Journal of Perinatal & Neonatal Nursing最新文献

Purpose: This review aims to ascertain the effects of mHealth on negative emotions among parents of preterm infants and analyze the current state of mHealth services in this context.

Background: Caring for preterm infants often engenders negative emotions in parents, such as anxiety, depression, and stress. Mobile Health (mHealth) services offer potential benefits for preterm infant care. However, there are several uncertainties regarding the impact of mHealth services on parental emotions.

Methods and study design: Randomized controlled trial (RCT) and quasi-RCT were published in English and Chinese until 2023 and are available in the electronic databases of MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINHAHL), Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang Database, and China Science and Technology Journal Database were reviewed. Review Manager 5.4 was employed for random-effects meta-analysis.

Results: Seven RCTs and 6 quasi-RCTs with high risks were included, most of them were based on small sample size and single-centered. Meta-analysis demonstrated that mHealth interventions mitigated negative emotions, including anxiety (standard mean difference [SMD] = -1.07; 95% confidence interval [CI], -1.47 to -0.66; P< 0.0001), depression (SMD = -1.94; 95% CI, -3.01 to -0.86; P< 0.0001), and stress (SMD = -1.24; 95% CI, -2.07 to -0.40; P< 0.0001), among parents of preterm infants.

Conclusions: It is recommended to develop independent specialized software for mHealth, enhance theoretical underpinnings, and standardize practical protocols. Incorporating early recognition and screening of negative emotions within mHealth could offer comprehensive support for the mental health of parents with preterm infants.

Implications: The mHealth-based interventions are needed to focus on the parents' emotional needs and minimize the impacts associated with mental stress.

Purpose: To examine Pinterest pins to discern the content, messaging and claims, and engagement with pins regarding formula hacking and homemade formula.

Background: The American Academy of Pediatrics and the Centers for Disease Control and Prevention discourage formula hacking (ie, preparing formula not according to directions to extend its use) and making homemade infant formula due to its associated health risks. Yet, caregivers are using social media platforms to find information on these topics.

Methods: This study conducted a content analysis of Pinterest pins related to formula hacking and homemade infant formula identified from the platform in January 2023 by using 14 search terms.

Results: A total of 63 pins were included in the sample. The topic of all (100.0%) pins was homemade formula. More than one-half (56.0%) of the 25 pins that provided a recipe included an unsafe ingredient, such as raw milk. The most frequently provided reasons to use homemade infant formula were in an emergency (38.2%) and when breastfeeding was not possible (38.2%). The most common claim was that homemade infant formula was healthy (59.6%). The total number of followers for the 63 pins was 861 636.

Conclusions: Pinterest is widely used by caregivers to find feeding information for their infants. Credible organizations should utilize Pinterest to disseminate safe infant feeding practices supported by the Centers for Disease Control and Prevention and the American Academy of Pediatrics.

Implications: The results will help nurses advocate for safe infant feeding and help them guide caregivers away from unsafe formula practices found on social media.

Objective: To examine the effects of an internet-based Developmental Home Care Support program (DHCSP) to reduce maternal psychological symptoms and improve preterm infants' physical growth outcomes.

Methods: A randomized controlled trial was conducted. The mother-infant dyads (nm = 34, np = 40) were randomly assigned to either the DHCSP intervention group or the control group. Data were collected at discharge (T0), 1-month corrected age (T1), and 2-month follow-up (T2), including mothers' postpartum depressive and posttraumatic stress disorder (PTSD) symptoms and mother-proxy infants' body length, weight, and head circumference.

Results: There were no significant differences in sociodemographic characteristics between the 2 groups at T0, except for mothers' age and monthly household income (both P = .01). Mothers in the DHCSP group reported significantly higher decreases in depression symptoms (β = -2.24; 95% confidence interval [CI], -4.31 to -0.16, P = .03), and their preterm infants showed significantly more increases in body length (β = 2.09; 95% CI, 0.30-3.87, P = .02) than the control participants at T2. The 2 groups did not show significant differences in mothers' PTSD symptoms or infants' body weight and head circumference.

Conclusion: The internet-based DHCSP intervention was effective in improving mothers' depressive symptoms and infants' body length.

Aim: We aimed to investigate the effect of "Baby Friendly NICU" practice on exclusive breastfeeding rates following discharge in very preterm infants.

Background: The Baby-Friendly Hospital Initiative (BFHI) is a global program launched by the World Health Organization (WHO) and UNICEF.

Methods: The feeding technique, type of nutrition (breastfeeding, formula, mixed) and anthropometric measurements of the very preterm infants (≤32 gestational weeks) were recorded for every month following discharge up to corrected 6 months of age. Exclusive breastfeeding rates were compared between 2 periods before "Baby Friendly NICU" practice (group 1) and after (group 2).

Results: Data of 252 infants, 135 in group 1 and 117 in group 2 were analyzed. Exclusive formula feeding rates decreased by 6 months age in group 2 (46 vs. 32%, P = .02); however, exclusively breastfeeding rates did not changed significantly (20% vs. 29%, P = .14).

Conclusion: Baby friendly NICU practices significantly decreased formula feeding rates at 6 months; however, it did not have an effect on exclusive breastfeeding rates at any time point during follow-up probably due to small sample size.

Background: The newborn can learn the voices of its mother and father during intrauterine life, and the reencounter with these familiar voices after birth has a relaxing and calming effect on the baby.

Purpose: The purpose of this study was to determine the effect of mother's voice and father's voice that newborns listened to during the heel blood collection procedure on pain level and physiological parameters.

Methods: The study was a randomized controlled trial. The study consisted of a total of 90 newborns as participants (mother voice group = 30, father voice group = 30, and control group = 30) at the Düzce Atatürk State Hospital Gynecology Service, Türkiye. Newborns randomly assigned to the intervention groups were made to listen to the mother's voice/father's voice during the heel prick procedure. The newborn in the control group received standard heel blood collection procedures.

Results: When the pain level of newborns was examined, it was determined that the lowest Newborn Infant Pain Scale score was in the mother's voice group (P < .05). When the physiological parameter results were evaluated, it was determined that the highest oxygen saturation value and the lowest heart rate were found in the mother's voice group (P < .05).

Conclusion: It was determined that the mother's voice was the most effective method in relieving the pain that occurred during the heel prick procedure and in the positive course of physiological parameters in newborns. According to the results of the study, it is recommended to use the mother's voice in order to reduce the pain caused by the heel prick attempt in newborns and to regulate their physiological parameters.

Purpose: To summarize how nursing resources and missed nursing care are associated with hospital breastfeeding outcomes, including human milk provision.

Background: Nurses are the primary providers of breastfeeding support in the hospital. Nursing resources, eg, staffing and the work environment, enable nurses to carry out their work successfully. If resources are constrained, nurses may miss providing breastfeeding support. There is a gap in the literature about the relationships among nursing resources, missed nursing care, and breastfeeding outcomes.

Methods: The Cumulative Index to Nursing and Allied Health Literature and PubMed were searched with keywords such as: "nurse staffing," "nurse work environment," "missed nursing care," "breastfeeding," "human milk," and "lactation." We included peer-reviewed studies of US samples in English published between 2014 and 2022.

Results: Of 312 references, 8 met inclusion criteria: 5 quantitative and 3 qualitative. Better nurse staffing and breastfeeding support were associated with improved breastfeeding outcomes in the qualitative and quantitative literature. Missed care partially mediated the relationship between staffing and exclusive breast milk feeding rates. Better nurse work environments were associated with increased breastfeeding support and provision of human milk.

Conclusions: Empirical evidence supports an association between the nurse work environment, nurse staffing, breastfeeding support, and outcomes. Implications for practice and research: Poor staffing may be associated with decreased breastfeeding support and outcomes. Hospital administrators and nurse managers may consider improving nurse staffing and the work environment to improve breastfeeding outcomes. Future research should simultaneously examine staffing and the work environment and address breastfeeding outcome disparities.

Background: Skin-to-skin contact (SSC) is crucial in neonatal intensive care unit (NICU) care; yet, challenges exist in its implementation. This study addresses a knowledge gap by examining the most effective ways to introduce SSC in the NICU, emphasizing the need to seamlessly integrate this practice for optimal infant and parent care. One way, among many, to implement SSC is to increase staff's knowledge and awareness about SSC.

Objective: To describe the effect of an educational intervention on SSC time, the number of SSC sessions per day, and the number of infants cared for with SSC within their first day of life.

Methods: A pre- and postinterventional study design was used to determine the effect of an educational intervention on SSC time, the number of SSC sessions per day, and the number of infants cared for with SSC within their first day of life.

Results: The prevalence of infants receiving SSC during their first 24 hours of life, the number of SSC sessions per day, and the duration of each SSC session increased after the intervention, and these effects persisted over 2 years.

Implications for practice: Our study highlights the impact of staff education and reflective discussions on SSC in the NICU. Integrating these with practical training, parental education, and NICU environment modifications is pivotal for enhancing and sustaining optimal SSC practices, benefiting both infants and parents.

The purpose of this program evaluation was to gather information on proportions of LGBTQIA+ individuals and families, their needs, and care experiences in a county health department's home visiting programs for perinatal clients and to make recommendations for improving culturally competent care for LGBTQIA+ individuals and families. In this engaged scholarship partnership, home visiting nurses administered a questionnaire to perinatal clients including demographic information on sexual orientation and gender identity. Differences between LBGTQIA+ identifying individuals' perception of the perinatal care received and those of heterosexual, cisgender individuals were assessed. On the basis of these data, 10% of the 52 respondents identified as LGBTQIA+ and 4% identified with a gender other than "woman." Clients who identified as straight had similar mean scores to those who listed an LGBTQIA+ sexual orientation. Clients who chose a gender identity other than "woman" had scores that fell within the 50th to 75th percentile of the overall mean. Qualitative interviews with 2 respondents provided additional in-depth information on their experiences. Overall, clients served by these perinatal programs reported similar diversity in terms of gender identity and sexual orientation as compared with national averages. This project provided evidence of the diversity among the clientele served by this agency and the importance of expanding the focus on inclusionary language and practices.

Purpose: This study aimed to assess the extent to which single-family room (SFR) designs enhance family presence and satisfaction and to examine the impact of built environment factors such as proximity, access, privacy, technology, lighting, and acoustics on these outcomes.

Background: The SFR neonatal intensive care unit (NICU) presents a highly intricate setting with distinctive design attributes. This study investigated a NICU environment moving from an open-bay model to a single-family unit.

Methods: A comprehensive research study was conducted by a NICU patient care manager and researchers specializing in design and health communication. Quantitative data were collected from NICU family participants by electronic surveys and 30 hours of observation focused on occupancy. Qualitative data were gathered through 7 focus groups and 1 interview.

Results: The findings reveal that single-family designs can facilitate enhanced feelings of safety, privacy, and satisfaction among families but support the desire for enhanced social opportunities among parents. The patient room was predominantly occupied by the patient, nursing staff, and family.

Conclusions: This study further validates that SFR NICUs are beneficial for families when compared to open-bay designs.

Implications for practice and research: As NICUs continue to increase in size, research should understand the impact this has on parental access to staff and concerns about isolation. This study highlights the importance of privacy, acoustics, and the implementation of technology in enhancing parental satisfaction. Optimizing NICU design positively influences parents' experiences, reinforcing the ongoing commitment to improving the environment for infant care.

Background: Neonatal clavicular fractures represent the most common fracture during delivery. We aimed to define risk factors associated with these fractures in a large population-based database.

Methods: Data were extracted from Clalit Health Services' electronic health records from 2000 to 2020. Newborns with clavicular fractures were compared with a healthy control group. The following parameters were compared-for the newborns: sex, birth weight, birth height, and head circumference; for the delivery process: assisted delivery, cesarean section, use of epidural, birth week, and number of fetuses; and for the mother: age at delivery, socioeconomic status, height, weight, and body mass index (BMI).

Results: We found a rate of 0.28% for neonatal clavicular fractures (5015 clavicular fractures/1 755 660 deliveries). Male gender and heavier birth weight were found to be significantly associated with clavicular fractures (P < .001). Increased risk was also associated with lower socioeconomic status, baseline weight, and maternal BMI (P < .001 for all). Assisted delivery increased the risk of clavicular fracture (OR = 2.274; 95% CI, 1.661-3.115; P < .0001), while cesarean section and use of epidural were found to be protective (OR = 0.149; 95% CI, 0.086-0.26; P < .0001; and OR = 0.687; 95% CI, 0.0531-0.89; P < .004, respectively).

Conclusions: This study provides insight into the risk factors associated with neonatal clavicular fractures on the largest group of patients reported to date.