Risk and protective factors associated with stress in mothers whose children are enrolled in early intervention services.

INTRODUCTION: Although considerable research has addressed children with special health care needs enrolled in early intervention (EI) services, little is known about families' needs. This study provides baseline data on factors informing health promotion and prevention interventions for mothers of children enrolled in EI services who are experiencing high levels of stress. METHODS: A non-experimental descriptive-correlational study measured the following risk and protective factors in mothers of children enrolled in EI services: parent stress, severity of child's behavior, stressful life events, family functioning, appraisal of the situation, resources, and social support. RESULTS: More than one third of mothers had stress and family-functioning scores necessitating referral. Services for cognitive or social-emotional delays, unhealthy family functioning, and many co-existing stress events were significantly associated with increased stress. Mothers did not find caring for a child with a disability stressful and were satisfied with their social support. Higher incomes and levels of education were significantly associated with less stress; however, this sample was highly educated with middle-class incomes. DISCUSSION: Many mothers with children enrolled in EI services could be helped by specific primary, secondary, and tertiary interventions by pediatric nurse practitioners and primary health care providers.

Results of a nurse-led workshop designed to prevent fetal alcohol spectrum disorder.

Preventing the negative consequences of prenatal exposure to alcohol remains an unmet challenge. This paper presents the results of a workshop, designed to increase the implementation of fetal alcohol spectrum disorders (FASD) prevention interventions in 8 counties of New York. The workshop was based on constructivist learning theory and used the Population-Based Public Health Nursing Intervention Model as the structure for discussing potential interventions. The number and type of FASD interventions implemented were determined by surveys sent out postworkshop to 167 participants. At 4 months postworkshop, 37 participants reported implementing 226 primary, secondary, and tertiary interventions in 74 different worksites. The results indicate that incorporation of constructivist learning theory shows promise for future public health and continuing education programs aimed at changing or enhancing practice.

Problems expressed by caregivers of children with fetal alcohol spectrum disorder.

PURPOSE: The purpose of this study was to determine if use of a standardized classification system could help identify potential nursing sensitive problems for caregivers of children with fetal alcohol spectrum disorder (FASD). METHOD: This study is a secondary analysis of data obtained from transcripts of public testimonies. Content analysis was conducted using a standardized classification system. The sample consisted of 376 statements from electronic transcripts of first person testimonies given by 48 caregivers of children with FASD in four states. FINDINGS: Forty-eight caregivers expressed a total of 53 signs and symptoms. The majority was in the problem areas: communication with community resources, caretaking/parenting, mental health, and income. CONCLUSIONS AND IMPLICATIONS FOR NURSING PRACTICE: Using a nursing classification system, investigators were able to identify nursing sensitive problems expressed by caregivers of children with FASD. The information from this study can be used in future studies to confirm or revise the signs/symptoms identified in this study.

Community/campus partnership: tailoring geographic information systems for perinatal health planning.

BACKGROUND: Geographic information systems (GIS) are seen as potentially important additions to traditional methods of studying risk factors in maternal and child health, but little is written on actual GIS use by communities. This article describes how one community-university collaboration used GIS for perinatal planning. OBJECTIVE: The objective was to determine whether utilizing GIS could help a community to identify risk and develop potential interventions to address perinatal health problems. METHODS: We tested the use of GIS over a 9-month period, using community-based participatory research (CBPR) methods. Diffusion of innovations (DOI) theory guided this work. RESULTS: This collaboration resulted in the development of a perinatal GIS model that helped community members to decide where to focus interventions and in continued use of GIS for planning. CONCLUSION: Close collaboration early in the planning process, coupled with the incorporation of DOI theory, is necessary for communities to use GIS to plan perinatal interventions.

Fetal alcohol spectrum disorder.

Fetal alcohol spectrum disorder (FASD) is a serious and widespread problem in this country. Positioned within the community with links to children, families, and healthcare systems, school nurses are a critical element in the prevention and treatment of those affected by fetal alcohol spectrum disorder. Although most school nurses are familiar with fetal alcohol syndrome (FAS) and the problems it poses, they may not be familiar with the newer term, fetal alcohol spectrum disorder. This article summarizes the most recent information about FASD and recently published guidelines on diagnostic criteria for FAS. Also outlined are primary, secondary, and tertiary prevention activities school nurses can take to help assure that children, families, and communities work to prevent the problem and to treat the children affected by it.

Using geographic information systems to design population-based interventions.

Geographic information systems (GIS) offer public health nurses a new technology to plan and implement interventions within communities. The present article gives a brief overview of GIS, describes a project designed to pilot-test the use of GIS for developing population-based interventions, and discusses lessons learned from the project that need to be applied to any future work. Using GIS to map the incidence and prevalence of disease, locate risk factors, and identify access to health care services is not difficult. Trying to move beyond that and use the technology to depict community networks and develop and implement population-based interventions is more problematic. The project identified specific questions that anyone involved in a planning or decision-making project in which GIS are used should ask.