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Axelin A, Feeley N, Cambell-Yeo M, Silnes Tandberg B, Szczapa T, Wielenga J, Weis J, Pavicic Bosnjak A, Jonsdottir RB, George K, Blomqvist YT, Bohlin K, Lehtonen L. Symptoms of depression in parents after discharge from NICU associated with family-centred care. J Adv Nurs 2021; 78:1676-1687. [PMID: 34897769 PMCID: PMC9299776 DOI: 10.1111/jan.15128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/03/2021] [Accepted: 11/27/2021] [Indexed: 12/01/2022]
Abstract
Aims The aim of this study was to examine the potential association of family‐centred care as perceived by parents during a NICU stay with parents’ depressive symptoms at discharge and at 4 months corrected for infant age. Design A longitudinal, multicentre cohort study was conducted from 2018 to 2020 in 23 NICUs across 15 countries. Methods Parents (n = 635 mothers, n = 466, fathers) of infants (n = 739) born before 35 weeks of gestation and admitted to the participating NICUs were enrolled to the study during the first weeks of their infants’ hospitalizations. They responded to Digi‐FCC daily text messages inquiring about their perception of family‐centred care provided by NICU staff. In addition, they completed a questionnaire assessing their overall perception of family‐centred care at discharge. Parents’ depressive symptoms were measured by the Edinburgh Postnatal Depression Scale at discharge and again after discharge when their infants were at 4 months corrected for age. Results The mothers’ and the fathers’ perceptions of family‐centred care were associated with their depressive symptoms at discharge and at 4 months corrected age, controlling for gestational age, multiple birth, parent education and relationship status. Parents’ participation in infant care, care‐related decisions and emotional support provided to parents by staff explained the variation in the parents’ perceptions of family‐centred care. The factors facilitating the implementation of family‐centred care included unlimited access to the unit for the parents and for their significant others, as well as amenities for parents. Conclusions Our study shows that family‐centred NICU care associates with parents’ depressive symptoms after a NICU stay. Impact Depression is common in parents of preterm infants. The provision of family‐centred care may protect the mental well‐being of parents of preterm infants.
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Affiliation(s)
- Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland.,Department of Women's and Children's Health, University of Uppsala, Uppsala, Sweden
| | - Nancy Feeley
- Ingram School of Nursing, McGill University, Montréal, Canada.,Centre for Nursing Research, Lady Davis Institute, Jewish General Hospital, Montréal, Canada
| | - Marsha Cambell-Yeo
- School of Nursing, Faculty of Health and Departments of Pediatrics, Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Bente Silnes Tandberg
- Department of Pediatric and Adolescent Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Tomasz Szczapa
- Department of Neonatology, Neonatal Biophysical Monitoring and Cardiopulmonary Therapies Research Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Joke Wielenga
- IC Neonatology, Emma Children's Hospital, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Janne Weis
- Department of Neonatology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anita Pavicic Bosnjak
- Department of Obstetrics and Gynecology, Clinical Hospital Sveti Duh Zagreb, Zagreb, Croatia.,Division on Breastfeeding Support, Human Milk Bank, Croatian Tissue and Cell Bank, Department for Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Rakel B Jonsdottir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Kendall George
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Qld, Australia
| | - Ylva T Blomqvist
- Neonatal Intensive Care Unit, University Children's Hospital, Uppsala, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Kajsa Bohlin
- Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Liisa Lehtonen
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland.,Department of Clinical Medicine, University of Turku, Turku, Finland
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Zakarija-Grkovic I, Pavicic Bosnjak A, Buljan I, Vettorazzi R, Smith LJ. The IBLCE exam: candidate experience, motivation, study strategies used and predictors of success. Int Breastfeed J 2019; 14:2. [PMID: 30631377 PMCID: PMC6323655 DOI: 10.1186/s13006-018-0197-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 12/11/2018] [Indexed: 11/10/2022] Open
Abstract
Background Optimising breastfeeding rates is a public health priority. Studies have shown that all forms of extra breastfeeding support increase breastfeeding rates, including support provided by trained health professionals. International Board Certified Lactation Consultants (IBCLCs) are trained healthcare professionals in the clinical management of breastfeeding and human lactation. The IBCLC certification is a sought-after credential and can only be obtained after passing the exam administered by the International Board of Lactation Consultant Examiners (IBLCE). In Slovenia and Croatia, the IBLCE exam has been offered since 2006 and 2009, respectively. In this study, our aim was to 1) determine which candidate characteristics are associated with a passing grade on the IBLCE exam; and 2) analyse differences between candidates from Slovenia and Croatia, given Slovenians' higher achievements in the past. Methods In February, 2017, a 4-page, 36-question survey was sent via Survey Monkey to the available email addresses of all past IBLCE exam candidates in Croatia and Slovenia. Questions covered sociodemographic data, breastfeeding education, exam preparation, motivation and experience taking the IBLCE exam. Results Ninety-two participants completed the online survey: 36 from Croatia and 55 from Slovenia, giving a response of 47 and 52%, respectively. No significant difference was found in pass rates between the two countries, despite Slovenians being younger and spending more time observing normal breastfeeding dyads. Variables found to be significantly more common among respondents who passed the IBLCE exam included: attending breastfeeding conferences/symposiums, using a breastfeeding atlas and studying with others. Statistical predictors of IBLCE exam success were: number of hours of bedside teaching, perceived clarity of photographs and breastfeeding conference/symposium attendance. Respondents who reported that they had attended a breastfeeding conference/symposium, had less hours of bedside teaching and perceived exam photographs as completely clear, were 7.49 (95% CI 2.26, 24.84), 0.48 (95% CI 0.28, 0.82), and 3.49 (95% CI 1.17, 10.41) times more likely to pass the exam, respectively. Conclusion Breastfeeding conference attendance, less bedside teaching and perceived clarity of exam photographs may be predictors of IBLCE exam success. Further studies on larger samples of exam candidates are required to confirm our findings and determine other factors associated with passing the IBLCE exam.
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Affiliation(s)
- Irena Zakarija-Grkovic
- 1Departments of Family Medicine and Clinical Skills, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia
| | - Anita Pavicic Bosnjak
- 2Division of Neonatology, Department of Obstetrics and Gynaecology, Medical School University of Zagreb, University Hospital "Sveti Duh", Zagreb, Croatia
| | - Ivan Buljan
- 3Department for Research in Biomedicine and Health, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia
| | - Renata Vettorazzi
- 4University of Ljubljana, Faculty of Health Sciences, Zdravstvena pot 5, 1000 Ljubljana, Slovenia
| | - Linda J Smith
- Bright Future Lactation Resource Centre, Ltd., Dayton, USA.,6Boonshoft School of Medicine, Wright State University, Dayton, OH USA
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Abstract
BACKGROUND Many mothers find it difficult to breastfeed exclusively for the recommended 6 months postpartum. The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) was developed to measure breastfeeding self-efficacy, an important predictor of breastfeeding outcomes. OBJECTIVE To translate and psychometrically assess the BSES-SF among women in Croatia. METHODS A convenience sample of 190 breastfeeding mothers was recruited from a Baby-Friendly hospital in Zagreb, Croatia. In-hospital mothers completed questionnaires that included the translated BSES-SF, Sense of Coherence Scale (SOC-13), and a demographic questionnaire. The follow-up questionnaires were administered to mothers at 1 and 6 months postpartum to determine their infant feeding method. RESULTS The mean total score of the Croatian version of the BSES-SF was 55 ± 7. The Cronbach α coefficient for internal consistency was 0.86, suggesting good reliability. In-hospital BSES-SF scores significantly predicted breastfeeding duration and exclusivity at 1 and 6 months postpartum, providing support for predictive validity. The BSES-SF scores were significantly correlated with the total SOC scores (r = 0.32, P < .001) and the SOC subscales of comprehensibility (r = 0.35, P < .001), manageability (r = 0.26, P < .001), and meaningfulness (r = 0.20, P = .005), providing support for construct validity. CONCLUSION This study provides evidence that the translated version of the BSES-SF may be a valid and reliable measure of breastfeeding self-efficacy among postpartum women in Croatia.
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Bosnjak AP, Grguric J, Stanojevic M, Sonicki Z. Influence of sociodemographic and psychosocial characteristics on breastfeeding duration of mothers attending breastfeeding support groups. J Perinat Med 2009; 37:185-92. [PMID: 18956963 DOI: 10.1515/jpm.2009.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM Duration of breastfeeding, socio-demographic and psychosocial characteristics of the mothers attending breastfeeding support groups were investigated. METHODS All examined mothers were cared for according to the Baby Friendly Hospital Initiative (BFHI) of the World Health Organization (WHO) and UNICEF. The investigated group of mothers attended a breastfeeding support group (BSG) led by a community nurse and women experienced in breastfeeding without additional training. Data on breastfeeding duration were collected retrospectively by self-reported questionnaire. RESULTS Of 980 eligible, 393 mothers were included to the study: 210 attended BSG, while 183 did not. The following differences between the two groups were found: time when the decision to breastfeed was made, smoking during lactation and social support while breastfeeding. More mothers in the investigated group continued breastfeeding at least six months postnatal (83.8% vs. 48.1%, P<0.001), with exclusive breastfeeding until the age of three months (56% vs. 23.5%, P<0.001). After logistic regression analysis, the following factors were found to be positively associated with the duration of breastfeeding for at least six months: time when the decision to breastfeed was made, intended duration of breastfeeding and household income. Maternal smoking during pregnancy affected duration of breastfeeding inversely. CONCLUSION Characteristics which positively influenced the duration of breastfeeding are the time when the decision to breastfeed was made, intended duration of breastfeeding, household income, and smoking during pregnancy. Mothers who attended BSG more often continued breastfeeding for at least six months if they decided to breastfeed after birth, intended to breastfeed for longer than six months, had higher monthly household income and did not smoke during pregnancy.
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Affiliation(s)
- Anita Pavicic Bosnjak
- Division of Neonatology, Department of Obstetrics and Gynecology Medical School University of Zagreb, General Hospital "Sv. Duh", Sv. Duh 64, Zagreb, Croatia.
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