Exploring Tandem Breastfeeding Motivations Via Self-Determination Theory: An Interpretative Phenomenological Study.

BACKGROUND: Tandem breastfeeding is defined as a situation in which a mother continues breastfeeding her child through a subsequent pregnancy, including after the new baby is born. In some countries where motherhood may be delayed and the time between births may be reduced, support for the promotion of tandem breastfeeding is necessary to help mothers continue to breastfeed their eldest child and avoid early weaning. There is no existing research about mothers' motivations to breastfeed in tandem. RESEARCH AIM: To explore the motivations of women to initiate and maintain tandem breastfeeding, based on their lived experience, framed within the self-determination theory. METHODS: A prospective, cross-sectional, interpretive, phenomenological study was carried out through in-depth interviews with 15 mothers in Madrid, who had practiced tandem breastfeeding for more than 6 months, and whose weaning of their eldest child had occurred within the previous year. Convenience and snowball sampling were used. The data were analyzed using an established interpretive phenomenological analysis process. RESULTS: Among the motivations for initiating tandem breastfeeding, the following themes were identified: "avoid wasting the effort invested," "desire such life experience," and "exercise the freedom to decide." The motivations for maintaining tandem breastfeeding were classified as "pass on parenting values" and "benefits of teamwork." CONCLUSION: The participants based their motivation to tandem breastfeed to follow their freely chosen motherhood model. They discovered the advantages of its implementation, forming a team of themselves and their children, and healing their traumatic perinatal experiences.

Exploring Knowledge about Fang Traditional Medicine: An Informal Health Seeking Behaviour for Medical or Cultural Afflictions in Equatorial Guinea.

This study explores a range of informal health-seeking behaviors, including the use of Fang Traditional Medicine (FTM) for medical or cultural afflictions in Equatorial Guinea (EQ), the therapeutic methods used, the health problems handled, the learning process, traditional medicine user profiles and the social images of Fang Traditional Healers (FTHs). Ethnography was employed as a qualitative strategy using emic-etic approaches. Semi-structured interviews were conducted with 45 individuals, including 6 community leaders, 19 tribal elders, 7 healthcare professionals, 11 FTHs and 2 relatives of traditional healers in 5 districts of EQ. FTM offers a cure for malaria and treatments for reproductive health issues, bone fractures and cultural illnesses. Several methods used to learn FTM are based on empirical observation, and without the need for traditional schooling, unlike with Western medical professionals: for example, watching a family member, or the spirits or ancestors, can reveal healing knowledge. Materials from forests, including tree barks and plants, and rituals are used to keep Fang populations healthy; in addition, two rituals known as "osuiñ" and "etoak" (infusions of tree barks with the blood of sacrificed animals) are the most commonly used treatments. In addition, elders and women are the most active consumers of FTM. FTM plays a relevant role in curing medical and cultural afflictions in Fang communities. The informal health-seeking behavior among the Fang community is conditioned by the explanation model of illness.

Stressors and difficulties perceived during the pandemic in the teaching activity of nursing professors.

Background: The coronavirus 2019 (COVID-19) pandemic has prompted several changes in teaching methods in addition to the ways of learning by students. Objective: To check whether a relationship between factors, such as resilience, self-esteem, depression, anxiety, academic stressors, and a change in teaching methods and learning since the first epidemic outbreak exists. Materials and methods: This study was a cross-sectional descriptive one with a non-random sample of nursing degree teachers who did or did not participate in clinical activities but had been teaching online since the start of the pandemic. Data were collected with online questionnaires validated for self-completion with Google Forms. Results: Regarding the analysis of the descriptive data of each scale, we can verify that data indicate very high levels of resilience and self-esteem in the normal range with minimal levels of depression, moderate anxiety, and finally not worrying about sources of stress in teachers. Also, negative correlations were found between the 10 Connor-Davidson Resilience Scale, Beck Depression Inventory (BDI 2), Beck Anxiety Inventory (BAI), and Scale of Sources of Stress in Teachers with a statistical significance of p < 0.001. The Rosenberg Self-Esteem Scale also showed negative correlations with the three previously mentioned scales with a statistical significance of p < 0.001. Finally, positive correlations between the Beck (BDI 2), Beck (BAI), and Sources of Stress in Teachers scales and between the Rosenberg Self-Esteem scale and the 10 CD RISC scale were found (p < 0.001). Discussion: Our study shows that nursing degree teachers combine teaching with activities and presented moderate levels of anxiety, depression, and tolerance to academic stressors and were able to maintain optimal levels of self-esteem and resilience, indicating that these two factors act as protectors against these stressors. Tweetable abstract: Nursing teachers presented moderate levels of anxiety, depression, and academic stressors due to optimal levels of self-esteem and resilience.

Personal Tools and Psychosocial Resources of Resilient Gender-Based Violence Women.

Gender-based violence is considered a serious social and public health problem. Overcoming this situation implies a process that results in the favorable biopsychosocial rehabilitation of the resilience of women. The objective of this study was to analyze the tools, resources and personal and psychosocial mechanisms used by women survivors of gender-based violence. The design was an interpretative phenomenology. It was carried out with 22 women who have overcome gender-based violence. Data were collected through personal interviews and narration. The results were grouped into four themes: "Process of violence", "Social resources for coping and overcoming GBV", "Personal tools for coping and overcoming GBV" and "Feelings identified, from the abuse stage to the survival stage". Several studies concluded that overcoming abuse is influenced by the women's social network, and it can be the action of these people determining their survival to gender violence. Despite the recognized usefulness of these available resources, it would be desirable to strengthen them in order to be able to drive more women toward survival, assuming a strengthening of coping and overcoming, without forgetting the importance of other support mechanisms, such as their family and group therapies.

Intergenerational Transmissible Meanings in Breastfeeding in Spain: A Phenomenological Study.

BACKGROUND: The process of breastfeeding is linked to intergenerational influences based on attitudes and messages of grandmothers about their own experience, and this can reinforce or interfere with the experiences of future mothers in breastfeeding. The aim of this study was to explore the meanings transmissible to the next generation of nursing mothers, based on the experiences of grandmothers. METHODS: We report the findings of an interpretive phenomenological qualitative research based on the philosophy of Martin Heidegger. In-depth interviews were conducted in Madrid with 17 participants who breastfed before the age of 35 and more than 8 years ago (to ensure the settlement of transmissible meanings in remote memory). Data were analyzed by interpretive phenomenological analysis (IPA). FINDINGS: Two thematic categories were identified: "Breastfeeding: life experiences" and "Breastfeeding: body and mind process", which show that mothers want to convey the need for a balance that allows maintaining the role of women outside of stereotypes but that is also compatible with the rhythm of life, giving new meanings to attachment, weaning, and modesty. CONCLUSIONS: Meanings that future grandmothers wish to transmit to the next generation of nursing mothers are related to the search for a satisfactory experience for the mother, who must make an adjustment in her life, freeing herself of inflexible messages about attachment and the maternal role. PRACTICAL IMPLICATIONS: Strategies to promote breastfeeding and care for nursing mothers can improve the impact of trying to understand the meanings that are transmitted by the grandmothers in the family environment.

Reliability and Repeatability of the Instrument for the Assessment of Stress in Nursing Students (ASNS).

Background and objectives: Stress in nursing students is a very common experience, especially when they face clinical practice. The aims of this study were to perform a transcultural adaptation and to examine the reliability and repeatability of the Instrument for the Assessment of Stress in Nursing Students for a Spanish population. Methods: A test-retest analysis was carried out in two face-to-face sessions with the students with a lapse of 10 days between the two sessions. A cross-sectional descriptive study was carried out between the months of May and June 2018. Sixty-four nursing students were recruited with a consecutive sampling method that targeted individuals in the freshman class. Results: A good internal consistency was shown for the total score (α = 0.8861) and for each of the six domains. The test-retest reliability, using the Wilcoxon paired test, was not significant, indicating no differences between the total scores or the domain scores (p ≥ 0.05). Finally, Bland and Altman plots of visual distributions did not show differences between the total scores and the domain scores. Conclusion: The Instrument for the Assessment of Stress in Nursing Students was shown to be a reliable tool for measuring stress factors among Spanish nursing students.

Exploring the knowledge, explanatory models of illness, and patterns of healthcare-seeking behaviour of Fang culture-bound syndromes in Equatorial Guinea.

In 1994, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) included "culture-bound syndromes" in its classification of psychiatric disorders and associated them with disease processes that manifest in behavioural or thought disorders that develop within a given cultural context. This study examines the definitions, explanatory models, signs and symptoms, and healthcare-seeking behaviours common to Fang culture-bound syndromes (i.e., kong, eluma, witchcraft, mibili, mikug, and nsamadalu). The Fang ethnic group is the majority ethnic group in Equatorial Guinea. From September 2012 to January 2013, 45 key Fang informants were selected, including community leaders, tribal elders, healthcare workers, traditional healers, and non-Catholic pastors in 39 of 724 Fang tribal villages in 6 of 13 districts in the mainland region of Equatorial Guinea. An ethnographic approach with an emic-etic perspective was employed. Data were collected using semi-structured interviews, participant observation and a questionnaire that included DHS6 key indicators. Interviews were designed based on the Cultural Formulation form in the DSM-5 and explored the definition of Fang cultural syndromes, symptoms, cultural perceptions of cause, and current help-seeking. Participants defined "Fang culture-bound syndromes" as those diseases that cannot be cured, treated, or diagnosed by science. Such syndromes present with the same signs and symptoms as diseases identified by Western medicine. However, they arise because of the actions of enemies, because of the actions of spirits or ancestors, as punishments for disregarding the law of God, because of the violation of sexual or dietary taboos, or because of the violation of a Fang rite of passage, the dzas, which is celebrated at birth. Six Fang culture-bound syndromes were included in the study: 1) Eluma, a disease that is targeted at the victim out of envy and starts out with sharp, intense, focussed pain and aggressiveness; 2) Witchcraft, characterized by isolation from the outside, socially maladaptive behaviour, and the use of hallucinogenic substances; 3) Kong, which is common among the wealthy class and manifests as a disconnection from the environment and a lack of vital energy; 4) Mibili, a possession by evil spirits that manifests through visual and auditory hallucinations; 5) Mikug, which appears after a person has had contact with human bones in a ritual; and 6) Nsamadalu, which emerges after a traumatic process caused by violating traditions through having sexual relations with one's sister or brother. The therapeutic resources of choice for addressing Fang culture-bound syndromes were traditional Fang medicine and the religious practices of the Bethany and Pentecostal churches, among others. Among African ethnic groups, symbolism, the weight of tradition, and the principle of chance in health and disease are underlying factors in the presentation of certain diseases, which in ethno-psychiatry are now referred to as culture-bound syndromes. In this study, traditional healers, elders, healthcare professionals, religious figures, and leaders of the Fang community in Equatorial Guinea referred to six such cultural syndromes: eluma, witchcraft, kong, mibili, mikug, and nsamadalu. In the absence of a multidisciplinary approach to mental illness in the country, the Fang ethnic group seeks healthcare for culture-bound syndromes from traditional healing and religious rites in the Evangelical faiths.

Attitudes and Expectations in the Intergenerational Transmission of Breastfeeding: A Phenomenological Study.

BACKGROUND: The socially constructed meanings of breastfeeding that have been passed from generation to generation by grandmothers produce continuities and discontinuities in the practices of breastfeeding. Research aim: The aim of this study is to explore the objectives and positioning of women today with respect to their role as future grandmothers, based on their experiences with breastfeeding. That is, what role do future grandmothers wish to have in the lives of their breastfeeding daughters and grandchildren? METHODS: A qualitative study with interpretative phenomenological analysis was conducted based on the philosophy of Martin Heidegger, using a sample of unstructured interviews from 20 women in Madrid. The data were analyzed using the steps of interpretative phenomenological analysis. RESULTS: Among the women who desired to have a supportive role for their future breastfeeding daughters and daughters-in-law, three emergent themes were identified that aimed at being supportive but remaining flexible and respecting their autonomy: "I'll give you what I didn't have," "the well-being of my daughter/daughter-in-law," and "seeking professional help." Two additional themes were identified that show the desire of these women to be present during this stage of family development and the lifecycle: "my role in the family" and "continuing to share." CONCLUSION: Future grandmothers desire to be involved in their daughters and daughters-in-law breastfeeding experience through flexibility and support and with the use of specialized and personalized professional help. In addition, future grandmothers desire to be valued and included in the vital process of breastfeeding.

Relationships between social skills and self-esteem in nurses: a questionnaire study.

BACKGROUND: Our study attempts to evaluate whether nurses' social skills are related to their self-concept and self-esteem. METHODS: A descriptive survey study was developed to 464 nurses who had worked for a minimum of one year in adult or pediatric services. The Rosenberg Self-Esteem Scale (RSE) and the Scale of Social Skills (SSS) by Gismero were used to measure nurses' self-esteem and social skills, respectively. RESULTS: Evaluation of self-esteem and social skills revealed no significant associations between sex and specific nursing speciality, (p > .05). Significant differences were observed based on the marital status for RSE and SSS Factor 1 (RSE, p = .013; SSS-F1, p = .033). Correlation and regression analyses demonstrated a significant correlation between nurse self-esteem and some social skills factors. CONCLUSION: This study shows that there exists a relationship between higher self-esteem and self-concept among nurses and this issue can affect effective communication with patients.

Papel de la abuela en la lactancia materna / The Grandmother's Role in Breastfeeding / O papel da avó na lactância materna

Objetivo: investigar la influencia de la abuela sobre la madre que da lactancia materna y su relación con la incidencia y prevalencia de la misma. Método: se realizó una revisión integral consultando de las bases de datos MEDLINE OVID, DIALNET y COCHRANEC LIBRARY. Tras el análisis de los textos, se escogieron once estudios de investigación que iban dirigidos directamente a comprobar la influencia de las abuelas en la incidencia y prevalencia de la lactancia materna en diferentes contextos. Resultados: la abuela apareció como fuente de apoyo en población rural (41%). En población urbana la abuela aparece entre los tres factores principales (intención de la madre de lactar o no, decisión de la madre del patrón de alimentación de su hijo e información objetiva sobre pautas de amamantamiento), tanto en el papel de apoyo (94,7%), como en el de obstáculo (26,7%). En cuanto a la decisión de la madre sobre el patrón de alimentación de sus hijos, el 78% refiere haber tomado la decisión antes del embarazo o en el primer trimestre. La convivencia con la abuela tuvo asociación positiva con dar agua o infusiones (PR regresión de Cox con IC 95%: 1,51 [1,10-2,09]; p = 0,011). Conclusiones: a la luz de la revisión, la influencia detractora o no que ejerce la abuela sobre la lactancia materna la da sobre los tres factores principales. La influencia detractora ejercida por los consejos de la abuela parece estar relacionada con conocimientos erróneos adquiridos como "generación del biberón" más que con la intencionalidad, y es susceptible de modificarse con información adecuada, con resultados favorables sobre el patrón de alimentación.

Objective: to investigate the effect the grandmother has on the breastfeeding mother and how it relates to the incidence and prevalence of breastfeeding. Materials and methods: A comprehensive database review was conducted in MEDLINE OVID, DIALNET and the COCHRANE LIBRARY. After analyzing the texts, eleven studies aimed directly at verifying the influence of grandmothers on the incidence and prevalence of breastfeeding in different contexts were selected. Results: The grandmother emerges as a source of support among the rural population (41%). In the urban population, the grandmother appears among the three main factors (mother's intention to breastfeed or not, mother's decision on a feeding pattern for her child, and objective information on breastfeeding patterns), in a supprting role (94, 7%) and in a hindering role (26.7%). As for the mother's decision on a feeding pattern for her children, 78% reported having made the decision before pregnancy or in the first quarter. Living with the grandmother is positively associated with providing water or teas (PR in Cox regression with 95% CI: 1.51 [1.10 to 2.09], p = 0.011). Conclusions: In the light of the review, the detracting or non-detracting influence exerted by the grandmother with respect to breastfeeding affects the three main factors. The detracting influence exerted by the grandmother's advice seems to be related to incorrect knowledge acquired more as part of the "bottle fed generation" rather than intentionality, and is susceptible to being modified through appropriate information, with favorable results on the feeding pattern.

Objetivo: pesquisar a influência da avó sobre a mãe que dá lactancia materna e sua relação com a incidência e prevalência desta. Materiais e métodos: realizou-se uma revisão integral consultando as bases de dados MEDLINE OVID, DIALNET e COCHRANE LIBRARY. Após a análise dos textos, escolheram-se onze estudos de pesquisa que vão dirigidos diretamente a comprovar a influência das avós na incidência e prevalência da lactancia materna em diferentes contextos. Resultados: constatou-se que a avó apareceu como fonte de apoio na população rural (41%). Na população urbana, a avó aparece entre os três fatores principais (intenção da mãe de lactar ou não, decisão da mãe do padrão de alimentação de seu filho e informação objetiva sobre pautas de amamentação), tanto no papel de apoio (94,7%) quanto no de obstáculo (26,7%). Quanto à decisão da mãe sobre o padrão de alimentação de seus filhos, 78% referem ter tomado a decisão antes da gravidez ou no primeiro trimestre. A convivência com a avó teve associação positiva com dar água ou infusões (PR regressão de Cox com IC 95%: 1,51 [1,10-2,09]; p = 0,011). Conclusões: à luz da revisão, a influência detratora ou não que exerce a avó sobre a lactancia materna se dá sobre os três fatores principais. A influência detratora exercida pelos conselhos avó parece estar mais relacionada com conhecimentos errôneos adquiridos como "geração da mamadeira" do que com a intencionalidade e é suscetível de ser modificado com informação adequada, com resultados favoráveis sobre o padrão de alimentação.