ISSN:0091-2182    

DOI:10.1016/0091-2182(95)00077-1

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0091-2182    

DOI:10.1016/0091-2182(96)88399-6

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACTAs life expectancy increases and members of the postwar generation settle into their fifth decade of life, hormone replacement therapy—estrogen or an estrogen‐progestin combination—has become a major research interest. An extensive, but often confusing and even contradictory, literature exists on the uses of hormone replacement for the treatment and prevention of a multitude of difficulties that may be associated with the perimenopausal and postmenopausal periods. These include hot flushes, vaginal changes, urinary tract changes, changes in sexuality, affective or emotional symptoms, changes in the oral mucosa and skin, loss of memory and Alzheimer's disease, bone loss and osteoporosis, and cardiovascular disease. This article reviews the literature in each of these areas. It also reviews studies relating to possible side effects of hormone therapy, including endometrial cancer, gall bladder disease, and breast cancer. The article outlines principles for practitioners to follow in assisting women to make informed and individualized decisions about this therapy. Part II of this article, which will appear in the May/June 1996 issue of theJournal of Nurse‐Midwifery, will cover specific therapeutic regimens and their management, as well as alternative therapies and preventive m

ISSN:0091-2182    

DOI:10.1016/0091-2182(95)00082-8

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACTHospitalization for childbirth has traditionally provided the opportunity to assure that infants and mothers have adjusted to the birth and that ongoing care has been arranged, but economic and social pressures have resulted in a dramatic decrease in the duration of hospitalization. Using a sample of mothers who delivered well infants from the 1988 nationally representative National Maternal and Infant Health Survey, this study examines how midwives and physicians used an extra day of hospitalization in response to demographic, economic, behavioral, health status, and health care risk factors. Although midwives were much more likely to discharge mothers early (OR = 2.29) there were marked differences between risk factors and discharge timing for midwives and physicians. For the patients of midwives, the only factor associated with early discharge timing was attendance at childbirth classes. For the patients of physicians, less than a high school education, inadequate prenatal care, receipt of Medicaid or lack of insurance, and no childbirth classes were associated with early discharge. In spite of the intense pressures to discharge patients early, midwives appear to have been more attentive to potential risk factors in making discharge decisions in 1988. Because brief hospitalization is now prevalent, attention to maternal and newborn adjustment after birth, as apparently practiced by midwives, is crucial.

ISSN:0091-2182    

DOI:10.1016/0091-2182(95)00070-4

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACTThe way members of an occupation or profession define themselves influences both their interaction with other occupations in the workplace and the future direction of their profession. In order to determine how certified nurse‐midwives define their occupational identity, a two‐phase study was done. In the first phase, 20 nurse‐midwives were interviewed at length. It was found that they used traditional midwifery ideologies of advocacy, normalcy, and competency to differentiate themselves from physicians and nurses. A nationwide survey was then sent to 300 nurse‐midwives in which they were asked whether they identified more with midwifery, nursing, or medicine. Their choice of identity was then examined in light of midwifery, ideologies, situational and background factors, and ability to tolerate ambiguity. The analysis of the survey indicated that nurse‐midwives identify occupationally with midwifery, rather than nursing or medicine, even though there is some alliance with both of the other occupations. The variables that were most predictive of a positive midwifery occupational identity were philosophical agreement with nurse‐midwifery ideologies and increased years of nurse‐midwifery practice. A short discussion of the implications of a midwifery versus a nursing identity conclude

ISSN:0091-2182    

DOI:10.1016/0091-2182(95)00063-1

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACTThis article reviews the history and structure of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). With particular focus on the Licensed Independent Practitioner, it reviews the significant content of the 1996 JCAHO Medical Staff Standards. A plan of action is proposed that supports the development of professional staff bylaws that accurately reflect CNM education and licensure and that provide access to the same system of due process available to physicians and dentists.

ISSN:0091-2182    

DOI:10.1016/0091-2182(95)00081-X

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The Governing Board of the ACNM Division of Accreditation (DOA) has been charged by the ACNM Board of Directors to consider requiring an entry‐level degree for nurse‐midwifery practice. This decision has far‐reaching implications and must be considered with utmost care. The decision will not be based on the issue of clinical competence but rather, the political statement to be made through the imposition of a degree requirement. The author urges the DOA's Governing Board to consider the implications of its action on a variety of audiences, including potential students, potential consumers, other health professionals, current and future employers, our international colleagues, health insurers and managed care organizations, and policymakers and lawm

ISSN:0091-2182    

DOI:10.1016/0091-2182(95)00048-8

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACTNurse‐midwifery students face multiple stressors in their educational experience. Strategies to resolve stress and promote adaptation to the new role are examined and measures used to promote students' adaptation to the educational experience are describe

ISSN:0091-2182    

DOI:10.1016/0091-2182(95)00072-0

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0091-2182    

DOI:10.1016/S0091-2182(96)90236-0

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0091-2182    

DOI:10.1016/S0091-2182(96)90239-6

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY