Assessing the Implementation of the Baby-Friendly Hospital Initiative in Hungary: A Cross-Sectional Study

We assessed the prevalence of the "Ten Steps to Successful Breastfeeding" in Hungary and identified possible associations of the steps with breastfeeding. Our quantitative, cross-sectional research was conducted anonymously online in Hungary with a self-administered questionnaire in 2021. Targeted sampling was used, with biological motherhood and having at least one child no older than 60 months as inclusion criteria (n = 2008). The implementation of the "Ten Steps to Successful Breastfeeding" was analyzed separately for breastfeeding and non-breastfeeding mothers. A breastfeeding mother was defined as breastfeeding for at least six months. Descriptive statistics, χ2 test, and t-test were calculated with SPSSv25 (p < 0.05). No significant differences were found between breastfeeding and non-breastfeeding mothers in terms of supplementary feeding at the advice of a health professional (p = 0.624) and in terms of assistance with breastfeeding or suggested breastfeeding positions during hospitalization (p = 0.413). Significant differences were found for receiving breastfeeding-friendly recommendations by staff (p = 0.006), valuing breastfeeding (p < 0.001), skin-to-skin contact within 1 h (p = 0.002), receiving supplementary feeding (p < 0.001), rooming-in (p < 0.001), responsive feeding, recognizing hunger signs (p < 0.001), pacifier/bottle use (p < 0.001), and availability of breastfeeding support (p = 0.005). Significant differences were observed between breastfeeding and non-breastfeeding subsamples regarding the implementation of baby-friendly steps (p < 0.001). Breastfeeding mothers experienced the implementation of more baby-friendly steps and a higher rate of breastfeeding, while there was no significant difference in the duration of exclusive (p = 0.795) and partial breastfeeding (p = 0.250) based on the results. We concluded that exposure to the Baby-Friendly Hospital Initiative may be associated with increased 6-month breastfeeding but may not influence longer durations.

The Impact of Mode of Delivery and Postpartum Conditions on Breastfeeding: A Cross-Sectional Study

Breast milk is the optimal and essential source of nutrients for babies. Many women, however, do not breastfeed or stop early after giving birth, often due to lack of support. For newborns delivered by caesarean section, there is often a delay, or no skin-to-skin contact after birth; thus, early breastfeeding is not achieved. Separation, complementary feeding or pacifier use also limits the mother's ability to breastfeed. A quantitative, cross-sectional study was conducted. Sociodemographic data, the mode of delivery and postpartum circumstances, information on breastfeeding, and the method and duration of feeding were collected (n = 2008). Two-thirds of children born by caesarean section did not have skin-to-skin contact after birth (p < 0.001). Lack of rooming-in placement increased the incidence of more frequent complementary feeding (p < 0.001) and shortened the duration of exclusive breastfeeding (p < 0.001). The duration of breastfeeding may also be negatively affected by scheduled feeding (p = 0.007) and pacifier utilization (p < 0.001). The mode of delivery and postpartum circumstances directly affecting the mother and the newborn can affect the feasibility of breastfeeding and the duration of exclusive and partial breastfeeding. For positive breastfeeding outcomes, skin-to-skin contact immediately after birth, rooming-in and unrestricted, demand breastfeeding, as well as the avoidance of the use of pacifiers, are recommended.

Paediatric nurses' burnout, quality of life and perceived patient adverse events during the COVID-19 pandemic: Testing an integrated model using structural equation modelling

PURPOSE

A model was hypothesised by integrating two theoretical models: the compassion satisfaction-compassion fatigue and empowerment models. This study aimed to assess the extent to which this integrated model can explain the relationships between paediatric nurses' burnout quality of life, perceived patient safety and work-related variables during the COVID-19 pandemic.

BACKGROUND

Nurses' burnout is negatively associated with quality of life (QOL) and positively with patient safety. Several theoretical models were introduced to explain burnout determinants and outcomes such as Golembiewski, Munzenrider and Stevenson model, Leiter and Maslach's process model, and Lee and Ashforth's model. However, few models described burnout in relation to QOL or patient safety.

METHODS

A sample of 225 paediatric nurses responded to questionnaires about burnout, QOL, adverse events and work-related variables. Compassion satisfaction - compassion fatigue and empowerment models were integrated into a single model and tested using structural equation modelling analysis. This study was prepared and is reported according to the STROBE checklist.

RESULTS

The final model explained 65% of the variance of burnout and 37% of the variance of QOL. The work-related variables (co-workers' support, job satisfaction, satisfaction with the monthly salary, participation in continuous education and exposure to violence) are predicting paediatric nurses' burnout and quality of life.

CONCLUSION

The Compassion satisfaction - compassion fatigue -Empowerment integrated model allows for assessing the different paths in the relationship between work-related variables and burnout.

RELEVANCE TO CLINICAL PRACTICE

These results might be essential for nursing managers to develop strategies that improve nurses' work environment and minimise their burnout during COVID-19 pandemic. These strategies should focus on enhancing co-workers' support, job satisfaction and participation in continuous education. Furthermore, paediatric nurses should be protected from any violence.

[Comparison of the feeding habits of breastfeeding and non-breastfeeding mothers and the sociodemographic factors influencing breastfeeding]

INTRODUCTION

Breastfeeding is the most ideal form of infant feeding, the biological norm that affects the mother's nutrition as well as certain sociodemographic factors.

OBJECTIVE

The aim of this research is to compare the nutritional habits of breastfeeding and non-breastfeeding mothers during the postpartum period, and to further examine the correlations of sociodemographic factors with breast milk feeding.

METHOD

Our quantitative, cross-sectional study was conducted between 26. 03. 2021 and 18. 07. 2021. During the non-random, targeted, expert sample selection, the target group included those biological mothers who raised at least one child born alive after the 37th gestational week in their own care. Exclusion criteria included adoption, pregnancy with the first child, inadequate completion of the mandatory questions, and reports of a congenital and/or acquired physical or mental illness that makes breastfeeding impossible. 2008 people met the inclusion and exclusion criteria. The survey was carried out anonymously via a self-filled questionnaire online. The statistical analysis was performed using the IBM SPSS 25 program, the significance level was determined at p<0.05.

RESULTS

There was a significant difference between the group of breastfeeding mothers and non-breastfeeding mothers in terms of age (p<0.001), place of residence (p<0.001), marital status (p<0.001), education (p<0.001), income status (p<0.001), the number of children (p = 0.005), the method of delivery (p = 0.018), how many children completed the questionnaire (p = 0.021). Varied nutrition was characteristic in a significantly higher proportion during the postpartum period among breastfeeding mothers (p = 0.006). There was a relationship between the two groups in terms of energy intake (p = 0.002) and daily vitamin/mineral/trace element intake (p = 0.044).

CONCLUSION

During the period of childbirth, breastfeeding mothers pay more attention to their nutrition than non-breastfeeding mothers. Breastfeeding can be significantly influenced by certain sociodemographic factors. Orv Hetil. 2023; 164(43): 1693-1700.

Inequalities in premature mortality from ischaemic heart disease in the WHO European region

OBJECTIVES

Ischaemic heart disease (IHD) is one of the leading causes of premature mortality. Our aim was to analyse standardised premature mortality rates from IHD by geographical groups in the age group 45-59 years.

METHODS

We performed a retrospective, quantitative analysis of age-standardized mortality rates from IHD between 1990-2014 per 100,000 population in Western European (WE: N = 17), Eastern European countries (EE: N = 10), and countries of the former Soviet Union (fSU: N = 15) within the European Region of the World Health Organisation (WHO) based on data retrieved from the WHO European Mortality Database. Descriptive statistics, time series analysis and statistical tests were used for the analyses (ANOVA, Kruskal-Wallis test, Mann-Whitney test, paired t-test).

RESULTS

On average, age-standardized death rates (ASDR) from IHD per 100,000 population were the lowest in WE (men 1990: 143.67, 2014: 50.29; women 1990: 29.06, 2014: 9.89), and the highest in fSU (men 1990: 358.69, 2014: 253.25; women 1990: 99.78, 2014: 57.85). Between 1990 and 2014, all three groups experienced significant decrease in ASDR both in men and women (fSU: -29.39%, -42.02%; EE: -49.41%, -50.57%; WE: -64.99%, -65.97%, respectively) (p < 0.05). Between 1990 and 2004, ASDR decreased in WE in both sexes (p < 0.001), in EE among males (p = 0.032). Between 2004 and 2014, ASDR from IHD decreased significantly in both sexes in fSU and WE, in EE only among women (p < 0.05).

CONCLUSIONS

During the whole period analysed, ischaemic heart disease mortality significantly decreased in both sexes in all the groups.

Burnout, quality of life and perceived patient adverse events among paediatric nurses during the COVID-19 pandemic

PURPOSE

This cross-sectional, descriptive, correlational study aimed to measure burnout, quality of life (QOL) and perceptions of patient-related adverse events among paediatric nurses amid the COVID-19 pandemic and assess the relationships between these scores and participants' demographic and work-related characteristics.

BACKGROUND

The mental health of most nurses may severely suffer due to the significant adversities that they struggle with while they care for their patients amid the COVID-19 pandemic. Mental distress negatively affects nurses' relationships and work performance, which may adversely influence the quality of care and patient safety.

METHODS

A convenient sample of 225 Jordanian paediatric nurses completed a test batter comprising the Copenhagen Burnout Inventory, the Brief Version of the World Health Organisation's Quality of Life questionnaire and the nurse-perceived patient adverse events' questionnaire. This study was prepared and is reported according to the STROBE checklist.

RESULTS

Paediatric nurses reported high levels of burnout, low QOL and high occurrence of hospital-acquired infections. Participants' age and hospital/unit capacity were significantly associated with burnout and QOL.

CONCLUSION

Personal traits, perceived salary insufficiency and hospital/unit capacity represent factors that aggravate burnout, lower quality of life and worsen perceived patient safety among paediatric nurses.

RELEVANCE TO CLINICAL PRACTICE

Policymakers should promote nurses' mental integrity and patient safety by addressing issues of workload and financial sufficiency and by provide interventions aimed to increase nurses' resilience.

PATIENT OR PUBLIC CONTRIBUTION

Patients or public were not involved in setting the research question, the outcome measures, the design or implementation of the study. However, paediatric nurses responded to the research questionnaires.

Nurse preferences of caring robots: A conjoint experiment to explore most valued robot features

AIM

Due to the COVID pandemic and technological innovation, robots gain increasing role in nursing services. While studies investigated negative attitudes of nurses towards robots, we lack an understanding of nurses' preferences about robot characteristics. Our aim was to explore how key robot features compare when weighed together.

METHODS

Cross-sectional research design based on a conjoint analysis approach. Robot dimensions tested were: (1) communication; (2) look; (3) safety; (4) self-learning ability; and (5) interactive behaviour. Participants were asked to rank robot profile cards from most to least preferred.

RESULTS

In order of importance, robot's ability to learn ranked first followed by behaviour, look, operating safety and communication. Most preferred robot combination was 'robot responds to commands only, looks like a machine, never misses target, runs programme only and behaves friendly'.

CONCLUSIONS

Robot self-learning capacity was least favoured by nurses showing potential fear of robots taking over core nurse competencies.

Paediatric nurses' burnout and perceived health: The moderating effect of the common work‐shift

Aims

This study aimed to: (1) explore the relationship between paediatric nurses' burnout, perceived health and common work‐shift, (2) examine the moderating effect of the common work‐shift on the relationship between paediatric nurses' burnout and perceived health, (3) compare burnout and perceived health between paediatric nurses working on day shifts and night/alternate shifts.

Design

A cross‐sectional, correlational design was used in this study.

Methods

A convenient sample of 225 paediatric nurses was selected from nine hospitals in Jordan. Participants were surveyed using a self‐administered questionnaire.

Results

The perceived health correlated negatively with paediatric nurses' burnout and their common work‐shift. Also, nurses' burnout and common work‐shift were significantly correlated. The common work‐shift moderated the relationship between paediatric nurses' burnout and their health. To control the impact of paediatric nurses' burnout on their health, the ratio of the night‐to‐day shifts should be observed and balanced.

Predicting cervical screening and HPV vaccination attendance of Roma women in Hungary: community nurse contribution is key

BACKGROUND

HPV screening/vaccination has been observed lower for ethic minorities. Understanding factors that predict and can improve attendance is therefore key. Hence, the aim was to identify causes, especially concerning the quality of the patient-provider relationship, that predict past HPV screening and vaccination turnout of Roma women in Hungary.

METHODS

Cross-sectional research design with self-developed, culturally sensitive questionnaire. A final, female Roma sample of 368 participants was randomly selected from census register. Community nurses contacted participants and distributed surveys. Surveys were mailed-in by participants. Bivariate logistic regression was used to predict former participation in HPV screening/vaccination.

RESULTS

Of the total sample, 17.4% of women attended at least one cervical screening and HPV vaccination in the past. Bad screening experience was positively associated with racially unfair behaviors of physicians. The odds of past attendance were 4.5 times greater if 'no negative earlier experience' occurred, 3.3 times likelier if community nurse performed screening/immunization and 1.6 times more probable if respondent felt 'no shame'. Evaluating the screening/vaccination process painful, being only financially motivated and attendance involving a lot of travel decreased the odds of 'no show' by 50%, 40% and 41%, respectively.

CONCLUSIONS

When considering the ratio of past cervical screening attendance, we conclude that our female Roma sample did not behave differently from the general population. We saw no evidence that racial mistreatment made any contribution to explaining cervical screening participation. Past positive screening experience and the quality of patient-provider relationship increased the odds of participation the most. Cancer of friends, pain, financial motivation and travel distance decreased odds of participation to a lesser extent. In order to improve future screening and immunization, community nurses should play more central and advanced role in the organization and implementation of such services specifically targeting Roma populations.

Serdülők alvásminősége az internethasználattal összefüggésben

Jelen vizsgálatunk korábbi kutatásunk folytatása, célja a serdülők alvásminőségének felmérése az internethasználat tükrében. Keresztmetszeti, kvantitatív, leíró jellegű kérdőíves felmérést végeztünk általános és középiskolai tanulmányokat végző, 12–18 éves diákok körében (n = 308). Saját szerkesztésű kérdőívet, az alváshigiénés szabályok skáláját és az Athén Insomnia Skálát alkalmaztuk. Az Athén Insomnia Skálán átlagosan 5,39 ( 3,93) pontot értek el, a serdülők 17%-a insomniásnak tekinthető. A diákok átlagosan 1,27 (1,04) órát néznek filmet naponta, és 47%-uk több mint két órán keresztül használja az internetet naponta. Negatívan befolyásolja az alvásminőséget a napi túlzott internet­hasz­nálat (p < 0,001) és az elalvás előtti okoseszköz-haszná­lat (p = 0,002). A stressz az internethasználattal párhuza­mosan nő (p = 0,001). Akik jobban alszanak, jobban teljesítenek az iskolában (p = 0,034). A túlzott okoseszköz-használat összefügg a magasabb stressz-szinttel, a rosszabb alvásminőséggel. Célunk a szülők és a serdülők figyelmének felhívása az internethasználat csökkentésére, a romló alvásminőség lehetséges következményeire.

The relationship between paediatric nurses' quality of life and intent to leave: The moderating role of hospital type

Background

Different types of hospitals exist in Jordan, and each type has its own leadership style. This might affect the nursing workforce in terms of quality of life and intent to leave.

Aim

This study aimed at (1) assessing the relationship between paediatric nurses' quality of life and intent to leave, (2) examining the moderating effect of the hospital type on this relationship, (3) comparing the quality of life of paediatric nurses working at ministry of health and the University‐Affiliated hospitals and (4) exploring the determinants of nurses' intent to leave.

Design

A cross‐sectional, comparative and correlational design was used in this study.

Methods

A multi‐site sample was selected from two types of hospitals in Jordan; the ministry of health and the University‐Affiliated hospitals. A sample of 225 paediatric nurses responded to the brief quality of life questionnaire by the World Health Organization in addition to a group of sociodemographic and work‐related questions.

Results and conclusion

Nurses' quality of life and intent to leave were negatively correlated. This correlation was moderated by the type of hospital. Nurses' quality of life was significantly different in the two types of hospitals. Both salary and nursing care model predicted paediatric nurses' intent to leave. The managerial style and work environment of the ministry of health hospitals should be benchmarked against the University‐Affiliated hospitals.

The relationships between paediatric nurses' social support, job satisfaction and patient adverse events

AIMS

To explore the relationships of family, co-worker and manager support with paediatric nurses' satisfaction and their perception of adverse events. Furthermore, this study aimed to assess the job satisfaction, social support and the perceived patient adverse events.

DESIGN

This study used a cross-sectional correlational design.

METHODS

A convenient sample of 225 paediatric nurses was selected from nine hospitals in Jordan. Both the Pearson correlations and multiple regression tests were used in the analysis. The study was prepared and is reported according to the STROBE checklist.

RESULTS

Significant and positive correlations were found between paediatric nurses' job satisfaction and the social support they receive. Significant negative correlations were also found between adverse events and both family and manager support. The multiple regression results showed that manager support is a significant negative predictor of both pressure ulcers and patient falls, and family support significantly predicted paediatric nurses' job satisfaction.

Nurses' burnout and quality of life: A systematic review and critical analysis of measures used

Background

Nurses’ burnout might affect their quality of life, productivity and nursing care services.

Aim

The aim of this systematic review was to systemically review the relationship between nurses’ burnout and quality of life and to introduce practical recommendations to reduce nurses’ BO and improve their QOL.

Methods

In April 2021, MeSH terms (("Nurses"[Mesh]) AND "Burnout, Professional"[Mesh]) AND "Quality of Life"[Majr] were used to search five electronic databases: CINAHL, PubMed, Medline, Psychology and Behavioral Sciences Collection and Google Scholar.

Results

The search produced 21 studies exploring nurses’ burnout and their quality of life within the last ten years (2009–2021). Most of these studies found significant relationships between the burnout dimension(s) and quality of life dimension(s) among the nurses.

Conclusion

Nurses have moderate to high levels of burnout and were negatively associated with poor quality of life. Interventional programs are needed to decrease nurses’ burnout and improve their quality of life.

Burnout and patient safety: A discriminant analysis of paediatric nurses by low to high managerial support

AIM

To explore how levels of managerial support discriminate paediatric nurses' burnout, quality of life, intent to leave and adverse patient events.

DESIGN

A quantitative correlational study.

METHODS

A total of 225 paediatric nurses were selected from nine major hospitals across Jordan. The main measures used were the Copenhagen Burnout Inventory and the brief version of World Health Organization-Quality of Life Instrument. The study methods were compliant with the STROBE checklist.

RESULTS

Nurse manager support was negatively associated with adverse patient events, work-related burnout, client-related burnout, and intent to leave; and positively with physical and psychological quality of life. Frequency of nosocomial infections characterized low manager support, whereas medication errors described high support. Greater nurse manager support decreased the likelihood of adverse patient outcomes.

Influence of cognitive function and nurse support on malnutrition risk in nursing home residents

Aim

To predict malnutrition risk of older residents by cognitive function, nurse support and self‐care capacity as primary measures of interest.

Design

Cross‐sectional, correlation design with linear regression analysis.

Methods

Older residents over 60 years of age were randomly selected from nursing homes. Mini Mental State Exam and the Mini Nutritional Assessment were used were as main measures.

Results

Lower malnutrition risk was associated with better cognitive functioning. Improved independence of self‐feeding was also linked to reduced nutritional risk. Nurse support was positively related to BMI and cognitive impairment. General self‐care capacity and ‘appetite the week before’ were key predictors of malnutrition risk; 1‐point increase in both variables caused nutritional risk to decrease by 1.73 and 1.38 points, respectively. That is, a 1‐point increase in self‐care capacity and appetite would decrease malnutrition risk by 5.76% and 4.6%. The regression model explained significant amount (65.6%) of variance in malnutrition risk.

Health behavior, sleep quality and subjective health status among Hungarian nurses working varying shifts

BACKGROUND

Distinctly, shift work is burdensome for nurses and may lead to health problems.

OBJECTIVE

The purpose of the study was to examine the nursing shift system genres and to analyze the potentially debilitating effects upon sleep quality and the subjective state of physical and mental health when considering varying shift schedules.

METHODS

The first cross-sectional study (n = 639) was performed at the Clinical Center at the University of Pécs, and throughout various hospitals in the South-Danubian Region. The Hungarian version of the Bergen Shift Work Sleep Questionnaire, the Berlin Questionnaire and the 13-item Sense of Coherence Scale were implemented. In the longitudinal survey (n = 52), the quality of sleep was determined by the ActiGraph GT1M type of activity meter supplemented with a sleep diary.

RESULTS

Interestingly, most respondents weight gained among the irregular schedule group (p = 0.004). The nurses working a flexible schedule reportedly slept better (p = 0.003), had a higher sense of coherence (p = 0.013) and exhibited better subjective health status (p = 0.017) than when compared with nurses working irregular shifts. The frequency of psychosomatic complaints aligned with the length of rest periods proved influential (p = 0.013).

CONCLUSION

Admittedly, the irregularity of work schedules is stressful for nurses. Due to the health status of nurses, it is a worthy consideration to establish the least exhausting work schedules.

[Work schedules in the Hungarian health care system and the sleep quality of nurses]

INTRODUCTION

One way of ensuring the continuity of health care is the shift work, which is burdensome and it can lead to sleep disturbances.

AIM

The aim of the study was to measure the typical Hungarian nursing shift systems in hospitals, to analyse the causes of irregular work schedules, and to compare the sleep quality of nurses in different work schedules.

METHOD

236 head nurses filled out the national online survey, and 217 nurses in clinics of the University of Pécs filled the Hungarian version of Bergen Shift Work Sleep Questionnaire.

RESULTS

The head nurses provided data of 8697 nurses's schedules. 51.89% of nurses work in flexible shift system. 1944 employees work in regular shift system, most of them in the following order: 12-hour day shift and 12-hour night shift, followed by a one- or two-day rest. Where there is no system of shifts, the most frequent causes are the needs of nurses and the nurse shortage. Nurses who are working in irregular shift system had worse sleep quality than nurses who are working in flexible and regular shift system (p = 0.044).

CONCLUSIONS

It would be helpful if the least burdensome shift system could be established.