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Biomedical subjects

Susan Gennaro

Publications and source records attributed to Susan Gennaro.

At least 19 recordsLinked to original sources
PubMed2005

Overview of current state of research on pregnancy outcomes in minority populations.

Pregnancy outcomes improved significantly over the 20th century in the United States but currently vary widely between women of different ethnic and racial backgrounds. The current health disparities that exist are based, in part, only on differences in socioeconomic status or education. There is wide variability in pregnancy outcomes within specific subgroups of women. Disparities may be due to underlying differences in health before pregnancy, differences in community norms, and individual lifestyle choices and to differences in health care delivery systems. Areas for needed research and promising new models of care are reviewed.

Delivery of Health Care↗
PubMed2005

Bioecological model for guiding social support research and interventions with pregnant adolescents.

Many environmental processes influence the pregnant adolescent and each process can either unlock the potential of the adolescent or act as a barrier to goal achievement or development. Social support is a powerful force in preventing adverse maternal and infant outcomes in the pregnant adolescent, and can come from several sources in the environment. The purpose of this article is to describe the use of the bioecological model of development to frame the complex environmental processes that determine social support received by pregnant adolescents. The bioecological model also can be used to guide mental health assessment of pregnant adolescents.

Adolescent↗
PubMed2005

Postpartum health in mothers of term and preterm infants.

Mothers have inadequate information about what to expect in the postpartum period in terms of their own health. Understanding common patterns of postpartum health may be particularly important for mothers of preterm low birthweight infants, so that they can plan how to optimize their own health as they care for their vulnerable infants. The purpose of this study was to compare the health of mothers of preterm and term infants prospectively for the first four months following delivery. This longitudinal descriptive study measured health status of 33 mothers of preterm infants and 32 mothers of term infants using health diaries and the Health Review Questionnaire every month for the first four months following delivery. No difference was observed between the two groups of mothers in how ill mothers reported feeling over time. The most common symptoms mothers experienced were headaches and cold symptoms. On average mothers reported between one and four days every month that they were not able to conduct their usual activities. Mothers reported feeling ill more frequently than they sought health care. The average mother at four months postpartum was still reporting she felt ill between 3 and 7 days during the month. This study has implications for families, health care providers, and policy makers.

Adult↗
PubMed2002

Health promotion for childbearing women in Rubanda, Uganda.

A train-the-trainer intervention, based on the World Health Organization's Safe Motherhood Initiative, was successful in changing some health beliefs and health practices among village men and women of childbearing age in a remote area of Uganda. Specifically, more villagers reported attending postpartum care and beginning prenatal care earlier in pregnancy. Some beliefs were not changed (eg, belief in bewitchment), but some beliefs (eg, use of herbal medicines during labor) were not as widely held as a result of this cost-effective and easily sustainable program.

Adult↗
PubMedDate not supplied

Barriers to and facilitators for newborn resuscitation in Malawi, Africa.

Newborn resuscitation is a key component of efforts to reduce neonatal morbidity and mortality. This article reports the findings of focus groups conducted to explore the barriers and facilitators present for obstetric nurse providers in a central urban hospital in Malawi regarding the training and provision of neonatal resuscitation. All obstetric nurse providers in this setting participated in focus groups; these groups identified 4 themes: 1) confidence in their skills in assessing newborns and recognizing the need for resuscitation, 2) a lack of resources, 3) facilitators who would enable them to introduce resuscitation, and 4) solutions to the current problems. Resource shortages and barriers to providing care included availability of staff, equipment, and supplies; labor ward geography; ethical dilemmas; and the lack of standard protocols regarding newborn resuscitation. Facilitators were professional experience and the critical load of deliveries performed. Solutions to barriers included small resource additions as well as long-term policy changes. With standard policy and protocols, experienced, confident nurses could overcome the barriers to providing newborn resuscitation. This group identified ways to change systems to decrease infant mortality, thereby improving the health and quality of life of women receiving care in Malawi.

Attitude of Health Personnel↗
PubMedDate not supplied

Neonatal hyperbilirubinemia.

Evidence of bilirubin-related brain damage has been reported in infants with kernicterus discharged as healthy from well-baby nurseries. Lapses in care have been attributed as root causes for kernicterus in an era when there should be no barriers to safe and effective bilirubin reduction strategies. Between 1984 and 2002, at least 125 cases of kernicterus occurred in the United States. This may be an underestimate because kernicterus is not a reportable condition in this country. In almost all cases, kernicterus is a preventable condition. The updated 2004 American Academy of Pediatrics guidelines recommend a systems approach, which, if implemented by all birthing institutions, should prevent virtually all cases of kernicterus in term and near-term infants.

Disease Notification↗
PubMedDate not supplied

Use of upright positioning with epidural analgesia: findings from an observational study.

PURPOSE: To present research findings and related nursing implications from an observational study designed to evaluate the use of upright positioning during second stage labor with patients who had received low-dose epidural analgesia. STUDY DESIGN AND METHODS: This descriptive study evaluated outcomes from a sample of 74 healthy women having their first childbirth. They had all received epidural analgesia during the first and second stages of labor. Data were also collected by nurses on the use of birthing beds, and the extent of physical and emotional support the women needed while following the upright positioning study protocol. RESULTS: All women were able to maintain upright positions throughout the second stage of labor following epidural analgesia administration. No adverse neonatal outcomes or maternal problems (such as excessive vaginal bleeding) were documented. CLINICAL IMPLICATIONS: Although women were capable of assuming upright positions during second stage, the study results indicated that constant physical and emotional support was necessary for most women. Future research on methods to prepare women for multiple position options after administration of low-dose epidural analgesia should be undertaken. In addition, nurses should evaluate the benefits of upright positioning in terms of facilitating progress of labor.

Adolescent↗
PubMedDate not supplied

Parenting the post-NICU premature infant.

The birth of a premature infant is stressful for family members who must adjust to unfamiliar surroundings, learn new vocabularies, cope with the infant's uncertain survival and outcome, maintain vigilance at the neonatal intensive care unit (NICU), and eventually assume care for a recovering infant at home. Nursing research has focused on many issues related to parenting prematurely born infants, including parenting during the initial hospitalization, concerns of mothers about infant discharge, the relationship between premature infants and their mothers during the first 2 years after hospital discharge, the quality of the home environment on premature infant outcomes, parenting after the first 2 years, and interventions to improve parenting. This article focuses on research about parenting the post-NICU discharge infant to assist nurses in giving comprehensive, evidence-based care.

Adaptation, Psychological↗
PubMedDate not supplied

Dating violence in college women: associated physical injury, healthcare usage, and mental health symptoms.

BACKGROUND: College-aged women report experiencing violence from a partner within the dating experience. OBJECTIVES: This study used a correlational design, to report physical injury, mental health symptoms, and healthcare associated with violence in the dating experiences of college women. METHODS: A convenience sample of 863 college women between 18 and 25 years of age from a private, historically Black university in the South, and a private college in the mid-Atlantic completed the Abuse Assessment Screen, a physical injury checklist, and the Symptom Checklist-R-90. Data analysis consisted of frequencies, ANOVA, and MANOVA. RESULTS: Almost half (48%) (n = 412) reported violence and, of these, 39% (n = 160) reported more than one form of violence. The most commonly reported injuries were scratches, bruises, welts, black eyes, swelling, or busted lip; and sore muscles, sprains, or pulls. Victims had significantly higher scores on depression, anxiety, somatization, interpersonal sensitivity, hostility, and global severity index than nonvictims. Victims of multiple forms of violence had significantly higher mental health scores and reported greater numbers of injuries than victims of a single form of violence. Less than half of those injured sought healthcare for injuries and less than 3% saw a mental health professional. DISCUSSION: Study findings suggest the importance of screening and identification of victims of violence. Knowledge of physical and mental health effects of violence can guide intervention, prevention, and health promotion strategies. Future research is needed to describe barriers to seeking healthcare, screening practices of college health programs, and programs to identify victims.

Adolescent↗
PubMedDate not supplied

A systems approach for neonatal hyperbilirubinemia in term and near-term newborns.

OBJECTIVE: To propose and implement a family-centered systems approach to manage newborn jaundice for safer outcomes. DESIGN: Observational study for known adverse outcomes. SETTING: Semiprivate urban birthing hospital. PATIENTS/PARTICIPANTS: 31,059 well babies discharged as healthy from a cohort of 41,961 live births (1990-2000). INTERVENTIONS: Incremental implementation of a systems approach that incorporated a hospital policy to (a) authorize nurses to obtain a bilirubin (total serum/transcutaneous) measurement for clinical jaundice, (b) universal predischarge total serum bilirubin (at routine metabolic screening), and (c) targeted follow-up, using the bilirubin nomogram (hour-specific, percentile-based total serum bilirubin/transcutaneous bilirubin). MAIN OUTCOME MEASURES: Known adverse outcomes assessed for early- and late-onset severe hyperbilirubinemia before, during, and after systems approach implementation. RESULTS: Adverse outcomes decreased for well babies: exchange transfusion, intensive phototherapy, and readmission. During the study period, there were no "never events" (total serum bilirubin greater than or equal to 30 mg/dl), while "close calls" (total serum bilirubin greater than or equal to 25 mg/dl) were 1 in 15,000 as compared to a reported incidence of 1 in 625. CONCLUSIONS: Reduced adverse events, significant reduction in close calls, and no never events met family expectations for safer experiences with this approach.

Aftercare↗
PubMedDate not supplied

Psychological and physiological stress: impact on preterm birth.

Stress increases corticotropin-releasing hormone and may ultimately result in increased uterine contractility. Stress also increases cytokine production, which independently may lead to preterm birth or increase susceptibility to infection, thereby increasing the risk of preterm birth. Finally, stress may change health behaviors that lead to preterm birth. Research findings on the relationship between stress and preterm birth have been contradictory. In this article, the authors propose a model of the relationship between stress and preterm birth, evaluate the research on stress and pregnancy outcomes, and discuss the implications for nursing practice and research.

Anxiety↗