Descriptive Exploratory Study Research Articles

Maternal Decision-making about Social Media after Leaving an Abusive Relationship: an Exploratory Descriptive Case Study of Women in Ontario

Maternal Decision-making about Social Media after Leaving an Abusive Relationship: an Exploratory Descriptive Case Study of Women in Ontario

REPRODUÇÃO ASSISTIDA: DESAFIOS E AVANÇOS DAFERTILIZAÇÃO IN VITRO E INSEMINAÇÃO ARTIFICIAL COM PERSPECTIVAS ATUAIS E FUTURAS

Assisted human reproduction (AHR) is a set of medical techniques that enable human reproduction with assistance, contributing to cases of infertility, advanced age, same-sex couples, independent gestation, and family planning. The main techniques are artificial insemination and in vitro fertilization (IVF). This exploratory-descriptive study investigates the challenges faced by these couples, as well as recent advancements and future perspectives of these techniques. The analysis includes a review of recent literature, focusing on advancements such as improved ovarian stimulation protocols and embryo selection, as well as the impact of emerging technologies. The study also addresses the variable success rates, procedure costs, and ethical issues involved. It is expected that ongoing innovations will improve success rates, reduce risks, and enhance the accessibility of these treatments. Currently, the technique of intracytoplasmic sperm injection (ICSI) is widely used. Despite the challenges, AHR has enabled infertile couples to realize their dream of parenthood. With scientific and technological advancements, it is anticipated that AHR techniques will continue to evolve to benefit more and more couples wishing to have children.

Precision health: Determining the capacity of practicing nurses across the United States.

Precision Health (PH) holds the promise of revolutionizing healthcare by enabling personalized disease prevention and management through the integration of genomic data, lifestyle factors, environmental influences, and other social determinants of health (SDoH). However, the absence of a baseline assessment of knowledge, skills, and attitudes (KSAs) of practicing nurses' capacity for PH hinders its integration. The purpose of this study is to determine the capacity of practicing Registered Nurses (RNs) for PH across the United States and to assess the validity and reliability of a tool designed for this use-the Precision Health Nurse Capacity Scale (PHNCS). A descriptive exploratory study was conducted to evaluate the capacity of practicing RNs for this evolving phenomenon, PH, using a convenience sample. The survey was sent via email and made available to all members of the American Nurses Association (ANA) who work in a variety of practice environments. The ANA represents the over 4 million nurses practicing in the United States. The majority of nurse respondents felt it is important for nurses to become more educated about all aspects of PH including SDoH but they lack confidence in the integration of PH. The PHNCS was found to be a valid and reliable tool in measuring the capacity of nurses to practice PH. The incorporation of PH into nursing practice suffers an immediate impediment: the lack of know-how of the US nursing workforce. This inaugural data on KSAs for PH establishes a logical baseline from which the requisite education and training should commence. Precision Health is an emerging healthcare approach in the United States and globally. Enabling it will require a nursing workforce prepared with the requisite KSAs. Determining the capacity of the nursing workforce is a foundational step to begin this process.

Emotional Suffering After the COVID-19 Pandemic: Grieving the Loss of Family Members in Brazil

(1) Background: Brazil has been severely affected by the COVID-19 pandemic, with over 700,000 deaths and, consequently, a drastic increase in the number of bereaved individuals. This study aims to understand the emotional suffering after the COVID-19 pandemic in Brazilian adults whose family members have died due to COVID-19. (2) Methods: A clinical–qualitative, cross-sectional, descriptive–exploratory study with a sample composed of 10 bereaved family members was used. Data collection took place in July 2021 through individual semi-structured interviews conducted via video call. The interviews were fully transcribed and subjected to thematic analysis. The corpus was analyzed based on Parkes’ theory of mourning, in dialog with research conducted in the pandemic context. (3) Results: The results were organized into three categories: Living the anticipation of loss in an unknown world; Living through grief in a changed world; and Glimpsing a new possibility of living. (4) Conclusions: The rupture of the presumed world in times of the pandemic, the impossibility of bidding farewell to deceased loved ones, and low levels of social support hindered the process of mourning during the health crisis.

Are we preparing healthy & responsible adolescents? Exploratory qualitative study to understand the health and social issues of adolescent living in Karachi, Pakistan.

This study aimed to understand the lives of adolescents living in squatter settlements of Karachi, Pakistan regarding their assigned roles and responsibilities, health and social issues, their decision-making process, and mechanism and channels of information. An exploratory descriptive qualitative study design was employed. Purposive sampling techniques were used to carry out Focus Group Discussions (FGDs) with adolescents (n = 10, Participants = 190), adolescents' parents (n = 10, Participants = 180), and In-Depth Interviews of with key adolescent stakeholders (n = 20). Adolescent stakeholder mapping was conducted for enrolling participants. The data were analysed thematically using deductive and inductive approaches. Based on gender norms parents assign specific roles and responsibilities to adolescent girls and boys. Due to societal norms, communication gap exists between adolescents and their parents. The most popular information channels are social media platforms and friends. Adolescents reported being subjected to a variety of physical, sexual, mental, social, and environmental pressures. Lack of guidance from parents, inadequate knowledge and skills to deal with physical, sexual, mental, social and environmental hazards, and misuse of social media lead to risky decisions, injuries, and social instability. This study underlines the urgent need for targeted interventions for addressing gender issues and improving adolescents' decision-making and life skills. We recommend Behavior Change Communication interventions to dismantle gender stereotypes and support a balanced domestic environment for children's education and well-being, awareness raising among parents, teachers, and healthcare providers about adolescent risks emphasizing their role in youth guidance, and advocacy for youth-led forums to co-create educational content engaging parents, educators, and health professionals focusing on life skills. These strategies would turn demographic transitions into productive dividends.

Exploring Physicians' Perceptions of Digital Health's Impact on the Patient-Physician Relationship in the Primary Health Care Setting: Qualitative Descriptive Study.

Digital health has become essential for effective clinical practice. However, the successful adoption of digital health is dependent on the strength of the patient-physician relationship. The patient-physician relationship shapes the quality of care and impacts health care outcomes, especially in primary care. However, the impact of the increasing use of digital health on the patient-physician relationship is uncertain. This study aims to explore the types of digital health primary care physicians use and understand their impact on the patient-physician relationship from their perspective. This exploratory qualitative descriptive study used individual in-depth interviews guided by a semistructured topic guide. We purposively sampled physicians from 6 general primary care clinics in Singapore and used thematic analysis to identify emergent themes. We conducted 12 interviews. We found that primary care physicians in Singapore had minimal exposure to digital health beyond the scope of institutional implementation. The three key themes that emerged were as follows: (1) evolving roles of both physicians and patients; (2) impact on trust, knowledge acquisition, and longitudinal care; and (3) adoption and use factors of digital health impacting patient-physician relationships. The adoption and use factors comprised "social and personal," "technical and material," and "organization and policy" factors. The study identified that, while primary care physicians held mostly positive views on adopting digital health in improving the patient-physician relationship, they were concerned that digital health might erode trust, hinder proper knowledge acquisition, and reduce humanistic interaction. These concerns called for a nuanced approach to ensure that digital health would not compromise the patient-physician relationship. This could be achieved by ensuring that physicians possess the necessary skills, knowledge, and positive attitude, while health care organizations would provide robust IT capabilities and support. We recommend that education be refined and government policies on digital health adoption and use be revised to align with the goal of strengthening the patient-physician relationship.

Patient expectations and understanding of hospital food service provision when declaring a food allergy.

Food allergies are increasingly common and so hospitals must promptly identify and manage these to maintain patient safety. The present study explored patient understanding and expectations of food allergy management in hospital food services. This exploratory descriptive study used mixed methods, including semi-structured interviews and surveys with hospital inpatients declaring food allergies, aiming to explore understanding, expectations and preferences for food allergy management in the hospital setting. Twenty-four participants were interviewed, reporting between one and six food allergies across 25 different allergens. Three main themes were identified: "Shared responsibility for declaring and managing allergens in hospital", "Varied understanding and trust in hospital food service processes" and "Satisfactory hospital food service experience". In the latter, participants identified 13 key factors valued for hospital food, including appearance, food quality and flavour. Remarkably, being "free from" the food allergen was not amongst the most common factors. Generally, participants felt that declaring a food allergy had not negatively impacted their hospital admission, and overall satisfaction with food services did not differ between the food allergic study participants and the general hospital population. Overall, the declaration of a food allergy did not negatively impact on hospital experience. However, further investigations are required to identify the most valued factors for hospital meals, aiming to enable a more targeted approach to better meet patient expectations.

Peer-to-Peer Human Milk Sharing Through Social Media Groups: The Experiences of Women Donors and Recipients in Hong Kong.

To explore the lived experience of donors and recipients involved in peer-to-peer human milk donation. An exploratory descriptive qualitative study. Semi-structured interviews were conducted between November 2022 and April 2023. A total of 50 women consisting of 34 donors and 16 recipients were recruited using purposive sampling from specific social media groups in Hong Kong that focus on breast milk donation and sharing. Data were analysed based on thematic analysis. Five key themes were identified in this study: Motivation; Milk sharing as a social act; Not a Norm; Recommendation to formal milk banks; and Formal donation as the preferred route. The findings indicate informal milk sharing is seen as an inferior alternative to formal milk donation systems. The establishment of formal milk banks is viewed as a way to address the shortcomings of informal sharing. The findings have implications for the healthcare field, particularly in improving the experiences of those involved in informal milk sharing. The insights gained from the experiences of informal milk sharers can directly inform and enhance the services provided by formal milk banks. Given the growing prevalence of online informal milk sharing, healthcare professionals should enhance their understanding of this practice. However, the practice has remained understudied, particularly in Asian region. This study brings together the experiences of both milk donors and recipients, providing a comprehensive view on the phenomenon. The Standards for Reporting Qualitative Research (SRQR). No patient or public contribution.

Trauma Connect Clinic: Continuing the trauma case management model for patients affected by traumatic injuries: A quality improvement initiative

Background: A case-management model of care is frequently used in acute-care settings for patients with major traumatic injuries; however, its application to trauma follow-up care after hospital discharge remains unclear. Aim: To describe the services provided by the Trauma Connect Clinic (TCC): a NP- led case management model, in trauma follow-up care. Methods: An exploratory descriptive study design was used. Data collected included patient and injury characteristics, clinic activities, attendance rates, referral patterns and complications. Results: Three-hundred and twenty-four TCC appointments were scheduled for 194 patients (n = 302) with an attendance rate of 93% (n = 302). Ongoing health issues included pain (n = 22, 37%), thrombotic events (n = 8, 13%) and infection (n = 7, 12%). Clinic activity included 77 referrals to the wider MDT (n = 77), radiology reviews (n = 225) and 39 prescribing events, consisting mainly of analgesia. Conclusion: A case management model can successfully deliver trauma follow-up care and efficiently use limited resources. Key elements involve careful assessment and management of patients’ physical and emotional needs. Evaluation of longer-term outcomes of this model of care in trauma settings is required.

The place of privacy in the caregiver-caregiver relationship: a descriptive exploratory study

During care, privacy is subject to physical or moral disrespect. This crucial right of the patient is increasingly neglected in the care-giver-patient relationship. However, it is observed that this is linked to soft skills, and that the majority of healthcare professionals have only one objective, which is the mastery of technical skills. The aim of the present study is to explore and describe in depth the place of respect for privacy in the care-giver-patient relationship in the maternity department of a provincial hospital in Casablanca-Settat region, in Morocco.

Spatio-temporal distribution of Dengue, Zika and Chikungunya in Cali, Colombia: 2014-2016

Introduction: Emerging and re-emerging arboviral infections have become a public health challenge in the Americas due to their epidemic potential. Objective: To determine the spatio-temporal distribution of the dengue, Zika, and chikungunya viruses during an epidemic period in Cali, Colombia. Materials and methods: Multi-method descriptive ecological and exploratory study of confirmed and suspected cases reported to the epidemiological surveillance system between 2014 and 2016. Results: 40,168 cases were analyzed, and it was found that dengue was the most frequent arboviral infection (59.2 %). The most affected individuals were women (65 %) and those with a mean age of 34.5 years. Although arboviral infections spread out throughout the city, the three diseases were concentrated in significant groups located at the center-east and northeast areas of Cali (p<0.01; z=-203.7). Conclusions: This study identified critical zones for the three arboviral infections, which are located in areas with low socioeconomic status. Likewise, the results suggest that in addition to eco-epidemiological and bio-psychosocial factors, temperature, precipitation, and the aedic index may play an important role in the spatio-temporal behavior of these diseases. A multidisciplinary and collaborative approach is necessary, which must involve communities and authorities to implement effective control strategies, especially during epidemic periods.

Circumstances leading to home childbirths among women living in Winterveldt, Tshwane Municipality of South Africa.

Childbirth complications, which may include maternal and perinatal mortality are common among women giving birth at home compared to those giving birth at health care facilities. Increasing access to childbirth in health care facilities improves the maternal and perinatal health outcomes for both the mother and child. There are however reported cases of home childbirth and decreasing numbers of health care facilities' births in developing countries. The researchers identified an increase in number of babies born before arrival in several health care facilities and therefore explored this phenomenon in order to understand circumstances leading to this practice. The findings of the study have a potential to inform interventions and strategies to strengthen community health education and engagement on maternal and child health issues. Information gathered through this study will also be important in informing decision making on prioritization of key interventions to incorporate Traditional Birth Attendants (TBAs) services in reproductive health care. An exploratory descriptive qualitative study was used to conduct in-depth interviews amongst women of childbearing age living in a semi urban area of the Tshwane municipality in South Africa. The sample of this study was made of 21 purposively selected women who had experienced home childbirth. Thematic content analysis was used for data analysis. Many women made a choice to give birth at home due to religious and cultural beliefs. However, some women wished to give birth in a health care facility but due to unintentional factors such as lack of transport, failure to identify labour pains, and fast labour; they ended up giving birth at home. Some of the women indicated harsh treatment in health care facilities compared to the pleasant birthing experience at home as reasons for opting for home childbirth.

Student perspectives of simulated learning to improve their dysphagia management

Background: The use of simulation to enhance knowledge translation and bridge the theoretical-clinical gap to enhance clinical training and competency in health professions has received mixed reviews in the literature.Objectives: This research examined student perspectives of a simulation laboratory in speech therapy to improve students’ clinical competency when working with adults with communication and dysphagia impairments.Method: An exploratory descriptive pilot study was conducted in 2022 with 16 third-year speech-language therapy students. This mixed-methods study involved students completing purposefully developed pre-and post-surveys to explore their experiences with simulated teaching and learning and their perceptions of confidence. Data were analysed using an independent t-test. Following the surveys, the students participated in a focus group discussion about their simulation experience, and data were analysed using thematic analysis.Results: Student ratings of clinical skills improved from pre to post-simulation significantly overall and across six out of the eight items. The focus group revealed insights into students’ experiences, highlighting increased confidence, the benefits of making mistakes in a safe environment and improved preparedness to work with dysphagia in patients.Conclusion: While simulation serves as a valuable tool in enhancing clinical skills and building confidence, it must be used as an adjunct to real-life exposure and not as a replacement.Contribution: The integration of both simulated and real-life experiences is essential to provide a comprehensive and practical learning environment for students.

Why do women with early breast cancer in Northern Sri Lanka undergo mastectomy? Decision-making and ways forward

BackgroundDespite robust evidence confirming equivalent survival rates and better cosmetic outcomes with breast-conserving surgery (BCS) and radiotherapy compared to mastectomy, the rates of mastectomy among women with early breast cancer have not declined significantly in Sri Lanka. This study explores views on the surgical treatment of breast cancer among Northern Sri Lankan women who were eligible for BCS but underwent mastectomy.MethodsAn exploratory descriptive qualitative study was carried out among 15 women who underwent mastectomy for early breast cancer. Patients who were referred to the Tellippalai Trail Cancer Hospital for adjuvant therapy after mastectomy and matched the study criteria were recruited. Data were collected through in-depth semi-structured interviews, which were transcribed in Tamil, translated into English, coded using QDA Miner Lite software, and analysed thematically.ResultsNine out of 15 participants were either not aware of breast-conserving surgery (BCS) as a treatment option or their eligibility for BCS at the time of mastectomy. According to participant narratives, the treating team had recommended mastectomy to most participants. While many opted for mastectomy believing that it was associated with lower rates of recurrence and spread compared to BCS, these beliefs were frequently reinforced by the treating team. The pros and cons of the two approaches had not been discussed before surgery with most participants. In the absence of information, family and friends weighed in on the decision to opt for mastectomy, ultimately resulting in feelings of loss and regret in most instances.ConclusionMost participants were not aware that they were eligible for BCS. These information gaps need to be urgently addressed for women to make informed decisions about their health.

Family relationships and environmental factors of children in social vulnerability

This study sought to analyze the dynamics of family relationships and environmental factors in children in situations of social vulnerability and violence served by an educational institution. This is a descriptive-exploratory study, with eight families served by a non-governmental institution located in a municipality in the Southern Region of Brazil. Semi-structured interviews were applied to fathers, mothers and/or guardians for the analysis of the Comprehensive Assessment Synthesis Instruments (ISAC). The results showed averages close to 3.0 (from 1 to 5) in ISAC, which conceives situations in which there are strengths, but also vulnerabilities in families, especially socioeconomic factors. It was also identified difficulty in accessing health services, education, employment and adequate food. Therefore, health promotion actions should be encouraged, seeking to develop a culture of peace, reduce vulnerabilities and strengthen support networks.

An exploratory study of nursing tasks that induce physical and mental stress among hospital nurses

BackgroundNursing tasks are major contributing factors of nurses' stress. Identifying these stress-inducing tasks by hospital and department is the first step in devising practical strategies to address this issue. ObjectivesThis study aimed to develop a nursing task list by categorizing nursing tasks and identifying the ones that induced physical and mental stress among hospital nurses. MethodsThis descriptive exploratory study was conducted. In the first phase, the nursing task list was formulated based on a literature review and an expert content validity verification. In the second phase, the stress-inducing (both physical and mental) nursing tasks in different departments at two types of hospitals were investigated from 775 nurses. The data were analyzed using descriptive statistics, t-test, χ2 test and ANOVA performed using SPSS/WIN 26.0. ResultsThe nursing task of “exercise and position change” was identified to cause the highest physical stress across all five departments in both advanced general hospitals and general hospitals. Similarly, the nursing task “explanation of patients' condition upon request from the patients' family members” induced the greatest mental stress in both advanced general hospitals and general hospitals. Finally, “substitution for physicians: prescription” was identified as the greatest mental stress-inducing nursing task in general hospitals. ConclusionBased on a nursing task list developed, we determined which nursing tasks induce physical and mental stress in different departments at two types of hospitals. This foundational work will be crucial for exploring practical strategies to relieve nurses' stress.

Desired support system to eradicate urban homelessness: an exploratory descriptive study.

Background - The new increasing homeless lately consist of women, children, youth, the elderly and marginalized ethnic or migrant groups. Some of them are working and earn salaries, however, the income is not sufficient to live modestly. Purpose - The purpose of this research is to establish a desired support system to eradicate urban homelessness in the country. Design/methodology/approach - This is an exploratory descriptive method study which employed quantitative techniques. The study employed a social ecological model to investigate behavior of homeless via multiple levels of influences including intrapersonal, interpersonal, organizational, community and public policy. Surveys have been conducted on sixty-five homeless individuals. Findings - It was found that support systems and structures should be derived from the whole streams from families, communities, organizations and government. Employment opportunities, long-term shelters within the community places and highly demanded skills are needed to improve their living condition. Research limitations - This study is only focused on the socio-economic structures of the homeless in a capital city. Originality/value - This is an empirical research using a social ecological model for the homeless in the Kuala Lumpur area. Research on homeless study has received little attention and has yet to be fully explored.

Caregivers’ experiences on preterm infants’ management in a tertiary care facility in Ghana: a qualitative exploratory study

BackgroundPreterm birth is a process that fundamentally alters parental or caregiver roles, particularly in the early weeks of childbirth. Caregiver experiences can be distressing due to struggles with an unfamiliar and potentially threatening environment of the Neonatal Intensive Care Unit (NICU). These experiences can affect the development of parenting or caregiving roles to a greater extent. Supporting caregivers of preterm infants through education and information sharing can significantly improve neonatal outcomes. This study sought to explore the experiences of caregivers with hospitalized preterm infants regarding the education and information they received from healthcare workers on the care of preterm infants.MethodAn exploratory descriptive qualitative study that explored caregivers’ experiences with the management of preterm infants hospitalized at the Level III Neonatal Intensive Care Unit (NICU) of a tertiary level facility with an annual delivery of almost 7500 and a bed capacity of 26. The study utilized a deductive approach and a purposive sampling technique to recruit 16 caregivers who participated in an in-depth interview using a piloted semi-structured interview guide. The interviews were audio-recorded, transcribed, and analyzed using thematic analysis.FindingsThe study identified three major themes, which were (1) preterm infant feeding and keeping infants warm, (2) routine procedures and activities at the NICU, and (3) preparation towards homecare after discharge. Seven (7) sub-themes were generated. Caregivers were satisfied with the education and information they received on infant feeding and keeping the infant ward. They also had adequate education that prepared them for home care of the preterm infant. Caregivers did not receive timely information and education on the health status of their infants and the care processes of the NICU. They felt they were left out as they were not involved in decision-making. Regarding the care of the preterm infant. The inadequate flow of information and use of medical terminologies were a great source of worry and frustration for participants. The study showed that although the NICU staff were willing to offer health education to caregivers, information giving and education were not structured and hence did not address all the needs of the caregivers.ConclusionHealthcare providers caring for preterm infants include caregiver education in their routine NICU activities and procedures. These processes start from the period of admission till discharge. Their education sessions primarily focus on breastfeeding, keeping the infant warm and adequate preparation of caregivers for preterm infant home care. This notwithstanding there are gaps in caregiver education and information on routine procedures in the NICU as well as information on the health needs of the infant. Participants are not fully involved in the decision-making processes and the use of medical terminologies compound caregivers’ frustrations and anxieties. It is important to develop structured educational programs tailored to address the information needs faced by caregivers to ensure optimal health outcomes for their preterm infants.

Exploring the role of the Recovery College model as a transformative tool for recovery-oriented practice: perceived benefits and perspectives from health practitioners in Quebec, Canada.

Mental health practitioners (MHPs), including occupational therapists (OTs), need support to adopt a truly recovery-oriented practice. Like other practitioners, if OTs often embrace the principles of recovery as a philosophical foundation for their practice, these principles may not always reflect in their attitudes, behaviors or in their interventions. While further research is needed to demonstrate the positive effects of recovery-oriented training programs on MHPs' attitudes and practice, there is a need to explore novel training programs. The Recovery College (RC) model is one of the interventions that are designed to facilitate these changes in practice, through co-production and co-delivery of recovery-focused courses curriculum. Although the perceived benefits and outcomes of RC courses are widely documented, very few studies focus specifically on what MHPs gain from them or on their global experience. The aim of this article is to describe the experience of MHPs learners in RC courses and the perceived benefits on their practice. An exploratory descriptive qualitative study was conducted. Data were collected through semi-structured interviews and analyzed using Miles and Huberman's stepwise qualitative analysis method. Participants were 13 MHPs working in community organizations or healthcare institutions and who participated as learners in a RC, in the province of Quebec, Canada. Ten themes emerged from the qualitative analysis. Participants expressed their perspectives on the format of the courses, their initial expectations and their recommendations. They also identified the types of knowledge they shared during the courses. Participants reported changes in their practice, raised awareness on their clinical and personal issues, improved well-being and recovery. Group composition, interactions within the group, complementarity of the different types of knowledge, and pedagogical design and learning activities were identified as key ingredients of RC. This study highlighted RCs' role in enriching MHPs clinically and personally. RC curriculum and courses drive changes in practice and attitudes towards service users. RCs may assist MHPs reflect on practice and improve their clinical reasoning. This study advances understanding of a promising, accessible training program for adopting a recovery-oriented practice amid a paradigm shift among MHPs and OTs.

Perceptions of primigravida and their husbands regarding the need for maternal-fetal attachment stimulation

Prenatal class programs for primigravidas are important to improve fetal care behavior and reduce infant mortality. In prenatal classes, there is no maternal-fetal attachment stimulation education program which is important for improving maternal-fetal attachment and fetal well-being. The perceptions of pregnant women and their husbands regarding knowledge and experience of pregnancy as well as maternal-fetal attachment (MFA) stimulation are important for assessing the need for MFA educational materials. The research aimed to examine the perceptions of primigravidas and their husbands regarding pregnancy and MFA stimulation. Exploratory descriptive qualitative study method. Data were collected using in-depth interviews with 10 primigravidas and their husbands at the Community Health Center in Bantul, Yogyakarta, Indonesia, using an interview guide. Data analysis by condensing data, presenting data, and drawing conclusions, verbatim results of interviews are presented in coding, found categories, and themes. Four themes were produced: knowledge of pregnancy and fetal growth and development; concept of maternal-fetal attachment skills; management of pregnancy emotional management; and husband's support. The conclusion of this theme's findings underlies the development of maternal-fetal attachment educational materials in prenatal classes to prepare mothers for their role, and improve MFA and maternal-fetal health.