Effectiveness of a Postpartum Breastfeeding Support Group Intervention in Promoting Exclusive Breastfeeding and Perceived Self-Efficacy: A Multicentre Randomized Clinical Trial.

There are numerous recognized benefits of breastfeeding; however, sociocultural, individual, and environmental factors influence its initiation and continuation, sometimes leading to breastfeeding rates that are lower than recommended by international guidelines. The aim of this study was to evaluate the effectiveness of a group intervention led by midwives supporting breastfeeding during the postpartum period in promoting exclusive breastfeeding, as well as to assess the impact of this intervention on perceived self-efficacy. This was a non-blind, multicentric, cluster-randomized controlled trial. Recruitment started October 2021, concluding May 2023. A total of 382 women from Andalusia (Spain) participated in the study. The results showed that at 4 months postpartum there was a higher prevalence of breastfeeding in the intervention group compared to formula feeding (p = 0.01), as well as a higher prevalence of exclusive breastfeeding (p = 0.03), and also at 6 months (p = 0.01). Perceived self-efficacy was similar in both groups for the first two months after delivery, which then remained stable until 4 months and decreased slightly at 6 months in both groups (p = 0.99). The intervention improved the average scores of perceived self-efficacy and indirectly caused higher rates of exclusive breastfeeding (p = 0.005). In conclusion, the midwife-led group intervention supporting breastfeeding proved to be effective at maintaining exclusive breastfeeding at 6 months postpartum and also at increasing perceived self-efficacy.

Evaluation of the Impact of a Midwife-Led Breastfeeding Group Intervention on Prevention of Postpartum Depression: A Multicentre Randomised Clinical Trial.

Postpartum depression is a significant health issue affecting both mothers and newborns during the postpartum period. Group support interventions during this period have proven effective in helping women cope with depression and improving breastfeeding rates. This study aimed to assess the effectiveness of a midwife-led breastfeeding support group intervention on breastfeeding rates, postpartum depression and general self-efficacy. This was a multicentric cluster randomised controlled trial with control and intervention groups and was not blinded. It was conducted in Andalusia (southern Spain) from October 2021 to May 2023. A total of 382 women participated in the study. The results showed a significant difference in exclusive breastfeeding rates at 4 months postpartum between the groups (control 50% vs. intervention 69.9%; p < 0.001). Additionally, there was a lower mean score on the Edinburgh Postnatal Depression Scale in the intervention group (12.49 ± 3.6 vs. 13.39 ± 4.0; p = 0.044). Similarly, higher scores of general self-efficacy were observed among breastfeeding women at 2 and 4 months postpartum (77.73 ± 14.81; p = 0.002 and 76.46 ± 15.26; p < 0.001, respectively). In conclusion, midwife-led breastfeeding support groups enhanced self-efficacy, prolonged breastfeeding and reduced postpartum depression 4 months after giving birth.

Virtual reality vs. buzzy®. efficacy in pain and anxiety management during pediatric venipuncture. Systematic review and meta-analysis.

PROBLEM: Non-pharmacological distraction methods are novel alternatives that can help to alleviate pain and anxiety generated by venipuncture in the pediatric population. The aim is to determine the effectiveness of virtual reality, compared to cold and vibration devices (Buzzy® device), as a distraction method used during venipuncture in the management of pain and anxiety in children. ELIGIBILITY CRITERIA: Clinical trials, cohort and quasi-experimental studies, published between 2017 and 2022, in Spanish or English and pediatric age, found in Medline, the Cochrane Library, Scopus, Web Of Science, CINAHL and Embase databases. SAMPLE: Twenty-one studies were included and ten met the criteria for meta-analysis. RESULTS: Fifty-seven percent of the studies evaluate virtual reality, 33.3% the Buzzy® device and 9.5% both comparatively. The effectiveness of virtual reality in reducing pain (66.6%, n = 14) and anxiety (47.6%, n = 10) compared to standard care (control group), 95% CI = 1.53 [0.91-2.16], p < 0.001, I2 = 78% and 95% CI = 1.53 [1.16-1.90]), p < 0.001, I2 = 77% respectively is demonstrated. Similarly, the effectiveness of Buzzy® in reducing pain (42.9%, n = 9) and anxiety (23.8%, n = 5), 95% CI = 1.62 [0.90-2.34], p < 0.001, I2 = 94% and 95% CI = 1.40 [0.06-2.20, p < 0.001, I2 = 91% respectively is demonstrated. Comparatively, there is no significant difference between both methods 95% CI = 0.29 [-0.19-0.78], p = 0.24, I2 = 81%. CONCLUSIONS: The methods studied are effective in relieving pain and anxiety during venipuncture. Further research is needed on the level of satisfaction, adverse effects and cost-benefit. IMPLICATIONS: This study provides evidence of novel tools in daily practice to provide more humane, holistic and quality care.

Stressors inherent to clinical practices and their relationship with emotional intelligence in nursing students: A cross sectional study.

BACKGROUND: There is a wide body of knowledge about Emotional Intelligence and its benefits in health care, generating better productivity, clinical performance and communication with work teams, patients and families. Its relationship with stress and with performance of clinical practices has also been studied, although the results are not conclusive or up-to-date. OBJECTIVES: To study and correlate the perception of Emotional Intelligence and the stressors inherent to Nursing students' clinical practices. DESIGN: A multicenter and observational study was carried out through cross-sectional surveys with Nursing students during the 2021/2022 academic year. PARTICIPANTS: 377 students were included in the study, recruited through non-probabilistic sampling in four Spanish universities. METHODS: Sociodemographic and academic variables were collected, as well as the following main variables: perceived Emotional Intelligence and stressors in clinical practices. RESULTS: The study sample consisted of 377 students (89.1 % women; mean age of 23.15 ± 5.50). The perception of Emotional Intelligence obtained adequate ranges. The stressors that generate most concern are being attacked by the patients, lack of competence, and impotence and uncertainty. There are statistically significant differences in Emotional Intelligence by gender and university, as well as in stressors between each other. The Emotional Intelligence dimensions are weakly correlated with the stressors, although with statistical significance. CONCLUSIONS: This study shows that Emotional Intelligence slightly influences the stressors inherent to clinical practices, so that EI can help cope with the difficulties of clinical work. Specifically, emotional clarity has an inverse relationship with some stressors. However, the attention and repair dimensions do not present such a clear relationship in our study or in previous ones. This shows the need to include Emotional Intelligence training in Nursing training curricula.

Breastfeeding experiences during the COVID-19 pandemic in Spain:a qualitative study.

BACKGROUND: The pandemic caused by COVID-19 has affected reproductive and perinatal health both through the infection itself and, indirectly, as a consequence of changes in medical care, social policy or social and economic circumstances. The objective of this study is to explore the impact of the pandemic and of the measures adopted on breastfeeding initiation and maintenance. METHODS: A qualitative descriptive study was conducted by means in-depth semi-structured interviews, until reaching data saturation. The study was conducted between the months of January to May 2021. Participants were recruited by midwives from the Primary Care Centres of the Andalusian provinces provinces of Seville, Cádiz, Huelva, Granada, and Jaén. The interviews were conducted via phone call and were subsequently transcribed and analysed by means of reflexive inductive thematic analysis, using Braun and Clarke's thematic analysis. RESULTS: A total of 30 interviews were conducted. Five main themes and ten subthemes were developed, namely: Information received (access to the information, figure who provided the information), unequal support from the professionals during the pandemic (support to postpartum hospitalization, support received from Primary Health Care during the postpartum period), social and family support about breastfeeding (support groups, family support), impact of confinement and of social restriction measures (positive influence on breastfeeding, influence on bonding with the newborn), emotional effect of the pandemic (insecurity and fear related to contagion by coronavirus, feelings of loneliness). CONCLUSION: The use of online breastfeeding support groups through applications such as WhatsApp®, Facebook® or Instagram® has provided important breastfeeding information and support sources. The main figure identified that has provided formal breastfeeding support during this period was that of the midwife. In addition, the social restrictions inherent to the pandemic have exerted a positive effect for women in bonding and breastfeeding, as a consequence of the increase in the time spent at their homes and in the family nucleus co-living.

Efectividad del uso de los probióticos en la prevención y el tratamiento de las mastitis durante la lactancia materna. Revisión integrativa / Effectiveness of the use of probiotics in the prevention and treatment of mastitis during breastfeeding. Integrative review

Objetivo: Determinar la efectividad del tratamiento probiótico en la prevención y el tratamiento de la mastitis, y comprobar si existe relación entre el uso de antibióticos pre/intra/posparto por causa extrínseca y la posterior aparición de mastitis. Metodología: Se realiza una revisión por pares en las bases de datos MEDLINE, CINAHL, CUIDENplus, Scopus, WoS y Cochrane Library. La estrategia de búsqueda se ha llevado a cabo a partir de los descriptores MeSH: «probióticos/probiotics», «mastitis/mastitis», «lactancia materna/ breast feeding», «prevención/prevention», «tratamiento/treatment» y «terapéutica/therapeutics». Resultados: Se obtuvo un total de 34 artículos potencialmente útiles. Tras la aplicación de los criterios de inclusión/exclusión, se han seleccionado 8 investigaciones a nivel nacional e internacional de los últimos 5 años. La toma de probióticos muestra una disminución en la carga de estafilococos, el dolor asociado y la incidencia global de mastitis; los probióticos más usados eran Lactobacillus salivarius PS2 y Lactobacillus fermentum CECT5716. La relación existente entre la ingesta de antibióticos pre/intra/posparto y la aparición de mastitis en el periodo puerperal parece confirmarse. Conclusiones: A pesar de que los probióticos muestran eficacia en la prevención y el tratamiento de la mastitis puerperal, son necesarias más investigaciones para verificar su instauración de forma reglada. Parece que el uso de antibióticos podría afectar a la posterior aparición de mastitis, aunque no se conoce el momento de la administración. (AU)

Objetive: To determine the effectiveness of probiotic treatment in the prevention and treatment of mastitis, as well as know if there is a link between the use of pre, intra- and postpartum antibiotics, for extrinsic cause and the subsequent onset of mastitis. Methodology: A peer review was carried out of the MEDLINE, CINAHL, CUIDENplus, Scopus, WoS and Cochrane Library databases. The search was narrowed on the basis of the MeSH descriptors: “probióticos/probiotics”, “mastitis/mastitis”, “lactancia materna/breast feeding”, “prevención/prevention”, “tratamiento/treatment” and “terapéutica/therapeutics”. Results: With a total of 34 potentially useful articles. Following the application of the inclusion/exclusion criteria, 8 national and international investigations have been considered over the past 5 years. Taking probiotics shows a decrease in staph load, associated pain and overall incidence of mastitis; being the most commonly used probiotics Lactobacillus salivarius PS2 and Lactobacillus fermentum CECT5716. The relationship between pre, intra- and postpartum antibiotic intake and the onset of mastitis in the postpartum period appears to be related. Conclusions: Although probiotics have been shown to be efficacious in the prevention and treatment of puerperal mastitis, further research is needed to verify whether their use should be implemented in a regulated manner. It seems that the use of antibiotics may affect subsequent occurrences of mastitis, although the timing of administration remains unknown. (AU)

Impact and Effectiveness of Group Strategies for Supporting Breastfeeding after Birth: A Systematic Review.

Despite the multiple benefits of breastfeeding both for the mother and for the infant, during the first months there is a progressive decline in the number of mothers who continue breastfeeding, with most countries reporting lower than recommended figures. The objective of this review is to analyse the most effective group support practices for breastfeeding, as well as the characteristics associated to their success in maintaining breastfeeding. A systematic review has been conducted in the 2015-2020 period, in the following databases: MedLine, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library and LILACS. The findings were summarized in narrative and table formats. A total of thirteen articles were included, eight of them being experimental studies and five observational. The findings show high heterogeneity regarding the characteristics of the interventions and their periodicity. The most successful group strategies to support and maintain breastfeeding during postpartum are those that combine peer support with the leadership or counselling of a health professional or IBCLC. However, more studies are necessary, randomized and with interventions of similar characteristics, which allow for better data comparison.

Assessment of the Anxiety Level of Andalusian Podiatrists during the COVID-19 Pandemic: The Increase Phase.

Coronavirus disease (COVID-19) is caused by SARS-CoV-2 and represents the causative agent of a potentially fatal disease that is of great global public health concern. COVID-19 is a respiratory disease produced by the coronavirus family. The World Health Organization declared the disease a pandemic on 11 March 2020. Podiatrists are in a peculiar situation regarding the COVID-19 pandemic: that of a health professional aspect and the singularity that most of them practise as self-employed workers. The aim of the study is to evaluate in a group of podiatrists, working at a national level, their knowledge, perception and degree of anxiety related to the COVID-19 pandemic via the use of a questionnaire specifically developed to this end in the initial phase of the pandemic. We employed a transversal descriptive study with 302 participants, with a purposive sampling technique. The degree of perception and knowledge of the podiatrists about COVID-19 was analysed as well as the cognitive impact of the situation of confinement. The results showed that the podiatrists perceive this situation as serious at the economic and health level, that they have a thorough knowledge of the disease and that they are in a moderate to severe percentile of anxiety. Additionally, 76.2% cancelled their usual work. The COVID-19 pandemic is negatively perceived by this group of podiatrists at the personal, professional, health and economic level, with even a state of anxiety being produced.

Prevalence of Depression in Retirees: A Meta-Analysis.

Background: Retirement is a final life stage characterized by the ceasing of work and the loss of a routine, social relations, role, status, accomplishments, and aspirations, etc. Many times it is accompanied by negative feelings and can provoke different psychoemotional reactions such as depression, among others. The aim of this study is to analyze the prevalence of depression, as well as its psychoeducational approach in retirees. Methods: A paired systematic review with meta-analysis was conducted in different databases-Medline, Scopus, CUIDEN, CINAHL, LILACS and PsycINFO. Original studies were included in English, Spanish and French that were published in the last 10 years, and which approached depression in retirees. Results: A total of 11 articles were selected after applying inclusion and exclusion criteria. The mean value of the prevalence levels of depression in retirees obtained in the meta-analysis was 28%. Depression is more frequent in retirees, with mandatory retirement, retirement due to illness, and anticipated retirement presenting higher levels of this disease. The health role in the psychoeducational approach is highlighted in 41.6% (n = 5). Conclusions: With almost one-third of retirees suffering from depression, it is necessary to implement prevention and early detection measures to approach a public health problem.

Probiotics as a Coadjuvant Factor in Active or Quiescent Inflammatory Bowel Disease of Adults-A Meta-Analytical Study.

(1) Background: Inflammatory bowel diseases are pathologies of unknown etiology and auto-immune pathogenia. The use of probiotics is studied in order to increase the arsenal of treatments. The aim was to assess the efficacy of the probiotics in these diseases in the active or quiescent phases; (2) Methods: A systematic review with meta-analysis was performed by an exhaustive bibliographic search in Medline, Cinahl, Embase, Scopus, Web of Science, and Cochrane Library. The inclusion criteria were studies of more than 10 years, English/Spanish, clinical trials, and involving human beings. Relative risk was used to compare efficacy, which was meta-analyzed using a fixed effects model. Heterogeneity was evaluated with the Higgins I2 test; (3) Results: Nineteen studies were included in the systematic review and 17 in the meta-analysis, with a total of 1537 patients (nexperimental group = 762; nplacebo group = 775). There are significant remission differences in ulcerative colitis (relative risk (RR) = 0.81; 95% CI = 0.72-0.91; I2 = 32%; p = 0.16). However, no significant differences were found in the use of probiotics for the prevention of ulcerative colitis, and for the remission of Crohn's disease; (4) Conclusions: There are data showing an additional beneficial effect of probiotics on active ulcerative colitis. More and better studies are needed which assess its possible therapeutic efficacy for quiescent ulcerative colitis and for Crohn's disease.

Correction to: Evaluation of the impact of breastfeeding support groups in primary health centres in Andalusia, Spain: a study protocol for a cluster randomized controlled trial (GALMA project).

An amendment to this paper has been published and can be accessed via the original article.

Evaluation of the impact of breastfeeding support groups in primary health CENTRES in Andalusia, Spain: a study protocol for a cluster randomized controlled trial (GALMA project).

BACKGROUND: In 2003, the World Health Organization recommended exclusive breastfeeding (EB) during the newborn's first 6 months of life and, if possible, during the first 2 years. However, EB rates resist these recommendations. In developed countries, only 1 out of 3 babies is breastfed during its first 6 months of life, and great differences between areas and countries can be observed. Only 35% of the newborns receive breastfeeding at 3-4 months of age. There are diverse strategies described in the literature that have proven their efficiency in improving breastfeeding rates. It has also been proven that professional support is an effective tool to extend any kind of breastfeeding; besides, it has been observed that mother-to-mother support also increases breastfeeding initiation, sustainment, and exclusive duration. The overall aim of the study is to assess the impact of the support groups on the sustainment of exclusive breastfeeding until 6 months after birth. METHODS/DESIGN: This study is a cluster-random multicentric clinical trial with a control group and an intervention group, without blinding because it is impossible to mask the intervention. A randomization by centres of primary health (clusters) will be carried out. The women allocated to the intervention or control group will be randomized with a simple randomization sampling. The participants' breastfeeding rate will be followed up at the first 10 days, and at 2, 4, and 6 months of their newborn's life. DISCUSSION: There is a need to assess the impact of mother support groups on exclusive breastfeeding. This study aims to analyse the outcomes related to the support received and to identify what should the structure of these groups be; in other words, to describe factors related to a better breastfeeding experience in order to help women increase breastfeeding rates. TRIAL REGISTRATION: The trial is prospectively recorded at the ISRCTN registry (Trial ID: ISRCTN17263529 ). Date recorded: 17/06/2020.

Beneficios del acompañamiento a la mujer por parte de su pareja durante el embarazo, el parto y el puerperio en relación con el vínculo paternofilial. Revisión bibliográfica (Disponible solo on line) / No disponible

El objetivo de este trabajo es conocer el beneficio del acompañamiento de la pareja durante el embarazo, el parto y el puerperio, en relación con el vínculo paternofilial, mediante una revisión bibliográfica de la literatura científica publicada. La madre establece el vínculo mediante visualizaciones del feto y las sensaciones que le producen sus movimientos intraútero. El padre no tiene por qué esperar al nacimiento; también puede comenzar este proceso desde el embarazo, acompañando y apoyando a la madre desde el inicio de la gestación. Se realizó una búsqueda bibliográfica en las bases de datos Cuiden Plus, CINHAL, PubMed, IME y Cochrane. Los resultados indican que el acompañamiento de la mujer y la mejora de la crisis de desarrollo familiar que comporta el embarazo y el parto se relacionan con la mejora del vínculo paternofilial, contribuyendo a que la nueva dinámica familiar se adopte con menos dificultades. Los futuros padres se incorporan cada vez más a este proceso de manera conjunta desde el embarazo

The aim of this paper is to establish the benefits of the mother being accompanied by her partner during pregnancy, birth and the postpartum period in terms of the parent-child link, through a bibliographical review of the published academic literature. The mother forges the link by seeing images of the foetus and through the feelings caused by its inter-uterine movements. The father need not await birth, but can also begin this process during pregnancy, accompanying and supporting the mother from the beginning of gestation. A bibliographical search was conducted of the Cuiden Plus, CINHAL, PubMed, IME and Cochrane databases. The results indicate an association between the woman being accompanied with an improvement in the progress of the pregnancy and birth process in the family, with an improved parent-child link, helping to adapt to the new family dynamic with less difficulties. Future parents increasingly take part together from pregnancy onward