Biomedical subjects

Deborah S Walker

Publications and source records attributed to Deborah S Walker.

9 recordsLinked to original sources

PubMed2005

Fetal alcohol spectrum disorders prevention: an exploratory study of women's use of, attitudes toward, and knowledge about alcohol.

PURPOSE: The incidence of fetal alcohol spectrum disorders (FASD) is increasing, even though it is 100% preventable. This study examined use of, knowledge about, and attitudes toward alcohol of women requesting emergency contraception (EC) and/or a pregnancy test, and evaluated whether a brief intervention would be effective in educating them about the risks of FASD. DATA SOURCES: Fifty women from two outpatient clinics participated. Information was collected on demographic and personal health habits, alcohol use, and knowledge of and attitudes toward alcohol. As a brief intervention to increase knowledge about FASD, participants read a short pamphlet about the risks of alcohol exposure in pregnancy and then completed a post-test questionnaire. Descriptive statistics, including means, standard deviations, and skewness, were calculated for all variables. Pearson correlations were computed to assess relationships between demographic/lifestyle variables and attitudes toward and knowledge about alcohol. Paired t-tests were used to analyze the relationship between pretest and post-test knowledge scores. CONCLUSIONS: The majority of participants were single (76%), college educated (94%), and received EC at the clinic visit (60%). The average age was 24 years. Slightly over half (52%) reported drinking beer at least once a week, with one to six cans on occasion. Younger women expressed more tolerant attitudes toward alcohol use (p= .02) and drank significantly more beer on occasion (p= .015). Women who reported drinking alcohol when they last had sex were significantly (p= .017) less tolerant in their attitudes toward alcohol use. The intervention used in this study was effective in communicating knowledge about FASD to this population (p < .0001). IMPLICATIONS FOR PRACTICE: These findings suggest that young women may be engaging in behaviors that could put potential offspring at risk for exposure to alcohol. Clinicians are advised to take a thorough history to determine alcohol use in all women of childbearing age and to provide information regarding FASD prevention.

Adolescent↗

PubMedDate not supplied

Web-based data collection in midwifery clinical education.

A Web-based computerized database for clinical data collection use by midwifery and nurse practitioner students was developed and revised over 2 years. The database provided insight into the number and diversity of clients seen as well as the student's level of autonomy. Students documented a selected set of data elements sensitive to nursing and midwifery care for all client encounters. Analysis of the clinical encounter data entered by nurse-midwifery students in the Antepartum Care course during two winter semesters included 1,417 client encounters. Results of the analyses are presented as well as educational and clinical issues involved in the development and maintenance of the database. Future work includes refining the current database, expanding the data set to include the ACNM nurse-midwifery clinical data sets for antepartum and intrapartum care, and pilot testing the Web-based version in Fall 2003 by using wireless, handheld technology.

Competency-Based Education↗

PubMedDate not supplied

Do birth certificate data accurately reflect the number of CNM-attended births? An exploratory study.

The number of midwife-attended births is increasing as reported on birth certificates in the United States. However, there is some evidence that births attended by certified nurse-midwives (CNMs) may not be accurately recorded. In this exploratory study, data on birth attendants for those clients giving birth during the study period were compared by using four sources: the client's hospital chart, the CNM birth log, hospital birth certificate records, and state vital statistics records. Researchers sought to determine the accuracy of birth attendant data as reflected in these four sources and whether other providers were listed as the birth attendant for actual CNM-attended births. During the study period, the CNM birth log showed that CNMs attended 97 vaginal births, whereas the client hospital charts for these same births noted 92 births as attended by CNMs (the other five were operative vaginal births). Hospital birth certificate and state vital statistics data during the study time period credited 88 and 82 of the client's births, respectively, to the CNMs. Exploration of the inaccurately reported birth attendant data, implications for practice, and recommendations for accurately recording birth certificate data are discussed.

Adult↗

PubMedDate not supplied

Midwifery models: students' conceptualization of a midwifery philosophy in clay.

Formulating a professional and personal philosophy statement assists nurses and midwives in clarifying focus and direction. It also facilitates grounding of the nursing and midwifery professions or professionals by enabling the identification of both shared beliefs and unique elements. The purpose of this activity was to assist beginning student nurse-midwives (SNMs) in exploring the intersection of their own and the profession's philosophy. Through the creation of a clay representation of their philosophical model, eight SNMs expressed their midwifery philosophies at the beginning of their clinical sequence by sculpting them in clay and then described their sculptures and how they exemplified their philosophies.

Aluminum Silicates↗

PubMedDate not supplied

Reduced frequency prenatal visits in midwifery practice: attitudes and use.

Recent research supports the use of reduced frequency prenatal visit schedules (RFVS) for women of low obstetric risk. However, for the RFVS to be widely adopted for use in practice, health care providers must implement and support its use. The purpose of this study was to explore midwives' attitudes toward and use of reduced frequency prenatal care visit schedules for the care of low-risk women. A descriptive, correlational study was conducted at the 1999 Annual Meeting of the American College of Nurse-Midwives with completed surveys received from 234 midwives. Seventy-two percent (n = 170) responded that they were familiar with the reduced frequency visit schedule. Of those, 71% agreed that they could give effective prenatal care by using reduced frequency scheduling, although few (17%) reported using it in practice. Significant differences were found between the midwives who were familiar versus those who were unfamiliar with the visit schedule in their perceptions for five central themes: 1) quality of care of the RFVS, 2) women's empowerment or self-care with the RFVS, 3) ability to manage practice, 4) patient satisfaction, and 5) barriers to the use of RFVS. Providers' responses to the use of RFVS have been mixed. Successful integration of this schedule into prenatal care services may require more than knowledge of its safety for low-risk women. Careful selection of women for whom the schedule is appropriate and a commitment from midwives to tailor prenatal care to the individual women's needs is indicated. Further research is also needed to evaluate the barriers that prevent midwives from using a reduced frequency visit schedule for the prenatal care of low-risk clients.

Attitude of Health Personnel↗

PubMedDate not supplied

Social justice: added metaparadigm concept for urban health nursing.

Historically, the nursing metaparadigm has been used to describe 4 concepts of nursing knowledge (person, environment, health, and nursing) that reflect beliefs held by the profession about nursing's context and content. The authors offer an assessment of the metaparadigm as it applies to community and public health nursing in urban settings and offer an amendment of the metaparadigm to include the central concept of social justice. Each of the metaparadigm concepts and the central concept of social justice is discussed as it applies to a model of urban health nursing teaching, research, and practice.

Attitude of Health Personnel↗

PubMedDate not supplied

Investigating users' requirements: computer-based anatomy learning modules for multiple user test beds.

OBJECTIVE: User data and information about anatomy education were used to guide development of a learning environment that is efficient and effective. The research question focused on how to design instructional software suitable for the educational goals of different groups of users of the Visible Human data set. The ultimate goal of the study was to provide options for students and teachers to use different anatomy learning modules corresponding to key topics, for course work and professional training. DESIGN: The research used both qualitative and quantitative methods. It was driven by the belief that good instructional design must address learning context information and pedagogic content information. The data collection emphasized measurement of users' perspectives, experience, and demands in anatomy learning. MEASUREMENT: Users' requirements elicited from 12 focus groups were combined and rated by 11 researchers. Collective data were sorted and analyzed by use of multidimensional scaling and cluster analysis. RESULTS: A set of functions and features in high demand across all groups of users was suggested by the results. However, several subgroups of users shared distinct demands. The design of the learning modules will encompass both unified core components and user-specific applications. The design templates will allow sufficient flexibility for dynamic insertion of different learning applications for different users. CONCLUSION: This study describes how users' requirements, associated with users' learning experiences, were systematically collected and analyzed and then transformed into guidelines informing the iterative design of multiple learning modules. Information about learning challenges and processes was gathered to define essential anatomy teaching strategies. A prototype instrument to design and polish the Visible Human user interface system is currently being developed using ideas and feedback from users.

Anatomy↗

PubMedDate not supplied

The effects of preferred provider organizations on costs and utilization of hysterectomy.

In this study, the costs and service utilization of preferred provider organizations (PPOs) were compared against traditional indemnity plans with similar benefits and utilization review for hysterectomy, a potentially overused procedure. PPOs were associated with significant cost savings, achieved primarily through lower utilization rates.

Adult↗

PubMedDate not supplied

Revolutionizing prenatal care: new evidence-based prenatal care delivery models.

Much of prenatal care is based on tradition and expert opinion rather than on sound scientific evidence. With the increased emphasis on providing evidence-based prenatal care, new research-based models are emerging. This article describes two new models of prenatal care delivery and the evidence supporting them. A model of reduced-frequency prenatal visits is adapted from the U.S. Department of Health and Human Services (HHS) Expert Panel on Prenatal Care (1989) recommendations that healthy, pregnant women who are at low risk for pregnancy complications may attend fewer visits without negative consequences. Another emerging model of group prenatal care, CenteringPregnancy, integrates group support with prenatal care. It is important that healthcare providers are aware of these models in order to offer the highest quality, evidence-based care to pregnant women.

Appointments and Schedules↗