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The Hypocritical Oath? Unintended Consequences of Prenatal Substance Use Policies and Considerations for Health Care Providers. 虚伪的誓言?产前药物使用政策的意外后果和医疗服务提供者的注意事项》。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-10-01 Epub Date: 2024-11-07 DOI: 10.1097/JPN.0000000000000836
Anastasia J Philippopoulos, Zoe E Brown, Adam K Lewkowitz, Elisabeth D Howard, Lauren Micalizzi

Prenatal substance use (PSU) is a serious perinatal health issue in the United States with consequential health effects. To address this issue and protect children from the detrimental effects of substance exposure during pregnancy, the US government amended the Child Abuse Prevention and Treatment Act to provide funding to states with protocol to notify child protective services of PSU cases and develop treatment plans for affected families. Although well-intentioned, this statute resulted in diverse inter- and intrastate interpretations and implementation of PSU regulations nationwide, ultimately leading to mass confusion about who the policy applies to and when it should be applied. PSU policies are largely punitive in nature, which has led to null or adverse effects on perinatal outcomes. Treatment-prioritizing policies present hope for supporting birthing parents who use substances; however, their potential benefits are obstructed by fear and confusion instilled by coexisting punitive policies, stigma of disclosing substance use during pregnancy, variable or lack of screening methods, and insufficient knowledge about PSU health risks and counseling methods. Precis: Punitive prenatal substance use policies may result in adverse perinatal outcomes. Treatment-oriented protocols and legislation should be prioritized.

在美国,产前使用药物(PSU)是一个严重的围产期健康问题,会对健康造成影响。为了解决这一问题,保护儿童免受孕期接触药物的有害影响,美国政府修订了《虐待儿童预防和治疗法》,为各州提供资金,使其能够按照规定向儿童保护服务机构通报 PSU 案例,并为受影响的家庭制定治疗计划。尽管这项法规的初衷是好的,但它却导致了全国范围内对 PSU 规定的不同州际和州内解释和执行,最终导致了关于该政策适用对象和适用时间的大规模混乱。PSU 政策在很大程度上是惩罚性的,这导致了对围产期结果的无效或不利影响。治疗优先政策为支持使用药物的分娩父母带来了希望;然而,由于同时存在的惩罚性政策所造成的恐惧和混乱、披露孕期使用药物的耻辱感、筛查方法的多变或缺乏,以及对 PSU 健康风险和咨询方法的认识不足,这些政策的潜在益处受到了阻碍。摘要:惩罚性的产前药物使用政策可能会导致不良的围产期结果。应以治疗为导向的方案和立法应优先考虑。
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引用次数: 0
How We Can Best Serve Our Patients to Safely Meet Their Goals: Behavioral Health and Substance Use: Erratum. 我们如何为患者提供最佳服务,以安全地实现他们的目标:行为健康与药物使用》:勘误。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-10-01 Epub Date: 2024-11-07 DOI: 10.1097/JPN.0000000000000884
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引用次数: 0
Introducing a Tool to Support Neonatal Nurse Engagement in Clinical Research. 推出支持新生儿护士参与临床研究的工具。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-10-01 Epub Date: 2024-11-07 DOI: 10.1097/JPN.0000000000000889
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引用次数: 0
Developing Resiliency in Our Future Work Force. 培养未来劳动力的应变能力。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-10-01 Epub Date: 2024-11-07 DOI: 10.1097/JPN.0000000000000875
Jennifer Korkosz
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引用次数: 0
Autonomy and Respect in Pregnancy Care for LGBTQIA+ Families: Evaluation of a Home Visiting Program. LGBTQIA+ 家庭孕期护理中的自主与尊重:家访计划评估。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-10-01 Epub Date: 2024-11-07 DOI: 10.1097/JPN.0000000000000809
Karen Ann Faulk, Mary Carroll, Nancy Niemczyk, Betty Braxter

The purpose of this program evaluation was to gather information on proportions of LGBTQIA+ individuals and families, their needs, and care experiences in a county health department's home visiting programs for perinatal clients and to make recommendations for improving culturally competent care for LGBTQIA+ individuals and families. In this engaged scholarship partnership, home visiting nurses administered a questionnaire to perinatal clients including demographic information on sexual orientation and gender identity. Differences between LBGTQIA+ identifying individuals' perception of the perinatal care received and those of heterosexual, cisgender individuals were assessed. On the basis of these data, 10% of the 52 respondents identified as LGBTQIA+ and 4% identified with a gender other than "woman." Clients who identified as straight had similar mean scores to those who listed an LGBTQIA+ sexual orientation. Clients who chose a gender identity other than "woman" had scores that fell within the 50th to 75th percentile of the overall mean. Qualitative interviews with 2 respondents provided additional in-depth information on their experiences. Overall, clients served by these perinatal programs reported similar diversity in terms of gender identity and sexual orientation as compared with national averages. This project provided evidence of the diversity among the clientele served by this agency and the importance of expanding the focus on inclusionary language and practices.

该项目评估的目的是收集有关 LGBTQIA+ 个人和家庭的比例、他们的需求以及在县卫生部门的围产期客户家访项目中的护理经验的信息,并就如何改善对 LGBTQIA+ 个人和家庭的文化胜任护理提出建议。在这项参与性奖学金合作项目中,家访护士对围产期客户进行了问卷调查,其中包括有关性取向和性别认同的人口统计学信息。评估了 LBGTQIA+ 认同者对所接受的围产期护理的看法与异性恋、双性恋者的看法之间的差异。根据这些数据,在 52 名受访者中,10% 的人认为自己是 LGBTQIA+,4% 的人认为自己的性别不是 "女性"。被认定为异性恋的客户的平均得分与列出 LGBTQIA+ 性取向的客户相近。选择 "女性 "以外性别认同的受访者的平均得分在总平均分的第 50 到 75 百分位之间。对 2 名受访者进行的定性访谈提供了有关其经历的更多深入信息。总体而言,与全国平均水平相比,这些围产期项目所服务的客户在性别认同和性取向方面具有相似的多样性。该项目证明了该机构服务对象的多样性,以及扩大对包容性语言和实践的关注的重要性。
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引用次数: 0
Considerations for Antenatal Milk Expression Education and Counseling in Clinical Settings. 在临床环境中开展产前挤奶教育和咨询的注意事项。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-10-01 Epub Date: 2024-11-07 DOI: 10.1097/JPN.0000000000000868
Jill R Demirci, Melissa L Glasser
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引用次数: 0
Evaluating the Neonate the Old-Fashioned Way. 用传统方法评估新生儿。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-10-01 Epub Date: 2024-11-07 DOI: 10.1097/JPN.0000000000000864
Alexandra Michel
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引用次数: 0
Embracing the Challenge of Opportunity. 迎接机遇的挑战。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-10-01 Epub Date: 2024-11-07 DOI: 10.1097/JPN.0000000000000871
Terri Marin
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引用次数: 0
COVID-Related Visitor Restrictions and Childbirth Experiences in One US Hospital. 美国一家医院与 COVID 相关的访客限制和分娩体验。
IF 16.4 4区 医学 Q3 NURSING Pub Date : 2024-10-01 Epub Date: 2024-11-07 DOI: 10.1097/JPN.0000000000000803
Payton Sciarratta, Kelsey Rondini, Ghislaine Barry, Nandi Dube, Isabella Seddon, John Katial, Roxanne Mirabal-Beltran

Objective: The objective of this study was to explore childbirth experiences during COVID-19 visitor restrictions.

Methods: We used a descriptive phenomenological approach in our study, which took place in a postpartum unit at a level IV birthing hospital in the Mideastern United States, where 3617 births occurred in 2019.

Results: A total of 22 participants who were older than 18 years, who gave birth at 37 weeks gestation or more, and who had at least 1 birth experience in the United States prior to the COVID-19 pandemic participated in this study. We assessed participants' birth experiences before and during COVID-19 visitor restrictions through in-depth interviews. Participant perspectives revealed the following 6 themes after an iterative analysis: A Shared Personal Connection is a Valued Trait, A Female Support Person is Important, Nurses Went the Extra Mile, Support People Help with Decision-Making, Two is an Ideal Number of Support People, and Increased Psychological Burden.

Discussion: These findings are vital to inform hospital visitor policies moving forward in the endemic reality of COVID-19 pandemic.

研究目的本研究旨在探讨 COVID-19 访客限制期间的分娩体验:我们在研究中采用了描述性现象学方法,研究在美国中东部一家四级分娩医院的产后病房进行,该医院在 2019 年共接生了 3617 例新生儿:共有 22 名年龄超过 18 岁、妊娠 37 周或以上分娩、在 COVID-19 大流行之前在美国至少有过一次分娩经历的参与者参与了本研究。我们通过深入访谈评估了参与者在 COVID-19 访客限制之前和期间的分娩经历。经过反复分析,参与者的观点揭示了以下 6 个主题:共同的个人联系是一种有价值的特质、女性支持者很重要、护士做了额外的工作、支持者有助于决策、两个支持者是理想的人数以及心理负担加重:在 COVID-19 大流行的现实情况下,这些研究结果对于医院访客政策的制定至关重要。
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引用次数: 0
Introducing a Resource to Support Neonatal Nurse Engagement in Clinical Research ©. 介绍支持新生儿护士参与临床研究的资源©。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2024-10-01 Epub Date: 2024-11-07 DOI: 10.1097/JPN.0000000000000857
Mary A Short

Purpose: This paper introduces the Resource to Support Neonatal Nurse Engagement in Clinical Research © to educate and support engagement of nurses in study design and protocol review. The resource serves to promote collaboration between nurses and pharmaceutical researchers to advance the development of neonatal therapies.

Background: Neonates remain therapeutic orphans, underserved by the drug development community. Off-label use of drugs in neonates negatively impacts the evaluation of their safety and efficacy. Although NICU nurses' competencies are examples of expertise needed for well-designed clinical trials, nurses may have limited experience in providing insights.

Methods: Resource development included a literature review and usability testing by multiple stakeholders.

Results: Usability testing indicated the resource was comprehensive and relevant to pharmaceutical and nonpharmaceutical studies. Reviewers commented resource prompts are beneficial in assessing study feasibility.

Conclusion: Sponsors of research need nurse engagement to improve feasibility and flexibility and prevent protocol deviations in clinical trials. Leveraging the "Resource to Support Neonatal Nurse Engagement in Clinical Research © " can enhance research education and foster engagement of nurses in neonatal research.

Implications for practice: The resource has implications for the nursing profession, the pharmaceutical industry, and the advancement of new therapies. Individual nurses benefit from education and a framework for research engagement. The profession benefits from enhanced visibility through research collaboration. The pharmaceutical industry gains valuable insights on neonatal care, family dynamics, and NICU standard of care. A resource to foster collaboration in the study development process is an important step for advancing new therapies for neonates.

目的:本文介绍了支持新生儿护士参与临床研究的资源©,以教育和支持护士参与研究设计和方案审查。该资源旨在促进护士与药物研究人员之间的合作,以推动新生儿疗法的开发:背景:新生儿仍然是治疗孤儿,没有得到药物开发界的充分服务。新生儿标示外用药对其安全性和有效性的评估产生了负面影响。虽然新生儿重症监护室护士的能力是精心设计临床试验所需的专业知识的范例,但护士在提供见解方面的经验可能有限:资源开发包括文献综述和多方利益相关者的可用性测试:结果:可用性测试表明,该资源内容全面,与制药和非制药研究相关。评审员认为资源提示有助于评估研究的可行性:研究发起人需要护士的参与,以提高可行性和灵活性,防止临床试验方案出现偏差。利用 "支持新生儿护士参与临床研究的资源©"可以加强研究教育,促进护士参与新生儿研究:该资源对护理行业、制药业和新疗法的发展都有影响。护士个人可从教育和研究参与框架中受益。通过研究合作提高知名度,使护理专业受益。制药业可从新生儿护理、家庭动态和新生儿重症监护室护理标准方面获得宝贵的见解。在研究开发过程中促进合作的资源是推进新生儿新疗法的重要一步。
{"title":"Introducing a Resource to Support Neonatal Nurse Engagement in Clinical Research ©.","authors":"Mary A Short","doi":"10.1097/JPN.0000000000000857","DOIUrl":"10.1097/JPN.0000000000000857","url":null,"abstract":"<p><strong>Purpose: </strong>This paper introduces the Resource to Support Neonatal Nurse Engagement in Clinical Research © to educate and support engagement of nurses in study design and protocol review. The resource serves to promote collaboration between nurses and pharmaceutical researchers to advance the development of neonatal therapies.</p><p><strong>Background: </strong>Neonates remain therapeutic orphans, underserved by the drug development community. Off-label use of drugs in neonates negatively impacts the evaluation of their safety and efficacy. Although NICU nurses' competencies are examples of expertise needed for well-designed clinical trials, nurses may have limited experience in providing insights.</p><p><strong>Methods: </strong>Resource development included a literature review and usability testing by multiple stakeholders.</p><p><strong>Results: </strong>Usability testing indicated the resource was comprehensive and relevant to pharmaceutical and nonpharmaceutical studies. Reviewers commented resource prompts are beneficial in assessing study feasibility.</p><p><strong>Conclusion: </strong>Sponsors of research need nurse engagement to improve feasibility and flexibility and prevent protocol deviations in clinical trials. Leveraging the \"Resource to Support Neonatal Nurse Engagement in Clinical Research © \" can enhance research education and foster engagement of nurses in neonatal research.</p><p><strong>Implications for practice: </strong>The resource has implications for the nursing profession, the pharmaceutical industry, and the advancement of new therapies. Individual nurses benefit from education and a framework for research engagement. The profession benefits from enhanced visibility through research collaboration. The pharmaceutical industry gains valuable insights on neonatal care, family dynamics, and NICU standard of care. A resource to foster collaboration in the study development process is an important step for advancing new therapies for neonates.</p>","PeriodicalId":54773,"journal":{"name":"Journal of Perinatal & Neonatal Nursing","volume":" ","pages":"374-384"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Journal of Perinatal & Neonatal Nursing
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