Contemporary Women’s Adaptation to Motherhood: The First 3 to 6 Weeks Postpartum

A better understanding of the process of adaptation to motherhood should enhance nurses’ ability to prepare women for the transition to motherhood and to provide care following childbirth. Knowledge about women’s adaptation to motherhood was developed primarily from the 1960s to the 1990s. Cesarean birthing was a special focus of research throughout the late 1970s and the 1980s, followed by functional status, and more recently, depression and stress associated with birth and postpartum. Adaptation to motherhood in the context of the early 21st century has received limited attention in nursing research, creating an assumption that the process of adaptation is universal and context-free rather than evolving within the life and societal context of women across generations. Although becoming and being a mother has been described as a normative transition rather than a stressor by some, knowledge development about adaptation to motherhood also has been constrained by the limited use of a unified perspective of transition as a process of adaptation. Therefore, the purposes of this exploratory study were to describe contemporary women’s physical, emotional, functional, and social adaptation to motherhood and to examine the relations of selected demographic and perinatal variables to adaptation to motherhood in the first 3 to 6 weeks of the postpartum

Teaching, Practice, and Research: An Integrative Approach Benefiting Students and Faculty

A project showing the integration of teaching, practice, and research is described. The project involved using information gathered as part of baccalaureate nursing students\u27 assessments of women\u27s perceptions of and responses to cesarean birth to extend a program of nursing research. Benefits to student learning and faculty research programs are identified. The project serves as a prototype for the teaching, practice, and research activities of all students and faculty in nursing and other professional disciplines

Adaptation to Cesarean Birth: Implementation of an International Multisite Study

The purpose of this column is to describe the implementation of an international multisite Roy adaptation model-based study of women’s perceptions of and responses to cesarean birth. The need for the study arose from the concern that women’s childbearing needs may not be met to their full satisfaction, especially if the infant is born by cesarean. Serendipity and networking played a part in the selection of four study sites in the United States (Boston, Milwaukee, Norfolk, Oklahoma City) and two in other countries (Finland, Australia). Data were collected by nursing students and staff nurses. Post-hoc consideration of the diversity of study sites revealed opportunities for examination of the influence of the contextual stimuli of culture and geographic region on the women’s adaptation to cesarean birth. Strategies used to foster integration of teaching, practice, and research are discussed

Women’s Perceptions of Caesarean Birth: A Roy International Study

The purpose of this Roy adaptation model-based multi-site international mixed method study was to examine the relations of type of caesarean birth (unplanned/planned), number of caesarean births (primary/repeat), and preparation for caesarean birth to women’s perceptions of and responses to caesarean birth. The sample included 488 women from the United States (n = 253), Finland (n = 213), and Australia (n = 22). Path analysis revealed direct effects for type of and preparation for caesarean birth on responses to caesarean birth, and an indirect effect for preparation on responses to caesarean birth through perception of birth the experience

Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis

The American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America jointly sponsored the development of this guideline for the treatment of drug-susceptible tuberculosis, which is also endorsed by the European Respiratory Society and the US National Tuberculosis Controllers Association. Representatives from the American Academy of Pediatrics, the Canadian Thoracic Society, the International Union Against Tuberculosis and Lung Disease, and the World Health Organization also participated in the development of the guideline. This guideline provides recommendations on the clinical and public health management of tuberculosis in children and adults in settings in which mycobacterial cultures, molecular and phenotypic drug susceptibility tests, and radiographic studies, among other diagnostic tools, are available on a routine basis. For all recommendations, literature reviews were performed, followed by discussion by an expert committee according to the Grading of Recommendations, Assessment, Development and Evaluation methodology. Given the public health implications of prompt diagnosis and effective management of tuberculosis, empiric multidrug treatment is initiated in almost all situations in which active tuberculosis is suspected. Additional characteristics such as presence of comorbidities, severity of disease, and response to treatment influence management decisions. Specific recommendations on the use of case management strategies (including directly observed therapy), regimen and dosing selection in adults and children (daily vs intermittent), treatment of tuberculosis in the presence of HIV infection (duration of tuberculosis treatment and timing of initiation of antiretroviral therapy), as well as treatment of extrapulmonary disease (central nervous system, pericardial among other sites) are provided. The development of more potent and better-tolerated drug regimens, optimization of drug exposure for the component drugs, optimal management of tuberculosis in special populations, identification of accurate biomarkers of treatment effect, and the assessment of new strategies for implementing regimens in the field remain key priority areas for research. See the full-text online version of the document for detailed discussion of the management of tuberculosis and recommendations for practice