Enhancing Patient-Provider Breastfeeding Conversations: Breastfeeding Intention and Prenatal Breastfeeding Self-Efficacy among a Sample of Pregnant Women.

OBJECTIVES: The purpose of this study was to investigate and identify which sociodemographic factors may be associated with breastfeeding intention and breastfeeding self-efficacy among pregnant women. METHODS: Pregnant women at a medical center in Alabama completed a cross-sectional survey. The Prenatal Rating of Efficacy in Preparation to Breastfeed Scale (PREP to BF) was used to assess prenatal breastfeeding self-efficacy. A valid 3-item breastfeeding intention scale and the Fetal Health Locus of Control Scale also were used. Nonparametric tests were used to assess differences in breastfeeding intention, locus of control subscales, and PREP to BF scores by history with breastfeeding, planned mode of delivery, and sociodemographic factors. RESULTS: The participants in the final analysis (N = 124) had a mean prenatal breastfeeding self-efficacy score of 299.5 (±92.33), with a range of 0 to 390. Significantly lower scores related to intention and PREP to BF were found among Black women (P ≤ 0.05), those with a high school education or less (P ≤ 0.019), single women (P ≤ 0.028), and those who had no breastfeeding experience (P ≤ 0.035). CONCLUSIONS: Identifying pregnant women with low breastfeeding self-efficacy and intention and recognizing the effects of social and cultural influences on breastfeeding are vital. Healthcare providers can engage in meaningful dialog to address ways to increase social support, communication, goal-setting skills, and overcoming mental and emotional barriers.

The Prenatal Rating of Efficacy in Preparation to Breastfeed Scale: A New Measurement Instrument for Prenatal Breastfeeding Self-efficacy.

BACKGROUND:: Breastfeeding self-efficacy and breastfeeding intention are two modifiable factors that influence rates of breastfeeding initiation. RESEARCH AIMS:: (1) To develop a scale to measure prenatal breastfeeding self-efficacy, and (2) test its psychometric properties by determining the internal consistency and reliability, and (3) assess the relationships between prenatal breastfeeding self-efficacy and breastfeeding intention. METHODS:: Cross-sectional prospective one-group survey design was used. A convenience sample of pregnant patients attending an obstetrics and gynecology clinic ( N=124) completed a survey at the recruitment site that assessed demographics, breastfeeding intention, and breastfeeding self-efficacy theory constructs. Retest surveys ( n=14) were taken home and returned to the researcher by mail after completion. RESULTS:: Cronbach's alpha for the 39-item scale was .98 (test) and .97 (retest) with an item-to-total correlation range of .54 to .78. A four-factor solution for the scale was retained. Test-retest indicated each factor was significant and highly correlated: Individual Processes (.88, p < .001), Interpersonal Processes (.893, p < .001), Professional Advice (.919, p < .001), and Social Support (.880, p < .001). Overall prenatal breastfeeding self-efficacy score was highly correlated (.610, p <.001) with breastfeeding intention scores. CONCLUSIONS:: The Prenatal Rating of Efficacy in Preparation to Breastfeed Scale is a valid and reliable measure of a prenatal women's self-efficacy in preparation to breastfeed. Measuring the level of self-efficacy could alert prenatal women and health professionals to individual skill sets.

The Effect of Transcranial Direct Current Stimulation (tDCS) on Resilience, Compassion Fatigue, Stress and Empathy in Professional Nurses.

The purpose of the study is to determine the effect of Transcranial Direct Current Stimulation (tDCS) on measured levels of resilience and empathy in professional nurses with evidence of compassion fatigue and other stress related problems. Lowered levels of resilience, compassion fatigue and decreased empathy are significant predictors of burnout in nurses. Enhanced levels of resilience are associated with improved empathic responses and overall emotional well-being. Nurses who work in high stress environments often exhibit compassion fatigue and post-traumatic stress disorders that may reduce their ability to function effectively. Because tDCS has been used successfully in a number of chronic disease conditions, it would seem that there is potential for it to be useful in a broader context. The treatment with tDCS may be a potential strategy for improving resilience and eliminating chronic stress responses. A timed series counterbalanced research design was used for the study. Participants completed 18 sessions of tDCS over a six week period. They also completed a resilience, compassion fatigue, stress and empathy scale before and after each tDCS administration. A repeated measure analysis was used to determine if tDCS had an impact on scale scores. The analysis showed that tDCS amperage had significant positive effects on empathy. On the outcomes of resilience, compassion fatigue and stress, tDCS did not produce any significant changes. This research provides a new approach to compassion fatigue, an old problem with caregivers. Notably, when implemented with individuals experiencing problems that involve apathy or indifference, tDCS is a non-effortful intervention that offers a pathway that may improve symptoms and does not require extensive outlays of physical or mental energy.

Examining the aftereffects of Hurricane Katrina in New Orleans: a qualitative study of faculty and staff perceptions.

Researchers have reported how Hurricane Katrina has affected teachers who work with Kindergarten to Grade 12 (K-12), yet little is known about how the natural disaster has affected other important K-12 faculty and staff (e.g., coaches, librarians, school counselors, and cafeteria workers). Missing from the literature is the impact that this natural disaster has had on these formal (school counselors) and informal (coaches, librarians) helpers of K-12 students. Using a focus group methodology, the authors examined the aftereffects of Hurricane Katrina on 12 school employees in New Orleans, Louisiana, 18 months after the hurricane. Informed by qualitative content analysis, three emergent themes were identified: emotion-focused aftereffects, positive coping, and worry and fear. The implications for future research and promoting hope in mental health counseling are discussed.