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

The guest editors for this series describe the importance of a life course perspective to women's mental health and introduce the articles in the issue.

Objective: To test the feasibility and acceptability of We See You, Sis, a therapeutically grounded virtual sister circle intervention for Black women with depression symptoms.

Design: A two-group quasi-experimental design.

Setting: Virtual on the Zoom version 5.13 platform.

Participants: Black women who were at least 40 years of age, with current depression symptoms, who had reliable access to Zoom (N = 30).

Method: We See You, Sis is a virtual sister circle intervention that is therapeutically grounded in the core processes of Pulling Out of Fire, a culturally adapted version of acceptance and commitment therapy. Groups 1 and 2 received the 6-week intervention during Weeks 1 through 6 and 7 through 12, respectively. The main outcomes were feasibility (recruitment, retention, and completion) and acceptability. The theoretical framework of acceptability informed the focus group guide used to assess acceptability. We used thematic analysis to code the qualitative data and to identify salient themes across participants' narratives.

Results: Recruitment (70%), retention (83.3%), and completion (82%) rates demonstrated that the intervention was feasible. Participants perceived the intervention to be acceptable, especially because it fit with their personal and collective values. We generated two overarching themes: Becoming More Whole and Having a Trusted Space to Address Depression Symptoms and Related Experiences, which represented the interconnected processes of personal growth and collective healing that occurred throughout the intervention.

Conclusion: The findings provide evidence to support the delivery of peer-delivered mental health interventions for middle-age and older Black women.

Menopause is a process of hormonal changes that typically starts in a woman's mid- to late 40s and is associated with an increased risk of depression. However, whether the association is truly causal or purely correlational has been disputed for decades. In this column, I review the evidence on the associations between menopause and depression symptoms and diagnoses, the controversy, and the implications for research and practice. I conclude with information from professional organizations, but there are noted gaps in mental health resources for menopause.

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 and improve positive maternal and neonatal outcomes.

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 analysis.

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 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 explore and describe perceptions of provider inquiry regarding housing status among pregnant women experiencing housing instability.

Design: Secondary qualitative analysis using analytic expansion.

Setting: In-person and online interviews in the Mid-Atlantic and Washington, DC, region.

Participants: English-speaking women who were pregnant or gave birth within the past year, were 18 years or older, and were experiencing housing instability (N = 14).

Methods: We undertook a secondary analysis of primary data collected via semistructured interviews in the mid-Atlantic and Washington, DC, region between February 2020 and December 2021. These data were part of a primary study in which we explored the effect of housing and health during pregnancy and the postpartum period, barriers and facilitators to health care, and social support. In this secondary analysis, we used reflexive thematic analyses to interpret interpretations and discover themes.

Results: Fourteen participants answered the question regarding provider inquiry. Nine participants (64%) expressed no inquiry about their housing status and reported that visits were too short or focused more on fetal health. Many participants shared that they received limited provider support with housing challenges. Disclosing housing status depended on the patient-provider relationship and belief in the provider's ability to help and support. Three overarching themes emerged: Provider Inquiry About Housing, The Value of Relationships, and Improving Access to Housing Support and Services.

Conclusion: The current service delivery model for pregnant women does not adequately address social determinants of health. Future researchers should focus on the intersection of pregnancy and housing instability to determine whether restructuring of policy and practice is needed. Nurse-midwives and other maternity care providers can be key points of contact in facilitating housing support for pregnant women with unstable housing status.

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.

Objective: To explore expectations and perspectives related to infant feeding of their first child among rural women.

Design: Qualitative descriptive.

Setting: Rural women who were first-time mothers (N = 18).

Methods: We recruited participants from the Special Supplemental Nutrition Program for Women, Infants, and Children clinics and a nurse home-visiting program in a midwestern U.S. state. Using the construct of habitus, we developed an interview guide and used semistructured interviews to explore the expectations and perspectives of participants regarding infant feeding of the first child. We analyzed the transcribed interviews using content analysis techniques to identify overall themes.

Results: We identified four overarching themes and associated subthemes that represented participants' expectations and perspectives: I'm Educated but Not So Much on Breastfeeding, This Is How It Is in a Small Town, I Had Expectations, and This Area Lacks Resources for Mothers.

Conclusion: Overall, participants had high expectations to breastfeed. However, most discontinued breastfeeding soon after giving birth due to a lack of pragmatic knowledge about how to breastfeed, poor understanding of infant nutritional needs in the first few weeks of life, and a nonsupportive habitus.

Objective: To explore what is currently known about women's breastfeeding experiences associated with maternity care in facilities that implement policies supported by the Baby-Friendly Hospital Initiative (BFHI).

Data sources: We used the scoping review methodology of JBI. We searched the Scopus, CINAHL, Embase, MEDLINE (Ovid), and PsycINFO databases and gray literature.

Study selection: We considered articles published during or after 1991 in English. Inclusion criteria were based on the participant, concept, and context framework and included women who gave birth and initiated breastfeeding during or after maternity care in facilities that were certified through the BFHI, were working toward certification, or were implementing BFHI-aligned policies.

Data extraction: We extracted the following data from each report: author(s), year/country of publication, study design, research aim, patient population/sample size, clinical setting, BFHI status, and outcomes. We further extracted relevant outcomes by using concepts from the interactive theory of breastfeeding.

Data synthesis: We included 44 reports of studies conducted in 19 countries in the review: 27 quantitative, 9 qualitative, and 8 mixed-methods studies. We mapped the extracted data to 10 concepts from the interactive theory of breastfeeding to classify patient experiences, including dynamic interaction between mother and child; stress; time; woman's and child's biological conditions; woman's and child's perception; woman's decision-making; family and social authority; woman's body image; space; and organizational systems for the protection, promotion, and support of breastfeeding.

Conclusion: We found that various interrelated factors in addition to BFHI-specific policies influenced women's experiences. Based on these results, we suggest that awareness of women's personal breastfeeding experiences is crucial to delivering optimal care and developing evidence-based policies. Breastfeeding practice guidelines and policies should be developed to encompass women's experiences to enhance future inpatient breastfeeding support.