Objective: Polycystic ovary syndrome (PCOS) is a multidimensional endocrine disorder characterized by at least two of the following three features: hyperandrogenism, ovulatory dysfunction and/or polycystic ovaries. Prevalence is estimated at 5-10 % of women of reproductive age worldwide and may impact between five and ten million women in the U.S. alone. Rather than a distinct disease entity, PCOS is characterized as a clustering of clinical concerns which include hyperandrogenism, obesity, and menstrual abnormalities/infertility. Our intent was to examine how these three PCOS characteristics impact psychological symptoms (e.g., depression, anxiety, interpersonal sensitivity) and PCOS health related quality of life concerns (weight, hair, infertility, menstrual, emotions). Design: Cross-sectional, correlational Setting: Women were recruited from private endocrinology practices in the rural Southeastern U.S. Patients/Participants: The study sample consisted of 126 women with PCOS. Half of these women were currently attempting to conceive in addition to being treated for their PCOS. The average woman in the study was 30 years of age (M=30.3, range=18-48), White (98 %) and married (79%). On average, participants weighed over 200 pounds (M=213.6 lbs, 116-361 lbs). Methods: During the seven-month enrollment period, women diagnosed with PCOS were invited to participate. Convenience sampling yielded 126 subjects who met the diagnosis for PCOS, underwent laboratory testing and physical assessment, completed psychological and quality of life survey instruments and were included in data analysis. Results: Results of multiple regression analyses, controlling for demographic covariates, were completed on markers of hyperandrogenism, obesity and current fertility intent. Findings revealed hirsutism was significantly related to increased symptoms of anxiety and somatization and decreased quality of life among women with PCOS, while elevated androgen levels were significantly related to decreased quality of life. Insulin level predicted increased levels of symptoms related to somatization, psychoticism, and a global symptom severity index. Current fertility intent significantly impacted symptoms related to interpersonal sensitivity, anxiety, psychoticism, and the global symptom severity index. Specifically, women not currently trying to have a baby had higher levels of these psychological symptom outcomes. Conclusion/Implications for nursing practice: Women with PCOS are at elevated risk for psychological distress, and psychological symptoms appear to increase with increasing severity of PCOS symptoms. Women not currently trying to conceive appear to be at higher risk for psychological distress and lower quality of life. Future attention might focus on screening and possible referring to mental health services for women not trying or no longer trying to conceive.

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.

Background: Previous studies have demonstrated that breastfed newborns spend more time awake than bottle‐fed newborns, breastfeeding mothers have more fragmented sleep than bottle‐feeding mothers, and mother‐newborn sleeping arrangements may affect the sleep/wake pattern of mother‐newborn pairs. Objective: To address the unsolved question of whether there is an interaction between type of feeding and sleeping arrangements that affects postpartum sleep during the 4th postpartum week. Design: Correlational, two‐way design using feeding method and location of newborn at night as independent variables, and sleep patterns as the dependent variables.Setting: Patient's home during 4th week after giving birth. Patients/Participants: First‐time mothers and their newborns (n = 33). Main Outcome Measures: Amount of total sleep, amount of night sleep, number of night awakenings, and number of sleep periods in 24 hours using a modified version of the self‐report sleep instrument by Barnard and Eyres. Results: Breastfed newborns had less total sleep per day than bottle‐fed newborns, and breastfeeding mothers had more sleep periods in 24 hours than bottle‐feeding mothers. Breastfeeding mothers slept more than bottle‐feeding mothers when co‐sleeping, but bottle‐feeding mothers’ sleep was unaffected by location of newborn. Average total sleep for 4‐week‐old newborns was about 14 hours daily. Conclusions: More sleep was obtained when breastfeeding mothers slept with the newborn. Methods or devices that allow breastfeeding mothers and newborns to sleep next to each other in complete safety need to be developed.

Preterm birth disrupts the development of the brain and other critical organs of the infant body. Since the brain is one of the last organs to finish developing during pregnancy, the risk for substantial neurological deficits increases as the gestational age decreases. One way to combat these deficits is to reconnect the preterm infant with the mother via skin-to-skin contact, also known as kangaroo care (KC). This intimate touch helps to replicate aspects of the environment that the preterm infant experienced in utero. The purpose of this literature review was to analyze the current literature to better understand the effects that KC may have on facilitating neurodevelopment of preterm infants in Neonatal Intensive Care Units (NICUs). Emphasis was placed on neurophysiologic functioning, autonomic functioning, and neurobehavioral functioning. A database search of CINAHL Plus with Full Text, PsycINFO, MEDLINE, Cochrane Central Register of Controlled Trials, and Health Source: Nursing/Academic Edition was conducted, and a total of six articles were reviewed based on their relevance and application towards this thesis. KC is a low-cost, relatively easy intervention to initiate that can have positive impacts on many aspects of preterm infant growth and maturation. There is limited research regarding the use of KC as an intervention to support neurodevelopment, especially with regards to long-term effects. Existing research supports the use of KC as an intervention to facilitate neurodevelopment in preterm infants in the NICU.

The purpose of this literature review was to identify differentiating risk factors in women for postpartum depression and postpartum psychosis. By understanding differentiating risk factors health care professionals, and nurses in particular, can be alert to women who are at higher risk for postpartum depression or postpartum psychosis. This information allows for early nursing intervention and the development of appropriate treatment plans. Fifteen peer-reviewed, English language research articles published between 2000 and 2015 were analyzed for the purpose of this literature review. Study results were inconclusive for the intention of this review, but do provide valuable information on independent risk factors for both disorders. A history of depression and significant life stressors are strong predictors for postpartum depression. Whereas a history of bipolar disorder is strongly associated with the development of postpartum psychosis. Further research is needed to examine the role of genetics in both postpartum depression and postpartum psychosis and to further evaluate risk factors for postpartum psychosis, specifically in women with no history of bipolar disorder. Moreover, additional research needs to be conducted within the United States due to a lack of generalizability of studies conducted in other nations.

The purpose of this study was to conduct an integrated review of the literature examining the use of non-pharmacologic pain management strategies in premature neonates and to explore the relationship between health outcomes and time to discharge from the neonatal intensive care unit (NICU). Non-pharmacologic pain management strategies include human touch, facilitated tucking, non-nutritive sucking, and kangaroo care. A systematic review of the literature was conducted from multiple online databases. Peer reviewed, English-language articles containing the keywords ‘pain management’, ‘neonatal intensive care unit’, and ‘non-pharmacologic’ were included for synthesis. Exclusion criteria included articles with a focus on infants not admitted to the NICU and infants with a gestational age greater than 37 weeks. Results revealed positive outcomes when alternative pain-relieving methods, rather than drug therapy, were used in the NICU. A majority of articles suggest facilitated tucking is very successful in lowering a preterm infant’s pain. However, facilitated tucking alone was significantly less effective in relieving procedural pain compared to facilitated tucking in combination with oral sucrose administration. Kangaroo care and gentle human touch also proved to reduce physiologic and behavioral signs of pain in neonates. The literature reveled an overall positive outcome when non-pharmacologic pain interventions are used in the NICU, with some behavioral interventions showing better efficacy than others at relieving neonatal pain. None of the reviewed articles explored the relationship between reduced length of stay and parameters assessing health outcomes based on pain control in neonates. The literature indicated nurses play a significant role in the use of pain-relieving methods in neonatal populations. Implications for future research that focuses on successful behavioral based pain management strategies that assists in refining neonatal pain relief would be of great benefit to improving health outcomes related to infant survival after discharge from the NICU.

Childhood obesity is a global health concern that puts children at risk for developing serious health complications. With increasing rates worldwide, it is important to determine how to decrease its prevalence and promote prevention in future generations. Emerging evidence indicating that pre-pregnancy weight status and/or gestational weight gain (GWG) may be linked with overweight/obesity in children. Much of this body of research focused on weight status of offspring at birth and at preschool age. The purpose of this study is to: (1) analyze the research findings regarding obesity in children 5 to 18 years and their mother’s pre-pregnancy weight status and/or GWG, and (2) make recommendations for prevention based on a review of current research. A database search of CINAHL, Medline, ERIC and PsycInfo was conducted. A total of 14 articles were identified based on their relevance to key search terms and meeting criteria. This literature review indicated support for associations between an underweight/overweight/obese pre-pregnancy weight status combined with greater than recommended total GWG and higher overweight/obesity in older children and adolescent offspring. Findings also supported the associations between pre-pregnancy weight status with high GWG during early pregnancy and increased offspring overweight/obesity. Pre-pregnancy overweight/obese weight status of mothers was the single factor consistently found to be strongly associated with risk for overweight and obesity in children 5 to 18 years of age. Results of this review support the need for further education, interventions, and policies aimed at healthy nutrition for women during and prior to pregnancy to prevent childhood obesity.

Background: Child abuse is a pervasive and serious problem in the United States. Over 3 million children are the victims of some kind of physical assault by adults. Due to their prolonged contact with children and opportunity to report, nurses should be trained to accurately assess, identify, and manage cases of child abuse. The purpose of this study was to examine student’s experiences with Child Protective Services, and explore their confidence and attitudes related to identifying and reporting child abuse. Factors associated with non-reporting were identified. Methodology: This was an exploratory, descriptive study. Students enrolled in the online Nursing Research course, NUR 3165, were asked to participate. Forty-four RN to BSN and Concurrent students completed the 27 questions survey on Qualtrics. It included demographic questions, questions regarding the participant’s beliefs about child abuse, The Child Abuse Reporting, Attitude and Experience Survey, and two vignettes. Survey data was analyzed using descriptive statistics. Results: There were total of 44 (6 males and 38 females) students who completed the survey; most of them were between the age of 20-24. Fourteen were RN to BSN students who have practiced nursing for more than a year and 30 were concurrent nursing students who are still working on their ASN degree. The results showed that nursing students had positive experiences with CPS and indicated that they had confidence in identifying child abuse. However, students felt that they have not received adequate professional education in this field. Many reported never receiving training regarding child abuse and 84.1% indicated never reporting a suspected case to CPS. When presented with vignettes describing scenarios related to abuse, participants were not able to positively identify cases of abuse versus cases that were ambiguous. Discussion: Nurses are mandatory child abuse reporters in Florida. Many nursing students indicated that they have never reported suspected cases of child abuse to CPS and some of the reasons for this could be the lack of experience, and proper training and education on child abuse. Regardless of the reason, nursing students should be given adequate education to improve their confidence and attitude in identification and reporting of child abuse cases. Nursing schools could focus on including more hands on activity such as case studies and simulation to improve knowledge. Employers could try to utilize protocols to help identify child abuse.

Purpose: Social determinants of health (SDoH) and rurality have both been shown to contribute to severe maternal morbidity (SMM). Appalachian communities often embody this compounded risk, but regional SMM is under-explored. This study’s purpose is to explore SMM in rural areas of Appalachian states. Aims: There are two specific aims. 1) Describe the prevalence of rural SMM in Appalachian states. 2) Investigate the relationship between SMM and SDoH, specifically income, education, and care access. Methods: An IRB exempt, descriptive correlational study was conducted. Birth data (2018-2022) were extracted from the CDC WONDER database for 12 Appalachian states. Demographic, income, and education data were obtained from the U.S. Census. Access was measured by March of Dimes (MoD) maternity care categorizations. Descriptive statistics and Pearson’s correlations were conducted in IBM SPSS. Results: Rural SMM rates correlated with poverty (r =.803, p Conclusions: This study describes rural SMM in Appalachian states, showing correlation with poverty, education, and maternity care access. Limited access to care is correlated with a higher SMM burden for rural areas. This points to the need for further exploration into rural SMM, and the interplay of SDoH and geography in relation to maternal health.

No description available.