Effectiveness of the Neonatal Discharge Program for Very Low-Birth-Weight Infants on Parental Efficacy and Psychological Distress.

This pilot study aimed to (i) evaluate the effectiveness of a neonatal discharge program, (ii) identify relationships between parent and infant factors and parental efficacy and psychological distress, and (iii) identify ways to improve the neonatal discharge program. A quasiexperimental 1-group pretest/posttest design was used. Through consecutive sampling, 42 participants were recruited. Data were collected using self-report questionnaires. Self-administering instruments gathered data on parental efficacy and psychological distress as well as feedback and recommendations on the intervention. A significant increase in parental efficacy and a reduction in psychological distress were observed from pre- to postdischarge intervention. Significant relationships were found between parental efficacy and infants' gestational age, birth weight, gender, and participants' level of education, and a significant relationship was found between psychological distress and number of children from previous pregnancies. Moreover, an Internet-based program, in addition to the face-to-face teaching, was identified as a preferred option to aid in information retention. It is important to evaluate and enhance the neonatal discharge program to suit the parents of today while providing them with informational and emotional support. Future studies should explore parental coping and the long-term effects of their infant's birth and the intervention.

A Qualitative Study on Midwives' Perceptions of Physiologic Birth in Singapore.

Midwives are advocates for parturients, and their actions and attitudes can influence a woman's experience during childbirth. Hence, it is valuable to examine midwives' perceptions of physiologic birth in an obstetric-led environment. A descriptive, qualitative study design was utilized. Semistructured face-to-face interviews were conducted with 10 registered midwives from the birthing suite of a public hospital in Singapore. Data were analyzed using thematic analysis. Three major themes were (1) perceptions of physiologic birth, (2) perceived facilitators of physiologic birth, and (3) perceived barriers to physiologic birth. Interestingly, senior midwives in this study experienced more negative outcomes with physiologic birth, resulting in apprehension and reduced confidence levels. This study contributed to the understanding of midwives' perceptions regarding facilitators and barriers to physiologic birth. Factors such as supporting birthing team and antepartum education could be useful in supporting physiologic birth. However, advanced age of some of the midwives was found in this study to be a barrier to physiologic birth.

An integrative literature review on midwives' perceptions on the facilitators and barriers of physiological birth.

AIM: To present a synthesis and summary of midwives' perceptions on the facilitators and barriers of physiological birth. BACKGROUND: Medicalisation of birth has transformed and dictated how birthing should take place since the 20th century. Midwives' perceptions on their role within this medicalised environment have not been well documented. DESIGN: An integrative literature review. DATA SOURCES AND REVIEW METHODS: Primary research articles published in English from the period of 2004 to 2015 were included in this review. The Joanna Briggs Institute's critical appraisal forms were used to appraise the quality of the articles. Data were identified from CINAHL, PubMed, PsycINFO, ScienceDirect, and Scopus. RESULTS: Eighteen articles were reviewed. Lack of knowledge due to inadequate training, existing obstetrician-led practices, and midwives' negative perceptions of physiological birth were identified as barriers in the literature. Facilitators like shared decision-making, women's preferences, teamwork, institutional support, and midwives' positive perceptions of physiological birth promoted physiological birth. Most of the studies were conducted in Western countries. CONCLUSION: Midwives face barriers and facilitators when promoting physiological birth during their clinical practise. Future studies exploring midwives' perceptions of physiological birth are needed, especially in Asia where cultural and organizational factors may differ from Western countries.

Perceptions of Parents With Preterm Infants Hospitalized in Singaporean Neonatal Intensive Care Unit.

Perceptions of parents with preterm infants who were hospitalized in a Singapore-based neonatal intensive care unit were observed. Convenience sampling method was used to recruit 8 parents of preterm infants. Semistructured face-to-face in-depth interviews were used to collect data between November 2013 and February 2014. Data were analyzed using thematic analysis. Four themes were identified: "negative emotions versus positive emotions," "finding ways forward," "nature of support received from various sources," and "need more informational and professional support." Parents of preterm infants experienced a multitude of emotions that varied from shock and sadness to excitement and anticipation through their babies' birth, hospitalization, and impending discharge. These parents adopted several strategies to cope with their birth and subsequent infant hospitalization. While their neonatal intensive care unit (NICU) experience was perceived as positive for most parents, some suggestions were made to improve on the information provided and professional care. This study provides evidence to health care professionals in addressing parents' negative emotions and coping abilities in practice. Emotional and informational support for parents is important for them to be more competent in coping with the hospitalization of their newborn in the NICU.

Maternal experiences and preference of maternity services in Singapore: A descriptive qualitative study.

PROBLEM: Little is known about mothers' experiences and preferences for maternity services in Singapore. A more nuanced understanding would identify areas for improvement in perinatal care, reducing the burden on healthcare providers in supporting maternity services. BACKGROUND: Expecting mothers are typically referred to hospital-based antenatal and postnatal services in Singapore. In recent years, Singapore has made maternity services available in primary care community settings called polyclinics, to improve accessibility of such services. AIM: To explore the experiences and preferences of Singaporean mothers in receiving maternity services in acute hospitals and polyclinics. METHODS: A descriptive qualitative study design was adopted, and data were collected from September to October 2023. In total, 13 mothers were recruited from a maternity care hospital in Singapore. Individual semi-structured audio-recorded interviews were conducted, and data were analysed using thematic analysis. FINDINGS: Three themes were identified: (1) Considerations when seeking maternity care, (2) Differing preferences and satisfaction levels, (3) Hopes for better perinatal care for mothers and babies. DISCUSSION: Most mothers preferred seeking hospital-based antenatal care and were more inclined to do postnatal follow-ups in polyclinics. Factors like accessibility, cost and perceived expertise of healthcare providers influenced the decision-making. Maternal satisfaction with care services also fluctuated based on interpersonal factors and whether their informational needs were met. CONCLUSION: Overall, mothers' perceptions of maternity services were positive. Findings suggest the possibility of further expanding maternity services in community settings to increase professional support for mothers. Future research is needed to ascertain these findings in non-English speaking and non-subsidized settings.

Nurses' perceived barriers to the implementation of a Fall Prevention Clinical Practice Guideline in Singapore hospitals.

BACKGROUND: Theories of behavior change indicate that an analysis of barriers to change is helpful when trying to influence professional practice. The aim of this study was to assess the perceived barriers to practice change by eliciting nurses' opinions with regard to barriers to, and facilitators of, implementation of a Fall Prevention clinical practice guideline in five acute care hospitals in Singapore. METHODS: Nurses were surveyed to identify their perceptions regarding barriers to implementation of clinical practice guidelines in their practice setting. The validated questionnaire, 'Barriers and facilitators assessment instrument', was administered to nurses (n = 1830) working in the medical, surgical, geriatric units, at five acute care hospitals in Singapore. RESULTS: An 80.2% response rate was achieved. The greatest barriers to implementation of clinical practice guidelines reported included: knowledge and motivation, availability of support staff, access to facilities, health status of patients, and, education of staff and patients. CONCLUSION: Numerous barriers to the use of the Fall Prevention Clinical Practice Guideline have been identified. This study has laid the foundation for further research into implementation of clinical practice guidelines in Singapore by identifying barriers to change in acute care settings.