Expectations and experiences of nursing students in supporting new mothers to breastfeed: A descriptive qualitative study.

BACKGROUND: Improving breastfeeding support to mothers has been the focus of several national and international health organisations. There is evidence that theoretical and clinical education improves breastfeeding knowledge and attitudes among nursing and other health professional students prior to clinical placement, to support women who are breastfeeding. AIMS AND OBJECTIVES: To explore the expectations and experiences of Taiwanese nursing students in supporting breastfeeding on clinical placement. To gain additional insight into student experience, we also sought the perspectives of mothers, nursing staff and teachers about the role of nursing students in supporting breastfeeding mothers. DESIGN: A qualitative descriptive approach guided this study. METHODS: Focus groups and small group interviews were conducted with four participant groups in southern Taiwan. Ethical approval was obtained prior to data collection. The consolidated criteria for reporting qualitative research checklist was used. FINDINGS: Three main themes emerged from the data that captured the nursing students' experiences during clinical practice, which were "High expectations"; "The reality is different"; and "Improving confidence in students." The study found that students lacked confidence in supporting breastfeeding in the clinical setting. Students were expected to support women to achieve their breastfeeding goals under the supervision. The students highlighted the importance of establishing trust to effectively support mothers, and for the students to feel confident to provide the breastfeeding information. CONCLUSIONS: Despite structured theoretical breastfeeding education prior to clinical placement, students did not feel they were adequately prepared to support women who are breastfeeding during their clinical placement. The findings demonstrated the need for further support in developing effective communication skills and building confidence prior to clinical placement. RELEVANCE TO CLINICAL PRACTICE: Enhancing the content of theoretical and simulated breastfeeding education to incorporate women's breastfeeding experience combined with realistic clinical student allocation could serve to improve students' confidence in supporting breastfeeding.

Breastfeeding knowledge and attitudes of baccalaureate nursing students in Taiwan: A cohort study.

BACKGROUND: Optimal nutrition during the first year of life is critical to infants' healthy growth and development. Hence, it is vital that undergraduate health professional curricula provide good quality learning environments to enable students to acquire the necessary knowledge and skills to support breastfeeding mothers. AIMS: To examine the change in knowledge and attitude in Taiwanese nursing students following theoretical and clinical learning experiences on breastfeeding. METHODS: This study used a pre-test/post-test survey design with two cohorts of nursing students (N=215). Knowledge and attitude were assessed before and after: (a) theoretical (didactic and skills laboratory) education in Cohort One, and (b) clinical placement in Cohort Two. FINDINGS: Students in both cohorts demonstrated significant improvements in knowledge and attitude post-theoretical education, and post-clinical placement. Prior to theoretical education in Cohort One, those with experience of close family members being breastfed were more than 14 times (adjusted odds ratio: 14.09, 95% confidence interval: 1.73-114.64) to be in the high knowledge group. However, following theoretical or clinical education, there were no sociodemographic group differences in breastfeeding knowledge or attitude in Cohorts One or Two. CONCLUSION: Results revealed that the current breastfeeding education program in Taiwan, both theoretical and clinical components, increased nursing students' knowledge and improved positive attitudes towards breastfeeding, and any sociodemographic differences in knowledge and attitude about breastfeeding were ameliorated following theoretical and clinical placement experience focused on breastfeeding.

The development of the own-race advantage in school-age children: A morphing face paradigm.

Previous studies examining the other-race effect in school-age children mostly focused on recognition memory performance. Here we investigated perceptual discriminability for Asian-like versus Caucasian-like morph faces in school-age Taiwanese children and adults. One-hundred-and-two 5- to 12-year-old children and twenty-three adults performed a sequential same/different face matching task, where they viewed an Asian- or a Caucasian-parent face followed by either the same parent face or a different morphed face (containing 15%, 30%, 45%, or 60% contribution from the other parent face) and judged if the two faces looked the same. We computed the d' as the sensitivity index for each age groups. We also analyzed the group mean rejection rates as a function of the morph level and fitted with a cumulative normal distribution function. Results showed that the adults and the oldest 11-12-year-old children exhibited a greater sensitivity (d') and a smaller discrimination threshold (µ) in the Asian-parent condition than those in the Caucasian-parent condition, indicating the presence of an own-race advantage. On the contrary, 5- to 10-year-old children showed an equal sensitivity and similar discrimination thresholds for both conditions, indicating an absence of the own-race advantage. Moreover, a gradual development in enhancing the discriminability for the Asian-parent condition was observed from age 5 to 12; however, the progression in the Caucasian-parent condition was less apparent. In sum, our findings suggest that expertise in face processing may take the entire childhood to develop, and supports the perceptual learning view of the other-race effect-the own-race advantage seen in adulthood likely reflects a result of prolonged learning specific to faces most commonly seen in one's visual environment such as own-race faces.

Validation of the Chinese Version of the Australian Breastfeeding Attitude Questionnaire.

BACKGROUND: The Australian Breastfeeding Knowledge and Attitude Questionnaire-Short Form (ABKAQ-SF) was designed to measure breastfeeding knowledge and attitudes of health professionals. To date, a Chinese version of the attitude component of the ABKAQ-SF (ABAQ) is not yet available and has not been cross-validated with nursing students. Research aims: This study aimed to examine (a) the psychometric properties of the ABAQ and (b) group differences and responsiveness of the revised 12-item ABAQ (ABAQ12) among nursing students in Taiwan. METHODS: Using a cross-sectional two-cohort study design, nursing students in Years 2 and 3 of a 4-year bachelor of nursing program ( N = 205) completed the Chinese version of the ABAQ, translated using forward and backward translations. Content validity, internal consistency reliability, construct validity, group differences, and responsiveness of the Chinese version of the ABAQ were assessed. RESULTS: Using the principal axis factoring procedure of exploratory factor analysis to examine the dimensionality of the ABAQ, a one-component structure was identified. Six items were deleted, based on the average interitem correlation (< 0.2), low corrected item-total correlation (< 0.35), and low factor loading (< 0.3). Confirmatory factor analysis of the ABAQ12 supported a one-factor solution, with good overall model fit (goodness-of-fit index = 0.949, Tucker-Lewis index = 0.951, comparative fit index = 0.965, root mean square error of approximation = 0.042). Responsiveness of the ABAQ12 scores indicated a positive change in breastfeeding attitude between the pre- and postclinical placement period. CONCLUSION: The Chinese version of the ABAQ12 is valid, reliable, and responsive and is suitable for assessing the breastfeeding attitudes of nursing students in the Taiwanese higher education settings.

Breastfeeding knowledge and attitudes of health professional students: a systematic review.

BACKGROUND: Breastfeeding support from health professionals can be effective in influencing a mother's decision to initiate and maintain breastfeeding. However, health professionals, including nursing students, do not always receive adequate breastfeeding education during their foundational education programme to effectively help mothers. In this paper, we report on a systematic review of the literature that aimed to describe nursing and other health professional students' knowledge and attitudes towards breastfeeding, and examine educational interventions designed to increase breastfeeding knowledge and attitudes amongst health professional students. METHODS: A systematic review of peer reviewed literature was performed. The search for literature was conducted utilising six electronic databases, CINAHL, MEDLINE, ProQuest, PubMed, Scopus, and Cochrane, for studies published in English from January 2000 to March 2017. Studies focused on nursing students' or other health professional students' knowledge, attitudes or experiences related to breastfeeding. Intervention studies to improve knowledge and attitudes, were also included. All papers were reviewed using the relevant Critical Appraisal Skills Programme (CASP) checklist. RESULTS: Fourteen studies were included in the review. This review indicates that in some settings, health professional students demonstrated mid-range scores on breastfeeding attitudes, and their knowledge of breastfeeding was limited, particularly in relation to breastfeeding assessment and management. All of the studies that tested a specialised breastfeeding education programme, appeared to increase nursing students' knowledge overall or aspects of their knowledge related to breastfeeding. Several factors were found to influence breastfeeding knowledge and attitudes, including timing of maternal and child health curriculum component, previous personal breastfeeding experience, gender, cultural practices and government legislation. CONCLUSIONS: Based on this review, it appears that nursing curriculum, or specialised programmes that emphasise the importance of breastfeeding initiation, can improve breastfeeding knowledge and attitudes and students' confidence in helping and guiding breastfeeding mothers.

Grief reactions of couples to perinatal loss: A one-year prospective follow-up.

AIMS AND OBJECTIVES: To explore couples' perceptions of the effects of perinatal loss on their marital relationship, social support and grief 1 year postloss, and analyse what factors changed the severity of their grief. BACKGROUND: Perinatal losses are traumatic events in the lives of families and can have serious long-term consequences for the psychological health of parents and any subsequent children. DESIGN: A prospective follow-up study. METHODS: We recruited, at a teaching hospital in southern Taiwan, a convenience sample of 30 couples whose babies either miscarried or were stillborn. At 1 month (T1), 3 months (T2), 6 months (T3) and 1 year (T4) after the pregnancy loss, all participants completed four questionnaires. To analyse the changing status of their grief and its related factors, we used a generalised estimating equation (GEE) to account for correlations between repeated observations. RESULTS: Postbereavement grief levels fell over the four time-points. Mothers reported feeling more grief than did the fathers. Couples with a history of infertility, no religious beliefs or no living children before the loss felt more grief from a perinatal miscarriage or stillbirth. Furthermore, couples reported more grief if their marital satisfaction level was low, if their socioemotional support from husband's parents was low or if they had never participated in a ritual for their deceased baby. CONCLUSIONS: Six months postloss is the crucial period for bereaved parents after a perinatal loss. Being a mother, having no previous living children and low-level socioemotional support from the husband's parents are significant high-risk factors for a high level of grief 1 year after perinatal death. RELEVANCE TO CLINICAL PRACTICE: We recommend that health professionals increase their ability to identify the factors that psychologically affect postloss grief. Active postloss follow-up programmes should focus on these factors to offer specific support and counselling.

Protective Effect of Tang Wang One Decoction on the Retinal Vessels of Diabetic Rats.

Objective. This study aimed to determine the influence of Tang Wang One Decoction (TWOD) on the retinal vessels of diabetic rats. Methods. The hemorheology of diabetic rats was observed. Morphological studies of retinal vessels were conducted using optical microscopy and electron microscopy. Immunological histochemistry assay was used to measure the expression levels of MMP-9, occludin, and claudin-5. Results. Obvious pathological damage was observed in the retinal vessels of diabetic rats. TWOD positively affected the hemorheology and morphology of retinal vessels. The decoction also decreased the expression of MMP-9 and increased the expression of occludin and claudin-5. Conclusions. The results suggest that the retinal protective effects of TWOD might be related to downregulation of MMP-9 and upregulation of occludin and claudin-5.

Bacterial Flora Changes in Conjunctiva of Rats with Streptozotocin-Induced Type I Diabetes.

BACKGROUND: The microbiota of both humans and animals plays an important role in their health and the development of disease. Therefore, the bacterial flora of the conjunctiva may also be associated with some diseases. However, there are no reports on the alteration of bacterial flora in conjunctiva of diabetic rats in the literature. Therefore, we investigated the changes in bacterial flora in bulbar conjunctiva of rats with streptozotocin (STZ)-induced type I diabetes. METHODS: A high dose of STZ (60 mg/kg, i.p.) was injected into Sprague-Dawley (SD) rats to induce type I diabetes mellitus (T1DM). The diabetic rats were raised in the animal laboratory and at 8 months post-injection of STZ swab samples were taken from the bulbar conjunctiva for cultivation of aerobic bacteria. The bacterial isolates were identified by Gram staining and biochemical features. The identified bacteria from both diabetic and healthy rats were then compared. RESULTS: The diabetic and healthy rats had different bacterial flora present in their bulbar conjunctiva. In total, 10 and 8 bacterial species were found in the STZ and control groups, respectively, with only three species (Enterococcus faecium, Enterococcus gallinarum and Escherichia coli) shared between the two groups. Gram-positive bacteria were common in both groups and the most abundant was Enterococcus faecium. However, after the development of T1DM, the bacterial flora in the rat bulbar conjunctiva changed considerably, with a reduced complexity evident. CONCLUSIONS: STZ-induced diabetes caused alterations of bacterial flora in the bulbar conjunctiva in rats, with some bacterial species disappearing and others emerging. Our results indicate that the conjunctival bacterial flora in diabetic humans should be surveyed for potential diagnostic markers or countermeasures to prevent eye infections in T1DM patients.

Clinical Efficacy Observation of Acupuncture Treatment for Nonarteritic Anterior Ischemic Optic Neuropathy.

Objective. To determine whether acupuncture treatment impacts the clinical efficacy of degenerative damage of the optic nerve caused by nonarteritic anterior ischemic optic neuropathy (NAION). Methods. 69 patients (93 eyes) with NAION who had been treated by acupuncture which is performed on different acupoints related to eyes by vertical insertion or Fingernail-pressure needle insertion. The best corrected visual acuity, mean defect (MD) and mean light sensitivity (MS) of the visual field, and latency and amplitude of pattern visual evoked potential (P-VEP) were compared before and after treatment. Results. After 2, 4, and 8 weeks of treatment, the total effective rates of visual acuity improvement were 74.19%, 78.89%, and 81.71%, respectively, and the decreased MD and increased MS were both statistically significant (P < 0.01). When compared with the situation before treatment, the average latency of the P100 wave was significantly reduced (P < 0.05), and the average amplitude was improved with no statistically significant difference (P > 0.05). Conclusions. Acupuncture treatment could obviously improve the visual function of patients with NAION and be used as complementary and alternative therapy in clinic.