Nursing Commons^™

Methods Used To Self-Predict Ovulation A Comparative Study, Richard Fehring

Richard J Fehring

Time of ovulation as detected by a self-test of luteinizing hormone (LH) in the urine was compared with time of ovulation as detected by self-observation of cervical mucus. Twenty regularly cycling women monitored their cervical mucus and urine LH for two complete menstrual cycles. Of the cycles that had an LH surge, 100% were on the peak day of cervical mucus or within three days before the peak day. Self-observation of cervical mucus, therefore, can be an accurate method of determining optimal fertility.

Effects Of Biofeedback-Aided Relaxation On The Psychological Stress Symptoms Of College Students, Richard Fehring

Richard J Fehring

The purpose of this study was to compare the effects of Benson's relaxation technique (BRT) with Benson's technique augmented with GSR biofeedback (i.e., biofeedback-aided relaxation, BAR) on the psychological stress symptoms of well college students. Seventy-eight normotensive college students were randomly assigned to one of three groups: the BRT group, the BAR group, and a control group. The BRT and BAR students were asked to practice their respective relaxation technique daily for an eight-week period. Pre-and postintervention, all subjects were administered a state-anxiety inventory and a profile-of-mood state (POMS) test. Posttest analysis indicated that the BAR group had significantly lower …

Grant Application: Randomized Comparison Of Two Internet-Supported Natural Family Planning Methods, Richard J. Fehring

Richard J Fehring

No abstract provided.

Final Report: Randomized Comparison Of Two Internet-Supported Methods Of Natural Family Planning, Richard J. Fehring, Mary Schneider

Richard J Fehring

Studies consistently show that women want safe, effective, easy to use, and convenient methods of family planning (Arévalo,1997; Severy 2001). Although Natural Family Planning (NFP) methods are free of side effects, they are often ineffective and complex to learn and use (Grimes et al. 2005). Efforts have occurred over the past 10 years to simplify the teaching and use of NFP methods and increase their efficacy. These efforts include the development of low tech calendar-based methods (Arévalo et al. 2004), simplifying instructions (Frank-Herrmann et al. 2005), and developing accurate biological markers of fertility (Guida et al. 1999). A new high-tech …

Self-Esteem, Spiritual Well-Being And Intimacy: A Comparison Among Couples Using Nfp And Oral Contraceptives, Richard Fehring, Donna M. Lawrence, Catherine M. Sauvage

Richard J Fehring

The purpose of this study was to compare the intimacy, spiritual well-being (SWB), and self-esteem of couples using natural family planning (NFP) with couples using oral contraceptives (OCs). Twenty-two couples who were using the Creighton Model Ovulation Method of NFP for one year to avoid pregnancy were matched with 22 couples who were using OCs for at least a one year period and administered a SWB, self-esteem, and intimacy inventory. Student t-tests were calculated to determine differences in the mean scores of the three inventories between the two groups. The results showed that the NFP couples had statistically higher self-esteem …

Physician And Nurses' Knowledge And Use Of Natural Family Planning, Richard Fehring

Richard J Fehring

Perinatal health professionals are in key positions to either promote or dissuade the use of Natural Family Planning (NFP). The purpose of this article is to describe a survey conducted with perinatal physicians and nurses on their knowledge and professional use of NFP. Four hundred and fifty physicians and nurses (150 MDs and 300 RNs) were sent a questionnaire on the use of and knowledge of NFP. One hundred sixty-six (or 37%) returned the completed questionnaires. Fifty-two percent of the nurses who returned the questionnaires and 48% of the physicians indicated they were taught about NFP in basic (generic) medical …

Promoting Natural Family Planning, Richard Jerome Fehring

Richard J Fehring

No abstract provided.

Efficacy Of Achieving Pregnancy With Fertility-Focused Intercourse, Qiyan Mu, Richard Fehring

Richard J Fehring

Purpose:

To compare pregnancy rates when women have intercourse on self-estimated high and peak fertile days and when they only have intercourse on low fertile days during the fertile window (FW).

Study Design and Methods:

We used a prospective observational cohort study design. Our convenience sample included 124 women who utilized our online charting Web sites to achieve pregnancy from January 2010 to November 2012. Participants used an electronic hormonal fertility monitor (EHFM) or self-observed cervical mucus or both to determine fertility during the estimated FW. Pregnancy rates were determined with Kaplan–Meier survival analysis. Chi square analysis was used to …

Pilot Evaluation Of An Internet-Based Natural Family Planning Education And Service Program, Richard Jerome Fehring, Mary Schneider, Kathleen Raviele

Richard J Fehring

Objective: To evaluate the efficacy, knowledge of fertility, and acceptability of a web-based natural family planning (NFP) education and service program. Design: A 6-month repeated measure longitudinal evaluation pilot study. Setting: A university based online website. Participants: The website was piloted with 468 volunteer women seeking NFP services. Of these participants, 222 used the automatic online fertility charting system to avoid pregnancy. The 222 charting participants had a mean age of 29.9 years (SD=5.6), 2.2 children (SD=1.9), 37% were postpartum, and 47% had regular menstrual cycle lengths. Intervention: Nurse-managed web-based NFP education and service program. Outcomes: Pregnancies were confirmed by …

Randomized Comparison Of Two Internet-Supported Natural Family Planning Methods (Preliminary Findings), Richard J. Fehring, Mary Schneider

Richard J Fehring

The aims of this study were to determine and compare efficacy, satisfaction, ease of use, and motivation in using an internet-based method of Natural Family Planning (NFP) that utilizes either electronic hormonal fertility monitoring (EHFM) or cervical-mucus monitoring (CMM). Four hundred fifty women (mean age 30.1) and their male partners (mean age 31.9) who sought to avoid pregnancy were randomized into either an EHFM (N=228) or CMM NFP group (N=222). Both groups utilized a Web site that provided NFP instructions, an electronic charting system, and support from professional nurses. Participants were assessed for satisfaction, ease of use, and motivation in …

Cohort Efficacy Study Of Natural Family Planning Among Perimenopause Age Women, Richard Fehring, Qiyan Mu

Richard J Fehring

Objective: To determine the efficacy of using natural family planning (NFP) methods to avoid unintended pregnancy among women of perimenopause age (i.e., age 40-55 years). Design: A secondary analysis of subset data from two prospective observational cohort studies. Setting: A university based in-person and online NFP service program. Participants: One hundred and sixty couples who used either a website or an in-person NFP service to learn how to avoid pregnancy from January 2001 to November 2012. Methods: A prospective 12-month effectiveness study among 160 women (between ages 40-55) who used NFP to avoid pregnancy. The women used either a hormonal …

Anthropological Differences Between Contraception And Natural Family Planning, Richard Fehring, William Kurz

Richard J Fehring

Almost twenty years ago, Pope John Paul II in his apostolic exhortation Familiaris Consortio called on scholars to study the anthropological and moral differences between the recourse to the natural rhythms of a woman’s menstrual cycle (i.e., natural family planning) and contraception (1). Although natural family planning (NFP) and contraception can both be used to prevent pregnancy, there are conspicuous differences between use of natural methods and contraception. Most people, however, have difficulty in distinguishing what the differences are and in understanding why some religious groups, health professionals, and other members of society consider contraception (but not natural family planning) …

Toward A Definition Of Nurse-Managed Centers, Richard Fehring, Judeen Schulte, Susan K. Riesch

Richard J Fehring

The purpose of this study was to gain consensus on a definition of Nurse-Managed Centers. To accomplish this task, Delphi survey methods were used with the participants of the Second Biennial Conference on Nurse-Managed Centers. Delphi methods entail obtaining autonomous consensus from experts through rounds of questionnaires and feedback of results. A questionnaire was developed that included 22 items obtained from the literature, past conferences, and the expertise of the authors. An additional 6 items were suggested by the conferees. Of the 168 conferees, 148 participated in the first round, 147 in the second, and 133 in the third. Fifty-three …

Randomized Comparison Of Two Internet-Supported Natural Family Planning Methods (Final Efficacy Results), Richard J. Fehring

Richard J Fehring

Both Internet provided NFP methods were effective with correct use but the electronic hormonal monitoring method was statistically better with a typical use of only 7 unintended pregnancies per 100 women over 12 months of use compared with 19 with the traditional cervical mucus monitoring method. Satisfaction of using the hormonal method increased over time but motivation decreased, i.e., they had a desire to achieve a pregnancy. A high discontinuation rate contributed to the limitation of the study. However, this Internet based method of providing NFP with professional support is efficient and effective for select motivated couples.

A Comparison Of The Fertile Phase As Determined By The Clearplan Easy Fertility Monitor™ And Self-Assessment Of Cervical Mucus, Richard Fehring, Kathleen Raviele, Mary Schneider

Richard J Fehring

The purpose of this study was to compare the fertile phase of the menstrual cycle as determined by the Clearplan Easy Fertility Monitor (CPEFM) with self-monitoring of cervical mucus. One-hundred women (mean age = 29.4 years) observed their cervical mucus and monitored their urine for estrogen and luteinizing hormone metabolites with the CPEFM on a daily basis for 2–6 cycles and generated 378 cycles of data; of these, 347 (92%) had a CPEFM peak. The beginning of the fertile window was, on average, day 11.8 (SD = 3.4) by the monitor and day 9.9 (SD = 3.0) by cervical mucus …

Wholistic Nursing Care: A Church & University Join Forces, Richard Fehring, Marilyn Frenn

Richard J Fehring

No abstract provided.

Spiritual Care Of Couples Practicing Natural Family Planning, Richard Fehring, Dana Rodriguez

Richard J Fehring

There are few studies that have investigated the spiritual problems of couples practicing natural family planning (NFP). The purpose of this paper is to analyze the spiritual problems and interventions of couples who were taught NFP by means of a professional online Web-based support system. Responses from this online system and its forums were categorized according to spiritual responses, spiritual problems, and spiritual interventions to the practice of NFP. Themes addressed included spiritual care in regards to decisions about the transmission of new life, difficulties in dealing with chastity and abstinence, bioethical problems related to pregnancy and illness, end of …

Trends In Contraceptive Use Among Catholics In The United States: 1988-1995, Richard Fehring, Andrea Schlidt

Richard J Fehring

National surveys to determine trends in contraceptive use in the United States have occurred every 6 to 10 years since 1955.1,2,3 Since that time, there has been a rapid decline in the use of natural methods of family planning; a sharp rise and slow decline in the use of oral contraceptives and, in the past ten years, a major reliance on surgical sterilization for contraception. Information from these national surveys has provided useful information for contraceptive providers, policy makers, and religious groups. The method of avoiding and achieving pregnancy that is promoted and encouraged by the Roman Catholic Church is …

An Analysis Of The Majority Report “Responsible Parenthood” And Its Recommendations On Abortion, Sterilization And Contraception, Richard Fehring

Richard J Fehring

This paper will focus on the majority report (titled “Responsible Parenthood”) of the 1966 Papal Birth Control Commission and its recommendations on abortion, sterilization, and contraception.(1) The analysis is made with the hindsight and perspective of thirty-seven years of scientific data on fertility, family planning, and family life. The analysis presented here does not concern the whole document but rather focuses on what are called the “objective criteria” that were provided in the document to help married couples make decisions on the use of contraception. While acknowledging the intellectual abilities and expertise of those who wrote the majority report, the …

Self-Esteem, Spiritual Well-Being, And Intimacy: A Comparison Among Couples Using Nfp And Oral Contraceptives, Richard Fehring, Donna M. Lawrence, Catherine M. Sauvage

Richard J Fehring

The purpose of this study was to compare the intimacy, spiritual well being (SWB), and self-esteem of couples using natural family planning (NFP) with those couples using oral contraceptives (OCs). 22 couples who were using the Creighton Model Ovulation Method of NFP for 1 year to avoid pregnancy were matched with 22 couples who were using OCs for a least a 1-year period and administered a SWB, self-esteem, and intimacy inventory. Student t-tests were calculated to determine differences in the mean scores of the 3 inventories between the 2 groups. The results showed that the NFP couples had statistically higher …

Attitudes, Intentions, And Ethical Stance Of Advanced Practice Nursing Students Toward Abortion Provision: Part One B Quantitative Findings, Richard Fehring

Richard J Fehring

The availability of pre-implantation abortion pills has increased the probability that advanced practice nurses (i.e., nurse practitioners and certified nurse midwives) will be instrumental in providing abortion services in the United States. The purpose of this pilot study was to determine the attitudes, intentions, and ethical stance of advanced practice nursing students towards the provision of abortion services. The study was a descriptive cross-sectional survey of 53 advanced practice nursing students at a private Midwestern Catholic university. A multi-item abortion attitude survey was administered to students in three required courses. The survey included a section on ethical principles and open-ended …

Multinational Validation Of Anxiety, Hopelessness, And Ineffective Airway Clearance, Richard Fehring, Teresa Fadden, Madeline Wake

Richard J Fehring

The effective use of nursing diagnosis internationally depends in part on incorporating language and cultural difference into the common language of nursing. International validation studies can provide a basis for this effort. This study tested three diagnoses—anxiety, hopelessness, and ineffective airway clearance—through multinational validation. The Diagnostic Content Validity (DCV) model was used to collect data from critical care nurses in six countries. Defining characteristics rated as critical (> .80) by the total sample were dyspnea for ineffective airway clearance and panic and nervousness for anxiety. No critical defining characteristics for hopelessness were identified. DCV ratios for all defining characteristics are …

Use Effectiveness Of The Creighton Model Ovulation Method Of Natural Family Planning, Richard Fehring, Donna M. Lawrence, Connie Philpot

Richard J Fehring

OBJECTIVE: To determine the use effectiveness of the Creighton model ovulation method in avoiding and achieving pregnancy. DESIGN: Prospective, descriptive. SETTING: A natural family planning clinic at a university nursing center. PARTICIPANTS: Records and charts from 242 couples who were taught the Creighton model. The sample represented 1,793 months of use of the model. MAIN OUTCOME MEASURE: Creighton model demographic forms and logbook. RESULTS: At 12 months of use, the Creighton model was 98.8% method effective and 98.0% use effective in avoiding pregnancy. It was 24.4% use effective in achieving pregnancy. The continuation rate for the sample at 12 months …

Executive Summary: Randomized Comparison Of Two Internet-Supported Methods Of Natural Family Planning, Richard J. Fehring, Mary Schneider

Richard J Fehring

Only 0.2% of US women use modern methods of natural family planning, i.e., the basal body temperature and the cervical mucus methods of natural family planning (NFP). The reason that such few women use NFP methods is because they are often ineffective, they are difficult to use, there is lack of access to properly trained NFP teachers, a lack of motivation to use a behavioral method, and health professionals are reluctant to prescribe NFP methods. One way to potentially increase the use of NFP methods is to provide easy access to an effective but simplified NFP method that uses a …

Characteristics Of The Menstrual Cycle After Discontinuation Of Oral Contraceptives, Claudia L. Nassaralla, Joseph B. Stanford, Diane Daly, Mary Schneider, Karen C. Schliep, Richard Fehring

Richard J Fehring

Background: Menstrual cycle function may continue to be altered after discontinuation of oral contraceptives (OC). Few studies have been published on the effects of recent OC use on menstrual cycle parameters; none have examined characteristics of the menstrual flow or the quality of cervical mucus. The purpose of this retrospective matched cohort study is to assess biomarkers of the menstrual cycle after discontinuation of OCs. Methods: Among a sample of women who daily recorded observations of menstrual cycle biomarkers, 70 women who had recently discontinued OCs were randomly matched by age and parity with 70 women who had not used …

Influence Of Motivation On The Efficacy Of Natural Family Planning, Richard J. Fehring, Mary Schneider, Mary Lee Barron, Jessica E. Pruszynski

Richard J Fehring

Purpose: Mutual motivation is recognized as essential for effective behavioral methods of family planning. Few studies have studied this factor in family planning efficacy. The purpose of this study was to determine the influence of mutual motivation on unintended pregnancy rates of couples who used natural family planning (NFP) methods to avoid pregnancy.

Study Design and Methods: Using an online taught NFP method, 358women and ( their male partners) indicated “how much” and “how hard” they wished to avoid pregnancy on a scale of 0-10 before each menstrual cycle charted over 12 month of use. This motivation scale is used …

Protocol For Determining Fertility While Breastfeeding And Not In Cycles, Richard Fehring, Mary Lee Barron, Mary Schneider

Richard J Fehring

A protocol was developed and evaluated for nonovulating breastfeeding women to determine potential fertility with an electronic hormonal fertility monitor. The amount of required abstinence (i.e., days of potential fertility) through the first menstrual cycle indicated by the fertility monitor was significantly lower (17% of the total days) compared with the amount of abstinence (50% of the total days) indicated by the self-observation of cervical mucus.

The Future Of Professional Education In Natural Family Planning, Richard Fehring

Richard J Fehring

Nurses and other health care professionals often have little knowledge of methods of natural family planning (NFP) and do not readily prescribe natural methods for their patients. One reason for this is that little or no information on NFP is provided in nursing or medical schools. The holistic, informational, and integrative nature of NFP fits well with professional nursing practice. A university online distance education NFP teacher training program, which offers academic credit and includes theory, practice, and the latest developments in fertility monitoring, has been developed for health care professionals. Professional NFP services in the United States need to …

Efficacy Of The Marquette Method Of Natural Family Planning, Richard Fehring, Mary Schneider, Mary Lee Barron

Richard J Fehring

Purpose: To determine the effectiveness of the Marquette Method (MM) of natural family planning (NFP) as a method of avoiding pregnancy. Study Design and Methods: This was a 12-month retrospective evaluation of the MM system of NFP. Two hundred and four women (mean age, 28.6 years) and their male partners (mean age, 30.3 years) who sought to learn a method for avoiding pregnancy with the MM from four clinical sites were taught to track their fertility by self-observation of cervical mucus, by use of an electronic monitor that measures urinary levels of estrone-3-glucuronide and luteinizing hormone, and by use of …

Use Of Ovulation Predictor Kits As Adjuncts When Using Fertility Awareness Methods (Fams): A Pilot Study, Rene Letva, Ula Burban, Edmond Kyrillos, Richard Fehring, Robin Mclaren, Catherine Dalzell, Elizabeth Tanguay

Richard J Fehring

Purpose: Difficult clinical signs such as confusing cervical mucus or erratic basal body temperature can make the use of fertility awareness methods (FAMs) difficult in some cases. The goal of this study was to assess the feasibility of using a cheap urinary luteinizing hormone (LH)–surge identification kit as an adjunct to identify the infertile phase after ovulation when facing these scenarios. Methods: The study used a block-allocation, crossover, 2-arm methodology (LH kit/FAM vs FAM only). Comparison of the 2 arms was done with regard to the accuracy of identification (yes/no) of the luteal phase in each cycle as confirmed by …