ABSTRACT
To determine whether predictors of birth outcomes differ for women in rural versus urban areas, data were obtained from the health records of women who received prenatal care through the Public Health Departments of a rural (N = 364) and urban (N = 415) setting. The rural group was more apt to be single, less educated, African-American, and have a lower income than the urban group. Rural women also had a higher incidence of low birth weight infants, which may be related to poor nutrition and low weight gain during pregnancy. Urban women had more maternal and neonatal complications, which may be related to a higher incidence of drug use and smoking. Membership in a rural or urban population did not predict low birth weight. Race, weeks gestation at first prenatal visit, number of total visits, and adequacy of diet and weight gain were significant predictors of birth weight. Neonatal complications were higher in the urban group and best predicted by poor diet, alcohol intake, and race. Both rural and urban women received inadequate prenatal care, as indicated by late entry into care and total number of visits. Alternative models of care which explore strategies to individualize care, while providing comprehensive care, should be investigated.
Subject(s)
Pregnancy Outcome , Prenatal Care , Rural Health/statistics & numerical data , Urban Health/statistics & numerical data , Adolescent , Adult , Birth Weight , Female , Humans , Infant, Newborn , Nursing Research , Pregnancy , Public Health , Regression Analysis , Socioeconomic FactorsABSTRACT
Thirty-nine very low birth weight (VLBW) and 32 normal birth weight (NBW) elementary school children were studied prospectively to determine patterns of academic achievement and special education resource use during the elementary school years. Reading, spelling, and mathematical abilities were evaluated. Mean scores for the VLBW children were significantly lower on the mathematic subtests. VLBW study participants experienced more grade retention (43% vs. 23%) and required 2.8 times more special academic assistance than their NBW peers. Thus, providing special educational resources for VLBW children is essential.
Subject(s)
Developmental Disabilities/etiology , Education, Special , Infant, Very Low Birth Weight , Adolescent , Adult , Child , Educational Status , Female , Health Services Needs and Demand , Humans , Infant, Newborn , Male , Prospective Studies , SurvivorsABSTRACT
A preliminary investigation of relationships among perceived self-efficacy, uncertainty, social support, psychological distress, and problem-focused coping was conducted in a convenience sample of 41 HIV-infected mothers. The mothers represented 93% of the clients in a large HIV clinic in 1992 who met the study criteria. Support was found for using Lazarus and Folkman's stress, appraisal, and coping framework to understand the health-related needs of HIV-infected mothers. Maternal coping was related to living with one's children and their HIV-status. The feasibility of studying this population of women was demonstrated. Findings suggest the need for exploration of family-focused interventions.
Subject(s)
Adaptation, Psychological , HIV Infections/psychology , Mothers/psychology , Problem Solving , Adult , Family Health , Female , HIV Infections/nursing , Humans , Mid-Atlantic Region , Self Concept , Social SupportABSTRACT
The contributions of early medical risk and the early and contemporary home environment on cognitive and academic outcomes of 35 nine-year-old survivors of very low birth weight (VLBW) who were followed prospectively were investigated. There were no significant relationships between the measures of early medical risk and outcome. The quality of the home environment accounted for half of the variance in outcome. Five themes that showed consistent associations over time with positive outcomes were: parental responsivity, parent support for learning, parent involvement with the child, exposure to a variety of experiences, and the presence of a father figure.
Subject(s)
Developmental Disabilities/etiology , Environment , Infant, Very Low Birth Weight , Parents , Analysis of Variance , Child , Female , Humans , Infant, Newborn , Male , Outcome Assessment, Health Care , Predictive Value of Tests , Prospective Studies , Risk Factors , Social SupportABSTRACT
Factors that influence school achievement in very-low-birth-weight (< 1,500 g) children were investigated at the completion of first grade. The subjects were 71 children and their primary caregivers. Thirty-nine children were very low birth weight (VLBW) and 32 were normal birth weight (NBW). After controlling for birth weight status, over one third of the variance in children's school achievement was accounted for by the age of the child's mother when she began childbearing. Birth weight status accounted for significant amounts of variance in information processing skills. Significantly more children in the VLBW group required special services and fewer were promoted to second grade, although the difference was not significant.
Subject(s)
Achievement , Infant, Low Birth Weight , Birth Weight , Child , Female , Humans , Infant, Newborn , Male , Mothers/statistics & numerical data , Observer Variation , Prospective Studies , Psychological Tests , Regression Analysis , Social Environment , Socioeconomic FactorsABSTRACT
The purpose of this study was to investigate parental perception of vulnerability, parental subjective stress concerning children's premature birth, and child temperament in families of very low birth weight (VLBW) and normal birth weight (NBW) children. The subjects were 39 VLBW children and 30 NBW 7-year-old children and their caregivers. Data on child temperament and parental perception of vulnerability was provided by the 69 families. Families of the VLBW group rated their degree of current stress concerning their children's premature birth. There were no differences between the NBW and VLBW caregivers in their perceptions of their child's vulnerability status. Caregivers of VLBW children had significantly lower scores on degree of subjective stress specific to the premature birth than the value reported on the standardization population. Child temperament made a significant contribution to parental perception of child vulnerability status in both VLBW and NBW parents.
Subject(s)
Infant, Low Birth Weight/psychology , Psychology, Child , Temperament , Birth Weight , Child , Child, Preschool , Humans , Infant, Newborn , Infant, Premature , Parents/psychology , Psychological Tests/methods , Psychological Tests/statistics & numerical data , Reproducibility of Results , Stress, Psychological/psychologyABSTRACT
Demographic, medical risk variables and information obtained during early home assessments of very low birth weight infants and their families were compared in their ability to identify subsequent risk in 4-year-old children who were very low birth weight. The home assessment data were equal or better than the demographic risk variables in efficacy and efficiency.
Subject(s)
Child Development , Home Care Services , Infant, Low Birth Weight , Nursing Assessment , Child, Preschool , Humans , Infant , Infant, Newborn , Psychological Tests , Risk Factors , Social Environment , Socioeconomic FactorsABSTRACT
The relationship between temperament, behavior problems, and learning skill abilities in preschool children who were born with very low birth weight (VLBW) is described. Subjects were 37 4-year-olds who weighed less than 1,500 grams at birth, were appropriate for gestational age, and free from congenital anomalies (M birth weight = 1,201 grams). Data were gathered when the children were 48 months chronological age and analyzed using point biserial and Pearson product moment correlation, chi square, and MANOVA. Temperament characteristics of rhythmicity, intensity, and persistence were related to behavior problems and learning skill abilities. Mothers reported more children with behavior problems than expected in the general population. Children with four or more behavior problems had significantly lower skill achievement scores than children with fewer behavior problems.
Subject(s)
Child Behavior Disorders/psychology , Infant, Low Birth Weight , Learning , Personality , Psychology, Child , Temperament , Child Behavior Disorders/diagnosis , Child, Preschool , Cognition , Female , Humans , Infant, Newborn , Male , Psychological TestsABSTRACT
The interactional process between mother and child is complex and critically important to understanding the mother-child dyad. This study examines components of the mother's description of toddler temperament and assesses the home environment.
