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Biomedical subjects

G C Anderson

Publications and source records attributed to G C Anderson.

At least 109 records · Page 6Linked to original sources
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Selected characteristics of nurses and physicians who have living wills.

The purpose of this report is to determine what characteristics are most closely associated with nurses and physicians who favor a living will. A statistical analysis called classification and regression trees (CART) was used on the data set from a previous study. The five predictor variables that were analyzed were chosen following incorporation of a univariate screening process in which variables were chosen by their association with the likelihood of signing a living will. In addition, variables that did not have complete data sets were not considered in the analysis. The CART procedure was then used to determine which of these five variables were considered significant predictors. Three variables were selected: religion, length of experience with the terminally ill, and nature of the relationship (professional or personal) with the terminally ill. The two nonsignificant and therefore rejected variables were education/occupation and current region of residence. Within the predictor variable religion, CART selected the grouping of values (agnostic/atheist and Christian/non-Christian) as the best predictor of nurses and physicians likely to sign a living will. The second best predictor variable identified was length of experience in providing care to at least one patient, family member, or friend who was terminally ill. The nature of the relationship (professional or personal) with the terminally ill was the next strongest predictor variable of signing a living will. No previous studies of the living will have used such multivariate techniques as CART analysis to predict the likelihood of a health care provider signing a living will.

Attitude of Health Personnel↗
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Maternal kangaroo (skin-to-skin) care in the NICU beginning 4 hours postbirth.

Kangaroo care (KC) for preterm infants is becoming well known in the United States. Typically, KC is given by mothers in the neonatal intensive care unit (NICU) beginning days or weeks postbirth. This case report documents KC beginning at 4.5 hours postbirth with a healthy mother whose 32-week, 1,953 gram infant required initial care in the NICU. The nurse's role in supporting this care is described. Both parents experienced KC with their son and were soon convinced of the exceptional benefits he received. The infant was transferred to intermediate care on Day 2, regained his birth weight by Day 12, was discharged home on Day 21. He was breast-feeding exclusively at 40 weeks corrected age, and had Bayley mental and motor development scores within normal limits at 6 months corrected age.

Adult↗
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Using kangaroo care in a clinical setting with fullterm infants having breastfeeding difficulties.

Usually Kangaroo Care (KC) or skin-to-skin holding care is done with preterm infants. This article, however, documents clinical experiences with three mothers and their fullterm infants who were having latching/breastfeeding difficulties. In each case the nurse placed the fullterm infant in KC for approximately 1 hour prior to and continuing into the next breastfeeding session. Although no recommendations can be made based on case studies, these clinical experiences suggest that KC is a worthwhile intervention to try when a mother and her fullterm infant are struggling to achieve successful breastfeeding.

Body Temperature↗
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Birth kangaroo (skin-to-skin) care and breastfeeding. An eclamptic woman's story.

Kangaroo care (KC), also known as skin-to-skin care, has been described often in the nursing literature for its benefits for both preterm and fullterm infants. In this case study KC was used for a mother in a high-risk situation: eclampsia. This mother gave birth to a 34-week preterm infant, and desired breastfeeding. KC was initiated, and due to the high risk for subsequent seizures, included close observation by these nurses. The mother successfully breastfed, and continued the KC at home.

Adult↗
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Kangaroo skin-to-skin care for premature twins and their adolescent parents.

Risk factors associated with prematurity and adolescent parenting greatly increase when combined with multiple birth. Kangaroo care (KC) for preterm infants is well documented, although KC with twins or with adolescent parents is mentioned only briefly. In this case study, adolescent parents experience KC with their 32-week twin sons beginning 19 hours postbirth. These young parents interacted with, responded to, and took responsibility for their newborn sons, behaviors that are sometimes difficult for adolescent parents. Thus, KC appeared to be an effective intervention for these adolescent parents. Additionally, three kinds of KC with twins were identified: separate, sequential, and shared.

Adolescent↗
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Shared kangaroo care for triplets.

The mother in this case study already had four children at home and was afraid she would be unable to bond to three additional babies. This article describes her experiences with shared kangaroo care (holding all three infants at once), how these experiences relieved her fears, and how kangaroo care was extended by co-bedding the triplets in a single pediatric crib. Clinical nurse specialists and advanced nurse practitioners can use the successful outcome reported here to promote kangaroo care for families with naturally occurring triplets as well as those families whose triplets result from treatment for infertility.

Adaptation, Psychological↗
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Kangaroo (skin-to-skin) care with a postpartum woman who felt depressed.

The mother in this case study had numerous known risk factors for postpartum depression and was in rehabilitation for drug abuse. She was crying at 2 hours postbirth and expressing feelings of sadness as her baby was being unwrapped for her first kangaroo care (KC) experience. Thereafter, during our research protocol, her self-reported depression scores decreased rapidly and had disappeared by 32 hours postbirth. A benefit of KC requiring systematic study is that KC may lessen maternal depression. There is new knowledge that some functions of the maternal HPA axis become dampened during the last trimester of pregnancy as the placenta increases its secretion of corticotrophin-releasing hormone. The sudden loss of the placenta following delivery, accompanied by a suppressed HPA axis, may have an effect on mood during the immediate postpartum period. Perhaps appropriate reactivation of the maternal HPA axis can be triggered following birth by the stimulation inherent in KC, thereby minimizing risk for postpartum depression.

Adaptation, Psychological↗
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Nonnutritive sucking during tube feedings: effect on clinical course in premature infants.

Fifty-nine infants, 28--34 weeks' gestation, were assigned to treatment and control groups. Treatment infants were offered a pacifier during and following every tube feeding; control infants received routine care. The treatment began when an infant could tolerate room air and 10 cc of full-strength formula by tube; it ended when the infant was totally bottle fed. Treated infants showed readiness for bottle feeding 3.4 days earlier, i.e., with 27 fewer tube feedings each. Performance during the first bottle feeding was assessed with a feeding scale and was statistically similar for both groups. From study entry to first bottle feeding the treated infants gained 2.6 gm/day more and were discharged 4 days sooner. Complications differed between the two groups.

Body Weight↗
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Relationship between integrated sucking pressures and first bottle-feeding scores in premature infants.

Reasons for delays in initiating premature infant bottle-feeding and the complications associated with various methods of providing nutrition to premature infants are discussed. A quantitative, correlational study was undertaken to assess premature infants' readiness to bottle-feed. Thirty premature infants, weighing 1,230 to 2,020 g were studied to determine the relationship between integrated sucking pressures and bottle-feeding scores. Sucking pressures were measured with research nipples and an electronic suckometer. Feeding ability was measured using a complex research scale and a simpler clinical scale. Feeding scales correlated significantly (r = 0.79, p less than 0.001) while sucking pressures and feeding scores did not correlate significantly. Study limitations may have been responsible for the lack of a significant correlation between sucking pressures and feeding scores. Further research is needed to establish simple, quantitative safety parameters for beginning oral feedings for premature infants.

Gestational Age↗
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Birth-related fatigue in 34-36-week preterm neonates: rapid recovery with very early kangaroo (skin-to-skin) care.

OBJECTIVE: To test preterm neonates' physiologic and behavioral responses when placed skin-to-skin on their mother's chests, called kangaroo care (KC), for the first 6 hours after birth, instead of having the neonates go to an intensive care unit. DESIGN: Convenience sampling was used in this descriptive study to enroll neonates who were given continuous KC beginning soon after birth in the delivery room and continuing for 6 hours. Heart rate, respiratory rate, oxygen saturation, abdominal temperature, and behavioral state were recorded each minute. SETTING: Data were collected in the delivery room and in a private labor room in tropical Cali, Colombia. PARTICIPANTS: Six 34-36-week preterm neonates with 5-minute APGAR scores of 6 or more were enrolled. Two neonates had grunting respirations before KC was begun. RESULTS: Temperature rose rapidly to thermoneutral range. With few exceptions, heart rate, respiratory rate, and oxygen saturation remained within normal limits; grunting respirations in two neonates disappeared with warmed humidified oxygen and continuous KC. Sleep predominated, and neonates were discharged home by 48 hours being fully breastfed, suggesting that KC was an environment conducive to recovery from fatigue. CONCLUSIONS: These data suggest that KC beginning in the delivery room can be given safely and perhaps with benefit to 34-36-week gestation neonates who appear healthy at birth. Kangaroo care was conducive to recovery from birth-related fatigue.

Body Temperature↗
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Mammalian birth.

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Animals↗