Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2015

Open Access 01-12-2015 | Research article

Nurses and midwives professional support increases with improved attitudes - design and effects of a longitudinal randomized controlled process-oriented intervention

Authors: Anette C Ekström, Stina Thorstensson

Published in: BMC Pregnancy and Childbirth | Issue 1/2015

Login to get access

Abstract

Background

Becoming parents for the first time is challenging. Mothers need both social and professional support to handle these challenges. Professionals’ attitudes affect quality of care and support. So to improve professional support, an intervention consisting of a process-oriented training was performed. Due to the positive results of the intervention there is a need to illuminate the methodological approach further. The overall aim was therefore to describe a methodological approach to improve and evaluate health care professionals’ attitudes toward breastfeeding and parental support in order to improve quality of care in childbearing.

Methods

This study was a longitudinal randomized control intervention study, in which groups of mothers received care in childbearing from midwives and child health nurses. These health professionals had gone through a process-oriented training, or not. In order to improve attitudes of health professionals the training was based on evidence, practical skills and reflective processes (both private and professional experiences) in relation to breastfeeding and parental support. Included in the longitudinal study were health professionals from five intervention municipalities n = 36 and health professionals from five control municipalities n = 45. All mothers who fulfilled the inclusion criteria were consecutively identified from the hospital register and asked to participate in the study. Mothers who accepted to participate were included in the interventions group (n = 206) or control groups (n = 162, n = 172 respectively) based on which municipality they belonged to.

Results

The results of the process-oriented training improved the professionals’ attitudes toward breastfeeding and parental support. These improved attitudes in health professionals increased intervention-group mother’s satisfaction with professional and social support. Intervention-group mother’s relation to and feelings for their baby as well as breastfeeding was also improved.

Conclusion

These results stress the importance of professionals’ attitude in quality of care during childbearing, as well as pointing to the possibility to improve professionals’ attitudes with a process-oriented training.

Trial registration

Australian New Zealand Clinical Trials Registry (ANZCTR), trial registration: ACTRN12611000354​987.
Appendix
Available only for authorised users
Literature
1.
Cowan CP, Cowan PA. When partners become parents. The big life change for couples. USA: Lawrence Erlbaum Associates; 2000.
2.
Thorstensson S, Hertfelt-Wahn E, Langius-Eklöf A, Ekström A. Evaluation of the Mother-to-Infant relation and feeling scale: Interviews with first-time mothers’ for feelings and relation to their baby three days after birth. International Journal of Nursing and Midwifery. 2012;4(1):8–15.
3.
Downe S. Toward Salutogenic Birth in the 21st Century. In: Walsh D, Downe S, editors. Essential midwifery practice: intrapartum care. Oxford: Wiley-Blackwell; 2010.
4.
Raphael-Leff J. Psychological processes of childbearing. 4th ed. Anna Freud Centre: Guildford; 2005.
5.
Hildingsson I, Thomas JE. Women’s Perspectives on Maternity Services in Sweden: Processes, Problems and Solutions. Journal of Midwifery and Womens Health. 2007;52(2):126–33.CrossRef
6.
Seefat-van Teeffelen A, Nieuwenhuijze M, Korstjens I. Women want proactive psychosocial support from midwives during transition to motherhood: a qualitative study. Midwifery. 2011;27(1):122–7.CrossRef
7.
Kahn R, Antonucci T. Convoys of the life Course: Attachment, Roles and Social support. In: Lifespan development and behavior, vol. 3. New York: Academic P; 1980. p. 253–86.
8.
Cassidy J. The nature of the child’s ties. In: Handbook of attachment Theory, research and clinical applications. Ith ed. New York: The Guildford Press; 1999. p. 925.
9.
Langford C, Bowsher J, Maloney J, Lillis P. Social support: a conceptual analysis. J Adv Nurs. 1997;25(1):95–100.CrossRefPubMed
10.
Oakley A: Giving support in pregnancy; the role of research midwives in a randomized controlled trial chap. 4. In: Midwives, Research and Childbirth. vol. 3. London: Chapman & Hall; 1994: 30–63.
11.
Bäckström C, Hertfelt-Wahn E. Support during labour: first-time fathers’ descriptions of requested and received support during the birth of their child. Midwifery. 2011;27(1):67–73.CrossRefPubMed
12.
Dahlen H, Barclay L, Homer C. The novice birthing; theorising first time mothers’ experiences of birth at home and in hospital in Australia. Midwifery. 2010;26(1):53–63.CrossRefPubMed
13.
Lundgren I. Releasing and relieving encounters: experiences of pregnancy and childbirth. Scand J Caring Sci. 2004;18(4):368–75.CrossRefPubMed
14.
Lundgren I. Swedish women’s experience of childbirth 2 years after birth. Midwifery. 2005;21(4):346–54.CrossRefPubMed
15.
Ekström A, Nissen E. A Mother’s feelings for Her infant are strengthen by excellent breast feeding counseling and continuity of care. Pediatrics. 2006;118(2):309–14.CrossRef
16.
Tarkka M-T, Paunonen M. Social support provided by nurses to recent mothers on a maternity ward. J Adv Nurs. 1996;23(6):1202–6.CrossRefPubMed
17.
Thorstensson S, Nissen E, Ekström A. Professional Support in Pregnancy Influence Maternal Relation to and Feelings for the Baby after Cesarean Birth; an Intervention Study. J Nurs Care. 2012;1(3). doi:10.​4172/​2167-1168.​1000112.
18.
Renfrew M, McCormick F, Wade A, Quinn B, Dowswell T. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev. 2012;5.
19.
Brown JB, Beckhof C, Bickford J, Stewart M, Freeman TR, Kasperski J. Women and their partners’ perception of the Key Roles of the Labor and Delivery Nurse. Clin Nurs Res. 2009;18(4):323–35.CrossRefPubMed
20.
Jerlock M, Falk K, Severinsson E. Academic nursing education guidelines: Tool for bridging the gap between theory, research and practice. Nurs health sci. 2003;5(3):219–28.CrossRefPubMed
21.
Phillips D, Fawns R, Hayes B. From personal reflection to social positioning: the development of a transformational model of professional education in midwifery. Nurs Inq. 2002;9(4):239–49.CrossRefPubMed
22.
Ekström A, Widström A, Nissen E. Process-oriented Training in Breastfeeding Alters Attitudes to Breastfeeding in Health Professionals. Scand J Public Health. 2005;33(6):424–31.CrossRefPubMed
23.
Blixt I, Mårtensson L, Ekström A. Process-oriented training in breastfeeding for health professionals decreases women’s experiences of breastfeeding challenges. Int Breastfeed J. 2014;9.
24.
Ekström A, Abrahamsson H, Eriksson R-M, Mårtensson L. Women’s use of nipple shields - their influence on breastfeeding duration after a process-oriented education for health professionals. Breastfeed Med. 2014;9.
25.
Ekström A, Guttke K, Lenz M, Hertfelt-Wahn E. Long term effects of professional breastfeeding support - An intervention International. J Nursing Midwifery. 2011;3(8):109–17.
26.
Ekström A, Kylberg E, Nissen E. A process-oriented breastfeeding training program for health professionals to promote breastfeeding. Breastfeed Med. 2012;7(2):85–92.PubMedCentralCrossRefPubMed
27.
Ekström A, Nissen E. Process-Oriented Training in Breastfeeding Attitudes and Continuity of Care Improve Mothers Perception of Support. In: Hong PR, editor. Health Education Research Trends. New York: Nova Science Publishers, Inc; 2007. p. 211–25.
28.
Ekström A, Widström A-M, Nissen E. Does continuity of care by well-trained breast feeding counselors improve a mothers perception of support? Birth. 2006;33(2):123–30.CrossRefPubMed
29.
Ekström A, Widström A-M, Nissen E. Duration of Breastfeeding in Swedish Primiparous and Multiparous Women. J Hum Lact. 2003;19(2):172–8.CrossRefPubMed
30.
Ekström A, Widström A-M, Nissen E. Breastfeeding Support from Partners and Grandmothers: Perceptions of Swedish Women. Birth. 2003;30(4):261–6.CrossRefPubMed
31.
Ekström A, Matthiesen A-S, Widström A-M, Nissen E. Breastfeeding attitudes among counselling health professionals. Scand J of Public Health. 2005;33(5):353–9.CrossRef
32.
Polit D, Beck C. Nursing Research. Generating and Assessing Evidence for Nursing Practice, 9th edn. Philadelphia: Lippincott Williams and Wilkins; 2011.
33.
Cohen L, Manion L, Morrison K. Research methods in education. 6th ed. New York, USA: Routledge; 2009.
34.
Zanna M, Rempel JK. Attitudes, a new look at an old concept. In: Bar-Tal D, Kruglanski A, editors. The social psychology of knowledge. University Press: NY, Cambridge; 1986.
35.
Brown J, Beckhof C, Bickford J, Stewart M, Freeman T, Kasperski J. Women and their partners’ perception of the Key Roles of the Labor and Delivery Nurse. Clin Nurs Res. 2009;18(4):323–5.CrossRefPubMed
36.
Thorstensson S, Ekström A, Lundgren I, Hertfelt Wahn E. Exploring Professional Support Offered by Midwives during Labour: An Observation and Interview Study. Nursing Research and Practice 2012; 648405:10. doi:10.​1155/​2012/​648405.
37.
38.
Uvnas-Moberg K, Arn I, Magnusson D. The psychobiology of emotion: the role of the oxytocinergic system. Int J Behav Med. 2005;12(2):59–65.CrossRef
39.
Fisher J, JAstbury J, Smith A. Adverse psychological impact of operative obstetric interventions: a prospective longitudinal study. Aust N Z J Psychiatry. 1997;31:728–38.CrossRefPubMed
40.
Garel M, Lelong N, Kaminski M. Follow-up study of psychological consequences of caesarean childbirth. Early Hum Dev. 1988;16(2–3):271–82.CrossRefPubMed
41.
Mutryn C. Psychosocial impact of cesarean section on the family; a literature review. Soc Sci Med. 1993;37(10):1271–81.CrossRefPubMed
42.
DiMatteo M, Morton S, Lepper H, Damush T, Carney M, Pearson M, et al. Caesarean childbirth and psychosocial outcomes: A meta analysis. Health Psychol. 1996;15:303–14.CrossRefPubMed
43.
Rowe-Murray H, Fisher J. Operative intervention in delivery is associated with compromised early mother-infant interaction. Br J Obstet Gynaecol. 2001;108(10):1068–75.
44.
Ingram J, Johnsson D, Condon L. The effects of baby friendly initiative training on breastfeeding rates and the breastfeeding attitudes, knowledge and self-efficacy of community health-care staff. Primary Health Care Research & Development. 2011;12(3):266–75.CrossRef
45.
Hauck Y, Graham-Smith C, McInerney J, Kay S. Western Australian women’s perceptions of conflicting advice around breast feeding. Midwifery. 2011;27(5):156–62.CrossRef
46.
47.
Dietrich Leurer M, Misskey E. “Be positive as well as realistic”: a qualitative description analysis of information gaps experienced by breastfeeding mothers. Int Breastfeed J. 2015;10:10.PubMedCentralCrossRefPubMed
48.
Moore E, Coty M-B. Prenatal and postpartum focus groups with primiparas: breastfeeding attitudes, support, barriers, self-efficacy, and intention. J Pediatr Health Care. 2006;20(1):35–46.CrossRefPubMed
49.
Haroon S, Das J, Salam R, Imdad A, Bhutta Z. Breastfeeding promotion interventions and breastfeeding practices: a systematic review. BMC Public Health. 2013;1(3):S20.CrossRef
50.
Laanterä S, Pietilä A-M, Ekström A, Pölkki T. Confidence in breastfeeding among pregnant women. West J Nurs Res. 2012;34(7):933–51.CrossRefPubMed
51.
Machin D, Campbell M. Design of Studies for Medical Research. John Wiley & Sons Ltd: Chichester, England, Great Britain; 2005.CrossRef
Metadata
Title
Nurses and midwives professional support increases with improved attitudes - design and effects of a longitudinal randomized controlled process-oriented intervention
Authors
Anette C Ekström
Stina Thorstensson
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2015
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-015-0712-z

Other articles of this Issue 1/2015

BMC Pregnancy and Childbirth 1/2015 Go to the issue

Research article

Maternal death reviews at Bugando hospital north-western Tanzania: a 2008–2012 retrospective analysis

Research article

Effect of external airflow resistive load on postural and exercise-associated cardiovascular and pulmonary responses in pregnancy: a case control study

Research article

Sexual life and dysfunction after maternal morbidity: a systematic review

Research article

Obesity and normal birth: A qualitative study of clinician’s management of obese pregnant women during labour

Research article

Prophylactic antibiotics for manual removal of retained placenta during vaginal birth: a systematic review of observational studies and meta-analysis

Research article

A qualitative study on barriers in the prevention of anaemia during pregnancy in public health centres: perceptions of Indonesian nurse-midwives