You can’t flight, you need to fight – a qualitative study of mothers’ experiences of feeding extremely preterm infants

Aim To describe mother\u27s experiences of feeding their extremely preterm infant. Background When an infant is born extremely preterm, there is a long rocky road for the mother if she wants to breastfeed. Some manage to reach their goals, others do not. Studies of feeding extremely preterm infants in the neonatal intensive care unit (NICU) are scarce. Design A qualitative method with an inductive approach. Methods Nine mothers giving birth to extremely preterm infants were interviewed by telephone after discharge from the NICU. The interviews were transcribed verbatim and analysed with qualitative content analysis. The COREQ checklist was followed. Results The overall theme was “you can\u27t flight, you need to fight.” The theme reflects the mothers’ will to do the best for their infants even if the struggle with milk expression and breastfeeding practice evoked feelings of helplessness, exposure, worry and disappointment. The categories forming the theme were as follows: The wish to provide own breastmilk; For the infant\u27s best; Loss of control; and Help to reach the goals. Conclusion The mothers had a strong will to provide breastmilk to their infants but requested more support in order to be successful. Relevance to clinical practice There is a need for evidence‐based support programmes for mothers of extremely preterm infants to encourage them to persevere with milk expression and breastfeeding over time

Saliva cortisol in girls with functional abdominal pain disorders: A randomized controlled dance and yoga intervention

Introduction: Functional abdominal pain disorders (FAPDs) are common among girls and has been associated with stress. Cortisol is one of the major stress hormones. Dance and yoga have been shown to reduce abdominal pain among girls with FAPDs. Aim: To investigate the effect of an 8-month intervention with dance and yoga on cortisol levels in saliva among girls with FAPDs. Methods: A total of 121 girls aged 9–13 years with irritable bowel syndrome (IBS) or functional abdominal pain were included in the study. Participants were randomized into an intervention group and a control group. The intervention group attended a combined dance and yoga session twice a week for 8 months. Saliva samples were collected during 1 day, in the morning and evening, at baseline, and at 4 and 8 months. Subjective pain and stress were assessed as well. Results: No significant effects on saliva cortisol levels between groups were observed after completion of the intervention at 8 months. However, evening cortisol and evening/morning quotient were significantly reduced at 4 months in the intervention group compared to the control group (p = 0.01, p = 0.004). There was no association between cortisol quota and pain or stress. Conclusion: Improvements in cortisol levels were seen in the intervention group at 4 months but did not persist until the end of the study. This indicates that dance and yoga could have a stress-reducing effect during the ongoing intervention

Seeing lockdown through the eyes of children from around the world: Reflecting on a children's artwork project.

The COVID-19 pandemic created new challenges for children including access to education and limiting social and emotional connections to extended family, friends, and the community. Globally, opportunities for sharing children’s self-reported experiences during lockdown were limited. The primary aim of this project was to create an art-E-Book that reflects children’s experiences of life during the COVID-19 pandemic that could be shared with other children around the world. Secondly, we wanted to reflect on the consultation undertaken within the International Network of Child and Family Centered Care (INCFCC) using Gibbs (1988) reflective cycle framework. Children from around the world were invited to submit a piece of artwork that reflected their experience during the COVID-19 pandemic via a Qualtrics-survey in May 2020. The children’s artwork and written pieces were transcribed verbatim into an E-Book and the artwork was further placed into groups based on similarity of meaning. Fifty-five children from 17 countries submitted an artwork piece. Four groups were evident within the children’s artwork including infection control measures, positive experiences and emotions (connection to family, fun activities), negative experiences and emotions (social impact, emotional impact), and uniting children globally. The E-Book is available to download free of charge via the INCFCC website. The E-Book illustrates how children of all ages can provide meaningful insightful commentary and valuable information on their experiences during an unprecedented pandemic

A scoping review of nursing research priorities in pediatric care

Problem: Priority setting for pediatric nursing is important to plan, coordinate and direct future research. The aim of this scoping review was to systematically identify and synthesise the nature, range and extent of published pediatric nursing research priorities. Eligibility criteria: English language full text publications focusing generic nursing research priorities for the child or adolescent, indexed in CINAHL, EMBASE, The Cochrane Database of Systematic Reviews, AMED, MEDLINE and PsycINFO and published from 2008 to 2019. Sample: A total of 789 citations were identified, 44 full text articles were retrieved and assessed for eligibility and eight studies were finally reviewed, quality assessed (CREDES) and synthesised. Results: All eight studies used a consensus building method to identify research priorities reported by nurses. Six used Delphi technique, one Nominal Group Technique (NGT) and one consensus workshop. CREDES score range was 10–14 of a possible 16. Synthesis of the 234 nursing research priorities generated four themes; evidenced-based practice, pediatric context, child and family-centered care; pediatric nursing, with 14 subthemes. Conclusion: The nursing research priorities reported appear to be still current and important to nurses. There was a focus on acute care, with fewer priorities reflecting areas of child-, school-, or mental- health. Consumer and community priorities have not been reported. Implications: These nursing research priorities can be used to inform the national or local research agenda, although there is a need to establish priorities from the perspective of all stakeholders and in particular, identify what is important to consumers

The cortisol response in parents staying with a sick child at hospital

Aim To study the cortisol response in parents staying with their child in paediatric wards, to compare the parents’ cortisol levels between the paediatric ward and at home 4 weeks after discharge and to compare the parents’ cortisol levels with data of an adult reference population, reported by Wust et al., as there are few studies investigating parental cortisol. Design This study has a descriptive and prospective comparative design. Method Thirty‐one parents participated. Saliva samples were collected in the paediatric ward and 4 weeks later at home. Results The parents had lower morning awakening cortisol levels in the paediatric ward than at home after discharge. There were no statistically significant differences in postawakening cortisol or cortisol awakening response (CAR). The child's age, diagnosis or previously diagnosed chronic condition did not affect the parents’ cortisol levels. The morning and postawakening cortisol levels were lower than those of the reference population. Conclusion The hospital stay with a sick child affects parents’ cortisol levels. Parental stress needs more attention to find interventions to prevent the risk of stress‐related complications that subsequently can affect the care of the child.What about the parents?: Sleep quality, mood, saliva cortisol response and sense of coherence in parents with a child admitted to pediatric car

Fathers experiences of feeding their extremely preterm infants in family-centred neonatal intensive care : a qualitative study

Background Extremely preterm infants need advanced intensive care for survival and are usually not discharged before they reach the time of expected birth. In a family-centred neonatal intensive care unit both parents are involved at all levels of care including the feeding process. However, studies focusing on fathers in this situation are scarce. The purpose of this study was to explore the experiences of feeding extremely preterm infants in a neonatal intensive care unit from fathers perspectives. Methods The study adopts a qualitative inductive method, reported according to the COREQ checklist. Seven fathers of extremely preterm infants (gestational age 24-27 weeks) in neonatal intensive care in Sweden were interviewed by telephone after discharge in 2013-2014. The interviews were analysed using a qualitative content analysis and confirmed by triangulation in 2021. Results Six sub-categories and two generic categories formed the main category: "a team striving towards the same goal". The fathers were equally involved and engaged members of the feeding team all hours of the day. The fathers shared responsibility and practical duties with the mothers, and they provided as much support to the mothers as they could. However, the fathers found it difficult to support and encourage the mothers to breastfeed and express breastmilk when the breastmilk production was low. The fathers experienced a loss when breastfeeding was not successful. Conclusions The findings indicate that fathers want to be involved with infant care, including night-time feeds, and long and demanding feeding processes. Fathers and staff need to collaborate to provide the best support to mothers during the feeding process. This study may inspire hospital staff to acknowledge and support fathers to become more involved in the oral feeding process when an infant is born extremely preterm.Funding Agencies|Perth Childrens Hospital Foundation</p

You can't flight, you need to fight -A qualitative study of mothers experiences of feeding extremely preterm infants

Aim To describe mothers experiences of feeding their extremely preterm infant. Background When an infant is born extremely preterm, there is a long rocky road for the mother if she wants to breastfeed. Some manage to reach their goals, others do not. Studies of feeding extremely preterm infants in the neonatal intensive care unit (NICU) are scarce. Design A qualitative method with an inductive approach. Methods Nine mothers giving birth to extremely preterm infants were interviewed by telephone after discharge from the NICU. The interviews were transcribed verbatim and analysed with qualitative content analysis. The COREQ checklist was followed. Results The overall theme was "you cant flight, you need to fight." The theme reflects the mothers will to do the best for their infants even if the struggle with milk expression and breastfeeding practice evoked feelings of helplessness, exposure, worry and disappointment. The categories forming the theme were as follows: The wish to provide own breastmilk; For the infants best; Loss of control; and Help to reach the goals. Conclusion The mothers had a strong will to provide breastmilk to their infants but requested more support in order to be successful. Relevance to clinical practice There is a need for evidence-based support programmes for mothers of extremely preterm infants to encourage them to persevere with milk expression and breastfeeding over time

Parental sleep when their child is sick : A phased principle-based concept analysis

Sleep is a common challenge for parents with sick children and can impact parents health, wellbeing, and caregiving responsibilities. Despite the vast research around parental sleep when their child is sick, the concept is not clearly defined. A phased principle-based concept analysis that includes triangulation of methods and quality criteria assessment was used to explore how the concept is described, used, and measured in the current literature. The aim was to analyse and clarify the conceptual, operational, and theoretical basis of parental sleep when their child is sick to produce an evidence-based definition and to identify knowledge gaps. A systematic literature search including databases CINAHL, Embase, MEDLINE, PsychARTICLES, PsychINFO, Pubmed, Scopus and Web of Science, identified 546 articles. The final dataset comprised 74 articles published between 2005 and 2021 and was assessed using a criteria tool for principle-based concept analysis. Data were managed using NVivo, and thematic analysis was undertaken. A precise definition is not present in the literature. Various tools have been used to measure parents sleep, as well as exploration via interviews, open-ended questions, and sleep diaries. The terminology used varied. Parental sleep when their child is sick is interrelated with other concepts (e.g., stress). A recommended definition is offered. A conceptual understanding of parental sleep when their child is sick will help to guide translational research and to conduct studies critical to clinical practice and research. Future research includes developing a measurement tool for parental sleep when their child is sick to be used in study design and future interventions.Funding Agencies|Chief Nursing and Midwifery Office in Western Australia; Nursing Research Department at Perth Childrens Hospital; School of Nursing and Midwifery at Edith Cowan University in Western Australia; Perth Childrens Hospital Foundation</p

The Report of Access and Engagement With Digital Health Interventions Among Children and Young People: Systematic Review

BackgroundDigital health interventions are increasingly used to deliver health-related interventions for children and young people to change health behaviors and improve health outcomes. Digital health interventions have the potential to enhance access to and engagement with children and young people; however, they may also increase the divide between those who can access technology and are supported to engage and those who are not. This review included studies that reported on the access to or engagement with digital health interventions among children and young people. ObjectiveThis review aims to identify and report on access and engagement in studies involving digital health interventions among children and young people. MethodsA systematic review following the Joanna Briggs Institute methods for conducting systematic reviews was conducted. An electronic literature search was conducted for all studies published between January 1, 2010, and August 2022, across sources, including MEDLINE, CINAHL, and PsycINFO. Studies were included if they examined any aspect of access or engagement in relation to interventions among children and young people. The quality of the included papers was assessed, and data were extracted. Data were considered for meta-analysis, where possible. ResultsA total of 3292 references were identified using search terms. Following the exclusion of duplicates and review by inclusion criteria, 40 studies were independently appraised for their methodological quality. A total of 16 studies were excluded owing to their low assessed quality and flawed critical elements in the study design. The studies focused on a variety of health conditions; type 1 diabetes, weight management and obesity, mental health issues, and sexual health were the predominant conditions. Most studies were conducted in developed countries, with most of them being conducted in the United States. Two studies reported data related to access and considered ethnicity and social determinants. No studies used strategies to enhance or increase access. All studies included in the review reported on at least 1 aspect of engagement. Engagement with interventions was measured in relation to frequency of engagement, with no reference to the concept of effective engagement. ConclusionsMost digital health interventions do not consider the factors that can affect access and engagement. Of those studies that measured either access or engagement or both, few sought to implement strategies to improve access or engagement to address potential disparities between groups. Although the literature to date provides some insight into access and engagement and how these are addressed in digital health interventions, there are major limitations in understanding how both can be enhanced to promote equity. Consideration of both access and engagement is vital to ensure that children and young people have the ability to participate in studies. Trial RegistrationPROSPERO CRD42020170874; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=17087