Aims and objectives. This study set out to explore, from the family's point of view, ways in which nursing staff can promote family health during the child's hospital stay.

Background. Having a child in hospital is a major source of stress and anxiety for the whole family. Earlier studies have described parental coping strategies, ways to strengthen those strategies and to support parental participation in child care, but no one has studied the promotion of family health during the child's hospitalization from the family's point of view.

Design. Interviews were conducted in 2002 with 29 families who had a child with a chronic illness which were receiving or had received treatment on the paediatric wards of two Finnish hospitals.

Methods. Data analysis was based on the grounded theory method, proceeding to the stage of axial coding. Data collection and analysis phases proceeded simultaneously.

Results. Five domains were distinguished in the promotion of family health: (1) reinforcing parenthood, (2) looking after the child's welfare, (3) sharing the emotional burden, (4) supporting everyday coping and (5) creating a confidential care relationship.

Conclusions. The results strengthen the knowledge base of family nursing by showing how nursing staff can promote family health during the child's hospital stay.

Relevance to clinical practice. The results have a number of practical applications for nursing, both for clinical practice and research. The results can be used in paediatric hospital wards caring for chronically ill children and their families. The five domains of family health promotion described here should be tested in other paediatric wards and in other geographical locations.

Objective: To describe policies, practices, and associated rationales of hospital obstetric units regarding mothers' support person options during childbirth and to explore practices concerning support of breastfeeding initiation after cesarean delivery.

Design: Descriptive telephone survey.

Setting: Hospitals in the southeastern region of the United States.

Participants: Convenience sample of 154 obstetric nurse manager and nurse representatives employed by the participating hospitals.

Main Outcome Measures: Types of policies regarding mothers' support person options during childbirth and immediate postpartum stage, initiation of breastfeeding after cesarean birth, and attitudes about policies.

Results: All hospitals allowed two or more support persons during vaginal births, 89% permitted only one support person during nonemergent cesareans, and 58.0% of the nurse representatives believed that mothers should be allowed a second support person. Less than one third (31.2%) of the hospitals considered a mother's request to breastfeed in the operating room, and most (78.6%) allowed mothers to breastfeed in the recovery room.

Conclusions: Overall, maternal support policies, practices, and nurse representatives' attitudes were mother and family friendly, particularly related to vaginal births. Though breastfeeding initiation after cesarean birth was encouraging, support person options during nonemergent cesarean births and related rationales warrant further examination. JOGNN, 35, 634-643; 2006. DOI: 10.1111/J.1552-6909.2006.00078.x

Aim. This paper reports a systematic review conducted to determine the effectiveness of the use of risk assessment scales for pressure ulcer prevention in clinical practice, degree of validation of risk assessment scales, and effectiveness of risk assessment scales as indicators of risk of developing a pressure ulcer.

Background. Pressure ulcers are an important health problem. The best strategy to avoid them is prevention. There are several risk assessment scales for pressure ulcer prevention which complement nurses' clinical judgement. However, some of these have not undergone proper validation.

Method. A systematic bibliographical review was conducted, based on a search of 14 databases in four languages using the keywords pressure ulcer or pressure sore or decubitus ulcer and risk assessment. Reports of clinical trials or prospective studies of validation were included in the review.

Findings. Thirty-three studies were included in the review, three on clinical effectiveness and the rest on scale validation. There is no decrease in pressure ulcer incidence was found which might be attributed to use of an assessment scale. However, the use of scales increases the intensity and effectiveness of prevention interventions. The Braden Scale shows optimal validation and the best sensitivity/specificity balance (57·1%/67·5%, respectively); its score is a good pressure ulcer risk predictor (odds ratio = 4·08, CI 95% = 2·56–6·48). The Norton Scale has reasonable scores for sensitivity (46·8%), specificity (61·8%) and risk prediction (OR = 2·16, CI 95% = 1·03–4·54). The Waterlow Scale offers a high sensitivity score (82·4%), but low specificity (27·4%); with a good risk prediction score (OR = 2·05, CI 95% = 1·11–3·76). Nurses' clinical judgement (only considered in three studies) gives moderate scores for sensitivity (50·6%) and specificity (60·1%), but is not a good pressure ulcer risk predictor (OR = 1·69, CI 95% = 0·76–3·75).

Conclusion. There is no evidence that the use of risk assessment scales decreases pressure ulcer incidence. The Braden Scale offers the best balance between sensitivity and specificity and the best risk estimate. Both the Braden and Norton Scales are more accurate than nurses' clinical judgement in predicting pressure ulcer risk.

Aims. This paper reports a study whose purpose was to revalidate the Hung Postpartum Stress Scale by expanding and revising its contexts to reflect the social changes that have occurred in Taiwan over the last two decades.

Background. Existing measures of general stress, which have also been used to assess postpartum stress, fail to measure women's specific childbearing stressors during the postpartum period. The Hung Postpartum Stress Scale was initially developed 11 years ago by Hung and associates to measure stress in the early postpartum period as it occurred in the Taiwanese social milieu of the time. However, revalidation was needed because of rapid changes in the Taiwanese social system.

Methods. Employing a non-experimental, quantitative research design and a proportional stratified quota sampling of hospitals by birth rate, the revised instrument was completed by 861 postpartum women selected from clinics and hospitals in Taiwan.

Results. An exploratory common factor analysis indicated the structure validity of three dimensions of postpartum stress: concerns about maternity role attainment, concerns about negative body changes, and concerns about lack of social support. With regard to generalizability of the factors across delivery type, education level, and income status subgroups within the population, high coefficients of congruence were shown. Moreover, the internal consistency reliabilities for the total Hung Postpartum Stress Scale and its three dimensions across the full sample and within pertinent sub-samples showed that it is a reliable tool for measuring postpartum stress.

Conclusions. A series of analyses supported the validity and reliability of the revised Hung Postpartum Stress Scale. Additional research is recommended using confirmatory factor analysis to determine the stability of the factor structure identified in the present study.