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

Female genital mutilation and cutting (FGM/C) is a human rights violation and a form of gender-based violence. Yet it is estimated that more than 230 million women and girls globally and over half a million women and girls living in the United States have been subjected to FGM/C or are at risk. Due to rising rates of immigration to the United States, it is more likely that health care providers will encounter patients subjected to FGM/C. In this column, I review clinicians’ knowledge of and experience in delivering care to women with FGM/C, patient experiences, the role of clinical guidelines, screening, research gaps, laws, and data. I conclude with recommendations from professional organizations related to the reproductive health needs of women affected by FGM/C during pregnancy and birth.

Objective

To explore the feasibility of recruitment, adherence, and retention and the acceptability of the FitMoms2B physical activity promotion program and study measures among non-Hispanic Black women with high-risk pregnancies.

Design

One-arm pilot feasibility study.

Setting

A large regional high-risk prenatal clinic in the southeastern United States.

Participants

Non-Hispanic Black women who had singleton, high-risk pregnancies at 16 to 23 weeks gestation with no contraindications to physical activity (N = 13).

Method

We evaluated the feasibility and acceptability of a multicomponent intervention, which included physical activity coaching, support from a workout partner, and an activity tracker. We also assessed the feasibility of study measures for future trials of the program.

Results

Of 179 patients screened, 20 were eligible, and 13 consented and enrolled (65%). Of the 13 participants, 9 completed data collection at Time Point (T) 1 (16–23 weeks gestation) and T2 (24–30 weeks), and 8 completed data collection at T3 (31 or more weeks). Adherence met expectations for coaching (63%), exercise with a workout partner (100%), and use of the activity tracker (92%). Acceptability was high (100%).

Conclusion

We found that recruitment, retention, and adherence are feasible for the FitMoms2B physical activity promotion program. The program and study measures were acceptable to participants in our sample. We provide preliminary support for a randomized controlled trial to study physical activity promotion with virtual coaching, workout partner support, and activity tracking among Black pregnant women with high-risk pregnancies without contraindications to physical activity.

Objective

To examine women’s experiences of pelvic congestion syndrome (PCS) pain.

Design

Descriptive, cross-sectional.

Setting

Online questionnaires in a Facebook PCS support group.

Participants

Convenience sample of 143 women who self-identified as being diagnosed with PCS.

Methods

We recruited women through a social media support group and invited them to participate in a self-reported questionnaire. We collected demographic information and used the McGill Pain Questionnaire to elicit responses related to pain quality, pain intensity, quality of life, and satisfaction with health care. We analyzed data using descriptive statistics and correlation coefficients.

Results

Respondents characterized their PCS pain as exhausting, stabbing, sharp, shooting, and tender. Respondents indicated that 19 of 24 daily activities increased PCS pain, whereas only 5 reduced PCS pain. Pain intensity was negatively related to the quality of life, health satisfaction, sleep, and sexual relationships.

Conclusion

Chronic pelvic pain from PCS severely affected quality of life among respondents. These findings suggest a difference in the presentation of PCS from historical pain depictions and further highlight the need to identify pain profiles to increase timely and precise diagnosis. Further research is needed to evaluate interventions to increase the quality of life for women with PCS.

Objective

To examine use of mental health treatment, substance use disorder treatment, and perceived barriers to treatment by whether a major depressive episode occurred during the past year among parenting women with opioid use disorder.

Design

Secondary analysis of survey data from the National Survey on Drug Use and Health, 2015–2019.

Setting

United States.

Participants

Women aged 18 to 44 years with opioid use disorder and at least one child in the household.

Methods

We computed descriptive statistics for demographic characteristics, treatment by major depressive episode status, and barriers to treatment by major depressive episode status. We conducted multinomial logistic regression to examine associations among demographic characteristics, major depressive episode status, and type of treatment.

Results

Of the 36% of respondents in our weighted sample (N ≈ 254,300) who experienced major depressive episode, 35% received substance use disorder and mental health treatment, and 27% did not receive any form of treatment. We found that identification as a person of color was significantly associated with a lower relative risk of receiving any type of treatment. Frequently reported barriers to treatment included affordability, access, and stigma.

Conclusion

Respondents with opioid use disorder and co-occurring major depressive episode did not obtain necessary treatment. Barriers to treatment, including affordability, access to treatment, and stigma, need to be addressed, particularly among women of color.

Objective

To describe the experiences of women with histories of depression who used a responsive infant bassinet during the first 6 months after birth during the COVID-19 pandemic.

Design

Secondary qualitative descriptive study with analytic expansion.

Setting

United States.

Participants

Women (N = 139) who gave birth up to 6 months previously and had histories of depression.

Methods

We used Kyngäs’s method of inductive content analysis to analyze 109 open-ended responses that were collected between August 2020 to November 2021 as part of a previously conducted longitudinal study of women who used a responsive bassinet.

Results

Most participants indicated that the responsive bassinet improved their infants’ sleep, which, in turn, subjectively improved their sleep and mood. External stressors and challenges presented barriers to good sleep for the participants and their infants, and participants described how these challenges contributed to their symptoms related to mood. When participants reported that they used the responsive bassinet, they shared that their infants were swaddled in the supine sleep position. Participants who did not use the bassinet commonly reported unsafe sleep practices. We identified seven themes from the data: Improved Maternal Sleep Quality, Barriers to Good Maternal Sleep, Mood and Sleep Go Hand and Hand, External Stressors Impair Mood, Improved Infant Sleep Quality, Barriers to Good Infant Sleep, and Safe Sleep Positioning.

Conclusion

These findings can be used to inform clinicians on how a responsive bassinet may offer women at high risk for postpartum depression improved sleep and instrumental support. Future researchers should use validated measures to objectively evaluate rates of postpartum depression and sleep quality in high-risk women when using a responsive bassinet.

Climate change poses a serious threat to the health and well-being of pregnant women and their developing fetuses. Certain populations are at greater risk of adverse outcomes from air pollution, a contributing factor to climate change. In addition, heightened exposure to extreme heat, a consequence of climate change, exacerbates the existing health care inequities in the United States. Nurses, midwives, and other health care clinicians are uniquely positioned to reduce the harmful effects of climate change by educating pregnant women and their families and advocating for systems and policies that can decelerate climate change. The purpose of this article is to provide resources for clinicians to use in educating pregnant women about the risks of extreme heat and air pollution, their potential effects on pregnancy and neonatal outcomes, and strategies to help mitigate risk. We conclude with implications for practice, opportunities for advocacy, and areas for future research.

Objective

To examine the effect of psychological distress, overall distress, and institutional support following a traumatic workplace event on absenteeism, turnover intention, and resilience among labor and delivery nurses.

Design

A quantitative cross-sectional survey.

Setting

Online distribution from January 13, 2021, to February 2, 2021.

Participants

A nationwide convenience sample of labor and delivery nurses recruited from the Association of Women’s Health, Obstetric and Neonatal Nurses (N = 171).

Methods

Participants completed a survey that included the Second Victim Experience and Support Tool–Revised and the Second Victim Support Desirability survey. We compared available versus desired support options using descriptive analyses. We examined levels of psychological distress and lack of institutional support in relation to turnover intention, absenteeism, and resilience using multiple regression analyses.

Results

Participants identified and described various traumatic experiences in the workplace, including neonatal and maternal death, complicated births, and workplace violence. Participants indicated that the available support services did not meet their needs. Psychological distress, overall distress, and lack of institutional support were associated with absenteeism and turnover, whereas only institutional support was associated with resilience.

Conclusion

Labor and delivery nurses encounter various traumatic events in the workplace, and the support services provided after an event do not meet their needs. Additional research is needed to understand the scope of the problem and investigate best practices to assist labor and delivery nurses following traumatic events.

Objective

To examine experiences of intimate partner violence (IPV) screening among women who sell sex.

Design

A qualitative descriptive study.

Setting

Telephone interviews during the COVID-19 pandemic (June 2020 to October 2020).

Participants

Women aged 18 to 49 years who sold or traded sex for food, drugs, money, or shelter at least three times during the past 3 months before recruitment (N = 22).

Methods

We used individual, semistructured telephone interviews to collect data about participants’ experiences with IPV and IPV screening during health care encounters. We used reflexive thematic analysis to examine these data.

Results

We identified two overarching themes related to IPV screening experiences: Preferences for IPV Screening and Barriers to Disclosure of IPV Experiences. Participants described a preference for IPV screening done face-to-face with providers who show a genuine interest in their responses. Stigma was a barrier of IPV disclosure.

Conclusion

Health care providers are a trusted safety net for disclosure of IPV experiences. Providing screening in a trauma-informed, nonstigmatizing manner may facilitate disclosure of IPV by women who sell sex. Future research among marginalized populations is needed to examine ways to address IPV in clinical settings with a harm reduction empowerment lens.

In this critical commentary, we describe the many limitations of the pregnancy planning paradigm as applied to pregnant and parenting teens. We describe how this paradigm, in characterizing pregnancies as intended or unintended, has shaped campaigns to prevent teen pregnancy and remains largely embedded in formal sex education and family planning programs in the United States. We argue that a paradigm shift is long overdue and describe how the reproductive justice framework addresses the limitations of the pregnancy planning paradigm. Although reproductive justice is endorsed by a growing number of organizations, recommended policies face formidable obstacles given that comprehensive sex education, contraception, and legal abortion are increasingly at risk in a post-Dobbs world.