Search PubMed⌕ Search

Biomedical subjects

J McFarlane

Publications and source records attributed to J McFarlane.

At least 19 recordsLinked to original sources
PubMed1995

Identification of abuse in emergency departments: effectiveness of a two-question screening tool.

OBJECTIVE: A national health objective for the year 2000 is that at least 90% of hospital emergency departments have protocols for routine identification, treatment, and referral for victims of spouse abuse. An effective assessment tool is needed to implement such protocols. METHODS: To test the effectiveness of a two-question, nurse-administered, screening tool to detect physical abuse, 416 black, Hispanic, and white women coming to public and private emergency departments with vaginal bleeding were asked two questions. Additionally, a 14-item Danger Assessment Scale to determine risk factors of homicide was administered to all women. RESULTS: In response to the two-question abuse assessment screen, 38% of the 416 women reported a history of physical or sexual abuse. For 61% of the women, the last episode of abuse occurred within the last 12 months. White women reported significantly more abuse than other ethnic groups (chi 2 = 18.71; df = 2; p = 0.00009). Teenagers reported more risk factors of homicide. DISCUSSION: Abuse to women who seek care in emergency departments is common and easily detected with a straightforward two-question screen. Universal assessment and accompanying information on safety and community resources is essential to interrupt abuse, prevent further trauma and potential homicide, and promote the health and safety of women.

Adolescent↗
PubMed1995

Abuse during pregnancy: frequency, severity, perpetrator, and risk factors of homicide.

To determine the frequency, severity, and perpetrator of abuse during pregnancy as well as the occurrence of risk factors of homicide, a stratified, prospective cohort analysis was completed on 1,203 African-American, Hispanic, and Anglo women in urban public health prenatal clinics. All women were assessed for abuse at the first prenatal visit and twice again during the pregnancy. All women were administered the Conflicts Tactics Scale, the Index of Spouse Abuse and the Danger Assessment Scale. Prevalence of physical abuse during pregnancy was 16%, one in every six women. Women abused during pregnancy had significantly higher scores on all instruments and more risk factors of homicide when compared with women abused prior to but not during pregnancy. To protect women's safety, a protocol of assessment and intervention for abuse must be standard care for all pregnant women.

Adolescent↗
PubMed1992

Assessing for abuse during pregnancy. Severity and frequency of injuries and associated entry into prenatal care.

OBJECTIVE: To assess the occurrence, frequency, and severity of physical abuse during pregnancy and associated initiation of prenatal care. DESIGN: Stratified, prospective cohort analysis. SETTING: Public prenatal clinics in Houston, Tex, and Baltimore, Md. PARTICIPANTS: Total population-based sample of 691 black, Hispanic, and white pregnant women. All of the women were urban residents and most of the Hispanic women were Mexican American. All participants were invited into the study at the first prenatal visit and were followed up until delivery. MAIN OUTCOME MEASURE: Identification of abuse status. RESULTS: A three-question Abuse Assessment Screen detected a 17% (1/6) prevalence of physical or sexual abuse during pregnancy, which is more than double all previous published reports. When evaluated against nationally tested research instruments, the three-question screen that was asked at the first prenatal visit was sensitive and specific to abuse status. Abuse was recurrent, with 60% of abused women reporting two or more episodes of assault. Location of abuse focused on the head. Frequency and severity of abuse and potential danger of homicide was appreciably worse for white women. Abused women were twice as likely as nonabused women to begin prenatal care during the third trimester. CONCLUSIONS: A simple clinical assessment screen completed by the health care provider in a private setting and with the male partner absent is as effective as research instruments in identifying abused women. Straightforward, routine clinical assessment is recommended as essential in preventing potential trauma, interrupting existing abuse, and protecting health.

Adolescent↗
PubMed1991

Feminist theory and nursing: an empowerment model for research.

This article describes the use of the feminist process to empower nurses in conducting research. The criteria for feminist research, defined by Duffy, are applied to a research study that identifies the effects of physical abuse during pregnancy on maternal-infant outcomes. The authors describe the process of empowerment of the investigators through the use of a consortium model of research, the staff nurses who are conducting the interviews, and the research participants (pregnant women). The integration of feminist principles and nursing research is a process that merges similar beliefs and ideologies.

Female↗
PubMed1991

Assessing for abuse: self-report versus nurse interview.

Estimates are that 1.8 million women are physically abused each year by their husbands. To prevent abuse and promote physical safety, routine assessment is essential. Planned Parenthood of Houston and Southeast Texas added four self-reported abuse assessment questions to their standard intake form completed by all initial and annual-visit clients. After one month of self-report by 477 women, the prevalence of physical abuse was 7.3%. To compare self-report to nurse interview assessment, the same four questions were asked of 300 women coming to the same clinic for initial or annual visits. The reported prevalence of abuse after a nurse interview was 29.3%.

Adolescent↗
PubMed1991

De Madres a Madres: a community partnership for health.

To increase the number of Hispanic women who begin early prenatal care, a community partnership for health was initiated among the general public, businesses, 14 volunteer mothers, and one community health nurse. Volunteer mothers living in the targeted community were taught how to identify Hispanic women at risk for not starting early prenatal care, and how to provide social support and community resource information within a culturally acceptable milieu. At the end of the first year of the partnership, over 2000 women at risk for not starting early prenatal care had been contacted by the volunteer mothers.

Community Health Nursing↗
PubMed1991

Preventing abuse during pregnancy: a national educational model for health providers.

The National Preceptorship Program was funded by the March of Dimes and established at Texas Woman's University in Houston to prepare health care providers to assess pregnant women for abuse and to initiate primary intervention strategies. Essential content was identified and a diversity of learner-focused teaching methods and learning strategies were required for the 21-hour program. Combining didactic and experiential strategies proved to be effective. Thirty-nine health care providers from across the country participated in the program. Process evaluation of the classroom and field learning experiences were particularly positive. A 1-year follow-up product evaluation revealed that participants had presented 120 seminars on preventing battering, had instituted assessment for battering in their agencies, and were planning future seminars.

Education, Continuing↗
PubMed1991

Establishing a screening program for abused women.

Estimates are that 1.8 million women are physically abused each year by their husband. Abused women are seen daily in emergency rooms, prenatal clinics, primary care centers, and inpatient units. To prevent abuse and the adverse health and economic consequences, routine assessment is essential. The authors offer a step-by-step plan to establish a successful abuse screening program.

Crisis Intervention↗
PubMed1989

Year 2000 health objectives for the nation.

An historical account for the development of national health objectives is presented, followed by the current process of formulating year 2000 health objectives. Priority areas are included together with suggested strategies for involvement in the process of setting the objectives.

Health Planning↗
PubMed1989

Battering during pregnancy: tip of an iceberg revealed.

Physical abuse of women is pervasive with one in three women experiencing battering. Battering occurs during pregnancy with women reporting blows to the pregnant abdomen, injuries to the breast and genitals, and sexual assault. A recent study in a large metropolitan area documented one in twelve pregnant women to have been physically battered during the present pregnancy. Among the women battered, 87% had been physically abused prior to pregnancy and 29% reported the abuse increased after becoming pregnant. Health care providers did not assess any of the women for abuse. When pregnancy outcome was analyzed in another study of 589 postpartum women, battered women were four times more likely to deliver a low-birthweight infant. This paper discusses the etiology of battering, prevalence of battering during pregnancy and pregnancy outcomes of battered women. A community-wide primary prevention program is presented that has linked the health care provider with law enforcement and shelters for battered women to interrupt the cycle of violence and promote the health and safety of pregnant women.

Adolescent↗
PubMed1989

The prevalence and characteristics of battered women in a primary care setting.

Estimates are that 2 million women are battered each year by their male partner. To prevent battering and promote physical safety, Planned Parenthood of Houston and Southeast Texas added four abuse-assessment questions to the standard intake form for all initial and annual-visit clients. To establish the prevalence of battering, all intake forms completed at four clinics during a one-month period were analyzed. A total of 793 forms were reviewed. The prevalence of physical battering was 8.2 percent. When the characteristics of the battered women were compared with the non-battered, statistically significant differences existed. Information on the health consequences of battering are presented along with suggested assessment questions.

Adolescent↗
PubMed1988

Late Niemann-Pick disease with neurovisceral storage: a classification problem.

A 51 year old man presented in 1969 with slowly progressive cerebellar ataxia of unknown origin. He was admitted to hospital aged 68 after a fall, and a ruptured spleen was removed at laparotomy. Histological analysis of the spleen suggested Niemann-Pick disease, which was subsequently confirmed. He deteriorated and died of bronchopneumonia shortly afterwards: subdural haemorrhage with storage material in neurones was found at necropsy. This late onset case of Niemann-Pick disease with neurovisceral storage is unusual and may represent a variant.

Age Factors↗
PubMed1987

Battered and pregnant: a prevalence study.

We interviewed 290 pregnant women randomly selected from public and private prenatal clinics, 80 per cent of whom were at least five months pregnant (ages 18-43, 42 per cent Latino, 22 per cent Black). Twenty-four women reported physical battering during this pregnancy (44 reported physical battering before the current pregnancy). Eight of the 24 pregnant women had sought medical treatment for injuries sustained; none reported having been assessed by prenatal care providers for abuse.

Adolescent↗