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Development and Evaluation of a Conceptual Framework for the Use of Fetal Myelomeningocele Repair 胎儿脊髓脊膜膨出修复的概念框架的发展和评价。
IF 2 4区 医学 Q2 NURSING Pub Date : 2025-11-01 DOI: 10.1016/j.jogn.2025.09.001
Stephanie A. Eyerly-Webb, Amanda J. Nickel, Amy M. Linabery, Emily F. Barthel, Shukri Jumale, Jill Palmer, Melinda Stober, Nicholas Juckel, Ian Wolfe, Saul Snowise, Clifton O. Brock, Stella K. Evans

Objective

To develop and evaluate a conceptual framework of the use of fetal myelomeningocele/myeloschisis (fMMC) repair.

Design

Exploratory sequential mixed methods study.

Setting

Midwest Fetal Care Center, Minneapolis, Minnesota.

Participants

Fetal care experts (n = 7) and health records of patients evaluated for fMMC repair (n = 159).

Methods

Through an expert roundtable, we developed a conceptual framework for the use of fMMC repair based on Andersen’s behavioral model of health service use (qualitative). We selected variables from our conceptual framework that were available in existing health records to examine associations between contextual and individual factors and eligibility for and use of fMMC repair (quantitative).

Results

Our conceptual framework (qualitative) included predisposing contextual factors (prenatal health care, community norms), enabling contextual factors (health care/insurance policies, referral patterns, center attributes), predisposing individual factors (demographics, beliefs), and enabling individual factors (finances, eligibility). In the quantitative analysis, we found that very few factors were associated with eligibility or use of fMMC repair, with the exception of private health insurance (p = .01), although we did not measure several contextual factors. Most participants (n = 148, 93%) resided in very low/low maternal vulnerability counties, and we observed no differences between the surgical disposition groups (p = .15).

Conclusions

We developed a framework to identify and conceptually relate contextual and individual-level characteristics that may affect the use of fMMC repair. Our conceptual framework may be used by future researchers to fully evaluate the access to and use of fMMC repair.
目的:发展和评估胎儿髓膜膨出/髓裂(fMMC)修复的概念框架。设计:探索性顺序混合方法研究。地点:明尼苏达州明尼阿波利斯中西部胎儿护理中心。参与者:胎儿护理专家(n = 7)和fMMC修复评估患者的健康记录(n = 159)。方法:通过专家圆桌会议,我们在Andersen的卫生服务使用行为模型(定性)的基础上,开发了fMMC修复使用的概念框架。我们从我们的概念框架中选择了现有健康记录中可用的变量,以检查环境和个人因素与fMMC修复资格和使用之间的关联(定量)。结果:我们的概念框架(定性)包括易感环境因素(产前保健、社区规范)、使能环境因素(卫生保健/保险政策、转诊模式、中心属性)、易感个人因素(人口统计学、信仰)和使能个人因素(经济状况、资格)。在定量分析中,我们发现除了私人健康保险外,很少有因素与fMMC修复的资格或使用相关(p = 0.01),尽管我们没有测量几个背景因素。大多数参与者(n = 148, 93%)居住在非常低/低产妇脆弱性县,我们观察到手术处理组之间没有差异(p = 0.15)。结论:我们开发了一个框架来识别和概念上联系可能影响fMMC修复使用的上下文和个人水平特征。我们的概念框架可以被未来的研究者用来全面评估fMMC修复的获取和使用。
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引用次数: 0
Access to Health Care 获得医疗保健。
IF 2 4区 医学 Q2 NURSING Pub Date : 2025-11-01 DOI: 10.1016/j.jogn.2025.07.001
Association of Women’s Health, Obstetric and Neonatal Nurses
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引用次数: 0
Enhancing JOGNN’s Online Presence for Better Access to Evidence 加强johnn的在线存在,以更好地获取证据。
IF 2 4区 医学 Q2 NURSING Pub Date : 2025-11-01 DOI: 10.1016/j.jogn.2025.10.003
Joyce K. Edmonds
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引用次数: 0
The REDUCED Trial: A Cluster Randomized Trial for REDucing the Utilization of Cesarean Delivery for Dystocia 减少试验:一项减少剖宫产难产利用率的聚类随机试验。
IF 2 4区 医学 Q2 NURSING Pub Date : 2025-11-01 DOI: 10.1016/j.jogn.2025.10.004
Ellise D. Adams PhD, RN
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引用次数: 0
Period Poverty Across the Life Course 贯穿一生的贫困时期。
IF 2 4区 医学 Q2 NURSING Pub Date : 2025-11-01 DOI: 10.1016/j.jogn.2025.10.007
Summer Sherburne Hawkins
Period poverty, defined as inadequate access to menstrual hygiene products due to financial constraints, is a hidden yet pressing public health issue in the United States. Between one-half and two-thirds of adolescents and women experience period poverty, leading to medical, mental health, educational, economic, and social consequences. In this column, I review the epidemiology of period poverty, gaps in research and screening, the importance of patient-provider partnerships, and policy implications. I conclude with information from professional organizations and the call to screen for period poverty in clinical settings.
经期贫困的定义是由于财政拮据而无法获得经期卫生用品,这是美国一个隐藏但紧迫的公共卫生问题。一半至三分之二的青少年和妇女经历经期贫困,导致医疗、心理健康、教育、经济和社会方面的后果。在本专栏中,我回顾了经期贫困的流行病学、研究和筛查方面的差距、患者-提供者伙伴关系的重要性以及政策含义。我总结了来自专业组织的信息以及在临床环境中筛查经期贫困的呼吁。
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引用次数: 0
Case Report of Piperacillin-Induced Toxic Epidermal Necrolysis During Pregnancy 妊娠期哌拉西林致中毒性表皮坏死松解1例报告。
IF 2 4区 医学 Q2 NURSING Pub Date : 2025-11-01 DOI: 10.1016/j.jogn.2025.07.007
Dongqi Yang, Liping Zhou
Toxic epidermal necrolysis (TEN) is a rare condition in the general population, and its occurrence during pregnancy is even more uncommon. Toxic epidermal necrolysis is associated with a high mortality rate that necessitates prompt referral to a specialized burn center upon diagnosis to optimize patient outcomes. In the case presented, the patient was treated in the obstetrics department, where nursing staff may have had limited experience in managing TEN. Currently, no established guidelines are available for the nursing care of patients with TEN during pregnancy. In this case report, we detail the nursing care process for a patient who developed TEN during early pregnancy, provide novel insights, and contribute to the limited literature on the management of pregnancy-associated TEN.
中毒性表皮坏死松解症(TEN)在一般人群中是一种罕见的疾病,在怀孕期间发生更是罕见。中毒性表皮坏死松解与高死亡率相关,需要在诊断后立即转诊到专门的烧伤中心,以优化患者的预后。在本病例中,患者在产科接受治疗,那里的护理人员可能在管理TEN方面经验有限。目前,尚无针对妊娠期TEN患者护理的既定指南。在本病例报告中,我们详细介绍了一位在妊娠早期发生TEN的患者的护理过程,提供了新的见解,并为妊娠相关TEN的管理提供了有限的文献。
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引用次数: 0
Patient Disability Status and the Use of Stigmatizing Language in Clinical Notes During Hospital Admission for Birth 住院分娩患者残疾状况及临床记录中污名化语言的使用
IF 2 4区 医学 Q2 NURSING Pub Date : 2025-11-01 DOI: 10.1016/j.jogn.2025.08.003
Sarah E. Harkins, Ismael I. Hulchafo, Jihye Kim Scroggins, Caroline Walsh, Meghan Didier, Maxim Topaz, Veronica Barcelona

Objective

To examine the association between patient disability status and use of stigmatizing language in clinical notes from the hospital admission for birth.

Design

Cross-sectional study of electronic health record data.

Setting

Two urban hospitals in the northeastern United States.

Participants

Patients at more than 20 weeks gestation admitted for birth from 2017 to 2019 (N = 19,094).

Methods

We used a natural language processing algorithm to identify categories of stigmatizing language used in free-text clinical notes (N = 211,841 unique clinical notes). We employed multivariable logistic regression to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for each stigmatizing language category by disability status, which we determined by ICD-10 (International Classification of Diseases, 10th revision) codes.

Results

Approximately 3% of patient records (n = 550) included ICD-10 codes for disability. Clinicians were more likely to use stigmatizing language for patients with disabilities compared with patients without disabilities (aOR = 1.75, 95% CI = [1.47, 2.09]). For patients with disabilities compared with patients without disabilities, clinicians were also more likely to use stigmatizing language in the difficult patient category (aOR = 1.96, 95% CI = [1.65, 2.33]) and the unilateral/authoritarian decisions category (aOR = 1.27, 95% CI = [1.06, 1.53]). We found no significant differences for the marginalized language/identities category by patient disability status (aOR = 1.19, 95% CI = [0.87, 1.62]).

Conclusion

The use of stigmatizing language in birth hospitalization notes differed by patient disability status. Stigmatizing language should be used as a marker of bias and an opportunity for clinicians to reflect on their thoughts, words, and actions. Patient-centered documentation and care practices are needed to improve perinatal health for all.
目的:探讨新生儿住院时临床记录中患者残疾状况与污名化语言使用的关系。设计:电子健康记录数据的横断面研究。环境:美国东北部的两家城市医院。参与者:2017年至2019年住院分娩的20周以上妊娠患者(N = 19094)。方法:采用自然语言处理算法识别自由文本临床笔记(N = 211,841个独特临床笔记)中使用的污名化语言类别。我们采用多变量逻辑回归来估计由残疾状况决定的每个污名化语言类别的调整优势比(aORs)和95%置信区间(CIs),我们由ICD-10(国际疾病分类,第10版)代码确定。结果:大约3%的患者记录(n = 550)包含ICD-10残疾代码。与无残疾患者相比,临床医生更容易对残疾患者使用污名化语言(aOR = 1.75, 95% CI =[1.47, 2.09])。对于残疾患者,与无残疾患者相比,临床医生在困难患者类别(aOR = 1.96, 95% CI =[1.65, 2.33])和单边/专制决策类别(aOR = 1.27, 95% CI =[1.06, 1.53])中也更容易使用污名化语言。我们发现边缘化语言/身份类别因患者残疾状况而无显著差异(aOR = 1.19, 95% CI =[0.87, 1.62])。结论:出生住院记录中污名化语言的使用因患者残疾状况而异。污名化的语言应该被用作偏见的标志,也是临床医生反思自己的思想、言语和行为的机会。需要以患者为中心的记录和护理实践,以改善所有人的围产期健康。
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引用次数: 0
Cervical Ripening and Labor Induction and Augmentation, 6th Edition 宫颈成熟和引产和增强,第6版。
IF 2 4区 医学 Q2 NURSING Pub Date : 2025-11-01 DOI: 10.1016/j.jogn.2025.03.002
Kathleen Rice Simpson
Cervical ripening and induction and augmentation of labor are common procedures in labor and birth units. The potential risks and benefits of the procedures should be explained to women so they can make an informed decision. Nurses should be knowledgeable about the methods and medications used and be skilled in maternal-fetal assessment. Adequate nurse staffing as per the AWHONN (2022c) Standards for Professional Registered Nurse Staffing for Perinatal Units is required to monitor the woman and fetus to promote the best possible outcomes.
This practice monograph includes information on mechanical and pharmacologic methods for cervical ripening; labor induction and augmentation with oxytocin, a high alert drug; and nurse staffing levels needed to provide safe and effective care during cervical ripening and labor induction and augmentation.
宫颈成熟和引产是产房和产房常见的程序。应该向妇女解释手术的潜在风险和益处,以便她们做出明智的决定。护士应了解所使用的方法和药物,并熟练掌握母胎评估。根据AWHONN (2022c)围产期专业注册护士配备标准,需要配备足够的护士来监测妇女和胎儿,以促进最佳结果。这个实践专著包括信息机械和药理学方法的宫颈成熟;催产素(一种高度警戒药物)引产和增强;在宫颈成熟和引产过程中需要提供安全有效的护理人员。
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引用次数: 0
Scoping Review of Health Literacy Interventions for Pregnant Women in Developing Countries. 发展中国家孕妇健康素养干预措施的范围审查。
IF 2 4区 医学 Q2 NURSING Pub Date : 2025-10-31 DOI: 10.1016/j.jogn.2025.10.008
Zama Mkhonta, Yu-Yun Hsu, Maggie Dumsile Dlamini

Objective: To identify and describe health literacy interventions for pregnant women in developing countries, including characteristics, implementation strategies, and cultural adaptations.

Data sources: MEDLINE, Embase, Cochrane Library, CINAHL, Education Resources Information Center, reference lists, and Google Scholar.

Study selection: We considered reports of studies published from the inception of each database through December 24, 2024. We included studies in which researchers evaluated interventions designed to improve health literacy among pregnant women who received antenatal care in clinical or community settings. We included studies regardless of language. We excluded conference abstracts, essays, dissertations, review articles, and studies that did not meet inclusion criteria after full-text review.

Data extraction: We extracted information on author(s), year of publication, country, study design, setting, type of intervention, delivery strategies, factors influencing health literacy, and reported outcomes.

Data synthesis: We grouped and described studies according to the reported interventions. We included 23 studies conducted across Africa (n = 18), Asia (n = 4), and the Caribbean (n = 1). Identified interventions included group-based education (n = 8), one-on-one education (n = 11), mobile health interventions (n = 5), peer educator-based programs (n = 1), and community-based approaches (n = 3). Most interventions were delivered within antenatal care clinics, and some were delivered in community settings. Participatory strategies, such as storytelling, role-playing, and culturally tailored communication, were commonly used.

Conclusion: Health literacy interventions strengthen communication, knowledge, and health-care-seeking behaviors; however, challenges related to access to health care services, sustainability, and cultural adaptation underscore the need for intervention designs that meet local health care contexts in developing countries.

目的:确定和描述发展中国家孕妇健康素养干预措施,包括特点、实施策略和文化适应。数据来源:MEDLINE, Embase, Cochrane图书馆,CINAHL,教育资源信息中心,参考文献列表,谷歌Scholar。研究选择:我们考虑了从每个数据库建立到2024年12月24日发表的研究报告。我们纳入的研究中,研究人员评估了旨在提高在临床或社区环境中接受产前护理的孕妇的健康素养的干预措施。我们纳入了与语言无关的研究。我们排除了在全文审查后不符合纳入标准的会议摘要、论文、论文、综述文章和研究。数据提取:我们提取了作者、发表年份、国家、研究设计、环境、干预类型、交付策略、影响健康素养的因素和报告结果等信息。数据综合:我们根据报道的干预措施对研究进行分组和描述。我们纳入了在非洲(n = 18)、亚洲(n = 4)和加勒比地区(n = 1)进行的23项研究。确定的干预措施包括基于群体的教育(n = 8)、一对一教育(n = 11)、流动卫生干预(n = 5)、基于同伴教育者的方案(n = 1)和基于社区的方法(n = 3)。大多数干预措施是在产前保健诊所提供的,有些是在社区环境中提供的。参与式策略,如讲故事、角色扮演和文化定制沟通,是常用的。结论:健康素养干预可增强沟通、知识和就医行为;然而,与获得卫生保健服务、可持续性和文化适应有关的挑战突出表明,需要设计符合发展中国家当地卫生保健情况的干预措施。
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引用次数: 0
Awareness of the Vaginal Microbiome and Willingness to Undergo Vaginal Microbiota Transplant. 对阴道微生物群的认识和接受阴道微生物群移植的意愿。
IF 2 4区 医学 Q2 NURSING Pub Date : 2025-10-31 DOI: 10.1016/j.jogn.2025.10.009
Ellie Kroeger, Caeli Malloy, Chen X Chen, Kaboni Whitney Gondwe, Kendra Kamp

Objective: To examine awareness of the vaginal microbiome and vaginal microbiota transplant, willingness to undergo vaginal microbiota transplant, and factors that influence the decision to undergo the procedure.

Design: Cross-sectional descriptive survey study.

Setting: Online distribution from October 2024 to January 2025.

Participants: Respondents (N = 210) who self-identified as women (n = 198), men (n = 2), gender nonconforming (n = 14), transgender (n = 3), other (n = 2), and not specified (n = 2) and had vaginas.

Methods: The survey included questions about patient demographics, gynecologic and pelvic symptoms and conditions, and vaginal microbiota transplantation awareness and willingness. We used descriptive statistics to summarize the quantitative data and conducted conventional content analysis to examine responses to open-ended questions about factors to undergo vaginal microbiota transplantation.

Results: Most respondents (n = 176, 83.8%) had not heard of vaginal microbiota transplant. However, more than 50% of respondents were willing or very willing to undergo vaginal microbiota transplantation for each presented indication: prevent yeast infections, bacterial vaginosis, or cytolytic vaginosis (n = 131, 62.4%); reduce risk of sexually transmitted infections (n = 130, 61.9%); alleviate menstrual pain (n = 126, 60.0%); prevent urinary tract infections (n = 126, 60.0%); alleviate vaginal symptoms (n = 120, 57.1%); prevent preterm births (n = 119, 56.7%). We identified five categories from 180 responses about factors that influenced the decision to undergo vaginal microbiota transplantation: Evidence, Procedure Logistics, Health Care Factors, Personal Factors, and Donor Health.

Conclusion: Increased awareness about the vaginal microbiome and vaginal microbiota transplantations is necessary. Factors that influence willingness to undergo the procedure should be addressed in designing and implementing this new intervention.

目的:了解阴道菌群和阴道菌群移植的认知度、接受阴道菌群移植的意愿以及影响接受阴道菌群移植决定的因素。设计:横断面描述性调查研究。设定:2024年10月至2025年1月在线发行。参与者:受访者(N = 210),自我认同为女性(N = 198),男性(N = 2),性别不一致(N = 14),变性(N = 3),其他(N = 2),以及未指定(N = 2),并有阴道。方法:调查包括患者人口统计学、妇科和盆腔症状和状况、阴道微生物群移植的意识和意愿等问题。我们使用描述性统计来总结定量数据,并进行常规内容分析来检查对开放式问题的回答,这些问题是关于进行阴道微生物群移植的因素。结果:大多数受访者(n = 176, 83.8%)没有听说过阴道菌群移植。然而,超过50%的受访者愿意或非常愿意接受阴道微生物群移植的每一个提出的适应症:预防酵母菌感染,细菌性阴道病,或溶解性阴道病(n = 131, 62.4%);减少性传播感染的风险(n = 130, 61.9%);缓解月经疼痛(n = 126, 60.0%);预防尿路感染(n = 126, 60.0%);缓解阴道症状(n = 120, 57.1%);预防早产(n = 119, 56.7%)。我们从180个影响接受阴道微生物群移植决定的因素中确定了五个类别:证据、程序后勤、卫生保健因素、个人因素和供体健康。结论:提高对阴道微生物群和阴道微生物群移植的认识是必要的。在设计和实施这种新的干预措施时,应解决影响接受手术意愿的因素。
{"title":"Awareness of the Vaginal Microbiome and Willingness to Undergo Vaginal Microbiota Transplant.","authors":"Ellie Kroeger, Caeli Malloy, Chen X Chen, Kaboni Whitney Gondwe, Kendra Kamp","doi":"10.1016/j.jogn.2025.10.009","DOIUrl":"10.1016/j.jogn.2025.10.009","url":null,"abstract":"<p><strong>Objective: </strong>To examine awareness of the vaginal microbiome and vaginal microbiota transplant, willingness to undergo vaginal microbiota transplant, and factors that influence the decision to undergo the procedure.</p><p><strong>Design: </strong>Cross-sectional descriptive survey study.</p><p><strong>Setting: </strong>Online distribution from October 2024 to January 2025.</p><p><strong>Participants: </strong>Respondents (N = 210) who self-identified as women (n = 198), men (n = 2), gender nonconforming (n = 14), transgender (n = 3), other (n = 2), and not specified (n = 2) and had vaginas.</p><p><strong>Methods: </strong>The survey included questions about patient demographics, gynecologic and pelvic symptoms and conditions, and vaginal microbiota transplantation awareness and willingness. We used descriptive statistics to summarize the quantitative data and conducted conventional content analysis to examine responses to open-ended questions about factors to undergo vaginal microbiota transplantation.</p><p><strong>Results: </strong>Most respondents (n = 176, 83.8%) had not heard of vaginal microbiota transplant. However, more than 50% of respondents were willing or very willing to undergo vaginal microbiota transplantation for each presented indication: prevent yeast infections, bacterial vaginosis, or cytolytic vaginosis (n = 131, 62.4%); reduce risk of sexually transmitted infections (n = 130, 61.9%); alleviate menstrual pain (n = 126, 60.0%); prevent urinary tract infections (n = 126, 60.0%); alleviate vaginal symptoms (n = 120, 57.1%); prevent preterm births (n = 119, 56.7%). We identified five categories from 180 responses about factors that influenced the decision to undergo vaginal microbiota transplantation: Evidence, Procedure Logistics, Health Care Factors, Personal Factors, and Donor Health.</p><p><strong>Conclusion: </strong>Increased awareness about the vaginal microbiome and vaginal microbiota transplantations is necessary. Factors that influence willingness to undergo the procedure should be addressed in designing and implementing this new intervention.</p>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12616623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing
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