Maternity hospital practices and breast feeding self-efficacy in Finnish primiparous and multiparous women during the immediate postpartum period.

OBJECTIVE: to explore the relationship between maternity hospital practices and breast feeding self-efficacy. DESIGN: the data were collected using a cross-sectional survey. The study is a part of a larger longitudinal research and development project called 'Urban parenthood'. SETTING: three urban maternity hospitals in Southern Finland. PARTICIPANTS: altogether 1400 questionnaires were given out and 573 primiparous and multiparous women completed the questionnaire within a week after childbirth. The response rate was 41%. FINDINGS: early and successful initiation of breast feeding, rooming-in and exclusive breast feeding during the hospital stay were associated with higher maternal breast feeding self-efficacy in both primiparous and multiparous women. The reason (medical or non-medical), frequency or method (bottle or cup) for supplementation was not associated with breast feeding self-efficacy. KEY CONCLUSION AND IMPLICATIONS FOR PRACTICE: breast feeding experiences during the immediate postpartum period have an association with breast feeding self-efficacy. Mothers who are not able to initiate breast feeding within an hour after birth or whose infants are supplemented during the hospital stay may benefit from additional support and breast feeding counselling.

Development and implementation of a bereavement follow-up intervention for grieving fathers: an action research.

AIMS AND OBJECTIVES: The aim is to present the development and implementation of a bereavement follow-up intervention for grieving fathers. The development and implementation process and components of the intervention are presented. BACKGROUND: There is a lack of research into fathers' grief and bereavement support for them after the death of a child. Promotion of evidence-based nursing requires transparent development and implementation of nursing interventions and models to be able to repeat, evaluate their effectiveness and redevelop them. DESIGN: Phases of action research were used when developing and implementing the intervention. METHODS: Results of the baseline study of father's grief and social support, the study of current bereavement support and the literature review were combined using triangulation. RESULTS: In this action research, the development of a bereavement follow-up intervention for grieving fathers began with the planning phase that included a baseline study about fathers' grief and social support, a study of current bereavement support systems in Finnish university hospitals and a systematic review of literature on the topic area and collaboration with a panel of experts. The developed bereavement follow-up intervention included three complementary components: support package, peer supporters' contact and health care personnel's contact. Implementation of the intervention included the development of a programme to be used in nursing practice, intervention training for programme implementers and intervention implementation. CONCLUSIONS: Developing and implementing an intervention is a complex, demanding and long-term process. The planning required theoretical knowledge as well as understanding the experiences of fathers, nursing practice and collaboration with those who implemented the intervention. RELEVANCE TO CLINICAL PRACTICE: New information about the fathers' grief and bereavement follow-up support is described. The model developed is evidence-based and can be applied in nursing care where grieving fathers and families are met.