The purpose of this study was to explore perceptions of pregnant and parenting substance-abusing women in an outpatient drug treatment program regarding provider and social support. Also identified were aspects of the rehabilitation program perceived by the women as assisting them to maintain abstinence from substance use. Data were collected through a demographic questionnaire and a tool designed by the authors based on the Social Stress Model of Substance Abuse (Lindenberg et al., 1993) and the literature of social support. The majority of the women were satisfied with their social support from family and friends. Sixty-seven percent of the women felt the support received from medical providers were not adequate. Also, the majority of the women received no information on risks of drug use and pregnancy from their medical providers. The women felt the program helped maintain abstinence by providing education, coping mechanisms, resources, 12-step programs, and spiritual guidance.

No abstract

This study describes the personal experiences of pregnancy for African-American women. Data were obtained from two group interviews with four African-American nurse-midwives who had experienced pregnancy and had extensive professional experience in the provision of health care services to pregnant African Americans. Three major themes were constructed from the interview narratives. The first concerned the experience of pregnancy as a transition experience from childhood to adulthood and from womanhood to motherhood, involving heightened senses of maturity, self-esteem, and intimacy. The second identified stresses experienced by African-American women, including the lack of material resources and emotional support. The last theme concerned the provision of effective support in pregnancy. The significance of interpersonal relationships with the pregnant women's mothers, other significant women, and their partners was described. Implications for practice included suggestions for the provision of effective emotional support from health care professionals such as attentive listening and the elimination of environmental factors that communicate lowered personal value.

Synopsis An Australia‐wide patient classification system for nursing is urgently needed as the health system attempts to develop benchmarks against which to measure and compare services. Standardised measures of demand for nursing care must be developed to allow appropriate reimbursement and to act as proxies for illness severity. Nurses need to identify the outcomes that measure the nursing contribution to episodes of care, and assist in developing outcome goals reflecting the efficacy of treatment and the quality of care. A system of measuring nursing requirements and costs of early discharge and coordinated care programs is required. It must be consistent with nursing classifications and hospital costing systems.

In a time of rapid change in the health care delivery system, health care professionals are challenged to fully understand their legal and ethical obligations for practice. The interface between law and ethics as it affects professional practice is complex and confusing. Three areas of legal and ethical interface and their associated history are explored: laws affecting scope of practice and the ethical obligation to provide access to care; laws affecting informed consent and the ethical obligation to respect autonomy; and laws limiting disclosure of personal identifiable information and the ethical obligation to protect privacy. A trend toward the use of statutes to protect and enforce patient rights has emerged, which has altered and limited professional practice.