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1	Caring for a Preterm Infant during the First Six Months Post NICU Discharge: A Mother’s Perspective Phillips-Pula, Lois 07 December 2011 (has links) Overview There are numerous studies in the current literature focusing on the intense emotions experienced by parents, following the birth of a preterm infant, (i.e., born prior to 37 weeks gestational age [GA]). Research findings have helped us understand the fear and anxiety they feel while attempting to navigate the neonatal intensive care unit (NICU) environment. What happens in those early weeks and months at home after discharge, however, is surprisingly absent from the literature. It is well known that preterm infants are readmitted to the hospital during the first few months after discharge at a rate of 10% - 35%, for an average 4.7 - 11.7 day stay and a cost of approximately $376 million (Underwood, 2007; Escobar, et al., 2005). The most common reasons for readmission are respiratory, feeding and jaundice problems (Spicer, et al., 2008; Underwood, 2007; Escobar, et al., 2005; Brissaud, et al., 2005). What we don’t yet know is what transpired during those early days and weeks at home and how mothers established their day-to-day routines. This missing information could foster a better understanding of family needs and promote the development of strategies to share with mothers prior to discharge, with the result being healthier transitions for both mothers and infants and a possible reduction in the inflated readmission rates for this cohort. The purpose of this research was to help bridge the gaps in the literature on the topic of transitioning a preterm infant to home following NICU discharge. Eight mothers who met the criteria of having a preterm infant born between 24 and 34 weeks GA, admitted to a NICU for a week or more, and who had been discharged to home for 6 months or less, were purposefully chosen from a convenience sample. Each mother was interviewed and asked to describe those first few months at home, e.g., how she met her infant’s needs, what she learned, and how she learned it. Two follow up questions were included and asked the mother what she would like us (HCPs) to know about her experience, and what she would say to other mothers whose infants were still in the NICU. Most mothers spoke at length of the fear they felt when bringing their infants home, and how inadequate they felt trying to provide care that had heretofore been provided by a team of specialists. They described the 2 difficulty and confusion associated with getting their infants to sleep in a quiet home environment until they thought to duplicate the noises of the NICU, and how the monitors, which all infants wore home from the NICU, were both friend and foe, alerting them to potential problems, but awakening the entire household in the process. Each mother also spoke of her determination to do whatever was necessary to ensure that her infant was not rehospitalized, and how thankful she was that her infant had made it to this point. Although each mother described a different approach to meeting the challenges associated with her infant, there was a consistency in the overall challenges each mother experienced. Most mothers wanted HCPs to know they were thankful for the part each had played in saving their infant’s life but they also wanted to impart their parental wisdom on the best ways to give information to a parent, the need for uniformity in what they called the “rules” of the NICU, and how a little encouragement from any HCP was sorely needed by most parents. These mothers were excited to be taking part in this study. They wanted to feel that something they saw, felt or did would make a difference for another mother with an infant in the NICU. Each thanked me for allowing them to share their experiences with me. The references for this document will appear at the end of each section. NICU preterm discharge Moustakas Medicine and Health Sciences Nursing
2	Knowledge, Attitudes, and Beliefs About Preconception Care Among American Adolescent Females Collins, Lynette Collins 01 January 2016 (has links) Despite an initiative to provide preconception care (PCC) and reproductive life planning (RLP) for all women of childbearing age, many women, especially those with low incomes, are not receiving it. As a result, there continues to be a high rate of infant morbidity and mortality in this population. Furthermore, low income adolescent females have not been adequately studied regarding this phenomenon. The purpose of this phenomenological study was to explore low income adolescent females' knowledge, attitudes, and beliefs about PCC and RLP in order to serve them more effectively. Five low income adolescent females, aged 18 to 21, were recruited through criterion sampling and they each engaged in 2 individual in-depth interviews. The health belief model, social cognitive theory, and adolescent affective and cognitive theory were the conceptual frameworks used to develop the interview guide, conduct the interviews, analyze the data, and formulate the recommendations for future studies. Moustakas's phenomenological interview process was used as a guiding framework to prepare and conduct the interviews. Qualitative data were analyzed using Moustakas's modified version of the Stevick-Colaizzi-Keen method of analysis. Findings were that participants (a) had no experiences with PCC or RLP, (b) lacked knowledge about preparing for pregnancy, (c) had negative interactions with medical personnel, and (d) wanted more information about PCC and RLP. Further research is recommended to examine current PCC/RLP practices, conduct additional PCC studies of adolescents, and develop culturally- and age-appropriate PCC programs. Findings from these studies could improve both the lives of the adolescents and the health of their offspring. Moustakas phenomenological study Preconception Care Qualitative Reproductive life planning Stevick-Colaizzi-Keen Nursing Public Health Education and Promotion
3	Exploring the Help-seeking / Helping Dynamic in Illegal Drug Use Polych, Carol 01 March 2011 (has links) Heuristic qualitative research techniques (Moustakas,1990) were used to explore the dynamic of the help-seeking / helping relationship in illegal drug use from the perspective of the professional. Six professionals, expert in helping people living with an addiction, shared their opinions and insights, analyzed problems, explained the rewards, and made recommendations for improvement, based on their own practices within the health care and social services systems. These professionals identify stigma as a major barrier to the provision of quality care in addictions, and analysis shows that a cultural predilection for scapegoating underlies the application of stigma. The many layered social purposes served by the designation of certain substances as illegal and the utility of scapegoating to hegemonic, vested interests is surveyed. This thesis reviews the true social costs of addictions, the entrenched and enmeshed nature of the alternate economy, and the many above ground institutions and professions sustained by the use of drugs designated as illegal. Prohibition and imprisonment as a response to illegal drug use is exposed as costly, inhumane, dangerous, and overwhelmingly counterproductive in terms of limiting harm from illegal drug use. A recent example of drug prohibition propaganda is deconstructed. Consideration is given to the role of the Drug War as a vehicle to accelerate social creep toward a fragmented self-disciplining surveillance society of consumer-producers in the service of economic elites. Classism is brought forward from a fractured social ground characterized by many splits: sexism, racism, age-ism, able-ism, size-ism, locationism, linguism, and others, to better track the nature of the social control that illegal drugs offer to economic elites. The moral loading that surrounds illegal drug use is deconstructed and the influence of religion is presented for discussion. The primitive roots of human understanding that endorse the ritual Drug War and its supporting mythology, leading to the demonization of illegal drugs and the people who use them, are uncovered. Direction is taken from Benner and Wrubel’s Primacy of Caring (1989) and other leaders in the professions as a means to move practitioners away from their roles as agents of social control into a paradigm of social change. addiction illegal drugs helping-seeking / helping helping relationship stigma anomie illegalization heuristic research professionalization consumerism arts-informed research Benner & Wrubel Goffman Link & Phelan Moustakas quality of care scapegoating prohibition prison harm-reduction drug propaganda drug war surveillance society classism elitism discrimination barriers to care mythology social control drug demonization teaching health care mental health infectious disease industrial disease Wittgenstein hegemony policing legalization education training power social violence institutionalized violence care attitude marginalization alienation Marx Chomsky infectious disease communicable disease 0516 0347 0627 0573 0700
4	Exploring the Help-seeking / Helping Dynamic in Illegal Drug Use Polych, Carol 01 March 2011 (has links) Heuristic qualitative research techniques (Moustakas,1990) were used to explore the dynamic of the help-seeking / helping relationship in illegal drug use from the perspective of the professional. Six professionals, expert in helping people living with an addiction, shared their opinions and insights, analyzed problems, explained the rewards, and made recommendations for improvement, based on their own practices within the health care and social services systems. These professionals identify stigma as a major barrier to the provision of quality care in addictions, and analysis shows that a cultural predilection for scapegoating underlies the application of stigma. The many layered social purposes served by the designation of certain substances as illegal and the utility of scapegoating to hegemonic, vested interests is surveyed. This thesis reviews the true social costs of addictions, the entrenched and enmeshed nature of the alternate economy, and the many above ground institutions and professions sustained by the use of drugs designated as illegal. Prohibition and imprisonment as a response to illegal drug use is exposed as costly, inhumane, dangerous, and overwhelmingly counterproductive in terms of limiting harm from illegal drug use. A recent example of drug prohibition propaganda is deconstructed. Consideration is given to the role of the Drug War as a vehicle to accelerate social creep toward a fragmented self-disciplining surveillance society of consumer-producers in the service of economic elites. Classism is brought forward from a fractured social ground characterized by many splits: sexism, racism, age-ism, able-ism, size-ism, locationism, linguism, and others, to better track the nature of the social control that illegal drugs offer to economic elites. The moral loading that surrounds illegal drug use is deconstructed and the influence of religion is presented for discussion. The primitive roots of human understanding that endorse the ritual Drug War and its supporting mythology, leading to the demonization of illegal drugs and the people who use them, are uncovered. Direction is taken from Benner and Wrubel’s Primacy of Caring (1989) and other leaders in the professions as a means to move practitioners away from their roles as agents of social control into a paradigm of social change. addiction illegal drugs helping-seeking / helping helping relationship stigma anomie illegalization heuristic research professionalization consumerism arts-informed research Benner & Wrubel Goffman Link & Phelan Moustakas quality of care scapegoating prohibition prison harm-reduction drug propaganda drug war surveillance society classism elitism discrimination barriers to care mythology social control drug demonization teaching health care mental health infectious disease industrial disease Wittgenstein hegemony policing legalization education training power social violence institutionalized violence care attitude marginalization alienation Marx Chomsky infectious disease communicable disease 0516 0347 0627 0573 0700

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