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

To effectively address the serious issue of maternal mortality, it is crucial to establish an accurate and encompassing framework for identifying and preventing severe maternal morbidity.

The authors of the featured article conducted a randomized clinical trial to determine if ventilation and umbilical cord clamping reduced rates of intraventricular hemorrhage and early death in extremely preterm infants.

An estimated 190 million women are affected by endometriosis worldwide yet delays in diagnosis and treatment and validation of patient symptoms remain significant barriers to care. While a lack of data and gaps in research remain central to understanding and addressing this disease, researchers are developing some promising innovations. In this column, I review prevalence and symptoms, barriers to diagnosis, and new innovations in care for endometriosis and the implications for research, practice, and policy. I conclude with information from professional organizations and the need for updated clinical guidelines.

Objective: To examine patient-provider nutrition conversations at initial prenatal visits.

Design: Convergent mixed methods observational study.

Setting: Two large metropolitan clinics in the midwestern United States.

Participants: Sixteen providers and 20 racially diverse pregnant women.

Methods: Guided by the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 model, we observed and audio-recorded initial prenatal visits with obstetric providers. Patients completed post-visit surveys and interviews, and providers completed post-visit interviews. Finally, we sent a practice-wide electronic survey to all providers. We completed quantitative data analysis for descriptive statistics of observation and survey results. We completed qualitative thematic analysis of visit and interview transcripts and combined and categorized results into components of the SEIPS 2.0 model.

Results: We identified multiple dynamic and interacting factors relevant to the work system and processes in the SEIPS 2.0 model in patient-provider conversations about nutrition. Although nutrition was covered in all visits, most conversations were provider-centered and covered basic, general recommendations related to a limited number of topics. Few individualized collaborative discussions that addressed contextual factors occurred.

Conclusion: Finding ways to incorporate and address contextual factors into patient-centered conversations about nutrition is vital to optimize the dietary habits of women, especially those from vulnerable populations. To do this, multidisciplinary teams that include nurse practitioners, nurses, obstetricians, and registered dietitians who can address the multiple social determinants of health that affect dietary choices are needed.

Objective: To explore how women who used substances during the perinatal period perceived the care they received from interprofessional perinatal care providers.

Design: Appreciative inquiry.

Setting: Interprofessional perinatal care clinic in a large urban tertiary care hospital in Canada.

Participants: Fourteen women with various backgrounds who used substances during pregnancy, including opioids, marijuana, and/or methamphetamine, and engaged in care with an interprofessional perinatal care team. The participants identified as First Nations (n = 3), Métis (n = 8), and White (n = 3).

Methods: Using appreciative inquiry, we followed the 4-D cycle of discovery, dream, design, and destiny to frame the semistructured interviews and analyze the data.

Results: Four overarching themes with nine subthemes emerged, representing participants' experiences with the interprofessional perinatal care team. The overarching themes were Safe Care, Compassionate Care, Dignified Care, and Connected Care. Participants suggested opportunities to improve care in relation to integration of cultural care, coordination of postpartum services, and increased support in the birth and hospital setting.

Conclusion: The findings highlight the strengths and assets of interprofessional perinatal care from the patients' perspectives. Participants outlined actionable ways for all perinatal providers to deliver safe, compassionate, dignified, and connected care, which can result in life-giving and lifesaving outcomes for patients.

Objective: To translate the Gynecological Cancers Awareness Scale (GCAS) into Chinese and validate its reliability and validity in assessing awareness of gynecologic cancer prevention and treatment among women in China.

Design: Descriptive psychometric study.

Setting: People's Republic of China.

Participants: Adult women who lived in China (N = 434).

Methods: We conducted the research in two phases. Phase 1 involved the translation and adaptation of the GCAS into Chinese. Phase 2 involved administering a cross-sectional survey using an electronic questionnaire.

Results: The translated GCAS had a Cronbach's α of .92, an intraclass correlation coefficient of 0.83, and an adequate content validity index. We used exploratory factor analysis to identify four factors that explained 64.01% of the variance and found that most fit indices in the confirmatory factor analysis were acceptable.

Conclusion: Among our participants, the Chinese version of the GCAS was a valid and reliable tool for assessing awareness of gynecologic cancer risk, prevention, and treatment among women in China.

Objective: To examine whether coping styles moderate the relationship between nursing stress and mental health in NICU nurses.

Design: Cross-sectional observational study.

Setting: Four Level 3 and 4 NICUs in New South Wales, Australia.

Participants: A total of 123 NICU nurses.

Methods: Participants completed self-report questionnaire measures of nursing stress (Nursing Stress Scale), dispositional stress coping styles (Brief Coping Orientation to Problems Experienced Inventory [Brief COPE]), and mental health (Mental Health Inventory-21). I conducted exploratory factor analysis of the Brief COPE to show that it comprises four factors: support-oriented coping, problem-oriented coping, emotion-oriented coping, and denial-oriented coping. I used hierarchical multiple regressions with interactions and simple slopes analyses to conduct moderation analyses.

Results: I found that the interaction between nursing stress and problem-oriented coping style (i.e., positive reframing, planning, religion, and active coping) was significant and explained further variance in psychological distress (ΔR² = .05, p = .013), emotional well-being (ΔR² = .03, p = .027), and hopelessness (ΔR² = .06, p = .005). The moderation effects on mental health were significantly different at high versus low levels of problem-oriented coping for psychological distress (t = 2.55, p = .011), emotional well-being (t = 2.26, p = .024), and hopelessness (t = 2.89, p = .004). The other coping styles did not have significant moderator effects.

Conclusion: Problem-oriented coping buffered the ill effects of nursing stress on positive and negative dimensions of mental health in NICU nurses. Accordingly, cognitive behavioral therapy may be the most effective counseling modality for NICU nurses. Understanding how and why problem-oriented coping might not be effective in certain clinical situations that are controllable and theoretically solvable should inform further mixed methods research in NICU nurses.

Objective: To assess consent rates and reasons for refusing consent after the introduction of peer navigators into the Outcomes of Babies With Opioid Exposure (OBOE) Study.

Design: Secondary analysis of data from the OBOE Study, a multisite observational study.

Setting: Medical centers in Alabama, Ohio, and Pennsylvania (N = 4).

Participants: Data about the use of peer navigators were obtained from the primary study, including 1,255 mothers or caregivers who were approached regarding participation in the study.

Methods: We used χ² tests to compare study consent rates and reasons for refusing consent before and after the use of peer navigators.

Results: Following the addition of peer navigators, study consent rates significantly improved (29% of 852 before vs. 38% of 403 after; p = .001), and the percentage of potential participants who indicated that they were not interested in sharing information for research significantly decreased (41% of 247 vs. 26% of 115; p = .005).

Conclusion: We demonstrate the potential effect of peer navigators on consent and interest in sharing information for research in a longitudinal research study. We recommend the inclusion of peer navigators in studies with high-risk populations.

In this case report, we describe a successful unplanned vaginal breech birth (VBB) for a primigravid woman who presented to the hospital in labor. This woman transferred to our hospital from an attempted home birth and was highly motivated to achieve a vaginal birth. The staff were recently trained on the provision of physiologic breech birth support, and after receiving informed consent, they facilitated a successful VBB. Planned VBB services are largely unavailable in the United States. Offering women the option to undergo VBB involves screening for good candidates, obtaining informed consent, and ensuring the availability of clinically skilled birth attendants and staff who can provide support and emergency management. The increased availability of physiologic VBB training programs and simulation experiences may enhance collaboration among nurses, midwives, and physicians and facilitate the support of VBB in hospital settings. The purpose of this report is to describe how physiologic VBB care may increase options for women with positive maternal and neonatal outcomes.