Clinical Research With Pregnant Women: Perspectives of Pregnant Women, Health Care Providers, and Researchers.

Limited clinical research with pregnant women has resulted in insufficient data to promote evidence-informed prenatal care. Charmaz's constructivist grounded theory methodology was used to explore how research with pregnant women would be determined ethically acceptable from the perspectives of pregnant women, health care providers, and researchers in reproductive sciences. Semistructured interviews were conducted with a purposive sample of 12 pregnant women, 10 health care providers, and nine reproductive science researchers. All three groups suggested the importance of informed consent and that permissible risk would be very limited and complex, being dependent on the personal benefits and risks of each particular study. Pregnant women, clinicians, and researchers shared concerns about the well-being of the woman and her fetus, and expressed a dilemma between promoting research for evidence-informed prenatal care while securing the safety in the course of research participation.

Laboring to mother in the context of past trauma: the transition to motherhood.

The occurrence of interpersonal trauma is a reality for many women, with effects that often persist long after the traumatic events end. The purpose of this feminist grounded theory study was to examine how past trauma shaped the lives of women as they became new mothers. We recruited a purposive sample of 32 women from two Canadian communities and conducted semistructured, dialogic interviews during the second trimester of pregnancy. We analyzed data using thematic content analytic methods, including open coding whereby we read transcripts line by line and applied codes to portions of text that illustrated concepts or themes. The substantive grounded theory, "laboring to mother in the context of past trauma," describes the exceedingly difficult emotional and cognitive work undertaken by pregnant women with histories of trauma as they anticipate becoming mothers. In this article, we present key components of the theory and offer recommendations for health and social service providers.

The mandala: first-year undergraduate nursing students' learning experiences.

The mandala is a circular art form used by psychologists to access subconscious thought through symbolism and it has recently been adopted by nurse educators as a learning strategy for self-awareness. The lived experiences of six first-year undergraduate nursing students who completed a mandala assignment for emotional learning were explored using hermeneutic phenomenology. Participants experiences diverged from their original expectations that the mandala assignment would allow for a fun and free expression of 'self'. Participants did describe experiences of self-discovery; however, their experiences also resembled those associated with socialization in nursing education. Participants described both self-reflection and critical-reflection while completing the mandala assignment. Nurse educators and researchers can gain insight regarding the use of this assignment as an integrated transformative learning approach for emotional learning.

Nursing students and clinical instructors' perceptions on the implementation of a best practice guideline.

A university nursing program in Ontario, Canada initiated the process of implementing the Registered Nurses' Association of Ontario best practice guideline (BPG) on smoking cessation into the curriculum. This study explored nursing students' and clinical instructors' perception of the BPG in their practice to support faculty in the development of a curriculum that promotes smoking cessation and the competencies necessary for graduates to implement health promotion skills in practice. Four student nurses and two clinical instructors participated in semistructured interviews. Four major themes were identified through the data analysis process: personal and professional self, health "preaching," developmental perspective and environmental constraints. This study presents a curricular model for health promotion practice incorporating the components of primary health care, health promotion counseling, smoking cessation BPG, and sociopolitical context.

Gestational diabetes: the meaning of an at-risk pregnancy.

Being diagnosed with gestational diabetes (GDM) is coupled with the implication that the woman and her fetus are at risk. In this study, the authors use a hermeneutic phenomenological approach to gain an in-depth understanding of GDM as pregnant women meaningfully experience it. They conducted conversational interviews with 12 women who were diagnosed with and being treated for diabetes in pregnancy. Data analysis involved a reflective process consistent with the guidelines of thematic analysis. Four themes identified as characteristic of the women's pregnancy experience were Living a Controlled Pregnancy, Balancing, Being a Responsible Mother, and Being Transformed. The findings challenge health care professionals to discuss openly and reassess their present models of care for pregnant women and their families.

Women's Satisfaction With Obstetric Triage Services.

OBJECTIVE: To determine the satisfaction of pregnant women who presented at a triage unit in an obstetric birthing care unit with obstetric triage services. DESIGN: Qualitative descriptive with conventional content analysis. SETTING: Individual audio recorded telephone interviews with women after discharge from a tertiary care hospital's obstetric triage unit. PARTICIPANTS: Purposive sample of 19 pregnant women who had received obstetric triage services. METHODS: A semi-structured interview guide was used for data collection. All interviews were audio-taped and transcribed verbatim. Data analysis was consistent with qualitative content analysis with open coding to categorize and develop themes to describe women's satisfaction with triage services and care. RESULTS: Five themes, Triage Unit Environment, Triage Staff Attitude and Behavior, Triage Team Function, Nursing Care Received in Triage and Time Spent in Triage, illustrated the women's recent triage experiences. Overall the women were very satisfied with the triage services. Women appreciated a caring approach from triage nurses, being informed about the well-being of themselves and their fetuses, being closely monitored, and effective teamwork among the members of the health care team. CONCLUSIONS: The results indicated that a humanizing, caring approach by the inter-professional team offering obstetric triage services contributed to women's satisfaction and woman-centered care.