This study aimed to delineate the optimal practices for early mother-infant skin-to-skin contact (SSC) by synthesizing the best available evidence, thereby facilitating its implementation and promotion.
We referred to the Joanna Briggs Institute (JBI) streamlined rapid review approach to conduct this study. Guide websites, institutional websites, national and international databases, and clinical decision-support systems were comprehensively searched. The Appraisal of Guidelines for Research and Evaluation II (AGREE II), AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews), and JBI appraisal tools were used to assess the quality of the included studies.
Fourteen guidelines, nine expert consensus reports, five evidence summaries, and one systematic review were included. Six domains comprising 18 recommendations were extracted: (1) target population; (2) preparations beforehand; (3) timing of initiation; (4) practices during SSC; (5) precautions during exposure; and (6) promotion of breastfeeding.
Based on the synthesized evidence, immediate or early uninterrupted SSC is recommended, regardless of the delivery mode. Newborns should be placed prone on the mother’s abdomen or chest as soon as possible after birth for a minimum of 60 or 90 min, or until completion of the first breastfeeding. Notably, we compared and selected evidence to address inconsistencies in practice. Our recommendations offer clarity on the target SSC population, preparation, precautions during exposure, and breastfeeding promotion. However, the explicit duration and initiation times of the SSC remain uncertain. These findings may serve as a valuable reference for future clinical practice and research.
Among the 7.8 million women with breast cancer worldwide, at least 33%–44% of them are affected by lymphatic pain. Lymphatic pain refers to co-occurring pain (e.g., pain, aching or soreness) and swelling. Pharmacological approaches, such as the uses of NSAIDS, opioids, antiepileptics, ketamine and lidocaine, have very limited effects on lymphatic pain. Limited research in this field has made it difficult for patients and clinicians to differentiate lymphatic pain from other types of pain. Precision assessment to distinguish different types of pain is essential for finding efficacious cure for pain. Innovative behavioral interventions to promote lymph flow and reduce inflammation are promising to reduce lymphatic pain. The goal of this review is to provide a comprehensive understanding of lymphatic pain through research evidence-based knowledge and insights into precision assessment and therapeutic behavioral intervention for lymphatic pain.
The SARS-CoV-2 pandemic accelerated the change in delivery of pediatric primary care services from in-person to telehealth to curb the spread of the SARS-CoV-2 virus, creating an urgent need to prepare competent, practice-ready Family Nurse Practitioner (FNP) graduates able to deliver high-quality pediatric telehealth services. The aim of this curricular quality improvement initiative was to develop preclinical telehealth competence through implementation of an innovative, technology-based, high-fidelity pediatric telehealth simulation educational intervention. The initiative was set in a private, urban university with a state-of-the art simulation center. Participants included FNP students, FNP faculty, and simulation faculty.
The Evidence Based Practice Improvement (EBPI) Model is the framework that was used for this initiative. A curricular gap analysis was conducted by faculty, results guiding the development of a high-fidelity, pediatric telehealth simulation educational intervention. Baseline measurements included student demographics, knowledge of essential pediatric telehealth concepts, and perceptions of self-efficacy in conducting telehealth visits. Knowledge assessment and self-efficacy were again measured after completion of a pre-briefing, pediatric telehealth asynchronous learning module, and self-efficacy for a third time after completion of the entire simulation intervention. Written, semi-structured qualitative questionnaires were also completed at the end of the intervention.
Knowledge assessment scores significantly increased from baseline after completion of the asynchronous learning module (P < 0.001). Pediatric telehealth self-efficacy scores also showed significant improvements from baseline after completion of the asynchronous learning module (P < 0.001) and again after completion of the simulation intervention (P < 0.001). Qualitative themes supported quantitative findings.
High-fidelity, pediatric telehealth simulation is an effective educational intervention to develop pre-clinical, telehealth competence in FNP students prior to pediatric clinical rotations and provide them with the skills to be practice-ready upon graduation.
We aimed to develop an implementation tool that could help healthcare professionals identify modifiable factors and develop tailored implementation strategies to promote the implementation of Early Essential Newborn Care (EENC) under the guidance of the Consolidated Framework for Implementation Research-Expert Recommendations for Implementing Change (CFIR-ERIC).
This theory-informed implementation study consists two phases. In Phase 1, an exploratory sequential design mixed-methods study will be used to explore the barriers and facilitators to implementing EENC. The qualitative results will be analyzed using NVivo 12.0, underpinned by the Consolidated Framework for Implementation Research (CFIR), whereas the quantitative results being achieved through questionnaires and analyzed using SPSS26.0. In Phase 2, based on the findings of Phase 1, a tailored EENC implementation strategies tool will be developed through iterative expert consultations utilizing the CFIR-ERIC tool and the Implementation Research Logic Model (IRLM).
To investigate the current situation and influencing factors of the childbirth experience of women with vaginal birth in China.
A total of 481 women were surveyed using a general information questionnaire and a childbirth experience questionnaire.
Significant differences in the scores for childbirth experience were found for 13 factors, including expected mode of delivery, number of births, time since last childbirth, methods used to access information, childbirth-related fear/anxiety, confidence in completing the delivery vaginally, total labor time, mode of delivery, the use of epidural anesthetic, gender preference for the newborn, primary caregiver during hospitalization, and general scores of fathers' childbirth experience. Stepwise multiple linear regression indicated that total labor time, fathers’ general childbirth experience scores, knowledge regarding delivery, delivery-related fear/anxiety, confidence in completing the delivery vaginally, mode of delivery, primary caregiver during hospitalization, and ethnicity explained 25.1% of the variation in responses to the childbirth experience questionnaire.
To improve the childbirth experience, medical and healthcare staff should increase maternal knowledge regarding vaginal delivery, reduce maternal fear and anxiety as well as the use of forceps and lateral incisions, and encourage spouses to be the primary caregivers during hospitalization.
Having a good diet quality not only increases the chance of getting all essential nutrients but also reduces the risk of non-communicable diseases.
This study aimed to investigate the socio-demographic determinants of diet quality among working women of reproductive age in the Klang Valley of Malaysia.
Socio-demographics (age, marital status, ethnicity, educational attainment, and monthly earned income) were self-reported by the respondents. The Diet Quality Questionnaire for Malaysia was used to assess all foods and drinks consumed by working women in the previous 24 h of a weekday and weekend day.
More than half of the 244 working women did not consume nuts and seeds (weekday = 71.7% versus weekend = 72.1%) or pulses (weekday = 63.1% versus weekend = 67.2%). Moreover, slightly less than half of working women (weekday = 43.9% versus weekend = 42.6%) reported not consuming milk or milk products. In contrast, grains, white roots and tubers, and plantains (weekday = 98.0% versus weekend = 98.0%) and meat, poultry, and fish (weekday = 97.1% versus weekend = 94.7%) emerged as the most consumed healthy food groups in the previous 24 h. This study also demonstrated that 13.1% (n = 32) of working women did not consume at least five healthy food groups daily. Age, marital status, ethnicity, educational attainment, and monthly earned income were the key socio-demographic determinants of diet quality in working women.
Healthcare professionals, especially nutritionists and dietitians, should work closely with the federal government of Malaysia to reiterate the importance of having a balanced and diversified diet in the nation.