Mikki Meadows-Oliver

Abstract

The purpose of this article was to synthesize the findings of six qualitative studies on homeless adolescent mothers. Metasynthesis was conducted using the meta-ethnographic approach of Noblit and Hare [Noblit, G., & Hare, R. (1988). Meta-ethnography: Synthesizing qualitative studies. Newbury Park, CA: Sage Publications]. Six reciprocal translations illuminating the experiences of homeless adolescent mothers emerged: being homeless, enduring abuse, lamenting lost years, searching for support, recreating self, and seeking a better life. The findings may be used by nurses working with this population as the basis for a framework of intervention strategies directed toward helping these mothers cope with their dual transitions into motherhood and adulthood while simultaneously being homeless.

Abstract

Although progress has been made in understanding the pathophysiology of asthma and identifying key features of quality asthma care, the prevalence of childhood asthma remains high. Barriers to effective asthma care that currently exist include the persistence of environmental risk factors, disparities in care that stem from poverty and cultural differences, and inconsistencies in the quality of asthma care provided by clinicians. Pediatric nurse practitioners at Yale New Haven Children's Hospital have actively implemented the recommended guidelines for asthma care and addressed causes for some of the disparities in asthma health care. Two major initiatives are described: the Asthma Care Coordination Project at Yale New Haven Hospital Pediatric Primary Care Center, and the establishment of an Asthma Outreach Program. Recommended resources and Web sites for the practitioner are also provided.

Abstract

Homelessness has been associated with levels of stress beyond the normal strain of living in poverty. For mothers who are homeless, support from their social networks may provide a buffer from some of the stresses associated with being homeless. To better understand the relationship between social support and female-headed homeless families, an integrative review was conducted of 12 research articles that compare social support among low-income housed mothers and homeless mothers, using guidelines set forth by Ganong. The included studies revealed four significant attributes of social support among housed and homeless mothers: size of the social support network; composition of the social support network; contacts with members of the social support network; and perceived support from members of the social support network. Nurses who work with homeless families are in a position to help develop ways for these families to cultivate and maintain their social support networks while homeless. Nurses can be available to offer support, including the necessary mental health services or referrals.

Abstract

BACKGROUND: Asthma is one of the most prevalent childhood chronic illnesses in the United States leading to nearly 190,000 pediatric hospitalizations yearly. In response to the increasing number of children with asthma being hospitalized, some institutions have developed and implemented clinical pathways and are now reporting their findings in the literature. The purpose of this paper was to conduct an integrative literature review of studies using an inpatient clinical pathway for the management of pediatric asthma. METHOD: Five research-based articles evaluating clinical pathways for the management of inpatient pediatric asthma were included in this review. The integrative review was conducted using the guidelines set forth by Ganong (1987). RESULTS: The results revealed that clinical pathways appear to be effective in reducing length of stay and hospital costs associated with inpatient pediatric asthma. The pathways were not as effective in reducing readmission rates or affecting clinical outcomes for patients such as increasing asthma education, the use of controller medications, spacers, and peak flow meters. PRACTICE IMPLICATIONS: Although the pathways are effective in reducing hospitalization costs associated with asthma, there was little reported improvement in clinical outcomes. Nurses should ensure that each pediatric asthma hospitalization provides an opportunity to promote education about asthma. This approach may lead to decreased asthma admissions and increased self and family management of pediatric asthma. Future research should focus on the clinical outcomes of patients using the inpatient pathways and also on the development of pathways to be used in outpatient settings that manage pediatric asthma.

Abstract

ISSUES AND PURPOSE: The purpose of this paper is to synthesize the current qualitative literature on homeless women with children living in shelters. METHODS: Eighteen qualitative studies on homeless women with children living in shelters were included in the synthesis. The meta-synthesis was conducted using the meta-ethnographic approach of Noblit and Hare (1988). RESULTS: Six reciprocal translations (themes) of homeless mothers caring for their children in shelters emerged: On becoming homeless, protective mothering, loss, stressed and depressed, survival strategies, and strategies for resolution. PRACTICE IMPLICATIONS: The results may be used by healthcare workers as a framework for developing intervention strategies directed toward helping mothers find new solutions to dealing with shelter living and innovative ways to resolve their homelessness.

Abstract

Introduction: The purpose of this research was to examine infant birth weights and high school completion rates for two cohorts of adolescent mothers attending an urban school-based program, the Polly T. McCabe Center. Results: The uncidence of low birth weight infants born to students was 4% in study I and 13.6% in study II. High school continuation/completion rates for study I were 79% at 3 years after leaving the program and 80% for study II at 1 year after leaving the program. Discussion: The young mothers and infants appear to have benefitted from the McCabe Center's intervention. Findings of the study suggest that continued implementation of supportive school-based programs similar to the McCabe Center may help prevent lower birth weight infants born to adolescent mothers and may help decrease the high school drop-out rate among this population.