Issue 29:4 of The Journal of Perinatal & Neonatal Nursing (JPNN) is a Selected Topics issue for the journal this quarter. A montage of articles, varying in focus, is presented for the reader. This issue precedes the beginning of the 30th Anniversary Year celebration for JPNN! We hope you will join us in our year of celebration!
The Perinatal Section presents 4 articles. Two are research in focus, one is a retrospective clinical outcomes review, and the last is a clinical article.
Cannella and Beckmann discuss factors related to intimidation during oxytocin administration. They developed a cross-sectional, descriptive study whose goal was to identify intimidating communication patterns when nurses manage oxytocin infusions. These communication patterns may adversely affect the care provided to laboring women when this medication for labor induction and augmentation is used.
Parenting stress in immigrant and Taiwanese mothers is explored by Tsao, Creedy, and Gamble. This is a comparative, descriptive cohort study of parenting stress and maternal psychological health, using the Child Care Stress Checklist and the Edinburgh Postpartum Depression Scale. Twenty-six foreign-born Vietnamese and 162 Taiwanese mothers were surveyed at 6 weeks' postpartum.
Roosevelt, Bailey, and Low showcase a retrospective review of nurse midwifery care at a large university health system. They characterize practice trends, outcomes, and changes over a 30-year period for a full-scope midwifery practice.
The article, titled "Lactation and the Substance-Exposed Mother-Infant Dyad," by Jansson and Velez identifies barriers to lactation in substance-exposed mother-infant dyads. The article provides clinical strategies to address these barriers to promote successful lactation in women with substance use disorders who want to breast-feed.
The Perinatal Section also directs the reader's attention to Tillett's column, titled "Gentle Cesarean Delivery," the Legal Issues and Risk Management column, titled "Death and the Pregnant Woman: A True Dilemma," and the Parting Thoughts column, titled "My Perinatal 'Bucket' List."
The neonatal section of this volume of Selected Topics includes articles focusing on the utility of the Score for Neonatal Acute Physiology (SNAP-II) tool for scoring the level of severity of illness, a case study experience of late-onset necrotizing enterocolitis (NEC), and 2 studies focused on pain response and pain management. Dr Susan Blackburn provides a column on Internet resources, and Dr Katherine Gregory's expert column focuses on helping parents survive and thrive in the neonatal intensive care unit (NICU).
The Continuing Education article, by Morse and coauthors, offers a systematic review of research using the revised SNAP, a research and clinical tool for measuring severity of illness in critically ill neonates. The article introduction also provides an excellent overview of the concept of severity of illness and how determining illness severity can contribute to care and potentially reduce morbidity and mortality in the NICU.
Gephart and her coauthors present the story of Joseph, a 24-week surviving twin who developed late-onset NEC. Many neonatal nurses are familiar with the difficult clinical course that NEC can present for neonates and their families. Through clinical and parent perspectives, made possible through Joseph's mother's coauthorship, this article provides an important description of a lived experience and recommendations for how the NICU team can support families whose infants experience NEC, during the NICU stay and in anticipation of long-term consequences.
Heel blood sampling is a common and painful procedure used in neonatal intensive care. Hwang and Seol present their study comparing the effects of using manual and automatic lancets on cerebral oxygenation and pain of heel blood sampling in a group of premature infants with respiratory distress syndrome. The automatic lancets were found to cause less pain and enhanced cerebral oxygenation.
The final article in this volume reports on a qualitative comparative study of nurses' experiences and perceptions regarding parent participation in pain management in neonatal intensive care. Nurses from 7 neonatal units in Finland, Sweden, and the United States participated in focus group interviews. Findings describe a spectrum of responses and themes from nurses controlling pain management, sharing some control with parents, and nurse-parent collaboration, with collaboration being most observed in nurses from Swedish NICUs. The authors conclude that additional research is needed to achieve consistency and evidence-based standards.
-Diane Angelini, EdD, CNM, NEA-BC, FACNM, FAAN
Perinatal Editor
-Susan Bakewell-Sachs, PhD, RN, PNP-BC, FAAN
Neonatal Editor