The purpose of the study was to develop and test a self-report instrument that describes the frequency that intrapartum nurses perform labor support and physiologic interventions and the nurses' beliefs of the helpfulness of their interventions. The Labor Support and Physiologic Intervention Scale (LSPIS) uses a Likert-style format in a 5-category range of answer options to collect data on nurses' practices to enhance the progress and process of women's labors. Social support theory and physiologic theory provided a conceptual foundation, while the scientific literature on labor support and intrapartum care provided a basis for the original 57 items used in the pilot (n=10) and the Phase I study (n=307). Five labor support experts evaluated the items, with an interrater agreement of .95 and a content validity index of .93. The 57-item LSPIS had an internal reliability of .93 and .95 for the frequency and helpfulness portions (respectively). Exploratory factor analysis identified a 6-factor solution accounting for 48% of the variance that matched the social support and labor support dimensions. The LSPIS was revised and shortened to 26 items based upon the Phase I data analyses. The Phase II study had 472 respondents recruited from two professional listserves. The internal consistency reliability of the revised LSPIS was .90 and .91 for the frequency and helpfulness portions (respectively). Construct validity was evaluated by exploratory factor analysis, which found several acceptable factor solutions that were consistent with the theoretical framework. A six-factor solution accounted for 59% of the variance and had the following components: instrumental or physical support, emotional support, partner support & information/advice, advocacy, mother-directed pushing, and sustenance. Known groups technique and content analysis of nurses' responses to open-ended questions further evaluated construct validity, while discriminant validity was ascertained using a short version of the Marlowe-Crowne Social Desirability Scale. Further data analyses explored relationships among LSPIS scores and various organizational, geographic, and provider variables. In both phases, instrument psychometrics were acceptable and the scale demonstrated acceptable content and construct validity. Further revisions and future uses of the instrument can be guided by the recommendations provided. / text

The purpose of this study is to examine how rhetoric functions in the Alternative Birth Movement (ABM). In particular, communication published by movement leaders will be examined to discover how rhetoric propels the movement from one stage to the next as well as how rhetoric facilitates the goals of the movement. When the ABM began in the early 1970s, it faced strong opposition from medical organizations, such as the American College of Obstetricians and Gynecologists. Through the use of powerful rhetoric, however, the movement was able to withstand pressure from the opposition, attract members, and move toward achieving its goals. To understand the functions of rhetoric throughout the alternative birth movement, this study combines Leland Griffin's method of examining movements in phases with Charles Stewart's functional perspective. The study will address the following research questions: 1. How does rhetoric progress the movement from one stage to another? 2. How does rhetoric facilitate the goals of the movement? / Graduation date: 2012

Women prepare for childbirth in a variety ways. These preparations include visits to healthcare providers, seeking information from family, friends, and the media, and attendance at childbirth classes. Documentation of birth preparation comes primarily from studies of middle class white women. Few researchers have identified or included middle class black women in their samples. Instead, research with black women often highlights pregnancy problems in low income populations. Also unexamined, except tangentially, is how the social context impacts childbirth for black women. Therefore, nursing practice knowledge lacks an understanding of the processes black women use to prepare for birthing within their social context. The aim of this qualitative study was to identify a theory that described the processes used by urban black women to prepare for childbirth. Also explored was the social context within which these processes occurred. Women in the last four months of pregnancy were recruited through churches, hair salons, newspapers, radio and internet web sites. Data were collected from five focus groups and two individual interviews (n=22). More than half the women reported income adequate for daily needs, were partnered or married, were employed, had at least a high school education and were younger than 23 years. Data analysis followed the grounded theory methods advocated by Strauss and Corbin (1998). The theory describing the processes used by the participants was weighing the impact on me. These women actively engaged in determining the best course of action for themselves. They weighed and considered advice from others, what relationships were crucial, what information was most important to them, and many other issues. Woven throughout were the importance of relationships and the social context in which the women lived. The processes used for birth preparation were divided into four, discovering pregnancy, managing pregnancy, preparing for delivery, and experiencing personal change. These processes were not sequential but represented the dynamic and constant need to assess and decide the best choices in preparing for childbirth. Building on this theory, future research should identify ways in which black women can more readily access the quality healthcare and services they so desire. / text