Psychometric properties of health risk attitude measures in predicting cessation among pregnant smokers.
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Biomedical subjects
Publications and source records attributed to C Nadon.
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OBJECTIVE: To evaluate two nursing approaches to promoting smoking cessation during initial antenatal visits. DESIGN: Experimental, with assignment to interventions using a random, alternate-day strategy and blind assessment of smoking at baseline, 1 month postintervention, 36 weeks' gestation, and 6 weeks postpartum. SETTING/PARTICIPANTS: 224 daily smokers, fewer than 31 weeks gestation, during first prenatal visit, at a teaching hospital antenatal clinic. INTERVENTIONS: An evening class providing guidance on a self-help program for 2 hours on a group basis or 20 minutes on an individual basis during the prenatal appointment. MAIN OUTCOME MEASURE: Smoking cessation, confirmed by urinary cotinine levels. RESULTS: All women assigned to the referral intervention received a referral, but none attended the classes. In contrast, 93% assigned to the immediate intervention received the intervention. The group receiving immediate intervention had two to three times higher rates of cessation at all follow-up periods, with significant differences at the 1-month follow-up. There were certain similarities between the groups. CONCLUSION: Cessation interventions should be administered during the first prenatal visit.
OBJECTIVE: To ensure safe care of mothers and babies after birth, irrespective of length of hospital stay, and to ensure effective links between hospital and community postnatal services. METHODS: Program aimed toward consumers and professionals working with them in Ottawa-Carleton (750,000 persons.) All pregnant women in the community included. Program developed by professionals, institutions and community agencies. Information on current practices elsewhere and early discharge literature studied. New provincial survey on practice changes performed in Ontario. Emergency room utilization data analyzed. Discharge and post-discharge criteria, and a common prenatal education curriculum, developed. RESULTS: Multidisciplinary, multi-sectoral committees, institutions and agencies have developed programs for appropriate discharge practice and improved postnatal follow-up. Professionals have supported flexible discharge guidelines. CONCLUSIONS: Provided discharge criteria and follow-up are available, flexible discharge timing and safety appear compatible. The Ottawa-Carleton process to develop criteria and programs has allowed a collaborative, consensus-based approach to 'early' newborn discharge.
Postnatal home visiting has been a routine part of the public health nurse's role in Canada for decades. Resource limitations in recent years have required Health Units to justify programming choices and in some cases have dictated a shift toward more intensive service provision to high risk clients. This study examined the screening accuracy of a tool developed for use by hospital liaison nurses to identify multiparas in need of home visiting. Results showed poor agreement between client information collected by the hospital liaison nurse and the assessment done by the PHN in the clients' home, even when explicit referral criteria were used. Changes are required in the referral process to effectively screen postnatal clients in need of further services.
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In June 1990, 436 women and their spouses attending prenatal classes in the Ottawa-Carleton region completed a self-administered questionnaire to identify use of and interest in first trimester prenatal classes, and possible contact points with women to encourage early prenatal class attendance. Only 23% of the women had attended classes during the first trimester, but another 39% said they would have been interested. Two major categories of deterrents to early prenatal class attendance were found: 1) low level of public knowledge about availability and usefulness and 2) low physician patient referral. Most (89.4%) women went to their physician early in pregnancy, and many (45.7%) found out they were pregnant through the drug store. Suggested approaches to promoting first trimester attendance at prenatal classes include public awareness campaigns through pharmacies, the workplace and in the general community, and education programs for physicians about the importance of referral to early classes.