ABSTRACT
In 1998, 20.2% of the approximately 4 million births in the United States occurred via cesarean delivery. Routine antibiotic prophylaxis has significantly reduced morbidity, yet each year between 41,000 and 206,000 women develop a subsequent infection of the uterus or surgical incision. A thorough understanding of the pathophysiology and complex interaction of risk factors for metritis and wound infection is vital for perinatal nurses. Nurses have a critical role in the identification and treatment of postcesarean infection.
Subject(s)
Cesarean Section/adverse effects , Cross Infection/etiology , Cross Infection/prevention & control , Endometritis/etiology , Endometritis/prevention & control , Puerperal Infection/etiology , Puerperal Infection/prevention & control , Surgical Wound Infection/etiology , Surgical Wound Infection/prevention & control , Cesarean Section/nursing , Cesarean Section/statistics & numerical data , Cross Infection/diagnosis , Cross Infection/epidemiology , Endometritis/diagnosis , Endometritis/epidemiology , Female , Humans , Incidence , Infection Control/methods , Morbidity , Neonatal Nursing/methods , Nurse's Role , Patient Education as Topic , Primary Prevention/methods , Puerperal Infection/diagnosis , Puerperal Infection/epidemiology , Risk Factors , Surgical Wound Infection/diagnosis , Surgical Wound Infection/epidemiology , United States/epidemiologyABSTRACT
OBJECTIVE: To describe maternal attachment to twin fetuses and determine whether such attachment differs between the twins. DESIGN: A descriptive, correlational, nonexperimental design was used to collect data on a convenience sample of high-risk and low-risk women pregnant with twins. SETTING: Questionnaires were distributed or mailed by presidents of parents of multiples clubs to interested participants. Participants mailed the questionnaires back to the researcher via stamped return envelope. PARTICIPANTS: During a 14-month period, 214 eligible women from 41 states and the District of Columbia completed the survey instruments. MAIN OUTCOME MEASURE: The Prenatal Attachment Inventory. RESULTS: Pregnant women reported greater attachment to Twin B than to Twin A. CONCLUSION: Pregnant women may be more attached to Twin B (typically the nonpresenting fetus) because this twin may be easier to see and touch. While the mean attachment scores between twins differed, the size of the difference was small. Further study is needed to determine the predictive value and clinical significance of this finding for future mother-infant relationships.
Subject(s)
Mothers/psychology , Object Attachment , Parent-Child Relations , Pregnancy, High-Risk/psychology , Twins/psychology , Adolescent , Adult , Female , Humans , Income , Maternal-Child Nursing , Middle Aged , Nursing Methodology Research , Occupations , Predictive Value of Tests , Pregnancy , Surveys and Questionnaires , United StatesABSTRACT
OBJECTIVE: To examine mothers' postpartum perceptions of stress and satisfaction. DESIGN: Methodologic triangulation with quantitative and qualitative data in a nonexperimental design. PARTICIPANTS AND SETTING: A convenience sample of 95 women was obtained during normally scheduled postpartum appointments at a health maintenance organization. MAIN OUTCOME MEASURES: The self-administered questionnaire included the Mothers' Information Tool (MIT), What Being the Parent of a Baby Is Like (WPL-R), and the Brief Symptom Inventory (BSI). Open-ended MIT items revealed mothers' perceptions of stress and satisfaction. The WPL-R provided maternal satisfaction scores, and the BSI yielded Global Stress Index scores. RESULTS: Content analysis identified the following categories: Roles, Tasks, Resources, and Relationships. Subcategories identified as areas of stress were Work/School, Sleep/Rest, Adjustment/Own Needs, Health/Body Image, Organization of Life, Child Care, Day Care, Housework, Future Challenges, Finances, Housing, Time, Partner, and Family. Subcategories identified as areas of satisfaction were Participating in Relationships, Sharing the Future, Being Proud to Be a Mother, Enjoying a Healthy Baby, and Caring for a Child. Levels of stress and satisfaction of mothers who scored high and low on quantitative measures were compared. CONCLUSION: The outcomes contribute to the knowledge concerning postpartum women's perceptions of the mothering experience and suggest approaches to nursing assessment and intervention to prevent postpartum adjustment difficulties.
Subject(s)
Personal Satisfaction , Puerperal Disorders/psychology , Stress, Psychological/psychology , Adolescent , Adult , Boston , Cross-Sectional Studies , Female , Humans , Mother-Child Relations , Parenting/psychologySubject(s)
Caregivers , Intergenerational Relations , Parenting , Aged , Caregivers/psychology , Child Rearing/psychology , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Parenting/psychology , Social Support , Stress, Psychological/psychologyABSTRACT
This study examined the association between the amount of direct care time and total time (direct and administrative) spent by CNSs with families of 39 very low birth weight infants (< or = 1500 grams) and infant outcomes (rehospitalizations and acute care visits). Documentation of the CNSs' time spent with infants and families was recorded during infant hospitalization and for 18 months after infant discharge. The number of infant rehospitalizations and acute care visits was recorded from hospital and physician records. The mean total time the CNS spent per infant for the 18-month period was 27.3 hours. After discharge, there were significant relationships between the amount of CNS direct care time and the number of acute care visits (r = 0.45, p < 0.01) and infant rehospitalizations (r = 0.51, p < 0.01). Although the study findings did not demonstrate improved infant outcomes associated with the amount of time the CNS spent with this high risk population, they document the amount of CNS time spent in intervention and follow-up of these infants. This study provides data for costing home visiting by the CNS in this patient population.
