Knowledge gaps related to breastfeeding and immunization in the mothers of infants with congenital heart diseases: An urgent concern

BackgroundInfants born with congenital heart diseases are extremely vulnerable to infections.ObjectivesWe explored the knowledge and practices of the mothers of infants with congenital heart disease (CHD) related to breastfeeding and immunization and also assessed the breastfeeding rate and immunization coverage of infants with CHD.MethodIn a cross-sectional study, mothers (N = 100) of infants with congenital heart disease attending the outdoor patient department (OPD) were enrolled using convenience sampling. A structured self-developed pretested and validated knowledge questionnaire was used to collect data. Data were analyzed using SPSS version 26.0 for windows.ResultThe mean age of the mothers was 26.57 years (SD ± 4.1), with most (59) mothers having one child and mothers educated up to secondary level (44). The median age of the infants was 4.35 months (IQR, 2–12). The median breastfeeding and immunization knowledge scores of the mothers were 9 (6.5–10.0) and 4.5 (2–6) respectively. A significant number of mothers had poor knowledge related to immunization (83) and breastfeeding (33). The majority of infants were either partially breastfed or not breastfed (69) and partially vaccinated (66) at the time of the survey.ConclusionA significant remediable gap was observed in the knowledge of the mothers of infants with CHD, requiring a regular educational session on breastfeeding and immunization in the follow-up OPD by the health care providers.     

Effectiveness of Nurse led structured teaching programme on knowledge and practice of postnatal mothers on low birth weight care

BackgroundLow birth weight (LBW) in infants is a critical issue worldwide. If the issue is not recognized early, it can lead to high mortality and morbidity rates. Mothers and caregivers of LBW newborns holds a great responsibility and need appropriate information and expertise in caring for the LBW newborns. This study aimed to evaluate the effectiveness of a Nurse led structured teaching program (NLSTP) on the knowledge and practice of mothers of LBW infants.MethodsA quantitative pre-experimental one group pre-test post-test research study was conducted. A sample of 30 postnatal mothers of LBW babies meeting the inclusion criteria were selected. The knowledge and practices of postnatal mothers on the care of LBW babies was tested using a structured interview schedule and a checklist before the administration of NLSTP. Thereafter, the NLSTP was conducted using an educational booklet. After the NLSTP, the knowledge and practice were assessed on the 7th day.ResultsThe findings of the study reflected poor knowledge and practice scores before the intervention in the pre-test. However, the mothers gained a good level of knowledge showing marked improvement in their practices after the NLSTP was implemented. The mean post-test knowledge score (17.6) was significantly higher than the mean pre-test knowledge score (10.8) with a SD of +1.33. Likewise, the mean post-test practice score (15.6) was significantly higher than the mean pre-test practice score (8.23) with a SD of +7.5. The paired ‘t’ test computed between pre-test and post-test knowledge scores (t = 67.6) and practice scores (t = 5.28) were highly significant at p ≤ 0.05 level. A significant association was found between the pre-test knowledge scores and monthly family income (p < 0.05 level).ConclusionThis study highlights that post-natal mothers have a lack of expertise in caring for their LBW babies. The NLSTP targeted at improving the knowledge and practices of post-natal mothers regarding the care of their LBW babies can help reduce the morbidity and mortality rates of LBW babies.     

Pain knowledge,attitudes and beliefs of Australian osteopaths drawn from a nationally representative sample of the profession

BackgroundPain has been identified as a global health issue with substantial effects on individuals and society. Health professionals managing pain complaints must have appropriate knowledge of pain neurophysiology, and attitudes and beliefs towards pain management that align with current practice guidelines.ObjectivesEvaluate Australian osteopaths' current level of knowledge of pain neurophysiology and their beliefs and attitudes towards pain, and explore associations with demographic variables.MethodAustralian osteopaths drawn from a nationally representative practice-based research network received the questionnaire. The questionnaire included demographic information, Neurophysiology of Pain Questionnaire (NPQ), Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) and the Attitudes to Back Pain Scale in Musculoskeletal Practitioners (ABS-mp).ResultsComplete responses were received from 211 osteopaths (21.3% response rate). The mean total NPQ score was equivalent to 72.2% correct responses. The PABS-PT Biomedical scale mean score was 38.8 ( ±9.1, α = 0.81) and the Biopsychosocial scale was 22.3 ( ±3.3, α = 0.38). ABS-mp mean factor scores suggest osteopaths support psychological approaches (22.1, ±3.3, α = 0.71) but endorsed more treatment sessions for those with back pain (15.9, ±4.7, α = 0.71). Trivial correlations between measures and most demographic variables were observed. Osteopaths who undertook further studies in pain had higher mean NPQ scores, with moderate negative correlations with a lower PABS-PT Biomedical subscale score (ρ = −0.45, p < 0.01).ConclusionsAustralian osteopaths demonstrate a range of pain neurophysiology knowledge, and beliefs and attitudes towards pain. The findings support the positive impact of professional development for improving pain knowledge in this population.     

An investigation of knowledge,attitude and practice towards simulation among clinical nursing teachers in China: A cross-sectional study

AimThis study aimed to investigate the knowledge, attitude and practice towards simulation among CNTs in China and analyze the influencing factors.BackgroundIn China, simulation is now increasingly used by Clinical Nursing Teachers (CNTs) who are mainly responsible for nurses’ continuing education, novice nurses training and nursing students practice in clinical settings. Over the past 20 years, enrolment scale of nursing education was expanded greatly, and the number of registered nurses increased from 1.22 to 4.10 million in China. To contribute to nurses’ or nursing students’ professional development and successful transition to competent practitioners, CNTs are now being challenged to use simulation to develop more learner-centered educational programs, which could better facilitate learner engagement. As faculty preparation is a prerequisite for conducting quality simulation, it is critical that CNTs have the requisite knowledge and skills to use simulation to its full potential. However, data on CNTs’ knowledge, attitude and practice towards simulation is limited.DesignA cross-sectional study.MethodsA total of 342 CNTs from six tertiary affiliated teaching hospitals of a medical university in Beijing, China, participated in the study. Electronic questionnaire of Nurse Educators’ Knowledge, Attitude and Practice towards Simulation (NEKAPS) was delivered to CNTs. Analysis of variance, t-test were used to analyze data.ResultsThe mean score of knowledge and attitude for all participants was 60.01 ± 13.42 and 81.40 ± 19.99, respectively. The mean practice score was 70.65 ± 22.05 for 162 participants (47.4 %) who had conducted simulation in their hospitals. Participants with higher educational level (F=3.476, p = 0.032) and nursing career length≤ 15 years (t = 2.676, p = 0.008) had higher knowledge scores. However, there were no significant differences among different groups for attitudes. Participants with age ≤ 35 years old (t = 3.355, p = 0.001), nursing teaching length ≤ 10 years (t = 2.073, p = 0.041) and advanced beginner nurses (t = 3.212, p = 0.002) presented higher practice scores.ConclusionsCNTs had a low level of knowledge on simulation. Their attitudes towards simulation were positive, whereas their practices were still lacking. It is highlighted an urgent need for standardized training of CNTs to improve their knowledge and practice towards simulation, so that they can optimize the simulation programs they provide for nurses or nursing students.     

Predictors of breastfeeding self-efficacy during the covid-19 pandemic

BackgroundBreastfeeding self-efficacy (BSE) is a strong predictor of the duration of breastfeeding. The aim of this study is to determine the predictors of BSE in breastfeeding mothers during the Covid-19 pandemic.MethodsA cross-sectional study was conducted with 300 breastfeeding mothers who breastfed during the Covid-19 pandemic. Convenience sampling was used to recruit participants. A battery of online questionnaires measured sociodemographic and obstetric characteristics, breastfeeding self-efficacy, spouse postpartum social support, perceived social support, anxiety and depression, and fear of Covid-19. Data were analyzed using Pearson correlation coefficients, one-way ANOVA, and multivariable linear regression via stepwise method. The significance level in this study was α = 0.05.ResultsThe mean BSE score among participants was 58.19 ± 10.48 (out of 70). Spouse postpartum social support (β = 0.732, p = 0.04), intention to breastfeed (β = 0.17, p = 0.001), use of formula while breastfeeding (β = ?0.09, p < 0.001), and depression (β = - 0.11, p < 0.001) were significant predictors of BSE. However, fear of Covid-19 was not significantly correlated with BSE (p = 0.514).ConclusionThe results of the present study showed that fear of Covid-19 was not a significant predictor of BSE, while spouse postpartum social support and having the intention of breastfeeding were positively associated with BSE. Depression and simultaneous use of formula in feeding the infant was negatively associated with BSE during Covid-19. Overall, breastfeeding can be encouraged through counseling to improve receiving spousal support, increasing breastfeeding intent, and reducing depression.     

A study of the prevalence and severity of retinopathy of prematurity in East of Iran during 2015–2017: A descriptive cross-sectional study

IntroductionRetinopathy of prematurity (ROP) is a retinal vascular disease in preterm infants, which can cause partial defects in visual acuity or lead to serious defects including retinal detachment and blindness. In most cases, ROP can be prevented and treated if detected early. In this study, the prevalence of ROP and some factors affecting the severity of this disease have been examined.MethodThis cross-sectional study was implemented on 253 premature infants referred to Khatam-Al-Anbia hospital in Mashhad in 2015–2017 period for ROP screening. The sampling was performed using census method. The data-gathering tool was a demographic questionnaire and a checklist for recording the stage of the disease, follow-up and treatment of the patients.ResultsThe sample consisted of 104 female infants (41.1%) and 149 male infants (58.9%). The mean gestational age of infants was 32.1 ± 2.9 weeks and the mean birth weight was 1697.2 ± 566.5 g. Of the sample, 112 (44.3%) had some degrees of ROP and only 1.98% were in need of treatment. In the first examination, the severity of retinopathy in both eyes of infants was the highest in infants with gestational age of less than 32 weeks, and the lowest in infants older than 34 weeks (P < 0.001). There was a significant correlation between ROP severity and gestational age (p ≥ 0.001). The severity of retinopathy in natural pregnancy was also lower than assisted reproduction techniques (P < 0.001). In this study, there was no significant relationship between ROP severity and gender (p ≥ 0.10).ConclusionIn general, the prevalence of ROP in our sample was relatively high. Considering that the severity of ROP was found to be related to the gestational age of infants, and since early diagnosis is the key to ROP treatment, it is suggested to administer ROP screening for all infants with a gestational age of less than 34 weeks or premature infants born by assisted reproduction techniques.     

Knowledge and attitudes of family members towards postpartum depression

BackgroundPostpartum depression (PPD) has been recently recognized as a public health issue. While family members play an important role in early recognition of PPD among women, research that explores family members awareness on PPD is limited from India.AimTo explore the knowledge and attitudes of family members towards postpartum depression.MethodsThis was a cross-sectional survey carried out among family members of postpartum women (N = 202) at a pediatric tertiary care center. The data was collected through face to face interview technique using a structured questionnaire.ResultsThe mean scores on knowledge (18.92 ± 3.27) attitude (31.39 ± 4.91) scales suggest that a majority of the participants had a good level of knowledge (54%) and positive attitudes (69.7%) towards women with postpartum depression. However, misconceptions and negative stereotypes related to postpartum depression still prevailed. Family members who had a good level of education (χ2 = 4.21, p < 0.05) and had come across women with postpartum depression (χ2 = 13.27, p < 0.001) hold positive attitudes towards postpartum depression compared to family members with a lower level of education and those did not come across women with postpartum depression.ConclusionThe findings of the present study suggest the need for educational campaigns to improve perinatal mental health literacy and address prejudices and negative stereotypes related to postpartum depression among family members.     

A Statewide Evaluation of the Breastfeeding Resource Nurse Model

ObjectiveTo evaluate a statewide initiative to increase the provisioning of human milk in NICUs.DesignA survey of nurses before participation in an educational session, immediately after education, and again 9 months later.SettingNurses from 22 hospitals throughout Florida.ParticipantsWe surveyed 121 participants, including some nurses who had prior breastfeeding education or certification as well as those without specialized breastfeeding training.InterventionAn educational project called the Breastfeeding Resource Nurse Master program was intended to educate NICU nurses to implement the “Ten Steps to Promote and Protect Human Milk and Breastfeeding in Vulnerable Infants.”MeasurementA quantitative needs assessment survey was administered to participants to determine current hospital practices, policies, and perceived areas for improvement. Pre- and immediate posttraining surveys assessed NICU nurses’ knowledge, attitudes, and beliefs about human milk feeding of critical care infants and their self-efficacy for implementing the program in their respective NICUs. A follow-up, open-ended survey was administered at 9 months to yield information on program implementation.ResultsNICU breastfeeding practices varied widely at baseline. Nurses’ scores for knowledge, beliefs, and behavioral intentions improved postsession, but the implementation of practice changes related to the Ten Steps for Vulnerable Infants proved difficult. Nurses identified insufficient time and resources as barriers to educating others and changing practice.ConclusionsPolicies and regulations that make hospitals accountable for increasing human milk provision to vulnerable infants may be necessary to ensure that hospitals devote adequate resources to implementing practice changes in this area.     

Promoting Breastfeeding and Lactation Among Mothers of Premature Newborns in a Hospital in China

ObjectiveTo promote breastfeeding and lactation in mothers separated from their premature infants admitted to the NICU in a hospital in China.DesignFor this evidence-based practice project we used a mixed method of survey measures and interviews and were guided by the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research Into Practice framework.Setting/Local ProblemObstetric unit of a Women and Children’s Hospital in China from September 2017 to August 2018. Before the project, the partial breastfeeding rate in the hospital was 17.9%, and the exclusive breastfeeding rate of premature infants was 1.8%; these rates were much lower than the national breastfeeding rate in the country.ParticipantsSeventeen nurses and 70 mothers of premature infants.Intervention/MeasurementsThe project included three phases: (a) finding the best evidence to promote breastfeeding in the literature and identifying the gaps between best practice and current practice, (b) implementing best practice strategies, and (c) comparing pre- and postintervention outcomes. Based on the evidence in the literature and the barriers, strategies were implemented in practice to promote breastfeeding and lactation among women separated from their preterm newborns. Chi-square and t tests were performed to compare the pre-/postintervention differences.ResultsPartial breastfeeding rates increased from 17.9% to 52.7%, and exclusive breastfeeding rates increased from 1.8% to 4.1%. Compliance with breastfeeding guidelines and measures of maternal lactation volume both improved significantly.ConclusionPromoting breastfeeding and lactation among mothers of premature infants requires not only scientific knowledge but also a caring environment and family-centered practice.     

Knowledge and Health Beliefs of Gestational Diabetes Mellitus Associated with Breastfeeding Intention Among Pregnant Women in Bangladesh

PurposeThis study aimed to investigate the knowledge of gestational diabetes mellitus (GDM) and the health beliefs about GDM management, as well as to investigate the effects of these factors on breastfeeding intention in Bangladesh.MethodsThis study involved a cross-sectional survey of 358 healthy pregnant women who visited antenatal clinics in Bangladesh.ResultsPerceived susceptibility, perceived benefit, and self-efficacy were identified as significant factors for breastfeeding intention (p < .05). Participants had a poor understanding and a lack of knowledge of GDM, which can lead to inadequate health behavior. Health beliefs were significantly associated with participants’ breastfeeding intention related to GDM.ConclusionAntenatal education for breastfeeding in GDM mothers should focus on providing accurate information on GDM and strengthening their health beliefs such as self-efficacy within the context of the mothers’ culture.     

Factors Associated With Exclusive Direct Breastfeeding in the First 3 Months

ObjectiveTo identify factors associated with exclusive direct breastfeeding in the first 3 months among mother and infant dyads living in the United States.DesignA secondary analysis of data collected using a cross-sectional online survey completed over a 4-month period in late 2019.ParticipantsWe recruited a convenience sample of 370 mothers with healthy full-term singleton infants between 1 and 12 weeks of age whose feeding methods consisted of direct breastfeeding at least once a day. Mothers had not returned to work/school at the time of the survey completion.MeasurementsThe questionnaire consisted of 34 questions about maternal and infant factors that influence decisions about infant feeding, professional support, and parental preferences.ResultsMothers who practiced feeding on demand (adjusted OR [aOR] = 35.76, 95% confidence interval [CI] [2.04, 500.00]) and mothers of infants 1 to 4 weeks of age (aOR = 2.74, 95% CI [1.54, 4.85]) were more likely to use exclusive direct breastfeeding. The odds of exclusive direct breastfeeding decreased with mothers who breastfed with a nipple shield while in the hospital/birth center/home (aOR = 0.13, 95% CI [0.05, 0.35]), used pacifiers (aOR = 0.31, 95% CI [0.21, 0.65]), or had perceptions of insufficient milk (aOR = 0.11, 95% CI [0.04, 0.26]).ConclusionDemand feeding and an infant’s age of 1 to 4 weeks contributed to exclusive direct breastfeeding. Lower rates of exclusive direct breastfeeding were associated with the use of nipple shields immediately after birth, pacifier use, and perceptions of insufficient milk. Further investigation is warranted to fully differentiate exclusive direct breastfeeding from exclusive breastfeeding.     

The effectiveness of Kangaroo Mother Care (KMC) on depression,anxiety, and stress of mothers with premature infants

ObjectiveThe stress and anxiety of mothers with preterm infants affect mother-infant interactions. Skin-to-skin contact demonstrates benefits in the relationship between a mother and a preterm infant. This study aimed to evaluate the effectiveness of Kangaroo Mother Care (KMC) on depression, anxiety, and stress of mothers with premature infants.MethodsThis quasi-experimental study was performed on 100 mothers of premature infants who were admitted to two Bu Ali Sina and Imam hospitals of Sari in 2020. A questionnaire containing demographic information and the Depression, Anxiety, Stress Scale (DASS) were used as data collection tools. All data analysis was performed using SPSS software version 25. Significant level is considered P < 0.05.ResultsThe mean age of mothers with premature infants was 28.7 ± 5.4 years. The neonatal birth weight was 1614 ± 342 g and their discharge weight was 2052 ± 418 g. After the intervention, the levels of depression (P = 0.004), anxiety (P = 0.000), and stress (P = 0.003) of mothers in the intervention group were significantly lower than the control group.ConclusionThe results of the present study showed that Kangaroo Mother Care can be used to improve the mental health of mothers with premature infants by reducing the level and severity of depression, anxiety, and stress.