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Rana R, Sirwani B, Mohandas S, Kirubakaran R, Puthussery S, Lelijveld N, Kerac M. Effectiveness of Postnatal Maternal or Caregiver Interventions on Outcomes among Infants under Six Months with Growth Faltering: A Systematic Review. Nutrients 2024; 16:837. [PMID: 38542748 PMCID: PMC10974267 DOI: 10.3390/nu16060837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/09/2024] [Accepted: 03/12/2024] [Indexed: 04/07/2024] Open
Abstract
The care of infants at risk of poor growth and development is a global priority. To inform new WHO guidelines update on prevention and management of growth faltering among infants under six months, we examined the effectiveness of postnatal maternal or caregiver interventions on outcomes among infants between 0 and 6 months. We searched nine electronic databases from January 2000 to August 2021, included interventional studies, evaluated the quality of evidence for seven outcome domains (anthropometric recovery, child development, anthropometric outcomes, mortality, readmission, relapse, and non-response) and followed the GRADE approach for certainty of evidence. We identified thirteen studies with preterm and/or low birth weight infants assessing effects of breastfeeding counselling or education (n = 8), maternal nutrition supplementation (n = 2), mental health (n = 1), relaxation therapy (n = 1), and cash transfer (n = 1) interventions. The evidence from these studies had serious indirectness and high risk of bias. Evidence suggests breastfeeding counselling or education compared to standard care may increase infant weight at one month, weight at two months and length at one month; however, the evidence is very uncertain (very low quality). Maternal nutrition supplementation compared to standard care may not increase infant weight at 36 weeks postmenstrual age and may not reduce infant mortality by 36 weeks post-menstrual age (low quality). Evidence on the effectiveness of postnatal maternal or caregiver interventions on outcomes among infants under six months with growth faltering is limited and of 'low' to 'very low' quality. This emphasizes the urgent need for future research. The protocol was registered with PROSPERO (CRD42022309001).
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Affiliation(s)
- Ritu Rana
- Department of Public Health Programmes, Indian Institute of Public Health Gandhinagar, Gandhinagar 382042, Gujarat, India; (B.S.); (S.M.)
| | - Barkha Sirwani
- Department of Public Health Programmes, Indian Institute of Public Health Gandhinagar, Gandhinagar 382042, Gujarat, India; (B.S.); (S.M.)
| | - Saranya Mohandas
- Department of Public Health Programmes, Indian Institute of Public Health Gandhinagar, Gandhinagar 382042, Gujarat, India; (B.S.); (S.M.)
| | - Richard Kirubakaran
- Prof BV Moses Centre for Evidence Informed Health Care, Christian Medical College, Vellore 632004, Tamil Nadu, India;
| | - Shuby Puthussery
- Maternal & Child Health Research Centre, Faculty of Health and Social Sciences, University of Bedfordshire, Luton LU1 3JU, UK;
| | | | - Marko Kerac
- Department of Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
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Flaherman VJ, Ginsburg AS, Nankabirwa V, Braima da Sa A, Medel‐Herrero A, Schaefer E, Dongol S, Shrestha A, Nisar I, Altaf M, Liaquat K, Baloch B, Rahman N, Shafiq Y, Ariff S, Jehan F, Roberts SB. Newborn weight change and predictors of underweight in the neonatal period in Guinea‐Bissau, Nepal, Pakistan and Uganda. MATERNAL & CHILD NUTRITION 2022; 18:e13396. [PMID: 35821647 PMCID: PMC9480948 DOI: 10.1111/mcn.13396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 06/08/2022] [Accepted: 06/12/2022] [Indexed: 11/27/2022]
Abstract
In low‐ and middle‐income countries (LMIC), growth impairment is common; however, the trajectory of growth over the course of the first month has not been well characterised. To describe newborn growth trajectory and predictors of growth impairment, we assessed growth frequently over the first 30 days among infants born ≥2000 g in Guinea‐Bissau, Nepal, Pakistan and Uganda. In this cohort of 741 infants, the mean birth weight was 3036 ± 424 g. For 721 (98%) infants, weight loss occurred for a median of 2 days (interquartile range, 1–4) following birth until weight nadir was reached 5.9 ± 4.3% below birth weight. At 30 days of age, the mean weight was 3934 ± 592 g. The prevalence of being underweight at 30 days ranged from 5% in Uganda to 31% in Pakistan. Of those underweight at 30 days of age, 56 (59%) had not been low birth weight (LBW), and 48 (50%) had reached weight nadir subsequent to 4 days of age. Male sex (relative risk [RR] 2.73 [1.58, 3.57]), LBW (RR 6.41 [4.67, 8.81]), maternal primiparity (1.74 [1.20, 2.51]) and reaching weight nadir subsequent to 4 days of age (RR 5.03 [3.46, 7.31]) were highly predictive of being underweight at 30 days of age. In this LMIC cohort, country of birth, male sex, LBW and maternal primiparity increased the risk of impaired growth, as did the modifiable factor of delayed initiation of growth. Interventions tailored to infants with modifiable risk factors could reduce the burden of growth impairment in LMIC. In our study, 98% of infants initially lost weight after birth before beginning weight gain. Although most infants began weight gain by 2 days of age, those with delayed initiation of weight gain were more likely to be underweight at 30 days of age. Male sex, country of birth, low birth weight, maternal primiparity and delayed initiation of weight gain were predictors of being underweight at 30 days of age and of wasting at 30 days of age.
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Affiliation(s)
| | - Amy S. Ginsburg
- Clinical Trials Center University of Washington Seattle Washington USA
| | | | | | | | - Eric Schaefer
- Penn State College of Medicine Hershey Pennsylvania USA
| | - Srijana Dongol
- Kathmandu University School of Medical Sciences Dhulikhel Nepal
| | - Akina Shrestha
- Kathmandu University School of Medical Sciences Dhulikhel Nepal
| | - Imran Nisar
- Department of Paediatrics and Child Health Aga Khan University Karachi Pakistan
| | - Muddassir Altaf
- Department of Paediatrics and Child Health Aga Khan University Karachi Pakistan
| | - Khushboo Liaquat
- Department of Paediatrics and Child Health Aga Khan University Karachi Pakistan
| | - Benazir Baloch
- Department of Paediatrics and Child Health Aga Khan University Karachi Pakistan
| | - Najeeb Rahman
- Department of Paediatrics and Child Health Aga Khan University Karachi Pakistan
| | - Yasir Shafiq
- Department of Paediatrics and Child Health Aga Khan University Karachi Pakistan
| | - Shabina Ariff
- Department of Paediatrics and Child Health Aga Khan University Karachi Pakistan
| | - Fyezah Jehan
- Department of Paediatrics and Child Health Aga Khan University Karachi Pakistan
| | - Susan B. Roberts
- The Gerald J and Dorothy R Friedman School of Nutrition Science and Policy Tufts University Boston Massachusetts USA
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Omidi A, Rahmani S, Amini R, Karami M. The effect of a planned lactation education program on the mother's breastfeeding practice and weight gain in low birth weight infants: a randomized clinical trial study. BMC Pregnancy Childbirth 2022; 22:482. [PMID: 35698072 PMCID: PMC9190089 DOI: 10.1186/s12884-022-04810-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 06/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background Low birth weight (LBW) infants are more prone to possible growth disorders, and their mothers need more specific education sessions regarding breastfeeding practice. This study aimed to investigate the effect of a planned lactation education program on the mother’s breastfeeding practice and weight gain in LBW infants. Methods A randomized clinical trial study was conducted on 80 mother-LBW infant dyads admitted to a gynecology and obstetrics hospital. The participants were selected randomly and divided into an experimental group and a control group, each with 40 mothers. Information on LBW infants’ weight and the mothers’ breastfeeding practice was collected using a questionnaire at birth. Then, a planned lactation education program was implemented in the experimental group in two sessions in the hospital and three 20-minute sessions in comprehensive health centers. Finally, the weight of 14–15 day-old and two-month-old LBW infants and the mothers’ breastfeeding practice for 14–15 day-old LBW infants in the two groups were recollected and analyzed using SPSS software version 16. Results Comparing the LBW infants’ weights and mothers’ breastfeeding practice revealed no statistically significant difference between the two groups pre-intervention. However, significant differences were observed between the two groups post-intervention in terms of weight gain in the LBW infants over 14–15 days and two months of age (F = 4720.6, p < 0.001) and the mothers’ breastfeeding practice for 14-15-day-old infants (p < 0.001). Conclusions Given the positive impact of lactation education on the mother’s breastfeeding practice and LBW infants’ weight, planned lactation education courses should be applied for LBW infants’ mothers. Trial registration This study was retrospectively registered in the Clinical Trial Registration Center of Iran, with the code: IRCT20120215009014N421 on 14/04/2022.
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Affiliation(s)
- Afsar Omidi
- Department of Community Health Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sahar Rahmani
- Community Health Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Hamadan, Iran
| | - Roya Amini
- Department of Community Health Nursing, School of Nursing and Midwifery, Chronic Diseases (Home care) Research Center, Hamadan University of Medical Sciences, Shahid Fahmideh Avenue, Hamadan, Iran.
| | - Manoochehr Karami
- Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Amoo TB, Popoola T, Lucas R. Promoting the practice of exclusive breastfeeding: a philosophic scoping review. BMC Pregnancy Childbirth 2022; 22:380. [PMID: 35501834 PMCID: PMC9063230 DOI: 10.1186/s12884-022-04689-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background The World Health Organization recommends exclusive breastfeeding for the first 6 months of an infant’s life and continued breastfeeding for 2 years. The global rate of exclusive breastfeeding is low at 33%. Thus, it is important to identify philosophical and theory-based strategies that can promote exclusive breastfeeding. The aim of the study was to identify philosophical schools of thought and theories used in research on promoting the practice of exclusive breastfeeding. Methods A scoping review using Arksey and O'Malley's framework explored the phenomenon of exclusive breastfeeding practice promotion. Searches were conducted using CINAHL Plus full-text, PubMed, APA PsycInfo, and Academic Search Premier. Search terms included theory, philosophy, framework, model, exclusive breastfeeding, promotion, support, English, and publication between 2001—2022. Results The online search yielded 1,682 articles, however, only 44 met the inclusion criteria for the scoping review. The articles promoting exclusive breastfeeding used pragmatism (n = 1) or phenomenology (n = 2) philosophies and theories of self-efficacy (n = 10), theory of planned behaviour (n = 13), social cognitive theories (n = 18) and represented 16 countries. Theories of self-efficacy and planned behaviour were the most used theories. Conclusions This review suggests that theories and models are increasingly being used to promote exclusive breastfeeding. Orienting exclusive breastfeeding programmes within theoretical frameworks is a step in the right direction because theories can sensitize researchers and practitioners to contextually relevant factors and processes appropriate for effective exclusive breastfeeding strategies. Future research should examine the efficacy and effectiveness of theory-informed exclusive breastfeeding programmes over time. Such information is important for designing cost-effective EBF programmes. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04689-w.
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Affiliation(s)
| | - Tosin Popoola
- School of Nursing, Victoria University of Wellington, Wellington, New Zealand
| | - Ruth Lucas
- School of Nursing, University of Connecticut, Storrs, CT, USA
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von Salmuth V, Brennan E, Kerac M, McGrath M, Frison S, Lelijveld N. Maternal-focused interventions to improve infant growth and nutritional status in low-middle income countries: A systematic review of reviews. PLoS One 2021; 16:e0256188. [PMID: 34407128 PMCID: PMC8372927 DOI: 10.1371/journal.pone.0256188] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/01/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Small and nutritionally at-risk infants under 6 months (<6m) are a vulnerable group at increased risk of mortality, morbidity, poor growth and sub-optimal development. Current national and international (World Health Organization) management guidelines focus mainly on infants' needs, yet growing evidence suggests that maternal factors also influence infant outcomes. We aimed to inform future guidelines by exploring the impacts of maternal-focused interventions on infant feeding and growth. METHODS We conducted a systematic review of reviews published since 2008 (PROSPERO, register number CRD 42019141724). We explored five databases and a wide variety of maternal-focused interventions based in low- and middle-income countries. Infant outcomes of interest included anthropometric status, birthweight, infant mortality, breastfeeding and complementary feeding practices. Given heterogenous interventions, we present a narrative synthesis of the extracted data. RESULTS We included a total of 55 systematic reviews. Numerous maternal interventions were effective in improving infant growth or feeding outcomes. These included breastfeeding promotion, education, support and counselling interventions. Maternal mental health, while under-researched, showed potential to positively impact infant growth. There was also some evidence for a positive impact of: women's empowerment, m-health technologies, conditional cash transfers, water, sanitation and hygiene and agricultural interventions. Effectiveness was increased when implemented as part of a multi-sectoral program. Antenatal supplementation with macronutrient, multiple micronutrients, Vitamin D, zinc, iron folic acid and possibly calcium, iodine and B12 in deficient women, improved birth outcomes. In contrast, evidence for postnatal supplementation was limited as was evidence directly focusing on small and nutritionally at-risk infants; most reviews focused on the prevention of growth faltering. CONCLUSION Our findings suggest sufficient evidence to justify greater inclusion of mothers in more holistic packages of care for small and nutritionally at-risk infants aged <6m. Context specific approaches are likely needed to support mother-infant dyads and ensure infants survive and thrive.
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Affiliation(s)
- Victoria von Salmuth
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Eilise Brennan
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Emergency Nutrition Network, Kidlington, Oxford, United Kingdom
| | - Marko Kerac
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Marie McGrath
- Emergency Nutrition Network, Kidlington, Oxford, United Kingdom
| | - Severine Frison
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Subramanian L, Murthy S, Bogam P, Yan SD, Marx Delaney M, Goodwin CDG, Bobanski L, Rangarajan AS, Bhowmik A, Kashyap S, Ramnarayan N, Hawrusik R, Bell G, Kaur B, Rajkumar N, Mishra A, Alam SS, Semrau KEA. Just-in-time postnatal education programees to improve newborn care practices: needs and opportunities in low-resource settings. BMJ Glob Health 2021; 5:bmjgh-2020-002660. [PMID: 32727842 PMCID: PMC7394013 DOI: 10.1136/bmjgh-2020-002660] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/03/2020] [Accepted: 06/15/2020] [Indexed: 11/16/2022] Open
Abstract
Worldwide, many newborns die in the first month of life, with most deaths happening in low/middle-income countries (LMICs). Families’ use of evidence-based newborn care practices in the home and timely care-seeking for illness can save newborn lives. Postnatal education is an important investment to improve families’ use of evidence-based newborn care practices, yet there are gaps in the literature on postnatal education programmes that have been evaluated to date. Recent findings from a 13 000+ person survey in 3 states in India show opportunities for improvement in postnatal education for mothers and families and their use of newborn care practices in the home. Our survey data and the literature suggest the need to incorporate the following strategies into future postnatal education programming: implement structured predischarge education with postdischarge reinforcement, using a multipronged teaching approach to reach whole families with education on multiple newborn care practices. Researchers need to conduct robust evaluation on postnatal education models incorporating these programee elements in the LMIC context, as well as explore whether this type of education model can work for other health areas that are critical for families to survive and thrive.
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Affiliation(s)
- Laura Subramanian
- Ariadne Labs, Harvard T.H. Chan School of Public Health/Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | | | | | - Megan Marx Delaney
- Ariadne Labs, Harvard T.H. Chan School of Public Health/Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Christian D G Goodwin
- Ariadne Labs, Harvard T.H. Chan School of Public Health/Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Lauren Bobanski
- Ariadne Labs, Harvard T.H. Chan School of Public Health/Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | | | - Sehj Kashyap
- Center for Biomedical Informatics, Stanford University, Stanford, California, USA
| | | | - Rebecca Hawrusik
- Ariadne Labs, Harvard T.H. Chan School of Public Health/Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Griffith Bell
- Ariadne Labs, Harvard T.H. Chan School of Public Health/Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Health Policy and Management, Harvard University TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Baljit Kaur
- Directorate of Health Services, Punjab, India
| | - N Rajkumar
- Directorate of Health & Family Welfare Services, Bangalore, Karnataka, India
| | - Archana Mishra
- Directorate of Public Health & Family Welfare, National Health Mission, Madhya Pradesh, India
| | | | - Katherine E A Semrau
- Ariadne Labs, Harvard T.H. Chan School of Public Health/Brigham and Women's Hospital, Boston, Massachusetts, USA.,Division of Global Health Equity & Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Effectiveness of Breastfeeding Support Packages in Low- and Middle-Income Countries for Infants under Six Months: A Systematic Review. Nutrients 2021; 13:nu13020681. [PMID: 33672692 PMCID: PMC7924359 DOI: 10.3390/nu13020681] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 11/17/2022] Open
Abstract
Small and nutritionally at-risk infants under six months, defined as those with wasting, underweight, or other forms of growth failure, are at high-risk of mortality and morbidity. The World Health Organisation 2013 guidelines on severe acute malnutrition highlight the need to effectively manage this vulnerable group, but programmatic challenges are widely reported. This review aims to inform future management strategies for small and nutritionally at-risk infants under six months in low- and middle-income countries (LMICs) by synthesising evidence on existing breastfeeding support packages for all infants under six months. We searched PubMed, CINAHL, Cochrane Library, EMBASE, and Global Health databases from inception to 18 July 2018. Intervention of interest were breastfeeding support packages. Studies reporting breastfeeding practices and/or caregivers'/healthcare staffs' knowledge/skills/practices for infants under six months from LMICs were included. Study quality was assessed using NICE quality appraisal checklist for intervention studies. A narrative data synthesis using the Synthesis Without Meta-analysis (SWiM) reporting guideline was conducted and key features of successful programmes identified. Of 15,256 studies initially identified, 41 were eligible for inclusion. They were geographically diverse, representing 22 LMICs. Interventions were mainly targeted at mother-infant pairs and only 7% (n = 3) studies included at-risk infants. Studies were rated to be of good or adequate quality. Twenty studies focused on hospital-based interventions, another 20 on community-based and one study compared both. Among all interventions, breastfeeding counselling (n = 6) and education (n = 6) support packages showed the most positive effect on breastfeeding practices followed by breastfeeding training (n = 4), promotion (n = 4) and peer support (n = 3). Breastfeeding education support (n = 3) also improved caregivers' knowledge/skills/practices. Identified breastfeeding support packages can serve as "primary prevention" interventions for all infants under six months in LMICs. For at-risk infants, these packages need to be adapted and formally tested in future studies. Future work should also examine impacts of breastfeeding support on anthropometry and morbidity outcomes. The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO 2018 CRD42018102795).
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Shahbazi A, Behboodi Moghadam Z, Maasoumi R, Saffari M, Mohammadi S, Montazeri A. Effect of a Health-Education Program Based on the BASNEF Model of Overall Sexual Health Satisfaction and Satisfaction with Quality of Sexual Relationship among Women with Infertility. Int J Womens Health 2020; 12:975-982. [PMID: 33177888 PMCID: PMC7651995 DOI: 10.2147/ijwh.s248734] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 10/20/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Female infertility is increasing in Iran, encompassing all dimensions of women's lives. One of the most important effects of infertility is on sexual function. All women have the right to sexual health. Using educational models, one can see a positive effect on women's sexual function. The present study aimed to investigate the effect of an education program based on the beliefs, attitudes, subjective norms, and enabling factors (BASNEF) model on promoting overall sexual health satisfaction and satisfaction with the quality of sexual relationships among women with infertility. Methods This was a quasiexperimental study conducted on 80 infertile women referred to an infertility center affiliated with Tehran University of Medical Sciences, in Tehran, Iran in 2016-2017. Infertile women with primary infertility were divided into experimental and control groups based on odd and even days. The intervention was carried out based on the BASNEF model over four sessions. Data were collected using a demographic questionnaire, the BASNEF questionnaire, and items on overall sexual health satisfaction and satisfaction with their sexual relationship. The questionnaires were completed before and 4 and 8 weeks after the intervention in the two groups. Friedman, χ2, and t-tests were used for data analysis. Results After the educational intervention, BASNEF values and overall sexual function and satisfaction with the quality of sexual relationships had significantly improved in the experimental group (p<0.05), while changes were not significant in the control group. Conclusion The results showed that the BASNEF model-based educational invention improved overall sexual health and satisfaction among intertitle women. Indeed, it seems that using theory-based educational interventions in infertility centers might be helpful.
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Affiliation(s)
- Azade Shahbazi
- Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Behboodi Moghadam
- Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Raziyeh Maasoumi
- Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Saffari
- Health Research Centre, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Saeed Mohammadi
- Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
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The Impact of an Educational Program Based on the BASNEF Model on Knowledge and Self-Care Behaviors of Patients with Hypertension. HEALTH SCOPE 2020. [DOI: 10.5812/jhealthscope.95588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Hypertension is an important health problem that can be controlled by self-care. Objectives: The present study aimed to determine the impact of an educational program based (BASNEF) model on knowledge and self-care behaviors for hypertensive patients in Bastak, Iran. Methods: This quasi-experimental study was performed on 180 patients with hypertension who were admitted to health centers of the Bastak city. The participants were randomly assigned to intervention (n = 90) and control (n = 90) groups. Data were collected using a questionnaire that had three sections of demographic information, knowledge, and BASNEF constructs. The questionnaires were completed before the intervention and two months after providing the intervention. After the pre-test, an appropriate educational intervention was designed and implemented only among the intervention group. To analyze the data, paired t-test, independent t-test, and chi-square tests were run by SPSS version 19. Results: The mean age of the participants was 50.62 ± 7.549 years. The results showed a statistically significant difference in the mean scores of attitudes, subjective norms, enabling factors, and self-care behaviors in the intervention group pre- and post-intervention (P = 0.001). Besides, it was found that enabling factors (0.311) play a significant role in predicting self-care behaviors. Conclusions: The results of this study support the effectiveness of educational interventions in raising awareness and improving self-care behaviors in patients with hypertension using the BASNEF model. Therefore, with an emphasis on enabling factors, the BASNEF model can be used as a framework to develop educational interventions for self-care.
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Kazemi F, Masoumi SZ, Soltani F, Oshvandi K, Ghelichkhani S, Niazy Z. Postpartum women's perception of stressors in the delivery ward: a qualitative study. BMC Res Notes 2020; 13:335. [PMID: 32660523 PMCID: PMC7359504 DOI: 10.1186/s13104-020-05176-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/07/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Delivery is a challenging event in women's lives. What happens during childbirth is stressful for most women. Regarding the short and long-term effects of stressors of the delivery ward on childbirth and neonatal outcomes, and given that understanding the stressors are influenced by existing social culture and factors, the present qualitative study was conducted to investigate women's perception of stressors in the delivery ward. Participants were 13 newly delivered women who were monitored in the recovery room at the Fatemieh Hospital of Hamadan, Iran. Purposive sampling was performed and continued until data saturation. The data collection method was in-depth and semi-structured. RESULTS The content analysis of qualitative data led to the emergence of two themes of human stressors and environmental stressors as well as four categories; i.e., personal factors, care staff-related factors, environmental factors, and equipment-related factors. The research findings indicated that several personal, environmental, staff-related, and equipment-related factors could lead to stress in the labor and delivery ward. Although ignoring them and increasing stress during childbirth may jeopardize the childbirth consequences, most of them are ignored and overlooked. It is necessary to consider measures to control these factors as much as possible.
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Affiliation(s)
- Farideh Kazemi
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyedeh Zahra Masoumi
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Farzaneh Soltani
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Khodayar Oshvandi
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Samereh Ghelichkhani
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ziba Niazy
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
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Asadi G, Aslani A, Nayebinia AS, Fathnezhad-Kazemi A. Explaining breastfeeding experiences and assessing factors affecting breastfeeding self-efficacy in mothers of premature infants: a mixed method study protocol. Reprod Health 2020; 17:42. [PMID: 32183866 PMCID: PMC7079430 DOI: 10.1186/s12978-020-0895-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 03/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breastfeeding has a great effect on health promotion and disease prevention in premature infants. However, various factors affect the success of breastfeeding process in mothers. The present study aims to: a) explain breastfeeding experiences; b) assess the factors affecting breastfeeding self-efficacy; and c) present a guideline for promoting breastfeeding in mothers of premature infants. METHODS This mixed-methods study with a sequential explanatory design consisted of three phases. The first phase is qualitative study to explore the breastfeeding experiences in mothers of premature infants. In this phase, the subjects will be selected through purposive sampling; moreover, in-depth individual interviewing will be used for data collection. Finally, the conventional content analysis approach will be employed for data analysis. The second phase is quantitative and will be used a cross-sectional approach to assess the association of the social determinants of health with breastfeeding self-efficacy in mothers of premature infants. In this phase, the multistage cluster sampling method will be used to select 360 subjects who will be visited healthcare centers in Tabriz, Iran. The third phase focused on developing strategies to increase the ability of mothers to breastfeed their premature infants, using the qualitative and quantitative results of previous phases, a review of the related literature, and the nominal group technique will be performed among experts. DISCUSSION The present research is the first study that investigated the experiences of breastfeeding and factors influencing breastfeeding self-efficacy in mothers of premature infants. For the purposes of the study, the mixed methods approach will be used which aimed to develop strategies for the improvement of healthcare services in this regard. It is worth noting that there is no strategic guideline in Iran's healthcare system for the improvement of breastfeeding, especially regarding mothers of premature infants. Therefore, it is hoped that the strategy proposed in the current study can lead to improvements in this regard. ETHICAL CODE IR.TBZMED.REC.1398.100.
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Affiliation(s)
- Gholamreza Asadi
- Department of Pediatric, Tabriz Branch, Islamic Azad University, Tabriz, Iran
| | - Armin Aslani
- Student Research Committee, Islamic Azad University, Tabriz branch, Tabriz, Iran
| | - Anvar-Sadat Nayebinia
- Department of Midwifery, College of Nursing & Midwifery, Clinical Cares and Health Promotion Research Center, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Azita Fathnezhad-Kazemi
- Reproductive Health, Department of Midwifery, Tabriz Branch, Islamic Azad University, Tabriz, Iran.
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McFadden A, Siebelt L, Marshall JL, Gavine A, Girard LC, Symon A, MacGillivray S. Counselling interventions to enable women to initiate and continue breastfeeding: a systematic review and meta-analysis. Int Breastfeed J 2019; 14:42. [PMID: 31649743 PMCID: PMC6805348 DOI: 10.1186/s13006-019-0235-8] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 09/04/2019] [Indexed: 11/10/2022] Open
Abstract
Background Many infants worldwide are not breastfeeding according to WHO recommendations and this impacts on the health of women and children. Increasing breastfeeding is identified as a priority area supported by current policy targets. However, interventions are complex and multi-component and it is unclear which elements of interventions are most effective to increase breastfeeding in which settings. Breastfeeding counselling is often part of complex interventions but evidence is lacking on the specific effect of counselling interventions on breastfeeding practices. The aim of this systematic review is to examine evidence on effectiveness of breastfeeding counselling to inform global guidelines. Methods A systematic search was conducted of six electronic databases in January 2018. Randomised controlled trials comparing breastfeeding counselling with no breastfeeding counselling or different formulations of counselling were included if they measured breastfeeding practices between birth and 24 months after birth. Results From the 5180 records identified in searches and a further 11 records found by hand searching, 63 studies were included. Of these, 48 were individually-randomised trials and 15 were cluster-randomised trials. A total of 69 relevant comparisons were reported involving 33,073 women. There was a significant effect of counselling interventions on any breastfeeding at 4 to 6 weeks (Relative risk [RR] 0.85, 95% CI 0.77, 0.94) and 6 months (RR 0.92, 95% CI 0.87, 0.94). Greater effects were found on exclusive breastfeeding at 4 to 6 weeks (RR 0.79, 95% CI 0.72, 0.87) and 6 months (RR 0.84, 95% CI 0.78, 0.91). Counselling delivered at least four times postnatally is more effective than counselling delivered antenatally only and/or fewer than four times. Evidence was mostly of low quality due to high or unclear risk of bias of the included trials and high heterogeneity. Conclusions Breastfeeding counselling is an effective public health intervention to increase rates of any and exclusive breastfeeding. Breastfeeding counselling should be provided face-to-face, and in addition, may be provided by telephone, both antenatally and postnatally, to all pregnant women and mothers with young children. To inform scale-up globally there is a need to further understand the elements of breastfeeding interventions such as counselling and their effectiveness in different contexts and circumstances. Study registration This systematic review was registered in Prospero (CRD42018086494).
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Affiliation(s)
- Alison McFadden
- 1School of Nursing and Health Sciences, University of Dundee, 11 Airlie Place, Dundee, DD1 4HJ Scotland
| | - Lindsay Siebelt
- 1School of Nursing and Health Sciences, University of Dundee, 11 Airlie Place, Dundee, DD1 4HJ Scotland
| | - Joyce L Marshall
- 2School of Human and Health Sciences, Harold Wilson Building, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH Scotland
| | - Anna Gavine
- 1School of Nursing and Health Sciences, University of Dundee, 11 Airlie Place, Dundee, DD1 4HJ Scotland
| | - Lisa-Christine Girard
- 3School of Health in Social Science, The University of Edinburgh, Doorway 6, Room 1m04, Old Medical School, Edinburgh, EH8 9AG Scotland
| | - Andrew Symon
- 1School of Nursing and Health Sciences, University of Dundee, 11 Airlie Place, Dundee, DD1 4HJ Scotland
| | - Stephen MacGillivray
- 1School of Nursing and Health Sciences, University of Dundee, 11 Airlie Place, Dundee, DD1 4HJ Scotland
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Rastgoo F, Vasli P, Rohani C, Amini A. Osteoporosis preventive behaviors in adolescent girls: the educational program based on BASNEF model. Arch Osteoporos 2019; 14:71. [PMID: 31250126 DOI: 10.1007/s11657-019-0623-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 06/17/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED Osteoporosis is a progressive and preventable metabolic disease. This study aimed to assess the short-term effect of the educational program based on the Beliefs, Attitude, Subjective Norms, Enabling Factors (BASNEF) model on the osteoporosis preventive behaviors in adolescent girls. It was found that the BASNEF model improved the osteoporosis preventive behaviors in adolescent girls. PURPOSE Osteoporosis is a progressive and preventable metabolic disease. This study aimed to investigate the short-term effect of the education program based on the BASNEF model on the osteoporosis preventive behaviors in adolescent girls. METHODS This randomized clinical trial was conducted on adolescent girls from January to August 2018 in an urban area of Iran. Subjects were 120 adolescent girls aged 13-14 years studying in the girls' high school that were randomly assigned to intervention and control groups. The data collection tool was the demographic questionnaire and the researcher-made questionnaire consisting of six domains based on the BASNEF model. Validity and reliability of the questionnaires were confirmed before data collections. The educational program was developed based on the BASNEF model in four sessions lasting from 30 to 45 min. Data was collected before, immediately and 1 month after the educational program and was analyzed via the SPSS software v.18. RESULTS No statistically significant differences were reported between the groups in terms of knowledge (p = 0.48), attitude (p = 0.94), subjective norms (p = 0.17), behavioral intention (p = 0.82), enabling factors (p = 0.62), and osteoporosis preventive behaviors (p = 0.32). Meanwhile, immediately and 1 month after the educational program, differences were reported between the two groups in knowledge (p < 0.001), attitude (p = 0.002, p < 0.001), subjective norms (p = 0.024, p = 0.001), behavioral intention (p < 0.001, p = 0.001), enabling factors (p < 0.001), and osteoporosis preventive behaviors (p < 0.001). CONCLUSION It is suggested that educational program based on the BASNEF model is used to strengthen the osteoporosis preventive behaviors among adolescent girls.
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Affiliation(s)
- Faezeh Rastgoo
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Vali Asr Ave., Niayesh Cross Road, Tehran, Iran
| | - Parvaneh Vasli
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Vali Asr Ave., Niayesh Cross Road, Tehran, Iran.
| | - Camelia Rohani
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Vali Asr Ave., Niayesh Cross Road, Tehran, Iran
| | - AminReza Amini
- Department of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Dol J, Campbell-Yeo M, Tomblin Murphy G, Aston M, McMillan D, Gahagan J, Richardson B. Parent-targeted postnatal educational interventions in low and middle-income countries: A scoping review and critical analysis. Int J Nurs Stud 2019; 94:60-73. [PMID: 30933873 DOI: 10.1016/j.ijnurstu.2019.03.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 03/10/2019] [Accepted: 03/12/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To identify and map existing postnatal educational interventions targeting parents in low and middle-income countries. A secondary objective is to conduct a critical analysis of the strengths and limitations of the educational strategies used for parent-targeted postnatal education. Design & data sources: Using scoping review methodology, MedLine, CINAHL, and SCOPUS were searched in October 2017. REVIEW METHODS All studies published after 2000 reporting on educational interventions that targeted parents from the period of birth to 6 weeks postnatally in low and middle-income countries were included. Studies were excluded if they targeted healthcare professionals or were community interventions that spanned antenatal to postnatal care. Title, abstract and full-text screening was conducted by two reviewers. RESULTS We initially identified 9284 articles with 77 articles included after title, abstract and full-text screening. Most of the studies were quantitative (94%) with over half published after 2014. Most studies (61%) targeted a single newborn care education intervention, of which 75% targeted breastfeeding. Interventions used on average three different methods of implementation (e.g., verbal, written information, counselling). Interventions were provided in the hospital (76%), at home (23%), at a clinic/hospital (8%), and/or virtually through an eHealth intervention, including phone or text messages (12%). Maternal outcomes primarily included knowledge, self-efficacy, anxiety and stress while newborn outcomes primarily included exclusive breastfeeding, weight gain at follow-up, and morbidities. Positive changes were found to occur for reported maternal outcomes (89%) and newborn outcomes (56%). CONCLUSIONS Parent-targeted education varied in terms of educational topics covered, method and location of intervention, and outcomes examined. While the best strategies of implementing postnatal education interventions to parents in low and middle-income countries is yet to be determined, evidence suggests that current interventions had a positive impact on parents' outcomes using a combined approach. Further work is needed to evaluate the impact on newborn outcomes and to identify the most effective methods and timing of the interventions.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, 6299 South St., Halifax, NS, 902-470-2638, Canada; World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, 6299 South St., Halifax, NS, Dalhousie University, Canada.
| | - Marsha Campbell-Yeo
- Faculty of Health, Dalhousie University, 6299 South St., Halifax, NS, 902-470-2638, Canada; School of Nursing, Faculty of Health, Dalhousie University, 6299 South St., Halifax, NS, Canada; Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, 6299 South St., Halifax, NS, Canada; World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, 6299 South St., Halifax, NS, Dalhousie University, Canada
| | - Gail Tomblin Murphy
- School of Nursing, Faculty of Health, Dalhousie University, 6299 South St., Halifax, NS, Canada; World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, 6299 South St., Halifax, NS, Dalhousie University, Canada
| | - Megan Aston
- School of Nursing, Faculty of Health, Dalhousie University, 6299 South St., Halifax, NS, Canada; World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, 6299 South St., Halifax, NS, Dalhousie University, Canada
| | - Douglas McMillan
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, 6299 South St., Halifax, NS, Canada
| | - Jacqueline Gahagan
- School of Health and Human Performance, Faculty of Health, 6299 South St., Halifax, NS, Dalhousie University, Canada
| | - Brianna Richardson
- School of Nursing, Faculty of Health, Dalhousie University, 6299 South St., Halifax, NS, Canada
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Mirmoammadi A, Parsa P, Khodakarami B, Roshanaei G. Effect of Consultation on Adherence to Clinical Breast Examination and Mammography in Iranian Women: A Randomized Control Trial. Asian Pac J Cancer Prev 2018; 19:3443-3449. [PMID: 30583667 PMCID: PMC6428530 DOI: 10.31557/apjcp.2018.19.12.3443] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Early diagnosis of breast cancer is directly related to success in treatment. The aim of this study was to determine the effect of consultation based on the health belief model on performance of clinical breast examination (CBE) and mammography in women. Methods: This research was a clinical trial study. Eligible women aged> 40 years attending to Hamadan health care centers in 2016 were randomly assigned to experimental and control groups (n = 75 in each group). The experimental group received 4 weekly sessions of breast cancer screening consulting based on Health Belief Model (HBM). Knowledge on breast cancer, HBM constructs, and practices were compared between two groups before, one and three months after intervention. Results: Before the intervention, no significant differences were observed in knowledge, HBM constructs and practice between experimental and control groups. While one and three months post intervention significant differences were detected between two groups on HBM constructs (except susceptibility and severity) and knowledge (p <0.05). Conclusions: The results showed the consultation promoted breast cancer screening in women.
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Affiliation(s)
- Ameneh Mirmoammadi
- Chronic Diseases (Home Care) Research Center, Department of Mother and Child Health, Hamadan University of Medical Sciences, Hamadan, Iran.
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Mohammadi MM, Poursaberi R. The Effect of Stress Inoculation Training on Breastfeeding Self-Efficacy and Perceived Stress of Mothers With Low Birth Weight Infants: A Clinical Trial. J Family Reprod Health 2018; 12:160-168. [PMID: 31223322 PMCID: PMC6571443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Objective: Mothers with low birth weight infants experience more stress, which results in reduced breastfeeding self-efficacy and exclusive breastfeeding; In this regard, stress Inoculation Training (SIT) is one of the effective ways for inoculation against stress and psychological distress; Therefore, this study aimed to investigate the effect of SIT on breastfeeding self-efficacy and perceived stress of mothers with low birth weight infants. Materials and methods: This clinical trial study was conducted from October to December 2017 on 100 mothers with low birth weight infants; the infants had been hospitalized in the neonatal intensive care unit (NICU) in Kermanshah, Iran. The eligible mothers were randomly divided into two groups, i.e., intervention (n = 50) and control (n = 50) groups. Results: The mean score of breastfeeding self-efficacy, before SIT (33.82 ± 8.92) compared to after SIT (42.02 ± 8.83), significantly increased (p < 0.001), though no statistically significant difference was reported in the control group (p > 0.05). The mean score of perceived stress was significantly reduced after SIT (26.29 ± 6.49) compared to values before SIT (31.25 ± 5.82) (p < 0.001). Conclusion: The present study showed that on the one hand, SIT can effectively increase the breastfeeding self-efficacy in mothers with low birth weight infants; on the other hand, it can reduce their perceived stress. Therefore, the need for holding in-service training courses is felt in order to train the caregiving personnel, especially nurses, in applying the SIT technique.
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Affiliation(s)
- Mohammad Mehdi Mohammadi
- Students Research Committee, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Parsa P, Karimi S, Basiri B, Roshanaei G. The effect of kangaroo mother care on physiological parameters of premature infants in Hamadan City, Iran. Pan Afr Med J 2018; 30:89. [PMID: 30344873 PMCID: PMC6192712 DOI: 10.11604/pamj.2018.30.89.14428] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Accepted: 05/02/2018] [Indexed: 11/11/2022] Open
Abstract
Introduction Breast-feeding and being with mother have positive effects on the preterm infant's health status. Therefore, this study was conducted to evaluate the effect of Kangaroo Mother Care (KMC) on physiological parameters of premature infants in Fatemiyeh Hospital in Hamadan in 2016. Methods This was a quasi-experimental study. One hundred newborns who were admitted to in neonatal intensive care unit of Fatemiyeh Hospital in Hamadan city, Iran were selected by convenience sampling. They were randomly divided into two groups (experimental group, n = 50 and control group, n = 50). In the experimental group, newborns were taken daily KMC for an hour during 7 days. In the control group, routine care was performed in the incubator. The data gathering tool was questionnaire of infants and mother characteristics, checklists of vital signs and oxygen saturation. Data analysis was performed by SPSS 19 software using descriptive and inferential statistics (Independent t -test, Paired t-test, Chi-square, ANOVA). Results Before intervention, there was no significant difference between the physiological parameters of the infants (heart rate, respiratory rate, arterial blood oxygen saturation and temperature) in experimental and control groups. However, after intervention, there was a significant difference between the two groups in terms of physiological indices (p < 0.001). Conclusion The findings of this study indicate the effect of KMC on enhancement of physiological indices. Therefore, it is recommended that KMC is taken as one of the routine care of premature infants.
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Affiliation(s)
- Parisa Parsa
- Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Simin Karimi
- Student Research Committee,Hamadan University of Medical Sciences, Hamadan, Iran
| | - Behnaz Basiri
- Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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Parsa P, Saeedzadeh N, Roshanaei G, Shobeiri F, Hakemzadeh F. The Effect of Entonox on Labour Pain Relief among Nulliparous Women: A Randomized Controlled Trial. J Clin Diagn Res 2017; 11:QC08-QC11. [PMID: 28511452 PMCID: PMC5427378 DOI: 10.7860/jcdr/2017/21611.9362] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 11/19/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Labour pain is one of the most severe pain in humans. Fear of labour pain is the most dreadful reason for Caesarean Section (CS). Entonox (a mixture of nitrous oxide+oxygen) is a safe inhalational analgesia during labour pain. AIM This study investigated the effect of entonox on pain relief and length of labour in nulliparous women. MATERIALS AND METHODS A clinical trial study was conducted among 120 nulliparous women (60 in intervention and 60 in control group) in 2015 in Atieh Hospital, Hamadan city, Iran. The women were chosen randomly to receive either entonox in the intervention group or oxygen in the control group. For the intervention group, entonox inhalation was introduced at the initiation of pain at each contraction. entonox gas was administrated via a face-mask. This enabled the women to breathe fresh gas in each inspiration. In the control group the oxygen inhalation was given with occurrence of pain at each contraction too. In both groups, the gas administration continued until the end of contraction pain with the patient finally breathing room air. Pain using Visual Analogue Scale (VAS), duration of labour and side effects were compared in two groups. RESULTS The mean age of women was 25.69 (SD=4.83). There were significant differences between two groups on labour pain at the first, second, third and fourth hours after intervention (p<0.05). Duration of labour in the intervention group (64.80 minutes) was significantly shorter than the control group (98.33 minutes) (p<0.05). There were no significant differences between the two groups on women's blood pressure and neonatal Apgar score. Only dizziness was slightly higher in the intervention group compared to the control group (p<0.05). CONCLUSION Entonox provides significant pain relief and it can quickly be implemented during painful labour.
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Affiliation(s)
- Parisa Parsa
- Associate Professor, Department of Mother and Child Health, Chronic Diseases (home care) Research Center of Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nafiseh Saeedzadeh
- Master of Science in Consultation of Midwifery, Department of Midwifery, Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ghodratallah Roshanaei
- Associate Professor, Department of Statistics, Faculty of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fatameh Shobeiri
- Associate Professor, Department of Midwifery, Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Faryar Hakemzadeh
- Anaesthesiologist, Department of Anaesthesiology, Atieh Hospital, Hamadan, Iran
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