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Biomedical subjects

J E Van der Zalm

Publications and source records attributed to J E Van der Zalm.

4 recordsLinked to original sources

Seeing baby: women's experience of prenatal ultrasound examination and unexpected fetal diagnosis.

OBJECTIVE: Although prenatal ultrasound (US) is a common clinical undertaking today, little information is available about women's experience of the procedure from the perspective of women themselves. The objective of this study was to explore women's experience of undergoing a routine prenatal US examination associated with an unexpected fetal diagnosis. STUDY DESIGN: Qualitative methods were used to explore the prenatal US experience of 13 women. Five women were given unexpected news of multiple pregnancy and eight women were given unexpected news of congenital fetal abnormality. One in-depth audio-taped interview was conducted with each woman. Content analysis of interview data identified themes common to women's experience of US. RESULTS: Identified themes of women's experience of routine prenatal US examination associated with an unexpected fetal diagnosis are: experiencing the setting, sensing information, feeling connected/disconnected, the power of the image, and communication rules. CONCLUSIONS: Women's experience of prenatal US examination is influenced by physical and environmental factors and by the behaviors of the US examiner. Behaviors of the examiner contribute to a woman's labeling of the US experience as positive or negative. Women identify being objectified by the examination and experience poor communication patterns after a fetal US diagnosis. Women's description of the US screen image as a baby suggests it is a powerful influence on subsequent clinical and ethical decision-making about the pregnancy.

Adult↗

Hermeneutic-phenomenology: providing living knowledge for nursing practice.

The phenomenological approach has gained popularity among nurse researchers as an alternative investigative method to those used in the natural sciences. As more nurse scholars and nurse researchers utilize phenomenology as a research approach, it becomes critical to examine the implications this may have for nursing knowledge development and for the utilization of that knowledge in practice. In this paper, an examination of the results of phenomenological inquiry is presented and compared with the types of knowledge considered important for nursing by Carper and White. It is clear that phenomenology contributes to empirical, moral, aesthetic, personal, and socio-political knowledge development. Its contribution is not in developing predictive and prescriptive theory, but in revealing the nature of human experience. Although interpretive inquiry, such as hermeneutic phenomenology, does not prescribe action for use in clinical practice, it does influence a thoughtful reflective attentive practice by its revealing of the meanings of human experience.

Esthetics↗

Accommodating a twin pregnancy: maternal processes.

The object of this study was to develop a theory of the relationship between a mother and her unborn twins using a qualitative grounded theory methodology. Ten women participated in interviews during the last trimester of a twin pregnancy and again during the early postpartum period. Data provided by these women was analysed using the constant comparative method. Two additional informants were sampled in order to formulate and verify the tentative theory. For women in this study, the findings indicate that mothers from a relationship with their unborn twins within the wider context of accommodating the twin pregnancy in their lives. A woman accomplishes this process by immediately seeking information about twin pregnancy, by making room, in all senses, for two babies instead of one in her life, and by appraising her own pregnancy risk. A mother engages in self-protective behaviors and in behaviors designed to protect the health of her unborn twins as a method of coping with the perceived risk of the twin pregnancy and with the twin pregnancy itself. As the twin pregnancy progresses, women move toward accepting the idea of being pregnant with twins. For women pregnant with twins, the birth of two infants confirms the reality of the pregnancy.

Adaptation, Psychological↗

The perinatal death of a twin. Karla's story of attaching and detaching.

This article examines the attaching and detaching experience of a mother encountering the perinatal death of a twin. Her experience is related to the relevant theoretical and research literature pertaining to prebirth and postbirth maternal-infant attachment and detachment (grieving). Literature for both single infants and twins is considered. The experience of this mother suggests that elements of postbirth attachment may have been accelerated into the prebirth period. In addition, her postbirth attaching and detaching experience suggests that an attachment and detachment to the twins as a unit preceded detachment from the twin who died. The health care provider's role in promoting maternal well-being, and indirectly the well-being of the surviving infant, is described.

Adult↗