Maternal, Child Health and Neonatal Nursing Commons^™

Congolese Mothers' Beliefs That Influence Health-Seeking Behaviors For Their Infants., Shawn Meiman

Electronic Theses and Dissertations

In 2024, approximately 100,000 refugees were admitted to the United States, with 20% coming from the DRC, while Kentucky continues to rank fourth in the country for refugee resettlement. The increasing number of Congolese refugee children in the United States and Kentucky necessitates a greater understanding of these beliefs and practices to ensure equitable, quality, and culturally informed health services. The purpose of this study was to explore Congolese refugee mothers’ culturally and socially situated beliefs, perceptions, practices, and resources related to health care that may influence their views and practices of preventive well-child health care for their infants in …

Exploration Of The Cultural Beliefs, Values, And Practices Of African American/Black Women Or Birthing Persons Regarding Postpartum Depression: A Focused Ethnography, Stephanie Jacobs

Electronic Theses and Dissertations

Introduction: Postpartum depression (PPD) is the most prevalent perinatal mental health illness in women, affecting approximately 10% to 20% of all women in the United States, and a disproportionately higher number of African American women. The aim of this study was to explore the cultural beliefs, values, and practices of African American/Black women or birthing persons regarding postpartum depression.

Research Question: What are the cultural beliefs, values, and practices of African American/Black women or birthing persons regarding postpartum depression?

Methodology: A focused ethnography was chosen for this study and consisted of semi-structured interviews. Data was transcribed and analyzed …

Preeclampsia: Implementation Of The American College Of Obstetricians And Gynecologists Standardized Protocol, Sheila Ann Harwell

Electronic Theses and Dissertations

Preeclampsia is a significant medical condition that affects the perinatal population, posing risks to both the mother and fetus. Complications associated with preeclampsia include stroke, seizure, placental abruption (premature separation of the placenta from the uterus), fetal growth restriction (impaired growth due to reduced blood flow through the placenta), premature birth, and low-birth-weight infants with associated developmental issues. Because there is no cure for preeclampsia, the current management involves the timely administration of intravenous antihypertensives to reduce the risk of stroke and seizure. The gap in practice identified was the obstetrical department’s lacking a standardized protocol, compared to adopting the …

“But The Trauma Did Not Fade Away” Childhood Sexual Abuse, Adolescent Pregnancy, And Rurality, Cynthia H. Mcniss

Electronic Theses and Dissertations

Childhood sexual abuse (CSA) and adolescent pregnancy are critical public health issues that intersect in complex ways, particularly in rural areas. Adolescents who have experienced CSA are at a significantly higher risk of becoming pregnant before the age of 19 compared to their peers without such a history (Madigan et al., 2014). Rurality is also associated with elevated rates of adolescent pregnancy due to various socio-economic and healthcare access challenges ("Rural Health Information Hub," 2024). This study employed a grounded theory approach to develop a comprehensive understanding of the social and psychosocial processes influencing the choices, actions, and decisions of …

The Lived Experience Of Nurses In Caring For Patients With Covid-19, Jessica Barre

Electronic Theses and Dissertations

Limited research exists about the experiences of nurses’ caring for patients during the COVID-19 pandemic post hoc. To understand nurses’ realities of caring for patients with COVID-19, I aimed to understand the lived experience of nurses caring for patients with COVID-19 in the United States. A qualitative design with a hermeneutic phenomenological methodology was used. Sixteen participants were recruited via purposive sampling, augmented with snowball sampling. Data were collected through unstructured interviews and were analyzed using Braun and Clarke’s Reflexive Thematic Analysis. Nurses’ experiences of caring for patients with COVID-19 in the U.S. were consolidated into four themes: “a living …

Examining School Nurses' Knowledge And Confidence Related To Their Intention To Screen For And Report Child Sexual Abuse: A Descriptive Cross-Sectional Study, Suzanne Ackers

Electronic Theses and Dissertations

Background: Child sexual abuse (CSA) in a preventable national public health problem that results in adverse health consequences. Research suggests many victims are currently attending school. Screening for early detection of health issues is integral to school nurse (SN) practice but there is little evidence that screening for CSA is occurring in schools despite recommendations that it should be. Lack of confidence and knowledge related to screening for suspected CSA contribute to a SN’s missed opportunity for early intervention.

Purpose: To describe SNs knowledge and self-efficacy associated with screening for and reporting CSA in school settings.

Methods: A descriptive cross-sectional …

Exploring The Lived Experiences Of Dysphoric Milk Ejection Reflex During Postpartum Breastfeeding: A Phenomenological Study, Stephanie Herr, Jessica Devido, Richard Zoucha, Jill Demirci

Electronic Theses and Dissertations

This study sought to explore the lived experiences of Dysphoric Milk Ejection Reflex (D-MER) during postpartum breastfeeding. A phenomenological method based on Giorgi’s phenomenological underpinnings was used. The setting for this study was virtual interviews in a secure online platform. The sample consisted of 13 participants, self-identifying as experiencing D-MER. Semi-structured interviews, with thematic analysis of transcription were conducted. Four major themes were identified: 1) Breastfeeding concessions and toleration; 2) Something does not feel “normal”; 3) I remember a feeling like this before 4) This is real, and recognition is validating. Conclusions were that women of this study value the …

Exploring The Effects Of Psychosocial Factors And Relationships To Postpartum Depression Symptoms Among Iranian Immigrant Women Living In Canada: A Cross-Sectional Study, Monica Gola

Electronic Theses and Dissertations

Introduction: Immigrant women’s health garners attention as migration creates changes in social networks and parenting needs. The effect of psychosocial factors, such as maternal self-efficacy, measured by ability to manage parenting responsibilities, social support and cultural postpartum practices on postpartum depression symptoms are not well known in Canadian immigrant women. Methodology: A cross-sectional descriptive survey design guided by Bandura’s Reciprocal Determinism was used to explore the relationships between psychosocial factors including: maternal self-efficacy, social support, cultural postpartum practices; and symptoms of postpartum depression (PPD) among recent Iranian immigrant women living in Canada. Results: A total of 114 participants completed the …

Pediatric Obesity In Primary Care, Lynne C. Liggins

Electronic Theses and Dissertations

The purpose of this evidence-based quantitative quasi-experimental research was to compare if providing the parents with information on the health risk associated with childhood obesity would cause the parents to make healthier food choices and encourage their children to be involved in a full hour of physical activity a day. Participants included parents and pediatric and adolescent children 5 to 18 years of age at a solo practice primary care office in a large city in Southern, California, which specializes in treating pediatric and adolescent patients. A pre- and postquantitative intervention design were used and analyzed using the paired t …

The Relationship Between Urban Green Space Perception And Use Within The Adolescent Population: A Focused Ethnography, Rachel Lyons

Electronic Theses and Dissertations

Introduction: Greenspace is beneficial for improving adolescent mental health, yet we still do not understand the connection between the built environment and subjective mental wellbeing. We also lack understanding of how this population uses greenspace and how they feel when in it. Purpose: The purpose of this qualitative study was threefold: to understand why adolescents use greenspace, to identify how they use greenspace, and to explore how they feel when they are in greenspace. Methods: participated in a focused ethnography that utilized auto photography for photo elicitation. Braun and Clark's (2006), six phases of thematic analysis were used to guide …

Determinants Of Reproductive Freedom Among Israeli Women Ages 18-50: A Mixed Methods Study, Abby Kra-Friedman

Electronic Theses and Dissertations

Introduction: Reproductive freedom is a social determinant of health (SDOH) that reduces health disparities and increases health equity. Through the National Health Insurance Plan, Israeli women can access a range of contraceptive methods. Scant data on Israeli women limits development of policies and interventions to meet international benchmarks for reproductive freedom. The purpose of this dissertation study is to synthesize current international multidisciplinary literature using the capability approach for reproductive freedom, explore determinants of reproductive freedom among Israeli women ages 18-50 using Nussbaum's capability approach, and make recommendations for nursing research, practice, and theory.

Methodology: Using Whittemore and …

Nursing Perceptions For Utilizing Essential Oil Application In Labor And The Effect Of Targeted Education, Joni R. Beckham

Electronic Theses and Dissertations

This Doctor of Nursing Practice project was implemented to determine how a nurse’s perception of aromatherapy influences their decision to provide aromatherapy for patients during labor and the effect of targeted education on a nurse’s perception. The purpose of this project was to determine how nurses view the use of aromatherapy resources at their disposal and the likelihood that they would offer the intervention to their patients. This project provided education to increase nurses’ confidence in providing optimal care to patients using a traditional and holistic avenue of aromatherapy while determining if education can positively influence nurses to support essential …

The Effect Of Postpartum Depression Screening Education For Postpartum Nurses, Shecarra S. Cook

Electronic Theses and Dissertations

Depression affects about 13% of pregnant women and about 10% of women after childbirth. Some cases are so severe, the mother may even commit suicide. If left untreated, postpartum depression (PPD) affects both the mother’s and the infant’s health as well as their quality of life. The gap in clinical practice is that currently, patients only complete a postpartum depression screening tool during their 6-week follow-up appointment with their OB/GYN, leaving a gap in PPD detection and care during the immediate postpartum period. Postpartum nurses are not usually given specialized training in postpartum depression. The purpose of this study was …

Decreasing Unintentional Pregnancies For Tennesseans, Paula M. Todd

Electronic Theses and Dissertations

In 2018, 49% of all pregnancies in the United States were unintended, with women with a lower- income status being five times more likely to experience an unplanned pregnancy. Tennessee has a high rate of unintended pregnancies, particularly among the uninsured, low-income, and rural teen populations; some 22% of these unintended pregnancies end in abortion. Oral or transdermal contraceptives that are affordable and accessible for women of childbearing age can reduce unintentional pregnancies. The addressed gap in clinical practice was that contraceptives are not currently available over the counter in Tennessee pharmacies without a prescription, which necessitates a costly medical …

Examining Predictors Of Attitudes And Knowledge Of Registered Nurses And Nursing Students In Tennessee Toward Pregnant And Perinatal Women With A Substance Use Disorder, Jessica Patrylo

Electronic Theses and Dissertations

Substance use disorders (SUDs) among pregnant and perinatal women continue to be a national public health crisis. Furthermore, nursing students and perinatal nurses have historically negative and punitive attitudes toward this vulnerable population of women. As nurses are primary care providers for pregnant and perinatal women, this is troublesome as perinatal patients express feeling stigmatized by nurses whom they should be able to trust. This contributes to the reluctance of women to seek needed medical and prenatal care. Tennessee was the first state to criminalize drug use in pregnancy and has higher neonatal abstinence syndrome (NAS) rates, which were more …

The Effect Of Breastfeeding Education In African American Women On Initiation And Duration Of Breastfeeding, Shalawn F. Harris

Electronic Theses and Dissertations

Abstract

This Doctor of Nursing Practice scholarly project aimed to evaluate the effectiveness of breastfeeding education in African American women on the initiation and duration of breastfeeding. Studies demonstrated that breastfeeding education by providers and a breastfeeding support network positively influenced breastfeeding initiation and continuation in African American women. Breastfeeding education containing information on the decreased risk of breast cancer in African American women may be an even greater motivator for breastfeeding. Participants for this project were African American women, ages 18–50, in their last trimester of pregnancy. The project was approved to be implemented at an urban clinic in …

Supporting Postnatal Women With Opioid Use Disorder Treated With Medication Avoidance Therapy, Lea Ann Quave

Electronic Theses and Dissertations

Recent data in 28 U.S. states revealed that opioid use during pregnancy had increased by four times since 2014, going from 1.5 to 6.5 per 1,000 admissions. The use of opioids during pregnancy is dangerous to the mother and developing fetus, greatly increasing the risk for maternal death, miscarriage, and premature birth. The increase in the number of women with opioid abuse disorder (OUD) is reflected by a fivefold increase of infants born with neonatal abstinence syndrome (NAS), a withdrawal syndrome from opioids. Corresponding with U.S. trends, a community hospital in the Texas Gulf Coast region has seen an increase …

Educational Interventions For Women And Their Support Persons On Breastfeeding Outcomes, Alexandra Cordell

Electronic Theses and Dissertations

n the United States breastfeeding duration and exclusivity rates are not at ideal levels, therefore there is a need to examine existing interventions. The purpose of this systematic review was to examine the effects of education and support interventions during the third trimester, immediate postpartum, and the first six months of life on breastfeeding duration and exclusivity from six weeks to six months. Inclusion criteria were (a) randomized controlled trials or controlled clinical trials, (b) pregnant and/or postpartum women, (c) lactation education and support interventions, (d) measurement of breastfeeding outcomes from six weeks to six months, and (e) published between …

Std Education Among African American Women: An Educational Improvement Initiative, Marqueta V. Abraham

Electronic Theses and Dissertations

Research reveals there is a knowledge gap facing African American women regarding sexual health education, specifically sexually transmitted diseases. The Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ) was used to assess participants’ knowledge and attitudes regarding sexually transmitted diseases. The STD-KQ self-assessment was administered to African American women and utilized to develop a 45-minute education seminar to bridge the knowledge gap. After an education seminar was held, a posttest was administered to test the women’s knowledge and to determine their level of awareness. Using a paired-samples t test, the researcher found an overall increase in awareness of the types of sexually …

Comprehensive Staff Education And Implementation Of A Checklist Tool To Increase Staff Adherence To Pitocin Titration Protocols, Tara N. Cassell

Electronic Theses and Dissertations

This quality improvement project was designed to increase staff adherence to an existing Pitocin titration protocol used in a labor and delivery unit at a community hospital. In the current U.S. health care climate, safe patient care is paramount and the Institute for Safe Medication Practices identified Pitocin as a high-alert medication. Evidence-based practice recommends the use of a titration protocol to guide proper use of Pitocin. Prior research has shown improvements in patient outcomes when facilities implement Pitocin titration protocols, with staff adherence key to the successful implementation of evidence-based titration protocols, which may be improved with the use …

The Effect Of A Mindfulness Intervention On The Depression Symptoms Of Mothers In Treatment For An Opioid Use Disorder, Karen Alexander

Electronic Theses and Dissertations

BACKGROUND: Mothers in treatment for an opioid use disorder experience a high prevalence of depression which may influence their relationship with their child. In the general population, mindfulness-based parenting intervention has been seen in the literature to have a clear positive effect on maternal depression. No research has been published regarding the effect of mindfulness intervention on maternal depression of women in treatment for an opioid use disorder.

OBJECTIVES: To describe the characteristics of mothers in treatment for opioid use disorder, including depression and adverse childhood experiences, and to evaluate the characteristics associated with participation in a mindfulness intervention. Lastly, …

Comparison Of Two Methods Of Pediatric Triage Education, Catherine Recznik

Electronic Theses and Dissertations

Introduction. The majority of pediatric emergency patients are seen in mixed-age emergency departments and triaged by general emergency nurses. Educational methods for teaching pediatric triage education to general emergency nurses have not been well studied, and previous studies of the use of the Emergency Severity Index in children have been performed primarily in centers that are high volume for pediatrics. Methods. A repeated measures, randomized crossover study comparing two different methods of pediatric triage education was conducted. Participants were general emergency triage nurses recruited from a general emergency department that is classified as low volume for pediatrics. Each participant was …

Perceptions Of Pediatric Nurses And Parents Of Hospitalized Children Engaged In Shared Decision Making., Lisa English Long

Electronic Theses and Dissertations

Achievement of optimal quality in today’s healthcare environment practices means that clinical practices must be based on evidence. Evidence-based practice (EBP) is the integration of research findings, clinician expertise, and patient-centeredness that includes a focus on preferences and values (Melnyk & Fineout-Overholt, 2015). An area within EBP needing increased attention is the aspect of patient preferences and values. The process of Shared Decision Making (SDM) incorporates assessment of preferences and values within a process in which where patients, families and healthcare professionals collaborate to make decisions regarding patient care. The purpose of this study was to describe perceptions of parents …

Discharge Readiness For Families With A Premature Infant Living In Appalachia, Kathy Zimmerman

Electronic Theses and Dissertations

With increased advances in technology, the overall survival rates in the Neonatal Intensive Care Unit (NICU) for premature infants at lower gestational ages, has also increased. Although premature infants survive at lower gestational ages, they are often discharged to home with unresolved medical issues. While the birth of a new baby for parents is a joyous occasion, they often have difficulty coping and transitioning into a parental role. Premature infants also have ongoing complications such as difficulty with feeding, developmental delays in growth, and long-term eye and respiratory complications. As a result of chronic health sequelae, premature infants require extensive …

Mental Health And Substance Use Disorders And Treatment Receipt Among Pregnant Women In The United States, 2008-2014 : Trend Analysis, Likelihood Of Treatment Receipt, And Ethnic Disparities In Mental Health Treatment., Taghreed Nayel Salameh

Electronic Theses and Dissertations

The purposes of this dissertation were to examine trends from 2008 to 2014 in mental health and substance use disorders and treatment receipt, and explore factors associated with treatment receipt in pregnant women aged 18-44 years in the United States. A systematic review showed that illicit drug use disorder increased in pregnant women over the past decade. Despite the increase in treatment admissions for these disorders from 1992 to 2012, the overall treatment admission rate for pregnant women remained relatively stable (4%). In a trend study, compared mental health and substance use disorders and treatment receipt across Matched groups of …

Parents Of Children Who Had Hypoxic-Ischemic Encephalopathy: A Mixed-Methods, Exploratory Study, Natalene Kramer

Electronic Theses and Dissertations

Background: There is scant literature addressing the parents of children who had hypoxic-ischemic encephalopathy (HIE). therefore only inferences may be made as to issues of that experience affecting parents.

Purpose: The purposes of this study was to uncover the lived experiences of parents of children who had HIE, evaluate issues of stress, depression, coping, and impact of neurologic disability in order to better care for them and thus their families

Methods: A parallel, convergent mixed-methods design was used to explore experiences and perceptions of these parents regarding their experiences and life changes. The quantitative strand addressed four research questions which …

Psychological And Sociocultural Influences Of Current And Historical Intimate Partner Violence In Pregnancy, Cindy D. Phillips

Electronic Theses and Dissertations

The Centers for Disease Control and Prevention (CDC) estimates that 1.5 million women are victims of intimate partner violence (IPV) each year, and 324,000 of these women are pregnant (2013). Research on the predictability of certain factors and their relationship to current and historical IPV is limited. In order to better understand IPV as it related to a sample of 1,016 Appalachian pregnant women selected for the Tennessee Interventions for Pregnant Smokers (TIPS), it was important to evaluate various influences that may predict the prevalence of IPV in this population when compared to the State of Tennessee and the U.S. …

Training Clinical Judgment Skills For Interpreting Feeding Behavior In Preterm Infants: A Comparison Of Video And In Vivo Simulation, Jamesa R. Ewing

Electronic Theses and Dissertations

Health and feeding outcomes for preterm infants depend upon healthcare providers’ ability to recognize non-verbal signs of distress during bottle-feeding. Methods of training future providers’ to interpret feeding behavior in preterm infants are unclear. This study used a pre-test/post-test design to compare the effects of in- vivo simulation and video-simulation training on students’ knowledge of feeding abnormalities, clinical judgment, and documentation accuracy. Fifty-two graduate level speech-language pathology students were assigned to the in-vivo (N= 27) or video-simulation (N= 25) group. Results revealed that both methods proved beneficial for increasing knowledge and clinical judgment skills. Participants trained using video-simulation training documented …

Nicu Culture Of Care For Infants With Neonatal Abstinence Syndrome: A Focused Ethnography, Monica M. Nelson

Electronic Theses and Dissertations

Purpose: The purpose of this ethnographic study was to describe the culture of care and nonpharmacological nursing interventions performed by NICU nurses for infants with NAS. Background: Infants with NAS are increasingly being cared for in the inpatient hospital setting by NICU nurses. Interventions used for the care of premature and sick infants in the NICU may or may not be the exact interventions that should be used for the care of the fragile infant with NAS. Research studies on the nonpharmacological nursing care of infants with NAS encompass 5 main areas of practice: environment, adequate rest and sleep, feeding, …