Browsing by Subject "Hospitalization"
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Item Colonizing the womb : women, midwifery, and the state in colonial Ghana(2011-12) Amponsah, Nana Akua; Falola, Toyin; Walker, Juliet E; Charumbira, Ruramisai; Jones, Omi Osun Joni L; Obeng, Cecilia S; Denbow, James RThis dissertation explores the British colonial government’s attempt to reconstruct women’s reproductive behaviors in colonial Ghana through the sites of maternal and infant welfare services and western midwifery education. In the early 1920s, the fear that the high maternal and infant mortality rates in the Gold Coast would have repercussive effects on economic productivity caused the colonial government to increasingly subject women’s reproduction to medical scrutiny and institutional care. I argue that female reproduction was selected as a site of intervention because the British colonial government conceived of it as a path of least resistance to social reconstruction, economic security, and political dominance. The five chapters have been designed to analyze colonial reproductive intervention as a socio-economic and political exigency of colonial rule. This dissertation speaks to the fact that cross-culturally, the female body has been politicized through narratives of power, culture, tradition, modernity, race, disempowerment, and empowerment.Item Indicators of Severity in Eating Disorders in Adolescents and the Effects on Rapidity of Weight Gain During Hospitalization(2010-01-12T18:58:13Z) Staub, Brittany Nicole; Stewart, SunitaEating disorders are a very complex and serious psychiatric condition that require an ongoing commitment to a comprehensive treatment plan involving both medical and psychological intervention. Increases in the prevalence of this disorder, the high cost of hospitalization and the mounting rates of relapse have lead to increased pressure to identify and to understand predictive indicators of recovery. Though predictive variables have been identified in multiple studies, results are inconsistent and continue to focus on psychological measures; meanwhile disease-related variables are less frequently explored with regard to weight gain and more consistently reviewed in connection with long-term outcome. The primary aim of this study was to explore whether measures of severity at admission predicted rapidity of weight gain, or, more specifically, the length of time for a patient to achieve 85 percent of his or her ideal body weight. The sample consisted of 59 patients who were hospitalized for an eating disorder and who were admitted below 85 percent of their ideal body weight. Upon admission, patients completed self-report measures to assess depression and eating disorder symptomatology. Additionally, archival data concerning other measures of severity were gathered from patient medical charts. The study’s results suggest that the patient-reported intensity of eating disordered symptoms at admission are a significant predictor of length of time to reach 85 percent of ideal body weight. In future studies, researchers should utilize alternative measures of psychological functioning and eating disorder symptomatology, in addition to self-reports, to obtain more accurate predictors of severity.Item The lived experience of nonpsychiatric hospitalization for persons with severe mental illness(2013-05) Zolnierek, Cynthia Diamond; Volker, Deborah L.People with severe mental illness experience medical comorbidities to a greater extent than the general population. When hospitalized in general hospital settings, they experience poorer outcomes and are experienced as difficult by nurses. An understanding of the experience of hospitalization from the patient's perspective is important to improving care and outcomes for this population. The purpose of this study was to explore the lived experience of nonpsychiatric hospitalization for persons with severe mental illness. Heideggarian phenomenology provided the philosophical underpinning and informed the methodology employed. Participants were recruited through mental health providers. Ten individuals with severe mental illness participated in minimally structured interviews and described their experience of hospitalization on a medical-surgical unit. Data, including transcribed interviews and field notes, were analyzed within the hermeneutic tradition as described by Cohen et al. (2000). The lived experience of nonpsychiatric hospitalization was expressed in four themes: taking care of me (subthemes: being cared for, not being cared for), it's my life, on my toes (subthemes: needing an advocate, managing my mental health), and being a good patient. Care providers' comportment, perception of the patient's illness, attentiveness, responsiveness, and personalized caring behaviors characterized the participant experience of being cared for or not being cared for. It's my life reflected participants' desire to be informed and involved so they could contribute to their recovery. Participants felt the need to be on my toes in order to look out for and advocate for themselves. The need to be on my toes extended to the management of a chronic illness while hospitalized for an unrelated acute condition. The final theme reflected the perceived patient role obligation to be a "good patient". Findings were consistent with the literature regarding experiences of hospitalization from the perspective of persons without mental illness. Identified themes emphasize the critical importance of the nurse-patient relationship to the patient experience. There are significant implications for how nurses come to know their patients in medical-surgical settings so that they can effectively personalize care. Reflective practices may empower nurses to solicit assistance and support to improve caring practicesItem Predictors and Correlates of Anxiety in Women Hospitalized With High-Risk Pregnancy(2007-08-08) Labat, Dana Broussard; Evans, H.M.Anxiety during pregnancy often negatively impacts a woman's perception of her pregnancy, as well as affects the development of the fetus and contributes to long-term negative sequelae during subsequent years post-delivery. Despite the increases in attention to the effects of anxiety in the perinatal literature, few studies utilize women with high-risk pregnancy as their population of study. These women would appear to be at a greater risk of experiencing anxiety because of the physical and psychological demands of their complicated pregnancies. Therefore, the current study attempted to determine the demographic and psychosocial correlates of anxiety in this unique population. This investigation also sought to improve significant methodological limitations found in previous published reports by employing a "gold standard" clinical diagnostic interview in addition to self-report measures of anxiety. Finally, this study examined the course of anxiety across hospitalization. From October 2005 to December 2006, 129 participants admitted to a high-risk antenatal unit participated in this investigation. Of those participants, 12% were diagnosed with an anxiety disorder. This prospective investigation revealed significant associations among anxiety symptoms and younger maternal age, lower education and income level, and Medicaid insurance status. Further multivariate analyses revealed that relationship maladjustment, greater number of and elevated perceived distress of stressful life events, and the consideration of termination were also significantly associated with the presence of anxiety symptoms. Logistic regression analyses determined that endorsed depressive symptoms predicted more than a one-and-a-half time's likelihood of increased anxiety symptoms. These findings show that anxiety symptoms are present in women hospitalized with high-risk pregnancy and directly impact the experience of pregnancy. These results demonstrate that identifying potential risk factors of anxiety through routine screenings at initial admission could lead to the development of hospital-based short-term interventions aimed at preventing negative antenatal and postpartum outcomes.Item Predictors of Depression in a High-Risk Hospitalized Pregnancy Population: A Prospective Longitudinal Study(2007-08-08) Miltenberger, Paula Dianne; Evans, H.M.Research is beginning to elucidate the prevalence and effects of antenatal depression on the mother and fetus. However, relatively little focus has been paid to the woman diagnosed with a high-risk pregnancy requiring hospitalization. The present study investigated the predictors and trajectory of depression in women hospitalized on an antepartum unit. The sample consisted of 129 who were hospitalized due to complications during pregnancy. At admission, the women completed self-report measures to assess depressive symptoms, life events as well as personality. Women who exceeded set thresholds on depressive measures were administered a structural clinical interview to assess for a formal diagnosis of Major Depressive Disorder. Additionally, women's depressive symptoms were assessed weekly across hospitalization until discharge. Forty-four percent of the sample exceeded set threshold at admission, indicating they were experiencing high levels of depressive symptoms. Logistic regression was used to determine predictors of group status at admission, based on depressive measures. Results indicated that only life events were predictive of those women exceeding set thresholds. Furthermore, consideration of pregnancy termination and prior psychiatric diagnosis were predictive of Major Depressive Disorder. Growth curve modeling was used to identify trajectory and changes in depressive symptoms over the course of hospitalization. The results indicated that most women experienced a decrease in symptoms over time. In measuring personality, the Depressive Experiences Questionnaire (Blatt, D'Affliti, & Quinlan, 1976) was used to determine if women characterized as self-critical would report more depression during pregnancy than women characterized as dependent. No significant differences were found between the personality scales and depression severity. However, those women who were high on both self-criticism and dependency had the highest scores on the depressive measures. These results suggests that women who score high on both self-criticism and dependency scales appear to be the most vulnerable to depressive symptoms during the antepartum period.Item Prenatal Attachment during Antepartum Hospitalization: Associations with Pregnancy Planning, Partner Relationship, And Postpartum Depression and Anxiety(2007-08-08) Rifkin, Jamie Brett; Evans, H.M.Little is known about factors that may interfere with a woman's ability to attach to her fetus in the context of antepartum hospitalization. This study investigated the effects of pregnancy planning, considering termination, and the quality of a romantic relationship on maternal-fetal attachment in a group of women hospitalized for obstetric complications. One hundred twenty-nine women completed the Maternal Antenatal Attachment Scale during antepartum hospitalization. Participants also completed the Dyadic Adjustment Scale and reported whether their pregnancy was planned and whether they had considered terminating their current pregnancy. No differences in reported levels of prenatal attachment were found between women with planned and unplanned pregnancies or between those who had considered termination and those who had not. There was a positive correlation between reported satisfaction in a primary romantic relationship and prenatal attachment. Although small associations were detected between prenatal attachment and postpartum depression, this finding did not reach statistical significance. No relationship between antenatal attachment and postpartum anxiety was identified. The findings suggest that the quality of a woman's relationship with her partner influences the level of attachment to her fetus.