The effect of relaxation training on breastfeeding self-efficacy of mothers with preterm infants: A randomized clinical trial

زمینه و هدف: شیر مادر هدیه‌ای خدادادی است که با عاطفه و محبت مادری در هم می‌آمیزد و متناسب با نیاز کودک و سن او ساخته می‌شود. در این بین خودکارآمدی شیردهی، چارچوب تعدیل پذیری است که با تدوین برنامه آموزشی می‌توان آن را ارتقاء داد و برای افزایش طول مدت ومیزان شیردهی مناسب می باشد. این پژوهش با هدف بررسی تأثیر آموزش تن آرامی بر خودکارآمدی شیردهی مادران دارای نوزاد نارس انجام شد. روش بررسی: در این مطالعه کارآزمایی، تعداد 60 مادر دارای نوزاد نارس بستری به صورت تصادفی طی دو بلوک زمانی دو ماهه در دو گروه مداخله و کنترل قرار گرفتند. مادران گروه مداخله طی 72-24 ساعت پس از زایمان توسط پژوهشگر به صورت عملی و انفرادی 30 تا 45 دقیقه تحت آموزش آرام سازی پیشرونده ی عضلانی به روش جاکوبسون قرار گرفتند. ابزار پژوهش پرسشنامه ی استاندارد خودکارآمدی شیردهی دنیس و فرم مشخصات دموگرافیک بود که پرسشنامه ی خودکارآمدی شیردهی در بدو ورود به مطالعه، پایان هفته چهارم و هشتم، توسط مادر تکمیل گردید. یافته ها: تفاوت معنی‌ داری از نظر متغیرهای زمینه‌ای در دو گروه آزمون و کنترل مشاهده نشد (05/0P). در ابتدای مطالعه تفاوت معنی داری در میانگین نمره خودکارآمدی شیردهی بین دو گروه وجود نداشت (05/0P)؛ اما این میانگین در گروه آزمون، چهار (79/6±51/50) و هشت (22/6±62/57) هفته بعد از مداخله نسبت به بدو مطالعه (85/8±01/47) افزایش معنی داری نشان داد (001/0P=). نمره خودکارآمدی شیردهی تنها در گروه مداخله در زمان های مختلف دارای اختلاف معنی دار بود (001/0>P). نتیجه گیری: با توجه به تأثیر آموزش تن آرامی بر خودکارآمدی شیردهی مادران دارای نوزاد نارس، آموزش و انجام این تمرینات به عنوان یک روش موثر و کم هزینه در جهت ارتقای سلامت مادران به ویژه مادران دارای نوزاد نارس پیشنهاد می شود

Evaluating the Effectiveness of Using a Progressive Muscle Relaxation Technique on the Self-Efficacy of Breastfeeding in Mothers With Preterm Infants.

BACKGROUND Breast milk is a God-given gift that conveys a mother's love and compassion and that is made according to the needs and age of the child. Mothers who are interested in the welfare of their newborns tend to breastfeed their children. Training programs have been shown to improve breastfeeding self-efficacy in terms of both duration and amount. PURPOSE The aim of this study was to evaluate the effect of using the progressive muscle relaxation (PMR) technique on the self-efficacy of breastfeeding in mothers with preterm infants. METHODS A clinical trial approach was used. Sixty mothers with preterm infants were randomly assigned to either the intervention or control group. The clinical trial ran for a period of 2 months for both groups. At 24-72 hours postpartum, the researcher used the Jacobson method to provide 30-45 minutes of individual training to the intervention group participants on PMR. Under the Jacobson method, mothers contract the 16 groups of muscles until they experience the feeling of pressure and then relax these muscles. The tools used in this study were the standard questionnaire of Dennis breastfeeding self-efficacy, which was completed by the participants at baseline, at the end of the fourth week, and during the eighth week. Data were analyzed using SPSS software. RESULTS No significant difference was observed between the intervention and control groups in terms of demographic variables (p > .05). Independent t tests found no significant difference between the two groups (p = .45) in terms of mean score of maternal breastfeeding self-efficacy at pretest and significantly higher scores for the intervention group than the control group at both 4 (p = .001) and 8 (p < .001) weeks posttest. Furthermore, the analysis of variance test showed significant differences in the mean score of breastfeeding self-efficacy for the intervention group between pretest and the first posttest and between the first posttest and the second posttest, respectively (p < .001). CONCLUSIONS/IMPLICATIONS FOR PRACTICE Considering the effect of relaxation training on the breastfeeding self-efficacy of mothers with preterm infants, training and performing these exercises as an effective and low-cost method to improve the health of mothers, particularly mothers of preterm infants, are recommended. The PMR technique facilitates the self-efficacy of breastfeeding in mothers with preterm infants and should be considered as an effective strategy to improve nursing care and the provision of better support services for mothers who breastfeed their infants

The Effect of Implementing a Discharge Program on Quality of Life of Mothers with Premature Infants

Background:Quality of life is low among mothers of premature infants; therefore, developing a post-discharge care program can be effective. Aim: This study aimed to investigate the effect of implementing a discharge program on the quality of life of mothers with premature infants. Method: This randomized, controlled, clinical trial was conducted on 60 mothers with premature infants in the neonatal intensive care unit (NICU) of BentolHoda Hospital, Bojnord, Iran, during 2015-2016. The participants were divided into two groups of intervention (four training sessions on caring for premature infant, screening, and four-week telephone counseling post-discharge) and control (routin care in NICU). Maternal quality of life was evaluated using the short form of the World Health Organization Quality of Life Questionnaire at the onset of the study, at discharge, and four weeks after discharge. The data was analyzed in SPSS, version 16, using repeated measures analysis of variance (ANOVA). Results: The mean ages of the intervention and control groups were 26.8±5.1 and 29.5±5.3 years, respectively. According to the findings of independent t-test, the total mean score for maternal quality of life before the intervention showed no significant differences between the intervention and control groups (P=0.48). However, the results of repeated measures ANOVA revealed statistically significant differences between the scores of quality of life at three-time measurements within both study groups (

The Effects of Field Massage Technique on Bilirubin Level and the Number of Defecations in Preterm Infants

Background: Hyperbilirubinemia is a common physiological problem in approximately 80% of preterm infants during the first week after birth. Increase in bowel movements reduces enterohepatic circulation and increases bilirubin excretion. Aim: This study aimed to evaluate the effects of Field massage technique on bilirubin level and the number of defecations in preterm infants Method: This clinical trial was performed on 80 preterm infants aged 30-36 weeks, who were hospitalized in neonatal intensive care units of Qaem, Imam Reza, and Ommolbanin hospitals of Mashhad, Iran, in 2011. The enrolled infants were randomized into intervention and control groups. The control group received the routine care, and the intervention group received a 15-minute massage twice a day (morning and evening), for five consecutive days. Field massage technique was applied by the researcher. The number of defecations and cutaneous bilirubin level were recorded on a daily basis until the sixth day after birth. Independent t-test and Mann-Whitney U test were performed to analyze the data, using SPSS version 14. Results: The mean age of the intervention and control groups was 17.2±4.5 and 17.1±4.5 hours, respectively. The mean level of cutaneous bilirubin in the intervention and control groups on the first and sixth days were not significantly different (10.7±1.5, 10.8±1.4, 13.4±2.0, and 13.4±2.6, respectively; the first day: P=0.67, the sixth day: P=0.98). The number of defecations on the fourth (P=0.01), fifth (

Effect of Tactile-Kinesthetic Stimulation on Weight Gaining of Preterm Infants

Background:The quality of life and standard of health care in a society is measured  by its preterm infants' mortality rate. The popularity and credibility of alternative treatment such as touch therapy may be effective in preterm and low birth weightinfants in order to increase their survival rate.The aim of this study was to determine the effect of touch intervention on the weight gain of preterm infants who were admitted to the Neonatal Intensive Care Unite(NICU). Methods:This study was a randomized controlled trial performed in NICU of  Emamreza hospital,Mashhad,Iran,from July 2007 to November 2007. There were two groups (the control group and the case group) and one response variable (weight gain).Infants in the control group received routine nursing care. Infants in the case  group,in addition to the routine care,received stroking/passive limb movement therapy  for three 15 minute sessions per day for a 10 day period.Then weight gaining was compared between the two groups .  Results:The weight gain data was analyzed by SPSS software. Over the 10 day study period, the case group gained significantly more weight compared to the control  group (p(p<0.001(.Conclusion:The data suggest that stroking/passive limb movement can be an efficientand cost effective way of enhancing growth in stable preterm infants

Comparing the Effect of Non-nutritive Sucking and Abdominal Massage on Feeding Tolerance in Preterm Newborns

Background:Enteral feeding intolerance is a major problem in the preterm neonates. Non-nutritive sucking and abdominal massage are among the most important nutritional interventions in this regard. Aim: This study aimed to compare the effect of non-nutritive sucking and abdominal massage on feeding tolerance in the preterm newborns. Method: This clinical trial was conducted on 52 preterm neonates in the Neonatal Intensive Care Unit of Imam Reza Hospital in Mashhad, Iran. The subjects were randomly divided into three groups, namely abdominal massage (17 newborns), non-nutritive sucking (18 newborns), and control groups (17 newborns). In the abdominal massage group, the intervention was fulfilled for 15 min twice a day, and in the non-nutritive sucking group, the intervention was performed for 10 min three times a day within 7 days. The control group only received tube feeding every two h without any intervention. Feeding tolerance was examined in terms of gastric residuals, vomiting, and abdominal distention. The data were collected through the recording daily information form. The data were analyzed through SPSS version 23, using ANOVA test and marginal models. Results: The mean gestational age of the abdominal massage group was 32.8±1.0 weeks. This value was 32.5±1.3 weeks in both sucking and control groups. Generalized estimating equation revealed that non-nutritive sucking was effective in the absence of distention (P=0.01) and vomiting (P=0.01). However, abdominal massage was effective only in the absence of vomiting (P=0.01). Implications for Practice: The use of non-nutritive sucking can increase the feeding tolerance in the preterm newborns

The Effect of Mother Empowerment Program on Mothers’ Attachment to their Hospitalized Premature Neonates

Background: Birth of a premature neonate is associated with hospital admission and separation from the family. Admission of the neonates intervenes on infant-mother attachment and so adversely affects on the quality of care given by the mother, and subsequently increases the risk of delayed behavioral problems in the children. Aim: To assess the effectiveness of mother empowerment program on the premature infant-mother attachment. Methods: In this randomized clinical trial, 70 mothers of premature infants, admitted to the neonatal intensive care unit (NICU) of Omolbanin hospital of Mashhad in 2014, were divided into of intervention and control groups. The Empowerment program was a multi-step treatment program, in which information about the premature infants was provided to mothers through an illustrated booklet with a workbook and audio file in each step. Mothers in the control group received information and routine care according to the hospital guideline. The mother-infant attachment was measured after the intervention using the maternal and neonatal behaviors Avant tool. Data analysis was performed using chi-square and t-student tests by SPSS software version 11.5. Results:The mean scores of maternal attachment behaviors after the intervention in the empowerment and control groups were (56.62±8.06) and (39.51±7.77), respectively; the difference between the groups was statistically significant (

The Impact of Praying on Stress and Anxiety in Mothers with Premature Infants Admitted to NICU

Background: Neonatal mortality, prematurity, and congenital disorders, known as crisis, are unexpected stressful events causing extreme maternal stress. According to the literature, about 28-70% of the mothers have a high degree of psychological stress. Among different treatments, praying as a complementary religious approach is the most common source that people use in difficult conditions. Regarding this, the aim of the present study was to determine the effect of praying on anxiety and stress in mothers with premature neonates admitted to the Neonatal Intensive Care Unit (NICU). Methods: This clinical trial was conducted on 60 mothers with premature neonates. The participants were randomly divided into the intervention and control groups. In the intervention group, praying was performed one day after the presence of the mother in the NICU for 7 days. The tools employed in this study included the demographic characteristics and subject selection forms, depression, anxiety, and stress scale, as well as Symptom Checklist-90-R and prayer questionnaires. The validity and reliability of these tools were approved using content validity and internal consistency, respectively. Data analysis was performed by independent and paired t-tests as well as ANOVA through SPSS version 11.5. Results: The two groups were matched in terms of all maternal demographic and neonatal characteristics, except neonatal birth weight (P=0.045). As the results demonstrated, there was a statistically significant difference between the intervention and control groups in terms of their anxiety scores (P=0.02); however, the difference was not significant after one month following the intervention (P=0.076). Nevertheless, no statistically significant difference was observed between the stress scores of the two groups. Conclusion: As the findings of the current study revealed, praying can be effective in reducing the maternal anxiety