Janet A. Deatrick

Understanding Interventions and Outcomes in Mothers of Infants

The first two years after an infants birth is a time of transition for mothers as changes in roles, responsibilities, expectations, and behaviors occur in response to the demands of caring for newborn infants and young children. Mothers play pivotal roles in overall child development and health and may benefit from nursing intervention that assists in the transition to motherhood. A review of the intervention literature related to the promotion of effective mothering was performed in order to examine the range of interventions and evidence of their usefulness for maternal–child and pediatric nursing practice. Five broad categories of interventions appropriate for nursing practice were identified through the literature review. Home visiting, skin-to-skin contact, individual, infant-focused education/counseling, and theory-based group intervention have a specific applicability for the promotion of mothering in particular populations of mothers. Based on the evidence, nurses can incorporate selected strategies into nursing care to promote effective mothering during the first years of a childs life.

The Individual, the Family, and Genetic Testing

Genetics plays a role in every disease, yet few health care providers understand basic genetic principles or the science underlying the genetic testing process. An understanding of the science behind genetic advances is necessary, and it is equally important for health professionals to have an understanding of the complex nature of genetic testing for individuals and their families. Much of the debate about the psychological effects of genetic testing has occurred in the absence of empirical data on diseases for which predictive testing has only recently emerged. This article will review selected literature on genetic testing and its implications for the individual and the family. The responses of families and individuals to the diagnosis of a genetic disease will be reviewed, and Huntington disease will be used as the paradigm for examining issues related to genetic testing for adult-onset cancers. Literature addressing the response to genetic susceptibility for adult-onset cancers and the implications of testing children also will be explored. Finally, identification of emerging issues relevant to genetic screening will provide a framework for identifying needed nursing research in genetic testing for adult-onset cancer risk.

Measuring parental participation: Part II.

The second part of a two-phase clinical research project was undetaken to implement a reliable, valid, and easily administered instrument for measuring parental participation in the care of the hospitalized child. Eleven parental participation activities were identified and validated in the first part of the project through exploratory research with parents of hospitalized children, previous research, and an expert panel. In the second part of the project, which is the focus of this report members of an eight-member task force were used as consultants for development of the instrument and for planning inservices. Two videotaped vignettes of a nurse interviewing a mother during admission of her child to a pediatric orthopedic setting formed the basis of the inservices. The first vignette familiarized the nursing staff (N = 31) with the instrument. The second vignette was used to measure the inter-rater reliabiality of the staff through completion of the instrument after viewing the tape. Eighty percent agr...

Chronic sorrow: A content analysis of parental differences

Sixty-eight mothers and 64 fathers of children with a neural tube defect responded to a questionnaire about chronic sorrow. Mothers reported a mood state change in very intense category from more pessimistic at time of diagnosis to more optimistic at current time. Fathers, although indicating a mood change in the very intense category to more optimistic, also had more pessimistic responses. Parental similarities and differences were also reported in both times and events that triggered the sorrow response. Categories across times and events were primarily related to health care, school/development concerns and social significance. Clinical and research implications of these findings are discussed.

Identifying the Educational Needs of Parents at the Completion of Their Child’s Cancer Therapy

For parents of children with cancer, the experience of completing treatment can be a time of celebration and hope as well as anxiety and fear. Previous research has identified the time immediately following completion of therapy as one of the most difficult and anxiety producing periods in parents’ trajectory of cancer treatment. A gap in knowledge exists to guide nursing practice regarding parents’ educational needs. The purpose of this study was to (a) determine the educational needs of parents as their children completed cancer treatment and (b) assess the feasibility of measuring parental educational needs, anxiety, and family management styles as treatment ends. The results support previous findings that parents are anxious at the end of therapy. Fear of relapse was their primary concern. Although parents desire education at the end of therapy, attention to parental readiness to learn and the individual needs of the patient and family must be considered. In the feasibility portion of this study, parents were able to complete the questionnaires with no negative feedback provided.

Role of the Nurse in Ethically Ambiguous Situations

Faced with concerns such as increasing technological sophistication, quality of life, and allocation of resources, the authors completed a study to describe the pediatric intensive care nurses view of common ethical dilemmas encountered in practice.