Journal of Perinatal & Neonatal Nursing最新文献

Purpose: To address care gaps in newborn pain management, a parent-targeted video (BSweet2Babies video) was developed using co-design principles. The purpose of the study was to specify which behavior change techniques are included in the BSweet2Babies video and whether they address key barriers to newborn pain management.

Background: Behavior change techniques are the active components of an implementation intervention and are meant to address barriers in order to increase the impact of the intervention.

Methods: This study adopted a mixed-method approach including 3 phases: (1) identifying behavior change techniques in the BSweet2Babies video, (2) coding parents' barriers for engaging in pain management for their newborn babies based on the theoretical domains framework (TDF), and (3) mapping behavior change techniques to barriers codes.

Results: Seven behavior change techniques were identified in the BSweet2Babies video. The key barriers to parents' engagement in newborn pain management were lack of (timely) information about pain management options, parents' difficulty in determining their role in pain management and neonatal intensive care unit environment (lack of space for parents, limited visiting hours). These barriers related to the TDF domains knowledge, social/ professional role and identity and environmental context and resources. The knowledge domain was addressed in the BSweet2Babies video; the other 2 domains were not.

Conclusions: This paper identified potential for additional behavior change techniques that may enhance the BSweet2Babies video.

Implications for practice and research: This is an exemplar study of a methodology that could be used to enhance existing implementation interventions.

Purpose: The purpose of this study was to determine the psychometric properties of the Eat Sleep Console Nurse Questionnaire (ESCNQ).

Background: Eat Sleep Console is a new approach to care for opioid-exposed infants with neonatal abstinence syndrome (NAS) and represents a significant change in NAS care practices for nurses. Use of a process and outcomes evaluation tool may provide insight for continuous improvement in the care of infants with NAS. The psychometric properties of the ESCNQ were analyzed in this secondary analysis.

Method: In a previous project, the ESCNQ was distributed to mother-baby postpartum and neonatal intensive care nurses (n = 52). Reliability testing of the ESCNQ was conducted for this project.

Results: Cronbach's alpha showed good internal consistency for the Processes scale (α = 0.764, n = 14 items). Perception items were positively, strongly, and significantly associated (r = 0.671, P = < 0.001). The full ESCNQ and other subscales did not demonstrate acceptable internal consistency.

Conclusion: Following future testing and refinement, the ESCNQ may be a viable option for use in both quality improvement and research settings.

Implications: Establishing a reliable tool to evaluate processes and outcomes of Eat Sleep Console practices allows healthcare teams to improve the quality of care for infants with NAS.

Aim: This study aims to evaluate the accuracy, comprehensibility, and scope of the information provided by ChatGPT regarding premature infant care.

Methods: This study is designed as a structured evaluation of ChatGPT's responses about premature infant care for parents, using data from answers generated in 2023 and 2024. The most frequently asked questions by parents about premature infant care were identified and presented to ChatGPT. The responses obtained were examined in terms of medical accuracy, comprehensibility, and scope. The responses were assessed by comparing them with current pediatric care protocols and scientific sources.

Results: The analysis results indicate that ChatGPT provides information largely consistent with current pediatric-care guidelines on topics such as medical care, nutrition, respiratory support, home care, and psychological support for premature infants. The responses were generally found to be presented in a language suitable for the health literacy level of parents and were deemed comprehensible. However, it was observed that some technical terms require more detailed explanations and that individualized guidance should be enhanced. In particular, topics such as long-term health monitoring of premature infants, neurodevelopmental follow-up, infection risk management, and the frequency of medical check-ups should be addressed more comprehensively.

Conclusion: The study demonstrates that AI-based systems like ChatGPT can serve as complementary tools in guiding parents in premature infant care. However, it is emphasized that such systems should be used under the supervision and guidance of health care professionals. Future research should further explore the impact of ChatGPT through evaluations based on parents' direct experiences.

Purpose: To identify factors affecting macronutrient levels in human milk (HM) from mothers of preterm infants in Thailand by examining maternal diet and body mass index (BMI).

Background: HM fortification has become standard care to meet preterm infant's nutritional needs, but macronutrient content varies throughout lactation, leading to challenges in managing HM nutrients. Understanding maternal nutrition factors affecting HM macronutrients should be considered.

Method: In this observational study, 47 mothers of premature infants were selected through convenience purposive sampling between October 2023 and March 2024. HM samples were collected at 2 time points: during 1-2 weeks of lactation (time point 1) and 3-4 weeks of lactation (time point 2) and analyzed using the Miris HM analyzer (Miris HMA™). Maternal dietary intake was assessed using 24-h dietary food recall records from 2 non-consecutive days and food frequency questionnaires (FFQs). Maternal BMI was measured using current body weight and height.

Results: Multiple linear regression analysis showed significant positive association between HM macronutrients and maternal dietary intake, including daily intake of carbohydrates, fats, and protein. No association was found between maternal BMI and HM macronutrients.

Conclusions: This study supports that maternal dietary intake can affect the nutritional profile of HM. Monitoring and modifying maternal dietary intake during lactation may enhance macronutrient content of HM for preterm infants.

Purpose: To evaluate the usefulness of the newborn infant parasympathetic evaluation (NIPE) percentage change instead of the NIPE absolute values. Additionally, we investigated the correlation between 2 neonatal pain assessment tools, the premature infant pain profiled-revised (PIPP-R) scale and NIPE, after blood extraction.

Background: Pain assessment is crucial for optimizing pain prevention and providing appropriate treatment; therefore, research on the best way to use pain assessment tools is required.

Methods: A prospective observational study was performed with infants admitted to the neonatal intensive care unit between June 2022 and April 2023 who underwent blood collection. Demographic data, aspects related to the procedure, PIPP-R, and NIPE index at baseline and 8 minutes following the procedure were recorded.

Results: The sample included 134 recordings, corresponding to 70 patients. The correlation coefficient for the association between PIPP-R scores and NIPE variations was weak: 0.32 (P < .05). To identify severe pain taking as reference PIPP-R ≥12 area under the curve (AUC) for percentage decrease of NIPE, NIPE values at first and second minutes were 0.68 (95% confidence interval: 0.59-0.78; P < .01); 0.5 (0.45-0.64; P = .4); 0.59 (0.50-0.68; P = .2) respectively. The best cutoff value for the percentage decrease in NIPE was 13%.

Conclusion: The correlation between NIPE and PIPP-R scores was weak. The percentage decrease in the NIPE had better sensitivity, specificity, and AUC than the absolute values of the NIPE.

Implications for practice and research: maximum percentage decrease in NIPE detects severe pain better than the absolute NIPE value. As the correlation was weak, neonatal pain assessment should include all available tools.

Background: Maternal syphilis is on the rise in the United States, posing a substantial public health concern. Caused by Treponema pallidum subspecies pallidum, syphilis can be transmitted sexually or vertically during pregnancy. This study provides the United States' national estimates on the prevalence, correlates, and outcomes of maternal syphilis.

Method: Using the Nationwide Inpatient Sample (NIS: 2016-2021), we analyzed maternal syphilis-associated pregnancy hospitalizations among women aged 13 to 49 years in the United States. We examined demographic, behavioral, hospital, and clinical characteristics associated with maternal syphilis. Joinpoint regression was used to describe the annual average percent change (AAPC) of these hospitalizations. Survey logistic regression assessed the association between maternal syphilis and pregnancy outcomes across different racial groups.

Results: Out of 23 551 491 pregnancy-related hospitalizations during the study period, 23 080 involved maternal syphilis. Pregnant women, who used alcohol, tobacco, cannabis, and opioids, as well as those with conditions such as bipolar disorder, HIV/AIDS, anxiety, depression, and obesity, were at increased risk of maternal syphilis. The overall prevalence of maternal syphilis during the study period is high for Native American and Black pregnant women. However, the average annual increment is notably higher among Native American women followed by White women. Adjusting for demographic, behavioral, and clinical confounders, women with maternal syphilis had a higher risk of preeclampsia, severe maternal morbidity, prolonged hospital stay, preterm birth, and intrauterine fetal demise.

Conclusion: The significant increase in maternal syphilis across all racial groups underscores the need for increased awareness, screening, and treatment efforts to mitigate its adverse impact on pregnancy and other health outcomes.

Background: Approximately 3.8 million babies are born each year with up to 10% requiring breathing assistance and 1% needing intensive resuscitation interventions. Effective ventilation is paramount for their outcomes, and laryngeal masks (LMs), also known as supraglottic airways, have emerged as safe, user-friendly tools for providing ventilation. However, despite Neonatal Resuscitation Program guidelines, there exist barriers impeding the routine utilization of LMs.

Purpose: This narrative review aims to delineate the current understanding of LM usage in neonatal resuscitation, identify obstacles, and propose strategies for enhancing LM implementation and neonatal resuscitation outcomes through interdisciplinary collaboration.

Methods: Databases including CINAHL/NURSING, Ovid/Medline, and PubMed were queried. Seven randomized controlled trials were identified, although none specifically targeted nurses in the United States.

Results: Perspectives from nursing, medicine, education, and economics are essential for comprehensively addressing the multifaceted nature of the problem and devising innovative solutions transcending disciplinary boundaries.

Conclusion: Despite standardized education about LM, it is underutilized. This suggests an opportunity to improve neonatal outcomes by improving the routine use of LM to support vulnerable newborns immediately after birth. An interdisciplinary approach will help us better understand the problem from the various invested disciplines and offer solutions that exceed the scope of a single discipline.

Purpose: This scoping review aims to synthesize existing evidence on the relationship between intrapartum synthetic oxytocin (synOT) exposure and maternal postpartum depression (PPD). Specifically, it examines methodological similarities and differences in the current literature and highlights persistent gaps in knowledge regarding the effects of synOT on PPD outcomes.

Background: PPD is a prevalent adverse outcome associated with childbirth, and has significant implications for maternal and child health. The increasing administration of synOT during birth has generated concerns regarding its potential effects on maternal physiological and psychosocial functioning, including its potential association with PPD.

Discussion: In this review, studies examining the relationship between synOT administration and PPD demonstrate mixed findings. These inconsistencies are likely influenced by variability in PPD assessment methods, clinical indications for synOT administration, the concurrent use of synOT with other obstetric interventions, and individual differences in the maternal endogenous oxytocin system.

Implications for research and practice: Future research is needed to investigate the onset and duration of PPD using standardized definitions and assess the potential dose-dependent effects of synOT on maternal PPD outcomes. Furthermore, additional studies are needed to examine the cumulative effect of multiple birth interventions and the influence of synOT on the maternal endogenous oxytocin system to better understand individual susceptibilities to PPD.