Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing最新文献

Women can experience significant and potentially life-threatening complications related to pregnancy. These conditions are commonly referred to as severe maternal morbidity (SMM). Severe maternal morbidity can have devastating effects on pregnant women and their children, and in some cases it can lead to maternal mortality. In the United States, SMM and maternal mortality occur at greater rates than in other high-income countries. Within the past few years, researchers and health care providers have placed an increased emphasis on identifying cases of SMM to improve maternal and perinatal outcomes. However, the term severe maternal morbidity is not consistently defined in the literature, and a standardized definition is necessary to accurately measure incidence. Therefore, the purpose of this commentary is to review current definitions for SMM and offer an integrative, potentially universal definition for the term.

"Benign gynecologic conditions" is an umbrella term widely used to describe prevalent conditions such as endometriosis, adenomyosis, uterine fibroids, and genitourinary syndrome of menopause in clinical guidelines, research, reviews, and health policy. However, this term is nonspecific, clinically misleading, and potentially harmful. Although these conditions are not cancerous, they can be chronic, painful, and life-disrupting, which renders the term inappropriate because it does not reflect women's experiences. In this article, we trace the historical origins of the term "benign" and explore how its continued use may contribute to delays in diagnosis, minimization of symptoms, and disinvestment in women's health research and education. Replacing the term benign with more precise and respectful phrases, such as "chronic gynecologic conditions," is an essential part of efforts to improve patient-centered care, restore trust, and advance equity in women's health.

Objective: To explore the factors that influence the implementation of the Association of Women's Health, Obstetric and Neonatal Nurses POST-BIRTH Warning Signs education program.

Design: Qualitative focus groups.

Setting: Online focus groups conducted via Microsoft Teams in the United States.

Participants: A purposive sample of 23 registered nurses from 17 states who implemented the POST-BIRTH Warning Signs (PBWS) education program.

Methods: Participants represented a variety of practice settings, including critical access hospitals (n = 14), a freestanding emergency department (n = 1), maternity care deserts (n = 2), high-resource emergency departments (n = 5), and a high-resource obstetric unit (n = 1). We conducted six focus groups and analyzed the data using Krippendorff's method for qualitative content analysis to cluster data units and identify emergent themes.

Results: We identified five convergent themes and ranked them in descending order based on the number of participants who described each thematic construct: Mountains to Climb in Achieving PBWS Implementation Success, Getting It Right Before They Go Home, The Cost of Unrecognized Warning Signs, Bridging the Gap Between Emergency Department and Obstetric Divides, and The Forgotten Year.

Conclusion: We found that implementing the PBWS education program exposed systemic challenges and presented pathways to progress. Participants highlighted the need for collaboration, timely education, and sustained support to ensure successful implementation. Our findings can guide future implementation and strategies to improve safety after birth in a variety of practice settings.

Objective: To describe needs for support, support-seeking actions, and level of patient activation in the postpartum period among four demographic groups defined by race, ethnicity, and spoken language.

Design: Cross-sectional study of survey data.

Setting: Online survey in the United States.

Participants: Adult women who gave birth in the past 12 months and were able to read and speak English or Spanish (N = 446).

Methods: We conducted descriptive analyses of all study variables and examined differences in sociodemographic characteristics, support needs, and patient activation across four demographic groups. We used chi-square or Fisher's exact tests to evaluate differences in categorical variables and analysis of variance for continuous variables, with Bonferroni-adjusted post hoc comparisons. We calculated effect sizes for all significant group differences.

Results: English-speaking Hispanic respondents were the most likely to report the need for support for mental symptoms (n = 98, 83.5%; p = .03) among all groups. Nearly all respondents who endorsed the need for physical (n = 363, 97.8%) or mental health support (n = 319, 96.1%) reported that they took some action such as calling a provider or going to a clinic or hospital. Spanish-speaking Hispanic respondents had lower reported activation levels (n = 81, 47.4%; p = .01) than English-speaking Hispanic (n = 83, 71.6%), Black (n = 68, 70.1%), and White respondents (n = 49, 79.0%).

Conclusion: Perceived needs for support and levels of patient activation in the postpartum period differed by demographic group. Future researchers should explore other demographic, psychosocial, and health care system factors associated with patient activation in the postpartum period and strategies to support improved skills and confidence in receiving postpartum care.

Objective: To map existing evidence on the needs and roles of grandparents of infants in the NICU.

Data sources: We searched five databases: CINAHL, MEDLINE, Scopus, APA PsycNet, and ProQuest Dissertations and Theses Global. We also reviewed reference lists and explored unpublished studies and gray literature. We included sources in which the authors described the needs and roles of grandparents of infants in the NICU as described by grandparents, parents, and health care professionals.

Study selection: Two independent reviewers screened titles and abstracts and then assessed full texts using predefined inclusion and exclusion criteria. We resolved disagreements through discussion or adjudication by the first author. We selected 22 publications, including quantitative, qualitative, and mixed-methods studies; a meta-review; and opinion papers.

Data extraction and synthesis: We extracted the following data: authors, publication year, country, aims, study design, methods, sample, data collection tools, and key findings. We created a summary table and wrote a narrative synthesis to connect findings with our objective.

Conclusion: Through the scoping review, we found that grandparents needed to be involved in the care of their grandchildren and to understand the NICU environment. As they sought to bond with their grandchildren, grandparents also provided key emotional and practical support for parents. To meet the needs of grandparents, health care professionals in the NICU should answer their questions within the bounds of privacy limitations and offer tailored interventions. Because recent research on this topic remains limited, we recommend further studies to address this gap and strengthen family-centered care in NICUs.