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March-April 2006

Volume 35Issue 2p165-311

EDITORIAL

  • Is Evidence‐Based Nursing Practice an Attainable Goal?

    • Nancy K. Lowe
    Published in issue: March 2006
    p165
    For three years, JOGNN has published a regular feature “Resources for Evidence‐Based Practice” written by Dr. Carol Sakala. The purpose of this column is to update JOGNN’s readers on the most current evidence available to support decisions about the care of women, mothers, and infants. The decision to include this column in JOGNN was based on the strong beliefs of its editors and editorial advisory board that the principles of evidence‐based practice are essential to the provision of high‐quality and ethical patient care.

CLINICAL RESEARCH

PRINCIPLES & PRACTICE

  • A Model for Postpartum Smoking Resumption Prevention for Women Who Stop Smoking While Pregnant

    • Pamela K. Pletsch
    Published in issue: March 2006
    p215-222
    Behavior change models and theories have been useful in our efforts to help people stop smoking. However, models that were developed for the general population do not always fit special populations such as pregnant women. Many women stop smoking while pregnant, but most resume smoking after giving birth. To help women who stop smoking while pregnant to stay smoke‐free, a model for tailoring a smoking resumption–prevention intervention to the special needs of pregnant and postpartum women is proposed.

CASE REPORT

  • Breast and Infant Temperatures With Twins During Shared Kangaroo Care

    • Susan M. Ludington‐Hoe,
    • Tina Lewis,
    • Kathy Morgan,
    • Xiaomei Cong,
    • Laurie Anderson,
    • Stacey Reese
    Published in issue: March 2006
    p223-231
    Kangaroo Care has been shown to keep a singleton preterm infant warm by body heat generated in maternal breasts that is conducted to the infant. No studies have examined whether twins simultaneously receiving Kangaroo Care, called Shared Kangaroo Care, are sufficiently warm and how the breasts respond to twin presence. Two case studies were done to determine the temperatures of twins being simultaneously kangarooed and the temperatures of maternal breasts during Shared Kangaroo Care. Two sets of premature twins were held in Shared Kangaroo Care for 1.5 hours.

CLINICAL RESEARCH

SPECIAL REPORT

CLINICAL ISSUES

  • Challenging the Status Quo: Innovations in Obstetric Care

    • Merry-K. Moos
    Published in issue: March 2006
    p277
    Family‐centered maternity care redefines the relationships between and among childbearing women, their families, and their maternity‐care providers (Zwelling & Phillips, 2001). Each of the four articles in this series is about an innovation in the care of pregnant women that has the potential to redefine these relationships. The topics were chosen because they represent changes in the structure of care that are becoming increasingly common and have been known to elicit strong negative reactions from nurses.
  • Prenatal Care: Limitations and Opportunities

    • Merry-K. Moos
    Published in issue: March 2006
    p278-285
    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.
  • CenteringPregnancy Group Prenatal Care: Promoting Relationship‐Centered Care

    • Zohar Massey,
    • Sharon Schindler Rising,
    • Jeannette Ickovics
    Published in issue: March 2006
    p286-294
    CenteringPregnancy is an innovative model of group prenatal care that has been implemented at more than 100 prenatal care sites since 1995. CenteringPregnancy provides group prenatal care that is relationship centered, nurturing and transforming relationships among women, their families, and health care professionals. Complete prenatal care is provided in a group setting. Prenatal assessment, education, and support occur in a facilitative environment. The model offers effective and efficient care that is sustainable and can enhance the health of women, their families, health care providers, and communities.
  • Birth Plans: The Good, the Bad, and the Future

    • Judith Lothian
    Published in issue: March 2006
    p295-303
    A written birth plan encourages women to clarify desires and expectations and communicate with their providers to make a realistic plan for care during labor. Tension between health professionals and patients caused by birth plans reflects the larger problems with contemporary maternity care: conflicting beliefs about birth, what constitutes safe, effective care, and ethical issues related to informed consent and informed refusal. The focus of birth plans should be to answer three patient‐focused questions: What will I do to stay confident and feel safe? What will I do to find comfort in response to my contractions? Who will support me through labor, and what will I need from them? In this article, the history and purposes of birth plans and approaches to resolving tensions will be discussed.
  • Nurses and Doulas: Complementary Roles to Provide Optimal Maternity Care

    • Lois Eve Ballen,
    • Ann J. Fulcher
    Published in issue: March 2006
    p304-311
    Staff in maternity‐care facilities are seeing an increase in doulas, nonmedical childbirth assistants, who are trained to provide continuous physical, emotional, and informational labor support. The long‐term medical and psychosocial benefits are well documented. In this article, misconceptions about the doula's role are corrected, and suggestions are offered on ways to improve communication between health care providers and doulas. Together, nurses and doulas can provide birthing women with a safe and satisfying birth.
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