Health assessment in high-risk pregnancies

Kemp, Virginia H.; Pond, Elizabeth

doi:10.1097/00003727-198602000-00004

Cited by 3 publications

(5 citation statements)

References 8 publications

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“…A final process issue is the tool used to screen for highrisk pregnancy, an issue debated in the literature. Many question the effectiveness of the tools and criteria used (Main, Richardson, Gabbe, Strong, & Weller, 1987;Mawn & Bradley, 1993;Thomas, Homer, McCaleb, & Shepherd, 1991;Wall, 1988); others suggest nonmedical risk factors as being significant predictors of risk (Bennett & Botti, 1989;Hays, Kroeger, Tachenko-Achord, & Peters, 1995;Kemp & Pond, 1986;Sherwen & Mele, 1986;Work, 1994), and some question the ethics of labeling a woman "at risk" given the inaccuracy of the screening tools (Kemp & Pond, 1986;Murphy, 1994). On the assumption there is benefit in identifying high-risk pregnancy, it is hard to disagree with Goodwin (1 994) that some women are clearly at high risk and some are clearly not at risk, it is with the large majority of pregnant women in the middle of the bell curve, where the degree of risk is questionable, that there is a need for an accurate predictor of risk.…”

Section: Discussionmentioning

confidence: 99%

Staff Evaluation of a High‐Risk Pregnancy Program

Mackey

Sobral

1997

Public Health Nursing

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A southeastern state implemented a multidisciplinary health care program for Medicaid eligible, medically high-risk pregnant women and their infants as part of a statewide effort to reduce perinatal morbidity and mortality. The purpose of this study was to obtain the staff's evaluation of this high-risk-pregnancy program. Clinical, supervisory, and clerical staff (N = 182) completed a questionnaire about the operation of the program and its perceived benefits. Staff identified program strengths: nurse case management, interdisciplinary structure, quality care, and positive health outcomes. Staff also identified program limitations including limited staff and time, inflexible protocols, administrative tasks, and narrow enrollment criteria. The majority of staff reported that the following barriers interfered with the effective operation of the program: paperwork, limited support, time, difficulty locating patients, and mandated time frames for patient contact. The majority of staff also reported that transportation most interfered with patient access to the program. The findings of this study support the need for ongoing staff evaluation of all perinatal health care programs.

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Section: Discussionmentioning

confidence: 99%

Staff Evaluation of a High‐Risk Pregnancy Program

Mackey

Sobral

1997

Public Health Nursing

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“…Physician assessment of the pregnant women has focused on biomedical risk, the legitimate domain of medical practice. The scientific literature indicates that a purely biomedical approach is insufficient for continued improvement in birth outcomes (Kemp & Pond, 1986;Sherwin & Mele, 1986). Nursing can provide holistic maternal and newborn care by including physiologic, psychosocial, and environmental factors in prenatal risk assessment and subsequent nursing interventions.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Nursing can provide holistic maternal and newborn care by including physiologic, psychosocial, and environmental factors in prenatal risk assessment and subsequent nursing interventions. The recommendation to broaden prenatal risk assessment to include psychosocial and environmental factors has been made repeatedly for the past 20 years (Nuckolls et al, 1972;Lesinski, 1975;Kemp & Pond, 1986;Sherwin & Mele, 1986) with little evidence of modification in the instruments.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Identification of these risks and their correlation with birth outcomes has been documented repeatedly in the literature (Creasy & Herron, 1981;Hobel et al, 1973;Hobel, 1977;Edwards et al, 1979). Less frequently assessed are the psychosocial and environmental stressors noted by pregnant women and their effects on pregnancy outcome (Kemp & Pond, 1986;Sherwin & Mele, 1986). Public health nurses conducted a holistic assessment for pregnant women and investigated the relationship between identified risks and birth outcome.…”

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confidence: 99%

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Reducing Prenatal Risk and Improving Birth Outcomes: The Public Health Nursing Role

Schmitz¹,

Reif²

1994

Public Health Nursing

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We conducted a descriptive study to determine the relationship between prenatal risk and birth outcomes in the antepartal caseloads of rural public health nurses. A convenience sample of 41 low-income pregnant women was assessed for prenatal risk by the nurses at the time of admission and again after 32 weeks' gestation. Birth outcome data were collected from maternal and infant hospital medical records. Analysis of the difference in mean scores from the first to the second assessment indicated a statistically significant change in the prenatal psychosocial risk score (P = 0.000) after public health nursing care. Physiologic and psychosocial risks at both assessment points were related to only one infant outcome measure: the 5-minute Apgar score. Psychosocial risk in late pregnancy accounted for 22% of the variance in 5-minute Apgar scores.

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“…Research indicates that including psychosocial assessment with biomedical assessment can improve the identification of women with pregnancy complications (12). Guidelines and questionnaires have been developed for health assessment (13,14) and self-assessments (15) of women during pregnancy. These instruments, however, include few questions on the woman's family, relationships, finances, and other socioenvironmental factors that may be more relevant than poverty itself.…”

Section: Introductionmentioning

confidence: 99%

Relationship of Street Drug Use, Hospitalization, and Psychosocial Factors to Low Birthweight Among Low‐Income Women

Lia‐Hoagberg

Knoll

Swaney

et al. 1988

Birth

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A retrospective study was conducted to determine differences in psychosocial and medical factors among low-income women with low and normal birthweight infants. The matched sample included 65 women in each group and data was collected on medical, demographic and detailed psychosocial information. Street drug use and hospitalization during pregnancy were significantly related to low birthweight after matching for 8 factors. Psychosocial factors from a patient's past background included mother's history of drug abuse, poor parenting by her mother and father, and being abused as a child. Psychosocial factors noted during the current pregnancy were major financial concerns, street drug use; poor relationships, particularly with father of the baby; and emotional and physical abuse. Study results suggest the need for more in-depth psychosocial assessment during pregnancy, and prenatal interventions designed to address these special psychosocial factors. (BIRTH 15:1, March 1988)

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Health assessment in high-risk pregnancies

Cited by 3 publications

References 8 publications

Staff Evaluation of a High‐Risk Pregnancy Program

Staff Evaluation of a High‐Risk Pregnancy Program

Reducing Prenatal Risk and Improving Birth Outcomes: The Public Health Nursing Role

Relationship of Street Drug Use, Hospitalization, and Psychosocial Factors to Low Birthweight Among Low‐Income Women

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