Prenatal and parenting programs for adolescent mothers.

Adolescence is a time of risk taking and exploration. The adolescent's exploration of the developmental and physical changes taking place often puts the adolescent at greater risk than at any other time in life. The risk-taking behaviors involve sexual activity, experimentation with substances including cigarettes and alcohol, rebellion against paternal norms, suicidal behavior, and violence. This chapter focuses on the potential outcome of one of these risky behaviors: sexual activity. The intent is to summarize the findings of the research community on the pregnancy and parenting programs for adolescents. A summary of some of the recent research and demonstration projects for pregnant and parenting adolescents is provided. Published and unpublished articles from a variety of disciplines are included. These articles vary by method, type of program, location, and outcome measurement. Methodological issues related to the preponderance of quasi-experimental designs with small samples and demonstration projects are addressed. The lack of theoretically driven, longitudinal research that is specific to the developmental level of the population is discussed, and directions are suggested for future research.

PIP: This chapter in a volume of the Annual Review of Nursing Research devoted to health issues in pediatric nursing summarizes research findings on pregnancy and parenting programs for adolescents in the US. The introduction, which describes the risk factors associated with adolescence and the particular risk of unintended pregnancy and acquisition of sexually transmitted diseases that have accompanied decreasing ages of sexual initiation and increasing numbers of sexual partners among adolescents, points out that many intervention programs that seek to address the needs of developing adolescents lack an evaluative component and a theoretical base. The next section presents the scope of this review, which focuses on programs for pregnant adolescents and adolescent parents. The chapter continues by reviewing 1) three pregnancy prevention programs not included in a 1995 compendium prepared by Moore, Sugarland, et al. and 2) prenatal and parenting programs. A look at programs deemed most effective at changing maternal or fetal outcomes is accomplished through a review of research on comprehensive programs, other types of programs, programs that consider differences in parenting among ethnic or racial groups, program location, development of practice models, intervention studies, and the adolescent father. The chapter ends with a summary that indicates the need for application of a more rigorous and systematic approach to this research in order to create a body of knowledge with a strong theoretical base and conceptual clarity.

Low-risk mothers. Oral intake and emesis in labor.

This study examined the pattern of oral intake and its impact on emesis and other complications in low-risk gravidas during labor. It is common clinical practice to restrict oral intake in most institutions. The historical bases for this restrictive practice are explored. Findings from this study indicate that when given a choice, all 106 women chose a variety of types and amounts of oral intake throughout all stages of labor. Over 80% of women who ate or drank during labor had no emesis. Of the 20 who did have any emesis, 40% (eight) vomited more than once. None of the women who vomited experienced poor outcomes. These data suggest that women who choose oral intake during labor are at relatively low risk for complications related to this intake. Based on a comprehensive review of the literature and these study results, practitioners should allow as much choice as is consistent with empirical knowledge and safe practice.

Dynamism in practice: parenting within King's framework.

A dynamic approach to parenting in a neonatal intensive care unit provides a framework to test King's nursing theory. The framework is based on selected concepts from King's theory of goal attainment and current literature on parenting. The framework stresses the valuational components of human interaction. This article describes an attempt to move neonatal care from medicalization of parenting toward transaction between parents and nurses.

Clinical cheating and moral development.

Clinical cheating is one of the most devastating ways students can breach moral principles, and its prevention should be a priority for nurse educators. Educators can promote the professional integrity of students by integrating moral development into all curricular efforts.