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Biomedical subjects

M S Miles

Publications and source records attributed to M S Miles.

At least 55 records · Page 3Linked to original sources
PubMed1980

The effects of a course on death and grief on nurses' attitudes toward dying patients and death.

The purpose of this study was to measure the effects of a course on death and grief on the attitudes toward death and toward dying patients of nurses who work in high-risk death areas of hospitals. This quasi-experimental design used four groups of subjects. One group experienced the treatment. Another group served as a waiting-list control group and then experienced the treatment. Two groups were control groups. The treatment consisted of attendance at a 6-week continuing education course entitled "Coping with Death and Dying in High-risk Areas of Hospitals." The Death Anxiety Semantic Differential, Parts I and II, was used as the dependent variable. The results indicate that the small-group counseling and education experience did have an impact on attitudes toward death and dying patients of nurses who attended. The discussion of the findings and recommendations for further study are presented.

Attitude to Death↗
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The usefulness of an assessment of emotional involvement of HIV-positive mothers and their infants.

INTRODUCTION: A positive mother-infant relationship is crucial for optimal child development; however, many factors may interfere with the development of a such a relationship. One group at risk for compromised mother-infant interactions is women with HIV infection. The purposes of this study were (a) to examine the usefulness of the Attachment During Stress scale (ADS) for measuring the emotional involvement of HIV-positive mothers with their infants during a clinic visit and (b) to explore the effects of maternal health status, age, parity, and educational level on mother-infant involvement. METHOD: A descriptive, longitudinal study was conducted with 57 primarily African American HIV-positive mothers and their infants who were patients at 1 of 2 regional referral centers. The ADS was completed during the child's physical examination at 3, 6, and 12 months of age, and mothers completed questionnaires during these visits. RESULTS: Maternal age, education level, health status, and parity were not related to maternal emotional involvement. However, the emotional involvement of the mother and infant were correlated (r = 0.73, P < .001). DISCUSSION: These findings suggest that the ADS may be a useful screening tool to supplement the nurse's clinical judgment in a pediatric outpatient setting. The ADS provides some useful information about the emotional involvement of the mother and infant, although it does not provide a comprehensive assessment of their relationship.

Adolescent↗
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Physical and mental health in African American mothers with HIV.

This article examines the physical and mental health of African American mothers during a 2-year period following the birth of an infant seropositive for human immunodeficiency virus (HIV). Participants were 34 African American mothers enrolled when the infants were approximately 3 months of age and reinterviewed when the infants were 6, 12, 18, and 24 months. Three self-report questionnaires were used to assess physical health (perception of health, activity limitation, and physical symptoms) and mental health (depressive symptoms and stigma). Health symptoms most often reported were infections, problems thinking and remembering, low energy, and gynecologic problems. Moderate levels of perceived stigma were reported. Depressive symptoms were high; a large number of women at each data point had depressive symptom scores above the cutoff, indicating risk for depression. There were significant correlations between depressive symptoms and health, suggesting a link between mental and physical health. These findings have significance for the health of the mother and the parenting of her infant. Attention should be paid to the mental and physical health of mothers with HIV, especially during the first 2 years after the birth of a child.

Adolescent↗
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Turning danger into opportunity: teaching psychiatric nursing in the aftermath of a disaster.

In the wake of a devastating flood that destroyed the ecology of a small town, undergraduates taking their first clinical course in psychiatric mental health nursing formed AGAST (Awesome Guerillas Against Situational Trauma) and, with their instructor, performed individual and group crisis intervention over an intensive 90-hour clinical rotation. Three theories were used to help guide the students assessments and interventions with survivors. The clinical experience required innovation, close connection with the host community, and multi-level support from the educational institution. Students rose to the occasion and blossomed in the rich clinical matrix of the experience. The example can be applied to the use of other naturally-occurring events as theaters for innovative clinical teaching.

Crisis Intervention↗
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Distress and growth outcomes in mothers of medically fragile infants.

BACKGROUND: With recent advances in medical and nursing care, many high-risk infants are surviving the neonatal period with severe, life-threatening chronic illnesses, resulting in extended hospitalizations and/or frequent rehospitalizations and long periods of dependence on technology for survival. OBJECTIVE: To describe the factors predicting maternal adjustment in mothers caring for medically fragile infants. METHOD: Subjects were mothers (n = 67) whose infants had a serious life-threatening illness requiring hospitalization and technology for survival. Data for this longitudinal study were collected at enrollment and hospital discharge, and at 6, 12, and 16 months after birth. Distress was measured as depressive symptoms using the Center for Epidemiologic Studies Depression Scale, and growth was assessed using a personal developmental impact rating scale. Data about personal characteristics, parental role attainment, infant-illness characteristics, and maternal illness distress were collected. RESULTS: Mothers of medically fragile infants experience distress and growth as a result of their child's illness. Mean scores on the depression scale at both time points were moderately high and a high percentage of mothers scored at risk for depressive symptoms. Maternal developmental impact ratings at 6 months were neutral to slightly negative and at 16 months were between neutral and positive. While the mean depressive symptom scores and maternal developmental ratings were lower at the later time points, these differences were not significant. Maternal depressive symptoms and developmental impact ratings were moderately but negatively correlated at 6 and 16 months, indicating that higher depressive symptoms were related to more negative developmental impact ratings. Distress was influenced by maternal characteristics, hospital environmental stress, and worry about the child's health. Growth was influenced by characteristics of the child's illness, hospital environmental stress, concern about the child's health, and level of maternal role attainment. CONCLUSIONS: Nurses should consider personal characteristics and level of parental role attainment as well as characteristics of the child and illness-related distress in their approaches to intervention with mothers of critically ill infants.

Adaptation, Psychological↗
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Conflicting responses: the experiences of fathers of infants diagnosed with severe congenital heart disease.

PURPOSE: To explore the experiences of fathers of infants newly diagnosed with severe congenital heart disease. DESIGN: An analysis of qualitative data collected as part of a larger longitudinal study of parenting the medically fragile infant. PARTICIPANTS: Eight fathers whose infants were hospitalized for severe congenital heart disease, were technology dependent at time of enrollment, and were expected to have serious chronic health problems at discharge. DATA COLLECTION MEASURES: Semistructured interviews in the hospital and the home until the child reached 15 months adjusted age. RESULTS: Findings indicate that fathers experience four interrelated conflicting reactions: the joy of seeing the child born and becoming a father, plus the sadness and loss associated with the baby's illness; the challenge of becoming attached while dealing with fears about the infant's vulnerability and potential death; the need to try to maintain control while feeling a loss of control; and the struggle to remain strong for others while hiding their intense emotions. These findings extend the previous limited research about fathers by identifying the unique conflicts fathers of seriously ill infants experience in coping with the child's diagnosis and treatment. Findings have implications for intervening with fathers during the early diagnostic phase of a serious illness, particularly serious congenital heart disease.

Adaptation, Psychological↗
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Spirituality in African-American mothers coping with a seriously ill infant.

ISSUES AND PURPOSE: To describe how African-American mothers' spirituality helped them cope during the time of their infants' hospitalization for a serious illness. DESIGN AND METHODS: Fourteen mothers whose infants were seriously ill in the early months of life were interviewed for this retrospective, descriptive study. RESULTS: The core theme related to prayer. Four mothers reported a strengthened faith, while two mothers continued to have difficulty relating to God or attending church. PRACTICE IMPLICATIONS: These findings support the importance of understanding and respecting the spiritual needs and expressions of spirituality in African-American mothers who are coping with a serious illness in one of their children.

Adaptation, Psychological↗
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Problems of mothers in management of children with diabetes.

This study was designed to determine which aspects of diabetic management were perceived by mothers of children with diabetes to be the most problematic. A secondary purpose was to explore how age and sex of the child, age at diagnosis, illness duration, marital status, and socioeconomic status of the mother were related to the mother's perception of problematic aspects of care. The 84 subjects in this study were asked to complete the Diabetic Management Concern Questionnaire, which measures concern about 11 dimensions of diabetes management, along with a personal-situational information sheet. Results indicated that the three dimensions classified by mothers as most problematic were future concerns, hypoglycemia, and diabetic control. The younger the child, the greater the maternal concern about hypoglycemic reactions and availability of help/support. The younger the child was at diagnosis, the more the mother was concerned with hypoglycemic reactions. A shorter duration of illness was related to concern about insulin injections. Subjects with lower socioeconomic status were concerned about finances, the availability of help/support, and the psychological stigma of diabetes. Single mothers were also concerned about financial aspects of management. There were no differences in concerns between mothers of boys and girls. Implications of the findings for clinical practice are presented.

Adolescent↗
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The search for meaning and its potential for affecting growth in bereaved parents.

Because of the unique relationship between parent and child, the death of a child is a profound human loss which ultimately sends bereaved parents into a deep and painful existential "search for meaning." This search may ultimately be a key factor in a positive "growth" versus a negative "despair" resolution of the grief experience. This paper examines data from open-ended questions collected in three separate studies which asked bereaved parents in various ways to describe themselves. The purpose of this descriptive analysis was to seek clues in these self-descriptions regarding both positive and negative resolutions following the death of a child. Although the findings must be considered with caution because of convenience sample and the indirect methods of data collection, the findings indicate that many of the comments given by the parents suggest potentially positive outcomes.

Adult↗
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Unsafe caregiving practices experienced by 3-year-old children born prematurely.

Unsafe caregiving practices were studied in relation to risk factors for unintentional injuries as reported in the literature. A total of 54 premature children at 3 years of age and their mothers were observed twice in their homes for 2-hour periods, and the HOME Inventory was scored at one of the visits. Field notes from these visits were analyzed for unsafe practices, including hazards in the environment and inadequate parental supervision. Unsafe practices occurred for approximately 30% of the children studied. T-tests indicated that children with no unsafe practices had higher HOME scores than children with unsafe practices. In addition, lower HOME scores and later birth order were correlated with a greater number of unsafe practices. Maternal age and education, family size, child birthweight, and maternal perception of child vulnerability were not related to the presence of unsafe caregiving practices. The findings also suggest that the HOME Inventory may have promise as a useful tool in screening for unsafe caregiving of preschool children.

Adult↗