Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing最新文献

{"title":"Improving the Process for Late Preterm Infant Discharge Follow-Up After Birth.","authors":"Amy L Williford, Joshua Barnes","doi":"10.1016/j.jogn.2026.08.002","DOIUrl":"10.1016/j.jogn.2026.08.002","url":null,"abstract":"<p><strong>Objective: </strong>To increase the number of follow-up appointments scheduled and documented in the electronic health record (EHR) for late preterm infants (LPIs) before discharge by developing a standardized workflow for health care providers.</p><p><strong>Design: </strong>Quality improvement project using a pre-post intervention design.</p><p><strong>Setting/local problem: </strong>Southeastern United States regional medical center.</p><p><strong>Patients: </strong>Late preterm infants born at 34 0/7 to 36 6/7 weeks gestation and discharged from the mother-baby unit and NICU from August 25 to December 8, 2025 (n = 111 pre-intervention period, n = 154 post-intervention period).</p><p><strong>Intervention/measurements: </strong>Health care providers who worked in the designated units received education on best practices for the discharge of LPIs, including a specific time frame for recommended follow-up (within 24-48 hours of discharge) and instructions to document appointments in a central location in the EHR. We used iterative Plan-Do-Study-Act cycles. We collected pre-intervention data retrospectively and post-intervention data monthly to guide workflow refinements and implementation strategies.</p><p><strong>Results: </strong>Scheduled appointments increased from 52 of 111 infants (46.8%) before the intervention to 101 of 154 infants (65.6%) after the intervention (p = .004). Documentation increased from 47 of 111 infants (42.3%) to 100 of 154 infants (64.9%) in the discharge summary and from 28 of 111 infants (25.2%) to 84 of 154 infants (54.5%) in the discharge tab (both ps < .001).</p><p><strong>Conclusion: </strong>Implementation of a standardized workflow increased the rate of follow-up appointments scheduled and documented in the EHR before discharge. Our findings support workflow standardization as a practical strategy to strengthen transitional care processes for LPIs.</p>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity and Reliability of the Italian Version of the Readiness for Hospital Discharge Scale-Postpartum Mothers.","authors":"Valentina Costanzi, Martina Dato, Patrizia Mussi, Monica Cecchin, Mayra Veronese, Matteo Danielis","doi":"10.1016/j.jogn.2026.08.003","DOIUrl":"10.1016/j.jogn.2026.08.003","url":null,"abstract":"<p><strong>Objective: </strong>To translate, culturally adapt, and assess the reliability and validity of the Readiness for Hospital Discharge Scale-Postpartum Mothers (ObRHDS) to the Italian context.</p><p><strong>Design: </strong>Validation study with a cross-sectional design.</p><p><strong>Setting: </strong>Obstetric unit of a 1,000-bed tertiary hospital in north-eastern Italy.</p><p><strong>Participants: </strong>Women who gave birth and were scheduled for discharge on the second or third day after birth (N = 220).</p><p><strong>Methods: </strong>We used a paper-based questionnaire to collect data on sociodemographic characteristics, clinical information, and the ObRHDS from July to September 2025. We translated the ObRHDS using the forward-backward translation method and culturally adapted it through review by an expert panel. We conducted exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Rasch analysis and assessed internal consistency using Cronbach's α.</p><p><strong>Results: </strong>We identified four factors of the Italian version of ObRHDS through EFA: Knowledge and Coping Ability, Personal Status, ExpectedSupport, and Barriers to Discharge, with Cronbach's reliability coefficients of .93, .88, 1.00, and .41, respectively. The results of the Rasch analysis and CFA indicated that the first three factors were robust. We removed Factor 4 because of poor psychometric performance, including unstable and nonsignificant loadings, negligible correlation with other factors, and low reliability.</p><p><strong>Conclusion: </strong>The Italian version of ObRHDS is a valid tool for assessing discharge readiness during the postpartum period that shows good clarity and internal consistency across key factors. The Barriers to Discharge factor requires further refinement. Our findings support the scale's preliminary use, paving the way for international comparative research.</p>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Activation in the Postpartum Period by Race, Ethnicity, and Spoken Language","authors":"Sarah E. Harkins,&nbsp;Janice J. Aubey,&nbsp;Jessica S. Ancker,&nbsp;Robin B. Kalish,&nbsp;Laura E. Riley,&nbsp;Alison Hermann,&nbsp;Natalie C. Benda","doi":"10.1016/j.jogn.2026.02.002","DOIUrl":"10.1016/j.jogn.2026.02.002","url":null,"abstract":"<div><h3>Objective</h3><div>To describe needs for support, support-seeking actions, and level of patient activation in the postpartum period among four demographic groups defined by race, ethnicity, and spoken language.</div></div><div><h3>Design</h3><div>Cross-sectional study of survey data.</div></div><div><h3>Setting</h3><div>Online survey in the United States.</div></div><div><h3>Participants</h3><div>Adult women who gave birth in the past 12 months and were able to read and speak English or Spanish (<em>N</em> = 446).</div></div><div><h3>Methods</h3><div>We conducted descriptive analyses of all study variables and examined differences in sociodemographic characteristics, support needs, and patient activation across four demographic groups. We used chi-square or Fisher’s exact tests to evaluate differences in categorical variables and analysis of variance for continuous variables, with Bonferroni-adjusted post hoc comparisons. We calculated effect sizes for all significant group differences.</div></div><div><h3>Results</h3><div>English-speaking Hispanic respondents were the most likely to report the need for support for mental symptoms (<em>n</em> = 98, 83.5%; <em>p</em> = .03) among all groups. Nearly all respondents who endorsed the need for physical (<em>n</em> = 363, 97.8%) or mental health support (n = 319, 96.1%) reported that they took some action such as calling a provider or going to a clinic or hospital. Spanish-speaking Hispanic respondents had lower reported activation levels (<em>n</em> = 81, 47.4%; <em>p</em> = .01) than English-speaking Hispanic (<em>n</em> = 83, 71.6%), Black (<em>n</em> = 68, 70.1%), and White respondents (<em>n</em> = 49, 79.0%).</div></div><div><h3>Conclusion</h3><div>Perceived needs for support and levels of patient activation in the postpartum period differed by demographic group. Future researchers should explore other demographic, psychosocial, and health care system factors associated with patient activation in the postpartum period and strategies to support improved skills and confidence in receiving postpartum care.</div></div>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":"55 5","pages":"Pages 485-491"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147461269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric Evaluation of the Breast Inflammatory Symptom Severity Index Versions 2 and 3 Among Lactating Women.","authors":"Emma Heron, Nazmul Karim, Adelle McArdle, Ching Tat Lai, Donna Geddes, Leanda McKenna","doi":"10.1016/j.jogn.2026.07.005","DOIUrl":"10.1016/j.jogn.2026.07.005","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the psychometric properties of Versions 2 and 3 of the Breast Inflammatory Symptom Severity Index (BISSI).</p><p><strong>Design: </strong>Secondary data analysis of clinical trial data.</p><p><strong>Setting: </strong>Private physiotherapy practices, a public tertiary hospital, and a community in Melbourne, Australia.</p><p><strong>Participants: </strong>Women more than 7 days after birth with inflammatory conditions of the lactating breast (N = 43).</p><p><strong>Methods: </strong>We performed confirmatory factor analysis of the BISSI Version 2 to examine item loading, which informed development of the BISSI Version 3 (V3). We assessed convergent validity by comparing total BISSI V3 scores with human milk sodium to potassium ratio (Na⁺:K⁺) at Trial Days 1, 3, and 10 using Bland-Altman plots. We compared item-level scores for size of affected area with objective breast area measurements using Bland-Altman plots. We used receiver operating characteristic curve analysis to assess discriminant validity for symptom severity and Cronbach's alpha for internal reliability.</p><p><strong>Results: </strong>After confirmatory factor analysis, we removed two items, resulting in a six-item BISSI V3. All retained items demonstrated comparable loading on the overall scale. Limits of agreement for total BISSI V3 scores and item-level scores for size of affected area were acceptable at all time points, with more than 90% of observations falling within 2 standard deviations of the mean difference, supporting convergent validity. Discriminant validity and high internal reliability of the BISSI V3 were demonstrated at Trial Days 3 and 10.</p><p><strong>Conclusion: </strong>Our findings provide evidence for the validity and reliability of the BISSI V3 and support clinical use of the BISSI V3 alongside human milk Na⁺:K⁺ analysis to enhance management of inflammatory conditions of the lactating breast.</p>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Donor Human Milk Compared With Formula Supplementation for Breastfeeding Term Newborns Treated With Phototherapy","authors":"Erika Kusche,&nbsp;Amanda Dimas,&nbsp;Heather Bodden,&nbsp;Rebecca Miller,&nbsp;Karen Stanzo","doi":"10.1016/j.jogn.2026.04.001","DOIUrl":"10.1016/j.jogn.2026.04.001","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the effects of donor human milk and formula supplementation on bilirubin levels and total phototherapy duration among term breastfeeding newborns who received phototherapy for neonatal hyperbilirubinemia.</div></div><div><h3>Design</h3><div>Retrospective, nonexperimental observational study.</div></div><div><h3>Setting</h3><div>Well-newborn nurseries in four health care facilities in Central and North Texas.</div></div><div><h3>Participants</h3><div>Charts of breastfeeding term newborns (≥37 weeks gestation) who underwent phototherapy and received supplementation for the management of neonatal hyperbilirubinemia (<em>N</em> = 383).</div></div><div><h3>Methods</h3><div>We compared the charts of breastfeeding newborns who received supplemental formula with the charts of those who received supplemental donor human milk. We analyzed group differences in bilirubin levels, phototherapy duration, and supplementation volume using independent-samples <em>t</em> tests, with effect sizes calculated as Cohen’s <em>d</em> and reported with 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>We found that newborns who received supplemental donor human milk spent approximately 6 more hours on phototherapy than those who received formula (31.57 vs. 25.99 hours; <em>d</em> = 0.35; 95% CI [0.15, 0.56], <em>p</em> &lt; .001). Final bilirubin levels did not differ significantly between groups (10.16 vs. 10.39 mg/dl; <em>p</em> = .63). Newborns who were given supplemental formula received more than twice the supplementation volume as those who were given supplemental donor human milk (344.63 vs. 982.00 ml; <em>d</em> = 5.82; 95% CI [0.90, 10.71], <em>p</em> = .01).</div></div><div><h3>Conclusion</h3><div>Breastfeeding newborns with neonatal hyperbilirubinemia who receive supplemental donor human milk as an alternative to formula supplementation may spend more time on phototherapy.</div></div>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":"55 5","pages":"Pages 522-530"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypothermia in Extremely Low-Birth-Weight Infants After NICU Admission","authors":"Seungjin Lee,&nbsp;Young Hwa Jung,&nbsp;Sun-Mi Chae","doi":"10.1016/j.jogn.2026.04.002","DOIUrl":"10.1016/j.jogn.2026.04.002","url":null,"abstract":"<div><h3>Objective</h3><div>To identify the clinical and procedural factors associated with hypothermia in extremely low-birth-weight (ELBW) infants in the NICU.</div></div><div><h3>Design</h3><div>Retrospective cohort study using electronic medical record data.</div></div><div><h3>Setting</h3><div>Level IV NICU in South Korea.</div></div><div><h3>Participants</h3><div>The records of ELBW infants (<em>N</em> = 190) admitted to the NICU from January 2018 to December 2023.</div></div><div><h3>Methods</h3><div>We assessed hypothermia in infant records at NICU admission and 2 hours after NICU admission. We performed univariate and multivariable logistic regression analyses to identify clinical and procedural factors associated with hypothermia.</div></div><div><h3>Results</h3><div>At admission to the NICU, records indicated that 47.9% (<em>n</em> = 91) of included infants had hypothermia, and 42.6% (<em>n</em> = 81) of the records indicated that included infants remained hypothermic at 2 hours after NICU admission. Gestational age was inversely associated with post-admission hypothermia (odds ratio (<em>OR</em>) = 0.77, 95% confidence interval (<em>CI</em>) [0.62, 0.95], <em>p</em> = .015). The records of infants who had endotracheal tubes or central lines that were repositioned indicated a greater risk of hypothermia (<em>OR</em> = 2.73, 95% <em>CI</em> [1.05, 7.11], <em>p</em> = .040).</div></div><div><h3>Conclusion</h3><div>We recommend active thermal management and minimal disruption during the early stabilization period to prevent hypothermia among ELBW infants and that neonatal nurses shift their focus from passive monitoring to active procedural stewardship in the NICU.</div></div>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":"55 5","pages":"Pages 531-541"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seeking a Universal Definition for Severe Maternal Morbidity","authors":"Tina Smith,&nbsp;Julie Schexnayder,&nbsp;Hsiao-Lan Wang,&nbsp;Allison Shorten","doi":"10.1016/j.jogn.2026.02.003","DOIUrl":"10.1016/j.jogn.2026.02.003","url":null,"abstract":"<div><div>Women can experience significant and potentially life-threatening complications related to pregnancy. These conditions are commonly referred to as severe maternal morbidity (SMM). Severe maternal morbidity can have devastating effects on pregnant women and their children, and in some cases it can lead to maternal mortality. In the United States, SMM and maternal mortality occur at greater rates than in other high-income countries. Within the past few years, researchers and health care providers have placed an increased emphasis on identifying cases of SMM to improve maternal and perinatal outcomes. However, the term severe maternal morbidity is not consistently defined in the literature, and a standardized definition is necessary to accurately measure incidence. Therefore, the purpose of this commentary is to review current definitions for SMM and offer an integrative, potentially universal definition for the term.</div></div>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":"55 5","pages":"Pages 492-500"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"At Your Service","authors":"","doi":"10.1016/S0884-2175(26)00192-9","DOIUrl":"10.1016/S0884-2175(26)00192-9","url":null,"abstract":"","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":"55 5","pages":"Page A4"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148951520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fractured Guidance in Recent U.S. Vaccine Policy and Implications for Nurses","authors":"Sasha N. Poole,&nbsp;Gina C. Rowe,&nbsp;Lauri A. Andress,&nbsp;Roberta Lavin,&nbsp;Nicholas Edwardson","doi":"10.1016/j.jogn.2026.07.004","DOIUrl":"10.1016/j.jogn.2026.07.004","url":null,"abstract":"<div><div>Historically, U.S. vaccine policy relied on a stable, multi-agency infrastructure and external scientific advisory processes to maintain public health. However, beginning in 2025, radical departures from these established scientific norms occurred and led to significant changes to the federal vaccination schedule for children and pregnant women. These events have resulted in a fractured vaccine policy, with numerous states and professional organizations now bypassing federal guidance in favor of recommendations from nongovernment bodies such as the American Academy of Pediatrics and the Maternal Immunization Task Force. In this article, we trace the history of U.S. vaccine policy, detail recent federal changes, and examine the responses from state and professional entities. The fracturing of vaccine policy has far-reaching implications for the health and health care of women, childbearing and childrearing families, and newborns through decreased vaccine rates, increased disease rates, and general erosion of public trust. We explore the effect on nursing practice and emphasize the heightened pressure on health care professionals to be compassionate, evidence-based communicators. Finally, we offer a call to action for nurses to employ personalized, trusted interactions and clear, knowledgeable explanations to address vaccine hesitancy and protect community health in this rapidly evolving policy landscape.</div><div><em>The purpose of this series is to critically examine emerging federal and state health policy changes and their implications for the health and well-being of women, childbearing families, and young children and to provide evidence-based analyses that inform the nurses who care for these populations. The author solicitation and preparation of each article are overseen by series coordinators Mindy B. Tinkle, PhD, RN, WHNP-BC, CNE, FAAN, associate professor, and Nick Edwardson, PhD, MS, associate professor, College of Nursing, University of New Mexico, Albuquerque, NM.</em></div></div>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":"55 5","pages":"Pages 471-484"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Harm of the Use of the Word “Benign” in Gynecologic Care","authors":"Mary G. Hoberg,&nbsp;Lacey W. Heinsberg","doi":"10.1016/j.jogn.2026.02.005","DOIUrl":"10.1016/j.jogn.2026.02.005","url":null,"abstract":"<div><div>“Benign gynecologic conditions” is an umbrella term widely used to describe prevalent conditions such as endometriosis, adenomyosis, uterine fibroids, and genitourinary syndrome of menopause in clinical guidelines, research, reviews, and health policy. However, this term is nonspecific, clinically misleading, and potentially harmful. Although these conditions are not cancerous, they can be chronic, painful, and life-disrupting, which renders the term inappropriate because it does not reflect women’s experiences. In this article, we trace the historical origins of the term “benign” and explore how its continued use may contribute to delays in diagnosis, minimization of symptoms, and disinvestment in women’s health research and education. Replacing the term benign with more precise and respectful phrases, such as “chronic gynecologic conditions,” is an essential part of efforts to improve patient-centered care, restore trust, and advance equity in women’s health.</div></div>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":"55 5","pages":"Pages 501-509"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147461206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}