Topical Use of Human Milk in the Neonatal Intensive Care Unit: An Integrative Review.

BACKGROUND: Research has shown that the bioactive components in human milk could demonstrate efficacy when applied topically. One common neonatal skin issue is diaper dermatitis (DD). DD treatment and prevention guidelines often lack the inclusion of topical human milk as a viable option. PURPOSE: To analyze the safety and efficacy of topical human milk application as a means to support future research of human milk as a topical treatment for DD. DATA SOURCES: Google Scholar, CINAHL, PubMed, and Cochrane. STUDY SELECTION: The search was limited to articles published between 2011 and 2023 in the English language. Disqualifying characteristics included nonhuman subjects, literature reviews, inability to obtain articles, and non-peer-reviewed articles. DATA EXTRACTION: For Google Scholar, the search terms "human milk OR breast milk" and "topical" were used. For CINAHL, PubMed, and Cochrane, the search terms "human milk OR chest milk OR breast milk OR donor milk" and "topical" were used. Quantitative significance was defined by a P value of less than .05. RESULTS: The search yielded 20 articles. The results of the review demonstrate that topical human milk application is a safe and effective topical treatment to skin integrity/inflammatory issues such as DD. It also identified that caregivers will likely show positive regard to the treatment, promoting its acceptance. IMPLICATIONS FOR PRACTICE AND RESEARCH: The results provide evidence to support methodologic development for human milk application for the prevention and treatment of DD. Further studies can use the results to develop protocols that investigate the effects of human milk application.

Psychometric properties and validation of the Swedish Five Facet Mindfulness Questionnaire in a clinical and non-clinical sample among meditators and non-meditators.

Over a period of 15 years several attempts to conceptualize mindfulness have been presented and revised, but there is still no clear or agreed-upon definition. The use of mindfulness-based interventions has increased in clinical and research settings the last couple of years, including in Sweden. As a clinician it is crucial to know if a treatment works through the theoretically postulated mechanisms of change. Mindfulness is a concept that is difficult to measure. The overall aim of the current project was to examine the psychometric properties of the Swedish version of the Five Facet Mindfulness Questionnaire (FFMQ_SWE) using three different studies. To test the construct validity of the FFMQ_SWE a hierarchal confirmatory factor analysis was performed in a meditating non-clinical sample, to examine if all the five facets would load on an overall mindfulness construct. Psychometric properties of the instrument were examined in a non-clinical and a clinical sample, and discriminative relationships with other variables were analysed. The convergent validity was examined by analysing the correlations between FFMQ_SWE and Hospital Anxiety and Depression Scale, Sense of Coherence and Difficulties in Emotion Regulation Scale. Test-retest reliability was tested by distributing FFMQ_SWE at two occasions. The hierarchal confirmatory factor analysis showed good fit in a population of meditators. The FFMQ_SWE showed good convergent validity and test-retest reliability in both clinical and non-clinical populations. In sum, the Swedish version of the FFMQ showed good psychometric properties and can be a useful instrument as an evaluation of treatment effects in both health care settings and research settings.