Women as mothers and grandmothers.

This chapter analyzes the literature on women as mothers; research reports published between January 1985 and December 1999 were reviewed. As in the past, almost all of the extant studies analyzed the experience of mothers in their children's first year of life. Although therapeutic suggestions were made in many studies, relatively few interventions have been implemented and evaluated. More studies are needed that go beyond traditional family forms and that explore mothers' role development over the full course of their children's growth and development. Additional longitudinal research that views maternal role development as a process is indicated.

Responsibility-centered management: a 10-year nursing assessment.

In 1988-89, Indiana University became the first public university to implement responsibility-centered management (RCM) comprehensively. This article describes and assesses the implementation of RCM on the core campus of Indiana University School of Nursing in Indianapolis. It describes how RCM encouraged an information-rich environment, particularly with the advent of economic modeling; decision making linked to strategic goals/objectives; and a performance-based reward structure (e.g., merit pay increases and incentive plans). It ends with a discussion about the worth of RCM and the changes that frame-work produced, particularly in reconceptualizing the roles of the business officer and dean. The most profound consequence of RCM may be the effect it has in encouraging rethinking of what it means to be a school of nursing at this point in time.

Nursing and gerontology.

This article, originally prepared as a think piece for The John A. Hartford Foundation, explores the interrelationship between nursing and gerontology: strengths nursing brings to the area of aging; challenges that must be addressed both at the societal level and within the profession for nursing to achieve its full potential in gerontology; and strategies that might be adopted to maximize strengths and address identified gaps. These strategies include high-lighting the heroic behaviors of the gerontologic nurse, increasing support for gerontologic advanced practice nursing, promoting collaborative gerontologic research, encouraging dissemination of nursing's knowledge base, and collaborating with foundations to promote self-care. It is proposed that nursing's research-practice agenda in the third millennium must be: preventing disease where possible; minimizing morbidity and maximizing quality of life when disease cannot be prevented, and having the wisdom to reconcile the two.

The Postpartum Support Questionnaire: reliability and validity.

Support has been found to be related to perinatal health, resulting in the development of the Postpartum Support Questionnaire based on the four categories of support (informational, material, emotional and comparison) identified by House (1981) and Cronenwett (1985). Data from four studies (N = 207) provided evidence of the psychometric properties of the instrument. Internal consistency reliability was demonstrated (alpha = .90 to .94 for total instrument). Test-retest reliability ranged from .69 to .79 for total scores and .30 to .79 for for categories of support. Measures of concurrent validity with the Personal Resource Questionnaire .85 were .42 and .48 at 6 and 8 weeks postpartum. Confirmatory factor analysis using LISREL 7 supported the four categories of support, but the use of these factors separately remains to be demonstrated.

Social support and postpartum depression.

Discrepancies between prenatal social support expectations and subsequent perceptions of support actually received were examined in relation to postpartum depression. Low-risk primiparous women (N = 105) were surveyed 1 month before and 1 month after delivery. Almost half of the women prenatally and one third postpartially had depression scores which would lead them to be classified as possibly depressed (CES-D scores of 16 or greater). In multiple regression, two social support discrepancy measures, prenatal depression and postpartal closeness to husband, correlated with postpartal depression and accounted for nearly 40% of its variance. The generalizability of the findings should be further explored, but the findings suggest the need for attention to prenatal expectations of postpartum support as a way to influence the incidence of postpartum depression. In addition, continued efforts to identify causes of postpartum closeness with the spouse are needed.

Strategies to implement geropsychiatric nursing curricula content.

1. Before a curriculum revolution can take place, the health care system must confront its orientation toward mortality; the inadequacies of our theoretical frameworks and research must be addressed; and gerontology and geropsychiatry/geropsychology must be recognized as a nontraditional specialty and subspecialty. 2. Geropsychiatric care will not come into its own if certain stereotypes and assumptions are not changed. One challenge is for health care providers to become involved in a reformulation of the public's stereotyped image of older adults, which reinforces prejudices rather than possibilities. 3. Collectively, geropsychiatric nurses must communicate the excitement of their field to students, faculty, alumni, patients, colleagues in other disciplines, and the media.

From gynecology to GYN-ecology: developing a practice-research agenda for women's health.

Women's health as an area of specialization has moved away from a focus on gynecology to a focus on GYN-ecology, meaning a concern for the fit between the woman and her environment. To be concerned about the fit between person and environment demands an understanding of the extent to which individual behavior is constrained or facilitated by contextual factors: Do larger sociopolitical conditions exist in which a woman can perform the activities of daily living in a way that maximizes her sense of well-being? Seven factors are explored to illustrate the many ways in which women's health has been traditionally constrained by contextual factors. Suggestions for a comprehensive practice-research agenda for women's health are then presented.