Academic journal article Journal of Theory Construction and Testing

Development of the Adolescent Support Model

Academic journal article Journal of Theory Construction and Testing

Development of the Adolescent Support Model

Article excerpt


Adolescents approach their childbirth and breastfeeding experiences through the lens of their cognitive and psychosocial needs. Developing interventions which facilitate adolescents' childbirth satisfaction and initiation of breastfeeding may promote the health of these young mothers and their children through increasing their breastfeeding rates. The authors propose the Adolescent Support Model as a potential framework. Three studies have been conducted to facilitate the model's development. Six theoretical constructs were developed from the findings of these studies. These constructs include the client's perspective, the nurse's perspective, supportive needs of adolescents during childbirth, professional labor support, coping resources, and health outcomes. Although the Adolescent Support Model needs testing and refinement, it can provide a framework for planning and implementing interventions to enhance adolescents' childbirth and early breastfeeding experiences.

Key Words: adolescent childbirth, breastfeeding support, labor support

Adolescent pregnancies and childbirth continue to be a major concern in the U.S. After years of decline, pregnancy rates in the US have increased for females less than 19 years old, making the U.S. first among all developed countries in adolescent pregnancy rates (National Center for Healdi Statistics, 2008). The literature has focused on adverse economic, social, and health outcomes of adolescent pregnancy rather dian strategies to improve health outcomes for adolescent mothers and their children. As the health care professionals who have the most sustained interactions witfi women during pregnancy, childbirth and the postpartum period, nurses can play a significant role in promoting the health of childbearing adolescents (Mercer, 1990). Models are needed to guide nurses as they provide support to these young mothers.

Over the past 26 years, only six studies examined childbirth from an adolescent mother's perspective. Four explored adolescents' perceptions of their childbirth experiences (Anderson & McGuinness, 2008; Low, Martin, Sampselle, Guthrie, & Oakley, 2003; Mercer, 1986; Nichols, 1996). Only two identified adolescents' petspectives of helpful nurse behaviors (Sauls, 2004; Sauls, 2010). The purpose of this article is to describe the development of the Adolescent Support Model, which conceptualizes supportive nursing care for adolescents during childbirth and initiation of breastfeeding.

Origins of the Model

The development of the Adolescent Support Model© was based on four assumptions. First, childbirth is a pivotal event of powerful psychological importance in a young woman's life. Second, a positive childbirth experience sets the stage for a positive breastfeeding experience. Third, intrapartum nurses, through the professional labor support they offer, can increase women's chances of having positive childbirfh and initial breastfeeding experiences. Fourth, in a time of transition between childhood and adulthood, adolescents' developmental needs affect how they experience pregnancy and childbirth. Each of these assumptions will be discussed.

A pivotal event. Childbirth is a pivotal event of powerful psychological importance in a young woman's life (Nichols, 1996). Research has shown that the childbirth experience, whether positive or negative, can impact psychological outcomes. When the childbirth experience is positive, a woman develops a positive attitude toward motherhood which fosters positive feelings toward her infant (Laurence, 1997). This response facilitates transition into the maternal role (Mercer, Hackley, & Bostrom, 1983). A satisfactory transition into the maternal role, which includes emotional attachment to the infant, has an immediate and long-term effect on her relationship with her infant. Emotional attachment insures survival by increasing the mother's sensitivity to her infant's signals (Waldenstrom, 1996). …

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