RÉSUMÉ
Importance: Improving birth outcomes for low-income mothers is a public health priority. Intensive nurse home visiting has been proposed as an intervention to improve these outcomes. Objective: To determine the effect of an intensive nurse home visiting program on a composite outcome of preterm birth, low birth weight, small for gestational age, or perinatal mortality. Design, Setting, and Participants: This was a randomized clinical trial that included 5670 Medicaid-eligible, nulliparous pregnant individuals at less than 28 weeks' gestation, enrolled between April 1, 2016, and March 17, 2020, with follow-up through February 2021. Interventions: Participants were randomized 2:1 to Nurse Family Partnership program (n = 3806) or control (n = 1864). The program is an established model of nurse home visiting; regular visits begin prenatally and continue through 2 postnatal years. Nurses provide education, assessments, and goal-setting related to prenatal health, child health and development, and maternal life course. The control group received usual care services and a list of community resources. Neither staff nor participants were blinded to intervention group. Main Outcomes and Measures: There were 3 primary outcomes. This article reports on a composite of adverse birth outcomes: preterm birth, low birth weight, small for gestational age, or perinatal mortality based on vital records, Medicaid claims, and hospital discharge records through February 2021. The other primary outcomes of interbirth intervals of less than 21 months and major injury or concern for abuse or neglect in the child's first 24 months have not yet completed measurement. There were 54 secondary outcomes; those related to maternal and newborn health that have completed measurement included all elements of the composite plus birth weight, gestational length, large for gestational age, extremely preterm, very low birth weight, overnight neonatal intensive care unit admission, severe maternal morbidity, and cesarean delivery. Results: Among 5670 participants enrolled, 4966 (3319 intervention; 1647 control) were analyzed for the primary maternal and neonatal health outcome (median age, 21 years [1.2% non-Hispanic Asian, Indigenous, or Native Hawaiian and Pacific Islander; 5.7% Hispanic; 55.2% non-Hispanic Black; 34.8% non-Hispanic White; and 3.0% more than 1 race reported [non-Hispanic]). The incidence of the composite adverse birth outcome was 26.9% in the intervention group and 26.1% in the control group (adjusted between-group difference, 0.5% [95% CI, -2.1% to 3.1%]). Outcomes for the intervention group were not significantly better for any of the maternal and newborn health primary or secondary outcomes in the overall sample or in either of the prespecified subgroups. Conclusions and Relevance: In this South Carolina-based trial of Medicaid-eligible pregnant individuals, assignment to participate in an intensive nurse home visiting program did not significantly reduce the incidence of a composite of adverse birth outcomes. Evaluation of the overall effectiveness of this program is incomplete, pending assessment of early childhood and birth spacing outcomes. Trial Registration: ClinicalTrials.gov Identifier: NCT03360539.
Sujet(s)
Soins infirmiers à domicile , Visites à domicile , Complications de la grossesse , Enfant , Enfant d'âge préscolaire , Femelle , Soins infirmiers à domicile/économie , Soins infirmiers à domicile/statistiques et données numériques , Visites à domicile/économie , Visites à domicile/statistiques et données numériques , Humains , Nourrisson à faible poids de naissance , Nouveau-né , Medicaid (USA)/économie , Medicaid (USA)/statistiques et données numériques , Mortalité périnatale , Pauvreté/économie , Pauvreté/statistiques et données numériques , Grossesse , Complications de la grossesse/économie , Complications de la grossesse/épidémiologie , Complications de la grossesse/soins infirmiers , Complications de la grossesse/prévention et contrôle , Issue de la grossesse/épidémiologie , Naissance prématurée/épidémiologie , Naissance prématurée/prévention et contrôle , Caroline du Sud/épidémiologie , États-Unis/épidémiologie , Jeune adulteRÉSUMÉ
Adverse childhood experiences and trauma significantly impact physical and mental health. Increased maternal perinatal depression/anxiety, preterm labor, and low birth weight, as well as infant morbidity and mortality, are some examples of the impact of trauma on perinatal health. Trauma-informed care begins with knowledge about trauma, the ability to recognize signs of a trauma response, responding to patients effectively, and resisting retraumatization. As holistic providers, perinatal nurses can create safe care environments, establish collaborative patient relationships based on trust, demonstrate compassion, offer patients options when possible to support patient autonomy, and provide resources for trauma survivors. This can prevent or reduce the negative impact of trauma and improve the health and well-being of infants, mothers, and future generations. This clinical article outlines key strategies for implementation of patient-centered trauma-informed perinatal nursing care.
Sujet(s)
Expériences défavorables de l'enfance/prévention et contrôle , Soins infirmiers holistiques/méthodes , Soins infirmiers maternels et infantiles/méthodes , Soins infirmiers en néonatalogie/méthodes , Complications de la grossesse , Troubles liés aux traumatismes et au stress , Dépression du postpartum/complications , Dépression du postpartum/soins infirmiers , Femelle , Humains , Nourrisson , Mortalité infantile , Nouveau-né , Effets indésirables à long terme/soins infirmiers , Effets indésirables à long terme/prévention et contrôle , Santé mentale , Travail obstétrical prématuré/soins infirmiers , Travail obstétrical prématuré/psychologie , Soins centrés sur le patient , Grossesse , Complications de la grossesse/soins infirmiers , Complications de la grossesse/psychologie , Troubles liés aux traumatismes et au stress/étiologie , Troubles liés aux traumatismes et au stress/soins infirmiers , Troubles liés aux traumatismes et au stress/prévention et contrôleRÉSUMÉ
Screening and brief counseling interventions are evidence-based approaches.
Sujet(s)
Consommation d'alcool , Complications de la grossesse/psychologie , Consommation d'alcool/effets indésirables , Alcoolisme/complications , Alcoolisme/diagnostic , Assistance , Femelle , Troubles du spectre de l'alcoolisation foetale/étiologie , Humains , Relations infirmier-patient , Grossesse , Complications de la grossesse/soins infirmiers , Effets différés de l'exposition prénatale à des facteurs de risqueRÉSUMÉ
Saiba mais em www.saopaulo.sp.gov.br/coronavirus/planosp
Sujet(s)
Betacoronavirus , Pneumopathie virale/prévention et contrôle , Infections à coronavirus/prévention et contrôle , Pandémies/prévention et contrôle , Transmission verticale de maladie infectieuse/prévention et contrôle , Santé Maternoinfantile , Complications de la grossesse/soins infirmiersRÉSUMÉ
Objetivo: Identificar a importância da assistência de enfermagem às gestantes com Síndrome Hipertensiva Gestacional. Método: Estudo bibliográfico, descritivo e exploratório, realizado busca no banco de dados da Biblioteca Virtual em Saúde (BVS), Sistema Latino-Americano e do Caribe de Informações em Ciências da Saúde (LILACS), Scientific Eletrônic Library Online (SCIELO) e Bancos de dados em enfermagem (BDENF). Resultados: A Síndrome Hipertensiva da Gravidez (SHEG) apresenta como uma das mais importantes complicações durante o ciclo gravídicopuerperal e a sua etiologia ainda permanece desconhecida. A pré-eclâmpsia evolui naturalmente e quando não tratada/interrompida a gestação, ocorre o desenvolvimento para as formas mais graves, especialmente, a eclampsia e a síndrome HELLP. É de grande importância que o profissional de enfermagem atue de forma mais efetiva e presente, para que as reais necessidades das pacientes sejam supridas, havendo melhora do quadro clínico e eventuais complicações sejam evitadas. Conclusões: A assistência efetiva durante o pré-natal, pelos profissionais, diminui os índices de SHEG em gestantes e as tiram do grupo de risco, principalmente as que possuem fatores predisponentes e etiológicos. Assim, é possível descrever a atuação do enfermeiro frente à patologia, observando a necessidade de um trabalho conjunto à uma equipe multidisciplinar para que ocorra um atendimento eficaz à gestante (AU)
This study aimed to identify and characterize the importance of nursing care for pregnant women with Gestational Hypertensive Syndrome. Method: Bibliographic,descriptive and exploratory study, searches the database of the Virtual Health Library (VHL), Latin American and Caribbean Health Sciences Information System (LILACS), Scientific Electronic Library Online (SCIELO) and Banks. of Nursing Data (BDENF). Results: Hypertensive Pregnancy Syndrome (SHEG) is one of the most important complications during the pregnancy-puerperal cycle and its etiology is still unknown. Preeclampsia evolves naturally and when untreated / interrupted pregnancy develops into the most severe forms, especially eclampsia and HELLP syndrome. It is of great importance that the nursing professional acts more effectively and present, so that the real needs of patients are met, with improvement of the clinical picture and eventual complications are avoided. Conclusions: The effective prenatal care by professionals reduces the rates of SHEG in pregnant women and remove them from the risk group, especially those with predisposing and etiological factors. Thus, it is possible to describe the role of nurses in the pathology, noting the need for a joint work with a multidisciplinary team for effective care to pregnant women (AU)
Sujet(s)
Humains , Femelle , Grossesse , Complications de la grossesse/soins infirmiers , Hypertension artérielle gravidique/soins infirmiers , Infirmiers spécialisés , Pré-éclampsie , Santé publique , HELLP syndrome , Éclampsie/prévention et contrôleRÉSUMÉ
INTRODUCCIÓN: En la actualidad, se conoce que el lupus eritematoso sistémico no afecta a la fertilidad; sin embargo, el embarazo en mujeres que lo padecen se asocia a riesgos, tanto maternos como fetales. OBJETIVO: Determinar las variables que intervienen en la preparación y control de la gestación en mujeres con lupus eritematoso sistémico, así como las medidas de enfermería más importantes. MATERIAL Y MÉTODO: Se ha realizado una revisión integrativa mediante una búsqueda en las bases de datos Proquest, Pubmed y Web of Science. Se incluyeron artículos científicos originales, observacionales y de revisión, en inglés y español, excluyendo aquellos artículos anteriores a 2009 o que no estuviesen en texto completo. RESULTADOS: Se han incluido 15 artículos publicados entre el año 2009 y 2019. El embarazo en pacientes con lupus eritematoso sistémico es complejo, ya que necesita de un control exhaustivo y continuo para conseguir buenos resultados. Un cambio de tratamiento, test de laboratorio cada cierto tiempo y la vigilancia de un equipo multidisciplinar, harán que la enfermedad se encuentre controlada y los riesgos de complicaciones maternas y fetales disminuyan. CONCLUSIONES: En la actualidad, la mayoría de las mujeres con lupus eritematoso sistémico pueden conseguir el objetivo de la maternidad, siempre y cuando la enfermedad se encuentre controlada al menos 6 meses antes de la concepción y durante todo el embarazo. Las variables más determinantes en el embarazo de la mujer con lupus eritematoso sistémico son la fertilidad, las complicaciones o el tratamiento, que influyen de forma directa sobre el embarazo
INTRODUCTION: At present, it is known that systemic lupus erythematosus does not affect fertility; however, pregnancy in these women is associated with risks, both maternal and fetal. OBJECTIVE: To determine the variables involved in the preparation and control of pregnancy in women with systemic lupus erythematosus, as well as the most important nursing actions. MATERIAL AND METHOD: An integrative review has been carried out through a search in the ProQuest, PubMed and Web of Science databases. Original, observational and review scientific articles were included, in English and Spanish, excluding those articles published before 2009 or that were not in full text in the databases. RESULTS: 15 articles published between 2009 and 2019 have been included. Pregnancy in patients with systemic lupus erythematosus is complex. Comprehensive and continuous control is required to achieve good results. A change of treatment, laboratory tests from time to time and the monitoring of a multidisciplinary team will control the disease and will reduce the risk of maternal and fetal complications. CONCLUSIONS: Currently, most women with systemic lupus erythematosus can achieve the goal of motherhood, if the disease is controlled at least 6 months before conception and throughout pregnancy. The most determinant variables in pregnancy of women with systemic lupus erythematosus are fertility, complications or treatment, which directly influence pregnancy
Sujet(s)
Humains , Femelle , Grossesse , Nouveau-né , Complications de la grossesse/soins infirmiers , Lupus érythémateux disséminé/soins infirmiers , Issue de la grossesse , Lupus érythémateux disséminé/épidémiologie , Lupus érythémateux disséminé/thérapie , Complications de la grossesse/épidémiologie , Complications de la grossesse/thérapieRÉSUMÉ
The model of group prenatal care was initially developed to include peer support and to improve education and health-promoting behaviors during pregnancy. This model has since been adapted for populations with unique educational needs. Mama Care is an adaptation of the CenteringPregnancy Model of prenatal care. Mama Care is situated within a national and international referral center for families with prenatally diagnosed fetal anomalies. In December 2013, the Center for Fetal Diagnosis and Treatment at Children's Hospital of Philadelphia began offering a model of group prenatal care to women whose pregnancies are affected by a prenatal diagnosis of a fetal anomaly. The model incorporates significant adaptations of CenteringPregnancy in order to accommodate these women, who typically transition their care from community-based settings to the Center for Fetal Diagnosis and Treatment in the late second or early third trimester. Unique challenges associated with caring for families within a referral center include a condensed visit schedule, complex social needs such as housing and psychosocial support, as well as an increased need for antenatal surveillance and frequent preterm birth. Outcomes of the program are favorable and suggest group prenatal care models can be developed to support the needs of patients with prenatally diagnosed fetal anomalies.
Sujet(s)
Malformations/diagnostic , Complications de la grossesse/liquide cérébrospinal , Prise en charge prénatale/méthodes , Diagnostic prénatal/méthodes , Malformations/soins infirmiers , Femelle , Processus de groupe , Humains , Nouveau-né , Modèles de soins infirmiers , Grossesse , Complications de la grossesse/diagnostic , Complications de la grossesse/soins infirmiersRÉSUMÉ
BACKGROUND: A significant proportion of women with Severe Mental Illness (SMI) will become mothers during their reproductive life. These pregnancies are, however, more at risk of psychiatric, obstetrical and neonatal complications (increased risks of post-partum depression, relapse, suicide, gestational diabetes, placental abnormalities or low birth weight). Midwives often feel isolated and resourceless when taking care of these women. Specialized units such as mother-infant psychiatric units or the Transversal Unit of Perinatal Care (UTAP) in the Grenoble Alpes University Hospital (CHUGA) enhance the coordination between psychiatric and obstetrical teams and have shown effectiveness in improving maternal and child outcomes. OBJECTIVES: i) to assess midwives' feelings about the postpartum care of women with SMI; ii) to determine UTAP's impact on this feeling and its determinants; iii) to look for unmet needs. METHODS: This study is a prospective, exploratory, qualitative analysis. Twenty midwives from Grenoble Alpes University Hospital who took care of one of the selected patients participated in this study. Two women had schizophrenia and one bipolar disorder. Interviews realized with a semi-structured guide were fully transcribed, anonymized and thematically analyzed. Topics have been structured according to the number of occurrences to build a thematic tree. RESULTS: Midwives felt insecure and resourceless when the postpartum care was unclear, insufficiently anticipated and in case of a danger for the women or the children. They felt uneasy when not feeling able to provide usual care to these patients (due to lack of specific knowledge about SMI and to the impossibility to consider their patient otherwise than through their pathology). Midwives felt at ease and secure when the postpartum care was anticipated. UTAP was identified as a resource for midwives. Specific training and improvements in the organization of the pre and post-natal care could improve midwives' feelings when taking care of women with SMI.
Sujet(s)
Attitude du personnel soignant , Troubles mentaux/psychologie , Profession de sage-femme , Période du postpartum/psychologie , Adulte , Émotions/physiologie , Femelle , Humains , Soins du nourrisson/psychologie , Nouveau-né , Troubles mentaux/soins infirmiers , Adulte d'âge moyen , Relations infirmier-patient , Parturition/physiologie , Parturition/psychologie , Période du postpartum/physiologie , Grossesse , Complications de la grossesse/soins infirmiers , Complications de la grossesse/psychologie , Études prospectives , Recherche qualitative , Indice de gravité de la maladie , Jeune adulteRÉSUMÉ
Objetivo: Develar el significado de la experiencia vivida de la hospitalización de mujeres con gestaciones de alto riesgo en una institución de salud en la ciudad de Medellín. Metodología: Esta es una investigación cualitativa realizada con el enfoque fenomenológico hermenéutico. La muestra fue definida por el criterio único de saturación a través de un muestreo de tipo intencional. Las participantes fueron cuatro mujeres que cumplieron con los criterios de inclusión. La recolección de la información se hizo mediante entrevista en profundidad, realizada en dos sesiones por participante, para un total de 8 entrevistas. De manera previa, se hizo un estudio exploratorio con una mujer que estuvo hospitalizada en otra institución, pero estos datos no forman parte de los resultados. El análisis de la información recopilada fue guiado por los cinco existenciales de Max Van Manen: cuerpo vivido, relación vivida, espacio vivido, tiempo vivido y cosas vividas. Resultados: Por medio de tres aproximaciones (holística, selectiva y línea a línea) se logró develar el mundo de cada una de las participantes a través de los cinco existenciales de Van Manen. En la experiencia cuerpo vivido, "Sos vos con el pensamiento", las mujeres relatan una lucha interna entre lo que sienten y lo que expresan. El significado de la relación vivida, Los tres otros, estuvo mediada por una conexión con un ser superior, ayudada por las relaciones con sus familiares y con el apoyo y la tranquilidad que les brindaba el personal de salud. Por su parte, el espacio vivido, transitando por los diferentes servicios, fue significativo ya que tuvo en cuenta el lugar y los sucesos ocurridos en el espacio, y estos permitieron percibir vivencias con diferentes matices. En cuanto a la experiencia tiempo vivido, el pasado que anticipa el futuro, se refiere a experiencias pasadas que influyen los sentimientos, pensamientos y las emociones del presente. Por último, las cosas vividas, (como, cuando me lo quitaban en la noche, que no me hacían monitoreo, sentía como una paz) expresan, en este caso, la molestia por el uso de los dispositivos médicos, pero entendiendo que eran necesarios para su cuidado. Conclusiones: El significado de la experiencia vivida de la hospitalización es relatado por las participantes como una lucha interna con sus pensamientos; esto desencadena en ellas una cascada de emociones en la que los acontecimientos hacen que, de manera abrupta, pasen de una emoción a otra. La incertidumbre se siente a lo largo de la experiencia, es parte del proceso y se expresa de diferentes formas. A su vez, el paso del tiempo les permite percibir, de forma corporal, las implicaciones de las situaciones, y altera la experiencia del espacio que están habitando. Las mujeres quieren ser reconocidas por la complejidad de su enfermedad y por su proceso de embarazo, reclaman que las hagan sentir únicas y especiales a través de un cuidado humanizado. (AU)
Objective: To reveal lived experience meaning from women at Inpatient care high-risk pregnancies in Healthcare Facility at Medellin city. Methodology: Qualitative research with a hermeneutical phenomenological approach proposed by Max Van Manen. The sample was defined by a single criterion of saturation and through intentional sampling. Our participants were four women who met the inclusion criteria. The information was collected through an in-depth interview, carried out in two sessions by each participant for a total of 8 interviews, these were carried out after the exploratory study was done, which included the participation of a woman who was hospitalized in another institution but she isn´t part of the data. The information analysis was guided by Max Van Manen's five existentialist, lived body, lived relationship, lived space, lived time and lived things. Results: Through three holistic, selective and line by line approaches it was possible to unveil the life's world from each one participants by means of the five existential's comprehension In the experience of the lived body, the women relate "Are you with voices with thought "an internal struggle between what they feel and express. The meaning lived relationship: "The three others" were mediated by a connection with a higher being aided by family relationships and the support and tranquility provided by health personnel, for their part, the lived space: Transiting through the different services It was significant according to the place and the events that occurred within the space that made this experience perceived with different nuances. The time lived: The past that anticipates the future, the past experiences influenced their feelings, thoughts and emotions of the present and the other part the things lived "When they took it off me at night, they didn't monitor me, it felt like a peace" meant feeling discomfort for the use of the devices but understanding that they were necessary for their care. Conclusions: Their lived experience meaning from inpatient setting is lived and related by the participants as an internal struggle with their thoughts which triggers a cascade of emotions where events make them abruptly transition from one emotion to another. Uncertainty is felt throughout the experience, it is part of the process and is expressed in different ways. In turn, the passage of time allows them to perceive the implications of situations in a bodily way, altering the experience of the space they are inhabiting. Women want to be recognized for the complexity of their disease and their pregnancy process, they demand that they make them feel unique and special through humanized care. (AU)
Sujet(s)
Humains , Femelle , Grossesse , Complications de la grossesse/soins infirmiers , Grossesse à haut risque , Femmes enceintes , Recherche qualitative , Hospitalisation , Événements de vieRÉSUMÉ
Life expectancy for individuals with cystic fibrosis (CF) has significantly increased during the last few decades, and subsequently, more women with CF are considering pregnancy. A detailed understanding of the management of pregnancy, specific pulmonary treatments, and necessary medications is essential to provide specialized care for women with CF. In this article, we present the physical and psychosocial aspects of care for pregnant women with CF and describe a case involving the planned pregnancy of a nulliparous woman with CF. We suggest vigilant monitoring for adequate nutrition, weight gain, and pulmonary function throughout pregnancy as implications for nursing care.
Sujet(s)
Mucoviscidose/soins infirmiers , Soins infirmiers , Complications de la grossesse/soins infirmiers , Prise en charge prénatale/méthodes , Adulte , Mucoviscidose/thérapie , Femelle , Humains , Planification des soins du patient/organisation et administration , Grossesse , Complications de la grossesse/thérapie , Issue de la grossesse , PronosticRÉSUMÉ
El presente artículo se genera a partir de los resultados de la investigación: Creencias y prácticas de cuidado cultural de mujeres con morbilidad materna extrema (Hoyos & Muñoz, 2017). OBJETIVO: Describir las creencias y prácticas de cuidado cultural de mujeres que tuvieron morbilidad materna extrema, inasistentes al control prenatal y atendidas en un Hospital de la ciudad de Medellín-Colombia. MÉTODO: Cualitativo, etnográfico, utilizando la etnoenfermería propuesto por Leininger y la entrevista etnográfica de Spradley. Muestra: 17 mujeres con morbilidad materna extrema, inasistentes a control prenatal. RESULTADOS: Se encontró 3 temas generales y 2 taxonomías. CONCLUSIONES: El estudio concluyó que la mujer con morbilidad materna extrema, inasistente al control prenatal tiene sus propios modos de cuidado a sí misma y al hijo por nacer cuando está enferma, porque el acceso a los servicios en salud materna es deficiente. Palabras clave: Enfermería, etnoenfermería, cuidado cultural, salud, morbilidad materna extrema
The present article is generated from the results of the research: Beliefs and cultural care practices of women with extreme maternal morbidity (Hoyos & Muñoz, 2017). OBJECTIVE: To describe the cultural care beliefs and practices of women who had extreme maternal morbidity, who were not in control of prenatal care and who were treated at hospital in the city of Medellín, Colombia. Sample: 17 women with extreme maternal morbidity, not in control of prenatal care. METHOD: Qualitative, ethnographic, using ethno-nursing proposed by Leininger and Spradley's ethnographic interview. RESULTS: 3 general topics and 2 taxonomies were found. CONCLUSIONS: The study concluded that women with extreme maternal morbidity, who do not have prenatal care, have their own ways of caring for themselves and their unborn child when they are sick, because access to maternal health services is poor
Este artigo tem sua origen no projeto da pesquisa: Crenças e práticas de cuidados culturais de mulheres com extrema morbidade materna (Hoyos & Muñoz, 2017). OBJETIVO: Descrever as crenças e práticas de atenção cultural de mulheres que tiveram morbidade materna extrema, que não controlavam o pré-natal e que foram atendidas em um hospital da cidade de Medellín, na Colômbia. MÉTODO: Qualitativo, etnográfico, utilizando a etno-enfermagem proposto pela entrevista etnográfica de Leininger e Spradley. Amostra:17 mulheres com extrema morbidade materna, não controlando o pré-natal. RESULTADOS: Foram encontrados 3 tópicos gerais e 2 taxonomias. CONCLUSÕES: O estudo concluiu que as mulheres com morbidade materna extrema, que não controlam o pré-natal, têm suas próprias formas de cuidar de si mesmas e do nascituro quando estão doentes, porque o acesso aos serviços de saúde materna é fraco
Sujet(s)
Humains , Femelle , Grossesse , Soins adaptés sur le plan culturel , Complications de la grossesse/soins infirmiers , Soins infirmiers transculturels , Indice de gravité de la maladie , 25783 , Morbidité , ColombieSujet(s)
Mortalité maternelle/tendances , Complications de la grossesse/mortalité , Prise en charge prénatale , Facteurs socioéconomiques , Femelle , Humains , Soins infirmiers en obstétrique , Grossesse , Complications de la grossesse/ethnologie , Complications de la grossesse/soins infirmiers , Complications de la grossesse/prévention et contrôle , États-UnisRÉSUMÉ
The growing opioid crisis in the United States affects childbearing women and their infants at an alarming rate. Substance use disorders in pregnancy have transitioned from a topic barely addressed to one that has become mainstream in the issue of pregnancy management. Opioid use can include appropriate use of a prescribed medication, the misuse of street drugs, and maintenance on an opioid agonist treatment such as methadone. Identifying this population of childbearing women is critical to be able to organize the appropriate resources and to provide a comprehensive multidisciplinary evidence-based plan of care. All clinicians need to be educated in identifying and caring for the growing population of women with substance use disorders. Each component of the continuum from prenatal care, labor and birth, and postpartum has challenges and issues that can have a positive or negative impact on the outcome of the pregnancy and the mother-infant relationship. Risk assessment, medication-assisted treatment, pain management, and fostering maternal-infant bonding are important considerations in the care of the woman with substance use disorder. Unbiased empathetic nurses are well positioned to strongly advocate and intervene on behalf of women with substance use disorder, which in turn will help to create positive outcomes for the mother and her baby.
Sujet(s)
Syndrome de sevrage néonatal/prévention et contrôle , Troubles liés aux opiacés/prévention et contrôle , Complications de la grossesse/prévention et contrôle , Prise en charge prénatale , Femelle , Humains , Nouveau-né , Syndrome de sevrage néonatal/soins infirmiers , Soins infirmiers en obstétrique , Troubles liés aux opiacés/soins infirmiers , Grossesse , Complications de la grossesse/soins infirmiersSujet(s)
Soins infirmiers en obstétrique/normes , Guides de bonnes pratiques cliniques comme sujet , Complications de la grossesse/étiologie , Issue de la grossesse , Prise en charge prénatale/normes , Troubles liés à une substance/diagnostic , Adulte , Femelle , Politique de santé/législation et jurisprudence , Humains , Nouveau-né , Rôle de l'infirmier , Processus politique , Période du postpartum , Grossesse , Complications de la grossesse/soins infirmiers , Complications de la grossesse/physiopathologie , Sociétés des infirmiers et infirmières/normes , Troubles liés à une substance/complications , Troubles liés à une substance/thérapie , États-Unis , Santé des femmes , Jeune adulteRÉSUMÉ
AIM: To examine public health nurses' education, training, and professional support needs in perinatal mental health. BACKGROUND: Public health nurses have a key role in supporting maternal mental health including screening, support, referral, and decreasing stigmatization. DESIGN: A cross-sectional survey. METHODS: Data were collected from a convenience sample of Irish public health nurses (N = 105) from December 2016-February 2018. The anonymous postal survey consisted of the Perinatal Mental Health Questionnaire, Mental Illness: Clinician's Attitudes scale and Perinatal Mental Health Learning Needs questionnaire. RESULTS: Public health nurses reported good levels of knowledge (77.2%) and confidence (83.8%) in recognising women experiencing stress, anxiety and depression. They indicated less confidence in caring (50.5%) for women. The average score for the Mental Illness: Clinician's Attitudes scale was 35.9 (SD 5.9), suggesting positive attitudes towards women with significant mental illness. CONCLUSION: Public health nurses require educational opportunities to explore expressions of psychological distress across cultures and their own personal attitudes to mental health, systems of clinical supervision, and support pathways. IMPACT: Generating new knowledge on the importance of incorporating an attitude component in perinatal mental health education for public health nurses.
Sujet(s)
Formation continue infirmier/organisation et administration , Troubles mentaux/soins infirmiers , Évaluation des besoins , Complications de la grossesse/soins infirmiers , Soins infirmiers en santé publique , Adulte , Études transversales , Femelle , Humains , Irlande , Adulte d'âge moyen , Grossesse , Perfectionnement du personnel , Enquêtes et questionnairesRÉSUMÉ
Critical care nurses are faced with many challenges, and one that is particularly stressful is caring for obstetric patients. This care can become more complex when the obstetric patient requires extracorporeal membrane oxygenation. It is imperative that critical care nurses have knowledge about this unique population, the expected physical changes of pregnancy, and the management of extracorporeal membrane oxygenation. Obstetric patients present unique challenges, and care is focused on the woman and her family. The purpose of this paper is to provide information for critical care nurses regarding care of obstetric patients who receive extracorporeal membrane oxygenation.
Sujet(s)
Soins infirmiers intensifs/normes , Oxygénation extracorporelle sur oxygénateur à membrane/soins infirmiers , Soins infirmiers en obstétrique/normes , Guides de bonnes pratiques cliniques comme sujet , Complications de la grossesse/soins infirmiers , Adulte , Femelle , Humains , Grossesse , Résultat thérapeutiqueRÉSUMÉ
BACKGROUND: The ability to adopt and implement health promotion behaviors is one of the most important determinants of health status. Various factors affect the successful changing of behaviors and choosing a healthy lifestyle. The present study aims at exploring the experiences of overweight pregnant women in terms of the factors influencing selection and adoption of health promoting behaviors during pregnancy. METHODS: This qualitative study reports the findings of individual and group in-depth interviews with 32 overweight pregnant women using semi-structured questions which was conducted in Tabriz-Iran in 2017 and lasted for 6 months. The data collection continued until the saturation of the data. Participants were selected using purposive sampling and study inclusion criteria. Interviews were recorded and transcribed. Thereafter, content analysis was made using MAXQDA v. 10. Strength of data was verified by both participants and external control. RESULTS: The reported effective factors led to identification of the two themes of two contextual perceived barriers and facilitators, which were classified into four main categories and nine subcategories: 1. Individual barriers (disabilities-additional needs in pregnancy and mental barriers) 2. Socio- environmental barriers (adverse effects of the environment, adverse effects of the relatives and financial pressures) 3. Individual facilitators (intrinsic incentives, abundance and individual skills) 4. Socio- environmental (social and family support, incentive environments, and raising awareness). CONCLUSION: The adoption of health behaviors and healthy lifestyle is under the mutual influence of individual characteristics and socio-environmental factors. What should be considered in planning and designing interventions is focused on removing barriers and strengthening facilitators, in particular by moderating social factors and taking into account individual needs and personal expectations.
Sujet(s)
Éducation pour la santé/méthodes , Promotion de la santé/méthodes , Surpoids/prévention et contrôle , Complications de la grossesse/prévention et contrôle , Adulte , Femelle , Humains , Mode de vie , Surpoids/soins infirmiers , Surpoids/psychologie , Grossesse , Complications de la grossesse/soins infirmiers , Complications de la grossesse/psychologie , Femmes enceintes/psychologie , Soutien social , Jeune adulteRÉSUMÉ
OBJECTIVE: The study was conducted to determine the effects of prenatal education on quality of life and complaints during pregnancy. METHODS: This study is a quasi-experimental research with a control group. Personal Information Form and Scale of Complaints during Pregnancy and their Effects on Quality of Life (SCPEQL) were used to collect the data. Thirty participants were included in both the control and the intervention groups (N = 60). RESULTS: The mean scores of SCPEQL of the intervention group was 46.2 ± 21.1 and the mean scores of SCPEQL of the control group was 99.8 ± 21.6 in 2nd trimester. In the 3rd trimester, the mean score of SCPEQL of the intervention group was 43.5 ± 16.4, and the mean score of SCPEQL of the control group was 108.0 ± 16.8. The difference between the groups was statistically significant in 2nd and 3rd trimesters (p < 0.05). CONCLUSION: Findings of the study suggest that providing prenatal education reduces complaints and increases quality of life of pregnant women. PRACTICE IMPLICATIONS: Assessing complaints during pregnancy by nurses is a part of the prenatal care. Therefore, nurses should evaluate pregnancy-related complaints. Quality of life should be increased by giving effective education about complaints during pregnancy.