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

Interest in developing hospital-based domestic violence programs, protocols, policies, and procedures is growing secondary to efforts by national nursing, medical, and hospital accreditation organizations. Creating specialized health services for domestic violence survivors can be expedited by reviewing existing protocols, policies, and procedures. A reference list of sample domestic violence protocols and a sample domestic violence policy and procedure are provided. The authors share their experiences in developing two of the nation's eight hospital-based domestic violence programs. Domestic violence is a nursing concern, and nurses have been the leaders in providing perinatal and women's health services to battered women. Implementing the suggestions contained in this article will enhance hospitals' successful compliance with the 1992 Joint Commission on Accreditation of Healthcare Organizations guidelines for emergency and ambulatory services departments. The need for preprogram data collection, multidisciplinary support, patient and staff safety, specific program services, and staff supervision is addressed.

Ethical theory about what is right and good in human conduct lies behind the issues practitioners face and the codes they turn to for guidance; it also provides guidance for actions, practices, and policies. Principles of obligation, such as egoism, utilitarianism, and deontology, offer general answers to the question, "Which acts/practices are morally right?" A re-emerging alternative to using such principles to assess individual conduct is to center normative theory on personal virtues. For structuring society's institutions, principles of social justice offer alternative answers to the question, "How should social benefits and burdens be distributed?" But human concerns about right and good call for more than just theoretical responses. Some critics (eg, the postmodernists and the feminists) charge that normative ethical theorizing is a misguided enterprise. However, that charge should be taken as a caution and not as a refutation of normative ethical theorizing.

This article discusses the concept of values and the roles of values in the ethical decision-making process. The acquisition of values and the role of different types of values are explored. A model is presented to illustrate the nature of values as a guide to behavior. Finally, the role and impact of the individual values systems of health care professionals and patients are identified as essential ingredients in the resolution of ethical dilemmas.

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.

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.