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Shi W, Wu L, Li X, Qi F, Ji W. Community-embedded follow-up management intervention for geriatric primary care: a mixed-methods study of an integrated health services model. BMC Health Serv Res 2024; 24:298. [PMID: 38448882 PMCID: PMC10918903 DOI: 10.1186/s12913-024-10804-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 02/29/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND To propose a community-embedded follow-up management model to provide health services for elderly patients with osteoporosis who live alone. METHODS Researchers randomly selected 396 people with osteoporosis living alone from five communities in Nantong, China, for the study. These participants were randomly assigned to control and intervention groups. Twenty-four community physicians in five communities provided professional support based on a community-embedded follow-up management model. Participants completed quantitative questionnaires at baseline and after the 6-month follow-up intervention, and some participants underwent semi-structured face-to-face interviews. The primary outcome is the effectiveness of the community-embedded follow-up management model in improving the quality of life of elderly patients with osteoporosis living alone. Based on an objective quantitative assessment, the qualitative study explains and adds essential components of this community-based follow-up management model. RESULTS The quantitative study showed that scores in physical functioning, ability to perform daily activities, self-efficacy, and mental status were significantly improved in the intervention group compared to the control group (p < 0.05). The most significant improvements were found in "mental status" (p = 0.012) and "self-care skills" (p = 0.003). The qualitative study reported the essential elements of a community healthcare model for older people living alone with osteoporosis, including professional support, personalized services, social support, and empowerment. CONCLUSIONS Community-embedded follow-up management meets the need for elderly patients with osteoporosis living alone. It helps to improve health perception, promote physical and mental health, and optimize the quality of life in this population. Personalized services and professional support are two major contributing factors to effective embedded follow-up management in the community.
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Affiliation(s)
- Wenjing Shi
- Xinglin College, Nantong University, 226019, Nantong, China
| | - Lingling Wu
- Department of Orthopedics, The Yancheng Clinical College of Xuzhou Medical University (The First People's Hospital of Yancheng), 224001, Yancheng, China
| | - Xiaodong Li
- School of Public Health, Nantong University, 226019, Nantong, China
| | - Feng Qi
- Department of Pharmacy, The Yancheng Clinical College of Xuzhou Medical University (The First People's Hospital of Yancheng), 224001, Yancheng, China.
| | - Wanyu Ji
- Xinglin College, Nantong University, 226019, Nantong, China.
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Lipscomb ST, Chandler KD, Abshire C, Jaramillo J, Kothari B. Early Childhood Teachers' Self-efficacy and Professional Support Predict Work Engagement. Early Child Educ J 2022; 50:675-685. [PMID: 33903791 PMCID: PMC8059119 DOI: 10.1007/s10643-021-01182-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/22/2021] [Indexed: 05/19/2023]
Abstract
Early childhood teachers play a central role in children's learning and development. Yet, they encounter stressors that can negatively impact their well-being, relationships with children, and, ultimately, job retention. To inform efforts to support early childhood teachers' work-related well-being, the current study examines positive factors that predict work engagement. Participants were 50 early childhood teachers from Head Start (34%), center-based programs (32%), and licensed home-based programs (34%). Consistent with a resilience framework and the Job Demands-Resources model, we examined both a personal resource (self-efficacy) and a workplace resource (professional support) in relation to work engagement, or the positive, fulfilling connection to one's work. Teachers' self-efficacy and professional support predicted greater work engagement, accounting for job demands (teachers' compassion fatigue/work distress and children's challenging behaviors) and teachers' education and professional development. Although not causal, findings are suggestive that supporting early childhood teachers with what they need to do their job effectively and feel that they can make meaningful differences in children's lives may help them to engage in their work with passion, dedication, and positive energy. Ultimately, supporting teachers' work engagement may in turn have developmental benefits for children as well.
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Affiliation(s)
- Shannon T. Lipscomb
- Human Development and Family Sciences, College of Public Health and Human Sciences, Oregon State University – Cascades, 1500 SW Chandler Ave, Bend, OR 97702 USA
| | - Kelly D. Chandler
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR USA
| | - Caitlyn Abshire
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR USA
| | | | - Brianne Kothari
- Human Development and Family Sciences, College of Public Health and Human Sciences, Oregon State University – Cascades, 1500 SW Chandler Ave, Bend, OR 97702 USA
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3
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van Dongen SI, Stoevelaar R, Kranenburg LW, Noorlandt HW, Witkamp FE, van der Rijt CCD, van der Heide A, Rietjens JAC. The views of healthcare professionals on self-management of patients with advanced cancer: An interview study. Patient Educ Couns 2022; 105:136-144. [PMID: 34034936 DOI: 10.1016/j.pec.2021.05.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 04/13/2021] [Accepted: 05/12/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Self-management of patients with advanced cancer is challenging. Although healthcare professionals may play a crucial role in supporting these patients, scant scientific attention has been paid to their perspectives. Therefore, we examined healthcare professionals' views on self-management and self-management support in this population. METHODS We conducted qualitative interviews with 27 purposively sampled medical specialists (n = 6), nurse specialists (n = 6), general practitioners (n = 8) and homecare/ hospice nurses (n = 7) in the Netherlands. Transcripts were analysed using thematic analysis. RESULTS Healthcare professionals experienced self-management of patients with advanced cancer to be diverse, dynamic and challenging. They adopted instructive, collaborative and advisory roles in self-management support for this population. Whereas some professionals preferred or inclined towards one role, others indicated to switch roles, depending on the situation. CONCLUSIONS Just like patients with advanced cancer, healthcare professionals differ in their views and approaches regarding self-management and self-management support in this population. Therefore, instructive, collaborative and advisory self-management support roles will all be useful under certain circumstances. PRACTICE IMPLICATIONS Healthcare professionals can support self-management by being aware of their own views and communicating these clearly to their patients and colleagues. Education in self-management support should include self-reflection skills and discuss the relation between self-management and professional care.
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Affiliation(s)
- S I van Dongen
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| | - R Stoevelaar
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| | - L W Kranenburg
- Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| | - H W Noorlandt
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| | - F E Witkamp
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands; Faculty of Nursing and Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.
| | - C C D van der Rijt
- Department of Medical Oncology, Erasmus MC, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| | - A van der Heide
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| | - J A C Rietjens
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
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Magliano L, Obici L, Sforzini C, Mazzeo A, Russo M, Cappelli F, Fenu S, Luigetti M, Tagliapietra M, Gemelli C, Leonardi L, Tozza S, Pradotto LG, Citarelli G, Mauro A, Manganelli F, Antonini G, Grandis M, Fabrizi GM, Sabatelli M, Pareyson D, Perfetto F, Merlini G, Vita G. Psychosocial burden and professional and social support in patients with hereditary transthyretin amyloidosis (ATTRv) and their relatives in Italy. Orphanet J Rare Dis 2021; 16:163. [PMID: 33827635 PMCID: PMC8028211 DOI: 10.1186/s13023-021-01812-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/17/2020] [Accepted: 03/31/2021] [Indexed: 12/27/2022] Open
Abstract
Background Hereditary transthyretin amyloidosis (hATTR), alias ATTR variant (ATTRv) is a severe and disabling disease causing sensory and motor neuropathy, autonomic dysfunction, and cardiomyopathy. The progressive decline of patient’s functional autonomy negatively affects the patient’s quality of life and requires increasing involvement of relatives in the patient’s daily life. Family caregiving may become particularly demanding when the patient is no longer able to move independently. This study is focused on the psychosocial aspects of ATTRv from the patient and relative perspectives. In particular, it explored: the practical and psychological burdens experienced by symptomatic patients with ATTRv and their key relatives and the professional and social network support they may rely on; whether burden varied in relation to patients’ and relatives’ socio-demographic variables, patients’ clinical variables, and perceived professional and social network support; and, any difference in burden and support between patients and their matched relatives. Methods The study was carried out on symptomatic patients included in the ATTRv Italian national registry and living with at least one adult relative not suffering from severe illness and being free from ATTRv symptoms. Patients and relatives’ assessments were performed using validated self-reported tools. Results Overall, 141 patients and 69 relatives were evaluated. Constraints of leisure activities, feelings of loss and worries for the future were the consequences of ATTRv most frequently reported by patients and relatives. Both in patients and their relatives, the burden increased with the duration of symptoms and the level of help in daily activities needed by the patient. In the 69 matched patient-relative pairs, the practical burden was significantly higher among the patients than among their relatives, while the psychological burden was similar in the two groups. Moreover, compared to their relatives, patients with ATTRv reported higher levels of professional and social network support. Conclusions These results show that ATTRv is a disease affecting quality of life of both patients and their families. Supporting interventions should be guaranteed to patients, to facilitate their adaptation to the disease, and to their families, to cope as best as possible with the difficulties that this pathology may involve. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-01812-6.
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Affiliation(s)
- Lorenza Magliano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100, Caserta, Italy.
| | - Laura Obici
- Amyloidosis Research and Treatment Center, IRCCS Fondazione Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Claudia Sforzini
- Amyloidosis Research and Treatment Center, IRCCS Fondazione Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Massimo Russo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Francesco Cappelli
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy
| | - Silvia Fenu
- Rare Neurodegenerative and Neurometabolic Diseases Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Marco Luigetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS. UOC Neurologia, Rome, Italy.,Dipartimento Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Matteo Tagliapietra
- Department of Neuroscience, Biomedicine and Movement Sciences, University and AOUI Verona, Verona, Italy
| | - Chiara Gemelli
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences (DINOGMI), University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Luca Leonardi
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Stefano Tozza
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples, Federico II, Naples, Italy
| | - Luca Guglielmo Pradotto
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.,Unit of Neurology and Neurorehabilitation, IRCCS - Istituto Auxologico Italiano, Piancavallo, VB, Italy
| | - Giulia Citarelli
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100, Caserta, Italy
| | - Alessandro Mauro
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.,Unit of Neurology and Neurorehabilitation, IRCCS - Istituto Auxologico Italiano, Piancavallo, VB, Italy
| | - Fiore Manganelli
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples, Federico II, Naples, Italy
| | - Giovanni Antonini
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Marina Grandis
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences (DINOGMI), University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Gian Maria Fabrizi
- Department of Neuroscience, Biomedicine and Movement Sciences, University and AOUI Verona, Verona, Italy
| | - Mario Sabatelli
- Dipartimento Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy.,NEuroMuscular Omnicentre (NEMO), Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Davide Pareyson
- Rare Neurodegenerative and Neurometabolic Diseases Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Federico Perfetto
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy
| | - Giampaolo Merlini
- Amyloidosis Research and Treatment Center, IRCCS Fondazione Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Giuseppe Vita
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Wells MB, Aronson O. Paternal postnatal depression and received midwife, child health nurse, and maternal support: A cross-sectional analysis of primiparous and multiparous fathers. J Affect Disord 2021; 280:127-135. [PMID: 33212403 DOI: 10.1016/j.jad.2020.11.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/21/2020] [Accepted: 11/07/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Fathers want more professional and social support during the transition to fatherhood. It is unclear if these supports are associated with decreased depressive symptoms in fathers of infants. AIM The aim of the current study was to assess if fathers' self-reported received professional and social support were related to changes in the odds for having depressive symptoms, with interaction terms focusing on differences of support based on the fathers' parity. METHODS In total, 612 fathers from Sweden completed a Facebook-advertised anonymous online survey. The Edinburgh Postnatal Depression Scale was used to detect depressive symptoms (≥10 points). Multiple imputation of missing data was performed. Logistic regressions were used, with interaction terms for fathers' parity. RESULTS Around 21% of fathers had depressive symptoms. There were no associations between depressive symptoms frequencies and paternal parity. Fathers reported fewer depressive symptoms when they received professional support from the prenatal midwife (OR = .39, p = .007), labor/birth midwife/nurse team (OR = .42, p = .021), and child health nurse (OR = .25, p = .001), as well as social support from their partner and if they had a higher income (odds ratios vary in different models). Multiparous fathers received significantly less professional and social support and were less frequently invited to child health visits than primiparous fathers. LIMITATIONS The data collected was cross-sectional; therefore, causal links cannot be determined. CONCLUSIONS Both primiparous and multiparous fathers should receive postnatal depression screenings and interventions to help reduce their depressive symptoms.
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Affiliation(s)
- Michael B Wells
- Department of Women's and Children's Health, Karolinska Institutet.
| | - Olov Aronson
- School of Health and Welfare, Jönköping University
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6
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Abstract
Previous literature has indicated that perceptions of social support (PSS) may be an important predictor of parental stress levels, particularly for parents of children diagnosed with autism spectrum disorders (ASD). The current study implemented structural equation modelling to further investigate the relationship between PSS and parental stress in a sample of 454 parents of children diagnosed with ASD. Results indicate that PSS derived from friends was the most important factor in protecting against stress, with PSS from both a significant other and family appearing to be less pervasive in this regard. In addition, the importance of PSS was further underlined by the finding that it remained a significant predictor of parental stress after controlling for the absence/presence of professional support.
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Nan Y, Zhang J, Nisar A, Huo L, Yang L, Yin J, Wang D, Rahman A, Gao Y, Li X. Professional support during the postpartum period: primiparous mothers' views on professional services and their expectations, and barriers to utilizing professional help. BMC Pregnancy Childbirth 2020; 20:402. [PMID: 32652965 DOI: 10.1186/s12884-020-03087-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 07/02/2020] [Indexed: 12/30/2022] Open
Abstract
Background Primiparous mothers who lack of experience and knowledge of child caring, are usually overwhelmed by multifarious stressors and challenges. Although professional support is needed for primiparas, there is a gap between the necessary high-quality services and the currently provided poor services. This study aimed to explore Chinese primiparous mothers’ views on professional services, identify barriers to utilizing professional support, and further understand mothers’ expectations of and preferences for the delivery of professional services. Method A descriptive phenomenological study design was utilized in this study, and semi-structured interviews were conducted with 28 primiparous mothers who had given birth in the first year period before the interview and were selected from two community health centres in Xi’an city, Shaanxi Province, Northwest China. Each conversational interview lasted between 20 and 86 min. Colaizzi’s seven-step phenomenological approach was used to analyse the data. Results Three major themes were identified: (a) dissatisfaction with current professional services for postpartum mothers, (b) likelihood of health care professional help-seeking behaviour, (c) highlighting the demands for new health care services. The related seven sub-themes included being disappointed with current hospital services; distrusting services provided by community health centres, private institutes and commercial online platforms; preferring not seeking help from professionals as their first choice; hesitating to express their inner discourse to professionals; following confinement requirement and family burden prevents mothers from seeking professional help; experiencing urgent needs for new baby-care-related services; and determining the importance of mothers’ needs. The necessity of professional support in the first month after childbirth was strongly emphasized by the participants. Online professional guidance and support were perceived as the best way to receive services in this study. Conclusion The results of this descriptive phenomenological study suggested that the current maternal and child health care services were insufficient and could not meet primiparous mothers’ need. The results also indicated that identifying barriers and providing services focused on mothers’ needs may be an effective strategy to enhance primiparous mothers’ well-being, and further suggested that feasibility, convenience, and the cultural adaptability of health care services should be considered during the delivery of postpartum interventions.
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Petrini F, Graziani E, Caputo MA, Meringolo P. Continuum between Relational and Therapeutic Models of Self-help in Mental Health: A Qualitative Approach. Am J Community Psychol 2020; 65:290-304. [PMID: 31587311 DOI: 10.1002/ajcp.12399] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Self-help groups are generally described as "group[s] composed of individuals who meet on a regular basis to help one another cope with a life problem" (APA, 2019). Yet, it is challenging to find a univocal definition of self-help groups. Scholars usually use different labels to highlight various features of self-help groups, suggesting the need for further inquiry regarding commonalities and differences. The level of professional involvement is one of the most disputed factors influencing whether a group is considered to belong to the "self-help family." The present qualitative study aimed to understand how professional support in Tuscany, Italy can influence the organizational choices of these groups (place for meetings, admission criteria, timing, etc.), as well as the personal beliefs of members. The study included 17 self-help groups. During 13 focus groups meetings, 92 participants were interviewed; then, we individually interviewed 19 facilitators and six additional key informants from mental health settings. We used a grounded theory approach, and we discussed the emerging models with participants at a public event. Results show the emergence of two theoretical models to define self-help groups, not to be interpreted as mutually exclusive. The "relational model" refers to self-help groups whose main feature is to guarantee the acquisition of specific skills (social comparison skills, active listening, and empathy), while the "therapeutic model" seems to represent a kind of assimilation of other types of interventions.
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Affiliation(s)
- Fausto Petrini
- Dipartimento di Psicologia, Università degli Studi di Firenze, Firenze, Italy
| | - Elena Graziani
- Dipartimento di Psicologia, Università degli Studi di Firenze, Firenze, Italy
| | - Maria Angela Caputo
- Dipartimento di Psicologia, Università degli Studi di Firenze, Firenze, Italy
| | - Patrizia Meringolo
- Dipartimento di Psicologia, Università degli Studi di Firenze, Firenze, Italy
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Cheng LY, Wang X, Mo PK. The effect of home-based intervention with professional support on promoting breastfeeding: a systematic review. Int J Public Health 2019; 64:999-1014. [PMID: 31197407 DOI: 10.1007/s00038-019-01266-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 05/29/2019] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES Low breastfeeding rate and high early cessation of breastfeeding are observed worldwide. There is a need to review the effects of home visits with professional support on promoting breastfeeding. The present study evaluated the efficacy of home visits on promoting breastfeeding outcomes (i.e., breastfeeding initiation rate, exclusive breastfeeding rate/duration, and breastfeeding rate/duration) using a systematic review. METHODS Search of EMBASE, MEDLINE, CENTRAL-Cochrane central register of controlled trials, PsycInfo, and ClinicalTrials.gov was conducted by February 28, 2019, to identify relevant studies. RESULTS A total of 26 studies were included. Fourteen of the included studies investigated rate/duration of exclusive breastfeeding; ten of them demonstrated a significant increase on the rate/duration of exclusive breastfeeding. Sixteen of the included studies investigated rate/duration of breastfeeding; four of them demonstrated a significant increase on the rate/duration of breastfeeding. Four studies evaluated initiation of breastfeeding and three of them did not show a significant effect. CONCLUSIONS Findings suggest that breastfeeding can be increased by home-based interventions with professional support. Support-based intervention is likely an effective way to promote breastfeeding.
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Hussein R, Everett B, Ramjan LM, Hu W, Salamonson Y. New graduate nurses' experiences in a clinical specialty: a follow up study of newcomer perceptions of transitional support. BMC Nurs 2017; 16:42. [PMID: 28775671 PMCID: PMC5534089 DOI: 10.1186/s12912-017-0236-0] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [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: 12/21/2016] [Accepted: 07/13/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Given the increasing complexity of acute care settings, high patient acuity and demanding workloads, new graduate nurses continue to require greater levels of support to manage rising patient clinical care needs. Little is known about how change in new graduate nurses' satisfaction with clinical supervision and the practice environment impacts on their transitioning experience and expectations during first year of practice. This study aimed to examine change in new graduate nurses' perceptions over the 12-month Transitional Support Program, and identify how organizational factors and elements of clinical supervision influenced their experiences. METHODS Using a convergent mixed methods design, a prospective survey with open-ended questions was administered to new graduate nurses' working in a tertiary level teaching hospital in Sydney, Australia. Nurses were surveyed at baseline (8-10 weeks) and follow-up (10-12 months) between May 2012 and August 2013. Two standardised instruments: the Manchester Clinical Supervision Scale (MCSS-26) and the Practice Environment Scale Australia (PES-AUS) were used. In addition to socio-demographic data, single -item measures were used to rate new graduate nurses' confidence, clinical capability and support received. Participants were also able to provide open-ended comments explaining their responses. Free-text responses to the open-ended questions were initially reviewed for emergent themes, then coded as either positive or negative aspects of these preliminary themes. Descriptive and inferential statistics were used to analyse the quantitative data and the qualitative data was analysed using conventional content analysis (CCA). The study was approved by the relevant Human Research Ethics Committees. RESULTS Eighty seven new graduate nurses completed the follow-up surveys, representing a 76% response rate. The median age was 23 years (Range: 20 to 53). No change was seen in new graduate nurses' satisfaction with clinical supervision (mean MCSS-26 scores: 73.2 versus 72.2, p = 0.503), satisfaction with the clinical practice environment (mean PES-AUS scores: 112.4 versus 110.7, p = 0.298), overall satisfaction with the transitional support program (mean: 7.6 versus 7.8, p = 0.337), satisfaction with the number of study days received, orientation days received (mean: 6.4 versus 6.6, p = 0.541), unit orientation (mean: 4.4 versus 4.8, p = 0.081), confidence levels (mean: 3.6 versus 3.5, p = 0.933) and not practising beyond personal clinical capability (mean: 3.9 versus 4.0, p = 0.629). Negative responses to the open-ended questions were associated with increasing workload, mismatch in the level of support against clinical demands and expectations. Emergent themes from qualitative data included i) orientation and Transitional Support Program as a foundation for success; and ii) developing clinical competence. CONCLUSIONS While transitional support programs are helpful in supporting new graduate nurses in their first year of practice, there are unmet needs for clinical, social and emotional support. Understanding new graduate nurses' experiences and their unmet needs during their first year of practice will enable nurse managers, educators and nurses to better support new graduate nurses' and promote confidence and competence to practice within their scope.
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Affiliation(s)
- Rafic Hussein
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751 Australia
- Centre for Applied Nursing Research (CANR), Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 Australia
| | - Bronwyn Everett
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751 Australia
- Centre for Applied Nursing Research (CANR), Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 Australia
| | - Lucie M. Ramjan
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751 Australia
- Centre for Applied Nursing Research (CANR), Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 Australia
| | - Wendy Hu
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Yenna Salamonson
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751 Australia
- Centre for Applied Nursing Research (CANR), Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 Australia
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Bäckström C, Thorstensson S, Mårtensson LB, Grimming R, Nyblin Y, Golsäter M. 'To be able to support her, I must feel calm and safe': pregnant women's partners perceptions of professional support during pregnancy. BMC Pregnancy Childbirth 2017; 17:234. [PMID: 28716133 PMCID: PMC5513399 DOI: 10.1186/s12884-017-1411-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 09/28/2016] [Accepted: 07/05/2017] [Indexed: 11/13/2022] Open
Abstract
Background Professional support does not always meet the needs of expectant fathers or co-mothers. The way in which professional support is offered during pregnancy varies internationally, depending on the country. In order to attain a greater understanding of partners’ experiences of professional support, it is necessary to further illuminate their perceptions of it. The aim of this study was therefore to explore pregnant women’s partners’ perceptions of professional support during pregnancy. Methods Qualitative research design. Partners of pregnant women were interviewed during gestational week 36–38. Individual semi-structured interviews were used to explore the partners’ perceptions. The data was analysed using a phenomenographic approach. The study was performed in a county in south-western Sweden; the data collection was conducted from November 2014 to February 2015. Fourteen partners (expectant fathers and co-mothers) of women who were expectant first-time mothers with singleton pregnancies, were interviewed. Results The findings of the study are presented through four descriptive categories: Ability to absorb adequate information; Possibility to meet and share with other expectant parents; Confirmation of the partner’s importance; and Influence on the couple relationship. Using a theoretical assumption of the relationship between the categories showed that the fourth category was influenced by the other three categories. Conclusions The partners perceived that professional support during pregnancy could influence the couple relationship. The partners’ ability to communicate and to experience togetherness with the women increased when the expectant couple received professional support together. The support created also possibilities to meet and share experiences with other expectant parents. In contrast, a lack of support was found to contribute to partners’ feelings of unimportance. It was essential that the midwives included the partners by confirming that they were individuals who had different needs for various types of professional support. The partners perceived it easier to absorb information when it was adequate and given with a pedagogic that made the partners become interested and emotionally engaged.
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Affiliation(s)
- Caroline Bäckström
- University of Skövde, School of Health and Education, P.O. Box 408, SE-541 28, Skövde, Sweden. .,Skaraborg Hospital Skövde, Woman, Child (K3), SE-541 85, Skövde, Sweden. .,Jönköping University, School of Health and Welfare, CHILD-research group, Box 1026, SE-551 11, Jönköping, Sweden.
| | - Stina Thorstensson
- University of Skövde, School of Health and Education, P.O. Box 408, SE-541 28, Skövde, Sweden
| | - Lena B Mårtensson
- University of Skövde, School of Health and Education, P.O. Box 408, SE-541 28, Skövde, Sweden
| | - Rebecca Grimming
- University of Skövde, School of Health and Education, P.O. Box 408, SE-541 28, Skövde, Sweden.,Närhälsan Skaraborg, Young Persons Clinic, SE-541 85, Skövde, Sweden
| | - Yrsa Nyblin
- University of Skövde, School of Health and Education, P.O. Box 408, SE-541 28, Skövde, Sweden.,Danderyd Hospital AB, Women's care, Gynecology ward, SE-18288, Stockholm, Sweden
| | - Marie Golsäter
- Jönköping University, School of Health and Welfare, CHILD-research group, Box 1026, SE-551 11, Jönköping, Sweden
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Hauck YL, Blixt I, Hildingsson I, Gallagher L, Rubertsson C, Thomson B, Lewis L. Australian, Irish and Swedish women's perceptions of what assisted them to breastfeed for six months: exploratory design using critical incident technique. BMC Public Health 2016; 16:1067. [PMID: 27724932 PMCID: PMC5057437 DOI: 10.1186/s12889-016-3740-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 10/04/2016] [Indexed: 11/23/2022] Open
Abstract
Background Breastfeeding initiation rates in some developed countries are high (98 % in Sweden and 96 % in Australia) whereas in others, they are not as favourable (46 % to 55 % in Ireland). Although the World Health Organization recommends exclusively breastfeeding for six months, 15 % of Australian women, 11 % of Swedish women and less than 7 % of Irish women achieve this goal. Awareness of what women in different countries perceive as essential breastfeeding support is a gap in our knowledge. Methods Our aim was to explore Australian, Irish and Swedish women’s perceptions of what assisted them to continue breastfeeding for six months. An exploratory design using critical incident techniques was used. Recruitment occurred through advertisements in local newspapers and on social networking platforms. Initial sampling was purposive, followed by snowball sampling. Telephone interviews were conducted with 64 Irish, 139 Swedish and 153 Australian women who responded to one question “what has assisted you to continue breastfeeding for at least six months?” Content analysis was conducted and common categories determined to allow comparison of frequencies and priority ranking. Results Categories reflected the individual mother, her inner social network, her outer social network (informal support either face to face or online), and societal support (health professionals, work environment and breastfeeding being regarded as the cultural norm). Categories ranked in the top five across the three countries were ‘informal face to face support’ and ‘maternal determination’. Swedish and Australian women ranked “health professional support” higher (first and third respectively) than Irish women who ranked ‘informal online support’ as second compared to ninth and tenth for Swedish and Australian women. Conclusions The support required to assist breastfeeding women is complex and multi-faceted. Although common international categories were revealed, the ranking of these supportive categories varied. We must recognize how the cultural context of breastfeeding support can vary for women in differing countries and acknowledge the resourcefulness of women who embrace innovations such as social media where face to face formal and informal support are not as accessible.
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Affiliation(s)
- Yvonne L Hauck
- School of Nursing, Midwifery and Paramedicine, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. .,Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Bagot Rd, Subiaco, WA, 6008, Australia.
| | - Ingrid Blixt
- Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden.,Centre for Clinical Research Sörmland, Uppsala University, Kungsgatan 41, 631 88, Eskilstuna, Sweden
| | - Ingegerd Hildingsson
- Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden
| | - Louise Gallagher
- Trinity College Dublin, School of Nursing and Midwifery, 24 D'Olier Street, Dublin, Ireland
| | - Christine Rubertsson
- Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden
| | - Brooke Thomson
- School of Nursing, Midwifery and Paramedicine, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Lucy Lewis
- School of Nursing, Midwifery and Paramedicine, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.,Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Bagot Rd, Subiaco, WA, 6008, Australia
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Bäckström CA, Mårtensson LB, Golsäter MH, Thorstensson SA. "It's like a puzzle": Pregnant women's perceptions of professional support in midwifery care. Women Birth 2016; 29:e110-e118. [PMID: 27199171 DOI: 10.1016/j.wombi.2016.04.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/25/2016] [Accepted: 04/27/2016] [Indexed: 10/21/2022]
Abstract
PROBLEM Pregnant women are not always satisfied with the professional support they receive during their midwifery care. More knowledge is needed to understand what professional support pregnant women need for childbirth and parenting. BACKGROUND Childbearing and the transition to becoming a parent is a sensitive period in one's life during which one should have the opportunity to receive professional support. Professional support does not always correspond to pregnant women's needs. To understand pregnant women's needs for professional support within midwifery care, it is crucial to further illuminate women's experiences of this support. AIM To explore pregnant women's perceptions of professional support in midwifery care. METHODS A qualitative study using semi-structured interviews. Fifteen women were interviewed during gestational weeks 36-38. Data was analysed using phenomenography. FINDINGS The women perceived professional support in midwifery care to be reassuring and emotional, to consist of reliable information, and to be mediated with pedagogical creativity. The professional support facilitated new social contacts, partner involvement and contributed to mental preparedness. The findings of the study were presented in six categories and the category Professional support contributes to mental preparedness was influenced by the five other categories. CONCLUSION Pregnant women prepare for childbirth and parenting by using several different types of professional support in midwifery care: a strategy that could be described as piecing together a puzzle. When the women put the puzzle together, each type of professional support works as a valuable piece in the whole puzzle. Through this, professional support could contribute to women's mental preparedness for childbirth and parenting.
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Affiliation(s)
- Caroline A Bäckström
- University of Skövde, School of Health and Education, P.O. Box 408, SE-541 28 Skövde, Sweden; Skaraborg Hospital Skövde, "Woman, Child" (K3), SE-541 85 Skövde, Sweden; Jönköping University, School of Health and Welfare, CHILD-Research Group, Box 1026, SE-551 11 Jönköping, Sweden.
| | - Lena B Mårtensson
- University of Skövde, School of Health and Education, P.O. Box 408, SE-541 28 Skövde, Sweden
| | - Marie H Golsäter
- Jönköping University, School of Health and Welfare, CHILD-Research Group, Box 1026, SE-551 11 Jönköping, Sweden
| | - Stina A Thorstensson
- University of Skövde, School of Health and Education, P.O. Box 408, SE-541 28 Skövde, Sweden
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Thorley V. The Tenth Step of the BFHI: What midwives need to know about optimal support for mothers, post-discharge. Midwifery 2015; 31:829-33. [PMID: 26123740 DOI: 10.1016/j.midw.2015.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 06/05/2015] [Accepted: 06/07/2015] [Indexed: 11/24/2022]
Abstract
This commentary discusses the 10th Step of the Baby-Friendly Hospital Initiative (BFHI), the only step that goes beyond the hospital to provide for the mother to receive breast-feeding support after she returns to the community. The reasons why such support is needed, and how this support has been provided in different settings, will be discussed. Post-discharge support for breast-feeding mothers takes many forms and is optimised when mothers can access both professional and peer support. The mother-baby dyad is best served by the right advice from the right person at the right time. Midwives who assist the new mother with information about easily accessible support in the community enable the care she has received during her short hospital stay and during any midwifery home visiting to continue when she is in an environment that may not be supportive of breast feeding.
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Affiliation(s)
- Virginia Thorley
- School of Historical and Philosophical Inquiry, The University of Queensland, Qld 4072, Australia.
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Abstract
OBJECTIVE To examine women's experience of professional support for breast-feeding and health-care professionals' experience of providing support. DESIGN We conducted semi-structured qualitative interviews among women with experience of breast-feeding and health-care professionals with infant feeding roles. Interviews with women were designed to explore their experience of support for breast-feeding antenatally, in hospital and postnatally. Interviews with health-care professionals were designed to explore their views on their role and experience in providing breast-feeding support. Interview transcripts were analysed using content analysis and aspects of Grounded Theory. Overarching themes and categories within the two sets were identified. SETTING Urban and suburban areas of North Dublin, Ireland. SUBJECTS Twenty-two women all of whom had experience of breast-feeding and fifty-eight health-care professionals. RESULTS Two overarching themes emerged and in each of these a number of categories were developed: theme 1, facilitators to breast-feeding support, within which being facilitated to breast-feed, having the right person at the right time, being discerning and breast-feeding support groups were discussed; and theme 2, barriers to breast-feeding support, within which time, conflicting information, medicalisation of breast-feeding and the role of health-care professionals in providing support for breast-feeding were discussed. CONCLUSIONS Breast-feeding is being placed within a medical model of care in Ireland which is dependent on health-care professionals. There is a need for training around breast-feeding for all health-care professionals; however, they are limited in their support due to external barriers such as lack of time. Alternative support such as peer support workers should be provided.
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