Gloria Giarratano

Men of Diverse Cultures: Knowledge and Attitudes About Breastfeeding

OBJECTIVE The purpose of this study was three-fold: (a) to describe the knowledge of and attitudes on breastfeeding of men from diverse racial backgrounds, (b) to determine the relationship between knowledge and attitude toward breastfeeding, and (c) to determine the relationship between specified demographic variables and mens knowledge or attitudes on breastfeeding. DESIGN Descriptive SETTING An inner-city teaching hospital and its associated prenatal clinic located in the southern United States. PARTICIPANTS One hundred men from diverse cultures who spoke either English or Spanish, were 18 years of age or older, and were present at either the hospital maternity units or associated prenatal clinic. RESULTS Eighty-one percent (81%) of the men in this study indicated that they would prefer their infants to be breastfed. Ethnicity and age were found to be linked to attitudes and knowledge of breastfeeding. CONCLUSIONS This study demonstrated that men had a strong desire that their infants be breastfed and wanted to be included in decisions concerning breastfeeding.Objective: The purpose of this study was three-fold: (a) to describe the knowledge of and attitudes on breastfeeding of men from diverse racial backgrounds, (b) to determine the relationship between knowledge and attitude toward breastfeeding, and (c) to determine the relationship between specified demographic variables and mens knowledge or attitudes on breastfeeding. Design: Descriptive Setting: An inner-city teaching hospital and its associated prenatal clinic located in the southern United States. Participants: One hundred men from diverse cultures who spoke either English or Spanish, were 18 years of age or older, and were present at either the hospital maternity units or associated prenatal clinic. Results: Eighty-one percent (81%) of the men in this study indicated that they would prefer their infants to be breastfed. Ethnicity and age were found to be linked to attitudes and knowledge of breastfeeding. Conclusions: This study demonstrated that men had a strong desire that their infants be breastfed and wanted to be included in decisions concerning breastfeeding.

A Multicultural and Multilingual Outreach Program for Cervical and Breast Cancer Screening

Partners in Health: The Breast and Cervical Health Cooperative is a New Orleans-based community health intervention program designed to increase the access of underserved multicultural, multiethnic, and multilingual women to cervical and breast cancer health education and screening. This article describes innovative approaches used over the past 4 years to successfully link the services of a university cancer center to women in the community through a culturally sensitive outreach program. In addition to cancer screening, health referrals were made for many other diverse medical/social complications such as hypertension, obesity, and violence. The program initially targeted African American women but during the past year has successfully integrated Latinas. Key to the programs success was the collaboration of community lay health educators, community churches, advanced practice nurses, and public health programs. This article provides an overview of program strategies and outcomes and discusses multicultural and multilingual issues.

Genetic influences on preterm birth.

This article summarizes the scientific evidence supporting a genetic predisposition to preterm birth (PTB) and current molecular methods used to study the genetic links. Selected candidate genes currently under consideration for study are also discussed.Understanding the etiology and pathophysiology of PTB remains at the forefront of research efforts to solve this critical problem. Awareness of the contributing factors is imperative to the development of prevention and early intervention strategies that can reduce the incidence of PTB and the consequence of long-term neonatal complications. The possibility of a genetic predisposition to preterm delivery is a relatively new area of study to emerge over the past few years, although for a long time it has been suspected that PTB results from gene-environment interactions. More advanced genetic research methods are now being applied to study this hypothesis. A sample of candidate genes under study and their speculated role in PTB are presented in this article. There will be more research that links genetic influences and environmental factors to PTB in future, and researchers are hopeful that genetic knowledge can be applied to better understand the entire spectrum of prematurity.

Post-Katrina Perinatal Mood and the Use of Alternative Therapies

Purpose and Design: The purpose of this cross-sectional, exploratory study is to describe perinatal moods and complementary alternative therapy (CAT) use among childbearing women living in New Orleans, post—Hurricane Katrina. How women coped with the disaster with limited access to mental health services was not known. Method: A convenience sample of 199 postpartal/expectant mothers completed two questionnaires. The Edinburgh Postnatal Depression Scale measured risk for perinatal depression (>10 for depression risk) and the Perinatal Alternative Therapy Index (PATI) obtained subjects’ self-perceived overall scores for anxiety and overall mood, frequency and type of use of alternative therapies, and health behaviors. Open-ended questions solicited qualitative data. Findings: The mean EPDS score was 8.47, yet 37% of the postpartum subjects had scores ≥10, indicating risk for depression, while 25% of the women in the prenatal group had scores ≥10. Ninety-five percent of women reported using CATs to improve their mood during pregnancy. Two themes emerged from the qualitative data: (a) Distress and Instability: The Katrina Effect and (b) Life Transitions. Conclusion: Post-Katrina, most women were proactive in seeking ways to improve their mood. Knowing that there are effective, alternative therapies to improve mood during the perinatal period, nurses and other care providers can offer more information about these nonmedical, accessible interventions.

Targeting Prenatal Emergency Preparedness Through Childbirth Education

The lack of emergency preparedness planning remains problematic for families, but there is a special concern for prenatal women and families. This article proposes childbirth education as one avenue through which nurses can engage families to prepare for a disaster. Template guides and references are included for community-specific emergency preparedness education for childbearing families. Critical issues unique to childbearing women and newborns related to evacuation, sheltering, birthing in place, and mental health are addressed.

Perinatal Considerations in the Hospital Disaster Management Process

ABSTRACT Nurses play a vital role in providing care to mothers and infants during a disaster, yet few are fully prepared for the challenges they will encounter under extreme conditions. The ability to provide the best possible care for families begins with understanding the perinatal issues in relation to each phase of the disaster management process. This article reviews the hospital and perinatal nursing role in the mitigation, preparedness, response, and recovery phases of disaster management.

Experiences of Intimate Partner and Neighborhood Violence and Their Association With Mental Health in Pregnant Women

Both intimate partner violence and neighborhood crime have been associated with worse mental health outcomes, but less is known about cumulative effects. This association was studied in a sample of pregnant women who were enrolled in a study of disaster exposure, prenatal care, and mental and physical health outcomes between 2010 and 2012. Women were interviewed about their exposure to intimate partner violence and perceptions of neighborhood safety, crime, and disorder. Main study outcomes included symptoms of poor mental health; including depression, pregnancy-specific anxiety (PA), and posttraumatic stress disorder (PTSD). Logistic regression was used to examine predictors of mental health with adjustment for confounders. Women who experienced high levels of intimate partner violence and perceived neighborhood violence had increased odds of probable depression in individual models. Weighted high cumulative (intimate partner and neighborhood) experiences of violence were also associated with increased odds of having probable depression when compared with those with low violence. Weighed high cumulative violence was also associated with increased odds of PTSD. This study provides additional evidence that cumulative exposure to violence is associated with poorer mental health in pregnant women.

Association of complementary and alternative therapies with mental health outcomes in pregnant women living in a postdisaster recovery environment

Purpose: The objective of this study was to determine if complementary and alternative medicine therapies are associated with mental health in postdisaster environments. Design: Pregnant women (N = 402) were interviewed between 2010 and 2012 as part of a larger cross-sectional study on hurricane recovery and models of prenatal care. Methods: Symptoms of depression (Edinburgh Postnatal Depression Screen), prenatal anxiety (Revised Prenatal Distress Questionnaire), posttraumatic stress (PCL-S), and perceived stress (PSS) were examined. Logistic regression was used to adjust for income, race, education, parity, and age. The most commonly reported therapies were prayer, music, multivitamins, massage, and aromatherapy. Findings: Mental illness symptoms were common (30.7% had likely depression, 17.4% had anxiety, and 9.0% had posttraumatic stress). Massage was protective for depression (Edinburgh Postnatal Depression Index [EDSI] >8; adjusted odds ratio [aOR] = 0.6, 95% confidence interval [CI] = 0.3-0.9), while use of aromatherapy (aOR = 1.9, 95% CI = 1.1-3.2) and keeping a journal (aOR = 1.9, 95% CI = 1.1-3.2) were associated with increased odds of depression. Aromatherapy was associated with symptoms of pregnancy-related anxiety (aOR = 2.0, 95% CI = 1.1-3.8). Conclusions: Symptoms of mental illness persist after disaster, when untreated. Nurses should consider assessing for complementary and alternative medicine utilization in pregnancy as a potentially protective factor for mental health symptoms.