Listening to Black Women's Perspectives of Birth Centers and Midwifery Care: Advocacy, Protection, and Empowerment.

INTRODUCTION: Black women in Texas experience high rates of adverse maternal outcomes that have been linked to health inequities and structural racism in the maternal care system. Birth centers and midwifery care are highlighted in the literature as contributing to improved perinatal care experiences and decreased adverse outcomes for Black women. However, compared with White women, Black women underuse birth centers and midwifery care. Black women's perceptions in Texas of birth center and midwifery care are underrepresented in research. Thus, this study aimed to highlight the views of Black women residing in Texas on birth centers and midwifery care to identify their needs and explore ways to increasing access to perinatal care. METHODS: Semistructured interviews were conducted with 10 pregnant and postpartum Black women residing in Texas. Questions focused on the women's access, knowledge, and use of birth centers and midwifery care in the context of their lived maternal care experiences. Interview transcripts were reviewed and analyzed using inductive, qualitative content analysis. RESULTS: The Black women interviewed all shared experiences of discrimination and bias while receiving obstetric care that affected their interest in and overall perceptions of birth center and midwifery care. Participants also discussed financial and institutional barriers that impacted their ease of access to birth center and midwifery care services. Additionally, participants highlighted the need for culturally sensitive and respectful perinatal health care. DISCUSSION: The Black women interviewed in this study emphasized the prevalence of racism and discrimination in perinatal health care encounters, a reflection consistent with current literature. Black women also expressed a desire to use birth centers and midwifery care but identified the barriers in Texas that impede access. Study findings highlight the need to address barriers to promote equitable perinatal health care access for Black women.

On "Diagnosis and Management of Perinatal Depression".

Commentary and response on the subject of depression in the perinatal period.

An Integrative Review of the Perinatal Experiences of Black Women.

OBJECTIVE: To synthesize the current body of evidence regarding the perinatal experiences of Black women. DATA SOURCES: The databases PubMed, the Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Scopus were searched with the search terms "African American" (in PubMed), "Black" (in Scopus), or "Black" OR "African American" (in CINAHL) AND "pregnancy" AND "experiences." STUDY SELECTION: Searches yielded 266 articles published between January 2015 and May 2021. After initial screening, 68 articles were assessed for eligibility, yielding 23 studies that met the inclusion criteria of this review. DATA EXTRACTION: Studies were reviewed for the perinatal experiences of Black women. Nonresearch articles, systematic reviews, and instrument development articles were removed. Also excluded were articles with a focus on adolescent pregnancy, breastfeeding experiences, and those outside of the perinatal time frame. DATA SYNTHESIS: Analysis showed that Black women continue to report negative experiences in perinatal care and that these negative experiences spanned various sociodemographic characteristics. Although some Black women described positive interactions, many more expressed dissatisfaction with the lack of education, resources, and continuity in care, as well as poor communication. Additionally, experiences of racism and biases in care, mistrust in the health care system, and doubts of the efficacy or necessity of medical treatments exist. CONCLUSION: Negative perinatal care experiences and dissatisfaction among Black women remain common. Although Black women desire more holistic, naturalistic, and empowering care, Black women first want safe, respectful care and a health care team that removes biases and racism from its system. More research is needed that includes the voices of Black women to understand these experiences and to develop interventions to improve the perinatal care experience. Nurses and other health care providers providing care in the perinatal period must also listen to, trust, and respect Black women.

"You're acting womanish!" A qualitative descriptive study of the experiences of African American women in menopausal transition.

This study explores how African American women understand and experience menopausal transition. Data were collected from 14 women in individual interviews and a focus group of seven participants. Transcripts were analyzed using content analysis. Black Feminist Thought and Womanist Thought were the frameworks used to understand the experiences of participants. Key themes emerged including silence as a form of survival, resilience amidst the chaos, socialization for self-preservation and empowerment, and reshaping and reclaiming womanhood. African American women need to be approached from a culturally sensitive care model to address their care during this phase and to optimize health outcomes.

Teens' Experiences with Sexting: A Grounded Theory Study.

INTRODUCTION: To explore and understand the relationship between sexting behavior and adolescent mental health and well-being. METHOD: A constructivist grounded theory study was conducted. Seventeen 18-22-year-old participants provided recollective and reflective accounts of sexting experiences throughout their adolescence. RESULTS: Engaging in the Culture of Teen Sexting materialized as the central process and title for the grounded theory that emerged. Six primary processes included Engaging in the Culture of Teen Sexting, Identifying Motivating Factors, Forming Perceptions and Feelings, Acknowledging and Managing Risks, Connecting Mental Health and Sexting, and Finding a Sexual Self. DISCUSSION: The findings suggested sexting is part of teen culture and normal adolescent sexual growth and development. Acknowledging sexting as a culture and normal part of sexual growth and development will assist pediatric nurse practitioners in engaging teens in conversations about sexting, helping them to navigate the risks of sexting and find healthy ways to manage sexting behavior.

Needs of Socioeconomically Diverse Fathers of Premature Hospitalized Infants: A Multicenter Study.

BACKGROUND: To effectively practice true family-centered care (FCC) in the neonatal intensive care unit (NICU) setting, a nurse needs to understand the perceptions and concerns of all fathers. Although research is emerging on fathers' perceptions and experiences, the samples of fathers represented are not from diverse socioeconomic, racial, and ethnic populations, which limit the findings' generalizability. PURPOSE: The purpose of this study was to determine the needs of NICU fathers and whether these needs differed based on sociodemographic factors. METHODS: A quantitative, comparative, descriptive design was used to determine the needs of NICU fathers. Additional analysis was conducted to determine whether the needs differed based on education, income, and gestational age, whether the father preferred speaking English or Spanish, and whether these sociodemographic factors could predict needs. To determine sociodemographic factors and needs, a demographic questionnaire and the NICU Family Needs Inventory were administered to 99 fathers in 6 level III NICUs. RESULTS: Data were analyzed using independent sample t test, 1-way analysis of variance, and multiple linear regression. The results showed that fathers reported a broad span of needs and fathers from disadvantaged populations may have greater needs in certain areas. IMPLICATIONS FOR PRACTICE: These results emphasize the importance of the nurses' role in assessing the needs of NICU fathers. By understanding fathers' needs, nurses can provide individualized FCC to fathers to help them be more involved in the care and support of their infant. IMPLICATIONS FOR RESEARCH: Further research is needed to support these findings and test interventions that promote communication between providers and fathers.

A Qualitative Description of Nurses' Experiences With Incorporating Research Into Practice.

BACKGROUND: Baccalaureate-prepared nurses should be competent in accessing, evaluating, and implementing research evidence into nursing practice. The purpose of this study was to gain insight into nurses' experiences in accessing, evaluating, and implementing research into practice. METHOD: Researchers conducted a qualitative descriptive study. Data were collected through in-depth interviews and field notes. RESULTS: Thirteen nurses participated in individual interviews. Themes that emerged included awareness, motivation-empowering change, and barriers to evidence-based practice implementation (EBP). Several experienced nurses expressed the importance of EBP in practice but could not provide clear definitions of EBP. Personal and organizational barriers negatively influence EBP implementation in clinical practice. Nurses could be motivated to use EBP if it were translated in an easy way to understand. CONCLUSION: The information derived from this study can be used to design learning opportunities that prepare practicing nurses to appropriately appraise research and integrate evidence into practice. J Contin Educ Nurs. 2018;49(7):299-306.

Multi-institutional Collaboration to Promote Undergraduate Clinical Research Nursing.

Clinical research nursing is distinct from nursing research and includes the coordination and delivery of care for patients enrolled in clinical research trials. An innovative elective in clinical research nursing was developed collaboratively by stakeholders at a university, research institute, and national organization to provide experiential learning for undergraduate nursing students. The multi-institutional collaborative process, course overview, and precepted experience are described.

Medications and Breastfeeding for Mothers With Chronic Illness.

Mothers with chronic illnesses are often discouraged from breastfeeding by health care professionals, most often because of use of medication and fear of adverse effects in the infant. Most medications taken by mothers are not contraindicated for breastfeeding. Understanding factors that affect transfer of medications into human milk can help providers give appropriate guidance to mothers with chronic illnesses who want to breastfeed.

African American Women's Breastfeeding Experiences: Cultural, Personal, and Political Voices.

The low rate of breastfeeding among African American women in the United States is a poorly understood, persistent disparity. Our purpose in this study was to gain an understanding of how African American women experience breastfeeding in the context of their day-to-day lives. The Sequential-Consensual Qualitative Design (SCQD), a 3-stage qualitative methodology aimed at exploring the cultural, personal, and political context of phenomena, was used to explore the experiences of African American women who felt successful with breastfeeding. An integration of qualitative content analysis and Black feminist theory was used to analyze the data. Themes that emerged from Stage-2 data analysis included self-determination, spirituality and breastfeeding, and empowerment. In Stage 3 of the study, participant recommendations regarding breastfeeding promotion and support initiatives for African American breastfeeding were categorized into three themes, including engaging spheres of influence, sparking breastfeeding activism, and addressing images of the sexual breast vs. the nurturing breast.

African American women and breastfeeding: an integrative literature review.

The purpose of this article is to present a review of literature regarding factors that influence breastfeeding intentions, initiation, and duration in the African American population. Research related to health disparities experienced by African Americans in the United States, as well as research regarding the protective benefits of breastfeeding for those specific health disparities, are also presented. Community and institutional interventions and promotional campaigns aimed at increasing initiation and duration of breastfeeding in the African American population are discussed. Future research regarding African American women's breastfeeding experiences using Black feminist thought as a theoretical foundation is recommended.

The development and psychometric testing of the Supportive Needs of Adolescents Breastfeeding Scale.

AIM: To report the development and psychometric testing of the Supportive Needs of Adolescents Breastfeeding Scale. BACKGROUND: Nurses worldwide can influence adolescent mothers' decisions to initiate and continue breastfeeding through understanding their social support needs in the early postpartum. Review of the literature reveals a lack of instruments that measure adolescents' perceptions of supportive nursing behaviours when initiating breastfeeding. METHOD: An instrument development and psychometric evaluation study was conducted. In phase 1, scale items were developed from the literature using social support theory. Eight lactation consultants evaluated the scale's content validity in phase 2. During phase 3, the psychometric properties of the scale were tested using item analysis, scale reliability, and exploratory factor analysis. A convenience sample of 101 adolescents, aged 15-20 years old, was recruited during their postpartum stay at three hospitals in the USA between July 2009-July 2010. RESULTS: Content validity index was 0·82. Alpha estimate of internal consistency was 0·83. Principal components analysis resulted in a 3 factor scale that explained 48% of the total variance: Practical support, Informational support and Miscellaneous. CONCLUSION: The findings suggest evidence of the scale's adequate internal consistency. The factor analysis suggests two clear underlying dimensions of support: instrumental/emotional/appraisal and informational/emotional/appraisal, and a third miscellaneous dimension related to immediate skin-to-skin care and mothers' support persons. Further exploration of the possible global implications of the scale's dimensions is needed.

A grandmothers' tea: evaluation of a breastfeeding support intervention.

This study's purpose was to evaluate an intervention to facilitate grandmothers' knowledge and support of breastfeeding. A pilot study with a quasi-experimental two-group posttest design was used to evaluate whether the intervention made a difference in grandmothers' knowledge, attitudes, and intent to recommend breastfeeding. The 26 grandmothers in the intervention group attended A Grandmothers' Tea program; the 23 grandmothers in the control group received written information. The intervention group had greater posttest knowledge scores than the control group but had no significant differences in attitudes or intent. However, a significant difference was evident between the attitude scores of grandmothers who breastfed their infants and of grandmothers who did not breastfeed their infants regardless of receiving the intervention.

The 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiac care: an overview of the changes to pediatric basic and advanced life support.

The American Heart Association (AHA) has a strong commitment to implementing scientific research-based interventions for cardiopulmonary resuscitation and emergency cardiovascular care. This article presents the 2010 AHA major guideline changes to pediatric basic life support (BLS) and pediatric advanced life support (PALS) and the rationale for the changes. The following topics are covered in this article: (1) current understanding of cardiac arrest in the pediatric population, (2) major changes in pediatric BLS, and (3) major changes in PALS.