Development of a theoretical construct for risk and vulnerability from six empirical studies.

The concepts of risk and vulnerability are frequently the subject of nursing scholarship but lack semantic and conceptual clarity in the nursing literature. Using empirical evidence from 6 research studies, the authors define the concepts of risk and vulnerability, apply shared definitions to each of the study populations, and discuss 3 types of responses to risk observed in the research setting. This collaborative effort by nursing scholars advances conceptual clarity of risk and vulnerability for the development of nursing knowledge. Further, the examination of risk responses has the potential to link the various perspectives of risk and vulnerability common in nursing and generate nursing practice implications explored in this review.

An exploration of health concerns & health-promotion behaviors in pregnant women over age 35.

PURPOSE: To explore the specific health concerns and health-promotion behaviors of childbearing women 35 years of age or older. STUDY DESIGN AND METHODS: Semistructured interviews with women ( = 50) ages > or =35 in their third trimester of pregnancy. Interviews lasted approximately 1 hour, were conducted by two nursing faculty, and were scheduled to accommodate participant needs. Process recording was used to document participant responses. Verbatim statements were recorded, and subjects were redirected to clarify responses when necessary. Content analysis and coding were completed by an independent researcher, based upon techniques derived from Miles and Huberman (1994). Data reduction was accomplished by the identification of categories of responses that described the participants' meaning. RESULTS: Study participants reported concerns reflecting both fetal well-being and maternal health-related issues. The majority of childbearing women (86%) reported engaging in multiple health-promotion behaviors focusing on daily nutritional intake, lifestyle activities, and rest patterns. Participants reported conscientious decisions to eliminate substances recognized as harmful, and to alter exercise, employment, or daily responsibilities to accommodate physical changes during pregnancy. Participants were "proactive healthcare seekers," accessing information from a variety of sources and seeking services to meet their individualized needs. CLINICAL IMPLICATIONS: The multitude and frequency of health-promotion behaviors adopted by those > or =35 years of age during pregnancy is indicative of this group's ability to independently initiate change, and exceeds the percentages previously reported. The nurse can be influential in supporting lifestyle modifications adopted during the childbearing period as permanent health-promotion behaviors.