Journal of Perinatal & Neonatal Nursing最新文献

Aims/background: Fear of childbirth (FoC) and its extreme form, tokophobia, is a clinical condition that can lead to many negative consequences, and its importance is increasingly understood. This article aims to assess the severity of FoC and anxiety levels according to different attachment styles and to investigate the relationships between these factors.

Design/methods: A cross-sectional study was conducted in a state hospital in the largest city in Turkey. Three hundred pregnant women attending the Antenatal Outpatient Clinic were included. A sociodemographic questionnaire, Wijma Delivery Expectancy/Experience Questionnaire-version-A (W-DEQ), Spielberger State-Trait Anxiety Inventory and Adult Attachment Style Scale were administered.

Results: 8.1% of participants had tokophobia (W-DEQ sum score ≥85). FoC was significantly higher in pregnant women who had a history of pregnancy loss and past psychiatric history. For multiparous women, adverse birth outcomes were also associated with higher FoC. State and trait anxiety were positively correlated with FoC levels. Regarding the attachment patterns, pregnant women with avoidant attachment styles presented with higher levels of FoC than those with secure attachment styles. In logistic regression analysis, higher anxiety levels, adverse birth outcomes, and insecure attachment styles were found to predict severe and clinical FoC.

Conclusion: FoC has a considerable effect on pregnant women, albeit at different clinical levels. Adverse birth outcomes, high anxiety levels, and insecure attachment styles were associated with higher FoC. Therefore, antenatal patients with adverse birth outcomes and higher anxiety levels, which are risk factors for FoC, should be carefully evaluated in terms of tokophobia and referred to mental health professionals when necessary.

Purpose: This paper introduces the Resource to Support Neonatal Nurse Engagement in Clinical Research© to educate and support engagement of nurses in study design and protocol review. The resource serves to promote collaboration between nurses and pharmaceutical researchers to advance the development of neonatal therapies.

Background: Neonates remain therapeutic orphans, underserved by the drug development community. Off-label use of drugs in neonates negatively impacts the evaluation of their safety and efficacy. Although NICU nurses' competencies are examples of expertise needed for well-designed clinical trials, nurses may have limited experience in providing insights.

Methods: Resource development included a literature review and usability testing by multiple stakeholders.

Results: Usability testing indicated the resource was comprehensive and relevant to pharmaceutical and nonpharmaceutical studies. Reviewers commented resource prompts are beneficial in assessing study feasibility.

Conclusion: Sponsors of research need nurse engagement to improve feasibility and flexibility and prevent protocol deviations in clinical trials. Leveraging the "Resource to Support Neonatal Nurse Engagement in Clinical Research©" can enhance research education and foster engagement of nurses in neonatal research.

Implications for practice: The resource has implications for the nursing profession, the pharmaceutical industry, and the advancement of new therapies. Individual nurses benefit from education and a framework for research engagement. The profession benefits from enhanced visibility through research collaboration. The pharmaceutical industry gains valuable insights on neonatal care, family dynamics, and NICU standard of care. A resource to foster collaboration in the study development process is an important step for advancing new therapies for neonates.

Objective: The objective of this study was to explore childbirth experiences during COVID-19 visitor restrictions.

Methods: We used a descriptive phenomenological approach in our study, which took place in a postpartum unit at a level IV birthing hospital in the Mideastern United States, where 3617 births occurred in 2019.

Results: A total of 22 participants who were older than 18 years, who gave birth at 37 weeks gestation or more, and who had at least 1 birth experience in the United States prior to the COVID-19 pandemic participated in this study. We assessed participants' birth experiences before and during COVID-19 visitor restrictions through in-depth interviews. Participant perspectives revealed the following 6 themes after an iterative analysis: A Shared Personal Connection is a Valued Trait, A Female Support Person is Important, Nurses Went the Extra Mile, Support People Help with Decision-Making, Two is an Ideal Number of Support People, and Increased Psychological Burden.

Discussion: These findings are vital to inform hospital visitor policies moving forward in the endemic reality of COVID-19 pandemic.

Background: Individual states are becoming proactive in addressing the gaps in knowledge about newborns experiencing opioid withdrawal syndrome (ie, Neonatal Opioid Withdrawal Syndrome [NOWS]) through interdisciplinary efforts, perinatal learning collaboratives, and quality improvement initiatives.

Methods: Descriptive statistics and a repeated measures analysis of variance were used to analyze the data. The 5-step project implemented a team-led, evidence-based, nursing intervention toolkit. This project was completed in a Midwest, nonprofit, level III neonatal intensive care hospital serving a high-minority, low-income demographic. The participants included 38 registered nurses.

Intervention: A team-led initiative that developed a specialized toolkit aligned with the Indiana Perinatal Substance Use Practice Bundle. A pre-and posttraining assessment survey called "The Assessment of Nursing Knowledge and Self-Efficacy Related to NOWS" was developed to determine baseline knowledge and an increase in self-efficacy and knowledge. An educational curriculum intervention for onboarding new hires and completion of annual competencies was introduced.

Results: Posttraining, knowledge increased, and self-efficacy scores improved by 0.85 points. The curriculum change integrated the toolkit into consistent onboarding and annual competencies.

Conclusion: This comprehensive approach empowers nurses by equipping them with the skills and confidence necessary to provide quality care resulting in improved neonatal outcomes. Adopting a team-driven intervention for onboarding and annual competencies reinforce a dedication to continuous improvement and excellence in standards of care for newborns and their families.

Background: Nurses who care for newborn infants in the hospital have an opportunity to serve as a resource for child passenger safety (CPS). Literature lacks information on what CPS knowledge and provision of information exists for neonatal nurses.

Objective: In this study, we assessed neonatal nurses' knowledge and provision of CPS information.

Methods: The study design included an adapted, cross-sectional, and anonymous survey. A generic survey link was distributed to National Association of Neonatal Nurses' members. Descriptive and univariate analyses were used to summarize the data.

Results: One hundred thirteen registered nurses working in the hospital, representing 27 states, completed the survey. Approximately 38.1% (N = 43) "high knowledge" respondents answered 2 scenario-based and 3 knowledge-based CPS questions correctly. Nurses addressed CPS for parents/caregivers during newborn hospitalization through car seat tolerance screenings (85.8%), verbal education or answering questions (83.2%), and providing a pamphlet or handout (52.2%). Barriers to providing CPS recommendations were nursing staff not being trained in CPS (55.8%), perceived liability (50.4%), and lack of understanding/unaware of CPS guidelines (47.8%).

Conclusion: Neonatal nurses can benefit from CPS training and hospital policies which outline nurse expectations and liabilities.

Purpose: This scoping review explores the critical yet often overlooked role of fathers in the neonatal intensive care unit (NICU) environment, particularly during the emotionally tumultuous period following the birth of a critically ill infant.

Background: The birth of an infant significantly disrupts family dynamics and may impact the role of each parent. Fathers in the NICU are frequently overlooked, leading to feelings of isolation and stress. Fathers often face confusion, stress, and a sense of exclusion, which are compounded by the trauma of having a critically ill infant.

Discussion: Using the Preferred Reporting Item for Systematic Reviews and Meta-analysis model, the authors identified 18 articles that provide guidance on potential solutions to supporting an inclusive NICU environment for families, including fathers. The articles also consider the need for staff and provider training for a sustainable and inclusive NICU environment. Outcomes from the scoping review highlight the need for inclusive support for fathers, emphasizing that their involvement is crucial for the well-being of the infant and the family.

Implications for practice: Creating a welcoming NICU environment, training staff to address fathers' needs, and providing flexible policies can improve paternal engagement. Effective communication and support systems, including peer-led groups, are vital.

Precis statement: Inclusive practices, better communication, and tailored support for fathers in the NICU can enhance paternal involvement and engagement.

Introduction: Maternal speech has been shown to benefit premature infants by improving feeding outcomes and potentiating the development of the auditory cortex. To our knowledge, limited studies have addressed the benefits of exposure to maternal speech on neural development in premature infants. The objective of this study was to investigate the effect of early controlled exposure to maternal recording a passage of speech on heart rate variability (obtained before, during, and after playback of a test stimulus of a female stranger speaking the same passage) in very low-birth-weight premature infants tracked weekly from 28 to 34 weeks.

Methods: Prospective, randomized controlled trial, longitudinal, and repeated-measures design were conducted on 49 subjects. Infants heard a recording of their mother's speech twice a day from either 28 to 34 weeks (group 1) or from 32 to 34 weeks (group 2). Spectral analysis was measured weekly for 45 seconds before, during, and after playback of maternal speech. A generalized linear mixed model was conducted to examine the 2-way interaction in the log high-frequency power between groups, genders, sessions, and conditions.

Results: It was found that there were no significant differences between groups before, during, and after playback of the stimulus. A significant difference, however, was noted between conditions (before vs during period).

Conclusion: It can be concluded cautiously that playing back of maternal speech recordings to the premature infant has a beneficial impact on neural development after 32 weeks gestational age.

Objective: Breastfeeding is the optimal source of nutrition for all infants, but there are limited data on feeding outcomes in infants with neonatal abstinence syndrome (NAS) who are admitted in the neonatal intensive care unit (NICU).

Methods: A retrospective cohort study was conducted at a level II/III NICU. Study sample consisted infants with a diagnosis of NAS and those diagnosed with respiratory distress syndrome. The primary outcome was attainment of independent oral feeds, defined as the number of days to transition from full-tube to full oral feeds. Secondary outcomes included length of hospital stay and method (breast or bottle) of oral feeds at the start, at attainment of independent oral feeds, and at hospital discharge.

Results: Infants with NAS took significantly longer to attain independent oral feeds than controls ( P = .021) and received significantly fewer breastfeeds at the start of oral feeds, at independent oral feeds, and at hospital discharge ( P = .000). There was no difference in length of hospital stay between groups.

Conclusion: These results suggest that infants with NAS can experience difficulties achieving independent oral feeds and are less likely to receive breastfeeds. Additional support is required to enhance oral feeds in infants with NAS in the NICU.