PHYSIOLOGICAL AND PSYCHOLOGICAL DISTRESS: A DESCRIPTIVE STUDY OF NULLIPAROUS WOMEN WHO DEVELOP KETONURIA DURING LABOR.
Contributors: University of California, San Francisco.
Published: 1993
Number of pages: 111
Subjects: Health Sciences, Nursing.; Health Sciences, Obstetrics and Gynecology.
Description: The purpose of this exploratory, descriptive study is to describe seven selected indicators of physiological and psychological distress in nulliparous women who develop ketonuria during labor. Descriptions of women's labor experiences (N = 43) were obtained from chart review, self-report measures, and semi-structured interviews to examine the relevance of selected indicators of physiological distress and psychological distress that included: ketonuria, fluids, energy, length of labor, analgesia utilization, psychological symptom distress via scores from the Global Severity Index (GSI) of Derogatis' SCL-90-R, and sense of mastery via scores from the Labour Agentry Scale (LAS).

The sample was diverse in marital status (60% unmarried), age (44% teenagers), ethnicity (84% non-Anglo), and socioeconomic status (44% lower). Descriptors of physiological distress, represented by sample means, included: 29 women (67%) had moderate to large amounts of ketonuria; 69.86 ml/hr of fluid before the highest level of ketonuria; 11.44 hours of admission in the perinatal unit; 16.74 hours of limited fluid intake; 3.4 calories/hour intake during perinatal admission. Descriptors of psychological distress, represented by sample means included: 7.33 equianalgesic mg. of analgesia during labor; 0.92 Global Severity Index (GSI, SCL-90-R) reported for the period of labor; 0.76 GSI reported at 4 weeks postpartum (n = 35); total score of 134 (norm, 156.89; Hodnett & Simmons-Tropea, 1987) for the Labor Agentry Scale (LAS).

This convenience sample of nulliparae, who developed ketonuria during labor, had limited fluid and caloric intake, reported a higher degree of psychological symptom distress during labor and early postpartum, and reported a lower sense of mastery during childbirth than in other studies (Affonso, et al., 1992; Hodnett & Simmons-Tropea, 1987). Descriptive data from this study provide direction for future studies to further examine the phenomenon. Nursing interventions for women who experience difficult, prolonged labor, such as those of nulliparous women who develop ketonuria during labor, are implicated by results obtained from this exploratory study.
Notes: Source: Dissertation Abstracts International, Volume: 54-10, Section: B, page: 5091.

Thesis (PH.D.)--UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, 1993.

School code: 0034.
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