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Guiding Mothers' Management of Health Problems of Very Low Birth-Weight Infants

Authors

  • Karen A. Pridham Ph.D., R.N., F.A.A.N.,

    1. Helen Denne Schulte Professor of Nursing Emerita, School of Nursing and Department of Family Medicine, University of Wisconsin-Madison, Madison, Wisconsin.
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  • Mary M. Krolikowski M.S.N., R.N., P.N.P.,

    1. Research Nurse at the Herma Heart Center, Children's Hospital of Wisconsin, Milwaukee, Wisconsin.
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  • Rana K. Limbo Ph.D., R.N.,

    1. Director of Bereavement Services, Gundersen-Lutheran Medical Foundation, La Crosse, Wisconsin.
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  • Jill Paradowski M.S., R.N.,

    1. Healthcare Outreach Coordinator, City of Milwaukee Health Department, Milwaukee, Wisconsin.
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  • Nancy Rudd M.S., R.N., P.N.P.,

    1. nurse practitioner in the Herma Heart Center, Children's Hospital of Wisconsin, Milwaukee, Wisconsin.
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  • John R. Meurer M.D., M.M.,

    1. Medical Director, Downtown Health Center, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, and Associate Professor and Chief of General Pediatrics at the Medical College of Wisconsin, Milwaukee, Wisconsin.
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  • Ann Uttech M.S., L.M.F.T.,

    1. family therapist at Aurora Family Service, Milwaukee, Wisconsin.
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  • Jeffrey B. Henriques Ph.D.

    1. Senior Lecturer and Associate Researcher, School of Nursing and Department of Psychology, University of Wisconsin-Madison, Madison, Wisconsin.
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Karen Pridham, School of Nursing, University of Wisconsin-Madison, Clinical Science Center, H6/293, 600 Highland Ave., Madison, WI 53792. E-mail: kpridham@wisc.edu

Abstract

ABSTRACT Objective: Explore the feasibility, usefulness, and outcomes of a pilot program to support mothers in developing competencies for managing health problems of their very low birth-weight (VLBW) infants in partnership with the primary care clinician (PCC).

Design: In a randomized study, mothers who received guided participation (GP) and printed guidelines for managing VLBW infant health problems were compared with mothers who received only the guidelines and standard care (GL group).

Sample: All mothers (GP=20; GL=11) were at least 18 years old and English speaking. Infants were all VLBW (≤1,500 g).

Intervention: GP began during the infant's neonatal intensive care unit stay and continued with public health nurses (PHNs) and a family service clinician through the infant's first 4 postterm months.

Measurements: Intervention feasibility and usefulness were assessed with maternal and clinician feedback. Outcomes included maternal and clinician appraisal of mothers' use of clinical resources and mothers' perceptions of primary-care quality and the family-PCC relationship.

Results: Intervention feasibility and usefulness were supported. GP and GL groups did not differ significantly on outcomes.

Conclusions: Findings indicate a longer intervention period, GP organized by infant problem episodes, and enhancement of the PHN role in the context of interdisciplinary and interagency collaboration.

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