PubMed Health⌕ Search

Biomedical subjects

D Affonso

Publications and source records attributed to D Affonso.

8 recordsLinked to original sources

Reconciliation and healing for mothers through skin-to-skin contact provided in an American tertiary level intensive care nursery.

Feasibility and safety of skin-to-skin contact through the Kangaroo method of care in a modern American tertiary intensive care was studied, as well as effects of this innovative care on mother's emotional reactions. Eight mother infant dyads participated in skin-to-skin contact a minimum of 4 hours each day for six days per week during a period of three consecutive weeks. The cognitive adaptation framework was used to identify themes in maternal responses. During the first week, mothers were preoccupied with childbirth events in attempts to understand their sense of loss and victimization. During the second week, maternal emotions intensified and manifested in fears for the baby's well-being and a need to discuss negative and positive emotional reactions to having a premature and sick baby. All mothers requested respite time from skin-to-skin contact, so they could deal with their emotional crises. By the third week, mothers had an increased sense of meaning, mastery, and self-esteem about what had happened to themselves and their infants. Themes of reconciliation and healing occurred when mothers placed their infant skin-to-skin in the Kangaroo position over the three consecutive weeks that this type of nursing care was experienced.

Adult↗

Challenges in the perinatal clinical nurse specialist role.

Evolving changes in health care trends and national directives, including recommendations from the Institute of Medicine (1985), are shaping priorities in perinatal nursing care. This paper addresses considerations for expanding the scope of practice of perinatal clinical nurse specialists (PCNS). The role of the PCNS in the participation of healthy policy implementation is one area to activate. Legislative action involving perinatal nurses influences the scope of practice. Expansion of the clinical nurse specialist roles in consultation/education and practice/research is necessary to emphasize preventative health care, program development, and community liaison activities.

Consultants↗

Infant heart transplantation: a survey of physician beliefs.

Heart transplantation in infancy has become the fastest growing area in pediatric heart transplantation. Infant heart transplantation presents a profoundly complex decision-making situation for parents. There is a relationship between physician beliefs and their manner of presenting heart transplantation options to parents. The purpose of this study was (1) to determine the beliefs of physicians about neonatal heart transplantation, (2) to define their perceptions about their role in counseling parents about heart transplantation, and (3) to evaluate the differences of beliefs by physician specialties (pediatric cardiologists, neonatologists, and pediatricians) and practice settings (university, private, health maintenance organization). A questionnaire was designed to survey 117 physicians on their beliefs about heart transplantation. Findings revealed significant differences related to beliefs: (1) infant heart transplantation is still experimental (pediatric cardiologists, 56%; neonatologists, 85%; pediatricians, 63%; p < 0.05), (2) neonatal heart transplantation is acceptable for fatal heart disease (pediatric cardiologists, 86%; neonatologists, 73%; pediatricians, 63%; p < 0.05), (3) newborn heart transplantation should be presented negatively to protect parents from potential negative consequences on their quality of life (pediatric cardiologists, 14%; neonatologists, 33%; pediatricians, 48%; p < 0.05); (university, 25%; private, 18%; health maintenance organization, 61%; p < 0.05), and (4) infants with hypoplastic left heart syndrome should not be treated (university, 28%; private, 23%; health maintenance organization, 55%; p < 0.05). Though it is critical to impart information to parents with a fair representation of infant heart transplantation, we conclude that many physicians surveyed had a knowledge deficit or bias about the current state of the art of infant heart transplantation.

Academic Medical Centers↗