The neonatal intensive care unit (NICU) is frequently occupied by newborns who are marginally viable, or critically unwell, and could be considered terminally ill. It is a busy, highly technical environment with an arsenal of life-saving medical equipment at its disposal, and advances in technology used in this field stretch the boundaries of viability. Despite technological advances, increases in the margins of viability and highly skilled healthcare delivery, some newborns will still die in the NICU. In recent years, palliative care for the neonatal population has become increasingly topical and part of the lexicon of contemporary neonatal practice. Evidence-based protocols are available to inform this model of care, yet in reality, provision of palliative care to newborns is ad hoc. The reasons why implementing a palliative model of care have been problematic are unclear. The purpose of this study was to identify the barriers and facilitators to palliative care practice in neonatal nursing, and to develop policy recommendations to improve this area of practice. This exploratory research was conducted to answer two research questions: 1) What are the barriers and facilitators to palliative care practice in neonatal nursing? 2) How can the identified issues be addressed to inform policy and clinical guidelines in the practice environment? Phase one of this investigation developed, pilot tested, and administered an instrument to identify the barriers and facilitators to practice. Data analysis identified three subscales that indicated facilitators and barriers to palliative care practice. The second phase of this study used a translational research approach, utilizing interpretive methods to explore and contextualise the population study findings to inform policy development to improve palliative care practice in neonatal nursing. This research has identified that the facilitators that do exist for palliative care practice are subject to caveats that impinge markedly upon these facilitators. Furthermore, the barriers that were identified pose threats to the integration of a palliative model of care into Australian neonatal nursing practice. Thus, the overall results from this research have lead to a composite understanding of the barriers and facilitators to palliative care practice in Australian neonatal nursing, which may account for the gap between support of palliative care for marginally viable and critically ill newborns, and the application of this model of care in clinical practice. Translating the survey findings into policy directives that are applicable to the clinical environment has resulted in the development of recommendations that are aimed at improving palliative care practice in the NICU.

This descriptive study explored the congruency between the Prepared Childbirth couple's planned antenatal coaching support style and the observed coaching support style and the couple's postpartal perceptions of the coaching support style. Also explored were the relationship of coach's support style and the degree of the couple's postpartal satisfaction with the childbirth experience. A rrodified version of Campbell's Antenatal Questionnaire and Postpartal Questionnaire (1980) and Standley and Anderson's Naturalistic Observation Fonn were utilized for this study and administered to 10 Prepared Childbirth couples for labor observation and detennination of coaches' support styles. The researcher was not able to observe two of the couples in the sample during labor to determine the coach's style. Data collected from these two couples could only be used to answer twu of the four hypotheses, resulting in 16 subjects in the sample for these instead of 20. Only five of 16 subjects accurately predicted the coaching style that was observed. Six of the 16 subjects' postpartal perceptions of the coaching style agreed with the observer's classification. TWelve out of 20 subjects had congruent antepartal expectations and postpartal perceptions even though the coach may have demonstrated a different support style than planned. Based on the findings of the study, the majority of the subjects were not able to predict the support style that the individual coach would derronstrate during his wife's labor. This had little effect on postpartal satisfaction. The wives of coaches who utilized the "interactive through instrumentation" support style had the lowest rating of satisfaction with the childbirth a-perience. These wives also reported more complications occurring in labor during their postpartal interview.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Mothers of neonates admitted to neonatal intensive care units appear to suffer stress which may be related to the illness and treatments the neonate is undergoing, separation from the neonate and social and relationship issues. Nursing professionals employed in the neonatal intensive care unit (NICU) need specific preparation in order to assist mothers to cope with the experience of their neonate being admitted to the NICU. Research is required in order to adequately describe the nature of the stress and whether it changes over a period of time and to provide nursing professionals with information relating to the subject of stress suffered by mothers in this situation. A quantitative, longitudinal study of stress experienced by mothers of the neonate NICU patient was undertaken using the Neonatal Unit Parental Stress (NUPS) Scale (Reid, Bramwell, Booth & Weindling, 2007) (Reid et al., 2007). Mothers who met inclusion criteria were recruited to participate in the study. They were asked to complete the NUPS questionnaire at two time points. Correlations were examined between data obtained on the NUPS questionnaire and the mother and infant demographic data. The results of this study have shown that mothers experience the greatest stress as a result of neonatal suffering and their inability to perform functions of the mother role as a result of separation from the neonate. These findings have been used to make recommendations for the preparation of nursing professionals who work in the NICU.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

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.

The purpose of this study was to describe the lived experience of hope for mothers of premature infants in the Neonatal Intensive Care Unit (NICU). This study was grounded in the existential-phenomenologic philosophy of Merleau-Ponty. A purposive sample of six mothers of infants born between 23 ½ and 31 weeks gestation were interviewed by the researcher 10 months to 2 ½ years after birth. Mothers were asked to think back to when their infant was in the NICU and tell about a specific time when they were aware of hope. Interviews were transcribed verbatim and analyzed following a hermeneutic process developed by Thomas & Pollio (2002). Data analysis revealed consistent themes across participants. The contextual ground was the World of the NICU—a world in which uncertainty, powerlessness, and the marking of time from admission until discharge were set against the backdrop of an unfamiliar environment perceived as negative by mothers. In this context hope emerged from within the mother-infant relationship. Three themes were figural in the mothers’ experience of hope: 1) hope and the infant, 2) hope and others, and 3) hope and the mother. Mothers took their cues to have hope directly from their infant(s). Discouraging or encouraging events dictated the extent to which mothers felt hopeful. Others had a powerful influence, either supporting or threatening mothers’ fragile hope. Sub-themes in hope and the mother were: 1) lack of knowledge/uncertainty, 2) lack of control/powerlessness, and 3) feeling like a mother. Noteworthy findings included the delayed onset of an awareness of hope—often several weeks after birth. Mothers focused solely on their infants; others became figural as they affected hope within the mother/infant dyad. They appreciated nurses who went the extra mile to encourage hope. The negative attitude or biting words of a single nurse quickly destroyed hope. Mothers rarely mentioned fathers, which suggests their lesser role in supporting hope. Mothers used the internet to reach out to others as there was limited opportunity for parent-to-parent interaction. They felt constrained to interact with other families by the emphasis on privacy related to HIPAA rules.

Diss. (sammanfattning) Uppsala : Univ., 2003. / Härtill 4 uppsatser.