Stress, pre-term labour and birth outcomes.

Stress, pre-term labour and birth outcomes Preliminary studies have suggested that stress may be associated with the onset, treatment and outcomes of pre-term labour; however, a systematic comparison of the stress of women with and without pre-term labour has not been reported. Therefore, the purpose of this exploratory study was to compare the stress (daily hassles and mood states) and birth outcomes of black and white women who experienced pre-term labour (PTL) during pregnancy with those who did not. The convenience sample consisted of 35 pregnant women hospitalized in 1996-1997 for the treatment of PTL (24-35 weeks gestation) and 35 controls matched on age, race, parity, gestational age and method of hospital payment. Women in the PTL group had significantly higher tension-anxiety and depression-dejection on the Profile of Mood States (POMS), lower mean birthweight and mean gestational age, and a higher percentage of babies born <37 weeks and weighing 2500 g or less. Black women in the PTL group and white women in the control group had significantly higher scores on the fatigue sub-scale of the POMS and the work and future security sub-scales of the Daily Hassles Scale. Women in the PTL group whose babies weighed 2500 g or less had significantly higher scores on the health, inner concern and financial responsibility sub-scales of the Daily Hassles Scale. The findings from this study indicate the need for further exploration of the interaction of race and stress in understanding and preventing PTL and low birthweight and the need to examine the role of social support in preventing pre-term birth after an episode of PTL.

Future realities in nursing: partnerships, practice, and economics.

Health care reform, innovations in technology, and the need to make health care cost-effective have affected all aspects of health care practice and education. Critical thinking skills, interpersonal and communication skills, leadership and motivation skills, computer literacy, and cultural sensitivity are all capabilities nursing graduates must now possess if they are to practice effectively in the complex and competitive contexts that today define the health care marketplace. Partnerships with community agencies are essential if faculty are to prepare a new generation of nurses who will be proficient in the skills that 21st-century nursing practice will demand. Although academic institutions have made some changes to meet marketplace demands, nursing educators, practitioners, and researchers must thoroughly reconceptualize their philosophies and retool their curricula in response to these changes.

Writing for publication in an RN to Baccalaureate program: an exercise in critical thinking.

More than 35,700 registered nurses are currently enrolled in an RN to Baccalaureate completion program (I). The demand for these graduates is expected to continue, along with an increased demand for community-based educational programs. Many of these students have significant clinical experience and expertise. Nursing faculty are challenged to develop learning experiences and program outcomes that enhance their professional skills and add to their expertise.

Patterns of mental health care among Mexican Americans.

1. Extending cultural care beyond language enhances the use of mental health services and fosters a mutually agreed-on plan of care. 2. Understanding cultural characteristics facilitates an understanding of behavior, family and social dynamics, and adaptation patterns to stress that can empower clients to work toward their goals and validate the impact of emotions and behaviors on others. 3. Culturally appropriate mental health care reflects a synthesis among communication, space, social organization, time, environmental control, and biological variables.

Adolescents' description and management of pregnancy and preterm labor.

OBJECTIVE: To describe adolescents' experiences with pregnancy and preterm labor. DESIGN: Naturalistic inquiry, a qualitative study using intensive, open-ended, tape-recorded interviews and constant comparative data analysis. SETTING: Antepartum units of two hospitals in the southeastern section of the United States. PARTICIPANTS: Eight African American and five white adolescents, ages 14-19 years, hospitalized for preterm labor. RESULTS: The findings are broadly conceptualized as (a) describing pregnancy and preterm labor and (b) managing pregnancy and preterm labor. "Responding to Pregnancy" consisted of descriptions of the adolescents' reactions to pregnancy (initial concern and dislike) and pathophysiologic responses that put the adolescents at risk for preterm labor. "Responding to Preterm Labor" included the various ways that adolescents became aware of preterm labor and their various understandings of the causes and consequences of preterm labor. Vignettes illustrate how adolescents managed pregnancy and preterm labor with ease or with difficulty. Adolescents who received support from others, especially their mothers, tended to deliver near or at full-term. CONCLUSIONS: Nurses can use the findings from this study as a guide for assessing and monitoring adolescents throughout pregnancy. Advanced practice nurses may have the educational background and philosophy of care to provide the most appropriate prenatal care to pregnant adolescents. Research is needed to further explore stressful experiences and support in adolescents' lives and how these are related to preterm labor and birth.

Factors associated with penile amputation in Thailand.

This report describes factors associated with the act of penile amputation by three female partners in southern Thailand. While gender-specific roles and paternalistic behaviors are normative in Thai society, specific precipitating factors for the three amputations included: (1) an immediate financial crisis that adversely affected one of the children in the family; (2) ingestion of drugs or alcohol by the husband immediately before the event; (3) public humiliation of the wife in the presence of a mia noi (secondary wife) or concubine within the week that preceded the incident. Understanding women's cultural preservation in Thailand may promote culturally sensitive and meaningful nursing care.

Fathers' parenting attitudes during a child's first year.

OBJECTIVE: To determine whether fathers' interactions with their children from prebirth to 1 year of age changed the fathers' parenting attitudes as measured by the Adult-Adolescent Parenting Inventory (AAPI). DESIGN: Nonrandomized, longitudinal, descriptive study. SETTING: Private obstetricians' offices, prenatal clinics, and prenatal classes in a large city in the southeastern United States. PARTICIPANTS: White, well-educated, stable, upper-middle class fathers attending prenatal education classes. At time 1 (prebirth), n = 293 with 228 first-time fathers and 65 experienced fathers. At time 2 (3 months), n = 62 with 46 first-time fathers and 16 experienced fathers. At time 3 (1 year), n = 42 with 30 first-time fathers and 12 experienced fathers. MAIN OUTCOME MEASURES: Parenting attitudes as measured by the AAPI. RESULTS: Repeated measures analysis of variance revealed a significant difference in two of the four constructs measured by the AAPI. When their children were 3 months old, fathers scored significantly lower in the areas of expectations and belief in the use of corporal punishment, and their raw scores did not significantly differ in the areas of empathy and appropriate family roles. CONCLUSION: These fathers need education about appropriate expectations of a 3-month-old child and information regarding alternative methods of discipline.

Assessment of the potential for maladaptive parenting in expectant fathers with the Adult-Adolescent Parenting Inventory (AAPI).

The purpose of this investigation was to determine if expectant fathers could be assessed for potential maladaptive parenting with the Adult-Adolescent Parenting Inventory (AAPI). Image factor analysis with matrix rotation by SPSSx was used to replicate Bavolek's (1984) earlier work. It was concluded that the AAPI was appropriate for use with expectant fathers because their responses were not significantly different than those of other populations. The 232 subjects' scores indicated that although they had appropriate attitudes toward empathy and family roles, they had limited knowledge of child growth and development and had strong beliefs in physical discipline. Recommendations include the need for further studies using the AAPI to validate its effectiveness as a predictive tool in the primary prevention of child abuse and neglect.

Implementing negotiating strategies into teen parenting programs.

New parents need information and support to provide care for an infant. When that new parent is a teenager, teen parenting classes can provide the necessary information and support. In addition to basic infant care information, the inclusion of negotiation skills into teen parenting classes enhances the teenager's ability to communicate effectively with immediate family, successfully access preventive health care, and promote positive interactions with other social systems. Steps for incorporating negotiation strategies into teen parenting programs are offered.