Psychosocial and demographic factors related to health behaviors in the 1st trimester.

OBJECTIVE: To explore the relationship of psychosocial and demographic variables to health behaviors in early pregnancy. DESIGN: First trimester findings presented from a prospective study of weight gain in pregnancy. SETTING: A comprehensive health care system in central Texas. PARTICIPANTS: 114 pregnant women (75% white, 13% African American, 10% Hispanic, 2% Asian) of 12 weeks gestation or less. OUTCOME MEASURE: Self-Care Inventory, which includes diet/eating, substance abuse, recklessness, hygiene-related practices, sleep/rest, and exercise behaviors. RESULTS: In regression analysis the final model of demographic and psychosocial variables showed that higher depressive symptoms, lower internal locus of control for fetal health, and lower family income were related to poorer health behaviors in the 1st trimester of pregnancy. CONCLUSIONS: Health behaviors in early pregnancy may be affected by psychosocial factors such as depressive symptoms. Greater emphasis should be given to such factors in research and prenatal assessments.

Jelly beans as an alternative to a fifty-gram glucose beverage for gestational diabetes screening.

OBJECTIVE: This study tested the hypothesis that a standardized dose of jelly beans could be used as an alternative sugar source to the 50-g glucose beverage to screen for gestational diabetes mellitus. STUDY DESIGN: One hundred sixty pregnant women at 24 to 28 weeks' gestation were recruited for a prospective study to compare 2 sugar sources for serum glucose response, side effects, preference, and ability to detect gestational diabetes mellitus. Patients were randomly assigned to consume 50-g glucose beverage or 28 jelly beans (50 g simple carbohydrate). Serum glucose values were determined 1 hour later. The test was later repeated with the other sugar source. Finally, a 100-g 3-hour oral glucose tolerance test was performed. Participants completed a questionnaire recording subjective outcome variables. American Diabetes Association criteria were used to interpret all test results. RESULTS: Among 136 participants completing the study no significant differences were found between 1-hour serum glucose values (116.5 +/- 27 mg/dL with 50-g glucose beverage, 116.9 +/- 23.6 mg/dL with jelly beans; P =.84), frequency of discrepant results (P =.47), sensitivity, specificity, or predictive value. Jelly beans yielded fewer side effects (38% with 50-g glucose beverage, 20% with jelly beans; P <.001) and were preferred by 76% of participants (P <.001). Five cases (3.7% incidence) of gestational diabetes mellitus were diagnosed, 3 with 50-g glucose beverage alone, 1 with jelly beans alone, and 1 with both sugar sources. CONCLUSIONS: Jelly beans may be used as an alternative to the 50-g glucose beverage as a sugar source for gestational diabetes mellitus screening. The 2 sources provoke similar serum glucose responses. Patients report fewer side effects after a jelly bean challenge than after a 50-g glucose beverage challenge.

An orientation program for new graduate nurses: the basis of staff development and retention.

The nursing shortage and an increased demand for obstetric nurses led a Central Texas hospital to hire new graduates for the Level Three obstetric unit. This change in hiring policy necessitated a reevaluation of the orientation program resulting in a new approach in staff development. A three-phase program was developed beginning with orientation and socialization of the new staff member, continuing with the development of advanced skills, and leading to assignments of complex cases after completing appropriate educational programs. The program has fostered autonomy in the experienced staff nurse and increased job satisfaction as measured by advancement in the career ladder and retention rate. The program is regularly monitored by chart and peer review audits, as well as by the orientees' six-week and six-month evaluations.