Thesis (M.S.)--University of Michigan, 1981.

Thesis (M.S.)--University of Michigan, 1981.

Purpose: Prenatal care (PNC) is the healthcare service most often provided to women of childbearing age throughout the world. Poorly understood and defined, based on culture, and expensive for any healthcare system, PNC remains a target for change and improvement. The purpose of this cross-national qualitative research study using narrative inquiry methods was to explore consumer perspectives of individual health and routine PNC in the USA and Iceland. Methods: A purposive sampling technique was used to identify study participants (n = 32) from the United States (n = 16) and Iceland (n = 16). Data were collected via a semi structured interview which included demographic questions. Results: Content analysis processes were used to analyze the transcribed narratives to identify common conceptual themes. Subsequently, the narratives of the women from the two nations were compared to identify cultural variations about PNC. In respect to the findings, demographically the two groups were similar. Respondents from both nations preferred a more supportive role from PNC providers with adequate time to explore important personal concerns and less emphasis on monitoring weight gain during the pregnancy. Variations between the two groups related to the health care delivery system iv of the nation in which respondents resided. These findings have the potential for expanding the definition of PNC to include consumer perspectives. Discussion/Implication: Additional research is needed with other groups of women to validate, clarify and expand identified themes, as they may improve PNC, and ultimately, perinatal outcomes. Improving PNC holds the promise of improving infant mortality while at the same time reducing healthcare expenditures for countries around the world.

Trata-se de uma pesquisa~ comparativa entre a aplicação do Processo de Enfermagem em sub-programas de saúde materna e os registros habituais no processo das clientes. São conhecidas algumas características da populaçio, tais como: idade, escolaridade, ocupação, residência, cor da pele, estado civil, religião, primeiro contato com o centro de saúde na gestação em curso e paridade. Processo de Enfermagem é um termo aplicado a um sistema de intervenções específicas da enfermagem na saúde das gestantes. Detalhadamente, envolve o uso de método científico, para identificar os problemas de saúde e de enfermagem e consequentemente as necessidades de saúde das gestantes; utilizar estas selecionando as que podem mais efetivamente ser solucionadas pelos cuidados de enfermagem; também inclui planejamento para encontrar essas necessidades, providenciar cuidados (encaminhando os que não dizem respeito à enfermagem) e avaliar os resultados. Os instrumentos de pesquisa foram aplicados a cento e dezenove gestantes (quatro amostras probabilísticas sistematicas chamadas A, B, C e D com 32, 27, 30 e 30 gestantes) que representam 50 por cento da populaçio total de gestantes em cada centro de saúde. Através de uma análise estatística em termos quantitativos utilizando média, moda, desvio padrão, amplitude de variação e em termos qualitativos utilizando qui-quadrado (x2), coeficiente de Yule e amostras emparelhadas (teste de hipóteses) ao nível de significancia de 5 por cento , confirmámos as duas hipóteses formuladas. As principais conclusões foram: 1) A utilização do Processo de Enfermagem permitiu encontrar 1405 problemas de saúde e de enfermagem e nos registros nas fichas havia registrados 223. 2) Depois de encontrar os problemas, identificâmos as Necessidades Humanas Básicas afetadas: as psico-biológicas 1003 vezes e as psico-sociais 1069 vezes. 3) A utilização do plano assistencial permitiu fazer: - 887 orientações de saúde; - 372 supervisões em saúde; - 593 encaminhamentos para consulta médica e instituições ligadas à habitação e saneamento do meio. 4) Parece existir uma associação entre a procura do centro de saúde para seguimento da gestação desde o 1º mês e estar no grupo etário 15-29 anos (ao nível de significancia de 5 por cento ). 5) O papel da enfermagem e principalmente de educador e supervisor de saúde na enfermagem de saúde pública - saúde materna. 6) Este estudo demonstra que o corpo de conhecimentos da enfermagem está discriminado no planeamento das ações de saúde necessárias, de forma a responder à problemática das gestantes. 7) É evidente a importancia da pesquisa em enfermagem como a maior contribuição para encontrar as necessidades de saúde e bem-estar das pessoas. / This is a comparative survey between the application of the Nursing Process on the Maternal Health sub-programmes and the normal registrations in the file card. There are known some characteristics of the population such as: age, scolarity, occupation, residence, skin colour, marital status, religion, first contact with the health care center during pregnancy and offspring. Nursing process is a term applied to a system of characteristic nursing interventions in the health of the pregnant women. In detail, it involves the use of scientific methods for identifying health and nursing problems and, consequently, the health needs of the pregnant women and for using the latter to select those which can most effectively be met by nursing care. It also includes planning to meet those needs, providing the care and evaluating the results. The research instruments were applied to one hundred and nineteen pregnant women (four probabilistic and systematic samples called A, B, C and D with 32, 27, 30 and 30 pregnant women), who represents 50 per cent of the total population of pregnant women. By means of statistical analysis in quantitative terms, utilizing mean, mode, standard deviation, range of scores and, in qualitative terms, utilizing chi-square (x2), Yules\' coefficient and paired samples (hypothesis test - 5 per cent level of significance), we confirmed the two hypothesis formulated. The main research finding were: 1) Through the use of Nursing Process one find 1,405 health and nursing problems, on the other hand through the normal registrations in the file card one finds only 223. 2) After encountering problems, we can identify the Basic Human Needs affected: psycho-biological: 1,003 and psycho-social: 1,069. 3) The use of care planning permits one to deal with the foi lowing: - 887 subjects for health education; - 372 subjects for health supervision; - 593 subjects for guidance, specicilly regarding medical consultations and institutions of basic sanitation and housing. 4) lt seems to exist a significant relationship between the demand for the health care center by women, during the first three months of pregnancy in the 15 to 29 year old age group. 5) The nursing role is mainly health educator and health supervisor of public health nursing - maternal health. 6) This study demonstrates that the body of knowledge nursing is revealed in the planning of necessary health action in arder to answer to the problematics of pregnancy. 7) It is evident the importance of nursing research as a major contribution in meeting people is health and welfare needs.

Thesis advisor: Danny G. Willis / Purpose: The purpose of this qualitative research was to describe the phenomenon of privacy as experienced and conceptualized by patients who participated in the CenteringPregnancy model of group healthcare. Background: In healthcare, privacy is an ethical and legal right. Healthcare providers have an obligation to protect patient privacy and confidentiality. Group healthcare is an innovative approach that brings together a group of patients with a team of providers, offering the opportunity for holistic, integrated, and coordinated healthcare. Group healthcare challenges how healthcare providers manage privacy and confidentiality. Knowledge about patients’ experiences of privacy during group healthcare such as CenteringPregnancy is fundamental to developing an understanding of the risks and benefits incurred during group healthcare visits. Research focused on uncovering the patient experience of privacy within the context of group healthcare can provide useful direction for improving the patient care experience and health outcomes. Research Questions: 1) What is the privacy experience of women who participated in CenteringPregnancy? 2) How does the patient experience of privacy in a group healthcare setting differ from the experience of privacy during individual care? Methods: This qualitative research used phenomenography to examine the experiences of privacy for 15 women who participated in CenteringPregnancy at a large multisite, multispecialty healthcare practice. Results: Four main concepts related to privacy were identified. My Privacy: Agency of the Self emerged as the primary conception of privacy for both group and individual care settings. My Provider: Protecting My Privacy focused on the critical role of the group facilitator in protecting confidentiality and establishing group privacy. The Dynamics of Group Privacy encompassed the relational processes of trusting, respecting, and sharing. Benefits of Participating in Group Healthcare included friendship, comradery, learning, and relief of feelings of isolation, fear, and anxiety. Conclusions: Women’s experiences of privacy within the context of CenteringPregnancy were positive. Findings can guide recruitment efforts and the facilitation and management of the group environment. Healthcare providers can offer a full description of privacy within group healthcare settings as part of recruitment and informed consent and emphasize the shared responsibility for group privacy among all members in the group. / Thesis (PhD) — Boston College, 2015. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

Studies have reported that the most trusted health care relationship is that of the prenatal healthcare professionals (PHPs) and the prenatal patient. Yet many of the patient’s environmental health questions go unanswered for a variety of reasons. To better understand the situation, this research examines environmental health education practices of PHPs – obstetricians, prenatal nurses, family physicians, midwives and doulas - offered during the preconception and prenatal period. Specifically, this thesis discusses some of the PHP self-reported opportunities and barriers surrounding the provision of environmental health education (EHE). In person (n=17) and telephone (n=4) interviews were conducted with PHPs in the Ottawa Region. Additionally, a key informant within the Society of Obstetricians and Gynaecologists of Canada (SOGC) was asked specific questions about the association’s role in the development of standardized educational care guidelines. The results show that most PHPs have a limited knowledge of EHE and are reluctant to discuss it without access to more professional research. PHPs feel that there is little professional association support and that guidelines for adding EHE to their current prenatal care plans are non-existent. This study is one of the first studies that uniquely examined EHE in the prenatal period from perspective of prenatal healthcare professionals.

BACKGROUND: Rising rates of maternal morbidity and mortality and persistent disparities in care utilization and outcomes signal a need for new approaches to prenatal care delivery. This study uses perspectives of low-socioeconomic status (SES) pregnant women to generate features of a patient-centered intervention aimed at improving outcomes in high cost, high need pregnant individuals. METHODS: We performed a secondary analysis of qualitative interviews with Medicaid-insured pregnant high and low utilizers of unscheduled obstetric care. Using a grounded theory approach, we tightly mapped themes to generate intervention strategies with potential to improve prenatal care delivery. RESULTS: Three key themes translated into intervention features: social support, care delivery, and access. Unlike low utilizers, high utilizers had a desire for more social support, improved communication in care delivery, and access to timely and efficient appointments. For low utilizers, improved insurance access and the ability to opt out of support services that didn’t align with their priorities were essential. CONCLUSION: High and low utilizers of unscheduled obstetric care have unique ideas for improving their care. Targeted interventions to improve prenatal care can be tested to potentially address unmet needs of vulnerable subgroups of low-SES pregnant women at risk for poor outcomes. / 2019-10-31T00:00:00Z

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

FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgico / Objetivou-se avaliar o conhecimento, a atitude e a prÃtica dos enfermeiros atuantes na EstratÃgia SaÃde da FamÃlia (ESF) acerca do controle da sÃfilis na gestaÃÃo; associar as variÃveis explanatÃrias com o conhecimento, a atitude e a prÃtica dos enfermeiros acerca do controle da sÃfilis na gestaÃÃo e comparar o conhecimento e a atitude com a prÃtica em relaÃÃo à sÃfilis na gestaÃÃo. Trata-se de um estudo avaliativo do tipo Conhecimento, Atitude e PrÃtica (CAP) e abordagem quantitativa, realizado no perÃodo de junho a agosto de 2012, com 171 enfermeiros da ESF, utilizando-se como instrumento um questionÃrio inquÃrito CAP em relaÃÃo à sÃfilis na gestaÃÃo. Os dados foram organizados em tabelas e grÃficos, segundo a estatÃstica descritiva e inferencial utilizando-se os testes Mann-Whitney, Kruskal-Wallis, Qui-quadrado e Fisher. O estudo foi aprovado pelo COMEPE/UFC com o protocolo de n 81/12. Quanto ao perfil dos enfermeiros, verificou-se uma idade mÃdia de 37,5 anos, com 90,1% do sexo feminino, 64,3% com ensino superior em instituiÃÃes pÃblicas e 77,8% sÃo especialistas, formados hà cerca de 12 anos, atuando na ESF hà uma mÃdia de 9 anos e 53,8% tinha alguma capacitaÃÃo sobre a temÃtica. Em relaÃÃo ao conhecimento dos enfermeiros, a maioria (67,3%) foi classificada como adequado, mas ainda 32,7% de enfermeiros teve conhecimento inadequado e regular. Quanto à atitude e prÃtica, observou-se 97,1% dos participantes tinham crenÃas e opiniÃes adequadas e 94,2% as colocavam em prÃtica adequadamente. Houve uma associaÃÃo estatisticamente significativa entre a instituiÃÃo de graduaÃÃo e a atitude dos enfermeiros; a autoclassificaÃÃo positiva em relaÃÃo ao conhecimento acerca da sÃfilis na gestaÃÃo com a prÃtica adequada; o conhecimento e a prÃtica, bem como entre a atitude e a prÃtica. As principais dificuldades percebidas pelos enfermeiros no controle da sÃfilis congÃnita foram: a demora dos resultados dos exames de VDRL (45,6%); a dificuldade de convocar o(s) parceiro(s) e a sua adesÃo ao tratamento (28,1%), assim como o inÃcio tardio do prÃ-natal (19,9%). Frente ao exposto, destaca-se a importÃncia do reconhecimento da sÃfilis congÃnita como um importante problema de saÃde pÃblica pelo enfermeiro, visto que a partir de suas aÃÃes adequadas e baseadas no conhecimento tÃcnico-cientÃfico podem interferir diretamente no controle da sÃfilis congÃnita, ofertando-se uma assistÃncia prÃ-natal de qualidade, integral e humanizada.

Trata-se de uma pesquisa~ comparativa entre a aplicação do Processo de Enfermagem em sub-programas de saúde materna e os registros habituais no processo das clientes. São conhecidas algumas características da populaçio, tais como: idade, escolaridade, ocupação, residência, cor da pele, estado civil, religião, primeiro contato com o centro de saúde na gestação em curso e paridade. Processo de Enfermagem é um termo aplicado a um sistema de intervenções específicas da enfermagem na saúde das gestantes. Detalhadamente, envolve o uso de método científico, para identificar os problemas de saúde e de enfermagem e consequentemente as necessidades de saúde das gestantes; utilizar estas selecionando as que podem mais efetivamente ser solucionadas pelos cuidados de enfermagem; também inclui planejamento para encontrar essas necessidades, providenciar cuidados (encaminhando os que não dizem respeito à enfermagem) e avaliar os resultados. Os instrumentos de pesquisa foram aplicados a cento e dezenove gestantes (quatro amostras probabilísticas sistematicas chamadas A, B, C e D com 32, 27, 30 e 30 gestantes) que representam 50 por cento da populaçio total de gestantes em cada centro de saúde. Através de uma análise estatística em termos quantitativos utilizando média, moda, desvio padrão, amplitude de variação e em termos qualitativos utilizando qui-quadrado (x2), coeficiente de Yule e amostras emparelhadas (teste de hipóteses) ao nível de significancia de 5 por cento , confirmámos as duas hipóteses formuladas. As principais conclusões foram: 1) A utilização do Processo de Enfermagem permitiu encontrar 1405 problemas de saúde e de enfermagem e nos registros nas fichas havia registrados 223. 2) Depois de encontrar os problemas, identificâmos as Necessidades Humanas Básicas afetadas: as psico-biológicas 1003 vezes e as psico-sociais 1069 vezes. 3) A utilização do plano assistencial permitiu fazer: - 887 orientações de saúde; - 372 supervisões em saúde; - 593 encaminhamentos para consulta médica e instituições ligadas à habitação e saneamento do meio. 4) Parece existir uma associação entre a procura do centro de saúde para seguimento da gestação desde o 1º mês e estar no grupo etário 15-29 anos (ao nível de significancia de 5 por cento ). 5) O papel da enfermagem e principalmente de educador e supervisor de saúde na enfermagem de saúde pública - saúde materna. 6) Este estudo demonstra que o corpo de conhecimentos da enfermagem está discriminado no planeamento das ações de saúde necessárias, de forma a responder à problemática das gestantes. 7) É evidente a importancia da pesquisa em enfermagem como a maior contribuição para encontrar as necessidades de saúde e bem-estar das pessoas. / This is a comparative survey between the application of the Nursing Process on the Maternal Health sub-programmes and the normal registrations in the file card. There are known some characteristics of the population such as: age, scolarity, occupation, residence, skin colour, marital status, religion, first contact with the health care center during pregnancy and offspring. Nursing process is a term applied to a system of characteristic nursing interventions in the health of the pregnant women. In detail, it involves the use of scientific methods for identifying health and nursing problems and, consequently, the health needs of the pregnant women and for using the latter to select those which can most effectively be met by nursing care. It also includes planning to meet those needs, providing the care and evaluating the results. The research instruments were applied to one hundred and nineteen pregnant women (four probabilistic and systematic samples called A, B, C and D with 32, 27, 30 and 30 pregnant women), who represents 50 per cent of the total population of pregnant women. By means of statistical analysis in quantitative terms, utilizing mean, mode, standard deviation, range of scores and, in qualitative terms, utilizing chi-square (x2), Yules\' coefficient and paired samples (hypothesis test - 5 per cent level of significance), we confirmed the two hypothesis formulated. The main research finding were: 1) Through the use of Nursing Process one find 1,405 health and nursing problems, on the other hand through the normal registrations in the file card one finds only 223. 2) After encountering problems, we can identify the Basic Human Needs affected: psycho-biological: 1,003 and psycho-social: 1,069. 3) The use of care planning permits one to deal with the foi lowing: - 887 subjects for health education; - 372 subjects for health supervision; - 593 subjects for guidance, specicilly regarding medical consultations and institutions of basic sanitation and housing. 4) lt seems to exist a significant relationship between the demand for the health care center by women, during the first three months of pregnancy in the 15 to 29 year old age group. 5) The nursing role is mainly health educator and health supervisor of public health nursing - maternal health. 6) This study demonstrates that the body of knowledge nursing is revealed in the planning of necessary health action in arder to answer to the problematics of pregnancy. 7) It is evident the importance of nursing research as a major contribution in meeting people is health and welfare needs.