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

Prepared, childbirth education classes are designed to teach the expectant mother how to effectively cope with the childbirth experience through active participation, informed decision making, and noninvasive pain management skills. As knowledge and technology increase, it often becomes difficult for the childbirth educator to complete the important task of determining the essential content for each class. The childbirth educator can follow established guidelines for class content with a review the literature or structure the class to meet the needs of the participants. An approach used less often, but a powerful and effective one, is using a conceptual model as a framework for selecting the essential content for classes.

Recently, increasing numbers of women with disabilities are deciding to become pregnant. Several issues pertaining to pregnancy and disability are discussed, and a woman's personal account of her experiences of pregnancy, labor, and delivery after being diagnosed with multiple sclerosis is provided. Specific issues related to her experiences with the health care system are addressed. These include access to health care, self-care practices, sexuality, contraception, prenatal counseling, and parenting. Implications for clinical practice are discussed.

Modern health care presents significant dilemmas in nursing practice. Nurses are often entangled in the web of conflicts between the principles of autonomy, beneficence, and justice in managing the health care concerns of individuals, nurses, and the health care team. However, to achieve resolution the nurse needs an ethics model with which to determine appropriate care practices. According to the concept of autonomy, each individual has the fundamental right of self-determination in health care decisions. At the same time, the nurse strives toward beneficent care for individuals through the delivery of health care. Tension between these two principles generally is minimal. It is only when conflicts exist between the autonomous patient and the beneficent nurse that ethical problems surface. At these times, respect for individual freedom and the interest in doing good are juxtaposed. Nurses may have difficulty determining which actions best serve the purpose and interests of each party to the issue, or which issues, if any, must be regarded as fundamental obligations. For nurses to provide patient care within an ethical framework, clinical practitioners need (1) knowledge of basic rights and ethical principles; (2) conceptual models as ways of thinking about ethical dilemmas; and (3) opportunities to explore and resolve clinical dilemmas.

It frequently is assumed that research is being conducted in an ethical manner. Although this usually is the case, the approaches used to assure an ethical approach are not explicitly described in research proposals, protocols, presentations, or manuscripts. This paper explicates the ethical issues related to conducting clinical nursing research. Ethical principles and the problems of scientific misconduct are presented. Rights of human subjects and rights of special subjects are discussed, and practical points about the conduct of ethical research are summarized.

Pregnant women with disabilities have many of the same concerns as able-bodied pregnant women. However, pregnant women with disabilities have special perinatal education needs. Information on the problems encountered and approaches that can be used is presented based on current research and interviews with 36 childbearing women with disabilities.

School-based adolescent pregnancy classes provide the childbirth educator with a unique opportunity to be visible to students. Attitudes about sexuality and pregnancy can be changed within the mainstream population by the presence of prepared childbirth classes at schools. The problems of absenteeism and denial of pregnancy that result in late reporting to health care providers can be minimized. The expectant teen-ager can be encouraged to attend school and given self-confidence in assuming the role of a parent after birth. Support can be engendered from faculty, students, and the teen-ager's support person.

The focus of this article is on prominent Eurocentric beliefs, attitudes, and behaviors that may prevent African-American battered women from receiving effective intervention by health care professionals and other providers. Afrocentric perspectives are presented to provide an alternative context for understanding the traditions, beliefs, and behaviors that should be considered when providing care for African-American battered women. These perspectives are integrated into discussions of suspected contributions to the incidence of violence in the lives of African-American women. They also are incorporated into suggested interventions and a case study exploring nursing considerations that may be unique to providing effective care for African-American battered women.

Significant numbers of women in the United States experience violence and abuse in their intimate relationships that compromise the health and safety of the women and their children. This article discusses the problem of violence against women and outlines strategies for responding to violence and abuse in the primary care setting. Nurses can play a vital role in the primary prevention of abuse by implementing abuse screening and education on the issue of violence against women. This article presents strategies for the primary prevention of abuse and guidelines for mobilizing support for women. Collective prevention strategies aimed at eliminating violence against women at the institutional, community, professional, and political level are highlighted.

Children of battered women are at risk for a variety of emotional, cognitive, and behavioral difficulties. However, a growing body of research has described the important mediating effects on children of even one positive relationship with a significant person. Nurses need to be aware of family violence and to assess every client and family for this problem. Early identification and interventions can stem detrimental effects and help mothers and children recover.

Woman abuse is the number one cause of trauma to women in the United States and a leading cause of women's mortality and morbidity. Nursing has been in the forefront in conducting research, identifying survivors, and intervening with women abuse in a variety of health care settings. Several initiatives are being taken by the American health care system with regard to this problem. Nurses, especially those in maternal, child, and women's health care arenas, need to continue their leadership in and support for these policy measures.