Sherrilyn Coffman

Effects of clarification of support expectations in prenatal couples

The purpose of this study was to test a theoretical model of confirmation of expectations for mutual support after childbirth and to evaluate an intervention given in prenatal classes during which prospective parents clarified their expectations. Results provided support for the proposed model in that parents with greater confirmation of expectations were found to have more positive relationship satisfaction, emotional affect, and parenting attitudes. Differences in men and women emerged that demonstrated that confirmation of support expectations was more important to women, while the level of support actually received was more important to men. The prenatal class intervention did not significantly affect parent outcomes.

Mutual Intentionality: A Theory of Support Processes in Pregnant African American Women

The grounded theory study described in this article explored social support processes in low-income African American women during high-risk pregnancy and early parenthood. Participants included 10 pregnant African American women, 3 close support providers, and 11 health care providers. Investigators served as participant observers and conducted audiotaped interviews. The substantive theory of support that emerged from the data was labeled “mutual intentionality.” This term described the active role that both pregnant woman and support givers played in the helping process. The phrase “being there” summarized the women’s definition of support, implying that the support giver was available and willing to provide help when needed. Support was further described as “caring,”“respecting,”“sharing information” with, “knowing,”“believing in,” and “doing for” the other. For support to happen, mutuality must be established within the relationship, and both support giver and recipient intentionally aim to meet the recipient’s identified needs.

Infant-mother attachment: Relationships to maternal responsiveness and infant temperament

The purpose of this study was to explore the relationships between maternal responsiveness, infant temperament, and infant-mother attachment as measured in Ainsworths Strange Situation. Discriminant analysis revealed that infant temperament was more strongly related to attachment than maternal responsiveness. Infants rated as Anxious-Avoidant in attachment were perceived by their mothers as significantly easier in temperament. Possible explanations for findings and implications for nurses working with infants and parents are discussed.

Children's reactions to disaster

Childrens reactions to disaster are influenced by their developmental stage, as well as by situational, personal, and family factors. This review describes childrens experiences during man-made and natural disasters and uses drawings and narrative to illustrate specific reactions. Mental health outcomes, including post-traumatic stress disorder, are identified, as are approaches to working with children and families after disaster.

Social support and relationship change after childbirth: An expectancy model

Much has been written about social support, but little is known about the processes that promote continuity or discontinuity in supportive relationships. A proposed model of relationship processes (Levitt, 1991) specifies that changes in the quality of close relationships are likely to occur when expectations for social support are tested and disconfirmed. Relationships are particularly vulnerable to change after major life events, such as childbirth, when increased support needs precipitate the testing of expectations. In a preliminary assessment of this model, 43 mothers were interviewed at 1 month and 13 months after birth. Changes in relationship satisfaction were related strongly to the extent to which mothers perceived that their expectations for support had been disconfirmed. The results are consistent with the proposed model and suggest the value of considering the effects of social support in light of the individuals expectancies.

Temperament and Interactive Effects: Mothers and Infants in a Teaching Situation

Temperament is a theoretical concept used to understand individuals behavioral styles. In this study, temperament was measured in 13-month-old infants (N = 51) and their mothers, who were also observed together in a teaching situation. The purpose of the study was to determine the relationships between maternal and infant temperaments and interactive behaviors in the teaching situation. Mothers were given 10 minutes to teach infants four tasks designed to assess qualitative aspects of the interaction. In general, the interaction between mother and infant had a synchronous quality that was influenced by, but largely independent of, the temperamental characteristics of mother and infant. Responsive maternal teaching behaviors were significantly related to positive infant affect during teaching. Weak relationships were found between the temperament variables and interactive behaviors in the teaching situation. When mothers and infants were matched on temperament characteristics, no effects of matching temperaments on interactive behaviors in the teaching situation were found. These findings suggest that mothers are able to adjust their behaviors to compensate for their infants temperament. Based on these data, nurses can focus on the dynamics of the interactions themselves and avoid making judgments based on temperament alone when evaluating mother-infant relationships.

Respite care for families of children with disabilities

The number of children with chronic health problems and resultant disabilities is increasing. Most of the care received by these children is provided by family members, often at severe economic and psychologic cost. One service that has appeared in the past two decades to assist family caregivers is respite services. This article describes the needs for respite identified by family members, the types of respite services available, the benefits of respite care to families, and the essential roles nurses can assume in assuring this essential service is available to families.

Parents’ Perceptions of Needs for Themselves and Their Children in a Cerebral Palsy Clinic

Children with cerebral palsy and their families encounter numerous problems, needs, and concerns that are within the realm of nursing care. This study documents needs perceived by parents as indicated on a questionnaire. Data collection took place in the waiting area of an outpatient cerebral palsy clinic in a large pediatric referral hospital. Questionnaires were administered to a convenience sample of 203 parents over a 6-month period. Parents responded to the statement, “It would help me/my child to talk with a nurse about this.” Parents selected items from a list of 31 possible topics and identified topics of concern to themselves or to their child. As many as 78 percent of parents identified one or more topics for themselves to discuss with a nurse, but only 34 percent of parents identified one or more topics for their child to discuss. A limitation of the study was that no data were collected documenting mental retardation or speech disorders, which could have accounted for the fewer number of topic...

Description of a Nursing Diagnosis: Alteration in Bowel Elimination Related to Neurogenic Bowel in Children with Myelomeningocele

“Alteration in bowel elimination” is a common nursing diagnosis of the child with myelomeningocele. This study aims to identify the critical defining characteristics of the diagnosis. A review of literature cites multiple physical and psychosocial factors which cause and define bowel elimination problems. Most of these characteristics are also identified in the study findings. Data collection involved 33 parents of children with myelomeningocele in an outpatient clinic setting. Information was elicited by interview and by questionnaire regarding types of bowel problems encountered in their children, causes and management of bowel problems, and parent attitudes. Of the 28 children with abnormal bowel functioning, the most frequent bowel problems cited were incontinence (67%), diarrhea (64%), and constipation (61%). Most children had experienced three different bowel problems (33%), followed in frequency by two problems (30%), four or more (15%), one (12%), and none (9%). Specific causes of each problem wer...

Home care of the child and family after near drowning

A significant number of children experience submersion accidents every year in the United States, and many of these children suffer irreversible brain injury as a result. The effects on family members can be overwhelming as they adjust to caring for their disabled child at home. Nurses assist the family in planning for home care and provide direct care in the home. Nursing care is adapted to meet the unique requirements of the home setting. The nurse must be technically competent as well as compassionate to meet the needs of the child and family.