Laura W. Bernaix

The NICU experience of lactation and its relationship to family management style.

Purpose:To describe the impact of having a premature infant hospitalized in the neonatal intensive care unit (NICU) on the parents’ management of the lactation experience. Study Design and Methods:A descriptive study using interviews was conducted with nine couples who had decided to breastfeed, and who were parents of premature infants, 24 to 32 weeks gestation, hospitalized in a large, Midwestern NICU. The family management style conceptual framework guided the study. Qualitative descriptive methods were used to analyze the transcribed data. Results:The situational context of having a premature infant in the NICU was defined as “stressful,” “frightening,” and “difficult,” while the experience of providing breast milk was defined in terms of “altered expectations,” “difficulties,” and “rewards.” These definitions along with the management behaviors of each parent validated three family management-style typologies for lactation in families of premature infants: facilitating, maintaining, and obstructing. Clinical Implications:The family management style of lactation, which can be easily ascertained by interviewing families, may be a useful tool in planning appropriate interventions to promote lactation success.

Hospitalized children's perceptions of nurses and nurse behaviors.

PurposeTo contribute knowledge concerning hospitalized childrens perceptions of nurses and nurse behaviors based on the words of children. Study Design and MethodsThis qualitative study of hospitalized children (n = 65) involved the use of a semi-structured interview guide. Younger children were interviewed by staff nurse researchers; older children provided written responses. Data were analyzed using the reductionistic and constructionistic steps described by Knafl and Webster (1988) to identify themes and compare responses across demographic groups. ResultsSeven themes emerged from the childrens responses. Children appreciated nurses who smiled and used kind words (positive attitude/affect), took measures to reduce pain (physical comfort), provided age-appropriate diversion and light-hearted conversation (entertainment/humor), promoted positive well-being and a sense of security (advocacy), provided food and medicine (basic needs), interacted with them as an individual (acknowledgment), and provided comfort and support (reassurance). Differences were noted by age, chronicity, parental presence, prior admission, and days in the hospital. Clinical ImplicationsNurses caring for children should acknowledge them (with conversation or smiles) with each interaction, provide age-appropriate diversion and friendly interaction, provide basic needs in a gentle manner, and engage in protective and advocacy behaviors, such as frequent stops to assure a childs safety and well-being. Children appreciate a smile, a gentle touch, and kind words. Nurses who care for children should realize their continued need for physical comfort, reassurance, and conversation and know that these children understand and appreciate the advocacy roles nurses assume.

Adolescent Obesity: Current Trends in Identification and Management

Purpose To discuss the prevalence, identification, and clinical manifestations of adolescent obesity for the advanced practice nurse in primary care. Data Sources Selected research and clinical articles. Conclusions Adolescent obesity has been historically attributed to inappropriate diet and exercise; however, recent research also attributes adolescent obesity to genetic factors and metabolic dysfunction. If left untreated, adolescent obesity may result in the metabolic complications of dyslipidemia, hypertension, cardiovascular disease, and early onset of type 2 diabetes. Implications for Practice Practitioners should focus on using the new body mass index (BMI) national guidelines for early identification of obesity. Essential to the management of this condition are education, parental involvement, behavior modification, and psychological support.