The effect of oropharyngeal mother's milk on nutritional outcomes in preterm infants: a randomized controlled trial.

BACKGROUND AND OBJECTIVE: Oropharyngeal interventions are an accepted method to improve the nutritional performance of premature infants. Considering the countless benefits of breast milk and the few studies on the use of breast milk as an oral-pharyngeal intervention, this study was conducted with the aim of determining the effect of oral-pharyngeal administration of breast milk on nutritional outcomes in premature infants. MATERIALS AND METHODS: In this clinical trial, 80 premature infants hospitalized in the neonatal intensive care unit of Amir al-Mu'minin Hospital in Semnan (a city in Iran) were randomly assigned to intervention (n = 40) and control groups (n = 40). Infants in the intervention group were given breast milk, and infants in the control group were given sterile water as a placebo. The data collection tool included demographic and clinical questions checklist, including sex, gestational age, weight, milk administration time, lavage and its amount, vomiting, abdominal distension, and so on. Data analysis was performed using SPSS23. RESULTS: The mean volume of total milk received by infants (p = 0.047) and the mean volume of milk received by mouth (p < 0.000) at the time of discharge were higher in the intervention group. Moreover, the time to start enteral nutrition in the intervention group was lower than in the control group (P = 0.012). Administering mother's milk through the oropharyngeal method led to a reduction in infants' length of stay in the hospital (P = 0.022). CONCLUSION: Based on the results of the present study, the oropharyngeal administration of breast milk in the first days after the birth of premature infants admitted to the hospital improves the outcomes related to their nutritional status. Therefore, it is suggested that this convenient, safe, and feasible method be used in hospitalized premature infants as soon as possible so that premature infants can benefit from the important advantages of breast milk.

The effect of instructing mothers in attachment behaviors on short-term health outcomes of premature infants in NICU.

BACKGROUND: The birth of a pre-mature infant and subsequent hospitalization and separation from the family can impair maternal and neonatal attachment and quality of maternal care. This study aimed to assess the effect of instructing mothers in attachment behaviors on short-term health outcomes of pre-mature infants admitted to neonatal intensive care units (NICUs). MATERIAL AND METHODS: In this quasi experimental study, 80 mothers of pre-mature infants who were admitted to NICUs at two referral health centers in northern Iran were studied in two groups in 2018. Attachment behaviors were taught to mothers in the test group during four consecutive sessions. Mother-infant attachment behaviors were evaluated at both the beginning and the end of this study using a checklist derived from Avant's Maternal Attachment Assessment Strategy. Moreover, infants' short-term health consequences were investigated in two groups. SPSS 18 statistical software was used for data analysis. RESULTS: On average, it took respectively 34.90 ± 12/65 and 31/15 ± 14/35 days for the infants in the control and the intervention group to reach full oral feeding and 38/5 (38/4-42/11) and 37 (31/85-42/14) days to gain the minimum weight required for discharge. Moreover, the mean length of stay for the infants in the control and the intervention group was 41/80 ± 13/86 and 39/02 ± 16/01 days, respectively (P > 0/05). CONCLUSION: Instructing mothers in attachment behaviors clinically improved short-term health-related outcomes. Hence, this intervention is recommended to be incorporated in the care program for mothers with pre-mature infants.

Investigating the professional identity and resilience in nursing students during the COVID-19 pandemic.

BACKGROUND: Professional identity includes the values and beliefs of a nurse that guide her thinking, action, and interaction with patients. The stressful conditions of the COVID-19 pandemic may have affected nursing students' resilience and attitudes toward their profession. Therefore, the aim of this study was to investigate the professional identity and resilience in nursing students during the COVID-19 pandemic. MATERIALS AND METHODS: This cross-sectional descriptive study was performed in November and December 2020 with the participation of all nursing students of Babol University of Medical Sciences who spent at least one semester of internship in a hospital during the COVID-19 pandemic. Data were collected using demographic questionnaire, Connor-Davidson resilience scale, and nursing students' professional identity scale. Data analysis was performed using independent t-test, ANOVA, and correlation tests at a significance level of 0.05. RESULTS: Nursing students in the 3rd, 5th, and 7th semesters have spent a minimum of 13 and a maximum of 151 days of internship during the pandemic period. The mean score of professional identity of nursing students was 61.86 ± 9.34 and their mean resilience score was 32.08 ± 13.54. The resilience score of 92% of students was below 50. Professional identity was significantly stronger, and resilience was considerably higher in students who were satisfied with their profession and lived with their families (P < 0.05). In other words, students with higher professional identity scores had higher resilience (r = 0.39, P = 0.000). CONCLUSION: Despite a good professional identity score, the resilience of nursing students during the COVID-19 pandemic is low. Therefore, professors and the clinical education system should provide more support for students in such stressful times as the COVID-19 pandemic period.

The challenges of supporting nursing students in clinical education.

Clinical education requires creating a supportive atmosphere for learners and nursing students, who need support to be prepared for their future profession. The purpose of this study is to investigate the challenges of supporting the nursing students in clinical education. This article reviewed studies conducted between 2009 and 2019 with the keywords including support, challenge, students, education, and nursing using SID, Magiran, IranMedex, Google Scholar, Elsevier, and PubMed as databases. Among the 926 articles obtained during the two review stages, which were based on the inclusion and exclusion criteria and the first one analyzed the title and the abstract and the second one analyzed the whole article, ultimately 32 articles were selected for the study. The types of articles used in this study are as follows: qualitative (16 articles), descriptive analytical and cross-sectional (12 articles), review (3 articles), and mixed-methods (1 article). The focus of all studies was on the students' clinical education environment. The participants of the studies were undergraduate nursing students (in 22 articles), graduate students (in 2 articles), nursing instructors and students (in 4 articles), and nursing instructors and managers (in 1 article). Most of the challenges of supporting the students included violence, fear, and anxiety; socio-cultural challenges, environmental-organizational stresses; and ineffective clinical education. The findings of this study showed that nursing students face many challenges in the clinical setting. Therefore, the managers of educational and health-care centers should give a high priority to their students' support programs.

Lifelong learning strategies in nursing: A systematic review.

BACKGROUND: Lifelong learning is an expectation in the professional performance of nurses, which is directly related to the success of students in nursing schools. In spite of the considerable attention paid to this issue, lifelong learning strategies are not fully understood. OBJECTIVE: The aim of this study was to clarify lifelong learning strategies of nursing students with respect to international experience. METHODS: In this systematic review, an extensive investigation was carried out using Persian and English studies in Pub Med, ProQuest, Cochrane, Ovid, Scopus, Web of Science, SID, and Iran Doc using the following keywords: lifelong learning, self-directed learning, lifelong learning model, continuing education, nursing education, and lifelong program. Finally, 22 articles published from 1994 to 2016 were selected for the final analysis. Data extracted from the selected articles was summarized and classified based on the research questions. RESULTS: In this study, 8 main themes, namely intellectual and practical independence, collaborative (cooperative) learning, researcher thinking, persistence in learning, need-based learning, learning management, suitable learning environment, and inclusive growth, were extracted from the article data. CONCLUSION: Having identified and clarified lifelong learning strategies in nursing, it is recommended to use the research findings in the programs and teaching systems of nursing schools. Use of strategies of lifelong learning will led to increased quality of education, development of nursing competency and finally, increased quality of patient care.