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SCIENCE AND MIDWIFERY: PARADIGMS AND PARADOXES

Authors

  • Holly Powell Kennedy PhD, CNM, FACNM,

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    • Holly Powell Kennedy is an associate clinical professor and director of the Graduate Program in Nurse-Midwifery at the University of Rhode Island. She received her master of science as a family nurse practitioner from the Medical College of Georgia, her certificate in nurse-midwifery from the Frontier School of Midwifery and Family Nursing, and her PhD from the University of Rhode Island. She is currently completing an MCHB-sponsored fellowship in editorial leadership at the Boston University School of Public Health. Her program of research is focused on linking specific midwifery care processes to well defined women's health outcomes.

  • Nancy K. Lowe PhD, CNM

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    • Nancy K. Lowe is an associate professor at The Ohio State University College of Nursing, Columbus, and director of the Nurse-Midwifery Education Program at The Ohio State University. She received her certificate in nurse-midwifery from the CNEP Program at the Frontier School of Midwifery and Family Nursing, and her PhD from the University of Illinois, Chicago. Her program of research is focused on the psychophysiology of labor, self-efficacy for childbirth, pain during childbirth, care practices during labor and birth, and women's self-care of gynecologic infections. Dr. Lowe is currently the associate editor of the Journal of Obstetric, Gynecologic, and Neonatal Nursing (JOGGN). She becomes the editor of JOGGN in July 2001.


Graduate Program in Nurse-Midwifery, University of Rhode Island, White Hall, 2 Heathman Road, University of Rhode Island, Kingston, RI 02881.

ABSTRACT

The everyday world of clinical practice is filled with paradigms and paradoxes that stem from the issues of who defines knowledge, how it is generated, and how the individual midwife applies it when providing care for women and families. Research useful for clinical practice should provide evidence to support scientific approaches (models) or strategies (interventions) in caring for women. In a clinical discipline, the answers to research questions should eventually inform clinical decision-making by providing practical clinical knowledge. This article presents an application of Stevenson's research steps for the development of clinically applicable knowledge that the midwife can use to analyze and evaluate research findings as a basis for practice decisions. Specific examples of midwifery research are used to illustrate each stage in the process and the circular nature of knowledge development. The challenge is to prepare midwives who can apply research findings skillfully using the best evidence to support clinical practice, as well as to groom midwife researchers who will develop systematic programs of relevant research about midwifery practice and outcomes.

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