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Biomedical subjects

Merry-K Moos

Publications and source records attributed to Merry-K Moos.

13 recordsLinked to original sources
PubMed2006

The history of preconception care: evolving guidelines and standards.

This article explores the history of the preconception movement in the United States and the current status of professional practice guidelines and standards. Professionals with varying backgrounds (nurses, nurse practitioners, family practice physicians, pediatricians, nurse midwives, obstetricians/gynecologists) are in a position to provide preconception health services; standards and guidelines for numerous professional organizations, therefore, are explored. The professional nursing organization with the most highly developed preconception health standards is the American Academy of Nurse Midwives (ACNM); for physicians, it is the American College of Obstetricians and Gynecologists (ACOG). These guidelines and standards are discussed in detail.

Family Practice↗
PubMed2003

Measuring the intensity of pregnancy planning effort.

This study validated a measure of pregnancy planning effort based on Miller's conceptual framework in two clinical settings. The questionnaire's main items deal with general behaviour with regard to pregnancy, timing and proception (proception being the reverse of contraception). Values for these three items are added to yield a continuous score ranging from 0 to 12. The study population comprised 448 women of different cultural backgrounds recruited in prenatal, fertility and family planning clinics in Quebec and North Carolina. The results indicate that the internal consistency between the three items pertaining to pregnancy planning was excellent (Cronbach's alpha of 0.83). Test-retest reliability after a 4-week interval was excellent, with an intraclass correlation coefficient of 0.86 for the planning score. The planning score median for women attending family planning clinics (1.00) was significantly lower than that for those recruited in fertility clinics (11.00), confirming the discriminant ability of the instrument. Path analysis shows that the conceptual model corroborates the observed data and explains 53% of the pregnancy planning variability. In conclusion, this is the first questionnaire specifically designed to assess the intensity of pregnancy planning effort, a potentially important variable in epidemiological studies and clinical practice.

Family Planning Services↗
PubMedDate not supplied

Preconceptional health promotion: progress in changing a prevention paradigm.

Preconceptional health promotion is a proven strategy to impact reproductive outcomes. Despite energy to incorporate this prevention strategy into the care of women in this country, little evidence exists that the paradigm shift necessary to reframe the clinical care of women has occurred or that public awareness about critical opportunities for preventing reproductive casualties is high. This article reviews the rationale for preconceptional counseling, discusses progress in moving the agenda of prepregnancy wellness forward, and reveals some of the lessons learned from efforts to redesign prevention emphases for reproductive healthcare.

Counseling↗
PubMedDate not supplied

Local Health Departments. An underrecognized resource for women at high risk for preterm birth.

Every locale in the United States is covered by a public health entity, generally known as the local health department, which is an arm of local, state, and federal governments, and is designed to protect, promote, and preserve the health of the population. To meet these responsibilities, health departments often become providers of personal health-care services, including prenatal care. The common assumption that these publicly funded prenatal services are in some way inferior to privately secured care is unfounded. Not only do local health department clinics provide quality care, they also extend the care to address social, nutritional, and psychologic risks; these non-medical interventions are likely to benefit those at greatest risk for prematurity and other poor pregnancy outcomes. Current budget constraints in many locales are putting these services at risk; it is essential that nurses understand the importance of advocating for the continuation of women's healthcare services in local health departments.

Female↗
PubMedDate not supplied

Prenatal care: limitations and opportunities.

Prenatal care is a venerable tradition in the U.S. health care system and one that deserves critical examination. Inordinate amounts of public and personal resources are expended on a tradition of care that has not proven itself equal to current perinatal prevention challenges. In this article, the evolution of prenatal care is reviewed, its efficacy is critiqued, and efforts at restructuring the content and processes of care are examined. Three promising alternatives to the dominant medical model are described: the comprehensive prenatal care approach illustrated by many publicly funded prenatal clinics, the prenatal empowerment model as exemplified by midwifery care, and the prenatal group model as illustrated by CenteringPregnancy. Nurses are called upon to champion prenatal options for women.

Evidence-Based Medicine↗
PubMedDate not supplied

Unintended pregnancies: a call for nursing action.

Unintended pregnancies occur in all age groups and socioeconomic strata of our society and represent significant social, medical, and economic costs. Nearly 50% of all pregnancies in the United States are classified as unintended, and approximately 48% of all women ages 15 to 44 have experienced at least one unintended pregnancy. Contributors to unintended conceptions in the U.S. included barriers to accessing contraception, fears about using it, errors in use, and lack of back-up plans when errors in use occur. As important proponents of women's health, nurses are in an ideal position to address each of these contributors to unintended pregnancy through health promotion activities including patient education and counseling, through public policy advocacy, and through a commitment to a research agenda.

Adolescent↗