The relationship between posttraumatic stress symptoms of maternity professionals and quality of work life, cognitive status, and traumatic perinatal experiences.

PURPOSE: The purpose of this study was to determine the relationship between posttraumatic stress symptoms of maternity nursing/midwife and their quality of work life, cognitive distortions, and traumatic perinatal experiences. METHODS: A descriptive, cross-sectional survey design was used. Two hundred and sixty-six maternity nurses/midwives employed in maternity units of hospitals in a province located in the Central Anatolia Region of Turkey were included in the study. RESULTS: 37.2% of the maternity nurses/midwives met the criteria for posttraumatic stress disorder (% 95 CI [31.6, 43.2]). Previous birth-related traumatic experiences, transferring to another unit, and negative cognitions about the self-increase the risk of development of posttraumatic stress disorder by 63% (F = 7.638, P < 0.001). A positive correlation was found between the outcome variable PTS total score and the following predictors: the number of years in the profession, the number of traumatizing events, quality of work life, burnout symptoms, compassion fatigue, posttraumatic cognition, negative cognition about the world, and negative cognition about the self. It was found that those maternity nurses/midwives who were not happy with their profession, who witnessed a traumatic incident, who transferred to another unit, who considered to quit the profession, who had a history of a psychological disorder, and those lacked social life were more sensitive to posttraumatic stress symptoms. CONCLUSION: These outcomes have significant consequences for both personal and professional well-being of the maternity nurses/midwives and the welfare of the workforce. To prepare maternity nurses/midwives for such exposures, to support maternity nurses/midwives following traumatic perinatal events, and to provide effective intervention for those with significant symptoms, organizational strategies are necessary.

Association between the nationality of nurses and safety culture in maternity units of Oman.

BACKGROUND: Patient safety culture/climate in maternity units has been linked to better safety outcomes. Nurses have a crucial role in patient safety and represent the majority of staff in maternity units. In many countries, nurses are recruited from abroad, bringing their own perceptions of patient safety culture. Nonetheless, little is known about the relationship between perceptions of patient safety culture and nurses' nationality. Understanding this relationship will assist stakeholders in designing a responsive programme to improve patient safety culture. AIMS: To investigate the association between nurses' nationality and their perceptions about patient safety culture in maternity units in Ministry of Health hospitals in Oman. METHODS: In 2017, the Safety Attitude Questionnaire (SAQ) was distributed to all staff (892 distributed, 735 returned) in 10 maternity units. RESULTS: About three-quarters (74%, 541/735) of the returned SAQs were completed by nurses, of whom 34% were non-Omani, 21.8% were Omani and 44.7% did not report their nationality (missing). Overall, the mean safety score for non-Omani nurses was significantly higher than for the Omani nurses: 3.9 (SD 1.3) vs 3.6 (SD 1.2) (P < 0.001). The mean safety score for stress recognition was significantly lower for non-Omani nurses: 2.8 (SD 1.5) vs 3.2 (SD 1.3) (P < 0.001). CONCLUSION: Non-Omani nurses have a more positive perception of patient safety culture than Omani nurses except in respect of stress recognition. Decision-makers, directors, and clinicians should consider these differences when designing interventions to improve patient safety culture.

High-Fidelity Simulation and Clinical Judgment of Nursing Students in a Maternal-Newborn Course.

Clinical judgment, one's ability to think like a nurse, is an essential skill for safe nursing practice. With the rise of simulation to replace clinical experiences, there is limited evidence regarding the effectiveness of simulation on the development of clinical judgment. This study explored differences in clinical judgment in maternal-newborn courses between undergraduate nursing students participating exclusively in simulation and those participating in hospital-based clinical experiences. Following completion of the clinical rotation, students participated in an evaluative maternal-newborn high-fidelity simulation experience that was recorded and evaluated using the Lasater's Clinical Judgment Rubric (2007). Lasater's Clinical Judgment Rubric scores between the simulation and clinical practice groups were compared using an independent sample t-test. There was no statistical difference in clinical judgment scores between the simulation and hospital-based clinical groups (t = -1.056, P = .295). Our findings suggest that simulation may be a comparable alternative to clinical experience in nursing education.

Maternity Nurses' Knowledge about Sudden Unexpected Postnatal Collapse and Safe Newborn Positioning.

PURPOSE: Sudden unexpected postnatal collapse (SUPC) of healthy newborns in the first 2 days of life is increasing. These types of adverse events are known to be associated with unsafe positioning during skin-to-skin contact and breastfeeding. The purpose of the study was to determine maternity nurses' knowledge about SUPC and safe newborn positioning. DESIGN: Nurses who participate in a hosted listserv were solicited to complete a questionnaire. METHODS: An email with an embedded link to a 20-item questionnaire, the SUPC and Safe Positioning Knowledge Assessment Tool, and 16 demographic questions was sent to 605 maternity nurses in the United States who are part of a Perinatal Listserv for members of the Association of Women's Health, Obstetric and Neonatal Nurses. Scores were analyzed by mean, standard deviation, and percent correct answers. RESULTS: Fifty questionnaires were initiated (response rate of 8.2%), and 36 completed questionnaires (response rate of 5.9%) were analyzed. Maternity nurses' knowledge of SUPC was less than their knowledge of safe newborn positioning (61% correct vs. 72% correct; p < 0.001). CLINICAL IMPLICATIONS: Maternity nurses need more information about SUPC and safe newborn positioning, including risk factors, and effective strategies to reduce risk of preventable newborn harm.

How have the lives of pregnant women changed in the last 30 years?

BACKGROUND: To what extent have the characteristics and needs of pregnant women changed over time? This cross-sectional, comparative study describes some socio-demographic, mental health and lifestyle characteristics of two samples of pregnant women assessed 30 years apart. METHODS: We recruited two samples of pregnant women who were attending their first clinic visit at the same large Queensland maternity hospital 30 years apart between 1981 to 1984 (Sample A, N=6753) and 2011-2012 (Sample B, N=2156). The women were compared using the same survey tool. Descriptive statistics are presented. Pearson's chi-square tests were undertaken (significance at <0.05) to determine how the characteristics and needs of pregnant women may be changing over time. FINDINGS: Women, recently sampled, were older, more highly-educated and were more likely to be living with, but not married to, their partners, as well as having their first baby, than were women 30 years ago. As well, recently sampled, pregnant women were more likely to be non-smokers, to have higher body mass indexes and more symptoms of anxiety, but were less likely to be having an unplanned pregnancy. CONCLUSION: This study found a number of differences between the socio-demographic characteristics, lifestyles and mental health of two samples of pregnant women assessed 30 years apart. Our findings suggest the need for ongoing monitoring of pregnant women to determine changing health priorities. Being more educated, today's women may be more amenable to health education interventions. Higher body mass indexes for recently sampled women, highlights an emerging problem that needs to be addressed.

Attitudes of midwives and maternal child health nurses towards suicide: A cross-sectional study.

Perinatal women are at risk of depression and/or suicidality. Suicide is the highest cause of indirect maternal deaths in the perinatal period. Midwives and maternal child health nurses (MCHN), as key clinicians, need to be able to detect these mental health issues. Little is known about these clinicians' attitudes to suicide. In this paper, we report on the results of a cross-sectional study of midwives' and MCHN attitudes to suicide. A convenience sample of midwives (n = 95) and MCHN (n = 86) from south-eastern Victoria, Australia, was recruited into the study. Participants completed the Attitudes to Suicide Prevention Scale. The results showed that MCHN have more positive attitudes towards suicide prevention than midwives, and younger participants have more positive attitudes to suicide prevention compared to older participants. Midwives and MCHN could benefit from continuing professional education to build their knowledge and skills in assessing suicide risk for childbearing women and their families, increasing positive attitudes, improving detection, and mental health referrals.

Satisfacción materna con la experiencia del parto / Maternal satisfaction with the childbirth experience

OBJETIVO: analizar los factores predictores de la satisfacción delas mujeres con la experiencia del parto en el contexto público aragonés. MATERIAL Y MÉTODO: un total de 189 madres participaron en la investigación. La satisfacción de las mujeres con su parto fue calculada mediante la Escala de Satisfacción con el parto de Mackey durante su ingreso puerperal. RESULTADOS: la satisfacción de las mujeres fue elevada, destacando la labor de la matrona como la dimensión mejor valorada. Factores como el contacto precoz con el recién nacido, el desarrollo eutócico del parto, la multiparidad o el uso de la analgesia epidural se asociaron con niveles de satisfacción materna más elevados. CONCLUSIONES: existe cierto margen para la mejora de la satisfacción. La exploración específica de las expectativas de la mujer y su pareja es fundamental en su consecución

OBJECTIVE: to analyze those factors predicting satisfaction of women with the childbirth experience in the Aragonese publicsetting. MATERIALS AND METHOD: the research involved 189 mothers in total. Women's satisfaction with their childbirth was assessed through the Mackey Childbirth Satisfaction Scale during their postnatal hospitalization. RESULTS: the satisfaction of women with childbirth was high, and the work of the midwife was highlighted as the best valued dimension. Factors such as an early contact with the newborn, the normal development of childbirth, multiparity, or the use of epidural analgesics, were associated with higher levels of maternal satisfaction. CONCLUSIONS: there is a certain room for improvement in satisfaction. Specific examination of the expectations by women and their partners will be essential in order to achieve this

Potential Medicaid cost savings from maternity care based at a freestanding birth center.

OBJECTIVES: Medicaid pays for about half the births in the United States, at very high cost. Compared to usual obstetrical care, care by midwives at a birth center could reduce costs to the Medicaid program. This study draws on information from a previous study of the outcomes of birth center care to determine whether such care reduces Medicaid costs for low income women. METHODS: The study uses results from a study of maternal and infant outcomes at the Family Health and Birth Center in Washington, D.C. Costs to Medicaid are derived from birth center data and from other national sources of the cost of obstetrical care. RESULTS: We estimate that birth center care could save an average of $1,163 per birth (2008 constant dollars), or $11.6 million per 10,000 births per year. CONCLUSIONS: Medicaid is the leading payer for maternity services. As Medicaid faces continuing cost increases and budget constraints, policy makers should consider a larger role for midwives and birth centers in maternity care for low-risk Medicaid pregnant women.

Jordanian women's dissatisfaction with childbirth care.

BACKGROUND: Dissatisfaction with childbirth care can have a negative impact on a woman's health and well-being, as well as her relationships with her infant. AIM: To investigate the prevalence and associated factors of dissatisfaction with intrapartum care by Jordanian women. METHOD: A descriptive cross-sectional study was used. Participants (n = 320) who were 7 weeks post-partum were recruited from five maternal and child health centres in Irbid city in northern Jordan. Participants provided personal and obstetric information, and completed the Satisfaction with Childbirth Care Scale. RESULTS: The majority of women (75.6%) were dissatisfied with their intrapartum care. Dissatisfaction was associated with the attendance of unknown and unwanted persons during childbirth, experiencing labour as more painful than expected, and perceptions of inadequate help from healthcare providers to manage pain during labour. LIMITATIONS: Findings are limited to Jordanian women accessing public sector perinatal health services. CONCLUSION: The high percentage of women reporting dissatisfaction with intrapartum care in this study is of concern. Women's perception of pain and expectations of staff during labour and birth need to be addressed through education and improved communication by staff. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Development of national evidence-based policies and quality assurance systems would help reduce the rate of obstetric interventions and give greater emphasis to respect for women's preferences during labour and birth.

Resultados maternos e neonatais da assistência em casa de parto no município do Rio de Janeiro / Maternal and neonatal assistance results at Birthing Center in the municipality of Rio de Janeiro / Resultados maternos y neonatales de la asistencia en casa de nacimiento en el municipio de Rio de Janeiro

O objetivo deste estudo foi descrever os resultados maternos e neonatais da assistência na Casa de Parto David Capistrano Filho. Pesquisa exploratório-descritiva, com abordagem quantitativa, que analisou 458 prontuários dos partos normais e nascimentos no período de janeiro de 2008 a dezembro de 2009. As parturientes eram mulheres jovens, de 15 a 25 anos de idade (66,6%), e nulíparas (55%). Durante o trabalho de parto, elas permaneceram com o acompanhante (94,1%) e receberam cuidados para o relaxamento e o conforto. A taxa de episiotomia foi de 2,4%. Não houve óbitos maternos e neonatais. Os casos de asfixia neonatal representaram 0,2% dos nascidos vivos. As transferências para o hospital corresponderam a 2,8% das mulheres no pós-parto e 8,5% entre os neonatos. A maioria dos resultados encontrados foi semelhante aos descritos nas pesquisas brasileiras e internacionais acerca da assistência em centros de parto.

The purpose of this study was to describe the maternal and neonatal assistance results in the Casa de Parto David Capistrano Filho Birthing Center. An exploratory and descriptive research with a quantitative approach, which were analyzed 458 patients' files data of normal delivery and births in period from January 2008 to December 2009. The pregnants were young women, from 15 to 25 years old (66.6%), and nulliparous (55%). During labor, they remained with the companion (94.1%) and received care to relaxation and comfort. The episiotomy rate was 2.4%. There were no maternal and neonatal deaths. The cases of neonatal asphyxia accounted for 0.2% of live births. Transfers rate to hospital corresponded to 2.8% of women postpartum and 8.5% among newborns. Most results were similar to those described in Brazilian and internationals researches about birth centers assistance.

El objetivo de este estudio fue describir los resultados maternos y neonatales de la asistencia en la Casa de Parto David Capistrano Filho. Investigación exploratoria y descriptiva con enfoque cuantitativo, que analizó 458 registros clínicos de los partos normales y nacimientos en el período de Enero de 2008 a Diciembre de 2009. Las mujeres embarazadas eran mujeres jóvenes, entre 15 y 25 años de edad (66,6%), y nulíparas (55%). Durante el trabajo de parto, ellas recibieron dieta oral (100%), permanecieron con el acompañante (94,1%) y recibieron cuidados para la relajación y confort. La tasa de episiotomía fue del 2,4%. No hubo óbitos maternos y neonatales. Los casos de asfixia neonatal representaron 0,2% de los neonatos. Los traslados para el hospital correspondieron a 2,8% de las mujeres en el postparto y a 8,5% entre los recién nacidos. La mayoría de los resultados fueron similares a los descritos en las investigaciones brasileñas e internacionales a cerca de la asistencia en centros de nacimientos.

Recent trends in clinicians providing care to pregnant women in the United States.

INTRODUCTION: Health care needs of pregnant women are met by a variety of clinicians in a changing policy and practice environment. This study documents recent trends in types of clinicians providing care to pregnant women in the United States. METHODS: We used a repeat cross-sectional design and data from the Integrated Health Interview Series (2000-2009), a nationally representative data set, for respondents who reported being pregnant at the time of the survey (N = 3204). Using longitudinal logistic regression models, we analyzed changes over time in pregnant women's reported use of care from 1) obstetrician-gynecologists; 2) midwives, nurse practitioners (NPs), or physician assistants (PAs); or 3) both an obstetrician-gynecologist and a midwife, NP, or PA. RESULTS: The percentage of pregnant women who reported seeing an obstetrician-gynecologist (87%) remained steady from 2000 through 2009. After controlling for demographic and clinical variables, the percentage who reported receiving care from a midwife, NP, or PA increased 4% annually (yearly adjusted odds ratio [AOR] 1.04; P < .001), indicating a cumulative increase of 48% over the decade. The percentage of pregnant women who received care from both an obstetrician-gynecologist and a midwife, NP, or PA also increased (AOR 1.027; P < .001), for a cumulative increase of 30%. DISCUSSION: The increasing role of midwives, NPs, and PAs in the provision of maternity care suggests changes in the perinatal workforce and practice models that may promote collaborative care and quality improvement. However, better data collection is required to gather detailed information on specific provider types, these trends, and their implications.

Paediatric nurses' knowledge and attitudes related to breastfeeding and the hospitalised infant.

Breastfeeding and breastmilk are essential to hospitalised infants and young children and paediatric nurses are required to have breastfeeding knowledge. However, few studies have investigated paediatric nurses' knowledge and attitudes towards breastfeeding. A descriptive, cross-sectional survey design was used to investigate breastfeeding knowledge, knowledge related to breastfeeding the hospitalised infant, policy and guideline awareness, and attitudes to breastfeeding. Participants demonstrated excellent breastfeeding attitudes and general knowledge but deficits in breastfeeding knowledge related to specific outcomes were identified.

Perfil epidemiológico das puérperas assistidas em um alojamento conjunto / Epidemiological profile of postpartum women receiving rooming-in care / Perfil epidemiológico de puérperas asistidas en un alojamiento conjunto

O objetivo do estudo foi caracterizar as puérperas assistidas em um alojamento conjunto, quanto aos antecedentes obstétricos e à gestação atual. Foi realizada pesquisa de abordagem quantitativa, com 294 puérperas de uma maternidade em Fortaleza-Ceará, nos meses de agosto a outubro de 2007, mediante entrevistas. Identificou-se 168 (57,1%) multigestas, 119 (41,2%) mulheres com experiência anterior em amamentação, das quais 52 (43,7%) com duração de seis meses, embora 116 (97,4%) tenham admitido que enfrentaram dificuldades para estabelecer a amamentação, sendo as mais comuns o ingurgitamento, mamilo invertido e produção insuficiente de leite. Houve adesão significativa ao pré-natal. O estudo revelou uma clientela de estrato socioeconômico baixo, e isso deve ser levado em consideração na promoção de intervenções clínicas ou educativas e na construção de políticas públicas. O estudo constatou ainda alta adesão das mulheres à assistência pré-natal, o que repercute na promoção da saúde materno-fetal.

The aim of this quantitative study was to profile obstetric background and current pregnancy among postpartum women receiving rooming-in care. The study interviewed 294 postpartum women at a maternity hospital at Fortaleza, Ceará State, in August and October, 2007. Of the women, 168 (57.1%) were multiparous, 119 (41,2%) had breastfed previously, 52 (43.7%) had done so for six months and 116 (97.4%) found difficulty engaging with breastfeeding, particularly because of breast engorgement, nipple inversion and insufficient breast milk. Rate of adhesion to prenatal care was significant. The study revealed a socioeconomically lower-strata clientele, which should be taken into consideration in promoting clinical or educational interventions and in policy-making. This study also identified high degree of adhesion to prenatal care, which helps promote maternal-foetal health.

El objetivo del estudio fue caracterizar las puérperas asistidas en un alojamiento conjunto cuanto a los antecedentes obstétricos y al embarazo actual. Estudio de enfoque cuantitativo en el que fue entrevistado 294 puerperas de una maternidad en Fortaleza-Ceará-Brasil, en los meses de agosto a octubre de 2007, a través de entrevistas. Se identificó 168 (57,1%) multigestas, 119 (41,2%) mujeres con experiencia anterior en lactancia, de las cuales 52 (43,7%) con duración de seis meses, aunque 116 (97,4%) hubiesen admitido dificultades para establecer la lactancia, siendo las más comunes la ingurgitación, pezón invertido y insuficiente producción de leche. Hubo adhesión significativa al prenatal. El estudio reveló una clientela con baja condiciones socioeconómicas, lo que debe ser considerado en la promoción de intervenciones clínicas o educativas y en la construcción de políticas públicas. El estudio constató también gran adhesión de las mujeres a la asistencia prenatal, lo que afecta a la promoción de la salud materna y fetal.

Atuação do enfermeiro no atendimento à mulher no Programa Saúde da Família / Nurses’ Performance of Women’s Care in the Family Health Program

Estudo descritivo quantiqualitativo que buscou analisar a atuação do enfermeiro e descrever as dificuldades encontradas por ele no atendimento à mulher no município de Vitória, Estado do Espírito Santo. Participaram 51 enfermeiros lotados nas 20 unidades de saúde da família. Os dados foram coletados em 2006 mediante um questionário. Foram realizadas análise temática e análise estatística dos dados. Resultados: 96,08% da amostra realizam prevenção do câncer de colo de útero; 83,67% porcento - assistência ao pré-natal de baixo risco; 83,67%- planejamento familiar; e 64,71%educação em saúde. Identificou-se como dificuldades predominantes: área física inadequada - 49,02%; falta de adesão à assistência e de medicamentos - 27,45%; ausência de educação permanente - 21,57% porcento; e limitações do protocolo municipal de atenção à mulher - 17,65%. Conclui-se que, diante das atividades propostas no protocolo municipal, os enfermeiros prestam uma assistência efetiva.

This quanti-qualitative descriptive study examined nurses’ work and described the difficulties they encountered in providing care for women in the town of Vitória, Espirito Santo State, Brazil. The participants were 51 nurses at 20 family health clinics. Data collected in 2006 by questionnaire were subjected to thematic and statistical analysis. Results found that 96.08%perform cervical cancer prevention; 83.67%, low-risk prenatal care; 83.67%, familiar planning; and 64.71%, health education. The predominant difficulties were identified as: for 49.02%, the lack of appropriate physical space; 27.45%, lack of adhesion to care regimens and lack of medicines; 21.57%percent, lack of permanent education; and 17.65%, limitations in the municipal protocol for women’s care. Conclusion: the results suggest that, given the activities proposed in the municipal protocol, the nurses provide effective care.

Estudio descriptivo cuanticualitativo que buscó analizar el trabajo del enfermero y describir las dificultades encontradas en la atención a la mujer en la ciudad de Vitória – Espirito Santo – Brasil. Participaron 51 enfermeros actuantes en las 20 unidades de salud de la familia. Los datos fueron recolectados en 2006 mediante un cuestionario. Fueron realizados análisis temático y análisis estadístico de los datos. Resultados: 96.08% realizan prevención de la neoplasia cervical uterina; 83.67% hacen el prenatal de riesgo bajo; 83.67%, planeamiento familiar; y 64.71%; educación en salud. Se identificó como dificultades predominantes: área física inadecuada – 49,02%; falta de adhesión a la asistencia y a medicamentos – 27,45%; ausencia de educación permanente – 21,57%; y limitaciones del protocolo municipal de atención a la mujer – 17,65%. Se concluye que, delante de las actividades propuestas en el protocolo municipal, los enfermeros prestan una asistencia efectiva.

Engagement in paraprofessional home visitation: families' reasons for enrollment and program response to identified reasons.

Home visitation programs have exhibited modest impact in promoting maternal and child health outcomes; therefore, formative research is necessary to examine whether home visiting program models or actual implementation need to be modified. In particular, client engagement and retention have been identified as areas in which program implementation can be enhanced. This study assessed home visiting clients' reasons for entering home visiting programs and their perception of programs' response to these identified needs. We asked newly enrolled home visiting clients (n = 123) to identify reasons for entering their home visiting program, including their first and second most important reasons. The most frequently cited reasons for enrolling were wanting information about job training, completing one's education, keeping in good health during pregnancy, and learning about infant growth and development. Home visiting programs' response to clients' identified needs varied. Needs more closely related to home visiting program goals of providing parenting education and promoting prenatal health were most often met, whereas needs less closely related to program goals (e.g., life course needs such as information about job training or education) were less often met. Our findings suggest that home visiting programs in urban contexts should consider modifying their program protocols to better respond to employment- and education-related issues facing their clients.

Health professional's knowledge and awareness of perinatal depression: results of a national survey.

INTRODUCTION: Postnatal depression affects 14% of women, occurring also antenatally, with potential long-term consequences, making it an important disorder to detect and manage early. In this study we sought to examine knowledge and awareness of perinatal depression in health professionals involved in perinatal care throughout Australia prior to the implementation of a comprehensive screening program, aimed at improving detection and access to appropriate management. METHODS: A random sample of General Practitioners (GPs) and Maternal Child Health Nurses (MCHNs) and Midwives, in regions throughout Australia to be subsequently targeted by a screening and education program, were invited to participate. Responses to a hypothetical vignette and a knowledge questionnaire, as well as details of experience were completed. FINDINGS: Questionnaires were completed by 246 GPs, 338 MCHNs and 569 midwives, with overall response rates; GP's 23%; MCHN's 55% and midwives 57%. Although knowledge level was similar among professional groups, MCHNs had higher levels of awareness of perinatal depression. Both GPs and MCHNs were more likely than midwives to recognize the need for providing help to women with emotional distress. Depression was more likely to be considered postnatally than antenatally in all groups, with GPs most likely to provide this diagnosis. GPs had a significant propensity to recommend antidepressants, and midwives to select non-specific medications. CONCLUSIONS: Health professionals responding to this survey had a high awareness and similar knowledge base. Further education on antenatal depression and the safety risks and alternatives to medication is important for all groups, but particularly important for midwives and GPs. The latter is especially relevant given the preference for women with perinatal depression not to use pharmacological interventions to treat their emotional distress.

Mapping the literature of maternal-child/gynecologic nursing.

OBJECTIVES: As part of a project to map the literature of nursing, sponsored by the Nursing and Allied Health Resources Section of the Medical Library Association, this study identifies core journals cited in maternal-child/gynecologic nursing and the indexing services that access the cited journals. METHODS: Three source journals were selected and subjected to a citation analysis of articles from 1996 to 1998. RESULTS: Journals were the most frequently cited format (74.1%), followed by books (19.7%), miscellaneous (4.2%), and government documents (1.9%). Bradford's Law of Scattering was applied to the results, ranking cited journal references in descending order. One-third of the citations were found in a core of 14 journal titles; one-third were dispersed among a middle zone of 100 titles; and the remaining third were scattered in a larger zone of 1,194 titles. Indexing coverage for the core titles was most comprehensive in PubMed/MEDLINE, followed by Science Citation Index and CINAHL. CONCLUSION: The core of journals cited in this nursing specialty revealed a large number of medical titles, thus, the biomedical databases provide the best access. The interdisciplinary nature of maternal-child/ gynecologic nursing topics dictates that social sciences databases are an important adjunct. The study results will assist librarians in collection development, provide end users with guidelines for selecting databases, and influence database producers to consider extending coverage to identified titles.

Nurse home visits to maternal-child clients: a review of intervention research.

Home visiting has been considered a promising strategy for addressing the multiple needs of families at risk. Research reviews are a valuable resource for researchers, policymakers, and practitioners who develop and support new home-visiting interventions. This review examines 13 research studies published between the years of 1980 and 2000 that test the effectiveness of home-visiting interventions using professional nurses as home visitors. Findings indicate that a wide range of client problems are addressed during home visits using a variety of nursing interventions. Missing from most of the reports is a clear theoretical link between the client problem addressed, the nursing intervention, and target outcomes. About half of the studies were successful in achieving desired outcomes. Future research should be directed by middle-range practice theory, clearly explicate the nursing intervention being tested, use power analysis to determine sample size, and report reliability and validity of dependent variable measures with culturally diverse samples.