No Journals, No Evidence-Based Practice: Research Inaccessibility Affects Many Nurses No abstract available

Reducing Discomfort After Cesarean Birth Using Abdominal Binders Abstract: Purpose: The purpose of this study was to evaluate potential benefits of use of an abdominal binder after cesarean birth. Study Design and Methods: A randomized controlled trial was conducted at a Magnet-designated, academic medical center in the southwest United States. English- and Spanish-speaking adult women scheduled for an elective cesarean birth were randomized to the intervention or control group. Outcomes were measured for the first 48 hours postoperatively, including pain, medication use, and self-reported symptom distress. Results: Randomization resulted in balanced groups. Women who used the abdominal binder after cesarean birth reported a decrease in pain after ambulation, whereas women in the control group reported an increase in pain after ambulation (p < .001). Women in the binder group reported less distress on the Breathe and Cough items of the Symptom Distress Scale than those in the control group. On postoperative day 2, women in the binder group used more ibuprofen (p = .002) and acetaminophen (p = .027) than the control group. Clinical Implications: Use of an abdominal binder by women after cesarean birth can decrease pain, potentially enhancing speed of postoperative recovery. As a nursing intervention, abdominal binders may offer women a safe nonpharmacologic option to provide postoperative comfort.

Factors Affecting Uncertainty in Women with High-Risk Pregnancies Objective: To evaluate the state of the science on uncertainty in high-risk pregnancy and identify factors that influence uncertainty in women diagnosed with a high-risk pregnancy. Data Sources: Primary research articles from CINAHL, Ovid, MEDLINE, Scopus, and PsycINFO written in English, without date restrictions. Study Selection: Nineteen articles were identified, including 14 qualitative studies and 5 quantitative studies. Data Extraction: This integrative review was guided by Whittemore and Knafl's methodology. Studies were graded on level and quality of evidence as per Dearholt, Dang, and Sigma Theta Tau International. Data Synthesis: Studies were synthesized by using constant comparative methods according to factors influencing, outcomes of, and management of uncertainty. Conclusion: Uncertainty is a prominent theme in women experiencing a high-risk pregnancy. Uncertainty is influenced by various personal, pregnancy-related, demographic, and healthcare-related factors. Findings may offer insight and empathy for healthcare professionals. Nurses who understand significance of uncertainty in adjusting to two conflicting life events have the opportunity to help women in their understanding of a high-risk diagnosis during pregnancy through anticipatory guidance. Future research is needed to explore factors affecting uncertainty and to understand the experience of high-risk pregnancy to develop interventions aimed at mitigating uncertainty in high-risk pregnant women.

Mothers' Reasons for Early Breastfeeding Cessation Purpose: The purpose of this review is to assess maternal explanations for early breastfeeding cessation in economically developed countries. Study Design and Methods: The electromic databases EBSCO, CINAHL, Child Development & Adolescent Studies, PsycInfo, Health Source: Nursing/Academic Edition, Nursing and Allied Health; ProQuest databases: Family Health Database, Health and Medical Collection, Nursing and Allied Health, Psychology Database, and Public Health Databases were searched using the terms breastfeeding, cessation, stop, discontinuation, early weaning, quit*, early termination, and six months. Inclusion criteria included infants born at least 37 weeks gestation, single birth, and infant birthweight > 2,500 g. Results: Initial literature search yielded 117 studies; 10 studies met inclusion criteria. The two most common reasons for early breastfeeding cessation were perceived inadequate milk supply and maternal breast or nipple pain. Conclusion: Research on maternal reasons for early breastfeeding cessation is limited. Reasons for early breastfeeding cessation are varied; however, the most common themes were perceived inadequate supply and breast or nipple pain. Nurses should tailor assessment of each breastfeeding mother-baby couplet and associated interventions based on these findings.

Informing New Mothers about Newborn Screening Bloodspot Repositories during Postpartum Hospitalization Purpose: The primary goals of the study were to assess maternal knowledge and attitudes about the newborn screening bloodspot repository program in Texas and to evaluate the effect of a video about the bloodspot repository on the rate of parental permission to store infant bloodspots. Design: This descriptive, comparative study used descriptive statistics, nonparametric tests, and multivariable analyses to describe the sample, compare groups, and determine associations between factors that influenced parents' decisions to permit state storage of infant bloodspots. Results: There were 465 mothers in the study. Maternal knowledge about basic genetics and risks of genetic testing was poor, but mothers reported strong trust in the state to make good decisions about using genetic material for research. Race, ethnicity, and attitude toward research significantly influenced decisions to opt-in to the bloodspot storage program. Postpartum nurses provided the bulk of information about newborn screening and dried bloodspots, although 2/3 of respondents would have preferred to obtain this information prior to birth. Clinical Implications: Although postpartum nurses are the most common source of information about newborn screening, genuine informed consent for bloodspot storage is questionable. Information about newborn screening and bloodspot storage needs to be addressed in community venues prior to birth.

Mothers' Experiences Interacting with Infants after Traumatic Childbirth Purpose: The purpose of this study is to describe experiences of mothers interacting with their infants after traumatic childbirth. Study Design and Methods: A descriptive phenomenological method guided by Dahlberg, Dahlberg, and Nystrom's reflective lifeworld research was used. Women were recruited through Trauma and Birth Stress (TABS), a charitable trust in New Zealand, whose mission is to provide support for women who have experienced traumatic childbirth. Data were collected via an electronic survey. Women were asked to describe how their traumatic births affected their caring for and interactions with their infants and any other children they may have. Results: Eighteen women representing six countries across the globe participated. Four constituents of mothers' experiences interacting with their infants after traumatic births were identified: feelings of numbness and detachment, crying and anger, distressing cognitive changes, and limited outside social interactions. Clinical Implications: To help women struggling with the aftermath of their traumatic birth, nurses first need to identify them. Clinicians need to be attentive to symptoms such as a withdrawn, dazed look, and appearing distanced from their infants. Prior to hospital discharge after childbirth, women should be given opportunities to share their perceptions of their birth to determine if they view it as traumatic. Interventions should be started as soon as possible in this fragile mother–infant dyad to prevent long-term consequences.

Improving Perinatal Care Through Theory Application Theories from various perspectives can increase nurses' understanding of maternal behaviors throughout the developmental process of pregnancy and postpartum. The purpose of this article is to present relevant theories that maternity nurses will likely find useful, and to demonstrate their applicability through an unfolding exemplar case. Nurses can provide improved and more sensitive care when guided by psychosocial theories such as Rubin's tasks of pregnancy, prenatal attachment, pregnancy as a liminal phase, and the grief work in postpartum as proposed by Mercer. Use of relevant theories can promote holistic nursing care, increase critical thinking, and improve nursing responsiveness to unique family situations such as pregnancy after loss and premature birth.

Breastfeeding Support Guided by Swanson's Theory of Caring Purpose: Many women struggle with initiation of breastfeeding. The purpose of this study was to explore mothers' perceptions of care and support received from clinicians during breastfeeding initiation and the utility of Swanson's (1991) Theory of Caring to provide person-centered care to breastfeeding mothers and infants. Study Design and Methods: Directed content of secondary analysis of data obtained from 11 women via in-person interviews at three time points: before birth, a week after giving birth, and 6 to 8 weeks after giving birth. All women were breastfeeding at the end of the study interview series. Swanson's Theory of Caring provided the theoretical framework for the analysis. Results: Two overarching themes The Acts of Caring and The Lapses in Caring summarized women's experiences of care received during the initiation of breastfeeding. Five subthemes supported the Acts of Caring theme, and three subthemes supported the Lapses in Caring theme. Clinical Implications: Although all study participants chose to breastfeed after hospital discharge and the majority felt well supported, some received care that was perceived as uncaring, unsupportive, or harmful. Providing breastfeeding support consistent with research evidence and underpinnings of Swanson's Theory of Caring may help women build trusting relationships with clinicians and feel confident in meeting their breastfeeding goals.

Enhanced Recovery After Cesarean Birth No abstract available

Drowning Remains a Leading Cause of Injury-Related Deaths in Children No abstract available