Cost analysis of prenatal care using the activity-based costing model: a pilot study.

The cost of prenatal care in a private nurse-midwifery practice was examined using the activity-based costing system. Findings suggest that the activities of the nurse-midwife (the health care provider) constitute the major cost driver of this practice and that the model of care and associated, time-related activities influence the cost. This pilot study information will be used in the development of a comparative study of prenatal care, client education, and self care.

Survival strategies for nurse-midwifery students.

Nurse-midwifery students face multiple stressors in their educational experience. Strategies to resolve stress and promote adaptation to the new role are examined and measures used to promote students' adaptation to the educational experience are described.

Beliefs, values, and practices of Navajo childbearing women.

The purpose of this exploratory-descriptive study is to describe the beliefs, values, and practices regarding the childbearing experience as perceived by a sample of Navajo childbearing women. The methodology is a replication of that used in previous studies by the researchers and colleagues who investigated the childbearing experience as perceived by childbearing women of five other cultures. A Navajo nurse interviewed 20 pregnant Navajo women between 16 and 38 years of age who reside on the Navajo reservation. The 35 items with which at least 12 subjects agreed are reported. The great diversity in beliefs, values, and practices reported by this sample of Navajo childbearing women is consistent with findings of the five previous studies. The results reemphasize the need for individualized culture-specific assessment of each Navajo childbearing client to provide health care that is truly sensitive to her cultural needs.

Ernestine Wiedenbach. Her professional legacy.

A descriptive, historical research study of the life and career path of Ernestine Wiedenbach was conducted. A productive career spanning five decades included accomplishments in prepared childbirth education, family-centered maternity care, nurse-midwifery education, and nursing theory. Wiedenbach's prescriptive theory of nursing with its focus on "clarity of central purpose" stands out as an important early professional achievement of this practitioner, educator, author, and theorist. It represents one of Wiedenbach's many pioneer contributions to nursing as well as to the foundation of the philosophy and goals of nurse-midwifery practice and education.

Political participation behaviors of nurse-midwives.

Political participation, which is promoted by nurse-midwifery leaders, is a widely studied topic in this country. Yet, there is little data that describes political participation among health care providers such as nurse-midwives. The descriptive findings presented here are from a national survey of a random sample of members of the American College of Nurse-Midwives. The data indicate that nurse-midwives are inclined to be liberal and Democrats and they believe that individuals such as themselves can influence governmental activities. As in the general population of the country, the electoral act of voting is the predominant political activity. Nurse-midwives are more apt to demonstrate nonelectoral political behaviors in regard to women's issues. Overall, there is a general assumption that the representatives of the ACNM membership maintain the responsibility for political action.

The childbearing Haitian refugee--cultural applications to clinical nursing.

As a result of the recent influx of Haitian refugees, referred to as the "boat people," the large county-owned hospital in Miami, Fla., reported that, of the 8,000 births for 1980, approximately 1 in 5 deliveries was of a Haitian woman. One hundred fourteen Haitians gave birth at that institution during July 1980, and this pattern continues to date. Although some research investigations have been conducted in relation to Haitians, none have had the specific focus of this study which used an assessment tool to develop a cultural profile of the refugee Haitian childbearing client as a basis for deriving culturally appropriate nursing goals and interventions. Ten pregnant refugee women, born in Haiti and residing in Miami, were interviewed in their homes by a Haitian (Creole-speaking) interviewer. Areas of respondent consensus and individual responses of interest are discussed in this paper. The authors have compiled a list of care givers' goals and interventions directed toward specific beliefs, values, and practices. Assumptions held by nursing personnel that all Haitian childbearing clients who have recently arrived in south Florida are so different as to have few characteristics in common with the American culture are not supported by the findings of this investigation. Rather, the findings suggest that the 10 Haitian women who were interviewed generally perceived pregnancy and its particular needs and characteristics in much the same way and with similar concerns as their American counterparts. The variations in their responses reemphasized the need for accurate culture-specific assessment of each client in order to provide appropriate health care. Replicating the study among the other cultures in the Miami area would extend the interpretations of this study and be an exciting challenge.