Role In Attainment Research Articles

Older Japanese primiparas' experiences at the time of their post‐delivery hospital stay

The purpose of this study was to gain a deeper understanding of the postpartum experiences of older primiparas at the time of their postpartum hospital stay. Participants were Japanese primiparas aged 35-44 years who gave birth, without abnormalities for either the mother or child. Data were obtained using a semi-structured interview with 22 participants. Thirteen themes emerged through content analysis. We found that there were distinctive experiences, which included 'the health and growth of the baby: relief and continued anxiety', 'awareness of strengths and of concerns of primiparas', 'meaning of the pregnancy and childbirth experience' and 'developing one's own child-care approach'. Findings suggest that nursing care during the post-delivery hospital stay should use the unique strengths of older primiparas to enable their smooth transition to maternal role attainment.

Tyrėjo subjektyvaus patyrimo episteminė reikšmė lauko tyrimuose

Tyrėjo subjektyvaus patyrimo episteminė reikšmė lauko tyrimuose

Emerging Adulthood: Resilience and Support

Purpose: This article provides an overview of emerging adulthood, recentering, and resilience of youth with disabilities. Emerging adulthood is a developmental period during which individuals experience delays in attainment of adult roles and social expectations. Recentering is a process that emerging adults experience as they make distinct shifts from adolescence to adulthood. Successful recentering is a result of supports, opportunities, and available choices. In addition, resilience is a psychological construct that manifests when positive experiences come out of adverse situations and is a key factor in one’s ability to recenter. This article also provides an overview of identified aspects of resilience within the emerging adulthood framework.Method: A computer search of ERIC and PsycINFO was used to locate studies published between 1990 and 2013. This timeframe was selected because the genesis of emerging adulthood came about in the early 1990s (Arnett, 2006).Results: The authors explored various factors such as social supports, self-determination, agency, adaptation, and coping that are linked to resilience and an emerging adult’s ability to recenter.Conclusions: Important connections with evidence-based practices and considerations for professional development are discussed in assisting consumers who are emerging adults in the recentering process. There is great diversity among individuals’ supports, opportunities, and choices, and there is a need for research investigating emerging adulthood and individuals with disabilities.

A comparative analysis of role attainment and impairment in binge-eating disorder and bulimia nervosa: results from the WHO World Mental Health Surveys.

Background. Cross-national population data from the WHO World Mental Health surveys are used to compare role attainments and role impairments associated with binge-eating disorder (BED) and bulimia nervosa (BN). Methods. Community surveys assessed 23000 adults across 12 countries for BED, BN and ten other DSM-IV mental disorders using the WHO Composite International Diagnostic Interview. Age-of-onset was assessed retrospectively. Ten physical disorders were assessed using standard conditions checklists. Analyses examined reciprocal time-lagged associations of eating disorders (EDs) with education, associations of early-onset (i.e., prior to completing education) EDs with subsequent adult role attainments and cross-sectional associations of current EDs with days of role impairment. Results. BED and BN predicted significantly increased education (females). Student status predicted increased risk of subsequent BED and BN (females). Early-onset BED predicted reduced odds of current (at time of interview) marriage (females) and reduced odds of current employment (males). Early-onset BN predicted increased odds of current work disability (females and males). Current BED and BN were both associated with significantly increased days of role impairment (females and males). Significant BED and BN effects on adult role attainments and impairments were explained by controls for comorbid disorders. Conclusions. Effects of BED on role attainments and impairments are comparable with those of BN. The most plausible interpretation of the fact that these associations are explained by comorbid disorders is that causal effects of EDs are mediated through secondary disorders. Controlled treatment effectiveness studies are needed to trace out long-term effects of BED-BN on secondary disorders.

Key practices of the transition to parenthood: The everyday figuration of parents’ and children’s bodies and personalities through the lens of a new materialist ethnography

At the transition to parenthood humans become parents or children. Sociology traditionally defines the transition to parenthood as the attainment of a new role or a new cultural identity. Recent new materialist redefinitions of the human and human relations have consequences for the empirical and conceptual view on the transition to parenthood. Parents and children become figurations within material-cultural practices. Their bodies and personalities solidify in those processes. Research from this perspective has often focused on the conception and birth of children (and parents) within techno-scientific practices (e.g. IVF). The research presented here focuses on everyday material-cultural practices during the transition to parenthood to explicate how parents and children are produced during the transition to parenthood. This article gives detailed descriptions of four key practices that allow humans to gain the status of parent or child: gaining evidence over an existing pregnancy, the normalization of the foetus and the parents, the sexing of the child and the official registration of the child. These situated practices form ‘real’ parents and children and their living conditions.

State of the Science: Does the Theory of Maternal Role Attainment Apply to African American Motherhood?

This article reviews the current state of knowledge of the theory of maternal role attainment (MRA) and its relevance in describing African American motherhood. EBSCOhost Research Databases that included PubMed, CINAHL plus, MEDLINE, PsycINFO, SCOPUS, and Web of Science were searched for journal articles that examined maternal identity and MRA. Keyword searches included maternal identity, maternal role attainment, becoming a mother, prenatal attachment, maternal-fetal attachment, and maternal-infant attachment. Inclusion criteria for this review were published journal articles of studies conducted in the United States, with a clear delineation of the theoretical framework of MRA. Journal articles that measured MRA among women with depression or medically fragile infants were excluded. Two hundred and twelve studies were reviewed; 25 studies, published between 1975 and 2007, met the inclusion criteria. Nine articles described the theory of MRA, 11 articles measured variables thought to influence MRA, and 6 articles described maternal-fetal attachment, a construct of MRA. Studies were reviewed, categorized, and analyzed to determine current knowledge of how the theory of MRA describes African American motherhood. Categories included studies describing the theoretical framework of maternal identity and MRA, studies measuring key variables thought to impact MRA, and studies measuring maternal-fetal attachment and maternal-infant attachment. The studies were limited by homogenous samples of upper-middle-class white women and low-income, single, African American adolescents. Study results of MRA cannot be generalized to African American women. Further research is essential to identify attributes influencing MRA, specifically among larger samples of African American women with demographics similar to that of the white populations that have been included in studies thus far.

Child Abuse and Neglect, Developmental Role Attainment, and Adult Arrests

This study examines whether developmental role attainment in three areas (high school graduation, employment, and marriage) mediates the relationship between childhood abuse and neglect and adult arrest. Children with documented cases of physical and sexual abuse and neglect (before age 11) and a comparison group of nonabused or neglected children were matched on age, sex, race, and approximate socioeconomic status ( N = 1,169) and followed-up and interviewed at approximate age 29. Arrest records were collected from law enforcement agencies. Childhood abuse and neglect predicted decreased likelihood of graduating from high school, current employment, and current marriage and greater likelihood of juvenile and adult arrest. Each of these developmental roles partially mediated the relationship between childhood abuse and neglect and adult arrest. The importance of these three developmental milestones and implications of the results for intervening with abused and neglected youth are discussed.

Evaluation of the training course for a nursing intervention programme to promote maternal role attainment in pregnant Japanese women who have undergone assisted reproductive technology

This study evaluated the effectiveness of a 2 day training course for a nursing intervention programme to promote maternal role attainment in pregnant Japanese women who have undergone assisted reproductive technology. Participants were 12 Japanese nurses with more than 3 years of clinical experience at reproductive institutions. The effectiveness of the training course was evaluated by assessing the following: (i) understanding of the nursing intervention programme; (ii) attitudes of nurses towards women who are pregnant following assisted reproductive technology; and (iii) self-efficacy for implementing the programme. The training course was effective in increasing basic understanding of the programme and in assisting self-evaluation of the attitudes of participants towards pregnant women. However, acquisition of effective interview skills and changes to make the programme clinically feasible are still needed. Findings suggest that researchers who use this training programme may need to evaluate and include training of nurses in interview skills suitable for their working environments.

Introduction to Journal of Nursing and Human Sciences

Introduction to Journal of Nursing and Human Sciences

Nurse-Led Education Mitigates Maternal Stress and Enhances Knowledge in the NICU

Maternal stress common to the neonatal intensive care unit (NICU) experience often impairs bonding, plays a role in postpartum depression and anxiety, and decreases maternal milk production. This study evaluated the effect of a nurse-led intervention pertaining to the experience of having a baby in the NICU on maternal stress in a population of high-risk pregnant women at three different time points. Using a repeated measures design, 42 pregnant women cared for on the high-risk antenatal unit participated in the educational intervention. Evaluative data pertaining to the intervention included maternal stress and knowledge specific to premature birth and the NICU. Participants answered surveys at three time points: prior to the intervention, immediately following the intervention, and 48 to 72 hours after infant admission to the NICU. Following the intervention, mothers were significantly more knowledgeable about who would be taking care of their baby (p = .008), their baby's body (p = .002), their baby's physical needs (p = .000), and the equipment used in the NICU (p = .001). In addition, participation in the intervention significantly decreased aspects of maternal stress related to the sights and sounds of the NICU (p = .010) and infant behavior and appearance (p = .035). Participation did not significantly influence feelings related to maternal role attainment (p = .165). Nurse-led patient education is an effective intervention strategy when aiming to reduce maternal stress in the NICU. Family-centered interventions tailored to the care of the high-risk mother and infant can improve patient outcomes.

The effects of individual characteristics, socioeconomic status, and political engagement on the attainment of student leadership roles in Chinese university students

This study analyzes the effects of individual characteristics, socioeconomic status, and political engagement among Chinese university students with respect to their attainment of student leadership roles. The study investigated 10,930 students from elite Chinese universities. The results showed that female and only-child students were more likely to become student leaders than male students and students with siblings. Students from local Hukou (household registration) were less likely than students from nonlocal Hukou, to become student leaders. Each upgrade of one level in the membership of the Chinese Communist Party doubled the students’ odds for attaining student leadership roles.

Transition to early parenthood, and family functioning relationships in Japan: a longitudinal study

Greater knowledge of the process by which postpartum parents acquire further awareness of their child and fulfill parental roles will likely lead to an understanding that creates a new approach to nursing. This study explored the transition to parenthood and the relationship between parenthood and family functioning in first-time mothers and fathers. Seventy-eight parents (41 mothers, 37 fathers) participated in the study and completed the Scale of Early Childrearing Parenthood and Family Assessment Inventory at birth and at 1, 3, 6, and 12 months postpartum. The levels of parental role attainment and awareness of the child rose dramatically between birth and 3 months postpartum, thereafter stabilizing up to 12 months postpartum. Parenthood and family functioning showed a moderately positive correlation, which gradually became more positive over time. Appropriate nursing interventions might be necessary for parents who show difficulty in accepting their parental roles and have low levels of awareness of their child after 3 months postpartum. Such intervention might be necessary for not only the parents, but also the family unit.

Developing the Maternity Portfolio to promote maternal role attainment in women who have undergone artificial reproductive treatment

The purpose of this study was to develop the Maternity Portfolio to promote maternal role attainment in women who underwent artificial reproductive treatment. The following procedures were undertaken to develop the Maternity Portfolio: (i) a literature review was conducted to identify studies and articles related to maternal diary or portfolio usage; (ii) the research members discussed objectives and usages of the Maternity Portfolio; (iii) a trial product was developed in collaboration with two pregnant women (one following artificial reproductive treatment and one infertility patient) and seven nurses, and after feedback was completed, the product was revised; and (iv) the final product of the Maternity Portfolio was patented. The final Maternity Portfolio product consisted of a 40-page booklet; it contained an information section and a patient comments section. Following artificial reproductive treatment, this booklet can be provided to women during the first trimester. Women would then be instructed to bring the Maternity Portfolio to their prenatal checkups, where a nursing intervention program would be conducted by certified nurses. Through this program and the Maternity Portfolio, participating women are expected to obtain necessary information and maternal role attainment. The Maternity Portfolio was developed to promote maternal role attainment for women who have undergone artificial reproductive treatment. The intervention study with the Maternity Portfolio is a work in progress; therefore, a future evaluation of the study will clarify both positive and negative aspects, which should facilitate refinement of the functions and qualities of the Maternity Portfolio.

Parent Involvement in Pain Management for NICU Infants: A Randomized Controlled Trial

To demonstrate feasibility and estimate the effect of an intervention to increase parental involvement in infant pain management in the NICU on parents' stress and postdischarge parenting competence and confidence. The study involved a randomized controlled trial. Parents recruited from 4 NICUs were randomly assigned by site to receive (1) a pain information booklet and instruction on infant comforting techniques (n = 84 intervention) in addition to a generic NICU care booklet or (2) the generic NICU care booklet alone (n = 85 control). The primary outcome was postintervention Parent Stressor Scale: NICU (PSS:NICU) scores. Secondary outcomes included parent attitudes about infant pain, nursing pain assessment, and parenting competence and role attainment after discharge. No differences were found between groups in PSS:NICU scores. Significant differences favoring the intervention group were found for satisfaction with pain information, parents shown infant pain cues and comforting techniques, nursing pain assessment, and parent preference for involvement during painful procedures. Role attainment after discharge was higher for the intervention group than for the control group. Both the intervention and control groups highly valued attention to infant pain and wanted information and involvement. These results provide no evidence of a reduction in NICU-related stress for parents who receive an intervention to increase their understanding and involvement in infant pain management. However, parents in the intervention group were better prepared to take an active role in infant pain care and had more positive views about their role attainment in the postdischarge period.

Maternal Identity Development Education on Maternity Role Attainment and My Baby Perception of Primiparas

There are no interventional study results directed at maternal identity development education, including all stages of maternity role attainment, for expectant mothers with healthy babies. This research was conducted to assess the effect of maternal identity development education on the maternity role attainment and my baby perception of primigravidas. The research was carried out by using pretest-posttest quasi-experimental model with control group. A total of 120 mothers and their babies participated in this study. In the collection of the data, Personal Information Form, Semantic Differentation Scale-Myself as Mother and My Baby and the Pharis Self-Confidence Scale were used. It was detected that the training of identification development given for the mothers increased score averages taken from the scales of Myself as Mother, My Baby and the Pharis Self-Confidence Scale; this increase was statistically significant. There was a significant positive correlation between the Pharis Self-Confidence Scale post-test score averages and scales of Myself as Mother and My Baby. Nurses should offer maternal identity development education, support the baby perception process in the early postnatal stages, and help develop the self-confidence of the mother in order for mothers to develop successful motherhood behaviors. Maternal identity development education should be routinely offered to all expectant mothers by specialized nurses, not just to primigravidas. There is a requirement for similar studies to be conducted on broader populations related to the subject.

Exploring the gap: community pharmacists' perceptions of their current role compared with their aspirations

Abstract Objective To investigate community pharmacy managers' perceptions of their role in providing health care to patients and to compare these with their aspirations for the future. Method Fourteen pharmacist managers from one regional area of a UK national multiple pharmacy chain participated in two focus groups. Key findings Participants voiced a shared vision of wanting to play a more integral part in the health care of patients. Strategies put forward to embrace a more participative role included delegation of health screening and minor illness clinics from the prescriber to the pharmacist, having more formalised and open channels of communication with prescribers and moving away from performing technical duties, such as the physical assembly of medicines. Participants in both groups showed awareness that apathy and inaction would result in potential opportunities for pharmacy to be lost or passed over to another profession within the primary health care team (PHCT). Two key external obstacles that currently prevented attainment of desired roles were identified: first, a lack of awareness among other health care professionals and the general public about the pharmacist's skills and attributes and, secondly, current UK legislation that limits the potential for community pharmacists to expand their role away from the pharmacy premises. Conclusions Participants believed that they could provide a more comprehensive pharmaceutical service if given the chance. However, they believed that implementation of change would be difficult considering the obstacles that needed to be surmounted for change to occur.

Maternal role attainment with medically fragile infants: Part 1. measurement and correlates during the first year of life

The purpose of this study was to extend scholarship on maternal role attainment (MRA). We used a triangulation of behavioral and self-report variables to measure MRA-identity, presence, and competence-with mothers of medically fragile infants (n = 81), and explored characteristics that influenced MRA longitudinally. Competence and presence were best measured using both self-report and observational methods, whereas identity was best measured with a questionnaire. Mothers with less worry reported higher levels of identity. Presence was higher with less alert infants, whereas competence was higher with more alert infants, lower parental role stress, higher education, and being married. Mothers with more illness-related distress and less alert infants, and unmarried and less educated mothers may need interventions to enhance MRA.

Maternal role attainment with medically fragile infants: Part 2. relationship to the quality of parenting

We examined which components of maternal role attainment (identity, presence, competence) influenced quality of parenting for 72 medically fragile infants, controlling for maternal education and infant illness severity. Maternal competence was related to responsiveness. Maternal presence and technology dependence were inversely related to participation. Greater competence and maternal education were associated with better normal caregiving. Presence was negatively related although competence was positively related to illness-related caregiving. Mothers with lower competence and more technology dependent children perceived their children as more vulnerable and child cues as more difficult to read. Maternal role attainment influenced parenting quality for these infants more than did child illness severity; thus interventions are needed to help mothers develop their maternal role during hospitalization and after discharge. © 2010 Wiley Periodicals, Inc. Res Nurs Health 34:35-48, 2011.

Preparation of Nurses Who Precept Baccalaureate Nursing Students: A Descriptive Study

Clinical preceptorship is employed by baccalaureate nursing education programs as a capstone experience and a means of initiating the professional socialization of senior-level students who will shortly be new graduates. This quantitative, descriptive study explored the perceptions about preceptor preparation among nurses who precept baccalaureate nursing students. Mercer's Role Attainment Theory was the theoretical framework for this study, in which 75 participants from two hospitals in the Midwest completed a survey. Two key findings emerged from the data: All preceptors of senior-level nursing students want to know what their responsibilities are with regard to the student and the preceptorship experience, and nurses in critical care areas identified learning how to teach critical thinking to senior-level students as more essential than did nurses in other areas.

La comunicazione gestante-feto

- The prenatal origin of the parent-child relationship was proposed in the past century by authors from a psychoanalytical domain affirming the relevance of the parent's affective investment in the unborn baby. Extensive literature focused on psychological processes involved in transition to motherhood like adaptation to pregnancy, maternal role attainment, maternal identity forming and maternal representation of the unborn baby. During pregnancy the woman gradually becomes aware of the foetus as an individual being, increasingly recognizing the separate person. In the last twenty years literature has brought evidence to organized foetal sensory-motor behaviour, auditive competence and foetal learning capability as from the fifth month of gestation. These foetal abilities in turn contribute to the increasing maternal awareness of the foetus which seems to be crucial in establishing the mother's attachment to her unborn baby. Mothers often report interaction with their unborn babies by talking or caressing the baby in the tummy. This early communication is supposed to have an influence on the development of the baby's mind. In the uterus it is particularly easy for the fetus to catch the sonorous or tactile maternal stimulus and consequently the growing nervous system and the developing cortical areas may receive a specific stimulation. Moreover the emotional communication between the mother and foetus has been explored. Animal experimentation and human observational studies have pointed out a relationship between maternal depression or anxiety and the impairment of the fetal nervous system due to the exposition to maternal cortisol. Presence of anxious and depressive symptoms in pregnancy is common and is related to premature birth risk, obstetrical complications, lack in the mother's prenatal care of herself and her baby and persists in a high number of cases in post partum depression. Based on this evidence the consideration of the foetus as a sensible, communicative and vulnerable person becomes very important as well as the promotion of pre and perinatal maternal mental health must be a priority.