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Biomedical subjects

D Holditch-Davis

Publications and source records attributed to D Holditch-Davis.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1995

Effect of standard rest periods on convalescent preterm infants.

OBJECTIVE: To examine the effects of standardized rest periods on the sleep-wake states of preterm infants who were convalescing. DESIGN: A randomized experimental study conducted from time of infants' entry into intermediate care until their discharge from the hospital. Because subjects' time in this study varied, data were analyzed cross-sectionally using the observation made between 5-11 days of the study and longitudinally over 3 weeks using a subset of subjects. SETTING: The intermediate care nursery of a tertiary care hospital. SUBJECTS: Forty-six preterm infants (23 matched pairs). A subset of 12 pairs, in which infants in the experimental and the control groups were in the study for 3 weeks, was analyzed longitudinally. INTERVENTIONS: Four standardized rest periods each day. MAIN OUTCOME MEASURES: Infants were observed once a week between noon and 8 p.m. Three sleep-wake states--quiet awake, active, and sleep--were measured as percentages of the naps and total observation. RESULTS: Within 5 days, infants in the experimental group exhibited more sleep (F[1,44] = 2.37, p < 0.05) and less active states (F[1,44] = 3.06, p < 0.01) during nap time. Infants receiving the intervention for 3 weeks had more sleep (F[1,22] = 4.63, p < 0.05) and less quiet waking states (F[1,22] = 13.85, p < 0.01) during naps. State patterns over the entire observation did not differ between the groups at 5 days, but by 3 weeks, infants in the experimental group had less quiet waking (F[1,22] = 17.44, p < 0.001) and longer uninterrupted sleep bouts (F[1,22] = 5.19, p < 0.05). CONCLUSIONS: A simple modification of nursing care had an impact on the sleeping and waking states of preterm infants.

Activity Cycles↗
PubMed1995

Behaviors of preterm infants with and without chronic lung disease when alone and when with nurses.

Many clinicians believe that infants with chronic lung disease display more irritability and react more negatively to care than other preterm infants. Therefore, the sleep-wake states and behaviors displayed by 31 high-risk preterm infants without chronic lung disease and 20 infants with chronic lung disease during four-hour observations conducted in intermediate care between 32 and 36 weeks postconceptional age were compared. Separate analyses were conducted for times when infants were alone and when they were with nurses to determine whether behavioral differences might be greater during handling. There were very few differences between the groups in either situation. Sleep-wake states did not differ. The infants with chronic lung disease exhibited more jitters at every age, but only when they were alone. Infants with and without chronic lung disease showed isolated differences in five behaviors when they were alone but in only two behaviors when they were with nurses. Thus, there is no evidence that 32- to 36-week preterm infants with chronic lung disease are more irritable or react more negatively to care than other preterm infants.

Case-Control Studies↗
PubMed1994

Postoperative pain management in preverbal children: the prescription and administration of analgesics with and without caudal analgesia.

A retrospective chart review was conducted to examine the prescription and administration of analgesics with and without caudal analgesia to inpatient preverbal children within the first 48 hours after surgery. The 75 subjects were between birth and 24 months of age and had undergone various operative procedures. Seventy (93%) of these subjects were prescribed analgesics, but 8 of them had only acetaminophen prescribed. Of the 70 subjects who had a medication prescribed, 64 (91%) patients received analgesics. Morphine was the most frequently administered analgesic. The prescribed and administered mean dosages were less than the minimum recommended dosage for morphine. The mean prescribed and administered dosage for other analgesics exceeded the minimum recommended dosage. Preverbal children who had caudal analgesia during surgery were more likely to receive fewer dosages of analgesics and to receive lower dosages of narcotics even after 24 hours postoperatively than children who had not had caudal analgesia.

Acetaminophen↗
PubMed1994

Maternal perception of illness severity in premature infants.

This study examines relationships between the actual severity of the premature infant's medical condition, maternal perception of the severity of the infant's illness, the infant's birth weight, and maternal anxiety levels. Subjects for this study were 44 mothers who were part of a larger study of parental stress in neonatal intensive care units (NICUs). The premature infants of these mothers were hospitalized in the NICU of a large southeastern university medical center at the time of data collection. Mothers completed a severity perception scale and the State-Trait Anxiety Inventory. Data about actual severity of each infant's illness and about the infant's characteristics were collected from the medical chart. The findings indicate that maternal perceptions regarding the severity of their premature infants' illness are complex and are influenced by different factors at different points in time. A significant relationship was not found between the mother's recollection of infant severity at NICU admission and maternal perceptions at the time of the interview, two to five days after admission. Although maternal recall of the severity of the infant's illness on admission is not related to anxiety, perceptions of severity at the time of the interview (two to five days after admission) are related to anxiety scores.

Adolescent↗
PubMed1993

High-risk preterm infants at 3 years of age: parental response to the presence of developmental problems.

In this article we describe developmental status at 3 years and family utilization of early intervention services of 24 children who were born prematurely and weighed less than 1,500 g or who required mechanical ventilation at birth. Findings indicated (a) a low rate of major disabling conditions; (b) a high rate of developmental, mild cognitive, and behavioral concerns; and (c) a lack of family follow-through on referrals for early intervention services for potentially responsive children, even though the concerns put the children at risk for school difficulties.

Child Health Services↗
PubMed1992

Interactions of parents and nurses with high-risk preterm infants.

The interactions of preterm infants with parents were compared with their interactions with nurses. Twenty-nine high-risk preterm infants who were a part of a larger longitudinal study of behavioral development were observed once weekly from 7 p.m. to 11 p.m. A single observation for each infant that contained a minimum of 2 min of parental care and 2 min of nursing care was selected for analysis. Results showed that nurses and parents provided different types of stimulation with nurses more likely to engage in procedural care and parents more likely to hold, talk to, move, and touch the infants affectionately. Infants showed more sleep-wake transition, large body movements, and jitters when with nurses and more active sleep and more smiles when with parents. Similar differences were found when parents and nurses were just holding or touching the infants, but no differences in infant responses were seen during feeding or changing. Thus, the different infant behavioral responses appeared to result primarily from the different stimulation provided by parents and nurses. Implications of these findings for research and clinical practice are discussed.

Caregivers↗
PubMed1990

Pregnant moments: the process of conception in infertile couples.

This report is an explication of the process of conception in infertile couples as illuminated by 24 infertile couples and a comparison group of 6 couples with no fertility impairments. Employing techniques generic to grounded theory research, the investigators found that infertile couples lived conception as a series of biological and phenomenological moments. The process of biomedically-assisted conception consisted of three components including: (a) forcing conception; (b) resolving conceptional ambiguity; and (c) reconciling conception as an idea and as an event. The findings suggest the need for a re-examination of current orientations to pregnancy time and space and appraisal of couples' interpretations of conception. In addition, the convergence of the conception experiences of infertile and fertile couples raises questions about the meaning of normal conception in the current technological context of reproduction.

Adult↗
PubMed1989

Mazing: infertile couples and the quest for a child.

The overall purpose of the ongoing research project on which this report is based is to explore the transition to parenthood of infertile couples who achieve parenthood through adoption or biotechnical means. Mazing, the process of negotiating the paths to parenthood, was found to be a key component of that transition and the core variable that integrates the experiences of infertile couples after a period of trying but failing to have a child of their own on their own. The theory of mazing is grounded in information obtained from 40 couples who were designated for this study by means of theoretical sampling. Techniques generic to grounded theory research were employed; these included open-ended interviews, constant comparison and subject validation. Mazing, a recursive, iterative and resource-intensive process, includes (a) the construction of a calculus of pursuit, (b) six distinctive patterns of pursuit, and (c) the reframing of desire.

Decision Making↗
PubMedDate not supplied

The usefulness of an assessment of emotional involvement of HIV-positive mothers and their infants.

INTRODUCTION: A positive mother-infant relationship is crucial for optimal child development; however, many factors may interfere with the development of a such a relationship. One group at risk for compromised mother-infant interactions is women with HIV infection. The purposes of this study were (a) to examine the usefulness of the Attachment During Stress scale (ADS) for measuring the emotional involvement of HIV-positive mothers with their infants during a clinic visit and (b) to explore the effects of maternal health status, age, parity, and educational level on mother-infant involvement. METHOD: A descriptive, longitudinal study was conducted with 57 primarily African American HIV-positive mothers and their infants who were patients at 1 of 2 regional referral centers. The ADS was completed during the child's physical examination at 3, 6, and 12 months of age, and mothers completed questionnaires during these visits. RESULTS: Maternal age, education level, health status, and parity were not related to maternal emotional involvement. However, the emotional involvement of the mother and infant were correlated (r = 0.73, P < .001). DISCUSSION: These findings suggest that the ADS may be a useful screening tool to supplement the nurse's clinical judgment in a pediatric outpatient setting. The ADS provides some useful information about the emotional involvement of the mother and infant, although it does not provide a comprehensive assessment of their relationship.

Adolescent↗
PubMedDate not supplied

Physical and mental health in African American mothers with HIV.

This article examines the physical and mental health of African American mothers during a 2-year period following the birth of an infant seropositive for human immunodeficiency virus (HIV). Participants were 34 African American mothers enrolled when the infants were approximately 3 months of age and reinterviewed when the infants were 6, 12, 18, and 24 months. Three self-report questionnaires were used to assess physical health (perception of health, activity limitation, and physical symptoms) and mental health (depressive symptoms and stigma). Health symptoms most often reported were infections, problems thinking and remembering, low energy, and gynecologic problems. Moderate levels of perceived stigma were reported. Depressive symptoms were high; a large number of women at each data point had depressive symptom scores above the cutoff, indicating risk for depression. There were significant correlations between depressive symptoms and health, suggesting a link between mental and physical health. These findings have significance for the health of the mother and the parenting of her infant. Attention should be paid to the mental and physical health of mothers with HIV, especially during the first 2 years after the birth of a child.

Adolescent↗
PubMedDate not supplied

Parents as passengers during pediatric transport.

INTRODUCTION: The transport environment presents a unique setting in which the feasibility, advantages, and disadvantages of passengers accompanying a patient must be assessed carefully. The purpose of this study was to describe the current practice of including parents as passengers during pediatric interfacility transport. METHODS: One-hundred-eighty-eight critical care transport programs in the United States responded to a voluntary mail survey, providing information about current policies, practices, and crew perceptions of the advantages and disadvantages of carrying parents as passengers. RESULTS: Extra seating for passengers was available in 96% of ambulances, 86% of fixed-wing aircraft, and 54% of helicopters used for pediatric transport. Parents traveled as passengers in all types of vehicles; most frequently in ambulances and fixed-wing aircraft. Twenty percent of helicopter programs allowed parent passengers on more than half of their pediatric transports in this vehicle. Advantages of parent passengers included emotional benefit for the parent and child, availability of parents for history and consent, good public relations, and having the parent present if the child dies. Disadvantages included potential parent anxiety, crew distraction, and space limitations. DISCUSSION: This study reflects the widely diverse policies, practices, and opinions relevant to this topic and confirms a need for further study.

Air Ambulances↗