AWHONN's clinical issues in perinatal and women's health nursing最新文献

Creating an ethical work environment in a health care organization is both necessary and difficult. In the process of providing care, nurses often make decisions with ethical implications. This decision making is enhanced when the work environment supports an ethical approach. Nursing can implement strategies to support ethical decision making.

Resolution of ethical issues requires critical thinking and problem solving skills. This article reviews the professional code of ethics for nurses and decision-making frameworks as guides to assist nurses in becoming active participants in the process of ethical reflection.

Despite the growing national concern about the effect of the use of alcohol and other drugs on the health and productivity of men and women, relatively little is know about alcohol and other drug (AOD) problems in women. Because of this lack of research and the stigma associated with women who are alcoholic or drug addicted, AOD problems among women are less likely to be recognized and addressed. This article reviews patterns and consequences of AOD use among a number of special populations of women. Information about risk factors and assessment and screening are included to assist the nurse in the identification, counseling, and referral of women with AOD-related problems.

Women represent more than 75% of the individuals who receive obesity treatment; suprisingly, the numbers of morbidly obese white men and women are approximately equal. Surgical and nonsurgical medical treatments are successful in promoting weight loss; however, maintaining the weight loss is a continuing problem. Weight loss provides many benefits but can lead to undesirable consequences (eg, gallstones and nutrient deficiencies). Long-term success can be accomplished only if the weight loss is permanent; weight cycling increases the health risks associated with obesity. Caution should be exercised in choosing a treatment for obesity so that weight loss is not accomplished at the expense of the health of the individual.

This article discusses the perinatal health issue of abuse directed at pregnant women by their intimate partners. The incidence, prevalence, and severity of intimate violence during pregnancy are presented, as is a discussion of the possible health disruptions that can occur as a result of violence and abuse. Nursing interventions for abused pregnant women are presented within a framework of advocacy and empowerment. Strategies for primary prevention are outlined, and methods of secondary and tertiary intervention are discussed. The article concludes with a discussion of culturally relevant practice for abused women.

The eating disorders of anorexia nervosa and bulimia nervosa are important health problems for women today. Nurses at different practice sites are in a position to assess, treat, and refer these women, depending on educational and clinical preparation. This article presents information to facilitate the role of the nurse in working with women with eating disorders. Clinical features, risk factors, and treatment options are discussed.

Because of reported biologic research and mass media attention, the decision to take or not to take noncontraceptive hormones to prevent cardiovascular disease (CVD) is a major women's health issue. This article offers research-based knoweledge on menopause, CVD, and noncontraceptive hormones that is essential for postmenopausal clients and nurses for their thoughtful examination of this issue. By building on this knowledge base and using a client-provider interaction model, a shared decision can be sought that is comfortable and viable for the client.

Native American nations and peoples have experienced hundreds of years of oppression, prejudice, poverty, and the lack of self-determination. This has resulted in a disintegration of self-esteem and traditional values that are manifested in high rates of self-inflicted injury and other violence, including suicide, homicide, alcoholism, and domestic violence. Nurses have a key role to play in addressing violence in Native American communities. Cultural sensitivity is central to effective intervention.

Family-centered perinatal education is a health education service focused on the family unit during the childbirth period and is supportive to all family members as the family moves from one stage of development to the next. It is distinct from traditional childbirth education and family-centered maternity care by being a single educational intervention that addresses the needs of the entire family during the prenatal and postpartum periods. The advantages of family-centered perinatal education are discussed from the consumer's and educator's perspectives. Such education emphasizes extending social support into the postpartum period as a buffer against the effects of stress on new parents. Teaching and learning occur in a more timely manner. Family members learn what is most needed when it is most needed and avoid the feeling of being "cut loose" from the health care system right after the birth. Family-centered perinatal education is likely to become an increasingly popular consumer option as hospitals compete to provide the best obstetric/neonatal care.

This article presents research-based information about the teaching needs of parents of low-birth-weight, preterm infants. An overview is presented regarding who needs to be taught, at what times, and in what manner. The type of information that parents have stated they found important is reviewed, as are general categories of information that health care providers feel are important for families to know. Family teaching is a critical component of the care nurses give because it helps to ensure that families are able to care for their infants at home.