CE: Postpartum Depression: A Nurse's Guide.

ABSTRACT: Despite extensive research, the etiology behind postpartum depression (PPD) remains a mystery. Experts have theorized about various potential risk factors, including hormonal fluctuations, genetics, prior history of depression, low socioeconomic status, adolescent pregnancy, and certain personality traits. This article provides foundational information about PPD, reviewing the risk factors for and the consequences of this mood disorder. Postpartum blues and postpartum psychosis are briefly discussed for context, although they differ from PPD. Screening and treatment options are explained, and nursing implications for practice are presented.

Demonstração clínica no pré-natal para o manejo da prevenção do ingurgitamento mamário: estudo quase-experimental / Demostración clínica prenatal para el manejo de la prevención de la ingurgitación de mama: estudio casi experimental / Prenatal clinical demonstration for the management of the breast engorgement prevention: quasi-experimental study

RESUMO Objetivo: investigar a efetividade da educação em saúde sobre amamentação no pré-natal para a adoção de medidas de prevenção do ingurgitamento mamário decorrente do aleitamento materno. Método: trata-se de um estudo quase-experimental com 136 participantes. No grupo experimental (n=91) foi realizada intervenção educativa com demonstração clínica sobre amamentação durante a gestação e reforço das orientações por telefone; o grupo-controle (n=45) recebeu as orientações habituais da unidade de saúde sem interferência da equipe de pesquisa. Para a análise dos dados foi realizada estatística descritiva inferencial, e risco relativo para associação das variáveis de interesse. Resultado: a adoção de medidas de manejo do ingurgitamento mamário foi superior no grupo experimental (p=0,026). A técnica adequada de amamentação foi prevalente entre as mulheres que receberam a intervenção (p=0,030), em especial na posição (RR: 1,39; IC 95%: 1,002-1,94) e pega (RR:20,03; IC 95%: 5,2-77,8). Além disso, o grupo experimental realizou a interrupção da mamada de forma adequada (p<0,001). Conclusão: a educação em saúde com utilização de demonstração clínica é efetiva no manejo do ingurgitamento mamário, na técnica adequada de amamentação e comportamentos de proteção ao aleitamento materno.

RESUMEN Objetivo: investigar la efectividad de la educación en salud sobre lactancia materna en la atención prenatal para la adopción de medidas para prevenir la ingurgitación de mama resultante de la lactancia materna. Método: se trata de un estudio casi-experimental con 136 participantes. En el grupo experimental (n = 91) se realizó una intervención educativa con demostración clínica sobre lactancia materna durante el embarazo y refuerzo de las guías telefónicas; el grupo control (n = 45) recibió las instrucciones habituales de la unidad de salud sin interferencia del equipo de investigación. Para el análisis de los datos se realizó estadística descriptiva inferencial y riesgo relativo para la asociación de las variables de interés. Resultado: la adopción de medidas para el manejo de la congestión mamaria fue superior en el grupo experimental (p = 0.026). La técnica de lactancia adecuada prevaleció entre las mujeres que recibieron la intervención (p = 0,030), especialmente en la posición (RR: 1,39; IC 95%: 1,002-1,94) y agarre (RR: 20,03; IC 95%: 5,2-77,8). Además, el grupo experimental realizó la interrupción de la lactancia de forma adecuada (p <0,001). Conclusión: la educación en salud con el uso de la demostración clínica es eficaz en el manejo de la congestión mamaria, en la técnica adecuada de lactancia materna y conductas protectoras frente a la lactancia materna.

ABSTRACT Objective: to investigate the effectiveness of health education on breastfeeding in prenatal care for the adoption of measures to prevent breast engorgement resulting from breastfeeding. Method: this is a quasi-experimental study with 136 participants. In the experimental group (n = 91) an educational intervention was carried out with clinical demonstration on breastfeeding during pregnancy and reinforcement of guidelines by telephone; the control group (n = 45) received the usual instructions from the Primary Health Care without interference from the research team. For the analysis of the data, inferential descriptive statistics and relative risk for the association of the variables of interest were performed. Result: the adoption of measures to manage breast engorgement was superior in the experimental group (p = 0.026). The adequate breastfeeding technique was prevalent among women who received the intervention (p = 0.030), especially in the position (RR: 1.39; 95% CI: 1.002-1.94) and latching on (RR: 20.03; 95% CI: 5.2-77.8). Also, the experimental group performed the interruption of breastfeeding appropriately (p <0.001). Conclusion: health education with the use of clinical demonstration is effective in the management of breast engorgement, in the appropriate technique of breastfeeding, and protective behaviors against breastfeeding.

Training maternal and child health nurses in early relational trauma: An evaluation of the MERTIL workforce training.

BACKGROUND: Parents who experience relational trauma may inadvertently create contexts of care that undermine secure beginnings to life for their young children. Universal health services such as Maternal and Child Health (MCH) services offer a unique whole-of-population platform for prevention through early detection and intervention. To date however, relevant workforce training has been minimal. OBJECTIVES: We report on an evaluation of state-wide workforce training to support MCH nurses to identify and respond to early relational trauma within parent-child dyads. DESIGN: Process and learning evaluation data were obtained at baseline (N = 1450), exit (n = 734) and follow-up (n = 651). SETTINGS AND PARTICIPANTS: Specialist training was developed and delivered to 1513 MCH staff in Victoria, Australia, via a 20-hour program of online learning and clinical skills workshops. RESULTS: At baseline, across eight measures of confidence in recognizing and responding to relational trauma, 30-49% of nurses rated their confidence as low. Significant increases in all areas of self-rated learning were found post-training. Three months post-training, gains in confidence and capability were sustained, with no significant variations by participant role or setting. Overall program satisfaction was >90%. Continuing concerns at follow-up focused on pragmatic concerns about inadequacy of referral networks and appropriate intervention pathways. CONCLUSIONS: In this evaluation of a state-wide training program for nurses working with early relational trauma, we found excellent uptake and program satisfaction, and results support learning impact and retention. Findings are discussed with regard to translation potential across early childhood settings.

High-Fidelity Simulation and Clinical Judgment of Nursing Students in a Maternal-Newborn Course.

Clinical judgment, one's ability to think like a nurse, is an essential skill for safe nursing practice. With the rise of simulation to replace clinical experiences, there is limited evidence regarding the effectiveness of simulation on the development of clinical judgment. This study explored differences in clinical judgment in maternal-newborn courses between undergraduate nursing students participating exclusively in simulation and those participating in hospital-based clinical experiences. Following completion of the clinical rotation, students participated in an evaluative maternal-newborn high-fidelity simulation experience that was recorded and evaluated using the Lasater's Clinical Judgment Rubric (2007). Lasater's Clinical Judgment Rubric scores between the simulation and clinical practice groups were compared using an independent sample t-test. There was no statistical difference in clinical judgment scores between the simulation and hospital-based clinical groups (t = -1.056, P = .295). Our findings suggest that simulation may be a comparable alternative to clinical experience in nursing education.

Effect of hands-on interprofessional simulation training for local emergencies in Scotland: the THISTLE stepped-wedge design randomised controlled trial.

OBJECTIVE: To assess whether the implementation of an intrapartum training package (PROMPT (PRactical Obstetric Multi-Professional Training)) across a health service reduced the proportion of term babies born with Apgar score <7 at 5 min (<75mins). DESIGN: Stepped-wedge cluster randomised controlled trial. SETTING: Twelve randomised maternity units with ≥900 births/year in Scotland. Three additional units were included in a supplementary analysis to assess the effect across Scotland. The intervention commenced in March 2014 with follow-up until September 2016. INTERVENTION: The PROMPT training package (Second edition), with subsequent unit-level implementation of PROMPT courses for all maternity staff. MAIN OUTCOME MEASURES: The primary outcome was the proportion of term babies with Apgar<75mins. RESULTS: 87 204 eligible births (99.2% with an Apgar score), of which 1291 infants had an Apgar<75mins were delivered in the 12 randomised maternity units. Two units did not implement the intervention. The overall Apgar<75mins rate observed in the 12 randomised units was 1.49%, increasing from 1.32% preintervention to 1.59% postintervention. Once adjusted for a secular time trend, the 'intention-to-treat' analysis indicated a moderate but non-significant reduction in the rate of term babies with an Apgar scores <75mins following PROMPT training (OR=0.79 95%CI(0.63 to 1.01)). However, some units implemented the intervention earlier than their allocated step, whereas others delayed the intervention. The content and authenticity of the implemented intervention varied widely at unit level. When the actual date of implementation of the intervention in each unit was considered in the analysis, there was no evidence of improvement (OR=1.01 (0.84 to 1.22)). No intervention effect was detected by broadening the analysis to include all 15 large Scottish maternity units. Units with a history of higher rates of Apgar<75mins maintained higher Apgar rates during the study (OR=2.09 (1.28 to 3.41)) compared with units with pre-study rates aligned to the national rate. CONCLUSIONS: PROMPT training, as implemented, had no effect on the rate of Apgar <75mins in Scotland during the study period. Local implementation at scale was found to be more difficult than anticipated. Further research is required to understand why the positive effects observed in other single-unit studies have not been replicated in Scottish maternity units, and how units can be best supported to locally implement the intervention authentically and effectively. TRIAL REGISTRATION NUMBER: ISRCTN11640515.

What Do Women Want? Looking Beyond Patient Satisfaction.

OBJECTIVE: To hear the voices of women, their partners, and nurses about expectations and priorities during the postpartum hospitalization. DESIGN: Focus groups using semistructured interview questions. SETTING: A 12-bed labor-delivery-recovery-postpartum unit at a small urban hospital in the U.S. Northeast. PARTICIPANTS: Women who planned to or had given birth, their partners, and the maternity nurses who cared for them. MEASUREMENTS: Qualitative thematic analysis of focus group transcripts. RESULTS: Thematic analysis produced the following themes for women's priorities: Need for individualized attention to maternal physical and emotional care; Fear of providing inadequate care for the newborn, including establishing infant feeding; and Transitioning to parenting as a new mother versus as an experienced mother. Themes for nurses' priorities included Safety issues around sleep and breastfeeding, Transitioning to parenting with an emphasis on maternal self-care, and Addressing barriers to effective discharge education. Response comparisons between the women/partners and nurses suggest that there is a disconnection between women's and nurses' priorities and expectations for care during the postpartum period. CONCLUSION: Women and nurses identified unmet needs in the postpartum period, consistent with the current literature. Providing standardized education during the transitional period around discharge from the hospital to home may not be optimal and may even detract from meeting the needs for rest and connection with family and the health care team. Nursing care that extends beyond the maternity hospitalization may be needed to individualize care and meet previously unmet needs.

Traditional clinical training combined with high-fidelity simulation-based activities improves clinical competency and knowledge among nursing students on a maternity nursing course.

BACKGROUND: Providing adequate and quality clinical training to student nurses is a major issue in nursing education. In the Middle East, this issue is more prominent because providing intimate healthcare to women in maternity nursing, especially by male nursing students, remains a challenge. PURPOSE: This study compared the effects of a combination of traditional clinical training with high-fidelity simulation (TCT+HFS) activities vs TCT alone on the clinical competency and knowledge among students enrolled in a maternity nursing course in a Middle Eastern public university. METHOD: A quasi-experimental research design was adopted in the study. The sample consisted of 74 students (40 in the TCT group and 34 in the TCT+HFS group) from a cohort of nursing students in a Middle Eastern university. The Creighton Competency Evaluation Instrument and a 29-item, researcher-designed knowledge scale was used to measure the relevant outcomes. RESULTS: No significant difference was observed in the knowledge (F = 1.064, P = 0.306) or clinical competency scores (F = 0.168, P = 0.683) between the TCT+HFS group and the TCT group. CONCLUSION: Substituting 25% of the clinical hours with HFS may yield similar learning outcomes (knowledge and clinical competency) as TCT.

The impact of the using high-fidelity simulation and standardized patients to management of postpartum hemorrhage in undergraduate nursing students: A randomized controlled study in Turkey.

We examined the efficiency of different simulation methods for the improvement of knowledge and skills of nursing students in the management of postpartum hemorrhage. A total of 84 nursing students participated in the study. Data were obtained using a Semi-Structured Questionnaire Form, Student Satisfaction Evaluation Form, Effective Communication Skills Checklist, Spielberger's State-Trait Anxiety Inventory, and Skills Evaluation Form for Postpartum Bleeding Management. We suggest that the use of different simulation methods may be effective in improving the knowledge and skills of nursing students in the management of postpartum hemorrhage.

First week of integral health for the newborn: nursing actions of the Family Health Strategy. / Primeira semana saúde integral do recém-nascido: ações de enfermeiros da Estratégia Saúde da Família.

OBJECTIVE: To describe the nurses' actions of the Family Health Strategy about the First Week for Integral Health regarding the care devoted to the newborn. METHOD: It is a descriptive, exploratory research with qualitative approach carried out from October 2014 to February 2015, through a semi-structured interview, with nine nurses from the Family Health Strategy of João Pessoa-PB. Data were submitted to thematic analysis. RESULTS: The actions identified at the first visit to the newborn child are based on maternal guidance on basic newborn care, breastfeeding, neonatal screening, immunization and childcare, as well as evaluation of the puerperal, but it was sometimes performed outside the period recommended and with incomplete and outdated guidelines. CONCLUSION: Although there are potentialities in nurses' actions to this population, the fragilities compromise the care of the newborn and the puerperium, and it is necessary to sensitize these professionals about the importance and effectiveness of First Week for Integral Health.

Strategies to Overcome Gender Bias in Maternity Nursing.

Male nurses and nursing students who work in maternity care often experience role strain, reverse discrimination, and gender bias. There are various strategies that clinical instructors, floor nurses, nursing school faculty, and nurse managers can implement to help maintain gender equality in maternity nursing while still considering how to honor the wishes of some women who may be uncomfortable with a male presence.

Enhancing communication skills for telehealth: development and implementation of a Teach-Back intervention for a national maternal and child health helpline in Australia.

BACKGROUND: Telehealth professionals require advanced communication skills, in part to compensate for lack of visual cues. Teach-Back is a best practice communication technique that has been recommended but not previously evaluated for consumer telehealth. We aimed to implement Teach-Back at a national maternal and child health telephone helpline. We describe the intervention and report telenurse experiences learning to use Teach-Back. METHODS: We identified barriers (time, knowledge, skills, beliefs) and enablers (self-reflection) to using Teach-Back, and developed a novel training program to address these, guided by the Theoretical Domains Framework. We engaged maternal and child health telenurses to participate in a "communication skills" study. The intervention had two key components: guided self-reflection and a Teach-Back skills workshop. For the duration of the 7-week study nurses completed brief online surveys following each call, reflecting on both the effectiveness of their communication and perceived caller understanding. At the end of each shift they reflected on what worked well. Teach-Back knowledge, skills, and beliefs were addressed in a 2-h workshop using videos, discussion, and role play. We explored nurses' experiences of the intervention in focus groups and interviews; and analysed transcripts and comments from the self-reflection surveys using the Framework method. This study forms part of a larger evaluation conducted in 2016. RESULTS: In total 16 nurses participated: 15 were trained in Teach-Back, and 13 participated in focus groups or interviews. All engaged with both self-reflection and Teach-Back, although to differing extents. Those who reported acquiring Teach-Back skills easily limited themselves to one or two Teach-Back phrases. Nurses reported that actively self-reflecting (including on what they did well) was useful both for developing Teach-Back skills and analysing effectiveness of the techniques. Most wanted more opportunity to learn how their colleagues manage Teach-Back in different situations, and more visual reminders to use Teach-Back. CONCLUSIONS: Our theory-informed intervention successfully enabled nurses to use Teach-Back. Guided self-reflection is a low-resource method aligned with nurse professional identity that can facilitate Teach-Back skills learning, and could also be applied to other advanced communication skills for telehealth. Listening to multiple workplace-specific examples of Teach-Back is recommended for future training. TRIAL REGISTRATION: ACTRN12616000623493 Registered 15 May 2016. Retrospectively registered.

Primeira semana saúde integral do recém-nascido: ações de enfermeiros da Estratégia Saúde da Família / Primera semana salud integral del recién-nacido: acciones de enfermeros de la Estrategia Salud de la Familia / First week of integral health for the newborn: nursing actions of the Family Health Strategy

Resumo OBJETIVO Descrever as ações de enfermeiros da Estratégia Saúde da Família acerca da Primeira Semana Saúde Integral no cuidado ao recém-nascido. MÉTODO Pesquisa descritiva, exploratória com abordagem qualitativa realizada de outubro de 2014 a fevereiro de 2015, por meio de entrevista semiestruturada, com nove enfermeiros da Estratégia Saúde da Família de João Pessoa-PB. Os dados foram submetidos à análise temática. RESULTADOS As ações identificadas na primeira visita ao bebê se baseiam nas orientações maternas acerca dos cuidados básicos ao recém-nascido, aleitamento materno, testes de triagem neonatal, imunização e puericultura, bem como avaliação da puérpera, no entanto, por vezes eram realizadas fora do período recomendado e com orientações incompletas e desatualizadas. CONCLUSÃO Embora haja potencialidades nas ações dos enfermeiros prestadas a essa população, as fragilidades comprometem a assistência ao neonato e à puérpera, sendo necessário sensibilizar esses profissionais acerca da importância e eficácia da Primeira Semana Saúde Integral.

Resumen OBJETIVO Describir las acciones de enfermeros de la Estrategia Salud de la Familia acerca de la Primera Semana Salud Integral en la atención al recién-nacido. MÉTODO Investigación descriptiva, exploratoria con abordaje calitativo, realizada de octubre de 2014 hacia febrero de 2015, por medio de entrevista semiestructurada, con nueve enfermeros de la Estrategia Salud de la Familia de João Pessoa-PB. Los datos fueron sometidos al análisis temático. RESULTADOS Las acciones identificadas en la primera visita al bebé se basan en las orientaciones maternas sobre los cuidados básicos al recién nacido, la lactancia materna, las pruebas de selección neonatal, la inmunización y la puericultura, así como la evaluación de la puérpera, pero a veces se realizaban fuera del período recomendado y con directrices incompletas y obsoletas. CONCLUSIÓN Aunque hay potencialidades en las acciones de los enfermeros prestadas a esa población, las fragilidades comprometen la asistencia al neonato y a la puérpera, siendo necesario sensibilizar a esos profesionales acerca de la importancia y eficacia de la Primera Semana Salud Integral.

Abstract OBJECTIVE To describe the nurses' actions of the Family Health Strategy about the First Week for Integral Health regarding the care devoted to the newborn. METHOD It is a descriptive, exploratory research with qualitative approach carried out from October 2014 to February 2015, through a semi-structured interview, with nine nurses from the Family Health Strategy of João Pessoa-PB. Data were submitted to thematic analysis. RESULTS The actions identified at the first visit to the newborn child are based on maternal guidance on basic newborn care, breastfeeding, neonatal screening, immunization and childcare, as well as evaluation of the puerperal, but it was sometimes performed outside the period recommended and with incomplete and outdated guidelines. CONCLUSION Although there are potentialities in nurses' actions to this population, the fragilities compromise the care of the newborn and the puerperium, and it is necessary to sensitize these professionals about the importance and effectiveness of First Week for Integral Health.

Student and educator experiences of maternal-child simulation-based learning: a systematic review of qualitative evidence.

BACKGROUND: Although maternal-child care is a pillar of primary health care, there is a global shortage of maternal-child health care providers. Nurse educators experience difficulties providing undergraduate students with maternal-child learning experiences for a number of reasons. Simulation has the potential to complement learning in clinical and classroom settings. Although systematic reviews of simulation are available, no systematic reviews of qualitative evidence related to maternal-child simulation-based learning (SBL) for undergraduate nursing students and/or educators have been located. OBJECTIVES: The aim of this systematic review was to identify the appropriateness and meaningfulness of maternal-child simulation-based learning for undergraduate nursing students and nursing educators in educational settings to inform curriculum decision-making. The review questions are: INCLUSION CRITERIA TYPES OF PARTICIPANTS: Pre-registration or pre-licensure or undergraduate nursing or health professional students and educators. PHENOMENA OF INTEREST: Experiences of simulation in an educational setting with a focus relevant to maternal child nursing. TYPES OF STUDIES: Qualitative research and educational evaluation using qualitative methods. CONTEXT: North America, Europe, Australia and New Zealand. SEARCH STRATEGY: A three-step search strategy identified published studies in the English language from 2000 until April 2016. METHODOLOGICAL QUALITY: Identified studies that met the inclusion criteria were retrieved and critically appraised using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) by at least two independent reviewers. Overall the methodological quality of the included studies was low. DATA EXTRACTION: Qualitative findings were extracted by two independent reviewers using JBI-QARI data extraction tools. DATA SYNTHESIS: Findings were aggregated and categorized on the basis of similarity in meaning. Categories were subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings. RESULTS: Twenty-two articles from 19 studies were included in the review. A total of 112 findings were extracted from the included articles. Findings were grouped into 15 categories created on the basis of similarity of meaning. Meta-synthesis of these categories generated three synthesized findings.Synthesized finding 1 Students experienced simulated learning experiences (SLE) as preparation that enhanced their confidence in practice. When simulation was being used for evaluation purposes many students experienced anxiety about the SLE.Synthesized finding 2 Pedagogical practices thought to be appropriate and meaningful included: realistic, relevant and engaging scenarios, a safe non-threatening learning environment, supportive guidance throughout the process, and integration with curriculum.Synthesized finding 3 Barriers and enablers to incorporating SLEs into maternal child education were identified including adequate resources, technological support and faculty development. Students and educators recognized that some things, such as relationship building, could not be simulated. CONCLUSIONS: Students felt that simulation prepared them for practice through building their self-confidence related to frequently and infrequently seen maternal-child scenarios. Specific pedagogical elements support the meaningfulness of the simulation for student learning. The presence or absence of resources impacts the capacity of educators to integrate simulation activities throughout curricula.

Using Quantitative Literacy to Enhance Critical Thinking Skills in Undergraduate Nursing Students.

BACKGROUND: Critical thinking and quantitative literacy (QL) are similarly grounded: both focus on analyzing and evaluating evidence, identifying implications and consequences, drawing inferences, and communicating information. This teaching strategy was based on those commonalities and was designed so that undergraduate nursing students would enhance their critical thinking skills as they used their QL skills. METHOD: QL skills are most effective when taught, learned, and used to solve significant, pertinent problems. Using the principles of learner-centered, team-based learning, QL was integrated into the curriculum of the Maternal-Newborn Nursing course at an urban community college with a diverse student population. RESULTS: Students were engaged and demonstrated enhanced and ongoing development of their critical thinking and problem-solving skills. They also reported a better understanding of data interpretation and use. CONCLUSION: The positive outcome of this project revealed further opportunities for incorporating QL into nursing curricula and highlighted the need for research on the use of QL in nursing education. [J Nurs Educ. 2017;56(4):240-242.].

Adaptation of non-technical skills behavioural markers for delivery room simulation.

BACKGROUND: Simulation in healthcare has proved to be a useful method in improving skills and increasing the safety of clinical operations. The debriefing session, after the simulated scenario, is the core of the simulation, since it allows participants to integrate the experience with the theoretical frameworks and the procedural guidelines. There is consistent evidence for the relevance of non-technical skills (NTS) for the safe and efficient accomplishment of operations. However, the observation, assessment and feedback on these skills is particularly complex, because the process needs expert observers and the feedback is often provided in judgmental and ineffective ways. The aim of this study was therefore to develop and test a set of observation and rating forms for the NTS behavioural markers of multi-professional teams involved in delivery room emergency simulations (MINTS-DR, Multi-professional Inventory for Non-Technical Skills in the Delivery Room). METHODS: The MINTS-DR was developed by adapting the existing tools and, when needed, by designing new tools according to the literature. We followed a bottom-up process accompanied by interviews and co-design between practitioners and psychology experts. The forms were specific for anaesthetists, gynaecologists, nurses/midwives, assistants, plus a global team assessment tool. We administered the tools in five editions of a simulation training course that involved 48 practitioners. Ratings on usability and usefulness were collected. RESULTS: The mean ratings of the usability and usefulness of the tools were not statistically different to or higher than 4 on a 5-point rating scale. In either case no significant differences were found across professional categories. CONCLUSION: The MINTS-DR is quick and easy to administer. It is judged to be a useful asset in maximising the learning experience that is provided by the simulation.

A Qualitative Study to Explore the Male Nursing Student's Coping with Experiences in a Maternal-Newborn Nursing Course.

Nursing today is predominantly a female profession; however, men are reentering the profession in record numbers and challenging the perspective that they are inappropriate in caregiver roles, or incapable of providing compassionate and sensitive care. This study investigated the perceptions and experiences of male nursing students in a maternal-newborn nursing course and their coping strategies in dealing with the clinical rotation role stress. A purposive sample included 11 male nursing students who completed a survey, and 6 out of the 11 participated in individual interviews. Written responses and verbatim audio narratives were analyzed using qualitative content analysis to identify themes that described their perceptions and experiences. The results identified 7 themes, suggesting a need for nurse educators to develop theory-guided instructional strategies to support male nursing students' academic goals, which may be at stake because of the maternity learning environment.

Breastfeeding Curricular Content of Family Nurse Practitioner Programs.

INTRODUCTION: Health care provider support is essential for breastfeeding success. Family Nurse Practitioners (FNP) are in a unique position to promote and manage breastfeeding. There is a gap in the literature regarding the amount and type of breastfeeding curricular content in FNP programs. METHOD: An online survey of FNP programs was conducted. Data collection included program descriptors, didactic breastfeeding coursework, and clinical breastfeeding opportunities available to students. RESULTS: No programs offered courses specific to breastfeeding: 82% of programs devoted 1 to 2 hours of didactic lactation content. More than three quarters of the programs offered students breastfeeding counseling opportunities; no programs, however, identified specific breastfeeding clinical competencies. DISCUSSION: FNPs can play an integral role in breastfeeding promotion and counseling. There appears to be a lack of education provided to FNPs regarding breastfeeding management. Creative approaches that incorporate lactation education into FNP programs may increase FNPs' breastfeeding knowledge and enhance their ability to provide support to breastfeeding families.

Tecnologia educacional para a prevenção da infecção urinária na gravidez: estudo descritivo / Educational technology for the prevention of urinary tract infections during pregnancy: a descriptive study

Problema: a infecção do trato urinário é uma das principais afecções ocorridas no período gravídico, sendo causadora de importantes complicações materno-fetais que podem levar à morte. Objetivos: aplicar uma cartilha educativa sobre a prevenção da infecção urinária em um grupo de gestantes e analisar os problemas de enfermagem relacionados à ocorrência desse agravo. Método: estudo descritivo, qualitativo, realizado com 15 gestantes em uma unidade de Saúde da Família de Petrópolis/RJ, em abril de 2015. Os dados foram coletados por entrevistas ­ individual e grupal ­ e analisados por meio da técnica de triangulação dos dados. Resultado: a aplicação da cartilha evidenciou problemas de enfermagem relacionados à higiene, à alimentação, à ingestão hídrica, à eliminação intestinal e urinária, e ao coito. Conclusão: o uso da tecnologia impressa é uma importante ferramenta de discussão e aprendizado no processo de educação em saúde, e qualifica a prática assistencial do enfermeiro. (AU)

Problem: urinary tract infections are one of the main conditions that occur in the pregnancy period, causing important maternal-fetal complications that can lead to death. Aims: to implement an educational booklet on the prevention of urinary tract infections in a group of pregnant women and analyze the nursing problems related to the occurrence of this disease. Method: a descriptive, qualitative study with fifteen pregnant women at a Family Health Unit in Petrópolis, RJ, Brazil in April, 2015. Data was collected through interviews - individual and group - and was analyzed using the data triangulation technique. Results: the application of the booklet revealed nursing problems related to hygiene, food, water intake, intestinal and urinary elimination and coitus. Conclusion: the use of printed technology is an important tool for discussion and learning in the health education process, and it can be used to qualify the nurses' care practice. (AU)