Community health nurses' perceptions, knowledge, and involvement in abortion services.
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Biomedical subjects
Publications and source records attributed to I Swenson.
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Responses of schools of nursing to physically, mentally, and substance-impaired applicants and matriculating students were assessed in a 12% simple random sample (n = 132) of the 383 baccalaureate and 715 associate degree nursing schools and programs accredited by the National League for Nursing. A self-administered questionnaire concerning experiences, policies, procedures, and factors influencing decision-making was sent to the 132 deans and directors of the nursing schools and programs. Criteria for defining impairments, resources for developing criteria, methods of identifying impairments, actions taken, and individuals involved in the decision were also assessed. While the schools used external resources to guide decision-making, the majority of the responsibility was with the school of nursing faculty and administration. Schools offered a range of options for impaired individuals continuing in the program while under treatment; nevertheless, seeking treatment was a frequent requirement for continuation in the program.
A national sample of community health nurses were surveyed to assess their knowledge of, attitudes toward, and involvement with reproductive health services. Results indicated that slightly more than half of the nurses provided or administered contraceptive services to adolescents, although 73% worked in settings where contraceptive services were provided to adolescents. However, only 3.6% indicated that adolescents were their primary client population. The majority (64.3%) stated that they felt as prepared to work with adolescents as they did with adult clients. While 98% were aware that most adolescents are sexually active before seeking family planning services, a minority correctly answered questions about pregnancy and contraception among adolescents. Ninety-five percent agreed that contraceptives should be available to adolescents, and 90% agreed that parental consent should not be required for adolescents seeking contraceptive services. Yet only 21.5% were aware of the implications of the Adolescent Family Life Act.
Unintended pregnancy is a health problem that is particularly important in the practice of public health nurses (PHNs). Data from 844 PHNs showed that they were likely to practice in settings that incorporate family planning services and were knowledgeable about specific family planning methods. They favored family planning services and an expanded supportive government role in both family planning and abortion. Since PHNs are an important resource for the community activism required to build the consensus needed to expand these services, a multiple-regression analysis was performed to determine predictors of activism. Political participation was the major predictor for activism on both family planning and abortion.
Current concerns about sexually transmitted diseases (STDs) and acquired immunodeficiency syndrome (AIDS), as well as unintended pregnancy, have drawn increasing attention to reproductive health services for men. This report presents information about responses by 844 community health nurses (CHNs) to a self-administered mailed questionnaire that included questions about the extent of the nurses' involvement in delivering or administering family planning services to men, their knowledge and attitudes about men and family planning, and their preparation for working with men. Our sample included CHNs in practice in five states and a sample of CHNs belonging to a national organization of public health nursing, in order to gain information about CHNs in practice in the field and CHNs more likely to be in an educational or administrative position and thus able to influence or to set policy. Two thirds of the nurses surveyed work with men in their reproductive years but only 17.8% delivered or administered family planning services to men (23% of the state sample and 12.5% of the organization sample). Deficits in knowledge about male birth control methods were identified; for example, only 32% knew the use-effectiveness rate of the condom. However, 90% of the CHNs knew the condom has to be put on before any genital contact is made. The CHNs' attitudes were positive; more than 90% said they felt men had equal responsibility with their partners in preventing unwanted pregnancies, using contraception, and contraceptive decision making. Yet, only 9.6% of the CHNs felt men have as much knowledge about contraception as women do. Seventy percent of the nurses felt tha sex education in schools was directed more to female students than to male students. More than 90% said they believed that family planning providers have a responsibility to provide services to men; but two thirds felt that nurses are not as well prepared to work with male as with female clients. Increased educational preparation may improve CHNs' knowledge about men and family planning and enable them to feel professionally prepared to deliver and administer the services they feel are necessary for male as well as female clients. There are 101,430 CHNs in the United States, working in public health departments or other service agencies in almost every community across the country. These CHNs are a major resource for the family planning field.
The prognosis of juvenile rheumatoid arthritis (JRA) is generally good, although premature death occurs in a subset of children. Secondary infections, chronic amyloidosis, and heart disease have been reported as common causes. Our experience indicates that JRA can also herald the development of a severe immune enteropathy. In the case presented, typical JRA was followed by fulminant hepatitis; skin rashes; recurrent, severe, watery diarrhea; malabsorption; and ultimately death. Biopsies of the small bowel exposed to the patient's serum revealed deposition of complement and immunoglobulins in the epithelium. Although not widely appreciated, JRA can herald a multisystem syndrome characterized by severe immune enteropathy.
Researchers and practitioners frequently have criticized educational media's coverage of menstruation as being too oriented toward the "hygienic crisis" while de-emphasizing the emotional and other developmental aspects of puberty. In the present study, 31 audiovisual media currently available for sale/rental were reviewed for content related to the physical and psychological aspects of menstruation, the portrayal of adolescent girls, parents, and peers, and the relationship of menstruation to the developmental process. Seven films were produced by sanitary product manufacturers; 24 by other commercial filmmakers. The majority of the media depicted female anatomy by animated images and related the menstrual process to pubertal development. The relationship between menstruation and reproduction was mentioned in three cases. In general, variations in physical and emotional responses were described as normal. In all cases, fear and embarrassment were acknowledged. Openness in discussions among peers and with female adults was emphasized.
This study compares fertility and menstrual characteristics and contraceptive practices of white, black, and Southeast Asian refugee adolescents participating in the Minneapolis Health Department's Maternal and Infant Care Program between 1980 and 1982. Mean ages were similar among all racial groups; however, half the Hmong adolescents had a live birth as compared to less than 25% of the other racial groups. More than 75% of the Hmong and other Southeast Asian adolescents were married as compared to 11% of the whites and 8% of the blacks. Menarche was significantly later (2 years) for Hmong and other Southeast Asians, and the interval between menarche and first pregnancy was significantly shorter for the Hmong. While more than half of the whites and blacks previously used contraception, 14% of the Hmong and 29% of the other Southeast Asians had used contraception. Oral contraceptives were the most frequently used method for whites, blacks, and Southeast Asians; the Hmong were equally likely to choose oral contraceptives or barrier methods. The Hmong were less likely to choose contraception postpartum than were the other groups.
Education about menstruation is not restricted to school instruction or information provided by adults and peers; exposure to advertisements in teen media provides imagery depicting menstruation and feminine role expectations. This paper analyzes the imagery in advertisements for sanitary products and products for the relief of menstrual symptoms. A 25% random sample of Seventeen magazine issues from 1976 to 1986 stratified by year were reviewed. A total of 135 ads for sanitary products and 32 ads for products for the relief of menstrual discomfort were analyzed. Each ad was examined for recurrent themes in text, context and tone. Data collected were examined for similarities in themes across both product type and time. The ads depict menstruation as a "hygienic crisis" that is best managed by an effective "security system" affording protection and "peace of mind." The failure of adequate protection places the woman at risk for soiling, staining, embarrassment and odor. Menstruating women are depicted as dynamic, energetic and always functioning at their optimal level. Such imagery may encourage guilt and diminished self-esteem in the adolescent who experiences discomfort. A lack of maternal, teacher or male figures in the ads is evident; the importance of peer support is reinforced.
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The study population included 337 adolescents and 876 mothers who delivered live-born, singleton infants in the Maternity and Infant Care Program at the Minneapolis Health Department between 1980-1982. Whites and blacks on the average experienced menarche 1-2 years earlier than the Southeast Asians although age of first pregnancy was 2 years later for the Southeast Asians. In spite of the significantly later ages of entry into prenatal care, lower weight gains, and hematocrits among the Southeast Asians, compared to the white and black populations, overall height-weight status on admission compared favorably with whites and blacks. The virtual absence of alcohol and tobacco consumption among the Southeast Asians may in fact contribute to the generally favorable Apgar scores, length of gestation, and birth weights. The high frequencies of alcohol and tobacco consumption among white adolescents during pregnancy suggest the need for more intervention to discourage smoking in this population. Further, the potential adoption of these substances needs to be discouraged among the Southeast Asian adolescents. While 2-4% of the whites, blacks and Hmong adolescents experienced eclampsia, 1% of the older Hmong mothers and none of the other Southeast Asians experienced eclampsia. The most frequent complication for all groups was perineal laceration.
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Attitudinal changes about research among undergraduate nursing students during their two years in a baccalaureate nursing program showed no significant improvements except for significant improvements in confidence about understanding research terminology methods and evaluating the adequacy of research studies. These improvements were apparent after the course and in the second year when the students were queried again. The overall research attitude score was essentially the same in the senior year as it had been on the pre-test when the students began the program. Although 52.9% of the students indicated they wanted to go on for a master's degree, 6.2% said they definitely wanted to take additional research courses. In the senior year, 31.9% of the students indicated they definitely wanted to go on to graduate school, while 60.4% said they were uncertain; 7.7% indicated they definitely did not want to return to graduate school.
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The purpose of this study was to assess selected correlates of successful smoking cessation among a random sample of 600 professional nurses in North Carolina. A questionnaire utilizing multiple choice and/or Likert responses was mailed to a 1% sample of all active and inactive nurses registered with the N.C. Board of Nursing. Respondents were categorized as former, current, and never smokers. Emphasis on morbidity, mortality, and decreased respiratory function appears to have had the greatest impact on smoking cessation. Approximately half indicated the pressure from family and friends to stop smoking was a reason for their smoking cessation. Recommendations for individual and institutional interventions that will contribute to smoking cessation are identified.
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