A public health nursing early intervention program for adolescent mothers: Outcomes from pregnancy through 6 weeks postpartum
A public health nursing early intervention program for adolescent mothers: Outcomes from pregnancy through 6 weeks postpartum
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DOI：
10.1097/00006199-200005000-00003
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发表时间：
2000-05-01
期刊：
影响因子：
2.5
通讯作者：
Brecht, ML
中科院分区：
文献类型：
--
作者：
Koniak-Griffin, D;Anderson, NLR;Brecht, ML
背景资料：少女怀孕和养育子女仍然是公众关注的一个主要问题，因为它们影响到母婴健康以及国家的社会和经济福祉。联邦福利改革立法已经创造了一个迫切需要以社区为基础的护理干预计划，以改善健康和社会成果的弱势青少年母亲，并促进其self-sufficient.Objective：为了评估效果的早期干预计划（EIP），使用公共卫生护理模式对健康和社会成果的青少年母亲和他们的孩子和对质量的母子互动。将转诊到县卫生部门的怀孕少女随机分配到实验组（EIP）或对照组（传统公共卫生护理[TPHN]）。样本包括121名主要来自少数民族和贫困背景的青少年，他们从怀孕到产后6周进行了随访。公共卫生护士对EIP中的青少年进行了密集和全面的家访，并开设了母亲准备课程。根据医疗记录数据确定健康结果。其他措施包括产妇自我报告选定的行为，护士访谈，和护理儿童评估教学量表（NCATS）。结果：早期的研究结果表明，减少早产和低出生体重（LBW）率的年轻母亲接受这两种形式的公共卫生护理。两组之间的婴儿出生体重或分娩方式没有显著差异。在出生后的前6周内，EIP组的婴儿与出生相关的住院和再住院总天数显著少于TPHN组（卡方2 = 6.41; p = 0.01）。EIP中的青少年表现出更积极的教育成果（例如，结论：本研究的早期发现表明，怀孕的青少年受益于传统的和更密集的公共卫生护理在产前和围产期的结果。EIP与出生后6周内婴儿发病率的降低和母亲辍学率的降低有关。目前正在评估EIP的长期成果。
Background: Adolescent pregnancy and parenting remain a major public concern because of their impact on maternal-child health and on the social and economic well-being of the nation. Federal welfare reform legislation has created an urgent need for community-based nursing intervention programs to improve health and social outcomes for disadvantaged adolescent mothers and to promote their self-sufficiency.Objective: To evaluate the effects of an early intervention program (EIP) that uses a public health nursing model on health and social outcomes of adolescent mothers and their children and on the quality of mother-child interaction.Methods: Pregnant adolescents referred to a county health department were randomly assigned to an experimental (EIP) or control (traditional public health nursing [TPHN]) group. The sample included 121 adolescents from predominantly minority and impoverished backgrounds who were followed from pregnancy through 6 weeks postpartum. Intense and comprehensive home visitation by public health nurses and preparation for-motherhood classes were provided to adolescents in the EIP. Health outcomes were determined on the basis of medical record data. Other measures included maternal self-report on selected behaviors, nurse interviews, and the Nursing Child Assessment Teaching Scale (NCATS).Results: Early findings indicate reduced premature birth and low-birth-weight (LBW) rates for young mothers receiving both forms of public health nursing care. No significant differences between groups were found for infant birth weight or type of delivery. Infants in the EIP had significantly fewer total days of birth-related hospitalization and rehospitalization than those in the TPHN group during the first 6 weeks of life (chi (2)1 = 6.41; p = 0.01). Adolescents in the EIP demonstrated significantly more positive educational outcomes (e.g., lower school dropout rates) than those in the TPHN group (chi (2)1 = 6.76; p < 0.009).Conclusions:The early findings of this study demonstrate that pregnant adolescents benefit from both traditional and more intense public health nursing care in terms of prenatal and perinatal outcomes. The EIP was associated with decreased infant morbidity during the first 6 weeks of life and decreased maternal school dropout. Long-term outcomes for the EIP are being evaluated.