Back pain/discomfort in pregnancy: invisible and forgotten.

This paper is a comprehensive literature review of original research on the nature of back pain/discomfort in pregnancy. The causes of back pain/discomfort in pregnancy are reviewed and discussed, and the clinical manifestations and implications are explored. This analysis revealed that approximately 50% of pregnant women experience back pain/discomfort with little or no intervention from their health care providers. Thus, back pain/discomfort in pregnancy seems to be invisible and forgotten in contemporary antenatal care. Evidence-based guidelines are provided for both women and health professionals as a way of increasing attention to the prevention of unnecessary back pain/discomfort during pregnancy.

A case study of infant massage outcomes.

This article describes a case study of infant massage for a neonate in a neonatal intensive care unit (NICU). Infant massage is grounded in the theory of touch. In an NICU, the infant's tactile experiences can be uncomfortable or painful. This can lead to touch aversion. It is possible that providing pleasurable touch experiences through infant massage can help to develop touch acceptance. It is important to first assess the infant's readiness for massage according to his or her need and response. Infant massage as a complementary therapy in the NICU is demonstrated here in a photo-study of "Nicholas." The initial uncertainty and gradual acceptance by Nicholas of the massage experience is clearly depicted. At the end of the massage, Nicholas was relaxed and asleep in a semi-fetal position. The behavioral change in this infant indicates that he made a transition from touch aversion to touch acceptance.

The transforming power of research on practice: involving practitioners in analysis.

Nurses were invited to participate in the interpretation of transcribed interviews during the data analysis phase of a phenomenological study. They worked with the investigators in learning and using hermeneutic methods to identify and interpret meanings embedded in exemplars. Their expert clinical knowledge of the field of practice added rigor to the analytical process and depth to the understanding achieved. As the analysis progressed, the nurses began to spontaneously describe transformation occurring in their practice. Involving nurses in data analysis has transformative power on practice.

The efficacy of SeaBands for the control of nausea and vomiting in pregnancy.

Twenty-seven pregnant women (5-22 weeks gestation) participated in a study to determine the efficacy of SeaBands for the control of nausea and vomiting in pregnancy (NVP). NVP was reduced by 50% for these women. SeaBands are more effective if applied early in the symptom experience; less if applied late. SeaBands have considerable potential for a drug-free and noninvasive approach to control NVP.

Maternal work in the NICU: a case study of an "NICU-experienced" mother.

This study explored one woman's experience in becoming a mother to her premature son during his prolonged hospitalization. This paradigm case is an exemplar selected from a larger phenomenological study that examined the high-risk perinatal experience. Hermeneutic analysis led to the discovery of the phenomenon of maternal work embedded in the experience of this mother. Dimensions of her maternal work included working for love, working for meaningful moments, working amid uncertainty, working against the odds, and working overtime. Understanding the experience of maternal work can assist nurses to acknowledge and support the work inherent in becoming a mother within the neonatal intensive care unit.

Caring for a chronically ill infant: a paradigm case of maternal rehearsal in the neonatal intensive care unit.

This study examines a mother's perspective of caring for a chronically ill infant coming home from the neonatal intensive care unit. Understanding the meaning of the situation for the parent can foster excellence in clinical practice that is based on understanding derived from descriptions of their experience. This paper presents a paradigm case extracted from a larger phenomenological study that is examining the high-risk perinatal experience. Hermeneutic methods used for analysis led to the discovery of five meanings in the experience for the parent: (a) uncertainty; (b) experiencing the baby as powerful; (c) striving to gain acceptance from the baby; (d) blurred territory in taking up the practices of care; and (e) being alone and vulnerable.

Mismatched caring in high-risk perinatal situations.

A longitudinal study with a phenomenological approach revealed mismatched perceptions between caregivers and women in high-risk perinatal care. The participants were 27 women, 20 of which were recruited during a high-risk pregnancy and 7 who were recruited following the birth of a high-risk newborn. Interviews and diaries were analyzed to gain understanding of the subjective experience of being in a high-risk situation. One of the major discoveries was the inappropriate labeling of mothers as denying the seriousness of the situation. Mothers focused on the possibilities in the situation, whereas caregivers focused on the actual or potential problems. The article describes this mismatch and proposes changes in practice to offset dysynchronous caring.

Maternal tasks of uncertain motherhood.

A longitudinal, phenomenological study was carried out to gain understanding of what it was like for women to be in a high-risk perinatal situation. Twenty-seven women participated in the study during which focused, unstructured interviews were conducted throughout their experience. Hermeneutic methods were applied to the 174 interviews and 13 diaries collected. A serendipitous finding revealed that women in high-risk situations work on the same developmental tasks as described by Rubin in 1975. However, these tasks are altered by the uncertainty of attaining motherhood inherent in the high-risk situation. The alterations in the tasks are described in this paper. The importance of Rubin's work as basic clinical research for maternity nursing is underlined by this finding.

Parents' awareness of their unborn infant in the third trimester.

An exploratory, grounded-theory study revealed that parents develop a sense of their unborn infant's presence in an individualized manner. Four coexisting levels of cognitive and sensory awareness were delineated from a sample of primiparous and multiparous parents during the third trimester of pregnancy: awareness of the infant as an idea, awareness of the infant's presence, awareness of specific infant behavior, and awareness of the infant's interactive ability. Mothers controlled fathers' access to the unborn infant. Not all mothers interacted with their infant during pregnancy, indicating variability in style. These findings challenge current understanding of prenatal attachment.

The development of a practising nursing faculty.

Practice is where skills are developed and where theory must pass testing. This is best done by observing and responding to human needs so that theory generated will have a precise fit. A variety of joint appointments with a focus on nursing have been established between the Faculty of Nursing at The University of Calgary and nursing service agencies in Calgary, Alberta, Canada. The expected outcome is congruence between teaching, theory development, and practice. This paper differentiates faculty practice as scholarship from other forms of faculty involvement in practice settings. The nature of faculty practice is examined and various models of faculty practice are discussed. The Calgary model, designed to fit faculty member's focus on care to specific practice settings is described.

A format for recording the clinical performance of nursing students.

In summary, this format of recording student's clinical performance data has met the criteria established. Recording can be done previous to and throughout the clinical practice period, the learner finds the tool helpful in seeing evaluation as a process in which he/she plays a major role and the learning needs are identifiable from trends visible in the data recorded. Most importantly, a positive attitude prevailed about the recording of clinical performance for evaluative purposes.