Abstract

Infants born to adolescent and young adult mothers who abuse substances, are at high risk for chemical dependency and its sequelae. There is a need to identify such infants and their mothers so that intervention will be available to them. The purpose of this study was to develop a systematic approach to evaluate mothers and infants for potential drug use and improve the quality of the nurses decisions.

This research project involves two sub-projects. In Part A, a Substance Abuse Assessment Tool (SAAT) was developed. The hospital nurses used the SAAT March 1, 1990, through April 12, 1990. The incidence rate of positive urine drug screens was 17.3% for mothers and 7.2% for infants. Due to differences in metabolism, mothers and their infants may have disparate drug screens results. When positive mother or infant urine drug screen results are combined the incidence rate raised to 34%. Indicators of substance abuse found to be significant (p < .05) were: mother's tobacco use, history of spontaneous abortions, pronounced anxiety, inappropriate anger, anxious to leave the hospital, unrealistic panic reactions, poor hygiene/grooming, being single, presence of 'popping', and tracts; infant meconium stained, respiratory rate > 60/min., continuous high pitched cry, and poor feeding.

Experts identified from the literature were polled regarding scoring for the tool assessment items. The Tool Development Study results combined with the findings of the experts developed a scored SAAT. The scored SAAT is available for maternal and neonatal assessment and further research.

Part B of the study identified the current status of identification of maternal and neonatal substance abuse at six hospitals, August 1, 1989 to April 2, 1990. The hospitals had a positive urine drug screens incidence rate from zero percent to 22% for all mothers and infants admitted. The variability found in incidence rates may be due to differences of sophistication in substance abuse assessment methods. Differences in accuracy rates for the decision to test for drugs at six hospitals were not significant.

School

School of Public Health

First Advisor

Jerry W. Lee

Second Advisor

Christine Neish

Third Advisor

Ruth M. White

Degree Name

Doctor of Public Health (DrPH)

Degree Level

Ph.D.

Year Degree Awarded

1990

Date (Title Page)

9-1990

Library of Congress/MESH Subject Headings

Maternal Behavior; Substance Abuse Detection; Neonatal Abstinence Syndrome; Prenatal Exposure Delayed Effects; Substance-Related Disorders; Maternal Fetal Exchange; Maternal Exposure; Abnormalities, Drug-induced

Type

Dissertation

Page Count

xx; 433

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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