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Cai Q, Zhou Y, Hong M, Chen D, Xu X. Healthcare providers' perceptions and experiences of kangaroo mother care for preterm infants in four neonatal intensive care units in China: a qualitative descriptive study. Front Public Health 2024; 12:1419828. [PMID: 39040865 PMCID: PMC11260804 DOI: 10.3389/fpubh.2024.1419828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 06/20/2024] [Indexed: 07/24/2024] Open
Abstract
Background Kangaroo mother care (KMC) is an evidence-based intervention that can effectively reduce morbidity and mortality in preterm infants, but it has yet to be widely implemented in health systems in China. Most qualitative studies on KMC for preterm infants focused on the experiences and influencing factors from the perspective of preterm infant parents, while neglecting the perspective of healthcare providers, who played a critical role in guiding KMC practice. Therefore, this study aimed to explore the perceptions and experiences of healthcare providers regarding their involvement in KMC implementation for preterm infants to promote the contextualized implementation of KMC. Methods A descriptive qualitative approach was adopted. A purposive sampling was used to select healthcare providers involved in KMC implementation in the neonatal intensive care units (NICUs) as participants from four tertiary hospitals across four cities in Zhejiang Province, China. Face-to-face semi-structured interviews were conducted to collect information. Thematic analysis was employed to analyze the data. Results Seventeen healthcare professionals were recruited, including thirteen nurses and four doctors in the NICUs. Four themes and twelve subthemes emerged: different cognitions based on different perspectives (acknowledged effects and benefits, not profitable economically), ambivalent emotions regarding KMC implementation (gaining understanding, gratitude and trust from parents, not used to working under parental presence, and concerning nursing safety issues), barriers to KMC implementation (lack of unified norms and standards, lack of systematic training and communication platform, insufficient human resources, and inadequate parental compliance) and suggestions for KMC implementation (improving equipment and environment, strengthening collaboration between nurses and doctors, and support from hospital managers). Conclusions Despite acknowledging the clinical benefits of KMC, the lack of economic incentives, concerns about potential risks, and various barriers hindered healthcare providers' intrinsic motivation to implement KMC in NICUs in China. To facilitate the effective implementation of KMC, hospital managers should provide bonuses and training programs for healthcare providers, while giving them recognition and encouragement to enhance their motivation to implement KMC.
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Affiliation(s)
- Qian Cai
- Department of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Yunxian Zhou
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Mengxia Hong
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Danqi Chen
- Department of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Xinfen Xu
- Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
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Almutairi WM. Survey of Skin-to-Skin Contact with Obstetrics and Pediatric Nurses. NURSING REPORTS 2022; 12:13-21. [PMID: 35076611 PMCID: PMC8788535 DOI: 10.3390/nursrep12010002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 11/28/2021] [Accepted: 12/08/2021] [Indexed: 11/23/2022] Open
Abstract
Skin-to-skin, or chest-to-chest, contact (SSC) between newborns and their mothers is known as kangaroo mother care. The physiological and psychological benefits of SSC for infants and mothers are well established. The World Health Organization (WHO) recommends practicing SSC for term and preterm newborns. However, in Saudi Arabia, SSC is not practiced as widely as recommended. There is insufficient evidence of the nurses' knowledge and attitudes regarding SSC in Saudi Arabia. The aims of this study were to describe and determine relationships between knowledge, education, beliefs/attitudes, and the implementation of SSC in Jeddah, Saudi Arabia. Thank You for Your Time and Kind Suggestion Methods: Cross-sectional descriptive data were collected from 40 nurses using an English-language version of a knowledge, beliefs/attitudes, education, and implementation questionnaire used by others. Results: The mean age of the nurses was 42.4 years (SD = 3.2), with a mean experience of 12 years (SD = 2.1). The mean total score of SSC knowledge was 13.6 (SD = 2.3), the mean of total score of attitudes/beliefs was 12.3 (SD = 3.1), the SSC education mean score was 17.1 (SD = 3.4), and the SSC implementation mean score was 17.0 (SD = 4.1). In total, 55% of the nurses were not sure of the impact of SSC on brain development in neonates, 45% could not interpret infants' responses during SSC; 67% disagreed that it was the nurses' responsibility to facilitate SSC, 37.5% were not aware of SSC guidelines, and 47% of the nurses had not received any continuing education on SSC in their units. Pearson correlations revealed a significant association between SSC implementation and nurses' knowledge level (r = 0.297, p = 0.031), education (r = 0.85, p = 0.015), and beliefs (r = 0.31, p = 0.024). Conclusions: Once nurses have improved their knowledge, education, and beliefs/attitudes, SSC implementation may concomitantly increase. A continuing education program and clear guidelines are needed to promote SSC adoption in practice.
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Affiliation(s)
- Wedad M Almutairi
- Maternity and Child Department, Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia
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Al-Shehri H, Binmanee A. Kangaroo mother care practice, knowledge, and perception among NICU nurses in Riyadh, Saudi Arabia. Int J Pediatr Adolesc Med 2021; 8:29-34. [PMID: 33718574 PMCID: PMC7922834 DOI: 10.1016/j.ijpam.2019.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/21/2019] [Accepted: 11/20/2019] [Indexed: 11/29/2022]
Abstract
Background The imapct of Kangaroo Mother Care (KMC) in neonates is positively reported in the literature. However,several challenges hindered the wide-scale application of this practice. Objectives To assess the levels of knowledge and competency of kangaroo mother care (KMC) among nurses and to identify the potential barriers to practice. Methodology Structured web-based questionnaires were submitted to nurses working at neonatal intensive care units (NICUs) located in Riyadh, Saudi Arabia. The participants were asked to answer 23 questions distributed in four main domains, namely, demographic data, knowledge about KMC, practice levels, and barriers to KMC practice. For answers to the knowledge and barriers to practice domains, the mean scores (standard deviations) were calculated to present participants’ perceptions and beliefs from 1 (strongly disagree) to 5 (strongly agree). Results Two hundred nine NICU nurses responded (95.2% females, 89.5% working in a government hospital, 69.9% obtained a Bachelor’s degree). The majority of respondents perceived KMC as promoting maternal-infant bonding (4.47 ± 1.3) and enhancing successful breastfeeding (4.44 ± 0.9), while there were considerable uncertainties about KMC application in infants weighing < 1000 g (2.21 ± 1.2). Most of the nurses encouraged parents to perform KMC (92.8%) and provided sufficient information to optimize practice (90%). However, several barriers were apparent, including fear of accidental extubation, lack of time due to workload, familial reluctance to initiate KMC, and lack of privacy during KMC practice. Conclusion There is reasonable knowledge among NICU nurses, and most of them are actively engaged in practice. There is an urgent need to address the reported barriers through the implementation of clear practice guidelines, provision of suitable educational programs, optimization of staff numbers, and financial support for the development of areas conducive to KMC.
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Affiliation(s)
- Hassan Al-Shehri
- Department of Pediatrics, College of Medicine, Al-Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia.,Department of Pediatrics, Specialized Medical Center, Riyadh, Saudi Arabia
| | - Abdulaziz Binmanee
- Neonatology Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Artese C, Paterlini G, Mascheroni E, Montirosso R. Barriers and Facilitators to Conducting Kangaroo Mother Care in Italian Neonatal Intensive Care Units. J Pediatr Nurs 2021; 57:e68-e73. [PMID: 33189484 DOI: 10.1016/j.pedn.2020.10.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/20/2020] [Accepted: 10/29/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE This work aimed to investigate obstacles and facilitators for carrying out Kangaroo Mother Care (KMC) across Italian NICUs. DESIGN AND METHODS A survey that investigated Unit's characteristics, policies toward parents and KMC practice and policies was carried out. Data from 86 NICUs (80.4%) was collected. Descriptive statistics and Multiple Regression Models were computed. RESULTS Eighty-one NICUs provided KMC. These NICUs had a less restricted parental access policies (chi2 = 7.373, p = .007). More than the 70% of the units did not have adequate facilities for parents. KMC daily length was positively predicted (R2 = 0.18, F = 7.91, p = .001) by repeated sessions and documentation of KMC. CONCLUSION The implementation of KMC is characterized by different barriers and facilitators that determine the parent's possibility to provide KMC. Structural factors (e.g., adequate space and facilities) can support families in providing KMC. A unique result of this survey is that KMC documentation on medical records appears critical for improving its practice. PRACTICE IMPLICATIONS Although most of the Italian units provide KMC as a routine practice, improving its practical support would be beneficial to its implementation. A more formalized approach to KMC may strengthen staff habits to consider KMC like a standard care treatment.
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Affiliation(s)
- Claudia Artese
- SOD Neonatology and Neonatal Intensive Care Unit, Careggi Hospital-University, Italy
| | - Giuseppe Paterlini
- Department of Mother's and Child's Health, Neonatology and Neonatal Intensive Care Unit, Poliambulanza Foundation Hospital Institute, Italy
| | - Eleonora Mascheroni
- 0-3 Center for the at-Risk Infant, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy.
| | - Rosario Montirosso
- 0-3 Center for the at-Risk Infant, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
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Dadich A, Piper A, Coates D. Implementation science in maternity care: a scoping review. Implement Sci 2021; 16:16. [PMID: 33541371 PMCID: PMC7860184 DOI: 10.1186/s13012-021-01083-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 01/11/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Despite wide recognition that clinical care should be informed by the best available evidence, this does not always occur. Despite a myriad of theories, models and frameworks to promote evidence-based population health, there is still a long way to go, particularly in maternity care. The aim of this study is to appraise the scientific study of methods to promote the systematic uptake of evidence-based interventions in maternity care. This is achieved by clarifying if and how implementation science theories, models, and frameworks are used. METHODS To map relevant literature, a scoping review was conducted of articles published between January 2005 and December 2019, guided by Peters and colleagues' (2015) approach. Specifically, the following academic databases were systematically searched to identify publications that presented findings on implementation science or the implementation process (rather than just the intervention effect): Business Source Complete; CINAHL Plus with Full Text; Health Business Elite; Health Source: Nursing/Academic Edition; Medline; PsycARTICLES; PsycINFO; and PubMed. Information about each study was extracted using a purposely designed data extraction form. RESULTS Of the 1181 publications identified, 158 were included in this review. Most of these reported on factors that enabled implementation, including knowledge, training, service provider motivation, effective multilevel coordination, leadership and effective communication-yet there was limited expressed use of a theory, model or framework to guide implementation. Of the 158 publications, 144 solely reported on factors that helped and/or hindered implementation, while only 14 reported the use of a theory, model and/or framework. When a theory, model or framework was used, it typically guided data analysis or, to a lesser extent, the development of data collection tools-rather than for instance, the design of the study. CONCLUSION Given that models and frameworks can help to describe phenomenon, and theories can help to both describe and explain it, evidence-based maternity care might be promoted via the greater expressed use of these to ultimately inform implementation science. Specifically, advancing evidence-based maternity care, worldwide, will require the academic community to make greater explicit and judicious use of theories, models, and frameworks. REGISTRATION Registered with the Joanna Briggs Institute (registration number not provided).
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Affiliation(s)
- Ann Dadich
- Western Sydney University, School of Business, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Annika Piper
- Western Sydney University, School of Business, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Dominiek Coates
- University of Technology Sydney, Broadway, PO Box 123, Ultimo, NSW 2007 Australia
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Alabdulaziz H, Alquwez N, Almazan JU, Albougami A, Alshammari F, Cruz JP. The Self-Compassion Scale Arabic version for baccalaureate nursing students: A validation study. NURSE EDUCATION TODAY 2020; 89:104420. [PMID: 32276172 DOI: 10.1016/j.nedt.2020.104420] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/28/2020] [Accepted: 03/28/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The Self-Compassion Scale is an extensively used tool to measure self-compassion among different groups of population, including nurses. The tool has been translated and tested for its psychometric properties in previous studies. Assessing self-compassion among Saudi nursing students is critical as self-compassion is suggested to create a positive effect on one's wellbeing, coping, emotions, and other personal outcomes. OBJECTIVES This study determined the validity and reliability of the Self-Compassion Scale Arabic version (SCS-A) for nursing students. It also identified the demographic factors associated with the students' self-compassion. DESIGN A quantitative, cross-sectional design. SETTINGS The investigation was carried-out in two government universities in Saudi Arabia. PARTICIPANTS A sample of 322 Saudi nursing students in the 2nd to 4th year, as well as nurse interns was surveyed (mean age = 21.27, range = 18-27). METHODS The Self-Compassion Scale was culturally adapted to come up with the SCS-A. Content validity was established. Exploratory Factor Analysis (EFA) was used to establish the construct validity; whereas for reliability, internal consistency and test-retest reliability were established. Pearson's product correlation, t-test, and One-way Analysis of Variance were used to examine the demographic factors associated with self-compassion, accordingly. RESULTS A panel of experts rated content validity as excellent. The EFA revealed six dimensions namely "self-judgment," "self-kindness," "common humanity," "mindfulness," "isolation," and "over-identification", with total variance of 64.1%. Cronbach's alpha values for the six factors were from 0.76 to 0.85, with an overall α of the whole scale at 0.86. Computation revealed ICC values ranging from 0.84 to 0.92, whereas the ICC for the entire SCS-A was 0.81. CONCLUSION SCS-A shown satisfactory validity as well as good reliability. SCS-A can be used to collect baseline data on self-compassion, which could be used in developing policies in the universities and training hospitals to ensure that nurse interns and nursing students have compassion toward self. The study also opens opportunities for multi-country and cross-cultural studies on self-compassion among nursing students.
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Affiliation(s)
- Hawa Alabdulaziz
- Maternity and Children Department, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Nahed Alquwez
- Nursing Department, College of Applied Medical Sciences, Shaqra University, Al Dawadmi, Saudi Arabia.
| | - Joseph U Almazan
- Department of Nursing Education, School of Medicine, Nazerbayev University, Nur-Sultan, Kazakhstan
| | - Abdulrhman Albougami
- Nursing Department, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia.
| | | | - Jonas Preposi Cruz
- Nursing Department, College of Applied Medical Sciences, Shaqra University, Al Dawadmi, Saudi Arabia.
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Maniago JD, Almazan JU, Albougami AS. Nurses' Kangaroo Mother Care practice implementation and future challenges: an integrative review. Scand J Caring Sci 2019; 34:293-304. [PMID: 31657039 DOI: 10.1111/scs.12755] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 06/28/2019] [Accepted: 08/12/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nurses play a crucial role in Kangaroo Mother Care practice, but their application in specific policies and practices involves challenges. A comprehensive literature review is needed to improve understanding of specific barriers that are most relevant to nurses and the improvement of this practice. This review investigates nurses' barriers in implementing Kangaroo Mother Care, in order to illustrate directions for future research. METHODS This study was based on integrative review method and exploring nurses' barriers in implementing Kangaroo Mother Care, strategies to reduce its barriers. CINAHL, Medline, Web of Science, ProQuest Nursing and Allied Health Database, PubMed and Science Direct Taylor & Francis databases were searched for the following: (i) studies with no year restrictions, (ii) peer-reviewed journal articles, (iii) original research and (iv) articles written in English. Each article was appraised for methodological validity review using critical appraisal checklist. RESULTS The search revealed 19 articles from diverse countries. Four main themes were generated from the synthesis of the findings: (i) barriers related to nurses' perspective and emotion towards KMC, (ii) healthcare institution barriers towards KMC, (iii) barriers related to parental experience in providing KMC and (iv) strategy to improve KMC implementation. CONCLUSIONS Nurses experience several barriers in successfully implementing KMC in healthcare settings. This review reported strategies to reduce KMC barriers and to improve its utilisation in healthcare settings. Hospitals should establish adequate manpower, clear guidelines, sufficient supplies and equipment, capacity building among staff and proper Kangaroo Mother Care information dissemination for patients.
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Affiliation(s)
- Jestoni D Maniago
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Joseph U Almazan
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, Saudi Arabia.,Department of Nursing, Nazarbayev University School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan
| | - Abdulrhman S Albougami
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, Saudi Arabia
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