Laurie N. Gottlieb

Predictors of the duration of exclusive breastfeeding among first‐time mothers

Few women currently meet revised WHO recommendations to breastfeed exclusively for 6 months postpartum. In this prospective study we aimed to determine the influence of socio-demographic, psychosocial, and perinatal factors on the length of exclusive breastfeeding among 189 Canadian primiparous mothers. A majority of the participants did not meet their exclusive breastfeeding goals, and only 5% breastfed exclusively for a full 6 months. Breastfeeding self-efficacy, in-hospital formula supplementation, prenatal class attendance, and type of delivery independently predicted exclusive breastfeeding duration. Findings underscore the complex interplay of factors influencing breastfeeding, highlight the early postpartum weeks as a critical period for the establishment of exclusive breastfeeding, and suggest the need for a continuum of pre- and postnatal strategies for prolonging the exclusive breastfeeding period.

Nursing Approaches for Working With Family Strengths and Resources

In recent years, there has been an increasing interest in shifting the focus of clinical practice with families from a deficit to a strengths-based perspective. The concept of individual and family strengths is a central concept of the McGill Model of Nursing, yet there has been little description of the construct and how it can be used in practice. Through an examination of the practice of expert nurses and the approaches used in the assessment of families’ strengths and resources, planning and intervention were elucidated. This article describes how clinicians can identify and provide feedback concerning strengths, identify resources, and help families develop and call forth strengths, mobilize and use resources, and regulate the input of these resources.

The meaning of time: Mohawk women at midlife

Midlife has emerged as an important developmental transitional point for both men and women. For women, menopause is synonymous with midlife, and consequently, women and health professionals have focused on the losses and problems of this biological event. Few studies to date have placed menopause within the context of other life experiences occurring at this time and in varied cultural groups. Eight Mohawk women, aged 45 to 54 years, were visited in their homes on a weekly or bimonthly basis spanning a 6‐ to 8‐week period. Using a grounded theory approach, the women were encouraged to describe their experiences at this time. The four major issues experienced at midlife related to the concept of time: it is time for me, being where I should be, time for myself, and my time is spent meaningfully. Women fell into two groups. Those “in synchrony”; viewed their lives as following expected time pathways. Those “out of synchrony”; identified aspects of their lives as problematic. Of the four women who were out ...

Strengths-based nursing.

OverviewStrengths-based nursing (SBN) is an approach to care in which eight core values guide nursing action, thereby promoting empowerment, self-efficacy, and hope. In caring for patients and families, the nurse focuses on their inner and outer strengths—that is, on what patients and families do that best helps them deal with problems and minimize deficits. Across all levels of care, from the primary care of healthy patients to the critical care of patients who are unconscious, SBN reaffirms nursings goals of promoting health, facilitating healing, and alleviating suffering by creating environments that work with and bolster patients’ capacities for health and innate mechanisms of healing. In doing so, SBN complements medical care, provides a language that communicates nursings contribution to patient and family health and healing, and empowers the patient and family to gain greater control over their health and healing.

Strengths-Based Nursing: A Process for Implementing a Philosophy Into Practice

Strengths-Based Nursing (SBN) is both a philosophy and value-driven approach that can guide clinicians, educators, manager/leaders, and researchers. SBN is rooted in principles of person/family centered care, empowerment, relational care, and innate health and healing. SBN is family nursing yet not all family nursing models are strengths-based. The challenge is how to translate a philosophy to change practice. In this article, we describe a process of implementation that has organically evolved of a multi-layered and multi-pronged approach that involves patients and families, clinicians, educators, leaders, managers, and researchers as well as key stakeholders including union leaders, opinion leaders, and policy makers from both nursing and other disciplines. There are two phases to the implementation process, namely, Phase 1: pre-commitment/pre-adoption and Phase 2: adoption. Each phase consists of distinct steps with accompanying strategies. These phases occur both sequentially and concurrently. Facilitating factors that enable the implementation process include values which align, readiness to accept SBN, curiosity–courage–commitment on the part of early adopters, a critical mass of early adopters, and making SBN approach both relevant and context specific.