Biomedical subjects

D Holditch-Davis

Publications and source records attributed to D Holditch-Davis.

At least 19 recordsLinked to original sources

PubMed2001

Perceptions of health and their relationship to symptoms in African American women with type 2 diabetes.

Diabetes mellitus is an incurable disease and a major cause of mortality and morbidity. Diabetes disproportionately affects members of minorities who suffer from higher rates of complications and greater disability (Cowie & Eberhardt, 1996). The purpose of this study was to (a) describe the symptoms of African American women with Type 2 diabetes and examine the relationship among diabetes-related symptoms; (b) document complications of diabetes and perceptions of health and functioning; and (c) examine the relationship between duration of diabetes and age at diagnosis and perceived health. A convenience sample of 75 African American women with Type 2 diabetes were interviewed. A 44-item questionnaire measured selected demographic variables, symptoms, documented complications, and their perceived relationship to diabetes. The SF-20 was used to measure perceptions of health status. Data show that African American women with Type 2 diabetes have a wide variety of symptoms and poor perceptions of their general health and physical functioning.

Activities of Daily Living↗

PubMed2000

Developmental problems and interactions between mothers and prematurely born children.

This study explored how the developmental status of 49 3-year-old prematurely born children related to the interactions between these children and their mothers. Two 2-hour observations of mother-child interactions, the Home Observation for Measurement of the Environment (HOME) inventory, a developmental assessment, and Nursing Child Assessment Teaching Scale (NCATS) were scored when the child was 3 years corrected age. The effects of specific developmental problems (cognitive, language, and attention) were examined by comparing subgroups with and without these problems. Children with normal IQs spent less time not playing and scored higher on the NCATS than children with low IQs. Mothers of children with normal IQs scored higher on provision of play materials on the HOME. The mothers of children with language concerns interacted less, talked less, were more negative, and scored lower on the HOME and NCATS than mothers of the children with normal language abilities. Children with attention problems were more active than children with normal attention spans. These findings suggest that mother-child interactions might be useful for identifying children at risk for developmental delay and that interventions with preschool children with developmental delays will probably be more effective if their mothers are helped to provide a more appropriate social environment.

Adult↗

PubMed2000

Feeding and non-feeding interactions of mothers and prematures.

The interactions between mothers and premature infants during feeding and nonfeeding periods were explored. Twenty-nine premature infants and their mothers were observed interacting for 1 hour in their homes at 6 months corrected for prematurity. Mothers were more likely to engage in the following behaviors involving close contact during feeding: looking at the infant, holding the infant, having body contact, and rocking their infants. They interacted with their infants 96% of feeding time. During nonfeeding periods, they were more likely to engage in more distal behaviors (e.g., gesturing, touching, and playing with the infant) and spent only 67% of the time interacting with the infant. Infants were more likely to be alert, vocalize, play with objects, express negative affect, and locomote during nonfeeding, and they were more likely to be drowsy or asleep during feeding. Therefore, a complete understanding of interactions between mothers and prematures can only come from examining both feeding and nonfeeding periods.

Adult↗

PubMed1999

Nursing care and the development of sleeping and waking behaviors in preterm infants.

The relationship between nursing care and the development of sleep-wake behaviors of 71 medically high-risk preterms was examined. The development of preterm infants' sleep-wake states, jitteriness, and negative facial expressions were influenced not only by the presence of the nurse, but also by the type of caregiving the nurse provided. The infant was awake more often when with caregivers than when alone. Waking states increased over time only when the infant was with caregivers, whereas quiet sleep increased only when the infant was alone. Infant behaviors and sleep-wake development were related to the intrusiveness of care. For example, negative facial expressions and sleep-wake transitions increased over time during the most intrusive caregiving. The development of sleeping and waking in preterm infants appears to depend not only on biological maturation but also nursing stimulation. As long-term developmental effects of nurse caregiving are unknown, additional research is needed.

Chi-Square Distribution↗

PubMed1999

Early parental interactions with and perceptions of multiple birth infants.

The perceptions and interactions of mothers and fathers of seven sets of twins and one set of triplets were compared to those of parents of 49 singleton infants. Couples were typically interviewed together three times during the pregnancy and at 1 week and 3 months post-partum. Two-weekly observations of mother-father-infant interactions were conducted after the first postnatal interview. Three major themes were apparent in the interviews--the positive and negative specialness for multiple births, difficulties involved in managing more than one infant, and attachment issues--that were also evident during the observations. Although there were few differences in care-giving and interactive behaviours between the multiple birth and singleton parents, the logistics of caring for more than one infant dictated that multiple birth infants were left alone more and looked at, talked to and held less often. Couples used different strategies to care for their infants, varying in both the extent to which they interacted preferentially with the infants and in the relative involvement of the mother, father and others.

Analysis of Variance↗

PubMed1998

Modeling development of sleep-wake behaviors. II. Results of two cohorts of preterms.

A mixed general linear model analysis of the development of sleep-wake states was conducted on 37 high-risk preterm infants and replicated with a second cohort of 34 infants. Most dependent variables showed significant development over the preterm period: active sleep decreased, and active waking, quiet waking, and the organization of active sleep and quiet sleep increased over the preterm period in both cohorts. The amount of quiet sleep also increased over age, but this change was significant only for Cohort 1. Seven infant characteristics used as covariates had only minor effects. There were no significant differences in the developmental trajectories (slopes) of the two cohorts. The amounts of four variables differed between cohorts: Cohort 2 infants had less sleep-wake transition, more active sleep, less active sleep without REM, and more regular quiet sleep. These findings suggest that developmental patterns of sleep wake states are stable enough in the preterm period that deviant individual patterns might be used to identify infants with neurological problems.

Caregivers↗

PubMed1998

Modeling development of sleep-wake behaviors: I. Using the mixed general linear model.

The purpose of this paper is to demonstrate the use of the mixed general linear model (MixMod) for modeling development of sleep-wake behaviors in preterm infants. The mixed general linear model allows the concurrent identification of both group and individual developmental patterns in longitudinal data sets with inconsistently timed data, irregularly timed data, and randomly missing values. This statistical technique is well suited to data from preterm infants because these infants enter and leave longitudinal studies at varying times depending on their health status. One sleep organizational variable--the regularity of respiration in quiet sleep--obtained from a study of 37 preterm infants was used as an example. Seven infant characteristics were used as covariates. The various steps involved in conducting a mixed model analysis of this variable are illustrated. The strengths and limitations of this technique are discussed.

Aging↗

PubMed1998

Temporal organization of sleep-wake states in preterm infants.

The development of temporal organization of sleep-wake states during the preterm period was examined. Seventy-one high-risk preterms from two cohorts were observed from 7 to 11 p.m. weekly from the time they were no longer critical until discharge. Mixed general linear model analyses found that with increasing postconceptional age, quiet waking, active waking, and sleep-wake transition bouts occurred more frequently, quiet sleep bouts occurred less frequently, and active waking and quiet sleep bouts increased in length. However, these developmental patterns were not stable over cohorts. On the other hand, the transitional probabilities between states were similar in both cohorts, providing evidence for biological bases for some aspects of temporal organization. Active sleep was pivotal in state transitions. Younger infants showed fewer transitions that did not involve active sleep. Thus, temporal organization is an early characteristic of sleep-wake states but is not a unitary phenomenon. Transitional probabilities remain relatively invariant, whereas bouts lengths and frequencies may be altered in different populations or by differing environmental conditions.

Age Factors↗

PubMed1998

Pediatric nurses' use of behaviors to make medication administration decisions in infants recovering from surgery.

Although behavioral observation is recommended as the primary pain assessment for the nonverbal postsurgical child, little is known about clinicians' use of observation in their medication administration decisions. Eight infants were videotaped after surgery and segments of the videotapes were categorized as medication inactive or medication active (assumed to relieve pain) based on the usual duration of infants' analgesics. Nurses (N=50) viewed these segments and mean percent agreement with the pharmacologic categorization was 54%. Agreement was high for medication active segments and low for medication inactive ones. Nurses reported using the pain behaviors described in the literature as well as other infant characteristics in their decision making. Infant behaviors observed in the medication inactive snippets were not suggestive enough of the presence of pain to result in the nurses choosing to medicate.

Analgesics↗

PubMed1998

Infertility and early parent-infant interactions.

Approximately 50% of infertile couples will become parents through pregnancy or adoption, but they experience major difficulties while working towards this goal. Infertility treatments are associated with physical pain and psychological distress, and adoption procedures are prolonged and emotionally stressful. The extent to which these stressors alter the parenting of these couples is not known. The purpose of this study, therefore, was to examine the early parent-infant interactions in infertile couples who become parents through pregnancy or adoption. Two groups of infertile couples (30 who achieved pregnancy and 21 who adopted) and a group of 19 couples without fertility problems were observed interacting with their infants twice, 7 to 21 days after the infant's arrival and a week later, at a time when both parents were at home. Their babies were between 9 days and 5 months of age. Behaviours of the mother, father and infant were recorded every 10 seconds, beginning when the baby was picked up and ending when the baby was put down asleep or 1 1/2 hours had passed. Repeated measures ANOVAs were used to compare the three groups over the observations. There were no differences between fertile and infertile biological parents. Adopted infants showed more alertness, less sleeping, more smiles, and more looking than biological infants. Adoptive mothers spent less time as the sole interactor. Adoptive parents spent more time in playing with their infants and held and touched them less than did biological parents. Infertility, therefore, does not appear to affect early parenting. In general, the amounts of behaviours exhibited by infertile biological parents were very close to those of fertile parents. Differences in the behaviours of adoptive as compared to biological parents can best be explained as responses to the behaviours of their older infants, rather than as evidence of different parenting styles.

Adoption↗

PubMed1997

HOME inventory and NCATS: relation to mother and child behaviors during naturalistic observations. Home Observation for Measurement of the Environment. Nursing Child Assessment Teaching Scale.

The purpose of this study was to determine the relationships among the Nursing Child Assessment Teaching Scale (NCATS), the Home Observation for Measurement of the Environment (HOME) inventory, and interactive behaviors observed in the home for fifty-three 3-year-old, prematurely born children and their mothers. The total HOME score showed high internal consistency, with moderate subscale levels. NCATS total score showed high internal consistency, but low to moderate subscale consistency. Combining NCATS subscales into a mother subscale and child subscale improved internal consistency. The HOME and the NCATS mother subscale correlated with observed maternal behaviors, but the NCATS child subscale was unrelated to child behaviors. Relationships between observed behaviors and HOME scores did not differ for high- and low-education mothers or for Caucasians and African Americans, but only low-education mothers and African Americans exhibited correlations between NCATS scores and observed behaviors. These results show the HOME, NCATS, and naturalistic observations measure related, but not overlapping, aspects of the mother's contribution to her relationship with her child, but the NCATS child subscale should be used with caution with 3-year-olds.

Adult↗

PubMed1997

Parenting the prematurely born child: pathways of influence.

Recognizing the importance of parents in the lives of preterm infants, investigators and clinicians have increasingly focused on the needs of parents during the period when their infant is hospitalized in a neonatal intensive care unit and the impact of this experience on their subsequent parenting. The purpose of this report is to summarize research findings from over two decades of research, present a framework for understanding the various influences on parents of prematurely-born children, and suggest clinical interventions that are important in helping parents both in the hospital and after discharge.

Affective Symptoms↗

PubMed1997

Maternal recall of the neonatal intensive care unit.

This study examined how mothers of prematurely born three-year-old children retrospectively recall their responses to their infant's hospitalization in the neonatal intensive care unit (NICU). Forty-four mothers of three-year-old prematurely born children were interviewed as part of a longitudinal study. Data from maternal interviews were analyzed using the analytic inductive method. Findings support the hypotheses that were based on the Parental Stress in the ICU model. Three years after the birth of their premature infants, mothers reported vivid memories of stress related to the appearance and behavior of their infants, the pain and procedures the infants endured, alterations in their role as parents, and stress related to the infant's illness severity and uncertainty about infant outcomes. Prenatal problems, such as high-risk pregnancy or birth, infant loss, and disturbances in family support, were also recalled as sources of stress. Findings have implications for family-centered nursing care in NICUs.

Adult↗

PubMed1997

Parenting the prematurely born child.

The purpose of this chapter is to summarize the findings of the nursing research on parenting the prematurely born child. This research focused on eight general areas: impact of the home environment on infant development status, the relationship between premature infants and their mothers during the first 2 years, parenting during hospitalization, maternal concerns about infant discharge, fathering, subpopulations of premature infants, parenting after the first 2 years, and interventions to improve parenting. There is a need to strengthen the design and conceptualization of these studies, to move toward more intervention research, and to do research that is more culturally sensitive, especially toward fathers, ethnic and cultural minority groups, and the poor.

Child↗

PubMed1997

Effect of standard rest periods on apnea and weight gain in preterm infants.

This study determined the effect of modifying a single aspect of the intermediate care environment on the incidence of apnea and rate of weight gain in convalescent preterm infants. Twenty-two preterm infants were assigned to experimental and control groups using a randomized, matched-pair design. Over a three-week period, infants in the experimental group were provided a 1 1/2-hour nap period four times a day during which their beds were covered and they were left undisturbed. Control infants received standard nursing care. The infants in the experimental group had more apnea at the start of the study than the control infants but showed a significantly more rapid decline in the incidence of apnea. These infants also gained significantly more weight per day than the control infants. Thus, a simple modification of nursing care that involved minimal increases in nursing time had a beneficial effect on preterm infants.

Apnea↗

PubMed1995

Fertility status and symptoms in childbearing couples.

The symptoms of 58 pregnant couples--37 with a history of infertility and 21 without a history of infertility--were compared. The Symptomatology Inventory, a checklist of 42 common physical and psychological symptoms of pregnancy, was completed by each spouse from months 4 to 9 of pregnancy. For purposes of analysis, the individual symptoms were grouped into three categories: physical symptoms, negative affective symptoms, and positive affective symptoms. Although the infertile pregnant couples did not experience more symptoms than fertile couples, their pattern of reporting pregnancy-related symptoms was quite different. In terms of both number and type of symptoms, infertile spouses' symptoms tended to be positively related. Compared to fertile couples, the infertile couples experienced symptoms globally and were more consistent in the number of symptoms reported by each spouse. Additional research is needed to confirm these findings and to determine the implications of these differences for childbearing and the martial relationship.

Adult↗

PubMed1995

Compensatory parenting: how mothers describe parenting their 3-year-old, prematurely born children.

Premature infants and their mothers experience difficulties in establishing their relationships. The effect of these early problems on later parenting is not known. This study explored whether mothers' recollections surrounding the birth and hospitalization of a preterm infant affected their perceptions and their parenting of these children at 3 years of age. Twenty-seven primary caregivers of 30 prematurely born children completed three questionnaires on their perceptions of their children and were interviewed about parenting experiences. The core concept identified in analysis was compensatory parenting, a parenting style in which mothers provided special experiences and avoided others in an attempt to compensate the children for their neonatal experiences. Compensatory parenting was influenced by the view of these prematurely born children as both special and normal and by salient prenatal, labor, and delivery experiences; memories of the neonatal intensive care unit experience; the sequelae of emotional responses to these experiences; and subsequent health problems after discharge. Prospective research is needed to further study compensatory parenting and to develop interventions.

Adaptation, Psychological↗

PubMed1995

Comparison of pregnancy symptoms of infertile and fertile couples.

This study was undertaken to describe the most common symptoms experienced during pregnancy by couples with a history of infertility and to compare them with symptoms of expectant couples without a history of reproductive problems. The Symptomatology Inventory, a 42-item checklist of common pregnancy symptoms, was used. The 10 most frequent symptoms reported and their rank order were very similar for the women from both groups. Men from the two groups frequently reported similar symptoms, but differed on their rank order. This research provides evidence that in terms of pregnancy symptoms infertile and fertile couples are more alike than they are different.

Case-Control Studies↗