Baby lost and found: mothers' experiences of infants who cry persistently.

INTRODUCTION: The purpose of this study was to describe mothers' experiences of parenting an irritable infant. Although "colic" is regarded as a "self-limiting" condition that usually disappears by 3 to 4 months of age, the entire family is affected by the infant's crying; no definitive cause or cure has been identified. SAMPLE AND SETTING: Twelve middle-class married mothers (mean age=27.6 years) of irritable infants were interviewed. The women responded to open-ended questions, beginning with a description of the "typical day" with the infant. All interviews were tape recorded, transcribed verbatim, and entered into the AtlasTi qualitative analysis program. Grounded theory methods were used to analyze the data. Transcripts were read repeatedly to verify coding and emerging concepts. RESULTS: The basic social psychological problem was the loss of the perceived baby and competence as a mother. The psychosocial process was the search for the baby and sense of self as mother. Processes involved cycles of hope and despair and trial and error as mothers became more isolated. DISCUSSION: Implications for practitioners include support and listening to mothers during this difficult period.

Faculty retirement: stemming the tide.

The shortage of nursing faculty is becoming a crisis in schools of nursing and is contributing to the shortage of qualified graduates to add to the nursing workforce. Aging and retirement of existing faculty contribute to the crisis. Creating retention initiatives may encourage faculty to postpone retirement. This article explored the conditions and situations which would entice faculty to continue working beyond their intended retirement date. Faculty identified workload and responsibilities, available resources, personal and professional characteristics, and work environment as areas that could be developed into incentives to remain in the faculty workforce.

Revision and psychometric testing of the Barton Hospital Picture Test.

The Barton Hospital Picture Test (BHPT) is an instrument designed to elicit self-reports of stress in hospitalized children. This article reports two studies. The results of Study 1 were used to revise the pictures. Study 2 determined the reliability and validity of the revised BHPT. The revised BHPT has construct validity demonstrated by differences in total stress scores in the expected direction between hospitalized and community (well) children. The instrument has acceptable test-retest, interrater, and internal consistency reliability.

Physiologic and behavioral responses to stress, temperament, and incidence of infection and atopic disorders in the first year of life: a pilot study.

The purpose of this pilot study was to explore relationships among physiologic and behavioral responses to a standardized stressor (routine immunization), parent-reported temperament, and numbers of infections and atopic disorders in the first year of life. Infants were studied during 2- (n = 30) and 4-month (n = 24) routine clinic visits. Behavioral data were coded from videotapes filmed for 90 seconds after immunizations. Salivary cortisol measured physiologic arousal; specimens were obtained before and after immunizations. Two-month-old infants with higher levels of cortisol required more time to calm after immunization. Relationships were found between the temperament characteristics of persistence and adaptability and infections at 12 months.

Integral Nursing: an emerging framework for engaging the evolution of the profession.

These are turbulent times for health care as well as nursing. Nursing needs to consciously evolve to survive and thrive in the 21st century. The authors suggest that nursing has many of the theoretical and conceptual models needed to facilitate this evolution. However, the profession would benefit from the addition of a comprehensive framework that can integrate various aspects of nursing and serve as a device to effectively interface nursing with the rest of the health care system. We believe that the Integral Nursing approach described here is such a framework. In this article, we describe the model and explore benefits of its application for nursing within health care.

Parents' assistance to children having immunizations.

The purpose of this descriptive study was to determine parents' naturally occurring assistive actions when their child received immunizations. Additional purposes included describing the preparation the parent provided to the child prior to the immunization and parents' plans for assistance following the immunization. The convenience sample included 41 parents (or grandparents) of 40 children between the ages of 18 months and 6 years who were receiving routine immunizations at two urban and five rural clinics in the Midwest. Parents were interviewed regarding plans to assist their child before and after immunization; actual parent-child interactions during immunizations were audiotaped. Data were analyzed descriptively; researchers worked in pairs to achieve 100% inter-rater agreement when coding observations into themes. The parents reported using nine psychological preparation strategies (i.e., procedural information, sensory information, relaxation training, telling the child why the procedure was necessary, and role play) to assist their children in the preparatory phase. Three strategies were used both during (procedural information, distraction, and physical contact) and after (physical contact, praise, and rewards) the immunization. Ten children received no preparation for the immunization; nine of these were younger than 3 years of age. The single most reported source of information to parents about helping their child with immunizations was their physician.