Laura Elizabeth Downey
Breastfeeding Cessation: Contributing Factors in African-American Mothers
Eric A. Hodges, PhD, FNP, BC, Assistant Professor
While my previous career in environmental consulting allowed me to help create regulations that improved human health, particularly related to environmental
quality, these changes were often not realized for many years due to the nature of the regulatory process and were focused on improving health at the population level. I have chosen to pursue a career in nursing in order to make a difference more directly in the lives of individuals, families, and communities. With nursing’s holistic approach to healthcare, I believe nurses are among the best-equipped healthcare providers to develop collaborative partnerships with patients and their families, providing them the knowledge and tools they need to empower them to take an active role in their own health and wellness. Participation in the Honors Program has allowed me to explore an issue of interest to me in greater depth than I would be able to in class. Pursuing honors has also provided me the opportunity to learn first hand about nursing research while working closely with faculty who are leaders in this area.
This study was a secondary data analysis from a primary study, the Infant Care, Feeding, and Risk of Obesity Study (R01 HD042219, PI: Bentley). This secondary data analysis was a cross sectional analysis which used maternal self-report questionnaires at 3, 6, 9, 12, and 18 months of infant age to characterize African-American, WIC eligible mothers’ rationale for breastfeeding cessation and to explore how maternal and infant characteristics are associated with breast feeding cessation. Of the 128 mother-infant dyads included in this study, 93 (72.7%), 16 (12.5%), 5 (3.9%), 10 (7.8%), and 1 (0.8%) ceased breastfeeding at 3, 6, 9, 12, and 18 months of age, respectively. Mean maternal breastfeeding duration was 3.09 months ± 3.85 (N=125). The factors found to be significantly associated with breastfeeding cessation at three months were maternal education, marital status, age, and depression. In addition, the maternal reasons for cessation of insufficient supply and pain were significantly associated with breastfeeding cessation by three months. Qualitative data suggested that women often discontinued breastfeeding due to insufficient supply, disruption, work, teeth/biting, and self weaning of their infants. The reasons cited for cessation are amenable to nursing intervention. Interventions should be targeted during the zero to three month period when most mothers stop breastfeeding. Additionally, given the association between higher depression scores and breastfeeding cessation, there is a need for improved screening for postpartum depression and prompt treatment of identified cases.
Physical Restraint Use in the Pediatric Intensive Care Unit
Advisor: Diane Yorke, MBA, PhD, RN, CPNP, Clinical Assistant Professor
For me, becoming a nurse is not only an ideal career choice, but also a defining part of who I am. I have explored other career options before attending nursing school, and none of them fulfilled me the way that nursing does. I am very interested in human anatomy, pharmacology, and the disease process; I am even more interested in caring about the person. I ultimately decided on nursing because I truly care about people’s quality of life, their safety, their health, and their rights as human beings. This Honors project has helped me to develop critical thinking skills and independence both as a nurse and as a researcher. I have met many obstacles during the course of this project, and have had to learn about being resourceful and persistent in order to move forward with my goals. Conducting research has also solidified in my mind the importance of research to the care of our patients. I think it is a duty of all nurses to at least be consumers of research if not active participants. I will be much more prepared in future research endeavors after pursuing Honors, and I look forward to beginning the next project!
Very little research has been conducted regarding the use of restraints in patients in the pediatric intensive care unit (PICU). The purpose of this study was to 1) describe patient characteristics associated with the use of restraints, 2) describe documented alternatives to restraint use, 3) examine the relationship between length of stay in the PICU and the use of restraints, and 4) explore the relationship between the incidence of patient device removal and restraint use. The setting for this study was a major tertiary care center in the southeastern United States. Descriptive and exploratory methods were used to collect and analyze data from a convenience sample of data from 40 patients’ medical records in this hospital’s PICU. The findings from this study showed that the use of restraints is associated with increased length of stay in the hospital. Too few incidents of patient device removal were noted to form a reasonable conclusion. A notable finding was the increased use of restraints in minority patients. The study also revealed that only 50% of charts had documentations of a tried alternative method to restraint use. The findings from this pilot study serve as indication that further research is needed regarding the use of restraints in the PICU.