Journal of Perinatal & Neonatal Nursing最新文献

Purpose and background: The purpose of this evaluation was to assess doulas' sense of preparedness after completing birth doula training. The extent to which doulas feel prepared to serve clients after training is unknown.

Methods: This program evaluation took place within a hospital-based volunteer doula program in the southeastern United States. The analysis focused on comparing the self-reported preparedness of volunteer doulas trained through the Partners in Birth Training program, a doula training created by the doula program, with preparedness of volunteer doulas trained by nationally recognized training programs. A survey assessed doulas' preparedness to provide physical, emotional, and informational support.

Results: Of the 100 doulas active in the program at the time of survey administration, 48 had completed the Partners in Birth Training program, 26 (54%) of whom completed the survey. Of the 32 doulas who entered the doula program following training with national organizations, 19 (59%) completed the survey. The remaining 20 doulas in the program completed a third training option and were excluded from this evaluation. In comparing doulas' overall sense of preparedness between the 2 groups, results were similar, with the median response for both groups being mostly prepared (4 on a Likert scale from 1 to 5).

Conclusions: Results suggest that localized doula training offered by hospital-based doula programs may be as effective at preparing doulas to serve in such programs as Other training organizations.

Implications for practice and research: Systematic evaluations can help researchers and doulas identify topics and pedagogical approaches to training that increase preparedness.

Objective: This study aims to determine the internal and external factors affecting the attitudes of neonatal intensive care nurses toward evidence-based practices (EBP).

Methods: The population of this descriptive, cross-sectional, and relation-seeking multicenter study consisted of nurses working in 5 neonatal intensive care units located in 3 provinces of Türkiye. Data were collected using the Information Form, which included nurses' sociodemographic information and internal-external factors affecting evidence-based care practices, the Evidence-Based Nursing Attitude Questionnaire (EBNAQ).

Results: It was found that sociodemographic characteristics of nurses impacted the EBNAQ score. Of the internal factors, knowledge of EBP, having a sufficient foreign language level to follow EBP, self-efficacy in the process of seeking, finding, evaluating, and applying evidence, belief in the necessity of using EBP in nursing care, belief that cultural differences affect EBP, and belief that EBP negatively affect individualized care affected the EBNAQ score. In terms of external factors, the competence of the study team in searching evidence, the employment institution supporting the team in the use of EBP, and using clinical guidelines in neonatal care impacted the EBNAQ score.

Conclusion: It was concluded that neonatal nurses' attitudes toward evidence-based nursing are at a moderate level and are affected by internal and external factors.

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 (T 0 ), 1-month corrected age (T 1 ), and 2-month follow-up (T 2 ), 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 T 0 , 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 T 2 . 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.

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.

Parent-infant separation resulting from admission to a neonatal intensive care unit (NICU) is often reported as the most challenging and distressing experience for parents. Aiming to mitigate the stress of parent-infant separation, a new neonatal care model was designed to integrate NIC with delivery and postpartum care. Yet, little is known about the model and its implementation. Therefore, using a qualitative descriptive design with field observations, we describe the characteristics of an integrated neonatal intensive care (I-NIC) model and examined perceptions of clinical staff ( n = 8) and parents ( n = 3). The physical layout of the I-NIC rooms required additional oxygen and suction columns and new signage to specify them as NICU-equipped. Other NICU-related equipment was mobile, thus moved into rooms when necessary. Nurses were cross-trained in labor/delivery, postpartum, neonatal care; however, nurses primarily worked within their specific area of expertise. Clinician and parent perceptions of the model were notably positive, reporting decreased anxiety related to separation, increased ability for chest feeding and skin-to-skin care, and improved interdisciplinary care. Future work is needed to understand implementation of the model in other settings, with specific attention to unit architecture, level of NICU care services, patient census, and staff and patient outcomes.