Breastfeeding status during the first two years of infants' life and its risk factors based on BASNEF model structures in Isfahan

The effects of breast milk odor on the physiological and behavioral responses caused by venipuncture pain in term infants: A clinical trial study

BACKGROUND

Pain management is very important for infants who are unable to express it verbally. Pain control is one of the nursing actions and part of their duties. This study attempted to determine the effects of breast milk odor on the physiological and behavioral responses caused by venipuncture pain in full-term infants at an educational hospital.

MATERIALS AND METHODS

This randomized clinical trial study was carried out on 3-5 days' term and healthy babies with a gestational age of 34 weeks and later in the 9-Day Hospital of Torbet Heydariyeh, Iran, 2021. The sample size, taking into account the possibility of a 10% dropout of samples included 20 babies for each group and a total of 40 babies were selected by convenience sampling. To collect data, a checklist of demographic characteristics, a registration form for physiological responses, and the modified behavioral pain scale were used.

RESULTS

The results of this study showed that breast milk odor has a positive effect on behavioral responses (P < 0.001) and also a significant relationship was observed between the effects of breast milk odor and physiological responses percentage of oxygen uptake and pulse (P < 0.001). However, no significant relationship was observed between breast milk odor and breathing variables (P > 0.05).

CONCLUSIONS

According to the results, olfactory stimulation with breast milk during venous blood sampling showed positive effects on physiological responses and pain reduction in infants. Therefore, it is recommended to use soothing stimuli such as the smell of breast milk during painful procedures in babies.

Hemodynamically stable very low birth neonates weight gain is affected by the early initiation of full enteral feedings compared to standard feeding

BACKGROUND

Premature babies need to develop similarly to fetuses of the same gestational age. The majority of premature neonates experience a growth-restricted status while in the patent ductus arteriosus (PDA). Extrauterine growth failure is a significant barrier for infants with very low birth weight (VLBW).

MATERIALS AND METHODS

The study was conducted for six months at the Neonatology Unit, Department of Pediatrics, Coimbatore Medical College Hospital, Coimbatore, Tamil Nadu, India. Neonates with VLBW who met the inclusion criteria were assigned randomly to one of two feeding strategies, that is, full enteral feeding or partial feeding, based on the randomization sequence discovered by opening the sealed cover. The duration of stay, weight variation, neonatal variables, feeding intolerance, necrotizing enterocolitis (NEC), septicemia, apnea, newborn hyperbilirubinemia, PDA, hypoglycemia, intracranial bleeding, and mortality of neonatal recruits were all carefully evaluated.

RESULTS

Two thousand two hundred eighty-four neonates were hospitalized throughout the six-month trial period, and 408 had low birth weight. Three hundred forty-two babies were eliminated from the study due to hemodynamic instability, persistent respiratory distress, infections, metabolic issues, and congenital abnormalities. Sixty-six babies met the study's inclusion criteria, and thus participated in the study. Sixty-six newborns weighed between 1.251 and 1.500 kg. Randomly assigning intervention and control groups. Thirty-three newborns were assigned to group A (intervention) and another 33 to group B (control).

CONCLUSIONS

The study concluded that enteral feeding was effective, inexpensive, secure, and feasible. Early full enteral feeding reduced septicemia and infant hyperbilirubinemia. Thus, we must start enteral feeding as soon as possible to avoid inadequate nutrition in neonates with VLBW during a crucial growth period.

The Effects of Lifestyle Intervention Using the Modified Beliefs, Attitude, Subjective Norms, Enabling Factors Model in Hypertension Management: Quasi-Experimental Study

BACKGROUND

Hypertension is a serious health issue and a significant risk factor for cardiovascular disease and stroke. Although various health education models have been used to improve lifestyle in patients with hypertension, the findings have been inconsistent.

OBJECTIVE

This study aims to assess the effects of a lifestyle intervention program using a modified Beliefs, Attitude, Subjective Norms, Enabling Factors (BASNEF) model among nonadherent participants with hypertension in managing elevated blood pressure (BP) levels.

METHODS

This study reports a quantitative quasi-experimental research work, particularly using a repeated-measures design of the within-subjects approach on the 50 nonadherent patients who received a diagnosis of essential hypertension in Cebu, Philippines. The research participants received 5 sessions of training based on a modified BASNEF model. An adherence instrument was used as an evaluation platform. The first phase gathers participants' relevant profiles and background, and the final phase gathers participants' systolic BP, diastolic BP, heart rate, and adherence scores.

RESULTS

The results indicate that the phase 1 mean systolic readings (146.50, SD 19.59) differ significantly from the phase 4 mean systolic readings (134.92, SD 15.24). They also suggest that the lifestyle intervention based on session III or phase IV behavioral intention in the BASNEF model microgroup sessions positively affects BP readings among the research participants.

CONCLUSIONS

This study has established that the BASNEF model approach can be a good BP management technique.

The Perceived Health Needs of Primiparous Mothers Referring to Primary Health Care Centers: A Qualitative Study

Background

Since the first step in meeting the health needs of primiparous women involves understanding their conditions, the present study aimed to determine the health needs of primiparous women from their own viewpoints.

Methods

This study had a qualitative approach based on the conventional qualitative content analysis method, in which the purposive sampling method was used. Data were collected by semi-structured interviews. Data saturation was achieved by interviewing 12 participants. To ensure the study was rigorous, the four criteria of credibility, dependability, confirmability, and transferability were taken into account.

Results

The findings of this study consisted of 150 codes, 19 subcategories, and 6 categories, as follows: 1) the intense need for social support, 2) the need for prior preparation for pregnancy, 3) fears and worries, 4) the necessity of the availability of the needed infrastructures and requirements in the health center, 5) falling in love with the baby, and 6) seeking information from appropriate sources.

Conclusion

The present study showed that primiparous women need to receive more social and psychological support from family members and healthcare workers and that it is essential to improve the available infrastructures and services in healthcare centers and to provide the needed counseling to pregnant mothers to enable them to go through the pregnancy period smoothly.

The Impact of an Educational Program Based on the BASNEF Model on Knowledge and Self-Care Behaviors of Patients with Hypertension

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.

Prevalence of exclusive breastfeeding practice in the first six months of life and its determinants in Iran: a systematic review and meta-analysis

Background

Exclusive breastfeeding (EBF) in the first 6 months of life is the best and most complete option for an infant, in that supplies the vitamins and minerals the baby needs. Several studies in Iran have been conducted concerning the prevalence of EBF. The aim of this study was to determine the prevalence of EBF in the first 6 months of life and associated factors in Iran synthesizing published studies.

Methods

We searched PubMed/MEDLINE, Embase, Scopus, ISI/Web of Science, the Cochrane Library, Directory of Open Access Journals Directory (DOAJ) and Google Scholar as well as Iranian databases (Barakathns, MagIran and the Scientific Information Database or SID) up to November 2018. The Newcastle-Ottawa Scale was used to assess the quality of studies. Analyses were performed by pooling together studies using DerSimonian-Laird random-effects model with 95% confidence interval. To test for heterogeneity, I² test was used. The Egger’s regression test and funnel plot were used to evaluate the publication bias. The strength of EBF determinants was assessed computing the Odds-ratios (OR) using the Mantel–Haenszel method.

Results

In the initial search 725 records were found. Finally, 32 studies were selected based on inclusion/exclusion criteria. The sample size of studies varied between 50 and 63,071 subjects. The overall prevalence of EBF in Iran was 53% (CI 95%; 44–62). The OR for breastfeeding education received before pregnancy was 1.13 (0.94–1.36), for mother’s job 1.01 (0.81–1.27), for education level 1.12 (0.89–1.42), for type of delivery 1.16 (0.98–1.37), and for gender of child 1.03 (0.83–1.28).

Conclusion

In Iran health policy- and decision-makers should try to take interventions that encourage mothers to use their milk to breastfeed the infants.

[Health Technologies and their contributions to the promotion of breastfeeding: an integrative review of the literature]

Technologies can be promoters of breastfeeding. The scope of this review is therefore to identify health technologies and their contribution to the promotion of breastfeeding. A search was conducted in the following databases: Lilacs, SCOPUS, Medline and CINAHL, using the key words "breastfeeding," "technology" and "health promotion." The final sample consisted of 24 original articles, among which 19 technologies were identified and classified in managerial, educational and healthcare groupings. Educational technologies were predominant (12) and presented greater contributions to the promotion of breastfeeding. The combination of different technologies has revealed positive results in maintaining breastfeeding. The lack of studies with the use of managerial technologies during the lactation process, as well as the development of other research that prove the effects of each technology on increasing the prevalence of breastfeeding, was clearly detected in the review.

Intervention based on BASNEF model increases exclusive breastfeeding in preterm infants in Iran: a randomized controlled trial

BACKGROUND

The objective of this study is to determine the effect of a consultation model, Beliefs, Attitudes, Subjective Norms and Enabling Factors (BASNEF), and the counselling steps using GATHER-Greet clients, Ask clients about themselves, Tell clients about their choices, Help clients choose, Explain what to do, and Return for follow-up-on the continuation rates of exclusive breastfeeding in mothers of premature infants.

METHODS

This is a randomized controlled clinical trial carried out on 124 mothers with premature infants hospitalized in Fatemieh Hospital, city of Hamadan, in 2014. Participants were randomly assigned to either the intervention or control groups. The initial demographic questionnaire carried out in both groups included three questions about the continuation of exclusive breastfeeding, BASNEF, a checklist related to the lactation performance documented by mothers and the weight gain of their infants. Five breastfeeding consultation sessions based on the BASNEF model and counselling steps using GATHER, were held for the mothers in the intervention group for five consecutive days. Then follow-up weight gain and the questionnaire completion were performed in both groups at 1, 2, 3 and 4 months after the intervention.

RESULTS

Baseline characteristics were similar in the two groups. There were no significant differences between both groups in the rate of exclusive breastfeeding, lactation performance and infant weight at baseline. The intervention group had significantly higher rates of exclusive breastfeeding, 72.6% versus the control group of 16.1%, at the end of the 4 month follow-up. Also the intervention group had significantly higher mean scores of lactation performance (8.62 ± 2.08 vs 6.40 ± 1.84 in the control group) and infant weight (5694.80 ± 779.43 vs 4760.17 ± 859.12 in the control group) at the end of the 4 month follow-up.

CONCLUSION

Breastfeeding consultation of mothers based on the BASNEF model and using GATHER counselling steps increased the rate of exclusive breastfeeding, lactation performance and weight gain of premature infants. Therefore, breastfeeding counselling sessions are recommended for all mothers of premature infants.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials number IRCT2014111013405N6 and date registered, January 5, 2015.

The Effect of Educational Intervention based on BASNEF Model on Decreasing the Cesarean Section Rate among Pregnant Women in Khomain Country

OBJECTIVE

Over the past two decades, the incidence of cesarean section in most countries has increased. Cesarean section increases the risk of death and complications in the mother and fetus. Educational interventions based on behavior change models can play an important role in reduce the rate of cesarean section. The aim of our study is investigation the effect of educational intervention based on BASNEF Model on decreasing of cesarean section rate among pregnant women in Khomain County, from June to November 2013.

MATERIALS AND METHODS

In this interventional study, 140 nulliparous women who were in their last trimester of pregnancy were randomly allocated to case and control groups. Data gathering instrument was a questionnaire based on BASNEF framework. Data were analyzed by SPSS 14 software.

RESULTS

The scores of knowledge, attitudes, subjective norms, and enabling factors in the intervention group than the control group showed a significant difference (p < 0.001). After the study, it was found that 18 women (25.7%) in case group and 42 women (60%) in the control group underwent cesarean section. By Chi-square test showed that the difference in the type of delivery between the two groups was statistically significant (p < 0.001).

CONCLUSION

Design and implement curriculum based on BASNEF can be effective in reducing elective cesarean section.

Parents' Health Beliefs Influence Breastfeeding Patterns among Iranian Women

OBJECTIVES

To determine factors related to breastfeeding and its perceived health benefits among Iranian mothers.

METHODS

A cross-sectional study was performed using 240 postpartum women who were selected randomly from eight public health care centers in Hamadan, Iran, in 2012. Mothers who breastfed (BF) and mothers who never breastfed (NBF) were given a structured questionnaire to collect their demographic data and information regarding their health beliefs and attitude towards child-rearing. Descriptive and logistic regression were used for data analysis.

RESULTS

The mean length of breastfeeding was 11.6 (standard deviation=12.5) weeks. There was no difference in demographic variables, such as age, type of medical insurance, number of living children, employment, education, and household income (p>0.050), between mothers that breastfed and those that did not. Mothers' perception of the severity of child illness was higher in those who breastfed than those who never breastfed (p=0.050). In contrast, BF mothers had higher perceived confidence of medical care to prevent diseases (p<0.050) and a higher perception of reverse parent-child roles than NBF mothers (p<0.050).

CONCLUSION

Mothers' health beliefs and attitude to parenting has a significant role in choosing to breastfeed. Physicians and healthcare providers may provide supportive information that influence a mother's breastfeeding behavior.

The impact of an educational program based on BASNEF model on the selection of a contraceptive method in women

BACKGROUND

Quality of services, making communications with target groups, and educating them are among the most important success factors in implementation of family planning programs. Provision of public access to contraception and related methods, counseling services, and paying attention to social specification and cultures are important in promotion of service quality. With regard to applicability of health education theories and models, the present study aimed to find the impact of an educational program based on BASNEF model to choose contraceptive methods in women referring to health care centers in Minoodasht in 2012.

MATERIALS AND METHODS

This is a quasi-experimental study. Data were collected using BASNEF questionnaire by the researcher from women referring to health care centers in two groups of study and control (n = 100 in each group). Educational intervention (in the form of four educational 1-h sessions once a week during 1 month and two additional review sessions) was conducted in the form of group and face-to-face discussions and educational booklets were distributed. Data were analyzed by Chi-square, analysis of covariance (ANCOVA), paired t-test, and t-test through SPSS version 14.

RESULTS

After intervention, mean score of knowledge was significantly higher in the study group compared to control (P < 0.003). Intervention led to a better attitude in the study group (P < 0.0001). Mean score of subjective norms and enabling factors after intervention was significantly higher in the study group compared to control (P < 0.0001). The change in practice had a significant increase in the study group (54%) compared to control (9%).

CONCLUSIONS

BASNEF-based educational intervention was effective in increasing women's knowledge, attitude, and practice. As family and educational facilities are among the influencing factors on contraceptive method selection, interventional planning is hoped to be based on educational model.