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1
Mitra, Jose Mari Lawrence. "Perceptions of Male Nursing Students About Working in Women’s Health." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/honors/389.
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This study explores the opinions and experiences of East Tennessee State University (ETSU) male nursing students after they have completed their clinical rotations in obstetrics (OB). Participants are interviewed about their preconceptions and post-experience perspectives regarding the clinical rotation. After analyzing the interviews, the students’ perceptions appeared to be grounded in their perceived level of comfort with women’s health nursing. Themes include (1) preconceptions, (2) welcoming, (3) rejecting, and (4) culture.
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Kvale, Janice Keller. "Maternal and neonatal outcomes associated with selected intrapartum interventions." Case Western Reserve University School of Graduate Studies / OhioLINK, 1994. http://rave.ohiolink.edu/etdc/view?acc_num=case1061988693.
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Morrison, April H. "Utilization of Evidence-Based Guidelines to Improve Health Care Provider’s Breastfeeding Knowledge and Attitudes as a Step to Increase Healthy People 2020 Goals." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/7121.
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Morrison, April H. "Breastfeeding: Evidence-Based Clinical Guidelines Every Health Care Provider Should Know." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/7123.
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Bernath, Susan Diane. "A comparison of childbirth class attendance and presence at delivery and father-infant acquaintance/attachment." FIU Digital Commons, 1998. http://digitalcommons.fiu.edu/etd/1629.
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The relationship between parent and child is one of the most important and most studied of all human relationships. The purpose of this descriptive study was to compare first-time fathers’ attendance at an entire series of prepared childbirth classes and presence at the delivery with father-infant acquaintance/attachment at three to four months post-birth. First-time fathers living with the infant’s mother were asked to complete the How I Feel About My Baby Now scale and a demographic survey. Two groups of fathers were compared. The first group attended classes, and the other group did not attend classes. Results of a statistical analysis utilizing descriptive statistics, t-tests, and one way ANOVA indicated that fathers who attended the classes felt significantly more angry at their babies than those who did not, and that fathers in the group under 30 years of age felt more playful toward their babies than those over thirty years.
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Raines, Deborah A. "An analysis of the values influencing neonatal nurses' perceptions and behaviors in selected ethical dilemmas." VCU Scholars Compass, 1992. http://scholarscompass.vcu.edu/etd/3612.
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The purpose of this research was to identify the values influencing the nurse's perception and choice of behavior in a hypothetical clinical situation. The theoretical framework was Rokeach's (1973) Theory on the Nature of Human Values and Value Systems. A descriptive study using a mailed survey was conducted on a random sample of 331 members of the National Association of Neonatal Nurses. Data on individual nurses' values, perception of information and behavioral choices were collected with an investigator developed questionnaire, consisting of a values scale (alpha =.82) and an information scale and choice alternatives related to three hypothetical vignettes: a low birthweight infant (alpha =.75), an infant with trisomy-13 (alpha =.70) and a chronically ill infant (alpha =.68).
Results of this study indicate that (1) nurses identified a hierarchy of values related to their practice; "doing right" (x = 6.1), beneficence (x = 5.4), and justice (x = 4.8), (2) information related to the infant was consistently most important; however, in uncertain situations, rules or external protocols had an increased influence on the behavioral choice process, (3) the behavioral choice option with the greatest agreement was different for each situation, and a consistently negative association between the options within each vignette indicates that nurses have clearly defined choice preferences, (4) model testing revealed a consistent relationship among the variable of justice and protocol, doing right and infant characteristics, and infant characteristics and the choice options across the three vignettes (p <.05).
The major findings include the identification of the value dimension, "doing right" and a lack of congruence between the values the nurse identifies as important and the actions the individual implements in practice. The phenomenon of "doing right" is a combination of items originally hypothesized to measure nurse autonomy, family autonomy and beneficence. The convergence of these items results in an unique dimension that represents the nurse's internally directed motivation or sense of duty to the infant/family unit. The lack of congruence between the identified values and the behaviors implemented in practice represents the sense of frustration and feeling of powerlessness experienced by nurses (n = 97) as they balance the role of professional and the role of employee.
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Morrison, April H. "You are the Key to HPV Cancer Prevention – Update." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7117.
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Morrison, April H. "Sustaining Breastfeeding Success After Hospital Discharge." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7118.
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Morrison, April H. "Assessment and Solutions to Common Breastfeeding Challenges." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/7119.
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Morrison, April H. "Breastfeeding Expert Panel Member." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/7120.
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Evans, Lauren B., and L. Lee Glenn. "Type II Error and Evaluation of Kangaroo Care in Tertiary Neonatal Units." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/7461.
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Bales, Mary. "Knowledge of the Effects of Alcohol on Fetal Development Among Women of Childbearing Age." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/honors/22.
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While Fetal Alcohol Syndrome Disorder is a recognized problem with alcohol ingestion during the formation of facial features, Fetal Alcohol Spectrum Disorders are not as widely recognized. These disorders result from exposure to alcohol throughout pregnancy when the brain and nervous system are developing. The resulting disorders include attention deficit disorders, social disorders, inappropriate behaviors, learning disorders, and intellectual disability. The incidence of children with alcohol-related disorders is increasing as evidenced by children needing special services in the educational systems. It is unknown how much alcohol ingestion is safe during pregnancy or how genetic factors are involved in the development of these disorders. Women often get conflicting information from the media and other resources about safe levels of alcohol consumption during pregnancy. Abstinence of alcohol ingestion is the only known prevention of such intellectual disorders. It is hypothesized that women of childbearing age may not be knowledgeable of the relationship between drinking and the implications of alcohol exposure on fetal development.
The purpose of this research is to determine what women of childbearing age know about alcohol consumption during pregnancy and if there is a knowledge deficit that exists among women of a certain age or women that use specific resources for health information. The researcher surveyed 40 female students at East Tennessee State University by using true or false questions concerning alcohol consumption related to fetal development in order to determine if a knowledge deficit exists. Based on the findings, it may be determined if women of childbearing age need educational materials from a reliable source.
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Susmani, Krystle Anne. "Certified child life specialists' perspectives on supporting siblings of infants in the neonatal intensive care unit." Thesis, Mills College, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1588940.
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The current study sought to examine certified child life specialists’ perspectives on supporting siblings of infants in the neonatal intensive care unit (NICU). The intent of the study was to identify the types of support available, barriers to offering support, the individuals who offers support and the effectiveness of interventions by certified child life specialists with siblings of infants in the NICU. Sixty-eight certified child life specialists were surveyed regarding their work supporting siblings of infants in the neonatal intensive care unit. Results support previous literature suggesting that there are many barriers to offering support to siblings in the hospital, including: staff availability, space constraints, funding, and visitation policies. In addition, results demonstrated that provided supports still vary widely from hospital to hospital and certified child life specialists are the individuals who are most likely to offer support when it is available. Furthermore, the certified child life specialists surveyed view their interventions with siblings of infants in the NICU as effective or very effective. In conclusion, these findings support the need to increase the presence of certified child life specialists in the NICU in order to adequately meet the psychosocial needs of siblings.
Keywords: certified child life specialists, child life interventions, siblings, neonatal intensive care unit, NICU
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Latham, Leah M. "Birthing Positions: Is There a Connection Between Acutal Nursing Experience and Evidence-Based Research?" Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/honors/228.
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The objectives of this study were to determine whether there was an association between clinical nursing knowledge of four birthing positions and current evidence-based research of those same positions and also to identify possible areas where nursing knowledge of those birthing positions was inadequate. This pilot study used convenience sampling to survey registered nurses (RNs) and licensed practical nurses (LPNs) on labor and delivery units. The survey was distributed to three hospitals in the southeastern United States, and twenty-four RNs and LPNs participated. Participants’ knowledge did not reflect current clinical evidence in two key areas, (1) the best position to minimize blood loss and (2) the best position to decrease the likelihood anal sphincter tears. Respectively, only 13% and 27.3% of participants selected the correct position. Continuing education for maternity nurses regarding current evidence-based practice concerning various birthing positions remains a need, and incorporating this could include more frequent opportunities for education classes and unit inservices. Results from this study should not be generalized, and more research is needed in this area to validate these findings.
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Marrs, Jo-Ann. "Children’s Body Shop." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/7109.
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Nolen, Kalie, and L. Lee Glenn. "Heavy Lifting and Spontaneous Abortions." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/7492.
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Excerpt: The study by Lee and Jung (2012) recently published in Workplace Health and Safety concluded that, “A collective effort is needed on the parts of employers, employees, occupational health nurses, and the government to protect working women from lifting heavy items while pregnant” (p. 25). However, that conclusion over-reaches their data and consequently is not supported. First, inconsistencies existed in the odds ratios (ORs), indicating uncertainties in the stability of the statistical findings. Second, the study used a nonexperimental design with low internal validity, preventing conclusions about causation due to the possibility of external intervening variables.
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Nelson, Monica M. "NICU Culture of Care for Infants with Neonatal Abstinence Syndrome: A Focused Ethnography." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etd/2465.
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Purpose: The purpose of this ethnographic study was to describe the culture of care and nonpharmacological nursing interventions performed by NICU nurses for infants with NAS. Background: Infants with NAS are increasingly being cared for in the inpatient hospital setting by NICU nurses. Interventions used for the care of premature and sick infants in the NICU may or may not be the exact interventions that should be used for the care of the fragile infant with NAS. Research studies on the nonpharmacological nursing care of infants with NAS encompass 5 main areas of practice: environment, adequate rest and sleep, feeding, assessment and evaluation using Finnegan scoring by nurses, and nurses as caregivers. Method: Roper and Shapira’s (2000) framework for the analysis of ethnographic data was used for this research and included participant observation, individual interviews, and the examination to existing documents. Data analysis included: (a) coding for descriptive labels, (b) sorting to identify patterns, (c) identification of outliers or negative cases, (d) generalizing constructs and theories, and (e) memoing to note personal reflection and insights. Focused ethnography allows for the articulation of research questions before fieldwork while observing and describing a culture. Results: Five themes emerged from the data: learn the baby (routine care, comfort care, environment, adequate rest and sleep, feeding), core team relationships (support, interpersonal relationships), role satisfaction (nurturer or comforter, becoming an expert), grief, and making a difference (wonderful insanity, critical to them). Implications: The results of this were a description of the culture of care provided to infants with NAS by NICU nurses and provide general recommendations to the nurse caring for an infant with NAS in the areas of environment, adequate sleep and rest, feeding, and the role of the nurse. This study also has implications for future study of evidence-based research strategies to decrease withdrawal symptoms in infants with NAS. Research is needed in the areas of clinical practice guidelines to help the bedside nurse care for these infants using current research and evidence for practice. Nursing theory and nursing education both contribute to nursing research in how to better understand the culture of care provided by nurses.
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McCook, Judy G. "SANE Nursing, ACES and Trauma Informed Care." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7177.
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Shuman, Patricia, L. Lee Glenn, and Joellen B. Edwards. "Relationship Between Handling Heavy Items During Pregnancy and Spontaneous Abortion." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/7545.
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This pilot study sought to describe the patterns of health risk factors and objective physical findings in well rural Appalachian women. A retrospective chart review was conducted of the records of 50 women who received a health history, physical examination, and appropriate laboratory testing as part of a rural community wellness project. The most prevalent risk factors found were past or present smoking, history of lung disease, physical inactivity, obesity, and hypercholesterolemia. Higher numbers of risk factors per person were correlated with lower levels of education. The most prevalent physical findings were systolic blood pressure greater than 140 and diastolic greater than 90, diastolic blood pressure greater than 90 with normal systolic, total cholesterol greater than 240, low-density lipoprotein levels greater than 130, and greater than 20% over ideal weight. This sample reveals a high prevalence of risk factors for the leading causes of mortality in middle-aged women, partially accounted for by low formal education levels, poverty, and limited access to health care.
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Lake, Sharon W. "Barriers to Effective Pain Management in Preterm and Critically Ill Neonates." UKnowledge, 2013. http://uknowledge.uky.edu/nursing_etds/7.
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The purpose of this dissertation is to explore potential barriers nurses experience in providing effective pain management for preterm and critically ill infants in neonatal intensive care units (NICUs). The specific aims of the study conducted are to examine (a) NICU caregivers’ knowledge about pain, (b) scales used to evaluate pain in infants, (c) NICU nurses’ documented pain practices, and (d) bias in treating pain of certain types of infants.
This dissertation is comprised of three manuscripts. The first manuscript is an integrated review of the literature describing caregiver knowledge, barriers, and bias in the management of pain in neonates. The second manuscript is a systematic review of multidimensional pain scales developed for use in preterm and critically ill infants. The final manuscript reports a descriptive exploratory study designed to examine nurses’ knowledge of pain, knowledge of intensity and appropriate management of procedural pain, bias in treating pain of certain types of infants, and documented pain management practices.
Over the past 25 years, caregiver knowledge of pain in preterm and critically ill infants has advanced from beliefs that neonates do not feel pain, to the knowledge that preterm infants experience more pain than term infants, older children, and adults. Nine multidimensional pain scales with varying levels of reliability and validity have been developed, yet a gold standard for pain assessment in preterm and critically ill neonates has not emerged. In this study, baccalaureate prepared nurses (BSN) and nurses with higher total years of nursing experience had better knowledge of pain in this population than associate degree nurses (ADN). However, pain management was inconsistent, resulting in pain that was untreated as often as 80% of the time. Nurses reported that physician practice was the primary obstacle to providing effective pain management. Additional concerns included knowledge deficits of nurses and physicians, lack of communication and teamwork, and rushed care. Nurses reported biases in managing pain and were less likely to invest time and energy treating the pain of infants experiencing neonatal abstinence syndrome.
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Rhoads, Jacqueline, and Jo-Ann Marrs. "Disorders Usually Presenting in Infancy or Early Childhood 0-5 Years Age." Digital Commons @ East Tennessee State University, 2010. https://dc.etsu.edu/etsu-works/7098.
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Book Summary: This quick reference serves as an authoritative clinical guide to diagnostic treatment and monitoring recommendations for patients with mental disorders in the primary care setting. It offers fast and efficient access to evidence-based diagnostic and therapeutic guidelines for managing psychiatric and mental health conditions. The book guides family and adult advanced practice nurses in making clinical decisions that are supported by the best available evidence, reflecting current research and expert consensus. Additionally, researchers may use this book to identify important clinical questions where more research could be conducted to improve treatment decision making.
This comprehensive text is organized by major diagnostic categories, such as anxiety disorders, with specific diagnoses organized alphabetically within each category. It supports informed practice, which increases confidence in differential diagnosis, safe and effective treatment decision making, reliable treatment monitoring and, ultimately, improved patient outcomes. Additionally, DSM-IV-TR diagnostic standard summaries and ICD-9 codes are incorporated for use in the clinical setting. It is an essential resource in everyday practice for all health care providers.
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Baker, Sarah C., and L. Lee Glenn. "Measurement Reliability and Effect Direction for Self-Efficacy and Pain in Colorectal Cancer Patients." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/7463.
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Excerpt: The conclusions by Zhang et al. (2015) were notable, but the support for the conclusions was not particularly strong because of two issues. The first weakness is that although some studies have found correlations between self-efficacy and pain, the study did not consider the possibility that it is symptom distress that affects self-efficacy in colorectal cancer patients. Rather, it was assumed only that self-efficacy caused reduced symptom effects instead of a reverse or mutual relationship. The study did not consider the possibility that low self-efficacy in those with high symptom distress was actually caused by the distress itself, which is a plausible explanation. In fact, Chiarotto et al. (2014) found that cancer patients on pain medication have higher rates of self-efficacy, which would appear to show that distress reduces self-efficacy, rather than the other way around, as assumed in the above study.
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Ogden, Lori. "THE IMPACT OF MATERNAL NUTRITION DURING PREGNANCY ON INFLAMMATION AND BIRTH OUTCOMES." UKnowledge, 2019. https://uknowledge.uky.edu/nursing_etds/49.
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More than 85% of American adults do not consume recommended amounts of fruits or vegetables. Preterm birth and hypertensive disorders of pregnancy are common adverse conditions affecting pregnancy and are leading causes of maternal and fetal morbidity and mortality. Preterm birth affects nearly 10% of all births in the United States and is on the rise, as are hypertensive disorders, which have increased by 25% over the last two decades. Pregnancy is a state of controlled inflammation, and dysregulation has been linked to preterm birth and other adverse gestational outcomes. A healthy diet is recommended in pregnancy, but little is known about the effect fruit and vegetable intake on perinatal outcomes. Omega-3 (n-3) fatty acids are essential dietary components and are known to affect inflammatory state, but little is known about how they affect inflammation in pregnancy. As current evidence is lacking, further research is needed to investigate the relationships between maternal nutrition in pregnancy, inflammation and birth outcomes.
The purposes of this dissertation were to: 1) to review and evaluate the current evidence on the relationship between n-3 fatty acids and inflammation in pregnancy; 2) to evaluate the current state of the science on the impact of maternal dietary consumption of fruits and vegetables on preterm birth, gestational diabetes, preeclampsia, small for gestational age, gestational weight gain and measures of inflammation or oxidative stress in pregnancy; and 3) to examine relationships between maternal dietary intake of fruits and vegetables, cytokine expression in early and mid-pregnancy, preterm birth and gestational hypertension.
A critical review of literature examining the relationship between inflammation and n-3 intake during pregnancy found that multiple inflammatory cytokines in maternal and fetal tissues were lower in women who received n-3 supplements. A second review of literature review supported an inverse relationship between fruit and vegetables and risk of preeclampsia and suboptimal fetal growth. The available evidence was insufficient to establish relationships between fruit and vegetable intake and gestational diabetes, preterm birth or inflammation. A study evaluating the relationships between maternal fruit and vegetable intake, inflammation and birth outcomes was conducted. This study
provided evidence supporting a relationship between first and second trimester cytokine expression and maternal dietary intake of fruits and vegetables. Those who met recommended vegetable intake in the first trimester had higher first trimester serum CRP, IL1-α, IL-6 and TNF-α and lower first trimester cervicovaginal IL-6 levels. Those who met recommendations for first trimester fruit intake had 56% lower risk for preterm birth. Those who met second trimester vegetable intake recommendations had more than twice the risk of developing gestational hypertension.
The results of this dissertation provide support for the beneficial effects of omega-3 fatty acids and fruit and vegetable intake in pregnancy. Maternal intake of these dietary components may promote optimal immune status during pregnancy. Supplementation of maternal omega-3 fatty acids may help regulate inflammation via the anti-inflammatory effects their bioactive eicosanoids exert. Fruit and vegetables have antioxidant and anti-inflammatory effects that may also help balance the inflammatory state during pregnancy. These dietary components may help promote favorable immune status during pregnancy and reduce risk of adverse perinatal outcomes such as poor fetal growth, hypertensive disorders of pregnancy and preterm birth.
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McCook, Judy G., Stacey Williams, Beth Bailey, Sheeba Anand, and Nancy Reame. "Differential Contributions of the Reproductive and Metabolic Features of Polycystic Ovary Syndrome (PCOS) to Psychological Symptoms." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/7183.
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Objective: Although women with PCOS have elevated levels of psychological distress, findings regarding which aspects of PCOS contribute to psychological symptoms are inconsistent. The purpose of this study was to investigate the independent and differential contributions of the previously identified key PCOS manifestations (infertility, hirsutism, obesity, menstrual problems) to multiple psychological symptoms. Methods: Participants were 126 endocrinology patient volunteers diagnosed with PCOS who completed a cross-sectional study of key manifestations of PCOS (including the PCOSQ) and psychological symptoms (BSI). Results: Participants had significantly elevated scores on all nine BSI subscales of psychological symptoms. Menstrual problems were significantly associated with all symptom subscales as well as the global indicator, while hirsutism and obesity were significantly related to five or more subscales. Neither infertility status nor infertility concerns significantly predicted any of the psychological symptoms. After controlling for demographic factors, menstrual problems remained the strongest predictor of psychological symptoms. Conclusions: Findings suggest that for women with PCOS, the features of excess body hair, obesity and menstrual abnormalities are especially troubling and carry unique risks for serious adverse psychologic symptoms including depression, anxiety, somatization and interpersonal sensitivity. Specific manifestations of PCOS were differentially related to psychological symptoms suggesting that the predictive value of PCOS for depression and other mental health problems may vary according to the specific symptoms experienced. Menstrual problems may be the most salient of these features and deserve particular attention as a marker for psychological risk among women with PCOS.
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McCook, Judy G., Stacey Williams, Beth Bailey, Sheeba Anand, Nancy Reame, and Samuel Thatcher. "Differential Contributions of the Reproductive and Metabolic Features of Polycystic Ovary Syndrome (PCOS) to Psychological Symptoms." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/7184.
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Objective: Although women with PCOS have elevated levels of psychological distress, findings regarding which aspects of PCOS contribute to psychological symptoms are inconsistent. The purpose of this study was to investigate the independent and differential contributions of the previously identified key PCOS manifestations (infertility, hirsutism, obesity, menstrual problems) to multiple psychological symptoms. Methods: Participants were 126 endocrinology patient volunteers diagnosed with PCOS who completed a cross-sectional study of key manifestations of PCOS (including the PCOSQ) and psychological symptoms (BSI). Results: Participants had significantly elevated scores on all nine BSI subscales of psychological symptoms. Menstrual problems were significantly associated with all symptom subscales as well as the global indicator, while hirsutism and obesity were significantly related to five or more subscales. Neither infertility status nor infertility concerns significantly predicted any of the psychological symptoms. After controlling for demographic factors, menstrual problems remained the strongest predictor of psychological symptoms. Conclusions: Findings suggest that for women with PCOS, the features of excess body hair, obesity and menstrual abnormalities are especially troubling and carry unique risks for serious adverse psychologic symptoms including depression, anxiety, somatization and interpersonal sensitivity. Specific manifestations of PCOS were differentially related to psychological symptoms suggesting that the predictive value of PCOS for depression and other mental health problems may vary according to the specific symptoms experienced. Menstrual problems may be the most salient of these features and deserve particular attention as a marker for psychological risk among women with PCOS.
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McCook, Judy G., Nancy E. Reame, and Samuel S. Thatcher. "Health-Related Quality of Life Issues in Women with Polycystic Ovary Syndrome." Digital Commons @ East Tennessee State University, 2005. https://dc.etsu.edu/etsu-works/7174.
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Objective: To evaluate the influence of obesity, fertility status, and androgenism scores on health-related quality of life in women with polycystic ovary syndrome (PCOS).
Design: Cross-sectional, correlational.
Setting: Private reproductive endocrinology practice in two southeast U.S. cities.
Participants: Convenience sample of 128 women with PCOS, half of whom were attempting to conceive in addition to being treated for PCOS. Most were White (97%), married (78%), with a mean age of 30.4 years (SD ± 5.5).
Main Outcome Measures: The Health-Related Quality of Life Questionnaire (PCOSQ) for women with polycystic ovary syndrome. A laboratory panel and clinical measures, including body mass index, waist-to-hip ratio, and degree of hirsutism.
Results: The most common health-related quality of life concern reported by women with PCOS was weight, followed in descending order by menstrual problems, infertility, emotions, and body hair.
Conclusions: The psychological implications of PCOS are easily underestimated and have been largely ignored. Nursing has a pivotal role in recognizing these concerns and implementing therapy to improve quality of life in women with PCOS.
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Srisuthisak, Sasamon. "Relationship Among Stress of Labor, Support, and Childbirth Experience in Postpartum Mothers." VCU Scholars Compass, 2009. http://scholarscompass.vcu.edu/etd/1916.
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Background: Due to the profound and life-changing aspects of giving birth and to each woman’s individualized birthing experience, it is important to understand the myriad of factors that contribute to a positive childbirth experience. The aims of this study were to: (1) identify factors related to a positive childbirth experience; (2) to examine relationships among women’s perceptions and personal evaluations of their childbirth experience, stress associated with labor pain, support from the nursing staff, initial contact with the baby following birth, support from partners, education, age, and obstetric history; and (3) to identify predictors of a positive childbirth experience. Method: A cross-sectional correlational study was conducted using a sample of 122 new mothers recruited over a 3-month period. Data were collected using self-report questionnaires. The three questionnaires used in this study consisted of: (a) the Questionnaire Measuring Attitude About Labor and Delivery Experience (QMAALD 29 items); (b) the Questionnaire Measuring Stress Associated with Labor Pain [SLPS (version 2)]; and (c) Personal Information Questionnaire (Demographic data). The Cronbach’s alpha coefficient for the 29 item QMAALD in this study was .82 and the Cronbach’s alpha coefficient of the SLPS (version 2) in this study was .89. The SPSS statistical software version 16.0 for Windows was used for data analysis. Results: Participants reported a low degree of stress associated with labor pain and a moderate amount of support received from the nursing staff. They reported holding and touching their baby immediately after birth. A positive childbirth experience was inversely related to stress associated with labor pain. The reduction of stress due to support received from the nursing staff was found to be positively related to a positive childbirth. Education was related to a positive childbirth experience; but not a significant predictor of a positive childbirth experience. Maternal age, initial contact with the baby following birth, number of labor and delivery experiences, duration of labor, interventions during labor, attendance at prenatal classes, and support from a partner did not relate to a positive childbirth experience. The regression analysis results indicated that the stress associated with labor pain, the reduction of stress due to the support received from the nursing staff, and attendance at prenatal classes were significant predictors of a positive childbirth experience. Conclusion: Stress associated with labor pain and the reduction of stress due to support received from the nursing staff were key factors contributing to a positive childbirth experience. Further research is needed to better understand the factors influencing women’s positive perceptions of the childbirth experience.
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Rhoads, Jacqueline, Patrick J. M. Murphy, and Jo-Ann Marrs. "Treatment of Childhood and Adolescent Disorders." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/7097.
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Book Summary: This is the only advanced practice guide to provide an overview of the major DSM-IV-TR disorders across the lifespan and complete clinical guidelines for their psychopharmacologic management. It has been compiled by expert practitioners in psychiatric care and is designed for use by nurse practitioners and other primary caregivers in clinical practice.
The guide is organized in an easy-to-access format with disorders for which drugs can play a significant therapeutic role. The listing for each disorder includes clinical features and symptoms, as well as information about the most current and effective drugs for management. A clearly formatted table identifies the first and second lines of drug therapy along with adjunctive therapies for each disorder. Drugs are organized according to classification, and each listing provides the essential information needed to safely prescribe and monitor a patient's response to a particular drug. This includes brand and generic names, drug class, customary dosage, side effects, drug interactions, pharmacokinetics, precautions, and management of special populations. Convenient, practical, and portable, this guide will be a welcome and frequently used resource.
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Rhoads, Jacqueline, and Jo-Ann Marrs. "Dissociative Disorders in Childhood and Adolescence." Digital Commons @ East Tennessee State University, 2010. https://dc.etsu.edu/etsu-works/7099.
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Book Summary: This quick reference serves as an authoritative clinical guide to diagnostic treatment and monitoring recommendations for patients with mental disorders in the primary care setting. It offers fast and efficient access to evidence-based diagnostic and therapeutic guidelines for managing psychiatric and mental health conditions. The book guides family and adult advanced practice nurses in making clinical decisions that are supported by the best available evidence, reflecting current research and expert consensus. Additionally, researchers may use this book to identify important clinical questions where more research could be conducted to improve treatment decision making.
This comprehensive text is organized by major diagnostic categories, such as anxiety disorders, with specific diagnoses organized alphabetically within each category. It supports informed practice, which increases confidence in differential diagnosis, safe and effective treatment decision making, reliable treatment monitoring and, ultimately, improved patient outcomes. Additionally, DSM-IV-TR diagnostic standard summaries and ICD-9 codes are incorporated for use in the clinical setting. It is an essential resource in everyday practice for all health care providers.
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Isom, Morgan L. "The Impact of Inappropriate Gestational Weight Gain on Pregnancy, Delivery, and Neonatal Outcomes." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/honors/233.
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Inappropriate weight gain during pregnancy is a widespread problem associated with adverse maternal and newborn outcomes. This study’s objective was to examine the impact of gestational weight gain (GWG) above and below the Institute of Medicine (IOM) guidelines on pregnancy, delivery, and newborn outcomes in a rural population. Women were recruited at the first prenatal visit, and data was collected through research interviews and examination of prenatal and delivery medical records. Prepregnancy weight and weight at delivery were obtained, and the final sample (n=913) was restricted to women with singleton pregnancies. Participants were categorized by prepregnancy body mass index (BMI) and GWG above, within, or below IOM guidelines based on gestational length. After controlling for pregnancy smoking, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to identify significant outcomes associated with high or low weight gain, with normal GWG as the control. Of the 913 participants, 208 (22.8%) had inadequate GWG, 255 (27.9%) gained within the recommended range, and 450 (49.3%) gained more than recommended. Inadequate GWG was associated with delivery before 39 weeks, oxygen administration to the infant, admission to the neonatal intensive care unit (NICU), and a hospital stay longer than seven days. Excess GWG was associated with preeclampsia, pregnancy-induced hypertension (PIH), gestational diabetes mellitus, cesarean delivery, labor longer than 12 hours, macrosomia, and large-for-gestational-age (LGA) infants. GWG outside IOM guidelines was prevalent in the sample and associated with numerous adverse outcomes, suggesting a need for increased awareness and improved management of GWG in this population.
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Marrs, Jo-Ann, Sharon Trumbley, and Gaurav Malik. "Early Childhood Dental Cares: Determining the Risk Factors and Assessing the Prevention Strategies for Nursing Intervention." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/7101.
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Early childhood caries (ECC) is the most common chronic disease condition in childhood and involves the presence of one or more decayed (noncavitated or cavitated lesions), missing (due to caries), or filled teeth in children under 72 months of age (American Academy of Pediatric Dentistry, 2010a). ECC is a multifactorial disease that is preventable and requires intervention by the nurse. When teeth are discolored and damaged by dental caries, children may be reluctant to smile, have difficulty talking, miss school, or be unable to focus on studies due to dental pain. This "state of the science" article reviews the literature to determine the risk factors for ECC, assess the prevention strategies, and apply that information to enhance nursing practice. Computerized searches from MEDLINE, CINAHL, and the Cochrane Library were used.
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Adama, Esther Abena. "Ghanaian parents’ experiences of caring for their preterm infants after discharge from the neonatal unit - a narrative inquiry study." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2018. https://ro.ecu.edu.au/theses/2075.
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The care of preterm infants is associated with stress. In the busy neonatal unit where highly skilled healthcare workers are always present, parents have reported being stressed when caring for their preterm infants in the neonatal unit. In Ghana, preterm birth is the highest cause of neonatal mortality with 70% of these morbidities and mortalities occurring in the community. Yet to date, no study in Ghana has explored how parents experience their care giving role after discharge from the neonatal unit into the community.
This study explored the experiences of caring for preterm infants in the neonatal unit and after discharge from the perspective of parents. Narrative inquiry methodology was utilised as it explores lived experiences using stories as data. In all, 42 participant carers (mothers, fathers and significant others) of preterm infants discharged from one of four neonatal intensive care units in Ghana were interviewed at three different stages - one week, one month and four months after discharge. Data were collected from February to June, 2015 in the residences of parents. Interviews were conducted face-to-face and audio-recorded. As Ghanaians live communally, members of households were also engaged in informal conversation to explore their experiences of caring for preterm infants after discharge. In addition to this, participants were observed in their natural environment as they cared for the preterm infant in the community.
Results of the study suggest that in the neonatal units and after discharge, parents have concerns caring for their preterm infants. The findings suggest that after discharge, grandmothers of preterm infants who were not involved in pre-discharge education in the neonatal unit take charge of the care of preterm infants in the community. Grandmothers diagnose preterm infants’ illnesses and decide whether to refer an infant to hospital or herbalist for treatment. Cultural practices mainly initiated by grandmothers resulted in adverse health problems for preterm infants and disruption in parents’ mental health. The current study also revealed that in the neonatal unit, fathers were excluded from caring for their preterm infants, making them less confident to assume the caring role after discharge. This study has deepened our understanding of some of the challenges parents of preterm infants face in the neonatal unit and after discharge as they assume full responsibility of caring for their preterm infants in the Ghanaian community without any formal support from healthcare workers.
It is recommended that healthcare workers should identify the support persons of parents and involve them in the care of preterm infants while on admission in the neonatal unit and during pre-discharge education. In addition to this, the study recommends that healthcare workers place regular mobile phone calls to parents of discharged preterm infants to discuss areas of concerns about the care of the preterm infant in the community in order to provide evidence based support.
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Glenn, L. Lee, and Stephanie I. M. Quillin. "Opposing Effects of Maternal and Paternal Socioeconomic Status on Neonatal Feeding Method, Place of Sleep, and Maternal Sleep Time." Digital Commons @ East Tennessee State University, 2007. https://dc.etsu.edu/etsu-works/7519.
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OBJECTIVE: This study was conducted to compare the relative influence of the socioeconomic status of both mothers and fathers on feeding method and cosleeping. METHODS: The time and method of feeding and sleeping were recorded in a log during the 4th-week postpartum and analyzed according to the parental Hollingshead Index of Social Position in 33 families with their first newborn. RESULTS: The effect of socioeconomic status on feeding and sleep was parent specific. Low socioeconomic status of the mother, but not the father, was associated with cosleeping (t ≤ 2.39, P < .01); whereas, a low socioeconomic status of the father, but not the mother, was associated with bottle-feeding rather than breast-feeding (t ≤ 1.94, P < .05). CONCLUSIONS: Socioeconomic status of the parents differentially affects neonatal care. Programs to increase breast-feeding rates would be most effective if designed for and aimed at the fathers. Copyright © 2007 Wolters Kluwer Health | Lippincott Williams and Wilkins.
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Monterosso, Leanne. "The effect of nursing interventions on thermoregulation and neuromotor function in very low birthweight infants." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1999. https://ro.ecu.edu.au/theses/1222.
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The prone position is used routinely in neonatal intensive care units worldwide in the nursing of preterm infants because of reported beneficial psychological effects This position can, however, lead to development of flattened posture very low birthweight (VLBW) infants and contributes to both short and longer term implications for functional motor development of upper and lower extremities. To date limited research has been undertaken to investigate methods of reducing flattened posture and its related negative outcomes temperature instability is also a problem for VLBW infants and no nappy exists that meets postural size and thermoregulation requirements. The purpose of this study was to demonstrate the effect of a nursing care model designed for the primary prevention of neuromotor problems and temperature instability in VLBW infants. The theoretical framework was based on two bodies of knowledge thermoregulation and neuromotor development. A two phase study was used to test two hypotheses: (1) use of a cloth postural support nappy (N) with an inner absorbent nappy liner would improve temperature stability in VLBW infants nursed in incubators on infant servo control (ISC): and (2) use of a postural support roll (R) with or without a N would improve neuromotor development in the short and longer term. In Phase1 a sample of 23 infants < 31 weeks gestation nursed in incubators on ISC was recruited over two months to a randomised, observer blind, crossover trial infants were randomised to commence wearing either a N with or without an inner absorbent liner and alternated wearing each nappy for a 24 hour period over four days. Eight hourly per axilla (PA) temperatures and hourly measurements of infant handling, skin and incubator temperatures were recorded. lnfants in both groups were well matched for birth and postnatal variables. Findings showed that nursing infants in a N with an inner absorbent liner experienced clinically and statistically significant higher skin and lower incubator temperatures. In addition, a prediction model for PA temperature was developed that showed it was possible to predict PA temperatures from skin temperatures. In Phase 2. a sample of 123 infants < 31 weeks gestation was recruited to a randomised, observer blind, controlled trial. Infants were randomised to one of three treatment groups (i.e., N only, N and R, or R only). Measurements of neuromotor development were performed at three assessment periods (i.e., from birth to term conceptional age, then at four and eight months conceptional age). Randomisation was effective. Findings confirmed previous study findings that use of a N improves hip posture up to term conceptional age. The major finding was that use of a R while VLBW infants are nursed in the prone position in a NICU improved hip and shoulder posture up to eight months conceptional age. In addition, an Infant Posture Evaluation Tool (IPAT) was developed that will enhance the clinical skills of health Professionals involved in the care of these infants. The findings contribute to neonatal nursing theory development in thermoregulation and neuromotor development and function in VLBW infants. Practice implications focus on promoting temperature stability and normal neuromotor function in VLBW infants up until eight months conceptional age. Longer term research will determine the effect of postural interventions on gait and foot progression angles. Testing and validation of the IPAT will facilitate future research related to infant posture.
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McCook, Judy G., and Patricia Vanhook. "HELP SARA: An Answer to Rural SANE Shortage." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7176.
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McCook, Judy G., and Stacey Williams. "Methodology to Examine Perceived Infertility Stigma among Women." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/7190.
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Burrow, A. L., and L. Lee Glenn. "Greater Healthcare Utilization in Pregnancies for First Born Children." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/7500.
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Seidu, Mari. "Initiating a perinatal depression screening protocol in a community-based hospital." NSUWorks, 2016. https://nsuworks.nova.edu/hpd_con_stuetd/38.
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Background: According to the World Health Organization (WHO), perinatal depression (PD) is the most common childbirth complication. About 10% of pregnant women and about 13% of postpartum women experience a mental health disorder, primarily depression (WHO, 2016). One of the WHO (2015 a) goals for maternal mental health includes providing strategies for the promotion of psychosocial well-being and prevention of mental disorders of mothers during and after delivery. Purpose: The purpose of this performance improvement project was to establish a perinatal depression risk screening protocol and improve nursing knowledge on PD at a community-based hospital in Miami. Theoretical Framework: Beck’s postpartum depression theory Method: The project gained support and buy-in from the administration and management team of the healthcare institution. It included a comprehensive literature review used as a guide to establishing a perinatal depression screening protocol. Finally, staff nurses received education on PD, followed by an assessment for improved knowledge and retention of information. Result: A paired-samples t-test was conducted to compare pretest and posttest results for Registered nurses after receiving education on perinatal depression, N = 70. The results suggested improved knowledge and retention of new information. Conclusion: The perinatal depression screening protocol provided a framework for the assessment and first-line management for perinatal depression. There was evidence of improved nursing knowledge and retention of information on maternal mood disorders, especially perinatal depression.
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Bowman, Roxanne K. "THE FACTORS THAT INFLUENCE DURATION OF EXCLUSIVE BREASTFEEDING: A MIXED METHODS DESIGN." UKnowledge, 2013. http://uknowledge.uky.edu/nursing_etds/9.
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Breastfeeding is the gold standard of infant feeding and its benefits extend beyond the mother and child. Multiple organizations recommend exclusive breastfeeding for the first six months of an infant’s life. Exclusive breastfeeding rates nationally and in the state of Kentucky fall below the Healthy People 2020 goals. A mother’s intention to breastfeed has been shown to impact actual breastfeeding behavior. The current state of the measurement of intention was explored through a literature review. A majority of the measures were single item scales. The reliability and validity of the scales should be further tested in diverse populations.
The purposes of this dissertation were to: a) explore the role of breastfeeding intention on duration of exclusive breastfeeding, and b) determine the common modifiable factors among women who breastfeed exclusively for at least four months. English speaking mothers 18 years of age and older were asked to participate if they had delivered a healthy infant in the last 72 hours and if they intended to feed their baby some amount of breast milk (n = 84). Mothers were followed for 16 weeks or until they weaned their infant, whichever came first. Social support, breastfeeding self-efficacy and breastfeeding intention were measured at baseline. Breastfeeding support and breastfeeding self-efficacy were measured at four and 16 weeks. Results indicated that mothers with stronger intention to breastfeed were more likely to breastfeed exclusively for a longer period of time. Mothers who breastfed their infant exclusively for 16 weeks were asked to participate in one of two focus group meetings (n = 15). The following five themes emerged from the data: 1) knowledge, 2) peer experience, 3) support, 4) perseverance, and 5) the public.
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Copeland, Debra, and Petrice Sams-Abiodun. "Infant Feeding Support of Urban Fathers and Related Parent Educational Learning Needs during the First Year after Birth." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/secfr-conf/2018/schedule/27.
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Transitioning to the father role can be complex and stressful and fathers may not be fully prepared to assume the father role. Since fathers have little formal preparation for becoming a father, they may need more social support resources to support their adaptations to the father role. In addition, fathers are instrumental in supporting mothers’ breastfeeding and other infant feeding decisions, but may experience difficulties with infant care tasks, such as feeding and providing care to their infant. Studies show that many fathers want to be productive and nurturing in the father role but little is known about fathers’ parenting knowledge and needs. Therefore, the purpose of this study is to describe the social support resources of fathers with infant feeding and related parent educational learning needs during the first year after birth. Cross-sectional data was obtained for this descriptive, exploratory study by using a questionnaire and semi-structured interviews. Descriptive statistics were used to analyze questionnaire findings and directed content analysis was used to analyze the qualitative data. Since there is little evidenced-based literature on social support and parenting knowledge and needs of fathers in general, the study design was descriptive, exploratory and included new and experienced fathers. The study was guided by Bandura’s Self-Efficacy Theory. The findings reported in this study originated in a larger study on social support needs of urban fathers with infants during the first year after birth.
Thirty experienced and new fathers were recruited from community organizations that offer services to low-income families in a southern part of the United States. The mean age range of the fathers was 30 (SD = 5) and 60% were experienced fathers and 40% were new fathers. The majority of the fathers were single (67%), Black (90%), had some or completed high-school education (81%) and 85% reported low annual incomes of less than $20,000. Most infants were bottle-fed (73%) and all infants were between 2-12 months. Inclusion criteria included being 18 years old with an infant that was born full-term. The study was reviewed and approved by the university internal review board.
Findings revealed most fathers were confident with feeding their baby, however, some fathers were not confident because they were afraid to handle their baby due to the baby’s size or felt awkward when holding the baby. When fathers had difficulties with feeding their babies, they primarily asked family and friends for advice. Other resources included the internet and healthcare professionals. Fathers reported positive and negative attitudes towards breastfeeding and reasons why breastfeeding was stopped. After the baby’s birth, fathers reported the majority of parent educational learning needs related to how to take of infant, normal infant behavior, basic, daily care, and recognizing signs and symptoms of illness. At time of interview, the majority of parent educational learning needs related to how to cope with a difficulty baby, accessing positive parenting tips and resources, being responsive to the infant, coping with being a new father, and recognizing signs of depression. Recommendations for practice and research will be provided.
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Bailey, Beth, Lana McGrady, Judy G. McCook, and Audry Greenwell. "Educating Nursing Students on Pregnancy Smoking Issues to Improve Regional Intervention Efforts." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/7182.
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Objective: Rates of pregnancy smoking in the rural South are twice national averages and contribute to poor birth and long term outcomes for affected women and children. Efforts to intervene during prenatal care with pregnant women have been hampered by lack of knowledge, skill, comfort, and commitment from prenatal providers and their nursing staff. Regional community providers and staff have been reluctant to participate in available trainings, and even those who do seldom exhibit attitude and practice change long term. Therefore, efforts to educate health care professionals on the dangers of pregnancy smoking, and to provide necessary skills for intervention efforts, may need to occur before they ever enter practice. Thus, the goal of the current project was to implement and evaluate a pregnancy smoking-related training session for baccalaureate nursing students in rural Southern Appalachia. Design: Nursing students attended training on pregnancy smoking dangers/intervention techniques.
Sample: Third year students beginning clinical rotations in obstetrics.
Methods: 1.5-hour training including pre- and post-tests.
Implementation Strategies: Four months later, follow-up survey assessed gains in knowledge, skill, comfort, and willingness to address smoking.
Results: Over seven semesters, 659 nursing students were trained. Substantial gains in knowledge of pregnancy smoking issues were seen from pre- to post-testing, with knowledge retained at four- month follow-up. The percentage of students who felt they lacked skills to intervene with pregnant smokers dropped from 39% at pre-test to 6% at same day post-test. In addition, the percentage who reported they would be uncomfortable talking with pregnant women about smoking dropped from 10% to 1%, while the percentage who indicated they would always make time to address smoking with pregnant women increased from 54% to 87%. While most students did address smoking with multiple pregnant patients encountered during clinicals, and over half felt the patients benefited from their actions, only 58% were confident in their intervention skills at four month follow-up. Finally, 83% felt the training had been beneficial, and over 90% committed to addressing smoking with pregnant patients once they graduated.
Conclusion/Implications for nursing practice: Training can increase nursing student knowledge, skill, comfort, and willingness to address smoking with pregnant women. However, it appears ongoing education may be needed to promote skills and confidence long term. In the rural South, where smoking rates are high and provider efforts to address pregnancy smoking are inconsistent, educating future nurses could have substantial impact on pregnancy smoking rates and birth outcomes into the future.
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Williams, Stacey, and Judy G. McCook. "How Do We Assess Perceived Stigma? Initial Validation of a New Measure." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/7187.
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Hall, Brandi M., and L. Lee Glenn. "Detection and Management of Perinatal Depression by Midwives." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/7488.
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Hill-Holliday, Karen. "Father-Daughter Attachment and Sexual Behavior in African-American Daughters." VCU Scholars Compass, 2009. http://scholarscompass.vcu.edu/etd/1908.
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Although a relationship has been found in some studies between paternal attachment and female sexual behavior, knowledge of this relationship in African Americans has been limited. The purpose of this research was to determine if there was a relationship between father-daughter attachment, parent teen sexual risk communication and early sexual activity, condom use, history of sexually transmitted infection, global/sexual self-esteem and teen pregnancy in African-American females. An anonymous consent and survey was administered online to N=113 African American college women (age 18-21) attending a southeastern university. Measurements included the Parent Attachment Questionnaire (Father), Rosenberg’s Self-Esteem, Sexual Self-Esteem Inventory (short scale), the PTSRC and a sexual history. Findings of high levels of father attachment were found in this mostly middle class sample but neither attachment nor parent teen sexual risk communication was related to age of vaginal/oral initiation, condom use or sexually transmitted infections. However, attachment was predictive of global self-esteem. In addition, those with a high level of attachment were 1.0 times more likely to also have a positive pregnancy test history when maternal support for the father–daughter relationship was low. No relationship was found between sexual self-esteem and paternal attachment or between sexual self-esteem and condom use. Paternal monitoring was associated with older ages of vaginal initiation. Conclusion: Higher paternal attachment coupled with paternal monitoring may facilitate global self-esteem and be a protective factor against early sexual initiation (vaginal). Fathers are in need of education as to how to stay connected with daughters and to engage in direct and indirect sexual risk communication. Nevertheless, prevention strategies utilizing fathers could be effective in delaying onset of sexual activity. This document was originally created in Microsoft Word 2000 and later modified in Microsoft Word 2007 (compatibility mode). SPSS 17.0 statistical software was used for analysis and N-Query 6.0 was utilized for power analysis.
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Fletcher, Tifani R., Andrea D. Clements, and Beth Bailey. "Identifying Intimate Partner Violence during Pregnancy in Prenatal Care Settings." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/ijhse/vol3/iss1/3.
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More than 324,000 women each year are estimated as having experienced intimate partner violence (IPV) during pregnancy. Correctly identifying women experiencing all forms and severity of IPV is necessary to inform the implementation of interventions to prevent and treat IPV. This can optimally be accomplished with data from accurate screening instruments. The United States Preventative Services Task force has recently recommended that all women who are pregnant should be screened for IPV over the course of their pregnancy and postnatal visits. Currently, clinical practice and research are hindered by the lack of validated IPV screening measurements for a pregnant population. The current review examined accuracy measures of empirically tested IPV screening measures, and evaluated them for use in prenatal health care settings. Based on the information collected and presented, recommendations regarding which screens are, and are not, appropriate to use in prenatal care settings to identify IPV were presented. Further rigorous studies are needed to identify and evaluate screening measurements and procedures to increase sensitivity and suitability for use in a variety of clinical settings for pregnant women.
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Kehler, Stephanie A. "Examining Biological and Psychological Variables in Hypertensive Disorders of Pregnancy." UKnowledge, 2017. http://uknowledge.uky.edu/nursing_etds/32.
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Despite advances in obstetric care, hypertensive disorders continue to complicate pregnancies at a high rate. Worldwide, hypertensive disorders affect up to 10% of pregnancies. The United States has seen a 25% increase in the incidence of hypertensive disorders over the last two decades (American College of Obstetricians and Gynecologists, 2017). These complications constitute one of the greatest causes of maternal and perinatal morbidity and mortality with an estimated 50,000 to 60,000 deaths per year across the world (American College of Obstetricians and Gynecologists, 2017). Although the etiology of hypertensive disorders remains unclear, there may be an association with both maternal biological and psychological distress in the development of the disorder. Although both distress and biomarkers have been identified in association with a hypertensive disorder, little data exist examining the components of distress and the alterations in biomarkers in women developing these disorders. Due to the limited evidence, a critical need exists to examine the relationship of perceived maternal distress and biomarker measures in the development of a hypertensive disorder during pregnancy in order to better understand this phenomenon.
The purposes of this dissertation were to: 1) understand the experience of having a hypertensive disorder during pregnancy; 2) to investigate the association of perceived stress and changes in immune response via biomarker measures in women who develop a hypertensive disorder during pregnancy; 3) to review, summarize, and evaluate the literature examining the relationship between perceived maternal distress (stress, anxiety, and depression) and the development of a hypertensive disorder; and 4) to investigate the association of perceived distress in the development of a hypertensive disorder during pregnancy.
Data obtained from a qualitative study of women with a hypertensive disorder during pregnancy placed on bed rest reported several stressors associated with the experience. These stressors related to differing and often conflicting management plans by different providers and not feeling providers heard their concerns. The evidence supports these women experience stress during this pregnancy complication. Analysis of data obtained at each trimester of pregnancy did identify differences in biomarker levels based on perceived stress and women with a hypertensive disorder and those without a hypertensive disorder. Evidence from a systematic review of literature supporting maternal distress in the development of a hypertensive disorder was mixed. However, few studies existed and of those reviewed, most lacked rigor. Analysis of data obtained early and late in pregnancy did not indicate a relationship between psychological distress and the development of a hypertensive disorder in pregnancy. Women with a higher BMI were 12% more likely to develop a hypertensive disorder.
The factors associated with the development of a hypertensive disorder are complex. Maternal perceived stress and inflammatory responses differ between women with a hypertensive disorder and those without a hypertensive disorder in pregnancy; however maternal distress did not differ between groups. Body mass index was associated with the development of hypertension in pregnancy. Clinicians need to include assessment of maternal BMI as a modifiable risk factor in the development of a hypertensive disorder during pregnancy. In addition, although psychological distress was not associated with the development of a hypertensive disorder, women still suffer with components of distress. Clinicians could identify and support women experiencing distress thereby promoting a healthier pregnancy.
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Bailey, Beth, and Judy G. McCook. "The Potential “Double Whammy” of Cigarette Smoking and SSRI Use in Pregnancy: Reduced Infant Weight and Length." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/7181.
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Groer, M., A. Jordan, Jean Croce Hemphill, K. Plaas, M. Davis, and P. Droppleman. "Stress Perceptions, Experiences, and Physiological Responses in Breast and Bottle Feeders." Digital Commons @ East Tennessee State University, 2000. https://dc.etsu.edu/etsu-works/7583.
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Holness, Nola A. "The Effects of Resilience and Social Influences on Preventing Repeat Adolescent Pregnancies in Parenting Adolescent Mothers." FIU Digital Commons, 2014. http://digitalcommons.fiu.edu/etd/1120.
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Every year, 16 million women aged 15 to 19 years give birth globally. Adolescent births account for 11% of all births globally and 23% of the overall burden of disability and diseases due to pregnancy and childbirth. In the United States, 750,000 adolescents (15-19 years) become pregnant each year, making the United States the developed country with the highest rates of adolescent pregnancy. The economic burden of adolescent pregnancy in the U. S. is $7-15 billion per year.
Adolescent pregnancy brings risks associated with pregnancy induced hypertension, preterm infants, maternal and neonatal mortality. Social factors include poverty, low educational levels, alcohol, and drug use. Between 30-50% of adolescent mothers who have a first birth before age 18 years will have a second child within 12 to 24 months. Subsequent adolescent pregnancies compound fetal and maternal risks. Many vulnerable adolescent mothers succumb to external pressures and have a repeat adolescent pregnancy while others are able to overcome the challenges of an adolescent pregnancy and prevent a repeat adolescent pregnancy.
This cross sectional survey designed study investigated the effects of resilience and social influences on contraceptive use or abstinence by Black and Hispanic adolescent parenting mothers to prevent a repeat adolescent pregnancy. 140 adolescent mothers were recruited from three postpartum units of a tertiary hospital system in Miami, Florida. The Wagnild and Young Resilience Scale and the Adolescent Social Influence Scale were used to measure resilience and social influences, respectively. Demographic data, length of labor, plan for contraceptive use or
abstinence were measured by an investigator developed instrument.
Point biserial correlation showed a significant positive correlation between Black adolescent mothers’ resilience and contraceptive use (r =.366, p2(11, N=133) = 27.08, p =.004. (OR = .28). These results indicate a need for interventional strategies to maximize resilience in parenting adolescents to prevent a repeat adolescent pregnancy.
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Brumit, Erin M., and L. Lee Glenn. "Accuracy of the Spanish Emotional Labour Scale." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/7472.
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