Prenatal Adolescent Home-Based Care (PAHC) A nursing model
The frequency of day surgery continues to increase worldwide. However, knowledge of the patients experiences of symptoms and discomfort beyond the first 72 hours postoperatively remains almost nonexistent. The overall aim of this study was to describe patients' experiences of symptoms and discomforts and their impact on daily living. Adolescent pregnancy remains a significant social, economic and health issue in the United States. Yet adolescents who are pregnant tend to receive the least amount of prenatal care, even though they have been identified as at highest risk for maternal complications, infant morbidity and mortality. Available prenatal care does not address the specific needs of the adolescent since current prenatal models of care for women were designed for the adult woman. The prenatal adolescent home care (PAHC) model developed in Phase I was designed to foster a healthy pregnancy and safe delivery for pregnant adolescents living in New London, Ct. It utilizes the perspective of the client-nurse relationship to deliver prenatal care in the home in addition to regularly scheduled visits with an obstetrician in an office or clinic setting. Emphasis is on the provision of skilled nursing care and an expansive educational component tailored to the pregnant adolescent and her needs. The model expanded on and reframed earlier medical and nursing models for pregnant women, most specifically, the EPIC model; included teaching learning principles specific to adolescent learning; and incorporated a positive approach gleaned from the authors past work with this population. The eight step model begins with the referral from a private obstetrician's office or Obstetric Clinic, followed by a preadmission contact by a maternal child health, registered nurse in community health nursing assigned to the adolescent. The initial admission visit is followed by a sequence of approximately 16 clustered intensive one hour, home visits scheduled on opposite weeks of obstetric visits, beginning in the first trimester of pregnancy and concluding when the adolescent is admitted to the hospital for delivery. Initial evaluation of the model included three interviews with seven stakeholders (five nurses and two social workers), who agreed the model was appropriate, relevant, comprehensive, instructionally sound, feasible, and desirable and would be very applicable in the New London community. It covered the educational needs of the adolescent and provided support. The PAHC model is ready for evaluation by a broader range of stakeholders (e.g. physicians, community leaders) and adolescent clients.
Sharon Murano Burbelo,
"Prenatal Adolescent Home-Based Care (PAHC) A nursing model"
Dissertations and Master's Theses (Campus Access).