanger, who learned of the diaphragm in Europe. In the 1920s, tens of thousands of women were fitted for the device in Sanger’s clinic in New York City.3 Sanger and Stone outlined mechanical occlusive methods of contraception in 1931.4 Stone described in detail the clinical aspects of fitting diaphragms, making no mention of refitting after
PURPOSE
The relationship between weight change and vaginal diaphragm size change was chosen for investigation to examine whether the practice of refitting after weight change is necessary, and if not, to assist in discarding the practice. This study was an effort to support increased accountability in nursing by challenging a ritualistic practice.
METHODOLOGY
The ex post facto/correlational research design was employed. Because data were obtained from client records, no direct manipulation of the independent variable of weight change occurred. Subjects not experiencing a substantial weight change were compared with the group of subjects with a change of 10 or more pounds.
Data were collected from two family planning clinics. One agency (agency A), serving a rural population of a county of 70,000 people, was located in a mid-Atlantic state. The second
RESULTS
All clients who fit the requirements detailed above and whose charts contained complete information were used.
The data were collected during January 1983 and included visits that covered the time between October 1, 1975, and January 30, 1983. The mean time between visits for these data was 16.56 months. Although most clients had diaphragms refitted at annual examination, the data selection method randomly chose any two visits for clients who had more than one refitting recorded. Thus,
DISCUSSION
The distributions of the variables of weight change and diaphragm size change are markedly symmetric (Figure 1, Figure 2). The weight change distribution revealed a fairly wide range of changes, although most did not experience large weight changes. A change of 10 or more pounds occurred in 22.4% of the sample, which correlated closely with Fiscella’s sample, with 23.7% having a change of 10 or more pounds. The distribution of size changes reveals that the vast majority of the subjects (70.4%)
NURSING IMPLICATIONS
Because inconvenience is cited as a major drawback in diaphragm use,14 simplification of its use is desirable. Requiring fewer visits to the practitioner is likely to make this safe and effective contraceptive method attractive to more women.
In light of the findings of Fiscella’s and this study, nurses fitting diaphragms should closely examine their own practice. Trends similar to those described in this study may be observed. The belief that diaphragm size varies inversely with body weight may
CONCLUSIONS
The collected data were analyzed to determine the relationship, if any, between weight change and vaginal diaphragm size change. No relationship between the variables was discovered by three statistical tests. The group of subjects exhibiting minimal weight change was as likely to have a different-size diaphragm fitted as were subjects exhibiting substantial weight change. The null hypothesis of no relationship between weight change and diaphragm size change was not rejected.
The possibility of
Candace Kugel is a family nurse practitioner in a private practice of family physicians in Chambersburg, Pennsylvania. Ms. Kugel is a member of Sigma Theta Tau and ANA.
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Cited by (0)
Candace Kugel is a family nurse practitioner in a private practice of family physicians in Chambersburg, Pennsylvania. Ms. Kugel is a member of Sigma Theta Tau and ANA.
Hilary Verson is an adult nurse practitioner at Montefiore Hospital in New York. Ms. Verson is a member of Sigma Theta Tau and ANA.