Case Study of an Intervention to Enhance Maternal Sensitivity in Adolescent Mothers

The purpose of this case study was to examine the efficacy of a teen parenting home intervention on maternal sensitivity in one teen mother/infant dyad by exploring the changes from pre‐ to postintervention in parenting stress, depression, and social support, all of which influence maternal sensitivity. Levels in all four variables of interest changed postintervention as predicted. Assessment and intervention related to maternal sensitivity should be incorporated into care of adolescent mothers in all settings.     

Toxic Shock Syndrome: An Opportunity for Nursing Intervention

Toxic Shock Syndrome (TSS) is a potentially fatal illness caused by a particular strain of Staphylococcus aureus. The clinical presentation is similar to that of septic shock. The incidence of TSS peaked in the late 1970s and early 1980s, probably as a result of availability of super absorbent tampons. Although most commonly associated with menstruation, the overall incidence of menstrual and nonmenstrual TSS in men and women ranges from 1 to 3 per 100,000. There are almost equal numbers of menstrual and nonmenstrual cases of TSS identified annually. S. aureus, the causative microorganism in cases of TSS, has been isolated from many body tissues. Toxic shock syndrome presents as a flu-like illness with high fever, vomiting, diarrhea, general malaise, and muscle weakness. Nursing and medical management focus on controlling or preventing potentially serious complications, such as adult respiratory distress syndrome, renal failure, electrolyte imbalances, disseminated intravascular coagulation, encephalopathy, and cardiomyopathy. Judicious use of tampons and barrier contraceptive devices may decrease the risk of developing TSS.     

Adolescent Mothers' Social and Health-Related Interests: Report of a Project for Rural, Black Mothers

Group meetings, commonly used in prenatal care, took a different form in a project conducted in North Florida with rural, adolescent, black mothers. Discussions focused on the expressed interests of mothers who retained identification with their babies. The article describes their behaviors and cognitive patterns, provides insights into the concerns of mothers, and indicates that their needs are related to both adolescence and motherhood. It further suggests that loosely structured groups might be one method of approaching their health-related concerns. Adolescent parenthood is becoming an important concern in adolescent health cure; this article provides information concerning single, adolescent mothers and methods of dealing with their social and health-related concerns.     

Mentors Offering Maternal Support: A Support Intervention for Military Mothers

ObjectiveTo evaluate the effectiveness of the Mentors Offering Maternal Support (MOMS) program to promote maternal fetal attachment, maternal adaptation to pregnancy, self‐esteem, and perceived community support in women within a military environment.DesignA randomized, controlled, repeated measured pilot study compared two groups of pregnant military wives, a control group receiving standard prenatal care and an intervention group receiving a structured eight‐session MOMS program.SettingThe study was conducted at two Air Force installations in Florida having joint (Air Force, Army, and Navy) operations and high deployment requirements.ParticipantsSixty‐five military wives in their first trimester of pregnancy (control group, n = 36 and intervention group, n = 29) completed all aspects of the study.MethodsWomen randomized to the MOMS program received eight structured classes starting in the first trimester of pregnancy and occurring every other week until the third trimester. Outcome measures were obtained in each trimester. The women in the control group received usual prenatal care.ResultsNo statistically significant differences were found between the two groups for any of the outcome variables. The interaction of the amount of contact the women had with their deployed husbands and group assignment was statistically different for two variables, the Relationship with Husband Scale and the Rosenberg Self‐Esteem Inventory.     

Preparation for Breastfeeding A One-Year Followup of 34 Nursing Mothers

A retrospective survey of 34 breastfeeding mothers was undertaken. From the data the following hypotheses have been suggested for further study: 1) Class preparation for breastfeeding favors a longer duration of nursing. 2) Nipple rolling and breast massage with manual expression of colostrum during pregnancy are not associated with a longer duration of nursing, nor do they prevent sure nipples or breast engorgement postpartum. 3) Mothers with multiple complications are at high risk for lactation failure. 4) Limiting nursing time for the first few days postpartum does not prevent sore nipples.     

Shortened Hospital Stay for Low-Birth-weight Infants: Nuts and Bolts of a Nursing Intervention Project

Prolonged hospitalization of low-birth-weight (LRW) newborns places them at increased risk for a number of medical and psychosocial complications. A randomized trial of earlier hospital discharge with community-based nursing follow-up and intervention was performed. Community-based, in-home, public-health nursing and homemaker services were provided on an individualized basis according to assessed need. A significantly higher number of nurse home visits and telephone contacts were made to the intervention families. One of the most identified needs of families of LBW infants was assistance with breastfeeding. More than half of the early discharge families needed and received homemaker assistance during the first 8 weeks after the newborn's discharge from hospital. Results showed that a community-based program that provided individualized support and education for families of LBW infants was safe, cost-effective, and had a positive influence on the home environment.     

Postpartum Depression and Adolescent Mothers: A Review of Assessment and Treatment Approaches

Postpartum depression (PPD) affects a significant proportion of adolescent mothers. Adolescence presents unique challenges that may make the young mother more vulnerable than her adult counterparts to PPD. PPD impacts a mother's ability to care for her infant and has been associated with adverse effects on child development. A review of the literature on adolescent PPD was undertaken. The prevalence and the effects of PPD are reviewed, common screening instruments for PPD are compared, and the results of treatment outcome studies are highlighted. There is a need for randomized controlled studies of interventions for adolescents with PPD. Findings from treatment outcome studies with adults with PPD and pregnant adolescents who are depressed suggest that psychosocial interventions may also be effective for adolescents with PPD. Issues in assessment and treatment of PPD among adolescents are considered.     

Group Counseling for Mothers After Emergency Cesarean Section: A Randomized Controlled Trial of Intervention

Abstract: Background : An emergency cesarean section is often a traumatic experience for women, and can be associated with postnatal depression and posttraumatic stress. Various types of interventions have been tested to prevent such consequences. The purpose of this study was to test a model of group counseling for mothers after emergency cesarean section, and to examine its possible effects. Method : After undergoing an emergency cesarean section, 162 Swedish‐speaking women were randomized to group counseling or the control group. The participation rate was 75 percent. The counseling consisted of 2 sessions, conducted at about 2 months postpartum; 72 percent of the women randomized to the counseling group actually attended the sessions. At 6 months postpartum, all study participants completed a postal questionnaire (response rates were 92% in the counseling group and 89% in the control group). Results : No difference between the groups was found in terms of the level of fear after childbirth, symptoms of posttraumatic stress, or postnatal depression at 6 months after the emergency cesarean. The group counseling was much appreciated by the participating women, some of whose experiences are reported in this paper. Conclusion : Group counseling for mothers after emergency cesarean section did not influence their views on the recent delivery or prevent symptoms of posttraumatic stress or postnatal depression. It was, however, appreciated and did no harm. In future studies, other outcomes should be measured.     

An Advanced Neonatal Nursing Program Meeting Today's Challenge in Newborn Nursing

The chronological advances in neonatology and regionalization of care have greatly affected the role of the nursery nurse. Her role has emerged from that of a passive caretaker to one of active and primary surveillance. In order to fulfill this role, additional education and training is necessary to ensure prompt recognition of the subtlest change in condition and immediate treatment to promote quality life for the neonate. This paper describes the Advanced Neonatal Nursing Program, a 4-week educational course designed for neonatal nurses to improve neonatal nursing care within the region of Western New York and Northwestern Pennsylvania. The curriculum, methods of presentation, faculty, evaluation methods, and results of evaluation are discussed.     

A Fetal Intensive Care Nursing Program

A fetal intensive care nursing program, developed by a university department of obstetrics and gynecology in an attempt to provide optimal care for each fetus, is described. The concept is to make each labor and delivery area a fetal intensive care unit. The 160-hour training program of lectures and clinical experience consists of a review of basic anatomy and physiology, gametogenesis, maternal and fetal physiology, and the dynamics of uteroplacental circulation, focusing heavily on the intrapartum period, including fetal monitoring, oxytocin administration, and recognition of fetal problems during the course of labor. Nurses successfully completing the program are more valuable members of the obstetric team, understanding the theory and technique basic to necessary intervention as indicated by nursing and physician assessment of the fetus.     

A Report on the FIGO Saving Mothers and Newborns Project

In collaboration with member national professional associations, the International Federation of Gynecology and Obstetrics (FIGO) has been conducting a Saving Mothers and Newborns Project in 10 low- and middle-resource countries. The project aims to achieve the objectives set out in Millennium Development Goals 4 and 5 related to child survival and maternal mortality and to develop organizational capacity among member associations. Projects are developed in response to the needs of the local country, through a twinning of professional associations between high- and low-resource countries.     

A Comprehensive Fetal Monitoring Program for Nursing Practice and Education

Fetal monitoring is a critical part of obstetric nursing. Health-care institutions must educate stag validate their competency, and evaluate their practice to assure high-quality care in fetal monitoring. This article chronicles the development of a comprehensive program for nursing education and practice in fetal monitoring. Basic education and credentialing, recredentialing, in-service and continuing education, policies and procedures, standards of care, terminology, quality assurance, and linkage with a professional advancement system are reviewed.     

Demographic and Relationship Predictors of Paternity Establishment for Infants Born to Adolescent Mothers

Study ObjectiveTo identify demographic and relationship characteristics associated with paternity establishment for children born to adolescent mothers.Participants, Setting, and DesignThis prospective cohort study included 300 pregnant adolescents 12-19 years old, presenting for prenatal care between March 2002 and February 2005. Demographic and relationship characteristics were compared based on paternity establishment (father's name on the infant's birth certificate).Main Outcome MeasurePaternity establishment (father's name on the infant's birth certificate).ResultsOf the 273 participants with outcome data, 54% established paternity. Paternity establishment differed by maternal race/ethnicity (69% Hispanic vs 36% non-Hispanic Black vs 52% non-Hispanic White, P = .01), maternal age (37% for 12-15 years vs 64% for 18-19 years, P = .01), maternal country of birth (48% U.S. born vs 76% non-U.S. born, P = .01), relationship with father of the infant, and father involvement at the time of delivery.ConclusionPaternity establishment rates for children born to teens were low overall. To increase rates of paternity establishment, policies and programs need to consider the unique characteristics and circumstances of teen parents.