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Biomedical subjects

L J Mayberry

Publications and source records attributed to L J Mayberry.

At least 19 recordsLinked to original sources
PubMed2001

A Quality of Health Outcomes Model for guiding obstetrical practice.

PURPOSE: To describe the application of the Quality of Health Outcomes Model, introduced by the American Academy of Nursing Expert Panel on Quality of Health Care, to obstetrical care, particularly second-stage labor. ORGANIZING FRAMEWORK: The model is different from the more linear structure-process-outcome frameworks used in the past to a dynamic conceptualization of reciprocal relationships among the system, intervention, client, and outcome components. Analysis of these components can provide a comprehensive picture of the complexity of patient care decision making in hospital labor and delivery units. CONCLUSIONS: Research findings indicate that interventions such as cesarean delivery and epidural analgesia may result in several significant quality of health outcomes for women that should receive increased attention. Uses of this model for shaping best practices among physicians and nurses and for setting directions for priorities in future interdisciplinary research and health policy are discussed.

Benchmarking↗
PubMed2000

An international study exploring levels of postpartum depressive symptomatology.

OBJECTIVE: Differences in postpartum depressive symptomatology (PPDS) among an international sample of 892 women from nine countries representing five continents were explored. METHOD: Edinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory (BDI) were used to assess PPDS among a convenience sample that completed the two questionnaires twice, yielding a total of four sets of scores per subject. Women sampled were primiparae with no obstetrical complications, and had a healthy baby. Depression history and therapy were ruled out as exclusion criteria. RESULTS: Mean scores for EPDS and BDI varied across sites at both time points (P value<.001). European and Australian women had the lowest levels of PPDS, USA women fell at the midpoint, and women from Asia and South America had the highest depressive symptom scores. The moderate concordance between the EPDS and BDI suggested that the measures have complementary uses for screening and assessment. CONCLUSION: Utility of EPDS and BDI for yielding profiles of postpartum women's depressive symptomatology was demonstrated. Further research to validate depressive symptom measures with diverse international populations is indicated.

Adult↗
PubMed1999

Use of delayed pushing with epidural anesthesia: findings from a randomized, controlled trial.

OBJECTIVE: To compare outcomes between women receiving epidural anesthesia assigned to a group following either a 1-hour "delayed" pushing protocol or directed to initiate pushing at full cervical dilation. STUDY DESIGN: Using a randomized, controlled design, multivariate analyses were used to evaluate second stage labor duration and Apgar scores. An estimated odds ratio equation evaluated fetal descent progress. RESULTS: A 13.68-minute difference occurred in second stage labor length (p = 0.225). No differences were found in Apgar scores (p > 0.09). An estimated odds ratio, that progress in terms of one fetal station unit would occur for control group subjects as compared with subjects with similar progress in the experimental group, was 1.51 (95% confidence interval: 1.16, 1.95). CONCLUSION: Second stage labor was not significantly lengthened, and a similar rate of fetal descent occurred in the absence of directed pushing. Findings support further research on the potential advantages of minimizing the duration of pushing in labor.

Anesthesia, Epidural↗
PubMed1999

Cognitive adaptation: a women's health perspective for reducing stress during childbearing.

The purpose of this study is to evaluate psychological changes in women of three minority ethnic groups in a program of psychosocial services that promoted positive cognitive adaptation to childbearing throughout pregnancy and the postpartum period. In this prospective longitudinal study, both cognitive adaptation and generalized stress were measured at each trimester of pregnancy as well as after birth and 3 months postpartum. The mean scores at each time are first compared with first trimester scores for women in the program and then with scores for comparable women in a cross-sectional sample tested before the program. For women in the program, results of the psychological adaptation measures and the stress measures had improved from their first trimester value by the time of birth. Stress levels of women in the program were less than for women in the corresponding comparison sample from the third trimester on. Enhanced perinatal services that include interventions and monitoring strategies aimed at improving the cognitive adaptation of women to childbearing are important in promoting stress reduction in women and infants.

Adaptation, Psychological↗
PubMed1999

Integrating cultural values, beliefs, and customs into pregnancy and postpartum care: lessons learned from a Hawaiian public health nursing project.

Determining the elements of culturally competent health care is an important goal for nurses. This goal is particularly integral in efforts to design better preventive health care strategies for pregnant and postpartum women from multiple cultural and ethnic backgrounds. Learning about the values, beliefs, and customs surrounding health among the targeted groups is essential, but integrating this knowledge into the actual health care services delivery system is more difficult. The success of a prenatal and postpartum program developed for native Hawaiian, Filipino, and Japanese women in Hawaii has been attributed to the attention on training, direct care giving, and program monitoring participation by local cultural and ethnic healers and neighborhood leaders living in the community, with coordination by public health nurses. This article profiles central design elements with examples of specific interventions used in the Malama Na Wahine or Caring for Pregnant Women program to illustrate a unique approach to the delivery of culturally competent care.

Adult↗
PubMed1995

Influence of marital relationship and child-care stress on maternal depression symptoms in the postpartum.

The predictive influence of two psychosocial factors (marital adjustment and child-care stress) on maternal depressive symptoms at 6, 9 and 12 months postpartum, was investigated. Seventy-one women from a sample of 202 primiparae from a larger study were included. The women were primarily educated, white, middle-class, married women in their early 30s who returned to work within the first postpartum year. Regression analyses indicated that the interaction of marital adjustment and child-care stress significantly influenced maternal depression symptoms at 9 months postpartum. The findings from this study support the necessity for following women beyond the early weeks and months of postpartum in subsequent research.

Adult↗
PubMed1995

Neighborhood Women's Health Watch: partners in community care.

A successful program for delivering prenatal care in rural Hawaii incorporated women volunteers from the local community known as the "Neighborhood Women's Health Watch" (NWHW). Knowledgeable about the cultural mores among the various Asian American and Pacific Islander ethnic groups within the community, these respected women established strong collegial relationships with a public health nursing team to assist in various monitoring and care activities designed for pregnant and postpartum women. This article will address recruitment, training, and role functions of the NWHW, including recommendations for the development of similar programs.

Community Health Nursing↗
PubMed1992

Adaptation themes for prenatal care delivered by public health nurses.

An adaptation process involving three cognitive themes provides the framework for community nursing model for prenatal care on the island of Hawaii. The themes are based on the cognitive adaptation model developed by Taylor (1983) and include search for meaning, sense of mastery, and self-esteem. Each theme is used to guide public health nurses and is identified during designated encounters between the nurse and woman throughout the duration of prenatal care. A focus on adaptation themes for each trimester of pregnancy expands on the medical model of prenatal care to highlight developmental processes of childbearing and broaden the scope of practice for public health nurses responsible for assessment and intervention in the community.

Adaptation, Psychological↗
PubMed1992

Effect of exercise on uterine activity in the patient in preterm labor.

Preterm labor patients are at risk for physiologic complications associated with long-term bed rest. Although conditioning exercise programs are recommended for patients confined to bed rest, no studies have been reported that have evaluated the effects of exercise on uterine activity in women with preterm labor. A pilot study with 10 women was conducted to evaluate the short-term effects of exercise with a protocol involving pretesting and posttesting of uterine activity. The results indicated minimal changes in the frequency of uterine contractions after exercise. Future research is recommended with larger and more diverse samples to evaluate both short- and long-term effects of exercise throughout high-risk pregnancies.

Adult↗
PubMed1990

Common stressors reported by a group of childbearing American women.

A study was conducted on a group of 221 women (81 in the first trimester, 80 in the third trimester, and 60 in the postpartum period) to identify stressors common to pregnancy and to quantify their intensity using an interval rating scale. The most frequent stressors were related to physical symptoms, body image, baby welfare, changes in living patterns, emotional disturbances, and pregnancy-technological concerns. Stressors of high intensity targeted the baby's welfare, labor and delivery, pregnancy, newborn behaviors, and relationship with the baby's father. The frequency and intensity of stressors changed across pregnancy and postpartum, suggesting a need to tailor prenatal care to the different childbearing phases. Additional findings suggest that the normal physical changes of pregnancy can trigger disruptions in body image, relationship with the baby's father, and emotional functioning.

Adult↗
PubMed1987

Breast milk collection and storage practices among mothers of hospitalized neonates.

Data about breast milk expression, collection, and storage practices were obtained by questionnaires from 51 mothers of hospitalized neonates in the San Francisco Bay Area between September 1, 1984 and July 1, 1985. In addition, teaching sources, mothers' recall of breast-feeding information, and areas of concern as described by mothers were identified. The majority of mothers collected breast milk in plastic containers: however, over 50 per cent stored frozen milk in glass--this is considered a less than optimal choice for storage. Over 50 per cent of the mothers identified the need for additional information about breast-feeding upon returning home from the hospital, particularly in relation to pumping and storage techniques. Although 88 per cent of the mothers reported having received information on breast-feeding from ICN nurses, 47 per cent were not provided with written take-home instructions. Eighteen mothers considered discontinuing breast milk collection citing insufficient milk supplies and time requirements cited as common reasons.

Breast Feeding↗
PubMedDate not supplied

Infant temperament and postpartum depression: a review.

Although limited in number, reported research studies indicate a relationship between maternal perceptions of infant temperament and postpartum depression. Excessive crying in particular and the extent of adaptability and predictability have been implicated as infant behavioral indices. In this article, we present the results of a review of the literature linking early infant temperament to postpartum depression. Measurement issues for both infant temperament and depression are discussed. Recommendations for future research are offered.

Crying↗
PubMedDate not supplied

Worry: conceptual dimensions and relevance to childbearing women.

Worry is a cognitive activity that can be a behavioral expression to better understand how a person is coping and will adapt to his or her situation. The content and expression of worries are influenced by characteristics, such as personality, coping styles, cultural orientation, and social environment. Women experience multiple worries during the childbearing period, such as how pregnancy affects one's body image, whether the baby will be normal and healthy, how being pregnant affects the relationship with spouse/mate, whether to continue employment during or after pregnancy, and uncertainties about adequate finances to support the new or growing family. In this article we present the conceptual dimensions of worries with application to women's childbearing adaptation. Implications for development of research studies and the design of clinical practice strategies are identified.

Adaptation, Psychological↗
PubMedDate not supplied

Use of breast stimulation for contraction stress tests.

A breast stimulation technique is currently being used for stimulation of uterine contractions when a contraction stress test is indicated for antepartal fetal evaluation. The breast stimulation stress test is considered a practical alternative to the intravenous oxytocin stress test and may be as effective in producing contractions adequate for evaluation of fetal reserve as reflected in a fetal heart rate tracing. Along with a review of related research findings and the purpose of using the breast stimulation stress test indications for use and a step-by-step protocol are provided. In addition, the problem of hyperstimulation of uterine contractions and psychological considerations for the pregnant patient requiring a breast stimulation stress test are included.

Adult↗