Knowledge,practice and attitudes towards breastfeeding among mothers of infants with retinopathy of prematurity (ROP)

BackgroundBreastfeeding has several benefits for both the infants and mothers. This study assessed breastfeeding knowledge, attitudes, and practices (KAP) among mothers of infants with Retinopathy of Prematurity (ROP).MethodsA cross-sectional study was conducted among mothers of infants with ROP visiting the ROP clinic in a selected tertiary care centre. A total of 100 mothers were selected through the convenience sampling method and interviewed using a structured questionnaire.ResultA significant number of mothers had average to poor knowledge (81%) with a mean score of 8.32 ± 2.7. More than half of the mothers had poor practices related to breastfeeding with a mean score of 7.6 ± 2.4. The attitudes of the mothers towards breastfeeding was either neutral or positive towards formula feeding.ConclusionThe KAPs of mothers regarding breastfeeding were inadequate. Intervention measures are recommended for promoting breastfeeding practices among the mothers of infants with ROP.     

Oral mucosal mouthwash with chlorhexidine does not reduce the incidence of ventilator-associated pneumonia in critically ill children: A randomised controlled trial

BackgroundVentilator-associated pneumonia (VAP) is one of the most frequently encountered causes of hospital-acquired infection and results in high morbidity among intubated patients. Few trials have investigated the efficacy of oral care with chlorhexidine (CHX) mouthwash for the prevention of VAP in the paediatric population.ObjectivesThe objective of this study was to assess the efficacy of CHX mouthwash in the prevention of VAP and to determine risk factors for VAP in children aged 1 month to 18 years admitted to the paediatric intensive care unit (PICU).MethodsThis was a prospective, randomised, controlled, double-blind trial performed in the PICU. Patients were randomised into two groups receiving CHX (0.12%) (n = 88) or placebo (0.9% NaCl) (n = 86) and were followed up for VAP development. The main outcome measures were incidence of VAP, duration of hospital stay, duration of PICU stay, duration of ventilation, mortality, and the characteristics of organisms isolated in cases with VAP.Results:No difference was observed in the incidence of VAP and the type and distribution of organisms in the two groups (p > 0.05). In the CHX and placebo groups, we identified 21 and 22 patients with VAP, respectively. Incidence per 1000 ventilation days was 29.5 events in the CHX group and 35.1 events in the placebo group. Gram-negative bacteria were most common (71.4% in CHX vs. 54.5% in placebo). The use of 0.12% CHX did not influence hospital stay, PICU stay, ventilation, and mortality (p > 0.05). Multivariate analysis identified duration of ventilation as the only independent risk factor for VAP (p = 0.001).ConclusionThe use of 0.12% CHX did not reduce VAP frequency among critically ill children. The only factor that increased VAP frequency was longer duration on ventilation. It appears that low concentration of CHX is not effective for VAP prevention, especially in the presence of multiresistant bacteria.ClinicalTrials.gov IdentifierNCT04527276.     

Oral care practices of intensive care nurses: A descriptive study

The aim of this study was to investigate intensive care unit (ICU) nurses’ views and practices on oral care and to define the factors related to oral care measures. A study was carried out in eight ICUs of a teaching hospital in 2008. One hundred one nurses constituted the study sample. The data were collected using ‘Oral Care Practices Survey’ which included demographic characteristics (5 items) and current oral care practices (13 items). Oral care was given the highest priority by nearly 60% of the nurses. The most commonly used solution was sodium bicarbonate (79.2%), and the most frequently used equipment was foam swab (82.2%). Oral care was carried out less than every 4 h per day by 44.5% of the nurses. The oral care products and solutions were reported to be different in almost every unit. The relationship between the use of toothpaste and the place of employment was statistically significant (x² = 24.566, d.f. = 6, P = 0.000). There was a statistical significance between the clinics and frequency of oral care (x² = 81.486, d.f. = 42, P = 0.000). This study suggests that there is a wide variety of type and frequency of oral care measures among ICU nurses. Optimal oral care supported by evidence is an effective prevention method for eliminating oral complications.     

Effect of kangaroo care applied by mothers and fathers in premature infants: A crossover study

ObjectiveThis study aimed to compare kangaroo mother care (KMC) and kangaroo father care (KFC) with a crossover study in terms of physiological parameters and stress signs in preterm infants.MethodsIn this nonblinded, randomized, crossover trial, 30 preterm infants (<37 weeks gestation, <1500 gr birth weight) were randomly allocated for study. Preterm infants were given kangaroo care for 1 h a day, from the mother and father, alternately. Physiological parameters (temperature, HR, RR, O₂ saturation, BP) were recorded before, during, and after KC. Parents’ anxiety levels were evaluated before and after KC.ResultDuring KC time points, both KMC and KFC results showed that the physiological parameters of infants were within the normal range. But in KMC, O₂ saturation was higher than that in KFC at 30- and 60-min during KC (p < 0.05). In KFC, systolic BP (at 30 min) and body temperature (at 60 min) were higher than those in KMC (p < 0.05).ConclusionFindings suggest that both KMC and KFC improve physiological parameters of babies and ensure stability.     

The end-of-life care practices of emergency care nurses and the factors that influence these practices: An integrative review

IntroductionDue to philosophical tensions between end-of-life care and emergency care, nurses in the emergency department face challenges in the provision of end-of-life care. The purpose of this integrative review was to synthesise evidence of the end-of-life care practices of emergency care nurses and the factors that influence these practices.MethodsFor this integrative review, CINAHL, Embase, and MEDLINE databases were systematically searched in April 2020. In total, 30 studies written in English and published between 2010 and 2020 investigating the experiences of nurses caring for a patient that died in the emergency department were included. A constant comparative method was used to analyse and synthesise data.ResultsEnd-of-life care practices prominent in the literature included modifying the environment for privacy, the provision of information to families and the management of symptoms. The culture of emergency care, the nurse’s personal characteristics, the trajectory of death and available resources are factors that appear to determine whether ED nurses immerse themselves in end-of-life care or display distancing behaviours.ConclusionThere is limited evidence articulating the frequency to which specific practices are undertaken and the magnitude to which various factors influence end-oflife care provision. The generation of such knowledge may facilitate the development of initiatives that can optimise end-of-life care in the emergency department.     

Factors associated with dementia care practices among community health nurses: Results of a postal survey

Background

The incremental prevalence of dementia is making dementia management a worldwide issue. The role of community health nurses must grow along with the increasing aging population and the resulting increase in dementia cases.

Objectives

Explore the factors related to dementia care practices among the different types of community health nurses in Taiwan.

Design

Cross-sectional study.

Setting

Primary care centers or institutions in New Taipei City.

Participants

Community health nurses who work in health care centers (district nurses), long-term care centers (care managers), or home care institutions (home health care nurses).

Methods

Self-completion questionnaires sent by mail.

Results

A total of 195 participants returned the questionnaires (response rate 81.9%). Although 65.8% of participants had experience in case finding, just 34.6% of them reported using validated cognitive testing tools. Only 15% of participants provided case management following dementia case findings. The regression models showed that the different types of community health nurses, number of years working as a nurse, and their level of confidence was significantly related to their dementia care practice. District nurses identified significantly less suspected dementia cases and provided less nursing care to caregivers of dementia patients than care managers and home health care nurses. Among community health nurses, the care managers most often used formal cognitive instruments. District nurses provided the least amount of supportive resources information, had the most negative attitude and the lowest level of confidence toward dementia care than care managers and home health care nurses.

Conclusions

This study presented the profiles of dementia care practice in Taiwan. It showed the considerable variation in knowledge, attitude, confidence and dementia care practices among the different community health nurses. The professional roles regarding dementia care in Taiwan remain blurred. Future training must focus on promoting the level of confidence of community health nurses to identify and manage people with dementia and raise awareness about demented person's and their caregiver's need. The priority of the policy on dementia care in the community must be raised to high, and the professional responsibilities and roles of the different types of community health nurses for the ever increasing dementia population in Taiwan must be redefined and optimized.     

Severe postpartum distress in Icelandic mothers with difficult infants: a follow-up study on their health care

This article describes help seeking and health care of mothers with a difficult infant who suffered long-term depressive symptoms and a high degree of parenting stress. A subsample of severely distressed mothers (n = 37) was recruited from a cross-sectional national survey and followed up 2 months later by a semi-structured telephone interview. The survey included all Icelandic women who gave birth during a quarter of a year and had a live baby 2 months later (n = 1053). All distressed mothers with a difficult infant were selected from sample respondents on preset scores of two self-report distress measures. The study sample emerged during the selection process for an intervention study from which it was excluded on grounds of very high distress scores. Results showed that 5% of the surveyed population were postpartum severely distressed. Findings from this follow-up study revealed that only one woman of four received health care for severe distress by various professionals. One woman of six received help from others. Very few women utilized the services available at Health Care Centers. About half of the women held attitudes that hindered them in seeking help and health care. It is concluded that postpartum severely distressed women receive little primary health care for mental health problems and the majority of them show little initiative to seek out for help. More active outreach by health professionals is recommended.     

Proportion of mothers practicing kangaroo mother care at home and factors influencing the practices following hospital discharge,South Wollo,Ethiopia

BackgroundLow birth weight continues to be a significant public health problem globally. Kangaroo Mother Care (KMC) comprises of early and continuous skin-to-skin contact between mother and baby as well as exclusive breastfeeding. More interest has been given to initiate KMC at the health facility for low birth weight babies born at home but, there has been trace evidence to support initiation of KMC at home. Thus, this study was aimed to estimate the proportion of mothers who continued to practice kangaroo mother care at home and identify factors influencing this practice following hospital discharge.MethodsIt was a cross-sectional study of 190 mothers with their low birth weight babies who were discharged from KMC unit at Dessie referral and Akesta hospitals and counseled about KMC to practice at home. In the first week following hospital discharge, the data collectors visited the mothers to interview her about KMC practices and the factors influencing it and analyzed by SPSS V.25.0. Crude odds ratio and adjusted odds ratio were performed to test the association between dependent and independent variables.ResultThe proportion of mothers who practice KMC at home was 89(46.8%). Multivariate logistic regression showed that support from husband (AOR = 4.4, 95% CI = 1.8–10.4), support from health extension works(HEW)(AOR = 3.4, 95% CI = 1.6–7.2), availability of helper (AOR = 4.5, 95% CI = 1.9–4.10) and mothers explained the important of KMC (AOR = 2.3,95% CI = 1.1–4.9) were statistically associated with KMC practices at home.ConclusionThis study concludes that support comes from husband, health extension workers and family. Understanding of mothers about the importance of KMC was found to be one of the significant enhancing factors to implement KMC at home.     

Mutual trust in infant care: the nurses and mothers experiences

The relationship between healthcare providers and parents of infants in neonatal intensive care unit is based on trust and constitutes a core measure of family-centred care and health. The aim of the present qualitative study was to explore mothers and nurses experiences of trust in one another around the caregiving of the hospitalised infant in intensive neonatal care unit. Focused ethnographic research study conducted through observations and in-depth interviews with 20 mothers and 16 nurses in NICU of Tabriz (Iran) in 2017. Two main themes of ‘gradual and fragile trust of mother-to-nurse’ (subthemes: Primary trust-mistrust, mother's trust to responsible nurse, mother trust Increase with skilful nurse performance, and vulnerability to trust) and ‘gradual and fragile trust of nurse-to-mother’ (subthemes: Nurse's initial assessment of trust to mother's readiness to participate, Development of trust to mother, and vulnerability of nurse's trust to mother) were obtained. The present study revealed that mutual trust between the nurse and the mother in the care of the infant was a gradual and progressive process that was achieved over time. Complexities around the care of a hospitalised infant influenced how fragile or vulnerable the trust became between nurse and mother. Findings from this research can be used in supporting increased maternal participation in infant care and improvement of family-centred care in the neonatal intensive care unit.