Journal of nurse-midwifery最新文献

The International Confederation of Midwives is celebrating its 75th anniversary in 1994. The Confederation is composed of 61 member associations from 50 countries and thus includes more than 100,000 midwives. Its aims are to advance midwifery education and the role of the professional midwife, to improve the standard of maternal and child health care, and to support and advise associations of midwives in liaison with their governments. This article reviews the history and current activities of the Confederation, and discusses future challenges and new directions for the organization.

As health care reform unfolds over the next several years, nurse-midwives will be increasingly addressing issues of health care in women of all ages across the life span. For older women, a prevalent condition that has received minimal attention in this age group has been breast cancer. Distinctions have been noted in the literature between older and younger women in terms of the biology, screening, and treatment of breast cancer. Despite theories that breast tumors in older individuals are more indolent and slower growing than those found in younger women, older women's mortality from breast cancer is higher. Although part of this is theorized to be due to other biologic processes, such as increased immune suppression with aging, it appears that most of the distinction between the courses of breast cancer in older and younger individuals has been related to decreased screening during advanced age. This manuscript describes the individual client, health care provider, and health care system barriers to each of the three major elements of breast cancer screening—breast self-examination, clinical breast examination, and mammography. Suggestions and caveats including ethical, legal, and political issues regarding breast cancer screening in older women are presented.

An interdisciplinary care provider team conducted a nonexperimental, observational, descriptive study to determine a childbirth education curriculum that would meet the needs of pregnant adolescent and substance-using women who attend prenatal clinics at an urban, municipal hospital center. A childbirth education curriculum, originally taught to a clinic population in 1974, was used with the two special populations in 1993 for a 7-month period. Participants were encouraged to provide feedback about the curriculum for each class by offering suggestions for additions or deletions of content Provider staff also evaluated the content for applicability today. At the end of the study period, the pregnant adolescent group had been most involved with the class exercises; members of the group provided feedback about content. They were consistently positive in evaluating the entire six-class curriculum and recommended some additional topics. The adolescents demonstrated sustained interest in breast-feeding. The substance-using women, on the other hand, expressed a preference for content that focused on labor and birth; they preferred to ask questions, individually and in the privacy of the examining room, and showed negligible interest in breast-feeding.

Distance-learning has greatly expanded the number of students admitted to a nurse-midwifery education program. This article describes the Community-Based Nurse-Midwifery Education Program (CNEP) of the Frontier School of Midwifery and Family Nursing. The organizational structure and curriculum of the CNEP combines apprenticeship learning with academic rigor, permitting students who cannot relocate to the university to pursue graduate education. New technology, such as an interactive electronic bulletin board, networks students and faculty. The program emphasizes theories of independent, adult learning. There is a master's completion option available through the affiliation with Case Western Reserve University.