Nurse-midwives' knowledge and promotion of lactational amenorrhea and other natural family-planning methods for child spacing.

The purpose of this study was to describe and assess certified nurse-midwives' (CNMs) knowledge and promotion of two modalities for child spacing, natural family-planning (NFP) and the lactational amenorrhea method (LAM). One thousand two hundred CNMs were randomly selected from a national membership list and mailed a 24-item questionnaire on NFP and LAM. Of the 514 respondents (42.8% return rate), 450 (87.5%) were currently practicing as CNMs. Respondents had an average age of 46 years, with an average of 10 years of practice. CNMs ranked NFP as the ninth most used and the eighth most effective family-planning method in their practice, with an average perceived method-effectiveness of 88% and use-effectiveness of 70%. Although most respondents felt somewhat prepared during their education program to provide NFP, only 22% would offer NFP as a family-planning option for child spacing.

Evaluation of the Lady Free Biotester in determining the fertile period.

Small hand-held microscopes have been developed for self-observation of salivary ferning patterns to detect the fertile time of a woman's menstrual cycle. The purpose of this study was to evaluate one such microscope, the Lady Free Biotester, by comparing it with the self-observation of cervical-vaginal mucus and with the self-detection of luteinizing hormone (LH) in the urine. Twelve natural family planning teachers (average age 34.6 years) observed their cervical-vaginal mucus, tested their urine for LH, and observed salivary and cervical-vaginal mucus ferning patterns (with the Lady Free Biotester) for two menstrual cycles. Data indicated that there was a strong correlation between the LH in the urine and the peak in self-observed cervical-vaginal mucus ferning (r = 0.99, p < or = 0.001) and salivary ferning (r = 0.98, p < or = 0.001). However, it was difficult to assess the beginning and end of the fertile time based on the salivary ferning patterns. Further testing of salivary ferning patterns is recommended before widespread use of these devices for family planning.

PIP: Several small, hand-held microscopes have been developed and marketed for self-observation of ferning patterns in either saliva or cervical-vaginal mucus to detect the fertile period of a woman's menstrual cycle. This study evaluated the Lady Free Biotester microscope, which detects salivary ferning patterns, by comparing its performance with that of self-observation of cervical-vaginal mucus through the Creighton model vaginal discharge recording system and self-detection of luteinizing hormone (LH) in urine with an OvuQuick kit. 12 US natural family planning teachers (mean age, 36.7 years) practiced all three methods for two menstrual cycles. There was a strong correlation between urinary LH and the peak observed in cervical-vaginal mucus ferning (r = 0.99; p 0.001) and salivary ferning (r = 0.98; p 0.001). However, there was no discernible beginning or end to fertility as determined by salivary or cervical-vaginal ferning. In many cases, ferning days were found throughout the cycle. Until more definitive tests with salivary ferning patterns are conducted, it is recommended that the hand-held microscopes be used only in connection with other tested markers of fertility.

Accuracy of the Ovulon fertility monitor to predict and detect ovulation.

The purpose of this pilot study was to correlate the three biologic markers of the Ovulon fertility monitor (a long-term predictive peak about 6 days before ovulation, a short-term predictive peak about 1 day before ovulation, and a nadir at the time of ovulation) with the peak in cervical mucus and the luteinizing hormone (LH) surge in the urine. Ten volunteer subjects (mean age 30.2 years) monitored their cervical-vaginal mucus, the surge of LH in the urine with a home assay test, and their vaginal electrical readings (with Ovulon monitors) on a daily basis for one to four menstrual cycles. In 19 of the 21 cycles that indicated a LH surge, there was a strong positive correlation between the LH surge and the peak of cervical-vaginal mucus (r = 0.96, P < or = .01), and between the LH surge and both the Ovulon nadir and Ovulon short-term predictive peak (r = 0.84, P < or = .01), and a modest positive correlation between the long-term Ovulon predictive peak and the LH surge (r = 0.62, P < or = .01). The time of optimal fertility as determined by the peak in cervical mucus, the LH surge, and the Ovulon was similar. The Ovulon has potential as a reusable device to help women determine their fertile period.

Spiritual well-being, religiosity, hope, depression, and other mood states in elderly people coping with cancer.

PURPOSE/OBJECTIVES: To determine the relationships among spiritual well-being, religiosity, hope, depression, and other mood states in elderly people coping with cancer and if differences in hope, depression, and other mood states exist between those elderly with high and low intrinsic religiosity and spiritual well-being. DESIGN: Descriptive correlational and descriptive comparison. SETTING: Acute care units of two hospitals located in the midwestern United States. SAMPLE: 100 elderly people with diagnosis of cancer and a mean age of 73 years. Thirty-three of the subjects were male, and 67 were female. Sixty-two percent had either lung, breast, or colon cancer. METHODS: Each subject was administered an intrinsic and extrinsic religiosity index, a spiritual well-being scale, a geriatric depression scale, the Miller hope scale, and the Profile of Mood States scale. MAIN RESEARCH VARIABLES: Spiritual well-being, religiosity, hope, depression, and mood. FINDINGS: A consistent positive correlation was found among intrinsic religiosity, spiritual well-being, hope, and other positive mood states. A consistent negative correlation among intrinsic religiosity, depression, and other negative mood states existed. Analysis of variance indicated that significantly higher levels of hope and positive moods existed in elderly patients with high levels of intrinsic religiosity and spiritual well-being. CONCLUSION: Intrinsic religiosity and spiritual well-being are associated with hope and positive mood states in elderly people coping with cancer. IMPLICATIONS FOR NURSING PRACTICE: Nurses must assess and support intrinsic religiosity and promote spiritual well-being in elderly people coping with cancer.

A comparison of the ovulation method with the CUE ovulation predictor in determining the fertile period.

The purpose of this study was to compare the CUE Ovulation Predictor with the ovulation method in determining the fertile period. Eleven regularly ovulating women measured their salivary and vaginal electrical resistance (ER) with the CUE, observed their cervical-vaginal mucus, and measured their urine for a luteinizing hormone (LH) surge on a daily basis. Data from 21 menstrual cycles showed no statistical difference (T = 0.33, p = 0.63) between the CUE fertile period, which ranged from 5 to 10 days (mean = 6.7 days, SD = 1.6), and the fertile period of the ovulation method, which ranged from 4 to 9 days (mean = 6.5 days, SD = 2.0). The CUE has potential as an adjunctive device in the learning and use of natural family planning methods.

Use effectiveness of the Creighton model ovulation method of natural family planning.

OBJECTIVE: To determine the use effectiveness of the Creighton model ovulation method in avoiding and achieving pregnancy. DESIGN: Prospective, descriptive. SETTING: A natural family planning clinic at a university nursing center. PARTICIPANTS: Records and charts from 242 couples who were taught the Creighton model. The sample represented 1,793 months of use of the model. MAIN OUTCOME MEASURE: Creighton model demographic forms and logbook. RESULTS: At 12 months of use, the Creighton model was 98.8% method effective and 98.0% use effective in avoiding pregnancy. It was 24.4% use effective in achieving pregnancy. The continuation rate for the sample at 12 months of use was 78.0%. CONCLUSION: The Creighton model is an effective method of family planning when used to avoid or achieve pregnancy. However, its effectiveness depends on its being taught by qualified teachers. The effectiveness rate of the Creighton model is based on the assumption that if couples knowingly use the female partner's days of fertility for genital intercourse, they are using the method to achieve pregnancy.

PIP: In Wisconsin, nurse researchers followed 242 couples who had enrolled in the Marquette University Nursing Center's natural family planning program between October 1984 and May 1992 to determine the use effectiveness of the Creighton model ovulation detection method to avoid or achieve pregnancy. The couples were largely college educated (98%), white (93%), and Roman Catholic (80.2%). Natural family planning [NFP] practitioners trained according to the Creighton model use a standard teaching format and language to teach couples how to determine fertility by examining the cervical mucus. The practitioner informs each couple that if they choose to have genital intercourse during the fertile period, they have abandoned the model as a method of pregnancy avoidance and have adopted it as a method of achieving pregnancy. The NFP practitioners followed the couples for 12 months for a cumulative number of 2284 ordinal months, during which the couples used the Creighton model. The use effectiveness rate of avoiding pregnancy at the 12th ordinal month was 98%. The method effectiveness rate of avoiding pregnancy at the 12th ordinal month was 98.8%. The use effectiveness rate of achieving pregnancy at the 12th ordinal month was 24.4%. The cumulative discontinuation rate was 20.2% at the 12th ordinal month. Personal reasons (17.4%) were the major reason for discontinuation. These findings suggest that the Creighton model is effective at avoiding or achieving pregnancy, if it is taught by qualified teachers.

New technology in natural family planning.

In recent years, several new devices have been developed to help women achieve or avoid pregnancy. These devices include computerized basal body temperature thermometers, electronic fertility monitors, and chemical and hormonal ovulation detection kits. This article describes these new fertility devices and discusses their effectiveness and impact on helping women understand and control their fertility.

Multinational validation of anxiety, hopelessness, and ineffective airway clearance.

The effective use of nursing diagnosis internationally depends in part on incorporating language and cultural difference into the common language of nursing. International validation studies can provide a basis for this effort. This study tested three diagnoses--anxiety, hopelessness, and ineffective airway clearance--through multinational validation. The Diagnostic Content Validity (DCV) model was used to collect data from critical care nurses in six countries. Defining characteristics rated as critical (greater than .80) by the total sample were dyspnea for ineffective airway clearance and panic and nervousness for anxiety. No critical defining characteristics for hopelessness were identified. DCV ratios for all defining characteristics are compared by country.

Methods used to self-predict ovulation. A comparative study.

Time of ovulation as detected by a self-test of luteinizing hormone (LH) in the urine was compared with time of ovulation as detected by self-observation of cervical mucus. Twenty regularly cycling women monitored their cervical mucus and urine LH for two complete menstrual cycles. Of the cycles that had an LH surge, 100% were on the peak day of cervical mucus or within three days before the peak day. Self-observation of cervical mucus, therefore, can be an accurate method of determining optimal fertility.

Self-esteem, spiritual well-being, and intimacy: a comparison among couples using NFP and oral contraceptives.

The purpose of this study was to compare the intimacy, spiritual well being (SWB), and self-esteem of couples using natural family planning (NFP) with those couples using oral contraceptives (OCs). 22 couples who were using the Creighton Model Ovulation Method of NFP for 1 year to avoid pregnancy were matched with 22 couples who were using OCs for a least a 1-year period and administered a SWB, self-esteem, and intimacy inventory. Student t-tests were calculated to determine differences in the mean scores of the 3 inventories between the 2 groups. The results showed that the NFP couples had statistically higher self-esteem (T=3.15, p0.01), SWB (T=4.25. p0.001), and intellectual intimacy (T=2.53, p0.05) than the OC couples. There were no differences in emotional, social, recreational, and sexual intimacy between the groups. Although the results provide some evidence that NFP can enhance a couple's relationship, other factors such as a sampling bias and educational levels could explain the difference.

Psychological and spiritual well-being in college students.

Two separate correlational studies were conducted to investigate the relationship between spirituality and psychological mood states in response to life change. In the first study a spiritual well-being index, a spiritual-maturity scale, a life-change index, and a depression scale were administered to 95 freshman nursing students. The spiritual well-being index was composed of two sub-scales; a religious well-being and an existential well-being scale. In the second study a spiritual-outlook scale and the Profile of Mood State index was added to the above tests and administered to 75 randomly selected college students. The results demonstrated a weak positive relationship between life change and depression. unlike a previous study, spiritual well-being, existential well-being, and spiritual outlook showed strong inverse relationships with negative moods suggesting that spiritual variables may influence psychological well-being.

Effects of biofeedback-aided relaxation on the psychological stress symptoms of college students.

The purpose of this study was to compare the effects of Benson's relaxation technique (BRT) with Benson's technique augmented with GSR biofeedback (i.e., biofeedback-aided relaxation, BAR) on the psychological stress symptoms of well college students. Seventy-eight normotensive college students were randomly assigned to one of three groups: the BRT group, the BAR group, and a control group. The BRT and BAR students were asked to practice their respective relaxation technique daily for an eight-week period. Pre- and postintervention, all subjects were administered a state-anxiety inventory and a profile-of-mood state (POMS) test. Posttest analysis indicated that the BAR group had significantly lower state anxiety and POMS than the BRT and control groups (p less than 0.05). It was evident from the results that BAR did augment BRT in lowering psychological stress symptoms. Part of the effectiveness was due to the expectation of relief on the part of the BAR group. It was recommended that nurses study the effects of BAR in clinical settings.

Physical fitness of physical therapy students.

Physical fitness norms do not exist for physical therapists or physical therapy students. This lack, in part, reflects the complexity of physical fitness and the scarcity of data reported on physical fitness norms of other populations. This report describes the methods used and the results obtained for 16 physical fitness factors of 98 female and 13 male physical therapy upperclassmen and discusses the implications of physical fitness in the practice of physical therapy. Means, standard deviations, ranges, and percentile rankings are given by sex for each of the 16 fitness factors. The purpose of this study was to begin to establish physical fitness norms. As physical fitness norms are established, it will be possible to determine how norms of physical therapists and physical therapy students compare with established values.