| The drug Misoprostol, is among the newest obstetrical interventions administered to women to facilitate cervical ripening to initiate labor. Its use, can produce intense labor contractions that are unexpected and unpredictable in primigravid women. Using a practice theory perspective (Kim, 2000) nurses caring for these women are challenged to develop nursing strategies targeted to ameliorate the negative perceptions these women can develop during childbirth.;Ten women admitted to a 900 bed tertiary medical center for Misoprostol administration participated in a pilot study to test a new instrument and develop the context and sequence of the new nursing intervention. Using Bandura's informational strategies to increase self-efficacy, the primary study hypothesized that women receiving the nursing intervention would have increased self-efficacy and self esteem scores compared to women who received standard nursing care, as measured by the Induced Labor Inventory for Self-efficacy (ILISE) and by the Maternal Self Report Inventory (MSRI). Forty-one primigravid women were randomly assigned to treatment or control groups. A 1 x 2 between subject multivariate analysis of covariance was performed on two dependent variables: self-efficacy and maternal self esteem. Age, education, marital status and gestational age were covariates. Significant main effects were found for self-efficacy [F (1, 40) = 24, 1; p = .0001], but not for maternal self esteem. The intervention developed, extends the literature by providing support for both the domain of practice and a context-specific nursing intervention. |
