Nursing Commons^™

Treatment Outcomes For Opiate Addicted Pregnant Women, Jennifer L. Roth Parr

DNP Projects

The problem of opiate addiction is complex enough but compounded when the patient is pregnant. Substance use during pregnancy produces harmful and costly effects to both the mother and the fetus (Veilleux, Colvin, Anderson, York & Hines, 2010). The rate of opiate addiction among pregnant women in the U.S. has been increasing in epidemic numbers since the beginning of the 21st century. This paper looks at research on the origin of the problem, the demographics of the average pregnant opiate addicted patient, the effects on the woman and her unborn child, and available treatment options.

Antenatal Clinic: Using Ethnographic Methods To Listen To The Voices Of Pregnant Adolescents, Deborah Ireson

Theses: Doctorates and Masters

Aim: This research aims to explore the motivating reasons and external influences that affect pregnant adolescents’ reasons for attending an antenatal clinic. Background: Pregnancy during adolescence has been researched from perceived ‘poor’ decision making during pregnancy and postnatal perspectives involving high-risk outcomes for mother and baby. Antenatal clinic attendance by pregnant adolescents is often characterised by late and infrequent attendance, limiting midwifery contact with this inexperienced group. Gaps in the literature exist where the real-time voices of pregnant adolescents offer their current experiences of antenatal clinic as a relevant means to inform midwifery practice.

Research design: Using ethnographic methods, this …

Food Choices And Practices During Pregnancy Of Immigrant Women With High-Risk Pregnancies In Canada: A Pilot Study, Gina M A. Higginbottom, Helen Vallianatos, Joan Forgeron, Donna Gibbons, Fabiana Mamede, Rubina Barolia

School of Nursing & Midwifery

Background: Immigrant women may be regarded as a vulnerable population with respect to access and navigation of maternity care services. They may encounter difficulties when accessing culturally safe and appropriate maternity care, which may be further exacerbated by language difficulties and discriminatory practices or attitudes. The project aimed to understand ethnocultural food and health practices and how these intersect in a particular social context of cultural adaptation and adjustment in order to improve the care-giving capacities of health practitioners working in multicultural perinatal clinics.
Methods: This four-phase study employed a case study design allowing for multiple means of data collection …

Sexual And Reproductive Health And Rights Of Aymara Women In The Intercultural Health System In Chile / Salud Y Derechos Sexuales Y Reproductivos De Las Mujeres Aymara En El Sistema De Salud Intercultural De Chile, Ariela Schnyer

Independent Study Project (ISP) Collection

This investigation seeks to understand how Aymara women navigate their sexual and reproductive health and rights (SRHR) in Chile’s intercultural health care model. Indigenous communities have their own practices that complicate the provision of sexual and reproductive health by requiring health care providers to be aware of two different worldviews and how they may conflict, as well as what is necessary to provide respectful care. However, an ethnically and culturally pertinent framework is vital to actually assuring successful SRHR provision, whose tenants include autonomous choice and care free of discrimination, coercion or violence. These interactions were investigated through semi-structured interviews …

Preconception Care For Women With Pregestational Diabetes: Information For The Family Nurse Practitioner, Kathryn Conover Morrill

Student Works

Purpose: The purpose of this article is to evaluate present literature and guidelines regarding preconception care for women with type I diabetes mellitus (T1DM) or type II diabetes mellitus (T2DM) and familiarize the family nurse practitioner (FNP) with current clinical recommendations. Data Sources: The guidelines reviewed include the Clinical Practice Recommendations from the American Diabetes Association 2013, the American College of Obstetricians and Gynecologists pregestational diabetes mellitus guideline reaffirmed in 2010, and the National Institute for Health and Clinical Excellence on how to manage diabetes and its complications from preconception to the postnatal period 2008. Conclusions: Guidelines were established based …

Feasibility Of Oral Prenatal Probiotics Against Maternal Group B Streptococcus Vaginal And Rectal Colonization, Lisa Hanson, Leona Vandevusse, Megan Duster, Simone Warrack, Nasia Safdar

College of Nursing Faculty Research and Publications

Objective

To examine the effect of an oral prenatal probiotic on group B Streptococcus (GBS) colonization and to demonstrate the feasibility of a larger randomized controlled trial.

Design

This pilot study was an open‐label, two‐group quasi‐experiment.

Setting

An urban central city nurse‐midwifery and wellness center serving a diverse population.

Participants

Ten pregnant participants received the oral probiotic (Florajen3) taken once daily, and 10 participants served as controls.

Methods

A questionnaire on dietary practices, vaginal cleansing, sexual history, and symptoms and GBS colony count samples were taken at 28‐, 32‐, and 36‐weeks gestation.

Results

Participants in the probiotic group reported no …

Women’S Understanding Of The Effects Of Obesity On Pregnancy, Rachel A. Daniel

Senior Honors Theses

Obesity is a serious issue and is becoming a significant problem around the world. Obesity in general causes and complicates many health problems. As obesity increases in the population at large, the incidence of obesity in pregnancy continues to increase. Obesity during pregnancy has been linked in numerous studies to multiple complications, and the issues and risks have been clearly established. Also becoming pregnant or having multiple pregnancies increases the likelihood of developing obesity. Obese women of childbearing age many times do not even know these risks exist. There is a need to educate these women before they become pregnant, …

Prenatal Care: A Study Of Perceived And Actual Barriers For Utah County Women, Melanie Droubay, Dr. Rosanne Schwartz

Journal of Undergraduate Research

Prenatal care is a significant indicator of health care. Women who receive both early and adequate prenatal care have less problems with their pregnancy as well as decreased neonatal, infant and maternal mortality (Kiely & Kogan, 2000). Because Utah has a proportionally high volume of pregnancies, prenatal care is a major concern for this state. Through this research, the adequacy of prenatal care was studied as well as any possible barriers to receiving prenatal care for first-time mothers living in Utah County.

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

College of Nursing Faculty Research and Publications

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 …

Formaldehyde Exposure In Pregnant Women And Its Relationship To Fetal Growth, Azita Amiri

All ETDs from UAB

Formaldehyde exposure during pregnancy has been linked to adverse pregnancy outcomes such as poor fetal growth, although few studies have examined formaldehyde exposure during pregnancy and its relationship to fetal growth. The purpose of this study was to determine the level of formaldehyde exposure during pregnancy and examine the relationship between formaldehyde exposure and fetal growth. Formaldehyde exposure was examined, using vapor monitor badge and urine formic acid, in 140 women in their second trimester of pregnancy. One time urine samples were collected during a routine prenatal visit, and women wore the vapor badges for 24 hours. Fetal growth was …

Perinatal Outcomes Of Prenatal Probiotic And Prebiotic Administration: An Integrative Review, Leona Vandevusse, Lisa Hanson, Nasia Safdar

College of Nursing Faculty Research and Publications

The purpose of this integrative review was to identify, critique, and synthesize the maternal and neonatal evidence on the prenatal use of probiotics and prebiotics to inform perinatal health professionals. A comprehensive literature search resulted in 37 studies of prenatal probiotics and 1 on antepartal prebiotics published from 1990 through 2011 that reported maternal, fetal, and/or neonatal outcomes. The methodologic quality of the studies reviewed was high, although investigators used different probiotic combinations and inconsistently reported perinatal clinical outcomes. The extraction of perinatal outcome variables resulted in identification of 9 maternal and 5 neonatal categories. Prenatal probiotics significantly reduced the …

Immune Dysregulation And Glucocorticoid Resistance In Minority And Low Income Pregnant Women, Elizabeth J. Corwin, Ying Guo, Kathleen Pajer, Nancy Lowe, Donna O. Mccarthy, Sarah Schmiege, Mary Weber, Thaddeus Pace, Brian Stafford

College of Nursing Faculty Research and Publications

Chronic prenatal stress contributes to poor birth outcomes for women and infants. Importantly, poor birth outcomes are most common among minority and low income women. To investigate underlying mechanisms, we tested the hypothesis that chronic stress related to minority or low income status is associated with glucocorticoid resistance as indicated by disruption in the cytokine-glucocorticoid feedback circuit. Home visits were conducted during which 3rd trimester pregnant women completed stress and depression surveys and provided blood for pro- and anti-inflammatory cytokines. Saliva was collected 5 times the preceding day for diurnal cortisol levels. For statistical analyses, women were grouped 3 ways, …

Childbirth Experience Of Chinese Women, Robin Kartchner, Dr. Lynn C. Callister

Journal of Undergraduate Research

Women across the world share in the same biological process of childbirth. However, their experience with childbirth can vary widely depending on their cultural and spiritual background. The quality of care a woman receives during and after her pregnancy is deeply influenced by the understanding of these factors that the nurse brings to their interaction (1). This research built on previous studies of women from other cultures (2) by interviewing Chinese women in China about their childbirth experience.

Promoting Abstinence From Alcohol During Pregnancy: Implications From Formative Research, Kathryn France, Robert Donovan, Nadine Henley, Carol Bower, Elizabeth Elliott, Janet Payne, Heather D'Antoine, Anne Bartu

Research outputs 2013

This research developed messages to promote abstinence from alcohol during pregnancy and identified elements that enhance message persuasiveness. An exploratory phase was conducted in 2009 that comprised four focus groups with 23 women inWestern Australia and elicited beliefs and attitudes on alcohol use during pregnancy and motivations for behavior change. Four television concepts were subsequently developed and appraised in five focus groups with 31 participants using standard advertising pretesting questions. The implications for campaigns addressing prenatal alcohol exposure and further research are noted and limitations discussed. Funding was received from Healthway and the National Health and Medical Research Council.

Predictors Of Psychosocial Adaptation To Pregnancy Among Urban African-American Primiparas, Joan M. Visger

Wayne State University Dissertations

Psychosocial adaptation to pregnancy among urban African-American women has not been well-researched. The purpose of this study was to examine predictors of psychosocial adaptation to pregnancy and to explore relationships among socioeconomic status, experiences and frequency of discrimination, personal control beliefs, social support, planned pregnancy, and model of health care among urban African-American primiparas using life course theory and Lederman's model of psychosocial adaptation to pregnancy as the framework.

One hundred and nine women participated in this descriptive, cross-sectional, correlational study. Participants were recruited from three clinical sites that provided care using medical and/or midwifery models of care. Study variables …

Hard On Your Heart: A Qualitative Description Of Adolescent Prenatal Stress, Candace Clayton Knight

All ETDs from UAB

Introduction: Pregnancy during adolescence is potentially stressful due to the concurrent tasks of navigating the typically tumultuous adolescent stage of development and the life altering experience of pregnancy (Kaye, 2008). There is a growing body of research linking prenatal stress to poor birth and developmental outcomes such as premature birth and low birth weight infants (K. Keenan, Sheffield, & Boeldt, 2007; Mulder et al., 2002), which makes describing the relatively unexplored perceptions and experience of stress during adolescent pregnancy important. The life course framework, with its emphasis on social, environmental, and family risk factors, has implications for reducing disparities among …

Early Term Infant Care: Hospital Utilization And Breastfeeding Practices, Debra Craighead

Nursing Theses and Dissertations

Early term infants (ETI), with gestational ages from 37 to 38 weeks, have higher morbidity and mortality rates when compared with later term infant counterparts born at 39 to 41 weeks. Although this newly identified term infant subcategory is gaining attention, the immediate and long term health outcomes and care needs of ETI remain largely unexplored. The purpose of this research project was to examine the current research documenting ETI health and explore care practices that are currently utilized to promote ETI health. The original research study describes care practices used to promote health for ETIs born in Louisiana in …

Predictors Of Sexual Relationship Power, Communication And Sexual Decision Making Among Latino Couples, Yui Matsuda

Theses and Dissertations

Unintended pregnancy (UP) is increasing among Latinos in the United States. Unintended pregnancy contributes to many negative consequences for infants, mothers and families. Concurrently, various factors affect Latino couples’ sexual relationship power, communication and decision making about family planning, including sexual relationship power, relationship commitment, dyadic adjustment, individual background, and cultural characteristics. Previous research has not focused on understanding the factors that affect Latino couples’ sexual relationship power, communication and sexual decision making from each partner’s perspective. The purpose of this study was to examine the association between sexual relationship power, communication, and sexual decision making from each partner’s perspective …

Understanding The Experience Of Weight Gain And Body Image During Adolescent Pregnancy, Jessica L. Hinkley, Liana J. Newcombe

Honors Theses and Capstones

This qualitative descriptive study explores the experience of adolescent pregnancy and the influence of body image and other factors on weight gain. It identified three main themes through content analysis: Continuity of Care, Adolescent Investment in a Healthy Pregnancy, and the Impact of Pregnancy Symptoms.

Factors And Health Promoting Behaviors That Influence Maternal And Infant Outcomes In Older Pregnant Thai Women, Supawadee Thaewpia Phd, Msn, Rn

Dissertations

This dissertation summarizes research conducted in partial fulfillment of the program requirements for the Doctor of Philosophy in Nursing degree from the Hahn school of Nursing and Health Sciences, University of San Diego. The results of the dissertation research are organized as three discrete papers. Article one is entitled; "Reliability and Validity of Thai Translations of Instruments Measuring Psychosocial Factors and Health Promoting Behaviors among Older Pregnant Thai Women." This article describes the dissertation research study in which the selected instruments were piloted at an antenatal clinic in Thailand. The article determines the instruments' ability to examine perceived benefits, perceived …

Cord Blood Collection In Pregnant Women For Stem Cell Research, Irene Carr Phd

Dissertations

Umbilical cord blood (UCB) stem cells form commonly banked types of human tissue. Confusion remains about sources of stem cells and their use. Birth is a once in a lifetime opportunity with 74 million births per year in the world and four million occur in the United States. Cord blood contains hematopoietic stem cells and pluripotent mesenchymal cells (Moise, 2005). There is a surge of interest in the clinical use and research investigation of umbilical cord blood for transplantation and regenerative medicine. Clinicians need increased awareness and education of options for private versus public donation and banking of cord blood …

Gestational Diabetes, Depression, And The Impact On Maternal Child Health Outcomes, Mary Alice Byrn

Dissertations

Antenatal depression occurs in about 20% of all pregnancies and gestational diabetes occurs in up to 14% of all pregnancies. Although there is sufficient information on (1) depression during pregnancy and (2) depression and diabetes, there is little information about depression and gestational diabetes. This comparative, longitudinal research study was done to better understand the relationship between gestational diabetes and depression. The study aims were the following: (1) to determine whether women with gestational diabetes had more depression than women without gestational diabetes, (2) to determine whether factors predictive of depression in pregnant women with gestational diabetes were different from …

Barriers And Facilitators To Prenatal Care For Pregnant Latina Women In Cobb County, Georgia, Carol Holtz, Annette Bairan

Journal of Global Initiatives: Policy, Pedagogy, Perspective

This research study seeks to identify factors that serve as barriers and/or facilitators to prenatal care for Latina women and to provide data to assist health care providers, health care agencies, and policy makers in developing programs that maximize access to prenatal care for Latina women. In addition, other groups may also find this data useful, such as scholars in Latin American studies, immigration, cultural diversity, minority health care, and health care in general. The research questions consist of the following: (1) What do indigent pregnant (or recently delivered) Latina women believe about prenatal care? (2) What are the barriers …

Maternal And Neonatal Outcomes By Labor Onset Type And Gestational Age, Jennifer L Bailit, Kimberly D Gregory, Uma M Reddy, Victor H Gonzalez-Quintero, Judith U Hibbard, Mildred M Ramirez, D Ware Branch, Ronald Burkman, Shoshana Haberman, Christos G Hatjis, Matthew K Hoffman, Michelle Kominiarek, Helain J Landy, Lee A Learman, James Troendle, Paul Van Veldhuisen, Isabelle Wilkins, Liping Sun, Jun Zhang

Faculty, Staff and Student Publications

OBJECTIVE: We sought to determine maternal and neonatal outcomes by labor onset type and gestational age.

STUDY DESIGN: We used electronic medical records data from 10 US institutions in the Consortium on Safe Labor on 115,528 deliveries from 2002 through 2008. Deliveries were divided by labor onset type (spontaneous, elective induction, indicated induction, unlabored cesarean). Neonatal and maternal outcomes were calculated by labor onset type and gestational age.

RESULTS: Neonatal intensive care unit admissions and sepsis improved with each week of gestational age until 39 weeks (P < .001). After adjusting for complications, elective induction of labor was associated with a lower risk of ventilator use (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.28-0.53), sepsis (OR, 0.36; 95% CI, 0.26-0.49), and neonatal intensive care unit admissions (OR, 0.52; 95% CI, 0.48-0.57) compared to spontaneous labor. The relative risk of hysterectomy at term was 3.21 (95% CI, 1.08-9.54) with elective induction, 1.16 (95% CI, 0.24-5.58) with indicated induction, and 6.57 (95% CI, 1.78-24.30) with cesarean without labor compared to spontaneous labor.

CONCLUSION: Some neonatal outcomes improved until 39 weeks. Babies born with elective induction …

A Critical Appraisal Of Guidelines For Antenatal Care: Components Of Care And Priorities In Prenatal Education, Lisa Hanson, Leona Vandevusse, Joyce Roberts, Amanda Forristal

College of Nursing Faculty Research and Publications

There are a variety of published prenatal care (PNC) guidelines that claim a scientific basis for the information included. Four sets of PNC guidelines published between 2005 and 2009 were examined and critiqued. The recommendations for assessment procedures, laboratory testing, and education/counseling topics were analyzed within and between these guidelines. The PNC components were synthesized to provide an organized, comprehensive appendix that can guide providers of antepartum care. The appendix may be used to locate which guidelines addressed which topics to assist practitioners to identify evidence sources. The suggested timing for introducing and reinforcing specific topics is also presented in …

Associations Among Health Literacy Levels And Health Outcomes In Pregnant Women With Pregestational And Gestational Diabetes In An Urban Setting, Rosemary Ann Mclaughlin

Theses and Dissertations (ETD)

Purpose/Objectives: Poor health literacy is a problem for over 45% of American adults and is associated with a variety of adverse health outcomes. Low health literacy has been associated with poor prenatal care utilization and a higher likelihood of poorer glycemic control. Poor glycemic control can lead to poor birth outcomes for both the mother and infant. Health literacy levels of pregnant women with diabetes can influence these outcomes and need to be known early in the pregnancy. Interventions can influence tighter glycemic control and lessen the impact of diabetes for the mother and infant. Therefore, the purpose of this …

Paripartum Cardiomyopathy: Implications For Nps, Jeffrey A. Goss, A. Elaine Bond, Renea L. Beckstrand, Lynn C. Callister

Faculty Publications

Peripartum cardiomyopathy (PPCM), the fifth leading cause of death in pregnancy, is often overlooked or misdiagnosed because of vague symptoms and a lack of specific criteria for diagnosis. The authors performed a literature review of articles published between January 2000 and November 2007, and found that early diagnosis via echocardiography and interventions with specific treatment modalities can reduce mortality. Dobutamine stress testing may be prognostic for left ventricular (LV) dysfunction. Standard heart failure (HF) drug regimens, heart transplantation, and mechanical assist devices are viable treatment modalities, depending on individual needs. Subsequent pregnancies must be followed closely. The authors recommend that …

The Role Of The Nurse Practitioner In Health Promotion During Pregnancy, Sarah Elizabeth Hendrix

MSN Research Projects

Health promotion is fundamental to nurse practitioner practice. To be effective in health promotion, the nurse practitioner must have a clear understanding of the nature of behavioral change, the individual issues each client brings to a particular behavior, and have expertise in health promotion. The nurse practitioner must possess specific skills to facilitate the client’s movement along the continuum of health behavior change. Health promotion that enhances prenatal care has been described and established by evidence-based research and professional practice guidelines. The purpose of this evidence-based research project was to develop a current nurse practitioner knowledgebase regarding the role of …

Basal Body Temperature Assessment: Is It Useful To Couples Seeking Pregnancy?, Mary Lee Barron, Richard J. Fehring

College of Nursing Faculty Research and Publications

Advanced practice nurses in primary care settings are often asked to give appropriate advice to couples seeking pregnancy. This article examines the issue of basal body temperature (BBT), a time-honored way to establish the presence of ovulatory cycles, and asks if BBT is an outdated recommendation. The article also reviews the benefits and limitations of recommending BBT to couples seeking pregnancy in light of recent fecundity research.

State Mandated Prenatal Human Immunodeficiency Virus Screening At A Large Community Hospital, William Cusick, Julie G. Stewart, Michael Parry, Gavin Mcleod, Gerald Rakos, Chris Sullivan, John Rodis

Nursing Faculty Publications

Purpose: To describe the initial experience of state mandated prenatal HIV screening at a large community hospital.
Methods: HIV screening was provided to all pregnant women as of October 1, 1999. All HIV-positive women identified received aggressive antiretroviral therapy to reduce the likelihood for vertical transmission. Neonates were screened for HIV at zero, six, and 12 months of age.
Results: Seven pregnant women (0.3%) and two additional family members tested positive for HIV. All seven infants born to the identified HIV-positive women have tested negative for infection. We estimated that six of nine cases of HIV infection identified would have …