Issue 22:4 of the Journal of Perinatal & Neonatal Nursing focuses on a variety of topics in both the perinatal and neonatal sections. In the perinatal section, there are 2 research studies and 2 clinical presentations. The topics cover breast-feeding, postpartum adjustment, first-trimester ultrasound, and womens loss experiences with antiphospholipid syndrome.
Walker explores common breast-feeding issues. Nurses are the first to interact with a breast-feeding mother and are a key resource. Interventions to alleviate common breast-feeding problems that mothers encounter are noted.
Hall and Holden present a research study looking at the impact of psychosocial and demographic factors on symptoms of postpartum depression. Certain variables were found to be associated with postpartum negative thoughts and appraisals. Surveys were collected from 181 mothers with infants aged 0 to 7 months. The results give us pause to relook at the support new mothers receive.
First-trimester tricuspid regurgitation as a screening tool for Down syndrome is reviewed by McGee. Recently, there has been significant interest in first-trimester screening methods. The association between tricuspid regurgitation and aneuploidy fetuses is mentioned. Trends and pitfalls of first trimester screening are examined.
Finally, Mathewet al present a qualitative, phenomenological study looking at womens experiences with perinatal loss associated with antiphospholipid syndrome. Two major themes emerged: existence in bewil-derment and the quest for knowledge and information. Implications for clinical practice are presented.
The neonatal content for this volume includes 4 articles on selected topics highly relevant to neonatal nurses, including involving fathers in the intensive care nursery, infant responses to maternal voice on tape, use of simulation for training transport personnel, and neonatal nurse practitioner role transition. Two of the manuscripts are original nursing research with potential implications for nursing care and role development.
Most nursing practice and research with regard to parents and the intensive care nursery has focused on mothers. Observations of differences between mothers and fathers in terms of how they interact with their preterm infants and experience the neonatal intensive care environment have been documented. Dr Amy Nagorski Johnson presents an overview of the fathers perspective of the neonatal intensive care unit (NICU), identifying potential barriers perceived by fathers and suggesting interventions to support fathers in engaging with their infant and the babys mother in the NICU.
Maternal voice is recognized as a potentially important positive stimulus for newborn infants and for prematurely born newborns in neonatal intensive care, such that tape recorders with parental voices are used in nurseries. Dr Maryann Bozzette reports on her research study that examined behavioral and physiologic responses of premature infants to taped maternal voice. Of particular interest was documenting whether such practice was stressful for the infant. Results of this small study indicate that premature infants are capable of attending to taped maternal voice without adverse effects, as evidenced by stable physiologic status, less overall movement and activity, and more stability cues during exposure to maternal voice than during the baseline period.
Neonatal transport team members must be knowledgeable and skilled to safely and effectively transport critically ill neonates, which necessitates specialized training. LeFlore and Anderson describe and compare 2 educational approaches using high-fidelity simulation and evaluations in training experienced nurses, respiratory therapists, emergency medical technicians, and paramedics involved in neonatal transport. The educational approaches compared were self-paced modular learning and expert-modeled learning. Both methods appeared effective, and participants were satisfied with the use of simulation.
Nurses are familiar with Patricia Benners novice to expert process. Nurses who become advanced practice nurses experience significant role transition that may include moving from being an expert nurse through a period of being a novice advanced practice nurse. Dr. Regina Cusson presents her study on the progression of this transition in 70 neonatal nurses who have become neonatal nurse practitioners (NNPs). Her qualitative study yielded information on helpers and hinderers in the transition process as well as on vulnerability of the novice NNP to harsh criticism and the importance of support, especially from nurse colleagues. The important contribution of NNPs to neonatal critical care and the findings of this research in supporting nurses in achieving successful transition make this knowledge significant.
Diane J. Angelini, EdD, CNM, FACNM, FAAN, NEA-BC, Perinatal Editor
Susan Bakewell-Sachs, PhD, RN, PNP-BC, Neonatal Editor