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Biomedical subjects

P S Tomlinson

Publications and source records attributed to P S Tomlinson.

18 recordsLinked to original sources
PubMed1996

Family centered intrapartum care: revisiting an old concept.

The historic development of family centered care to the present time is traced, and future development is proposed. A family systems approach can help nurses focus on the family as a unit and on individual members. This requires nurses to develop skills in working with multiple family members, provide care and advocacy for varying and sometimes conflicting family needs, and promote family clarification of their own values and priorities. Such an approach can help intrapartum families add to their experience of coping with stress in a way that builds family cohesion and mutual support.

Child↗
PubMed1996

The influence of illness severity and family resources on maternal uncertainty during critical pediatric hospitalization.

BACKGROUND: Psychological management of parents during a child's critical illness is a challenge to intensive care nurses because of the uncertainty that accompanies hospitalization. OBJECTIVE: To explore the relationship among illness severity, family resources, and maternal uncertainty during the initial stage of a child's hospitalization in a pediatric intensive care unit for a life-threatening illness. METHODS: A convenience sample of 40 mothers rated perceptions of uncertainty (using Mishel's Uncertainty of Illness Scale: Parent Child Form), family cohesion (using Olson's Family Adaptability and Cohesion Evaluation Scale), and social support (using Norbeck's Social Support Questionnaire). Illness severity was estimated with the Pediatric Risk of Mortality Scale. RESULTS: ¿ Results showed a positive association between illness severity and maternal uncertainty and a negative association between family cohesion and maternal uncertainty. Severity of illness contributed less to maternal uncertainty than did family cohesion. CONCLUSIONS: Family relationship are important factors to consider when clinicians estimated the effect on parents of their child's critical illness, particularly when uncertainty over their child's outcome may lead to parental stress that can interfere with coping and child management. (American Journal of Critical Care.)

Adolescent↗
PubMed1993

The relationship of child acuity, maternal responses, nurse attitudes and contextual factors in the bone marrow transplant unit.

PURPOSE: This study was designed to examine the relationships between maternal perceptions of an acutely ill child, nurse caregivers and contextual factors in a pediatric critical care unit. METHODS: Subjects were mothers of 20 children who had had their first bone marrow transplant and the primary nurse of each child. The study was conducted on a bone marrow transplant unit. Variables included the acuity of the child, maternal satisfaction with nursing care, maternal vigilance as measured by the time spent at the child's bedside, nurses' attitudes toward family involvement with care, nursing experience and bone marrow transplant unit variables (census, unit acuity and staffing deficit). RESULTS: Positive associations were observed between the child's acuity and maternal satisfaction with nursing care, and between maternal vigilance and staffing deficit. There was an inverse relationship between maternal vigilance and length of nursing experience of the primary nurse and between positive attitudes of nurses toward family participation and years of nursing experience. CONCLUSION: These results show the complex nature of parental perceptions and involvement in the hospitalized child's care. They suggest that maternal attitudes about caregiving are associated with the child's acuity and that maternal vigilance is related to nursing and environmental factors, principally critical care experience of the primary nurse.

Acute Disease↗
PubMed1992

The family health system as an emerging paradigmatic view for nursing.

This paper explores the phenomena of family health from a nursing perspective by examining the view of health in the discipline of nursing, and the view of family health in multiple disciplines. A holistic definition of family health for nursing is proposed which includes five realms of family experience which make up the family health system. The proposed classification is offered as a beginning heuristic model to organize knowledge generation for use in the practice of family nursing.

Attitude to Health↗
PubMed1992

On the nature of social support for families of critically ill children.

The purpose of this study was to explore the nature of family social support during an acute life-threatening health crisis of a child. A convenience sample of 10 families was obtained from two pediatric intensive care units (PICUs) in a major midwestern metropolitan area. Tape-recorded interviews of parents took place in the hospital 2 to 13 days after admission to the PICU. The Family Crisis Support Interview (FCSI) was developed from existing literature on social support with content selected for specificity to this population. Qualitative analysis was used to reduce verbatim interview transcription data into four major categories with related themes. Results suggest that for these families (a) costs of support received sometimes outweighed the perceived benefits; (b) the benefit of the social network to parents was influenced by its density and level of connectedness; (c) mothers received more network support than fathers; and (d) dyadic cohesion was a central factor in perceptions of overall support. Interpretation of the data include general applications to family nursing management in pediatric critical care.

Adult↗
PubMed1990

Parental uncertainty in critical care hospitalization of children.

The purpose of this qualitative study was to explore the dimensions of uncertainty, including the source, family effect, and parental response, of parents whose child was hospitalized in a pediatric intensive care unit (PICU). A convenience sample of 13 parents of 8 critically ill children served as subjects for this study. Data were collected using a modified grounded theory method with 1 to 1-1/2 hour interviews of parents within 2-4 days after admission of their child to the PICU. A model of PICU uncertainty was derived which identified four areas in which ambiguity, conflicting information, or perceived inefficiency gave rise to uncertainty. These areas included: environmental uncertainty, illness uncertainty, caregiver uncertainty, and family systems uncertainty. Findings are related to Mishel's Theory of Uncertainty (1987) and implications for pediatric nursing research are discussed.

Adult↗
PubMed1986

Applying family stress theory to nursing practice.

Nursing research is increasing its use of theories derived from family sociology and family social science. A number of these theories are helpful in explaining health phenomena and guiding nursing practice in clinical settings wherein the family is an integral part of the intervention. The use of family stress theory in clinical practice is especially relevant in promoting health during normal family transitions, and in assessing family changes during a family member's acute or chronic illness.

Adaptation, Psychological↗
PubMedDate not supplied

Behavioral interaction of fathers with infants and mothers in the immediate postpartum period.

This study describes paternal behaviors of first-time fathers with their partner and newborn immediately after birth and identifies a progression of behaviors with the infant within the first 15 minutes after birth. Videotapes were made of 24 first-time fathers observed at birth a traditional delivery room setting. Utilizing an ethological approach to define behavioral codes, episodes of paternal behavior were measured with time interval sampling. Using a modified frequency method, behaviors were identified in four main categories: proximity, gaze, touch, and movement. The analysis showed that proximity and gaze were high-frequency behaviors and touch and movement were low-frequency behaviors. A progression of behaviors was identified, with gaze starting out high and diminishing, proximity and movement increasing over time, and touch remaining low but constant. Limitations of the setting and implications for clinical practice and research are discussed.

Father-Child Relations↗
PubMedDate not supplied

Identification of nurse-family intervention sites to decrease health-related family boundary ambiguity in PICU.

The most common explanation of parental stress associated with hospitalized children is based on individual stress theory. Using a family stress and family systems approach with an emphasis on examining family integrity, this qualitative study selected families in the Pediatric Intensive Care Unit (PICU) with high boundary ambiguity in the caregiving environment and identified potential sites for nursing actions that impede or assist families in maintaining family integrity. Within three days of admission of their child to a major tertiary children's hospital PICU, 29 families were recruited and screened with a Health-Related Family Boundary Ambiguity Scale. High scoring families (n = 11) were interviewed using an open-ended method. Data were analyzed using a content analysis method, and results were interpreted within a family systems framework. The following three potential areas of intervention to encourage family integrity during acute illness of a child were identified: fostering family normalcy, respecting family rights, and strengthening the family boundary. Implications for initiating or improving family centered care in the PICU are discussed.

Adolescent↗
PubMedDate not supplied

Graduate nursing education: developmental disabilities and special health care needs.

As children and adults with developmental disabilities and special health care needs are integrated into home, school, and community life, nurses are being required to provide leadership, advocacy, and training in community settings to a much greater extent than in the past. To assess the school and community need for formal graduate preparation for nurses who work with individuals with developmental disabilities and/or special health care needs, 25 nurses in leadership positions representing urban and rural health agencies throughout Minnesota took part in a 5-hour focus group discussion. Analysis of data summarized from this process shows five features of the recommended curriculum necessary for advanced practitioners in this specialty area: (a) discipline-specific core competencies, (b) discipline-specific specialty competencies, (c) genetic competencies not specific to nursing but necessary to function in nursing roles, (d) interdisciplinary and intradisciplinary learning experiences, and (e) clinical experiences with preceptors. The authors recommend the development of interdisciplinary graduate programs designed to prepare nurses to assume leadership roles in school health, public health, home health care, and systems management that will affect public policy and, ultimately, promote change in the systems charged with responsibility to serve this population.

Adult↗
PubMedDate not supplied

Children's temperament at 3 months and 6 years old: stability, reliability, and measurement issues.

This study examined the stability of temperament characteristics in children over a 6-year period as well as the reliability of Rothbart's infant and child temperament measures. Thirty-seven mothers rated their firstborns' temperaments using the Infant Behavior Questionnaire (IBQ) at 3 months and the Children's Behavior Questionnaire (CBQ) at 6 years of age. Paired t tests between matched IBQ/CBQ subscales revealed that children were rated significantly higher in all behavioral subscales at 6 years, with the exception of Soothability, which remained stable. Correlations among matched IBQ/CBQ subscales showed significant positive relationships between Soothability and Smiling over the 6-year period. Estimates of internal consistency on three of the six IBQ subscales were lower than Rothbart's reported values, whereas the CBQ values were similar. Findings suggest there was not long-term stability in temperament estimates from early infancy to childhood, except in positive affective response to the environment and rate of recovery from distress and excitement. Measurement issues related to using the IBQ/CBQ, assessing temperament at an early age, maturational effects, and implications for practice are discussed.

Adult↗
PubMedDate not supplied

Qualitative study of women's reports of family adaptation pattern four years following transition to parenthood.

This prospective qualitative study examined patterns of family adaptation over 4 years following the birth of a first child. Data were collected on 16 first-time mothers during their second trimester of pregnancy, at 4 months, 1 year, and 4 years after the birth of the infant. Both standard measures and an intensive semistructured interview were used to assess change in women's perceptions of marital adaptation and role reorganization. Using a case-study method, data were analyzed for patterns of family adaptation. Interview data showed that marital distress and later family disorganization patterns were related, in part, to the changes in the marital system starting during the early transition to parenthood, suggesting that subjects' negative perceptions of marital satisfaction as early as 4 months postbirth forecasted later family adjustment problems. Socioeconomic stress and substance use was associated with the changes for some of these subjects. Alternative interpretations and future directions for study are discussed.

Adaptation, Psychological↗
PubMedDate not supplied

Caregiver mental health and family health outcomes following critical hospitalization of a child.

Changes in caregiver and family health and in family health behavior patterns were examined 9 weeks after the hospitalization of a child for an acute, first-time illness in a pediatric intensive care unit (PICU). Family and caregiver health included reports of physical, mental, role, and social functioning as well as perceptions of health, pain, and changes in health behavior patterns at 3-7 days after admission to PICU and 9 weeks later. A convenience sample of 20 primary caregivers (all mothers) of children aged 2 days to 17 years served as subjects for the study. Results showed a decrease in mental health scores of all subjects over the 9-week period. Further, those caregivers whose child was rated as having a greater potential for chronicity had a significantly greater decline and were in the range of poor mental health at the 9-week posttest. Seventy percent of subjects reported new health problems in the family posthospitalization, and 43% reported at least one change in family health behavior patterns. Implications for testing the efficacy of mental health nursing consultation and case management during and after critical childhood illness are discussed.

Adolescent↗
PubMedDate not supplied

Spousal differences in marital satisfaction during transition to parenthood.

Ninety-six couples were assessed to determine the contributions of sex role attitudes, marital equity, perceived father involvement, and infant temperament to satisfaction during transition to parenthood. Both parents reported a significant decline in marital satisfaction from 3 months prebirth to 3 months postbirth. Mothers' evaluations of their postbirth marital relationships were positively influenced by more nontraditional sex role attitudes and greater father involvement in infant care, and negatively influenced by marital inequity and a more temperamentally active infant. Fathers' postbirth marital satisfaction was more negatively influenced by marital inequity than mothers'. Other factors did not contribute to fathers' marital assessment. Results suggest that a mother's perception of marital satisfaction after parenthood is more complex than a father's, and that equity is a greater consideration for men than for women during the transition to parenthood.

Adult↗