Mcn-The American Journal of Maternal-Child Nursing最新文献

Purpose: The purpose of this review is to investigate the current landscape of evidence-based mHealth resources designed to support pregnant patients with fetal anomalies, with a focus on enhancing maternal wellbeing, disseminating relevant information, and facilitating communication with nurses, physicians, and other health care professionals.

Study design: Using the JBI (formerly known as the Joanna Briggs Institute) scoping review protocol and the PRISMA-ScR framework, we conducted a comprehensive search across databases including CINAHL, Medline, Web of Science, and Google Scholar.

Methods: A keyword search was conducted, resulting in 227 unique records. Articles discussing mobile apps for pregnancies with a fetal diagnosis or fetal risk for anomaly were included, including hospital-affiliated or telehealth apps that were adapted for use with this specific population.

Results: Ten articles were selected for inclusion. Our analysis identified several predominant themes. The surge of mHealth, influenced in part by the COVID-19 pandemic, has provided critical access to care for pregnant patients with fetal anomalies through mobile platforms. Comprehensive resource tools integrating informational components via mHealth are needed to offer flexibility to patients as well as nurses, physicians, and other health care professionals. Adopting a patient-driven approach in developing mHealth resources is important in meeting the needs of patients, their families, and their health care team.

Clinical implications: A framework for the development and implementation of high-fidelity mHealth resources tailored to this vulnerable population is needed. Emphasizing a patient-centered approach in the creation of mHealth resources is paramount to ensuring their effectiveness and usefulness for pregnant women experiencing fetal anomalies, their families, and the perinatal health care team.

Background: Despite substantial investments in maternity care, the United States continues to experience higher maternal mortality rates than most high-income countries. Rural regions lack adequate prenatal care services, a contributing factor to disparate maternal health outcomes.

Methods: This integrative review on patient, nurse, midwife, physician, and community perspectives on accessing prenatal care in rural areas of the United States follows Whittemore and Knafl's integrative review framework, including a systematic literature search in various databases from January 1, 2010, to May 1, 2024. Eligible articles were published in English, peer-reviewed, and focused on subjective accounts of accessing prenatal care in rural areas of the United States. Seven articles met inclusion criteria and were assessed for quality using the Joanna Briggs Institute checklists.

Results: Three major categories influencing access to prenatal care in rural areas were developed. Individual factors included transportation, family support, motivation, and work commitments. Socioeconomic factors encompass health insurance, rurality, income, and housing. System factors involved the qualities of nurses, midwives, physicians, the clinic environment, and collaboration within the health care system. The findings emphasized the complexity of rural prenatal care access.

Conclusions: Understanding patient and care giver perspectives on accessing prenatal care in rural areas is crucial for addressing the factors influencing maternal outcomes. Rural pregnant women face unique challenges, contributing to an increased risk of maternal morbidity and mortality. Further research is needed to explore their experiences and develop interventions to improve access and outcomes in rural areas.

Abstract: Ornithine transcarbamylase deficiency is the most common urea cycle disorder. If left untreated, pathogenic variants in the OTC gene can cause hyperammonemia leading to neurotoxicity, coma, and death. A comprehensive overview of ornithine transcarbamylase deficiency is presented including the genetic cause; varied age of onset, clinical presentation, and severity; diagnostic testing; and lifelong and anticipated future treatments. More specifically, there is a focus on the prenatal, natal, and postpartum course and treatment recommendations for genetic heterozygous (carrier) females and hemizygous male newborns with ornithine transcarbamylase deficiency.