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The purpose of this Roy adaptation model-based multi-site international mixed method study was to examine the relations of type of caesarean birth (unplanned/planned), number of caesarean births (primary/repeat), and preparation for caesarean birth to women’s perceptions of and responses to caesarean birth. The sample included 488 women from the United States ( n = 253), Finland ( n = 213), and Australia ( n = 22). Path analysis revealed direct effects for type of and preparation for caesarean birth on responses to caesarean birth, and an indirect effect for preparation on responses to caesarean birth through perception of birth the experience.

Aims. The purpose of this Roy Adaptation Model-based study was to describe women’s physical, emotional, functional and social adaptation; postpartum concerns; and learning needs during the first two weeks following caesarean birth and identify relevant nursing interventions. Background. Studies of caesarean-delivered women indicated a trend toward normalisation of the caesarean birth experience. Escalating caesarean birth rates mandate continued study of contemporary caesarean-delivered women. Design. Mixed methods (qualitative and quantitative) descriptive research design. Methods. Nursing students collected data from 233 culturally diverse caesarean-delivered women in urban areas of the Midwestern and Northeastern USA between 2002–2004. The focal stimulus was the planned or unplanned caesarean birth; contextual stimuli were cultural identity and parity. Adaptation was measured by open-ended interview questions, fixed choice questionnaires about postpartum concerns and learning needs and nurse assessment of post-discharge problems. Potential interventions were identified using the Omaha System Intervention Scheme. Results. More positive than negative responses were reported for functional and social adaptation than for physical and emotional adaptation. Women with unplanned caesarean births and primiparous women reported less favourable adaptation than planned caesarean mothers and multiparas. Black women reported lower social adaptation, Hispanic women had more role function concerns and Black and Hispanic women had more learning needs than White women. Post-discharge nursing assessments revealed that actual problems accounted for 40% of identified actual or potential problems or needs. Health teaching was the most commonly recommended postpartum intervention strategy followed by case management, treatment and surveillance interventions. Conclusions. Caesarean-delivered women continue to experience some problems with adapting to childbirth. Recommended intervention strategies reflect the importance of health teaching following hospital discharge. Relevance to clinical practice. Women who experience caesarean birth require comprehensive assessment during the early postpartum period. Nurses should devise strategies to continue care services for these women following hospital discharge.

The Abuse Assessment Screen, Severity of Violence Against Women Scales, and Appraisal of Violent Situations scales were translated into versions for women originating from Brazil, Haiti, the Dominican Republic, and Puerto Rico. The procedure of back translation was chosen as the most reliable method for translation of these three instruments. The translated instruments were used to screen women for abuse during pregnancy and to determine the prevalence and severity of that abuse. This article discusses the translation process and illustrate with versions of the instruments for use with pregnant women from Puerto Rico.

A project showing the integration of teaching, practice, and research is described. The project involved using information gathered as part of baccalaureate nursing students' assessments of women's perceptions of and responses to cesarean birth to extend a program of nursing research. Benefits to student learning and faculty research programs are identified. The project serves as a prototype for the teaching, practice, and research activities of all students and faculty in nursing and other professional disciplines. J Prof Nurs 19:17-21, 2003. Copyright 2003 Elsevier, Inc. All rights reserved.

A better understanding of the process of adaptation to motherhood should enhance nurses’ ability to prepare women for the transition to motherhood and to provide care following childbirth. Knowledge about women’s adaptation to motherhood was developed primarily from the 1960s to the 1990s. Cesarean birthing was a special focus of research throughout the late 1970s and the 1980s, followed by functional status, and more recently, depression and stress associated with birth and postpartum. Adaptation to motherhood in the context of the early 21st century has received limited attention in nursing research, creating an assumption that the process of adaptation is universal and context-free rather than evolving within the life and societal context of women across generations. Although becoming and being a mother has been described as a normative transition rather than a stressor by some, knowledge development about adaptation to motherhood also has been constrained by the limited use of a unified perspective of transition as a process of adaptation. Therefore, the purposes of this exploratory study were to describe contemporary women’s physical, emotional, functional, and social adaptation to motherhood and to examine the relations of selected demographic and perinatal variables to adaptation to motherhood in the first 3 to 6 weeks of the postpartum.

To determine the images of women in picture advertisements, a stratified random sample of 32 medical journals, representing approximately 12% of medical journals published in the United States that are directed toward physicians in clinical practice, was subjected to content analysis. The sample consists of 209 different ads. The subjects of the ads included men, women, and children representing a variety of ethnic, racial, and socioeconomic groups. Notable, however, was the preponderance of Caucasian males pictured as physicians and the absence of women and people of color in this role. Women are pictured as 68.1% of consumers and men as 31.9%, a significant difference. Statistically significant differences also occur in the images of men and women as consumers. Most of the workers are men (68.2%), another significant difference. When women depicted are workers, they are secretaries and waitresses. Portrayals of women in medical advertisements continue to be stereotyped and outdated.

This investigation examined the content of advertisements in medical and nursing journals to determine if the images of nurses reflect the roles nurses play in health care. The method used was content analysis. Thirty-five nursing journals and 48 medical journals yielded 313 different advertisements picturing nurses. Data were analyzed using descriptive statistics, chi-square, correlation coefficients, and interpreted for overall impressions of the portrayals. Nurses are portrayed as sex objects, ornaments and as handmaidens to physicians. The findings demonstrate a freezing of the image of nurses in the print media.

The purpose of this column is to describe the implementation of an international multisite Roy adaptation model-based study of women’s perceptions of and responses to cesarean birth. The need for the study arose from the concern that women’s childbearing needs may not be met to their full satisfaction, especially if the infant is born by cesarean. Serendipity and networking played a part in the selection of four study sites in the United States (Boston, Milwaukee, Norfolk, Oklahoma City) and two in other countries (Finland, Australia). Data were collected by nursing students and staff nurses. Post-hoc consideration of the diversity of study sites revealed opportunities for examination of the influence of the contextual stimuli of culture and geographic region on the women’s adaptation to cesarean birth. Strategies used to foster integration of teaching, practice, and research are discussed.

Identification of factors associated with National Council Licensure Examination-Registered Nurse (NCLEX-RN) success is critical at public colleges of nursing with diverse student populations. This issue was the purpose of this research study. A descriptive correlational research design was used. Seventy-nine generic senior students enrolled in an urban public university participated in the study. Several internal and external blocks to success were described by the students, including family responsibilities, emotional distress, fatigue, and financial and work burdens. Significant correlations were found between success in the NCLEX-RN and cumulative undergraduate nursing program grade point average, English as the primary language spoken at home, lack of family responsibilities or demands, lack of emotional distress, and sense of competency in critical thinking. Establishment of a comprehensive data base—including factors associated with success in the NCLEX-RN and programs of advisement, tutoring, and stress management as well as classes in study skills, test taking, and NCLEX preparation—are recommended for public colleges of nursing with diverse student populations.

This study examined the paid work role as a predictor of widows' health during conjugal bereavement. The sample of widows aged 55-75 bereaved for two years prior to the study (N = 157) was identified through recorded death certificates as the surviving spouses of deceased men. Work history and work attitude were statistically significant predictors of health during bereavement.

This study was designed to examine the content of advertisements in medical journals to determine if the images of women are different than those of men. The method for this investigation was content analysis of a stratified random sample of issues of selected medical journals that regularly include picture advertisements. Advertisements were analyzed according to criteria and characteristics derived from a review of the literature. Interrater reliability was computed as a function of agreements. The results indicate that readers of medical journals are still being exposed to images of women that are negative and outdated. Until portrayals of women are consistently positive and timely, the images can have a negative effect on the health care women receive.