| 1. |
- Blixt, Ingrid, 1968-, et al.
(författare)
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Breastfeeding training improved healthcare professional's self-efficacy to provide evidence-based breastfeeding support : A pre-post intervention study
- 2023
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 125
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe healthcare professional's (HCP's) perceived self-efficacy in their ability to provide breastfeeding support before and after a breastfeeding training program.DESIGN: Pre-post intervention study.SETTING: Antenatal care and child healthcare (CHC) centres in Sweden during 2020.PARTICIPANTS: An intervention group consisting of 39 HCPs (midwives 51.3%, child healthcare nurses 46.2%) completing a questionnaire at baseline and after intervention, and a control group of 34 HCPs (midwives 61.8%, child healthcare nurses 38.2%) completing a questionnaire at baseline.INTERVENTION: A breastfeeding training program in line with the Ten Steps to Successful Breastfeeding and WHO recommendations about breastfeeding.MEASUREMENTS AND FINDINGS: The 11-item Breastfeeding Support Confidence Scale (BSCS) measures HCP's self-efficacy regarding providing breastfeeding support in line with Ten Steps to Successful Breastfeeding and WHO recommendations. The intervention group experienced a significantly increased self-efficacy from pre-intervention to post-intervention for 8 of the 11 BSCS items, with the overall BSCS index score increasing from 36.87 to 39.56 points (p = 0.001). The index score in the intervention group at follow-up was significantly higher than the corresponding score in the control group at baseline (p = 0.025). The intervention group had significantly higher scores at follow-up than the control group at baseline on the questions: "I'm sure that I can help mothers continue to breastfeed even if the infant doesn't follow the growth curve" (p = 0.026) and "I'm sure that I can help mothers continue to breastfeed when the breastfeeding is painful" (p = 0.048).KEY CONCLUSIONS: The breastfeeding training program improved HCP' self-efficacy to provide evidence-based support to breastfeeding mothers.IMPLICATIONS FOR PRACTICE: This training program is well suited to implement in clinical practice and follows the Ten Steps to Successful Breastfeeding.TRIAL REGISTRATION: ACTRN12623000648628.
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| 2. |
- Blixt, Ingrid, 1968-, et al.
(författare)
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Partners' experiences of breastfeeding : a qualitative evaluation of a breastfeeding support intervention in Sweden
- 2024
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Ingår i: International Breastfeeding Journal. - : BioMed Central (BMC). - 1746-4358. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background: The World Health Organization states that women and their families need breastfeeding support from the healthcare system. However, knowledge about the most effective way to involve the partner in breastfeeding is lacking. A qualitative evaluation can provide insight and knowledge about the partner's experiences towards a breastfeeding support intervention and thus contribute to how forthcoming breastfeeding support policies are designed. The aim of this study was to explore partners' experiences regarding breastfeeding while participating in The Breastfeeding Study.Methods: An exploratory, longitudinal and qualitative design was used. This study was part of The Breastfeeding Study, which took place in Sweden. The intervention was performed in line with the Ten Steps to Successful Breastfeeding. Partners in the in the intervention group (IG) were part of a structured breastfeeding support programme. An individual breastfeeding plan was established in cooperation with the parents-to-be during pregnancy, and the plan was followed up at the child healthcare centre. A purposive sample was recruited from March to December 2021. Interviews and diary entries from IG (n = 8) and control group (CG) (n = 8) during pregnancy and 2 months after birth were analysed by content analysis, in accordance with the COREQ guidelines.Results: Partners' experiences can be summarised under the main category of 'Striving to be part of the family and important that the family's everyday life was well-functioning'. IG partners experienced that both parents were involved and cooperated in the breastfeeding process and that guidance from healthcare professionals (HCPs) helped them to feel secure. CG partners experienced feeling excluded and not receiving support from HCPs.Conclusion: Both parents need to be targeted in breastfeeding support policies to meet the support needs. Midwives at antenatal care and child healthcare nurses at the child healthcare centre have important roles to play in providing structured breastfeeding support and a breastfeeding plan. Both IG and CG partners strived to become a part of the infant's life and to make family life work. Midwives should involve both parents in a reflective dialogue on how the partner can be involved, apart from just feeding the infant.
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| 3. |
- Blomqvist, Ylva Thernström, 1974-, et al.
(författare)
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Parents need support to find ways to optimise their own sleep without seeing their preterm infant's sleeping patterns as a problem
- 2017
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 106:2, s. 223-228
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This study described how parents perceived their own sleep, and their infants', during neonatal intensive care unit (NICU) admission and after discharge. It also explored the infants' sleeping location at home.METHODS: The study was conducted in the NICUs of two Swedish university hospitals. The parents of 86 infants - 86 mothers and 84 fathers - answered questionnaires during their infants' hospital stay, at discharge and at the infants' corrected ages of two, six and 12 months. The parents' own sleep was explored with the Insomnia Severity Index.RESULTS: Mothers reported more severe insomnia than fathers during their infants' hospitalisation, and these higher insomnia severity scores were associated with more severe infant sleep problems at discharge (p = 0.027) and at two months (p = 0.006) and 12 months (p = 0.002) of corrected age. During the study period, 4%-10% of the parents reported severe or very severe infant sleeping problems. The bed-sharing rate was 75% after discharge and about 60% at the corrected age of 12 months.CONCLUSION: Maternal insomnia during an infant's hospital stay was associated with later perceptions of sleep problems in their children. Parents need support to find solutions for optimal sleep without seeing their child's sleeping patterns as a problem.
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| 4. |
- Cato, Karin, 1977-, et al.
(författare)
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Instrument development and an intervention to increase parents' self-efficacy regarding their infant's sleep
- 2024
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 39
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveMany Swedish parents experience that their infant has sleeping problems. Parents’ self-efficacy regarding their infants’ sleep may play an important role in how they perceive these problems. This pilot study aimed to develop an instrument measuring parents’ self-efficacy regarding their infant’s sleep and to examine if parents’ self-efficacy was affected by an intervention focusing on parental education.MethodMothers and fathers, at a maternity unit in Sweden, were drawn into either an intervention (n = 46) or a control (n = 42) group. The intervention group received a home visit from a nurse who provided information about infant sleep; the importance of attachment; and advice regarding sleep, breastfeeding and bed sharing, including guidelines for safe bed sharing. Three months later, the participants answered questions on background data, breastfeeding, sleep and self-efficacy.ResultsThe 11-item two-factor Uppsala Parental Self-Efficacy about Infant Sleep Instrument (UPPSEISI) was constructed to measure parents’ perceived self-efficacy. In adjusted analyses, being in the intervention group was associated with a higher self-efficacy (P = 0.035), as were being a mother (P = 0.003) and being satisfied with one’s own sleep (P = 0.007), while parents’ own sleeping problems were associated with a lower self-efficacy (P = 0.015).ConclusionImportantly, parental education may increase parents’ self-efficacy regarding their infant’s sleep.
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| 5. |
- Dykes, Charlotta, et al.
(författare)
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Parents experience a sense of guilt when their newborn is diagnosed small for gestational age, SGA : A grounded theory study in Sweden
- 2022
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Ingår i: Journal of Pediatric Nursing. - : Elsevier BV. - 0882-5963 .- 1532-8449. ; 62, s. e8-e15
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To become a parent of a child who is born small for gestational age can lead to challenges in addition to the newly acquired parenting role. There is currently a lack of knowledge regarding parents' experiences of having a child born small for gestational age.PURPOSE: The purpose of this study was to describe the experience of becoming a parent of a child small for gestational age DESIGN AND METHOD: A qualitative inductive approach was chosen with grounded theory as a method, a strategic selection was used and individual interviews with open questions were performed.RESULTS: The results showed that the parents expressed guilt over the child's size and focused on the ability to nourish their child to keep their unexpectedly small child alive. An experienced concern about the child's food intake could be seen throughout the entire interview material and the need for information was great. A common experience of the parents was that constant feeding of the child dominates their lives.CONCLUSION: The conclusion is that the unexpectedly small size of the child awakens the parent's instinct to provide life-sustaining care and the parents need increased support and more information around the child's condition. This requires well-trained professionals, because parents to children born SGA often harbour feelings of unpreparedness and guilt.PRACTICE IMPLICATIONS: Increased understanding and knowledge about the parents' experience of having a child born SGA, healthcare services can optimize the potential for better attachment between parent and child as well as offer appropriate support.
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| 6. |
- Funkquist, Eva-Lotta, 1965-
(författare)
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Policies and Practice in Neonatal Nursing Related to Nutrition
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of these studies was to increase knowledge about hospital feeding routines in high-risk neonates. A retrospective medical chart review procedure was used to study routines at the neonatal units of two Swedish hospitals. In Papers I and II, the sample (Uppsala n=21 and Umeå n=21) comprised of small for gestational age (SGA) infants, in Papers III (Uppsala n=64 and Umeå n=59) and IV (n=127), the samples comprised of appropriate for gestational age (AGA) infants. Paper I indicated large enteral/oral milk volumes rendered i.v. administration of glucose unnecessary, reduced weight loss and helped SGA infants regain birth weight earlier. More rapid postnatal growth did not remain up to 18 months with corrected age in any growth variable (Paper II). In Paper III, effects were compared whether the infants’ volume of breast milk intake in hospital was estimated by “clinical indices” or determined by test-weighing. Infants treated in hospitals where test-weighing was practised attained exclusive breastfeeding at an earlier postmenstrual age (PMA), and they were discharged at an earlier PMA. However, the two study units were similar regarding the proportion of infants attaining exclusive breastfeeding. Paper IV revealed preterm AGA infants with higher standard deviation scores (SDS) at birth had more negative changes from birth to discharge for all growth variables. Conclusions: Papers I and II indicated that early initiation of enteral/oral feeding with proactive increases in milk volume was beneficial short term. No evidence was found for a proactive nutrition regimen with initial large volumes of milk resulting in a different pattern of growth up to the corrected age of 18 months. Test-weighing before and after breastfeeding might help infants to attain exclusive breastfeeding at an earlier PMA (study III). Finally, preterm AGA infants with higher SDS at birth are at higher risk of inadequate growth during their hospital stay (study IV).
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| 7. |
- Funkquist, Eva-Lotta, 1965-, et al.
(författare)
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Preterm appropriate for gestational age infants : size at birth explains subsequent growth
- 2010
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 99:12, s. 1828-1833
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim was to evaluate growth and breastfeeding up to 18 months corrected age (CA) among preterm appropriate for gestational age (AGA) infants whose mothers initiated breastfeeding during the infants' hospital stay. Methods: One hundred and twenty-seven preterm AGA infants with a median birth weight of 2320 (769-3250) g and gestational age 34.29 (25.00-35.86) weeks were evaluated up to a CA of 18 months. A retrospective, descriptive and comparative design was used. Data were obtained by chart review of hospital medical records and a questionnaire completed by the mothers. Results: The changes in standard deviation scores (SDS) during the infants' hospital stay were -0.9 for weight, -0.3 for length and -0.5 for head circumference (HC). Infants with higher SDS at birth showed more negative changes from birth to discharge. Median increments in SDS from discharge to a CA of 2 months were as high as, or higher than, the loss from birth to discharge. Conclusion: Preterm AGA infants with higher SDS for weight, length and HC at birth are at higher risk of inadequate growth during their hospital stay.
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| 8. |
- Gerhardsson, Emma, et al.
(författare)
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Developing the preterm breastfeeding attitudes instrument : A tool for describing attitudes to breastfeeding among health care professionals in neonatal intensive care
- 2021
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 94
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to develop an instrument that measures health care professionals' (HCPs) attitudes to breastfeeding and skin-to-skin contact in relation to the Baby-Friendly Hospital Initiative for neonatal intensive care.DESIGN: The study was part of a larger project aiming to revive the Ten Steps to Successful Breastfeeding for both full-term and preterm infants. The study had a pre-test/post-test design using online questionnaires distributed by email before and after a training programme.SETTING AND PARTICIPANTS: A total of 70 specialist registered nurses, registered nurses, assistant nurses and physicians working at a Swedish neonatal intensive care unit answered 55 breastfeeding attitudes questions online before the training. The Preterm Breastfeeding Attitudes Instrument (PreBAI) consists of twelve of these 55 items/questions, selected using exploratory factor analysis.MEASUREMENTS AND FINDINGS: Higher scores indicated more positive attitudes and the median total PreBAI score was 42 points (out of 48), on both the pre- and the post-test questionnaires, showing no significant difference. In the pre-test questionnaire, the majority of HCPs (84%) stated that they needed further breastfeeding training. They also stated that they perceived breastfeeding as very important, scoring a median of 10 (range 5-10) points on a 10-point scale. Three separate underlying dimensions were identified in the questionnaire, indicating different attitudes: Facilitating (five items), Regulating (four items), and Breastfeeding- and skin-to-skin contact-friendly (three items). A positive correlation was found between how many years the HCPs had worked in neonatal care, and their PreBAI score (rs = 0.383, p = 0.001). Those who had previously received extra breastfeeding education scored higher on the instrument.KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Neonatal intensive care units need to increase their efforts to support breastfeeding. An important factor for mothers when establishing breastfeeding is support from well-trained professionals with a positive attitude to breastfeeding. The PreBAI could be a useful tool for identifying attitudes among HCPs before and after attending a breastfeeding training programme.
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| 9. |
- Gerhardsson, Emma, et al.
(författare)
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Health care professionals report positive experience with a breastfeeding training program based on the Baby-Friendly Hospital Initiative for Neonatal Intensive Care
- 2023
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Ingår i: Journal of Perinatal & Neonatal Nursing. - : Elsevier. - 0893-2190 .- 1550-5073 .- 1355-1841 .- 1878-089X. ; 29:1, s. 75-80
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Tidskriftsartikel (refereegranskat)abstract
- Support from health care professionals (HCPs) with good knowledge and positive attitudes toward breastfeeding has been associated with better breastfeeding outcomes in the mothers of preterm infants. The aim of the study was to describe HCPs' experiences of a breastfeeding training program. A total of 48 specialist registered nurses, registered nurses, assistant nurses and physicians working at a neonatal intensive care unit attended a breastfeeding training program and answered a questionnaire including Likert scales and open-ended questions. The participants reported that their interest in breastfeeding had increased as a median (range) of 10 (8–10) on a 10-point scale and rated to what extent they had received new tools for breastfeeding support as a median of 10 (8–10) after training. There were no differences in the median between different professions' ratings. Qualitative content analysis of the open-ended questions resulted in two categories: Discussions of the case scenarios in the group and Knowledge regarding breastfeeding. The results showed that discussions based on breastfeeding scenarios were perceived as valuable; the health care professionals reported receiving new knowledge and useful practical skills. This program was shown to increase health care professionals’ interest in breastfeeding and is useful for different health care professions.
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| 10. |
- Gerhardsson, Emma, et al.
(författare)
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Mothers' Adaptation to a Late Preterm Infant When Breastfeeding
- 2020
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Ingår i: Journal of Perinatal & Neonatal Nursing. - : Wolters Kluwer. - 0893-2190 .- 1550-5073. ; 34:1, s. 88-95
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to psychometrically test the Adaptation to the Late Preterm Infant when Breastfeeding Scale (ALPIBS) and also to test how a mother's self-efficacy predicts adaptation to a late preterm infant when breastfeeding. This study had a longitudinal and prospective design, and data collection was consecutive. Mothers (n = 105) with infants born between and weeks were recruited from a neonatal intensive care unit or a maternity unit. The ALPIBS was developed using exploratory factor analysis, and the association between breastfeeding self-efficacy and ALPIBS score was examined using linear regression analysis. The Breastfeeding Self-Efficacy Scale-Short Form instrument was used to measure self-efficacy in breastfeeding. A higher degree of self-efficacy was significantly associated with a higher degree of adaptation to the late preterm infant's breastfeeding behavior (P < .001). We identified 4 separate underlying factors measured by 11 items in the ALPIBS: (A) breastfeeding is a stressful event; (B) the infant should breastfeed as often as he or she wants; (C) a mother has to breastfeed to be a good mother; and (D) it is important to ensure control over the infant's feeding behavior. There is a link between self-efficacy and ALPIBS score, and self-efficacy is a modifiable factor that influences breastfeeding.
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