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Little research has been done on social-psychological variables related to the use of natural family planning. The objective of this study was to analyze variables that differentiated between continuers and discontinuers of natural family planning (NFP). Questionnaires were obtained from couples who had received instruction in the sympto-thermal method of natural family planning at a large urban hospital. Subjects who were attempting to become pregnant or who were using other methods of contraception in conjunction with NFP were deleted from the analysis, leaving N of 74. With Pearson correlation, variables significantly related (p

It was late Friday night in the labor and delivery section of a large urban hospital. There was a lull in the usually constant activity. Only one woman was in active labor, and the monitor's sound of the fetal heartbeat echoed reassuringly down the hall. At about 2:00 A.M., a call came from the emergency department staff. They were sending us a patient with heavy vaginal bleeding and a hematocrit of 16. The woman had delivered large twins via cesarean section seven days previously and had been discharged earlier that day. Her name was Diane. She was surprisingly alert and oriented when she arrived on the unit. Her husband, Charles, accompanied her. He was pleasant and obviously concerned about his wife. In the emergency department, Diane's uterus had been vigorously massaged to encourage it to contract and diminish the bleeding. The fundus had been successfully brought down from the level of the xiphoid process to two fingerbreadths above the umbilicus. In the process, Diane had lost 500 cc of blood. She was receiving intravenous therapy of lactated Ringer's with oxytocin. Diane and Charles were Jehovah's Witnesses. They stated that they had come to the hospital seeking all possible medical help with the exception of a blood transfusion, a treatment that violated their religious beliefs.'

(96) Ray E. Trussell, Jack Elinson, and Morton L. Levin, "Comparison of Various Methods of Estimating the Prevalence of Chronic Disease in a Community," American Journal of Public Health, 46 (February, 1956), 173-182. (97) Urban Life Research Institute, Nursing Services in a Large Urban Hospital, New Orleans: Tulane University, 1954. (98) L. Wes Wager, "The Measurement of the Job Satisfaction of Professional Nurses," Research Studies of the State College of Washington, 20 (June, 1952), 45-55.

A measure of locational efficiency, the locational imbalance vector (LIVOR) is developed and applied in the analysis of nineteen hospitals which provide medical, surgical, and obstetrical services in the Cincinnati metropolitan area. With only a few exceptions, the locational efficiency of the individual hospitals presently serving the Cincinnati area is found to be quite low. Some possible policy implications of the study's measure of locational efficiency are illustrated and its relation to a larger question, that of explaining the pattern of occupancy pressure in a metropolitan area, is also briefly discussed.

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Many urban hospital centers are faced with a growing demand for community oriented programs and consumer participation. Often these demands require that the hospital enlarge the scope of its services beyond inpatient care to include such missions as ambulatory-care delivery systems, preventive care, and programs in narcotics addiction and lead poisoning. The experience of one urban hospital center in responding to these demands is described. The establishment of new programs in ambulatory care, narcotics addiction, and the training of allied health professionals is discussed, as are the problems and benefits associated with consumer participation in the health care decision-making process.

pain is hardly the usual start for a research report. Nevertheless, on an unforgettable Thursday morning, I began a pilgrimage into the world of the sick, and with that pilgrimage came time to reflect on a special institution in our society, the urban hospital. As an instructor in interpersonal communication, my attention has periodically focused on hospital communication patterns. I have been interested by the complex communication network in the hospital hierarchy. However, on the night of September 17, 1970, my interest in the communication process became unexpectedly, tragically personal. Who in that emergency room would tell me what was happening? Who could give support in those traumafilled hours? To study hospital communications from the perspective of the participating observer has some inherent limitations. Nevertheless, it may well be the most promising method by which we can acquire an understanding of the importance of interaction in the hospital. As I was recovering after a cholecystectomy, it became increasingly apparent that a critical dimension of total patient care is the manner in which members of the health profession interact with the patient. While each worker who came into

The hypothesis is tested that in special conditions religious beliefs can function as a stablizing force on personal and social systems. The sample was drawn from an urban hospital population, using criteria that produced a largely low-income sample of mothers. The data show that under the conditions of heightened psycho-situational stress and limited resources for adaptation, mothers who located causality of illness in God, in contrast to those who viewed illness as naturalistically determined, were more likely to report a marginal rather than a difficult or a smooth adaptation to family disruptions during illness. Theoretical implications of these findings are discussed.