Child Health Nurses' Acceptance and Use of a Novel Telehealth Platform: A Mixed-Method Study.

Telehealth appointments in the healthcare sector have increased since the COVID-19 pandemic, increasing patients' access to services. However, research exploring nurse perceptions of implemented telehealth services in the community sector is limited. Within the context of quality improvement, the current study aimed to understand child health nurses' acceptance and use of a novel telehealth platform using mixed methods. A total of 38 child health nurses completed an online survey that included multiple-choice questions based on an expanded Technology Acceptance Model and open-ended questions exploring barriers and facilitators to use. Results demonstrated that despite 70% of nurse users having completed less than three sessions with parents, perception and acceptance scores were high. Overall, 85% of variance in satisfaction with the platform and 46% of variance in intention to use the platform were predicted by perception scores. Three consistent themes generated from data were facilitators for use and five as barriers, which provided further understanding to findings. To ensure telehealth is adapted into routine clinical care, facilitators and barriers for implementation need to be identified and addressed. Nurses need to be engaged in implementation and ongoing maintenance to ensure the uptake and optimal use of technology within nursing care.

Understanding the experiences of mothers who are breastfeeding an infant with tongue-tie: a phenomenological study.

BACKGROUND: Tongue-tie or ankyloglossia is a congenital condition that negatively affects breastfeeding. The thickened, tightened, or shortened frenulum affects the infant's ability to suck and frequently results in sore and painful nipples. Although several studies have investigated outcomes associated with treatment of tongue-tie, none have investigated mothers' experiences of breastfeeding an infant with tongue-tie. OBJECTIVE: This study aimed to understand the breastfeeding experiences of women whose infants have tongue-tie. METHODS: A hermeneutic phenomenological design was employed. Data were collected using focused interviews and, following transcription, were analyzed in the phenomenological tradition. Ten women who presented at a breastfeeding clinic with feeding problems, and were diagnosed with tongue-tie, were interviewed on 2 occasions. RESULTS: The analysis revealed a common story of tension between the mothers' expectations and the breastfeeding challenges they faced. Their journey was characterized by 6 distinct phases described in the following themes: Expectations; Something is wrong; Questioning, seeking advice, no real answers; Symptoms and perseverance; Approaching the wall-it's all too much; and finally, Relief. CONCLUSION: The women in this study described a somewhat harrowing journey, which was at odds with the natural experience they had anticipated. They encountered health professionals who were found to have limited knowledge of tongue-tie and its potential effect on breastfeeding and were unable to provide appropriate advice concerning their breastfeeding difficulties. However, following treatment with frenotomy, their breastfeeding experience improved dramatically. The reported incidence of tongue-tie is significant, and early identification and prompt and effective management would contribute to improved breastfeeding.

Tongue-tie and breastfeeding: a review of the literature.

In Australia, initial exclusive breastfeeding rates are 80%, reducing to 14% at 6 months. One factor that contributes to early breastfeeding cessation is infant tongue-tie, a congenital abnormality occurring in 2.8-10.7% of infants, in which a thickened, tightened or shortened frenulum is present. Tongue-tie is linked to breastfeeding difficulties, speech and dental problems. It may prevent the baby from taking enough breast tissue into its mouth to form a teat and the mother may experience painful, bleeding nipples and frequent feeding with poor infant weight gain; these problems may contribute to early breastfeeding cessation. This review of research literature analyses the evidence regarding tongue-tie to determine if appropriate intervention can reduce its impact on breastfeeding cessation, concluding that, for most infants, frenotomy offers the best chance of improved and continued breastfeeding. Furthermore, studies have demonstrated that the procedure does not lead to complications for the infant or mother.