The effect of interventions on flat and inverted nipple on breastfeeding: A systematic review.

BACKGROUND: Some methods have been developed to solve flat and/or inverted nipple problems. This study aimed to examine the effects of flat and/or inverted nipple interventions on nipples and breastfeeding. METHODS: Before initiating the review, the protocol was registered in the 'PROSPERO' database. This study was based on the PRISMA-P guideline. Seven databases (Web of Science, PubMed, ScienceDirect, Scopus, The Cochrane Library, TÜBITAK Ulakbim and Google Scholar) were searched, and nine studies were included in this review. RESULTS: Hoffman's exercise, the inverted syringe method, and the nipple exercise was quite effective in increasing breastfeeding success. The rate of exclusive breastfeeding in the first, third, and sixth months of mothers followed up with postpartum multidimensional visits was found to be significantly higher in the intervention group than in the control group (p < 0.05). A study in which a rubber band was applied with the help of an injector on flat and inverted nipples showed that 63% of mothers on the third day and all of them in the first month were able to breastfeed without a rubber band. Hoffman's exercise, the inverted syringe technique, and rubber bands corrected the flat and/or inverted nipple. There were studies reporting complications as a result of nipple interventions. CONCLUSIONS AND IMPLICATIONS: It is necessary to disseminate the information that breastfeeding of mothers with flat and/or inverted nipples can be sustained with various interventions. Furthermore, it is believed that providing mothers with a chance to choose the interventions, and thus, the compliance of mothers to the intervention with the method of their choice may increase the success of the intervention.

Causes of burnout in nursing seniors: A mixed methods study.

BACKGROUND: In recent years, the issue of burnout in newly graduated and student nurses has become an increasing interest of researchers. Burnout seriously affects the behavior, health, life and relationships of individuals. OBJECTIVES: This research was conducted to investigate the causes of burnout in nursing senior students in depth. DESIGN: This research, based on mixed method, was carried out with a sequential exploratory design. PARTICIPANTS: The study was conducted with 148 nursing students in their last year at a university in the Marmara Region of Türkiye. METHOD: Data were collected with Personal Information Form, The Burnout Measure Short Version (BMS) and Maslach Burnout Inventory-Student Form (MBI-SF) between March and April 2022. Qualitative interviews were conducted face-to-face with 16 students determined by criterion sampling method between May and June 2022. A semi-structured interview form was used to collect qualitative data. Descriptive statistics (number, percentage, mean, standard deviation) were used for the analysis of quantitative data. Thematic analysis was performed for qualitative data. RESULTS: The mean BMS total score for the sample group was 4.50. MBI-SF sub-dimension mean scores; It is in the form of exhaustion (16.52), depersonalization (12.66) and competence (12.41). According to the scores of nursing senior students from BMS, it was determined that 22.3 % (n = 33) had burnout, 23 % (n = 34) had a serious burnout problem, and 28.4 % (n = 42) needed professional help as soon as possible. In addition, three main themes emerged as a result of the thematic analysis: (i) Effects of Burnout, (ii) Factors Affecting Burnout, (iii) Ways to Cope with Burnout. CONCLUSION: It was determined that one of the five nursing students was in danger of burnout. The prevalence of burnout in nursing senior students was 73.7 %. Besides, it was determined that the problems experienced in the student's nursing education and professional practices, the pandemic process, financial concerns, family-related situations, not finding time for social activities, and future anxiety were the factors causing burnout.

Water consumption in 0-6-month-old healthy infants and effective factors: A systematic review / Consumo de agua en lactantes sanos de cero a seis meses y factores efectivos: una revisión sistemática

INTRODUCTION: Early introduction of fluids and water affects the duration of breastfeeding, the infant immune system, and possibly causes infants to consume less breast milk, which may, in turn, affect their nutritional and immune status. OBJECTIVE: This study was carried out to determine water consumption in 0-6-month-old infants and the factors affecting this consumption. MATERIALS AND METHODS: A literature review was conducted in seven electronic databases (Medline, Web of Science, PubMed, ScienceDirect, Scopus, Cochrane Library, and TÜBITAK) for studies published until April 25, 2022, using the keywords: drinking water, infant, and breastfeeding. RESULTS: The systematic review included 13 studies. Five studies were crosssectional, three were descriptive and quasi-experimental, and the others were case-control and cohort studies. It was reported in the examined studies that 86.2% of the infants were around 6 weeks old, 44 % of the infants were 1 month old, 77% were 3 months old, 2.5% were 4 months old, and 2.5 to 85% of the infants were around 6 months old when they first consumed water. The prominent reasons for making the infants drink water are the thought that they need it and cultural reasons. CONCLUSIONS: The exclusive breastfeeding of 0-6-month-old infants is the recommendation of reliable health authorities. Nurses play a key role in implementing this practice. In this systematic review, it was seen that families gave their infants water at varying rates in the 0-6-month period, and the factors affecting this situation were revealed. If nurses determine which factors affect families in terms of the early introduction of fluids, they could be able to plan the necessary education and interventions.

Introducción: La introducción temprana de líquidos y agua afecta la duración de la lactancia, el sistema inmune del lactante y posiblemente hace que los lactantes consuman menos leche materna, lo que a su vez puede afectar su estado nutricional e inmunitario. Objetivo: Este estudio se realizó para determinar el consumo de agua en bebés de cero a seis meses y los factores que inciden en este consumo. Objetivo: Este estudio se realizó para determinar el consumo de agua en bebés de cero a seis meses y los factores que inciden en este consumo. Materiales y métodos: se hizo una revisión de la literatura en siete bases de dato electrónicas (Medline, Web of Science, PubMed, ScienceDirect, Scopus, Cochrane Library y TÜBITAK) para estudios publicados hasta el 25 de abril de 2022, utilizando las palabras clave: agua potable, lactante y lactancia. Resultados: La revisión sistemática incluyó 13 estudios. Cinco fueron estudios transversales, tres fueron descriptivos, cuasiexperimentales y los restantes fueron estudios de casos y controles, y de cohortes. En los estudios examinados se informó que le dieron agua al 86,2 % de los lactantes de seis semanas, al 44 % de los lactantes de un mes, al 77 % de los lactantes de tres meses, al 2,5 % de los lactantes de cuatro meses y al 2,5 % a 85 % de los lactantes de seis meses. Las razones principales para dar agua a los bebés son la idea de que los bebés necesitan agua y razones culturales. Conclusiones: La lactancia materna exclusiva es la recomendación de las autoridades sanitarias para los bebés de cero a seis meses. Las enfermeras juegan un papel clave en la implementación de esta práctica. En esta revisión sistemática se observó que las familias daban agua a sus bebés en proporciones variables durante el período de cero a seis meses y se revelaron los factores que inciden en esta situación. Si las enfermeras determinan qué factores afectan a las familias en cuanto a la introducción temprana de líquidos, podrían planificar las medidas educativas y las intervenciones necesarias.

The effects of kangaroo mother care on physiological parameters of premature neonates in neonatal intensive care unit: A systematic review.

PURPOSE: The effects of Kangaroo mother care (KMC) on physiological parameters in preterm infants have been reported in the literature by experimental and quasi-experimental studies, and varying findings have been presented. The present study was conducted to determine the effects of KMC on the physiological parameters of premature newborns in the Neonatal Intensive Care Unit. DESIGN AND METHOD: The review was conducted according to the specified keywords by scanning the EBSCO-host, Cochrane Library, Medline, PubMed, ScienceDirect, Web of Science, and TR index databases using the keywords "kangaroo care AND preterm AND vital signs." The pool mean differences (MDs) were calculated, adopting a 95% confidence interval (CIs) using the Stata 16 software for the meta-analysis [PROSPERO: CRD42021283475]. RESULTS: Eleven studies for systematic review and nine studies for meta-analysis, including 634 participants, were found eligible for inclusion. It was determined that the "temperature" (z = 3.21; p = 0.000) and "oxygen saturation" (z = 2.49; p = 0.000) values created a positive effect in general in the kangaroo care group; however, there was no sufficient evidence to state that it affected the "heart rate" (z = -0.60; p = 0.55) and "respiratory rate" (z = -1.45; p = 0.15) values. In the present study, the duration of KMC application had statistically different effects on temperature and oxygen saturation (SpO2) (p < 0.05). One-hour or shorter applications of KMC had a higher effect on the temperature and oxygen saturation values (1.83; 1.62, respectively). CONCLUSION: Our results provided references for clinical implications, and the "temperature" and "oxygen saturation (SpO2)" values created a positive effect in general in the KMC group. However, there was no sufficient evidence to state that it affected the "heart rate" and "respiratory rate" values. The duration of KMC application had statistically different effects on temperature and oxygen saturation. One-hour or shorter applications of KMC had a higher effect on the temperature and SpO2 values. Longitudinal, randomized, controlled studies examining the effects of KMC on vital signs in premature newborns with vital parameters outside the normal reference range are recommended. PRACTICE IMPLICATIONS: The goal of the NICU nurse is to improve the infant's well-being. The application of KMC is a unique care for the nurse in maintaining the newborn's well-being. The vital signs of newborns hospitalized in the NICU with critical problems may be out of normal limits. KMC is an essential developmental care practice that ensures that the neonate's vital signs are kept within normal limits by relaxing the neonate, reducing stress, increasing comfort, and supporting interventions and treatments. KMC application is unique for each mother­neonate pair. Depending on the tolerance of the mother and infant in terms of duration, it is recommended to perform KMC in the NICU under the supervision of a nurse. Neonatal nurses should support mothers in giving KMC in the NICU since KMC has ameliorative effects on the vital signs of premature neonates.

The relationship between fear of COVID-19 and psychological resilience according to personality traits of university students: A PATH analysis.

PURPOSE: The purpose of the current research was to identify the influence of university students' personality traits on their fear of COVID-19 and psychological resilience levels. DESIGN AND METHODS: A cross-sectional trial was completed with 690 students. Descriptive statistics and correlations were calculated, and a path analysis was employed with the objective of assessing the model fit and investigating direct and indirect impacts. FINDINGS: Among personality traits, conscientiousness and neuroticism were observed to affect fear of COVID-19, and conscientiousness, neuroticism, and openness to experience had an effect on psychological resilience. The tested model has a good fit and explains the direct effects of the study variables. PRACTICE IMPLICATIONS: Nurses should improve university students' psychological resilience by supporting them with protective and improving factors. The role of the psychiatric nurse is important in providing conscious and need-oriented support in extraordinary events such as pandemics.

Impact of COVID-19 pandemic on nurses' burnout and related factors: A rapid systematic review.

AIM: This study aimed to investigate the effect of COVID-19 pandemic on nurses' burnout and related factors. BACKGROUND: Nurses at the frontlines in every field of the health system and composed most of the health service industry closely experience all negative events during the pandemic. METHODS: This study is a rapid systematic review. RESULTS: A total of 751 studies were selected, of which 13 studies were compatible with the inclusion criteria. The sample size ranged from 107 to 12.596. The studies determined that nurses' burnout levels were generally moderate level and above during the COVID-19 pandemic. Sociodemographic, occupational, psychological, and COVID-19-related factors affected this burnout. CONCLUSION: The results of this review may use to make implications that would ease the effect of the pandemic on nurses and develop strategies to protect nurses from burnout in similar possible situations. The protocol information is included here for blind peer review. PROSPERO REGISTRATION NUMBER (ID): CRD42021244849. REGISTRATION AND PROTOCOL: Prior to undertaking the review, we registered the protocol in the International Prospective Register of Systematic Reviews (PROSPERO). The registration number is CRD42021244849. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021244849. The changes made during the review process were registered in PROSPERO with an update.

Breastfeeding/Breast Milk Safety in Infants of Mothers with Suspected or Confirmed COVID-19 Infection.

The purpose of this systematic review was to determine whether suspected or confirmed COVID-19 infected mothers in the lactation period can breastfeed their infants; and whether suspected or confirmed COVID-19 infected mothers can breastfeed their infants by taking some precautions. The study also aimed to present the measures that can be taken in line with the evidence. The studies conducted after November 2019 and including infants of suspected or confirmed COVID-19 infected mothers were reviewed between 2019 and 2020. A literature review was conducted in five electronic databases (MEDLINE, PubMed, ScienceDirect, Web of Science, and Scopus) to reach original quantitative studies in English. The present authors retrieved 46 of the 1,229 studies included after screening. Three studies were cross-sectional studies, 30 were case studies, and 13 were cohorts. In most of the sources examined, it was concluded that most of the breastfed infants had negative findings for SARS-Cov-2 infection in PCR. In line with the limited data available, it was concluded that most of the breastfed infants had negative findings for SARS-Cov-2 infection in PCR; and breastfeeding mothers should initiate breastfeeding by taking protective measures. Key Words: Breastfeeding, COVID-19, Suspected COVID-19 infected mothers, Confirmed COVID-19 infected mothers.

Mothers' breastfeeding attitudes when lactation overlaps with a new pregnancy.

Background and Aim: There is usually a strong cultural taboo when breastfeeding overlaps with pregnancy. A lot of mothers cease breastfeeding their infants when they conceive again due to social pressure, professional advice, or their own beliefs.The present research aimed to reveal the attitudes of mothers who conceived again while breastfeeding their infants and their experiences in this process. Methods: The data of the study, were collected between November 2018 and March 2019 in Sakarya University Education and Research Hospital, Sakarya. The study conducted in 40 women in whom lactation overlapped with pregnancy, and the face-to-face interview technique was employed for data collection. Data were collected using an information form containing information about the participants and a semi-structured interview form. The interviews conducted were then examined using the interpretative phenomenological analysis method, one of the qualitative research methods. The codes and themes were created using the NVIVO 9.0 program. In the report of this study, the Consolidated criteria for reporting qualitative research (COREQ) checklist was utilized as a guide. Results: The mean age of the mothers is 26.70±4.58 (min: 20, max: 36), 62.5% (n=25) of the mothers were in the third trimester. While 5% of the mothers (n=2) continued breastfeeding during pregnancy, 95% (n=38) ceased breastfeeding at certain periods of pregnancy. It was observed that the mothers who conceived again during the lactation period considerably hesitated how to act about breastfeeding, they were significantly influenced by the people in their environment concerning how to overcome this, and they were often misguided. Conclusion: There is obviously an urgent need for evidence-based studies on the subject. Studies to be carried out in this regard will increase the self-confidence of healthcare professionals and will enable them to perform effective training and counseling on the subject.

The Effect of the Covid-19 pandemic on emergency service home service calls due to home accidents in children aged 0-6 in Sakarya, Türkiye?

Background and Aim: The contribution of global pandemics to the emergence of home accidents is unknown. The study aims to retrospectively examine the effect of the Covid-19 Pandemic on Emergency Service Home Service Calls Due to Home Accidents in Children aged 0-6. Methods: Data are reported in two sections. The descriptive part is a retrospective analysis of patients admitted to Sakarya Training and Research Hospital Pediatric Emergency and Adult Emergency Unit between March 16, 2019 and January 31, 2020 (non-COVID-19era) and March 16, 2020 and January 31, 2021 (COVID-19era). The second part of the study, the comparative part, presents mean data for 2019-2020 (non-COVID-19era) and 2020-2021 (COVID-19era) from the same center and the same period. These data will then be compared. Results: A total of 9,110 pediatric patients applied to our center during the study period, of which 7,905 patients were in the non-Covid- 19era period and 1,205 patients were in the Covid-19 era. While the rate of hospital admissions decreased by 85% in the Covid-19era compared to the non Covid-19era, when the periods are evaluated within themselves; the forensic report retention rate in the Covid- 19era increased by 180% and the rate of hospitalization increased by 75%, The rate of drug overdose increased by 280% and chemical substance use increased by 325% compared to the non-Covid-19era. However The Covid-19 era, the fall rate decreased by 31% and the burn rate decreased by 17% compared to the non-Covid-19 era. Conclusions: During the national lockdown period, our pediatric emergency department experienced significantly reduced volumes of children. Despite the decrease in hospital admission rate during the COVID-19 pandemic, there was still a very high increase in poisoning from home accidents. This study can provide a basis for further research on alternative strategies to address the problem of home accidents during the COVID-19 pandemic.

Effect of Puppet Show on Children's anxiety and pain levels during the circumcision operation: A randomized controlled trial.

INTRODUCTION: Surgical procedures are the most common causes of anxiety and pain in hospitalized children. One of the most common surgical procedures for children is circumcision. Surgical procedures such as circumcision in hospitals are the most common causes of pain, fear, and anxiety in children. Therapeutic play methods as non-pharmacological applications are being developed recently for children who use analgesics in the treatment of pain and anxiety. Nurses can use the game in three areas such as a care strategy for hospitalized children during daily routine practices, surgery, and invasive or painful treatment procedures. An extensive literature review revealed that there were therapeutic game plays performed before and after the surgical procedure. Nonetheless, no therapeutic game play performed during the surgical procedure were reported. In addition, no reported study of puppet show which is one of the therapeutic game methods were found. OBJECTIVE: The aim of this study was to investigate the effect of the puppet show demonstrated to 7-11 years old children during circumcision on the anxiety and pain level of children. DESIGN: The study was designed as a randomized controlled experiment. MATERIALS AND METHODS: The population of the study was the children between 7 and 11 years of old and being circumcised in the urology clinic at Research and Training Hospital in Karabük Turkey between 1 May and 1 September 2017. A total of 81 (experimental group: 40, control group: 41) children were included in the study. "Participant Information Form", "Wong Baker Faces Pain Rating Scale" and "State-Trait Anxiety Inventory for Children" were used as implemented in the literature. RESULTS: The median pain score of the experimental group during and after the procedure was statistically lower than the control group. The level of anxiety during and after the procedure in the experimental group showed a statistically significant decrease compared to the pre-treatment level and the level of anxiety after the procedure showed a statistically significant decrease compared to the procedure. In the control group, while the level of anxiety during the procedure showed a statistically significant increase compared to the pre-treatment level, the level of anxiety after the procedure showed a statistically significant decrease compared to the one during the procedure. CONCLUSION: It was concluded that the puppet show performed during the circumcision procedure was effective in reducing the pain and anxiety that developed during the circumcision and continued after the procedure.