Evaluation of a dressing to reduce nipple pain and improve nipple skin condition in breast-feeding women.

This study was designed to evaluate whether maintenance of a moist environment on the nipple skin during the first week of breast-feeding would improve damaged nipple skin condition, as indicated by the presence of eschar, erythema, and fissures, and reduce pain. Fifty White women applied a polyethylene film dressing with a perimeter adhesive system to a randomly determined nipple. The dressing was present at all times except during feeding. Subjects were assessed every 48 hours (four times) over 7 days. Serial photographic slides were obtained and assessed for skin characteristics. Nipple pain was self-rated with a verbal descriptor scale. Use of an occlusive film dressing on nipple skin during the first week of breast-feeding appeared to have limited influence on improvement in damaged skin condition. Summary scores indicated significant reduction in the amount of eschar on the surface of the nipple. There were no differences in erythema intensity or fissure severity. Use of a dressing significantly reduced nipple pain during the study period.

Skin changes and pain in the nipple during the 1st week of lactation.

OBJECTIVE: To document skin changes in the nipple during the 1st week of breastfeeding and to explore the relationship of such changes to pain. DESIGN: Longitudinal descriptive study. Subjects were visited four times during the 1st week of breastfeeding. SAMPLE: Convenience sample of 20 Caucasian women. SETTING: Hospital and home. MAIN OUTCOME MEASURES: Observed skin characteristics of the nipple included erythema, edema, fissures, blisters, inflamed areas, eschar, white patches, dark patches, yellow patches, peeling, pus, and ecchymosis. Subject-rated nipple pain. RESULTS: Skin changes were identified and quantified. Changes were visible in 100% (20) of the sample, and 65% (13) had severe skin damage; 90% (18) of the subjects reported pain. Some correlations between skin characteristics and pain were statistically significant, but not clinically meaningful. Skin damage was concentrated on the tip of the nipple. CONCLUSIONS: The data chronicle skin changes and their relationship to nipple pain during the 1st week of breastfeeding. Normal neonatal sucking appears to induce a suction wound on the skin of the nipples of many breastfeeding women that may account for pain experienced at the onset of lactation.

Doctoral programs in nursing: philosophy, curricula, and program requirements.

This study examined the philosophy, curricula, and program requirements of doctoral nursing programs in the United States. Forty-four doctoral nursing programs were solicited by mail and information about doctoral nursing programs was obtained. Of the programs, 31 offer the doctor of philosophy degree, 11 the doctor of nursing science degree, and 1 the doctor of education degree. Program philosophies could not be distinguished from one another. Eighteen doctoral programs offered advanced clinical courses and 22 programs focused on role preparation; 16 offered both clinical and role preparation. There was much variation in credit requirements, but the standard program was 60 credits in length, with 48 credits in nursing and 12 credits in cognates and electives. Approximately half the required credits focused on research. The similarity in the curricula of doctoral programs is striking. Discipline-specific values may be strong and account for the congruence in the types of curricula found in this study. Continued focus on research preparation, with varying degrees of emphasis on clinical or role development, is expected. The dominance of the doctoral degree as the terminal degree for nursing is likely to continue.

Curricula of doctoral programs in nursing.

Each doctoral program possesses unique features that reflect the special characteristics of the faculty, the environment, and the students of its respective institution. This study focused more narrowly on the formalized structure of programs of study available in printed literature which does not fully capture the richness of doctoral education. While most doctoral programs in this country appear to possess curricular elements of quality previously identified by AACN with respect to curricular issues in the areas of research, theory construction, and philosophy, there was much more variation in the curricular content focusing on areas of substantive nursing knowledge, and data management, tools, and technology.

Breastfeeding the low-birthweight infant.

Human milk remains an important nutritional source for the low-birthweight infant, although supplementation may be necessary. Information on breast pumping, milk collection and storage, and breastfeeding techniques will help the new mother facilitate human milk feeding for her low-birthweight infant. Providing a supportive environment for the new mother to establish lactation at a time when her infant remains hospitalized is a challenge for the neonatal nurse.

Effects of information on postsurgical coping.

This study examined the effects of providing patients with selected types of information prior to surgery and the reported frequency of use of coping behaviors following surgery. The relationship of the reported frequency of coping behaviors and outcomes of surgery was also explored. A total of 111 patients were randomly assigned to three groups. One received procedure information; a second, procedure and sensation information; and a third group, procedure and sensation information, plus information on selected coping strategies. Results showed no evidence that the type of information provided for patients prior to surgery increased the reported frequency of coping behaviors or that the reported frequency of coping behaviors was related to improved outcomes as evaluated by pain intensity, distress, or selected physical complications.