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.

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.

Introduction & Background: Pre-eclampsia is a serious complication of pregnancy that is characterized by high blood pressure, swelling, and proteinuria as the primary symptoms. Preeclampsia affects 5-8 percent of pregnancies in the U. S. Medications can help to manage symptoms; however, delivery is the only way to resolve pre-eclampsia. Preterm delivery is sometimes necessary and is dependent on the gestational age of the fetus and the severity of symptoms in the mother. Women who have hypertension, diabetes, kidney disease or are pregnant with multiples are at higher-risk to develop pre-eclampsia. Purpose Statement Question: The purpose of this research was to identify what complications occur in women after a pre-eclampsia diagnosis. A systematic review of the literature was used to identify relevant articles that address complications of pre-eclampsia. Literature Review: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used to guide this systematic review. PubMed, CINAHL, and Google Scholar were used to identify relevant articles. Articles were published with the last 5 years (2018-2023). Search terms were “complications following pre-eclampsia.” A total of 128 results were found and reviewed. Nineteen articles were determined to be eligible for inclusion. Findings: A pre-eclampsia diagnosis comes with considerable risks for women. Short-term risks include elevated blood pressure, preterm delivery, renal dysfunction, and electrolyte imbalance. Longer term complications include chronic hypertension, cardiovascular disorders, stroke, and later memory problems including Alzheimer’s disease. Conclusions: A pre-eclampsia diagnosis confers significant risk to women. Complications can be severe and may affect women and infants long-term.

Pregnancy and childbirth are a unique and sacred time in many womens' lives and the process of giving birth often leaves women and families in a vulnerable position. This integrated literature review examined birthing experiences from the maternal perspective and focused on the short-term and long-term implications of negatively perceived maternal experiences. While there are several international studies, only a few have been published studies from the United States. The integrated review showed a significant impact of provider-client communication and shared decision making on a woman's overall perception of her birthing experience. Reports of excess intervention, lack of informed consent, and a perceived disregard for embodied knowledge- all contribute to negative perception of the birthing women. Implications for nursing education, practice, policy, and research are discussed in depth with a focus on improving maternal perception of the birth experience.

The purpose of this study was to conduct a literature review that examined parental coping mechanisms and stress relief techniques for parents of infants admitted to the neonatal intensive care unit (NICU). A search was conducted using multiples databases using key terms such as stress AND coping, parent* OR caregiver, ped* OR child*, support* or aid, NICU OR neonatal intensive care unit, and nurs*. The results were limited to scholarly, peer reviewed journals in the English language. Exclusion criteria included not relating to parents or caregivers and mechanisms of coping with stress or if they pertain to palliative or end-of-life care. Each article meeting the inclusion criteria were critiqued and analyzed for information pertaining to the topic of this review. The thirteen articles yielded from the search revolved around the common themes of Visitation/Participation, Communication, and Comfort Measures. The literature revealed an overall positive association in reducing the amount of stress experienced when an intervention was provided. Implications for further research involve directly comparing the efficacy of interventions to determine which could be most useful in practice.

Background: There is a documented overuse of C-sections (CS) in the United States. The majority of research surrounding CS overuse focuses on the physician’s role, location (state, city, hospital), hospital policies, and the reason why the CS is being performed. Little research focuses on the nurse’s influence on CS outcomes, although nurses spend the longest amount of time with the patient. Methods: Data for this literature review examined 13 research articles between 1992 to present, exploring factors relating to the overuse of CS, specifically, data relating to the correlation between CS and the nurse’s role. Results: Recent research has shown that factors such as short staffing affect nursing care provided to patients. Likewise, a nurse’s attitude towards patient care has influenced the level of attention and advocacy patients receive regarding CS. Experience level of nurses can also influence the outcome of CS deliveries. For example, experienced nurses showed higher CS rates among patients and were less likely to utilize therapeutic amounts of oxytocin during labor compared to newer nurses. Conclusion: The nurse’s influence also has implications on the outcome of CS delivery and requires further research. As the main advocate for patients, understanding how the nurse can help avoid unnecessary CS procedures is of great importance.

No description available.

<p><strong>Do women’s sociodemographic characteristics or type of prenatal care provider influence quality of prenatal care?</strong></p> <p><strong>Objective: </strong>This study examined whether sociodemographic characteristics or type of prenatal care provider influenced the quality of prenatal care received by women in Canada. The main predictors of high quality prenatal care received by Canadian women were identified.</p> <p><strong>Methods: </strong>A secondary analysis of data collected for a primary study that developed and tested the Quality of Prenatal Care Questionnaire (QPCQ) was conducted. Women (n=422), recruited from five cities, completed a background questionnaire and the QPCQ. Data analysis involved examining nine sociodemographic variables and one prenatal care provider variable using independent samples t‐ tests, one‐way analysis of variance, and analysis of covariance.</p> <p><strong>Results: </strong>Statistically significant differences in prenatal care quality were noted among women based on language spoken at home, racial background, marital status, family income, and education level. Women receiving midwifery care reported the highest quality of prenatal care, compared to women receiving care from obstetricians who reported lower quality prenatal care. The strongest predictors of high quality prenatal care were type of prenatal care provider and total family income.</p> <p><strong>Conclusions: </strong>Efforts to universally improve quality of prenatal care in Canada require practice, policy, and research initiatives. Incorporating alternative/ancillary prenatal care services has the potential to improve access, psychosocial supports, appropriate referrals, education, and interventions for women receiving lower quality prenatal care. Systemic practice and policy changes to increase midwifery care capacity would enable midwives to provide high quality prenatal care to a larger portion of low risk Canadian women. Shared care models could reduce the burden on obstetricians, enabling them to provide higher quality prenatal care to high risk Canadian women. Future research needs to focus on identifying the efficacy of each prenatal care component and examining their specific effects on birth outcomes.</p> / Master of Science (MSc)

<p>The Nurse-Family Partnership (NFP) is a targeted, nurse home visitation program for young, low-income, first time mothers. While the effectiveness of the NFP has been established in the context of the US, and is currently being evaluated in the Canadian public health care system, little has been done to document how work of this nature influences or impacts public health nurses (PHNs), an essential component of this program delivery model, on both professional and personal levels. This qualitative interpretive descriptive study explored PHNs’ experiences of long-term home visiting a targeted population of young, vulnerable mothers in a Canadian NFP program. The study was conducted in two phases beginning with a secondary analysis of five focus groups conducted with public health nurses (N = 6) who delivered the NFP intervention as part of the feasibility and acceptability pilot in Hamilton, Ontario. This was followed by further exploration of identified themes and a practice, problem and needs analysis through individual, semi-structured interviews with the original focus group participants and all PHNs who have since delivered the NFP (N =10). Relationships formed with clients, the NFP program and support of NFP colleagues were rewarding factors while workload and workplace factors were significant contributors to stress. The study findings have implications for the identification of strategies to minimize staff turnover, PHN burnout, secondary traumatic stress and compassion fatigue, and improve program delivery.</p> / Master of Science in Nursing (MSN)

The median prevalence of smoking among women of childbearing age in the United States is 22.4%. Of women who identify themselves as smokers in the three months prior to conception, 55% quit during pregnancy; however, 40% of those who quit relapse and return to smoking within six months after delivery. Smoking has been identified as an important means of stress management among smokers in general, and though limited to the perinatal period, pregnancy-specific stress adds to a woman’s typical day-to-day stress burden. Little data exists as to the effect of SHS exposure on smoking status during pregnancy and the impact of SHS exposure on the maternal perception of stress is unknown. Due to limited evidence, a critical need exists to examine the relationships of perceived maternal stress, SHS exposure, and perinatal smoking status in order to better understand perinatal smoking behaviors. The purposes of this dissertation were to: 1) evaluate the literature examining the relationship between the variables of maternal stress, SHS exposure, and perinatal smoking status; 2) determine the reliability and validity of the Everyday Stressors Index (ESI) use in pregnant women; and 3) to investigate the impacts of maternal perception of everyday stress, and SHS exposure on perinatal smoking status. Evidence obtained from the critical review of the literature supported an association between psychosocial stress and smoking during pregnancy or postpartum. Little information regarding the role of SHS exposure on perinatal smoking status was discovered. Psychometric testing of the ESI demonstrated strong internal consistency reliability, and factor analysis yielded three factors capturing three important domains of everyday stress. SHS exposure emerged as the most significant predictor of smoking status. Persistent smokers/relapsers had the highest ESI scores, followed by quitters, and then nonsmokers. While ESI means decreased in all smoking status groups from the first to the third trimester, the magnitude of decrease was not predictive. A significant interaction effect of SHS exposure in the home and decrease in ESI score occurred in the quit group only with quitters 1.14 times more likely to experience a decrease in ESI score compared to smokers/relapsers.