Biomedical subjects
M C Freda
Publications and source records attributed to M C Freda.
Now is the time.
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Is that your final answer?
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MCN: 25 years and counting.
The history of the journal MCN, The American Journal of Maternal/Child Nursing, is reviewed in this article, pointing out how the journal began and the changes it has undergone. Statistics concerning types of manuscripts published throughout its 25 year history are presented, and the future plans for the journal are described.
The more things change....
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If given the choice....
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What do pregnant women know about preventing preterm birth?
Approximately 75% of all perinatal mortality is attributable to preterm birth and its sequelae; therefore, the prevention of preterm birth is a major public health priority. In an effort to determine what pregnant women need to be taught about this subject, 211 pregnant women in an inner-city clinic were given a questionnaire to ascertain their basic knowledge about the subject. Among the results were that almost one-half of the women surveyed did not know how many weeks constituted a normal pregnancy and one-third did not know that neonates born preterm could have health problems. The importance of teaching these and other basic facts (which nurses might think are already known by pregnant women) is a notable finding of this research. If perinatal nurses are to effectively teach pregnant women about the prevention of preterm birth, they must target the appropriate facts and build their patients' knowledge base.
What pregnant women want to know: a comparison of client and provider perceptions.
OBJECTIVE: To compare client and health-care provider perceptions concerning health topics. DESIGN: A survey conducted at the first prenatal visit asked women to indicate levels of interest in 38 topics. Providers answered the same survey, indicating perceptions of clients' interests. SETTING: A prenatal clinic and a private office, both in an inner city area. PARTICIPANTS: Two groups of prenatal clients (n = 135 private care and n = 250 public care) and their health-care providers (n = 32 nurses and physicians). RESULTS: Significant differences were found (p < .01 for four topics, p < .05 for six topics) between the clients' interests and the providers' perceptions. Women in private and public care differed significantly (p < .01) in their levels of interest. Interest was significantly affected by parity, but not maternal education. CONCLUSIONS: Nurses and other health professionals should be aware of the range of topics in which clients express interest. This study suggests that site of care and parity should be considered when developing prenatal health education.
Informed consent for maternal serum alpha-fetoprotein screening in an inner city population: how informed is it?
OBJECTIVE: To determine if women who received information from a provider and viewed a videotape about maternal serum alpha-fetoprotein (MSAFP) screening understood enough to sign informed consent. DESIGN: A prospective qualitative design using tape recorded interviews of women who were provided information regarding MSAFP testing from a provider and from viewing a videotape. PARTICIPANTS: Fifty-three inner city pregnant women (58% Hispanic, 39% African-American, 3% white). RESULTS: Two women answered all questions correctly; no one answered all questions incorrectly. Sixty-two percent correctly answered "What is MSAFP?" Sixteen percent thought "something has to be taken from my belly" for the test. Fifty-nine percent understood that children with spina bifida could have difficulty walking or urinary problems. Seventy-two percent thought their infant would be healthy in all respects if the test was negative. Only 45% could describe the follow-up to a positive test. Eighty percent planned to have the test. Many misconceptions were apparent, and for some knowledge items, as many as 80% of the women answered incorrectly. CONCLUSIONS: Obtaining truly informed consent for a complex test is not a simple process. Participants met a few, but not all, of the criteria for informed consent. Women understood that the test was voluntary, but their comprehension of the meaning and implication of a positive test results was deficient. Despite this, they signed the informed consent document. The larger question of just how much comprehension is required to consider a woman "informed" has not been answered.
An effort to upgrade perinatal nursing practice in Albania.
In 1994 the Jacobi Medical Center in Bronx, New York, and the University Hospital in Tirana, Albania, entered into a partnership designed to upgrade certain aspects of the health care system in Albania. During a 2-week trip, an American contingent of nurses and nurse-midwives worked to increase the knowledge base of Albanian nurses about some of the most important issues in perinatal care and of the roles of nurses and nurse-midwives in the United States as patient advocates and educators.
Can precolposcopy education increase knowledge and decrease anxiety?
OBJECTIVE: To investigate the impact of an educational intervention on knowledge and anxiety level of women scheduled for colposcopy after an abnormal Papanicolaou (Pap) test. DESIGN: Experimental, randomized controlled study. SETTING: An inner-city medical school. PARTICIPANTS: The final sample consisted of 58 women in the intervention group and 55 women in the control group. Exclusion criteria included any previous colposcopy. INTERVENTIONS: The women in the intervention group received in the mail, approximately 1 week before their appointment, a one-page handout about colposcopy. The control group received no mailed handout. After arriving for the visit, women were asked to participate in the study and then were interviewed. MAIN OUTCOME MEASURES: Knowledge of reason for visit and knowledge of colposcopy as measured by content analysis of interview; and anxiety as measured by the Spielberger State/Trait Anxiety Inventory. RESULTS: Women in the intervention group demonstrated significantly more knowledge about the reason for their visit and about colposcopy than did the other women. No significant difference in mean anxiety score was found between the groups. CONCLUSIONS: The intervention increased knowledge about colposcopy for this population. Because patient education is an essential nursing function, these results are encouraging. This intervention can be replicated by nurses in other settings. Further research is necessary to understand how nurses can best help women alleviate anxiety before colposcopy.
"I hope I don't have cancer": colposcopy and minority women.
PURPOSE: To determine what women scheduled for colposcopy knew about the procedure and to understand their concerns about the test and its implications. DESIGN: Descriptive, exploratory, qualitative. SAMPLE AND SETTING: All women scheduled for colposcopy in a three-month period (n = 29) in an inner-city academic center in the northeast United States. The sample consisted of African American (66%), Hispanic (31%), and white (3%) women ranging in age from 17-59 years (x = 39 years). METHODS: Women were interviewed on the telephone or in person and were asked seven open-ended questions about why they were referred and what they expected would happen at the appointment. Interviews were content analyzed. FINDINGS: Four themes common to the women's responses emerged from the interview data: fear about their health, apprehension about the colposcopy, uncertainty about the meaning of the Pap test, and pervasive lack of knowledge. CONCLUSIONS: These results suggest that women in this study scheduled for colposcopy had little factual information about the test or its implications, were anxious about the appointment, and wanted more complete information. IMPLICATIONS FOR NURSING PRACTICE: Nurses cannot assume that women understand the reasons for their referral for colposcopy or the implications of the test. These study results imply that lengthened appointment time might be required to provide appropriate education and help alleviate women's anxiety. Future nursing research should examine the effect of anticipatory counselling and education for this group of women.
Should intravenous hydration be the first line of defense with threatened preterm labor? A critical review of the literature.
Because intravenous hydration is a commonly used first clinical effort to reduce preterm labor contractions, this review was initiated to determine whether the literature supports the effectiveness of this clinical strategy. An integrated, critical literature review was done by searching medical, nursing, public health, social, dissertation, and governmental databases to identify the studies relevant to this topic. Literature was chosen for review if it contained (1) objective data on the action of hydration on uterine contractility or (2) data on the clinical syndrome of threatened preterm labor. Research with animals has shown that rapid fluid administration blocks the central release of antidiuretic hormone and oxytocin through blood volume expansion, left atrial distention, and the resulting Henry-Gauer reflex, which thus alters uterine activity. Only four studies have been published that examined the effects of hydration for stopping labor. The effect of hydration was not significantly different from that of bedrest or of tocolytics in any of those studies. In all of them, time appears as an uncontrolled covariant. Although the consequences of hypervolemia might be expected to affect uterine contractions, there is no published evidence that pregnancies have been prolonged through the use of hydration. Hydration has rarely been studied as a single therapy in the prevention of preterm delivery. Caution concerning the use of intravenous hydration is advised by many authors reviewed, because if tocolytic drugs are administered after initial intravenous hydration with large amounts of fluids, the risk for pulmonary edema increases.