Antenatal Milk Expression as a Lactation Support Intervention for Parents of Infants With Severe Birth Defects

More research is needed to evaluate the feasibility, efficacy, and parent or provider perceptions of antenatal milk expression as a lactation support intervention for parents of surgical infants.

source: JPNN

Summary

A Case Series

[Posted 24/Jan/2023]

AUDIENCE: Nursing

KEY FINDINGS: More research is needed to evaluate the feasibility, efficacy, and parent or provider perceptions of antenatal milk expression as a lactation support intervention for parents of surgical infants.

BACKGROUND: A diet high in parent's own milk (parental milk) is a lifesaving intervention for critically ill infants. Lactating parents whose infants are born with birth defects that require surgical repair (surgical infants) shortly after birth often struggle to initiate and maintain a milk supply that meets their infant's nutritional needs. Antenatal milk expression has been identified as a safe, feasible, and potentially effective strategy that promotes parents' direct chest/breastfeeding or milk expression (lactation) confidence and helps parents attain their lactation goals. Two cases are presented to illustrate the potential for using antenatal milk expression as a lactation support intervention for parents of surgical infants.

DETAILS: Cases were drawn from a pilot study exploring the feasibility of implementing antenatal milk expression among pregnant parents of surgical infants. Participants were healthy women recruited after 30 weeks of gestation who received a fetal diagnosis of a complex congenital heart defect. Despite variability in clinical course and length of stay, parental milk was provided for the duration of each infant's hospitalization. Participant perceptions of antenatal milk expression varied.

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Source: Davis, J. A., Glasser, M., Clemens, M., et al. (2022). Antenatal Milk Expression as a Lactation Support Intervention for Parents of Infants With Severe Birth Defects: A Case Series. Journal of Perinatal and Neonatal Nursing. Published: January, 2023. DOI: 6497099.



Impact of Maternal Emotional Experiences at Birth and Self-Regulation In Preterm Children

The results underline that maternal symptomatology could be a risk factor for the co-construction of interactive exchanges between mother and premature baby and for the long-term development of the infant's self-regulation ability.

source: J. Neonatal Nurs.

Summary

The Role of Early Interactions

[Posted 31/Jan/2023]

AUDIENCE: Nursing

KEY FINDINGS: The results underline that maternal symptomatology could be a risk factor for the co-construction of interactive exchanges between mother and premature baby and for the long-term development of the infant's self-regulation ability.

BACKGROUND: Preterm birth can constitute an unexpected interruption of the transition to motherhood that can impact on a mother's well-being and her subsequent interactions with her child and, thus, be an important risk factor for the infant's emotional development. This study aims to shed light on early mother–child interactions, influenced by maternal symptomatology after childbirth, that can compromise a child's self-regulation ability.

DETAILS: A battery of self-report questionnaires was administered to 246 mothers a few days after their babies' birth. At 3 months of corrected infant age, mother–infant interactions were assessed using the GRS scales through video recording. At 12 and 24 months of corrected age, Bayley-III scales were administered to assess children's self-regulation ability. Significant correlations were found among maternal symptomatology and GRS dimensions in ELBW children. Regressions results showed how GRS scores were predicted by various POMS subscales.

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Source: Ionio, C., Giannoni, V., Colombo, C., et al. (2023). Impact of Maternal Emotional Experiences At Birth and Self-Regulation In Preterm Children: The Role of Early Interactions. J. Neonatal Nurs.. 2023; 29(1): 43-49. Published: February, 2023. DOI: 10.1016/j.jnn.2022.01.012.



Surgical Wound Assessment Tool

The application of the SWAT would improve the assessment of surgical wounds in daily nursing practice which will promote improved postoperative wound management.

source: J Clin Nurs

Summary

Construct Validity and Inter-Rater Reliability of a Tool Designed for Nurses

[Posted 17/Jan/2023]

AUDIENCE: Nursing

KEY FINDINGS: The surgical wound assessment tool was deemed to be acceptable, valid and reliable for monitoring the status of surgical wound healing. However, further modification and testing are needed to strengthen the tool and to determine the applicability of the tool in other populations.

BACKGROUND: Purpose of this study is to validate construct validity and inter-rater reliability of a surgical wound assessment tool. Wound assessment is central to appropriate wound management. However, limited standard surgical wound assessment tools are available to assist nurses in assessing and recording progress in the healing of surgical wounds.

DETAILS: A prospective observational study was utilised to test the validity and reliability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline was used. Convenience sampling was used to recruit 260 patients who underwent elective or emergency surgery at a hospital in Vietnam. Exploratory factor analysis was used to examine the construct validity of the surgical wound assessment tool. Inter-rater reliability was calculated using the intraclass correlation coefficient and Cohen's kappa to determine reliability of the overall scale and identified items. The results of the exploratory factor analysis supported a three-component structure of the surgical wound assessment tool. The intraclass correlation coefficient value of the overall scale was 0.79 (95% CI 0.67-0.89), p < .001, confirming excellent inter-rater reliability. Cohen's kappa value ranged from 0.5 to 1, demonstrating moderate to almost perfect level of agreement for individual items, except for one item on pain.

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Source: Do, H. T. T., Edwards, H., Finlayson, K. (2023). Surgical Wound Assessment Tool: Construct Validity and Inter-Rater Reliability of a Tool Designed for Nurses. Journal of Clinical Nursing. 2023; 32: 83-95. Published: January, 2023. DOI: 10.1111/jocn.16476.



Caring for the Bereaved Parents in the NICU

Due to cultural-religious backgrounds, traditional beliefs, structural problems, and organizational restrictions, fathers in NICUs do not receive adequate support, particularly when faced with their infant's death.

source: JPNN

Summary

Fathers-The Missing Piece of the Puzzle

[Posted 27/Dec/2022]

AUDIENCE: Nursing

KEY FINDINGS: Due to cultural-religious backgrounds, traditional beliefs, structural problems, and organizational restrictions, fathers in NICUs do not receive adequate support, particularly when faced with their infant's death. Bereaved fathers need to receive more support and attention from healthcare providers. Therefore, there is a need for changing the care providers' attitudes regarding the role of fathers and the quality of support that fathers should receive in the Muslim populations.

BACKGROUND: Grief after infant death is a common experience of bereaved parents often seen in the neonatal intensive care unit (NICU). The NICU staff tend to focus more on the mother's support, and fathers are often not treated equally as mothers. This study aimed to investigate the circumstance of caring for parents facing infant death in NICUs.

DETAILS: Twenty-eight face-to-face in-depth interviews were conducted between March 2018 and April 2019 in the northwest of Iran. Participants were selected via purposive sampling. An inductive thematic approach was used for data analysis. Three main themes and 7 subthemes were extracted. The main themes were: "the father-the missing piece of the puzzle in the mourning process," "restricted presence of fathers due to religious and traditional beliefs," and "the father-the patience stone."

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Source: Mirlashari, J., Nikbakht, N., Holsti, L., et al. (2022). Caring for the Bereaved Parents in the NICU: Fathers-The Missing Piece of the Puzzle. Journal of Perinatal and Neonatal Nursing. 2022; 36(4): E31-E39. Published: October/December, 2022. DOI: 6497226.



Effect of A Game-Based Intervention On Preoperative Pain And Anxiety In Children

Game-based interventions alleviate preoperative anxiety during the induction of anaesthesia in children.

source: J Clin Nurs

Summary

A Systematic Review And Meta-Analysis

[Posted 20/Dec/2022]

AUDIENCE: Nursing

KEY FINDINGS: Game-based interventions alleviate preoperative anxiety during the induction of anaesthesia in children. This innovative and pleasurable approach can be helpful in the care of paediatric surgical patients.

BACKGROUND: Games are increasingly being used as a means of alleviating pain and anxiety in paediatric patients, in the view that this form of distraction is effective, non-invasive and non-pharmacological. This study was done to determine whether a game-based intervention (via gamification or virtual reality) during the induction of anaesthesia reduces preoperative pain and anxiety in paediatric patients.

DETAILS: A systematic review with meta-analysis of randomised controlled trials was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and using RevMan software. The review was based on a search of the EMBASE, CINAHL, Medline, SciELO and Scopus databases, conducted in July 2021. No restriction was placed on the year of publication. 26 studies were found, with a total study population of 2525 children. Regarding pain reduction, no significant differences were reported. For anxiety during anaesthesia induction, however, a mean difference of -10.62 (95% CI -13.85, -7.39) on the Modified Yale Preoperative Anxiety Scale, in favour of game-based intervention, was recorded.

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Source: Suleiman-Martos, N., Garcia-Lara, R. A., Membrive-Jimenezet, M. J., al. (2022). Effect of A Game-Based Intervention On Preoperative Pain And Anxiety In Children: A Systematic Review And Meta-Analysis. J Clin Nurs. Published: December, 2022. DOI: 10.1111/jocn.16227.



An Exploratory Analysis of Maternal Health Variables Increasing the Severity of Congenital Heart Disease in Infants

Nurses must discuss optimal reproductive life planning strategies for decreasing risk of CHD and other infant disorders.

source: JPNN

Summary

[Posted 13/Dec/2022]

AUDIENCE: Nursing

KEY FINDINGS: Nurses must discuss optimal reproductive life planning strategies for decreasing risk of CHD and other infant disorders.

BACKGROUND: Congenital heart defects (CHD) are the most prevalent birth anomaly and leading cause of infant morbidity and mortality worldwide. Heart defects are often attributed to chromosomal abnormality or environmental factors, but most causes remain unknown. The purpose of this analysis was to explore maternal health variables and the relationships to birth outcomes in infants with CHD.

DETAILS: Maternal history of CHDs (odds ratio [OR] = 2.38; 95% confidence interval [CI], 1.42-3.98) and serious health conditions (OR = 1.537; 95%: CI, 1.08-2.17) increase infant risk and CHD severity. Maternal history of hypertension, serious health conditions, CHD, obesity, and income were predictors of birth weight (R[superscript digit two] = 0.049, P < .05). Maternal history of hypertension, influenza, serious health conditions, and housing were predictors of gestational age (R2 = 0.045, P < .05). Birth weight (BW) and gestational age (GA) did not correlate to the severity of CHD in this study (simple vs complex, BW = -0.014, GA = 0.011, r).

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Source: Butler, M. (2022). An Exploratory Analysis of Maternal Health Variables Increasing the Severity of Congenital Heart Disease in Infants. JPNN. Published: December, 2022. DOI: 6496668.



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