Baby boomers' use and perception of recommended assistive technology: A systematic review

Purpose.?The objective of this article is to review published studies to describe issues and quality of evidence surrounding assistive technology (AT) use by the baby boomer generation. As the baby boomer generation are ageing, they represent a new era for aged health care. In terms of helping this generation maintain independence, it is expected that there will be an increased demand for AT.

Method.?A systematic literature search of Medline, CINAHL and Cochrane was undertaken. Selected studies were critically appraised using a previously validated tool. Inclusion criteria were: research related to AT use by a population which includes baby boomers; published in peer-reviewed journals and full-text English language articles. Studies were based in acute rehabilitation units in the USA and Australia. Frequency of use and patient satisfaction surveys were the main outcome measures.

Results.?A total of 11 eligible studies were reviewed. All were cross-sectional. Many studies indicated a significant rate of AT non-use; use rates ranged from 35% to 86.5%. Numerous factors influencing use were proposed. Study quality was upper-mid range.

Conclusions.?Baby boomers will place more demand on AT in the future. There is a need for high-quality research to verify current findings and highlight AT issues specific to this generation.     

A factor-analytic study of the Social Problem-Solving Inventory: An integration of theory and data

Restricted (confirmatory) and unrestricted (exploratory) factor analyses were used to investigate the factor structure of the Social Problem-Solving Inventory (SPSI; D'Zurilla & Nezu, 1990). The SPSI is based on a theoretical model consisting of two general components (problem orientation and problem-solving skills) which are further divided into seven primary subcomponents (cognitive, emotional, and behavioral aspects of problem orientation and four specific problem-solving skills). Thus, both a two-factor model and a hierarchical model with seven first-order factors and two second-order factors were tested. The results provided only modest support for the two-factor model, and the hierarchical model failed to show substantial improvement over this model. Further analyses using exploratory as well as confirmatory methods found that an alternative five-factor model was best for the SPSI in the sense of goodness of fit, parsimony, and cross-validation. The implications of these results for social problem-solving theory and assessment are discussed.The participation of Albert Maydeu-Olivares in this research was supported by a Fulbright-La Caixa scholarship.     

StoriesAppreciating Both Sides of the Generation Gap: Baby Boomer and Generation X Nurses Working Together

With nurses from the baby boomer and Generation X providing the majority of bedside nursing care, multigenerational differences are present in the workplace. The key to improved job satisfaction is the development of understanding and talking through differences between nurses of these age groups. From the perspective of a Generation X nurse, this paper addresses the differences in work ethic and values between these age groups and shows how such differences affect satisfaction with professional nursing. Improved job fulfillment can increase nursing retention and lessen the effects of the nursing shortage.     

新生儿预防性应用抗生素与感染发病关系的浅析

目的　探讨有关羊水Ⅲ°污染和胎膜早破 >2 4小时的新生儿生后预防性应用抗生素与感染发病的关系。方法1996年 3月～ 1998年 4月本院出生的 2 47例羊水Ⅲ°污染和 117例胎膜早破 >2 4小时的新生儿分别设为Ⅰ组和Ⅱ组 ,生后不论有无感染均肌注头孢氨噻肟 10 0mg/ (kg·d)共 5天 ,用药前做腔道 (眼、鼻、耳、咽 )分泌物培养 ,部分新生儿加做血培养。同期出生无以上二种情况的新生儿 2 5 13例作为对照组。结果　对照组发生感染 45例 ,发病率 1.79%。Ⅰ组发生感染 14例 ,发病率 5 .66% ,明显高于对照组 ( χ2 =16.16,P <0 .0 1)。Ⅱ组发生感染 1例 ,发病率 0 .85 % ,与对照组比较无显著差异 ( χ2 =0 .5 7,P >0 .0 5 )。结论　胎膜早破疑有宫内感染的新生儿生后预防性用抗生素可降低感染发病率 ,而羊水Ⅲ°污染有胎窘、产时窒息的新生儿生后尽管应用抗生素仍不能降低感染的发病率 ,故预防重点是防止胎窘和产时窒息发生     

Maternal severity of illness across levels of care: A prospective, cross-sectional study

Background

The severity of illness of women experiencing severe maternal morbidity has not been quantified outside of the intensive care setting yet is likely to have a bearing on clinical needs.

Aim

To examine severity of illness in women with severe maternal morbidity.

Methods

A prospective observational study of critically ill pregnant and postpartum women was undertaken in intensive care units (ICU), high dependency units (HDU) and delivery suites (DS) of seven tertiary-level hospitals in Melbourne, during 2002–2004. Severity of illness was scored using the Acute Physiology and Chronic Health Evaluation version II (APACHE II) and Therapeutic Intervention Scoring System 28 items (TISS 28).

Results

137 women participated in the study: ICU (n = 33), HDU (n = 46) and DS (n = 58). The mean APACHE II score was 8.6 (95% CI 7.7–9.5) and mean TISS 28 score was 22.5 (95% CI 21.2–23.9). Women in ICU were sicker according to both APACHE II (mean 12.6, 95% CI 8.3–16.9) and TISS 28 (mean 31.5, 95% CI 28.2–35.5) compared to women not admitted to ICU (p < .005). There was no difference in the mean APACHE II scores of women in HDU (7.7, 95% CI 5.5–9.9) and DS (7.0, 95% CI 5.2–8.8; p = .20). Women born outside of Australia were more likely to be admitted to ICU (OR 3.27, 95% CI 1.19–8.97). Known risk factors like multiple pregnancy, age ≥35 years and nulliparity were not associated with ICU admission.

Conclusions

There was no difference in the severity of illness in women cared for in HDU and DS. It was not possible to predict which women would require ICU admission. Measurement of severity of illness adds a valuable dimension to the study of severe maternal morbidity.     

Maternal and family predictors of infant psychological development in at-risk families: A multilevel longitudinal study

The impact of different parenting-related variables on child psychological development is widely acknowledged. However, studies about the specific influence of maternal and family dimensions on child early developmental outcomes in at-risk dyads are still scarce. The aim of this longitudinal study was to investigate the short- and middle-term effects of prenatal and postnatal family and maternal features, and child attachment, on child psychological development at 3 and 24 months in at-risk families. Forty-two mothers with psychological, social and/or demographic risk conditions and their first-born infants were assessed longitudinally. Measurements of maternal personality, psychological and depressive symptoms, family socioeconomic status (SES), child–mother attachment, and infant general psychological development were collected at multiple time points, through validated questionnaires and/or mother–child observation. Maternal and family dimensions showed a significant effect on child psychological development over time. The expected detrimental role of reported maternal depressive symptoms was observed both at 3 and 24 months of child's age. Data also highlighted the negative contribution of low family SES and an unexpected positive influence of maternal personality trait of psychoticism on child psychological development at 24 months. We also found a positive association between attachment security and child developmental outcome. These findings might have relevant implications for the implementation of early prevention programs by differentiating the specific predictive role of maternal child and familial factors on child psychological development in at-risk families.     

Caregiving setting and Baby Boomer caregiver stress processes: Findings from the National Study of Caregiving (NSOC)

The aim of this study was to provide a comprehensive understanding of how the caregiving setting relates to caregiving experience among Baby Boomer caregivers (CGs). Based on a secondary data analysis (the National Study of Caregiving, N = 782), compared with CGs providing care to an older adult living in the community, CGs to older adults in non-NH residential care settings reported better emotional well-being, self-rated health, and relationship quality and less provision of assistance older adults with daily activities. While chronic conditions, relationship quality, and financial strain were associated with the health and well-being for both CG groups, degree of informal support was more consequential for the health of CGs providing care to older adults in the community. Our results provide critical information on the risk factors and areas of intervention for both CG groups.     

Maternal role attainment with medically fragile infants: Part 1. measurement and correlates during the first year of life

The purpose of this study was to extend scholarship on maternal role attainment (MRA). We used a triangulation of behavioral and self‐report variables to measure MRA—identity, presence, and competence—with mothers of medically fragile infants (n = 81), and explored characteristics that influenced MRA longitudinally. Competence and presence were best measured using both self‐report and observational methods, whereas identity was best measured with a questionnaire. Mothers with less worry reported higher levels of identity. Presence was higher with less alert infants, whereas competence was higher with more alert infants, lower parental role stress, higher education, and being married. Mothers with more illness‐related distress and less alert infants, and unmarried and less educated mothers may need interventions to enhance MRA. © 2011 Wiley Periodicals, Inc. Res Nurs Health 34:20–34, 2011     

Mothers' evaluation of their caregiving for premature and full-term infants through the first year: contributing factors

We explored change in mothers' evaluations of their caregiving through the first postterm year for full-term infants and for prematurely born, very low birth-weight infants with a history of lung disease, and we examined the contribution to this evaluation of infant, family, and mother conditions. Fifty-four mothers of premature infants and 49 mothers of full-term infants evaluated their caregiving relationship, performance, and satisfaction at 1, 4, 8, and 12 months infant postterm age. In addition, at the same intervals-1, 4, 8, and 12 months-mothers rated their symptoms of depression, infant responsiveness, and satisfaction with help from husband or partner. Positive and negative feeding behaviors of mother and of infant were rated from videotapes. Regression analysis, which included all rated variables, infant birth maturity/lung health status, and number of children in the mother's care, showed that the 1-month assessment differed significantly from the assessments at 4, 8, and 12 months. All conditions, except for infant birth maturity/lung health status and mother's positive feeding behavior, were significantly associated with caregiving evaluation. Findings support inclusion of infant, family, and mother conditions in a caregiving evaluation model. Infant responsiveness may be particularly salient to a mother's caregiving evaluation.     

229例产科监护室高危妊娠产妇泌乳启动延迟现状及影响因素分析

目的 调查产科监护室高危妊娠产妇泌乳Ⅱ期启动延迟现状,并分析其影响因素。方法 采用便利抽样方法,选取2019年5—10月浙江省某三级甲等母婴专科医院分娩后入住产科监护室的229例高危妊娠产妇作为研究对象。采用一般资料调查表、泌乳日志、爱丁堡产后抑郁量表及中文版疲乏评定量表对其进行调查。采用二分类Logistic回归分析产科监护室高危妊娠产妇泌乳启动延迟的影响因素。结果 229例产科监护室高危妊娠产妇发生泌乳启动延迟97例,发生率为42.4%;二分类Logistic回归分析结果显示,年龄≥35岁（OR=2.523,P=0.003）、有妊娠期高血压病（OR=2.523,P=0.003）、开奶时间晚（OR=0.924,P=0.025）是产科监护室高危妊娠产妇泌乳启动延迟的危险因素。结论 产科监护室高危妊娠产妇泌乳启动延迟率较高,尤其应关注年龄≥35岁、有妊娠期高血压疾病、开奶时间晚的高危妊娠产妇,建议做好孕期保健及健康教育,加强泌乳干预,促进营养吸收,增加产妇泌乳知识,以降低泌乳启动延迟率。     

Maternal death due to COVID‐19 and high BMI: A case report from Hamadan,Iran

Pregnant women suffering chronic illness or obstetric complications such as obesity are prone to severe pneumonia and COVID‐19. Obesity in pregnancy is associated with many complications for both mother and fetus. Here, we report the death of an obese mother with COVID‐19.     

Social support and psychological functioning among high-risk mothers: the impact of the Baby Love Maternal Outreach Worker Program

This study compared two groups of high-risk Medicaid-eligible mothers, 221 who participated in a maternal home visitation program and 198 who did not, to determine whether program participation was associated with improvements in the mothers' psychological functioning 1 year after delivery, and whether these improvements were associated with the type and intensity of support provided by home visitors. The results suggest that, compared to nonparticipants, participants provided with more intensive home visitor support had significantly higher self-esteem (p = 0.039) and were less depressed (p = 0.015). Participants with less intensive home visitor support, however, did not differ significantly from nonparticipants in their self-esteem or depression levels. No significant differences were observed in the perceived stress levels of participants as compared with nonparticipants, regardless of the intensity of home visitor support. Mothers who had support from the baby's father, however, had significantly lower perceived stress levels than mothers with no support from the baby's father (p = 0.046). Moreover, the type of support provided by home visitors (emotional, instrumental, informational) did not appear to be related to the mothers' psychological functioning. This study suggests that the intensity of support is an important component of maternal home visitation programs that aim to improve women's psychological functioning.     

Maternal body mass index in pregnancy and offspring physical and psychosocial functioning in older age: findings from the Helsinki Birth Cohort Study (HBCS)

Introduction: Maternal obesity is associated with several adverse long-term health outcomes in the offspring. In this study, we examined the association between maternal body mass index (BMI) and offspring physical and psychosocial functioning in late adulthood. Methods: The study included 1759 men and women born during 1934–1944 and belonging to the Helsinki Birth Cohort Study. Data on maternal weight and height in late pregnancy and on offspring birth weight were retrieved from hospital birth records. Physical and psychosocial functioning was assessed using the Short Form 36 scale. Results: Maternal BMI was positively associated with poorer physical and psychosocial functioning among men, but not among women. This association was not mediated by birth weight. Discussion: The present study emphasizes the importance of preventing overweight and obesity among women of childbearing age.

• Key messages

• Maternal BMI is known to be associated with adverse health outcomes among adult offspring.

• We found that higher maternal BMI was associated with poorer physical and psychosocial functioning among male offspring in late adulthood.

• The association between maternal BMI and offspring physical and psychosocial functioning was not mediated by birth weight.

     

Fatigue,depression, maternal confidence,and maternal satisfaction during the first month postpartum: A comparison of Japanese mothers by age and parity

The aim of the study was to assess fatigue, depressive symptoms, and maternal confidence or satisfaction among older primiparae during the first month postpartum. The number of older Japanese primiparae has rapidly increased. Older primiparae are believed to be at high risk for puerperal morbidity. A multicentre prospective cohort study design was used. Data were examined from 2854 Japanese women who participated in a 6‐month prospective cohort study conducted between May 2012 and September 2013. The women were classified into 4 groups based on maternal age and parity. All participants completed the Postnatal Accumulated Fatigue Scale, Japanese Edinburgh Postnatal Depression Scale, Postpartum Maternal Confidence Scale, and Postpartum Maternal Satisfaction Scale. Primiparae in all age groups were more severely fatigued and had a higher risk of postpartum depression than multiparous mothers during the first month postpartum. Older primiparae had significantly lower scores on maternal confidence and maternal satisfaction than the other 3 groups at 1 month postpartum. These findings suggest that postpartum nursing should focus on promoting adequate sleep, providing emotional support, and fostering the process of maternal role adaptation among older Japanese primiparae, particularly during the first postpartum month.     

Caring for twins during infancy: A systematic review of the literature on sleeping and feeding practices amongst parents of twins

ObjectiveTo better investigate how the parents of twins approach the care of their infants in terms of feeding and sleeping practices after birth by examining the sleeping and feeding behaviours of parents with twin babies.MethodsThree electronic databases (PubMed, PsycINFO, and ScienceDirect) were searched, and studies published between 2006 and 2016 were included. The Preferred Reporting Item for Systematic Reviews and Meta-Analyses (Moher et al., 2015) was adopted. Key findings were extracted and synthesised. ResultsFourteen studies were included (three focused on sleeping, seven focused on feeding, and four focused on sleeping but considered feeding to be a secondary issue).ConclusionCaring for twins presents unique challenges that require specific choices to be made. The parents of twins could benefit from additional and specially developed advice from health professionals for considering and implementing adequate sleep and feeding practices that reduce parental fatigue and stress, as well as promote parent-twin relationships.