The authors used a transcendental phenomenological approach to describe adolescent mothers' satisfactory and unsatisfactory inpatient postpartum nursing care experiences. They analyzed data from 14 in-depth interviews and found that adolescent mothers' satisfaction is dependent on their perceptions of the nurse's ability to place them "at ease." Nursing care qualities that contributed to satisfactory experiences included nurses' sharing information about themselves, being calm, demonstrating confidence in mothers, speaking to adolescent and adult mothers in the same way, and anticipating unstated needs. Nursing care was perceived to be unsatisfactory when it was too serious, limited to the job required, or different from care to adult mothers, or when nurses failed to recognize individual needs. In extreme cases, unsatisfactory experiences hindered development of an effective nurse-client relationship. These findings illustrate the value of qualitative inquiry for understanding patients' satisfaction with care, can be used for self-reflection, and have implications for nursing education programs.
Data were collected by telephone interviews with 178 mothers of full-term patients in a NICU (neonatal intensive care unit) concerning advice on facilitation of the initiation of breastfeeding. The main advice to the first author as a nurse in the NICU concerned the environment, advice on breastfeeding, distance between units, work organization and nurse behaviour. The advice to other mothers of patients centred on persistence, physical contact with the infant, and not to let nurses take over maternal role functions. The data were structured into themes and categories, classified by one author and two research assistants according to Roy's adaptation theory, and analysed for degree of interrater agreement. The overall agreement of classification was high, reaching 92.5%. It was easily applied by nurses after a brief introduction and proved useful for structuring interview data. It also contributed to clarification of nurse behaviour and division of roles between nurses and mothers. As the four adaptation modes showed considerable overlap, this kind of classification seems inadvisable for application to the assessment of patient/parent situations in the nursing process. For use in a clinical setting, the theory needs the addition of the interactive aspect of nurse and patient/family role functions, and may then be used as a framework for the development of assessment tools.
Breastfeeding clinics aim to increase breastfeeding duration and diminish breastfeeding difficulties. Actual improvement in the duration and satisfaction of the breastfeeding experience for women using these clinics remains unknown. This observational study assessed the impact of a Québec City breastfeeding clinic's interventions on breastfeeding duration and satisfaction among women experiencing breastfeeding difficulties in comparison with women who did not receive clinic services. The study surveyed 86 women using telephone questionnaires and semistructured interviews. After adjusted logistic regression analysis, women who attended the clinic had a higher probability of breastfeeding for at least 6 months (odds ratio [OR] = 4.34; 95% confidence interval [CI] = 1.35-13.96) than women from the comparison group. They also had a higher probability of being satisfied with their breastfeeding experience (OR = 4.17; 95% CI = 1.31-13.22). Physical and moral support could explain this influence. Larger studies on breastfeeding clinics are needed to confirm their role in enhancing breastfeeding duration and satisfaction.
to assess the effect of an antenatal training programme on knowledge, self-efficacy and problems related to breast feeding and on breast-feeding duration.
a randomised controlled trial.
the Aarhus Midwifery Clinic, a large clinic connected to a Danish university hospital in an urban area of Denmark.
a total of 1193 nulliparous women were recruited before week 21+6 days of gestation, 603 were randomised to the intervention group, and 590 to the reference group.
we compared a structured antenatal training programme attended in mid-pregnancy with usual practice.
data were collected through self-reported questionnaires sent to the women's e-mail addresses and analysed according to the intention to treat principle. The primary outcomes were duration of full and any breast feeding collected 6 weeks post partum (any) and 1 year post partum (full and any).
no differences were found between groups according to duration of breast feeding, self-efficacy score, or breast-feeding problems, but after participation in the course in week 36 of gestation women in the intervention group reported a higher level of confidence (p=0.05), and 6 weeks after birth they reported to have obtained sufficient knowledge about breast feeding (p=0.02). Supplemental analysis in the intervention group revealed that women with sufficient knowledge breast fed significantly longer than women without sufficient knowledge (HR=0.74 CI: 0.58-0.97). This association was not found in the reference group (HR=1.12 CI: 0.89-1.41).
antenatal training can increase confidence of breast feeding in pregnancy and provide women with sufficient knowledge about breast feeding after birth. Antenatal training may therefore be an important low-technology health promotion tool that can be provided at low costs in most settings. The antenatal training programme needs to be followed by postnatal breast-feeding support as it is not sufficient in itself to increase the duration of breast feeding or reduce breast-feeding problems.
INTRODUCTION: The aim of this study was to determine where and from whom postpartum women recalled receiving information about urinary incontinence (UI) and pelvic floor exercises (PFEs), the helpfulness of this information, and their preferred sources of help with UI. METHODS: Women who had recently given birth in a Danish hospital (N = 439) were mailed a survey that elicited information about their experiences of receiving information about UI and PFEs. RESULTS: Surveys were returned from 266 women, representing a response rate of 61%. Although almost all participants recalled receiving information about PFEs (95%), only half (55%) recalled being provided with information about UI. Midwives were the health care professionals who most commonly provided women with information about UI (33%) and PFEs (55%). Women generally perceived the information as being helpful, with the information from physiotherapists obtaining the highest mean ratings for helpfulness. Postpartum women indicated that they would prefer to consult with continence nurses or general nurses if they experienced UI. Health care professionals did not consistently provide postpartum women with information on UI and PFEs. DISCUSSION: A coordinated multidisciplinary approach is needed to ensure that women are adequately informed about the risk of developing UI after childbirth and the ways in which this condition can be managed or resolved.
To evaluate the effects of an information film on making an informed choice regarding Down syndrome screening, and women's knowledge and experiences of information.
Randomized controlled trial including 184 women in the intervention group and 206 controls recruited from maternity units in Stockholm, Sweden. The intervention was an information film presented as a complement to written and verbal information. Data were collected via a questionnaire in gestational week 27. Three different measures were combined to measure informed choice: attitudes towards Down syndrome screening, knowledge about Down syndrome and Down syndrome screening, and uptake of CUB (combined ultrasound and biochemical screening).
In the intervention group 71.5% made an informed choice versus 62.4% in the control group. Women in the intervention group had significantly increased knowledge, and to a greater extent than the control group, experienced the information as being sufficient, comprehensible, and correct.
An information film tended to increase the number of women who made an informed choice about Down syndrome screening. Participants were more satisfied with the information received.
Access to correct, nondirective, and sufficient information is essential when making a choice about prenatal diagnostics. It is essential with equivalent information to all women.
Vietnamese women's breastfeeding experience and challenges were explored, as were their families' needs for prenatal and postpartum health professional programs and services.
A qualitative study was conducted in Middlesex-London, Ontario, using in-depth, semi-structured interviews in a heterogeneous sample of 11 Vietnamese mothers of children younger than two years. Diverse subject characteristics were sought in terms of parity, maternal age, infant age, marital status, education, employment, and breastfeeding initiation and duration. The 45- to 60-minute interviews were audiotaped and transcribed verbatim. Research team members independently reviewed interview transcripts at several stages during data collection. Qualitative analysis was sequential, and involved a combination of editing and template organizing styles.
Lack of knowledge and misinformation were major barriers to breastfeeding. Inability to communicate in English and a lack of effective transportation were key obstacles to the women's ability to access mainstream prenatal and postpartum health programs and services. Standard nursing prenatal and postpartum services appear not to have reached this group of mothers effectively.
Culturally and linguistically sensitive breastfeeding promotion and postpartum support services are needed for this Vietnamese community.
BACKGROUND: In Europe, it is sometimes assumed that few barriers to prenatal care exist because extensive programs of health insurance and initiatives to promote participation in prenatal care have been established for many decades. METHODS: A case-control study was performed in ten European countries (Austria, Denmark, Germany, Greece, Hungary, Ireland, Italy, Portugal, Spain, and Sweden). Postpartum interviews were conducted between 1995 and 1996. A total of 1283 women with inadequate prenatal care (i.e., with 0, 1, or 2 prenatal care visits or a first prenatal care visit after 15 completed weeks of pregnancy) and 1280 controls with adequate prenatal care were included in the analysis combining data from the ten countries. RESULTS: Based on combined data of the ten countries, lack of health insurance was found to be an important risk factor for inadequate prenatal care (crude odds ratio [OR] at 95% confidence interval [CI]: 30.1 [20.1-47.1]). Women with inadequate prenatal care were more likely to be aged
Breast milk has been shown to contribute significantly to positive neurodevelopmental and medical outcomes in the extremely low birth weight (ELBW) infant population. It is crucial that ELBW infants receive their mother's colostrum as a first feeding, followed by expressed breast milk for as long as possible. Evidence-based literature supports the difficult challenges both mothers and ELBW infants face if they are to succeed at breast pumping and breastfeeding. Influencing factors include the medical fragility of the infant, limited frequency and duration of kangaroo care between mother and infant, lack of an adequate volume of breast milk, as well as inconsistent or incorrect information surrounding the use of breast milk and breastfeeding. A feeding care map as described in this article can help the bedside nurse assist the mother-ELBW infant dyad in optimizing breast milk volumes, laying the groundwork for breastfeeding. Displaying supportive practices and preterm infant developmental milestones, the map categorizes infant, maternal, and dyad feeding issues along a progressive time line from admission to discharge.
To examine infant feeding practices up to 8 weeks postpartum in Hamilton-Wentworth.
A cross-sectional survey of 227 women using a pre-discharge, self-administered questionnaire, medical record review and follow-up telephone interview.
Breastfeeding initiation rate was 85%. By 6-8 weeks postpartum, 30% of women had stopped breastfeeding; 55% had switched to formula within the first 14 days. Infants who did not receive supplementation in hospital were 2.49 times more likely than infants who received supplementation to breastfeed for at least 6 weeks. Although 54% of mothers who initiated breastfeeding reported receiving formula gift packs, no association was found.
The breastfeeding initiation rate appears to have increased in Hamilton-Wentworth since 1995. However, this study reinforces the need to address early cessation and infant supplementation, and raises concern about violation of the WHO/UNICEF International Code of Marketing of Breastmilk Substitutes through mailing of formula coupons.