Open Access
A complex intervention to support breastfeeding: a feasibility and acceptability study
(Wiley, 2023-07-18) Lucchini-Raies, Camila; Márquez-Doren, Francisca; Pérez, J. Carola; Campos, Solange; Beca, Paulina; López de Dicastillo Sáinz de Murieta, Olga; Ciencias de la Salud; Osasun Zientziak
Aims: The aims of this study are to assess the acceptability and feasibility of a multicomponent intervention to support breastfeeding women and their families and explore its effectiveness. Methods: A pilot study with control and intervention groups was conducted using the complex intervention framework in two primary healthcare centres. Overall, 44 childbearing women, their partners/relatives and 20 healthcare professionals participated in the study. The intervention's feasibility and acceptability were measured. The percentage of exclusive breastfeeding rates and women's self-efficacy were measured at pre-intervention, at 10 days postpartum, and again at 2, 4 and 6 months postpartum. Postpartum depression risk was measured at 2 and 6 months postpartum. Professional self-efficacy was measured at pre-intervention and 3 months later. Results: The intervention was feasible and acceptable. No difference in self-efficacy existed between the intervention and control groups. Preliminary effects of the intervention were found in exclusive breastfeeding percentage and postpartum depression risk in the intervention group. Conclusion: The intervention is feasible and acceptable. The results are promising not only for breastfeeding maintenance but also for preventing postpartum depression and recovering exclusive breastfeeding during pandemics.
Open Access
Parental self-efficacy to promote children's healthy lifestyles: a pilot and feasibility study
(MDPI, 2021) Ruiz-Zaldíbar, Cayetana; Serrano-Monzó, Inmaculada; López de Dicastillo Sáinz de Murieta, Olga; Pumar Méndez, María Jesús; Iriarte Roteta, Andrea; Bermejo-Martins, Elena; Mujika Zabaleta, Agurtzane; Ciencias de la Salud; Osasun Zientziak
Positive parenting programs are a key strategy to promote the development of parental competence. We designed a pilot study based on parental self-efficacy to promote healthy lifestyles in their children aged between 2 to 5 years old. In this pilot study, we aimed to assess the effects of a parenting program on parental self-efficacy and parenting styles. Twenty-five parents were allocated into intervention (N = 15) and control group (N = 10). Parents from the intervention group received four group sessions (120 mi per session) to develop a positive parenting, parenting styles and parenting skills regarding to children's diet, exercise, and screen time, and two additional sessions about child development and family games. Parents from the control group received these two latter sessions. Parental self-efficacy, parenting styles, and meal-related parenting practices were measured before and after the intervention and at 3-month follow-up. Acceptability and feasibility of the program was also measured. Quantitative data were analyzed using the repeat measures ANOVA and ANCOVA tests and the effect size calculation. Content analysis was used to analyse open questions. Positive trends were found regarding parental self-efficacy and the use of authoritative parenting style. Parents also reported a great acceptability of the program getting high satisfaction. According to the feasibility barriers and facilitators aspects were identified. The positive trends founded in this study support the development of parenting programs to promote healthy lifestyle in children.
Open Access
Volunteerism as adolescent health promotion asset: a scoping review
(Oxford University Press, 2020) Hernantes Colias, Naia; Pumar Méndez, María Jesús; López de Dicastillo Sáinz de Murieta, Olga; Iriarte Roteta, Andrea; Mujika Zabaleta, Agurtzane; Ciencias de la Salud; Osasun Zientziak
The Aim of this scoping review was to explore the available literature on volunteerism in adolescence and the benefits that this activity may report in their healthy development, from a salutogenic perspective. Searches were conducted in Pubmed, Cinahl, PsycINFO and Cochrane Library home databases; 15 articles were selected. Almost all of the studies were conducted in the United States between 1990 and 2000, primarily developed by psychologists and sociologists. The impact of volunteering was reflected in aspects that can be classified based on Lerner's dimensions of the PYD model. Volunteer activities promote an Improved academic, social, cognitive, and vocational competence in adolescents. An increase in conflict resolution capacity, leadership and personal agency, as well as improved pro-social attitudes and relationships with adults and peers, all of which contributed to their self-identification with the community. Moreover, increased positive development of adolescents reduces the rates of risky behaviors. Volunteerism may represent an opportunity for health promotion in adolescence. The concept of volunteering as an asset for health promotion during adolescence evokes the need to adopt and favor this view with regard to key areas of study associated with this stage such as education and health. Teams that work in community health, especially those in primary care, should recognize and value existing volunteer groups as an asset to promote the healthy development of adolescents. Friendlier health services should be encouraged that include comprehensive services from within educational institutions to community actions.
Open Access
The CRIAA Program complex intervention in primary care to support women and their families in breastfeeding: study protocol for a pilot trial
(Wiley, 2020) Lucchini-Raies, Camila; Márquez-Doren, Francisca; Beca, Paulina; Pérez, J. Carola; Campos, Solange; López de Dicastillo Sáinz de Murieta, Olga; Ciencias de la Salud; Osasun Zientziak
Aim: To report a pilot study protocol to assess the feasibility of a complex intervention, in the primary healthcare context, to support women and their families in breastfeeding. Design: A pilot/feasibility trial with control and intervention groups. Methods: The study will be conducted in two primary healthcare centres with 40 childbearing women (20 control group; 20 intervention group), with their partner/meaningful person and their respective healthcare professionals. Intervention group participants will receive the intervention: (a) in a breastfeeding workshop during their third trimester of pregnancy; and (b) via virtual breastfeeding support for six months postpartum. Health professionals will be trained to deliver the intervention. The control group will receive standard care in the outpatient clinic. The pilot will help determine the intervention's feasibility. Data collected pre-intervention, 10-days postpartum and two-, four-, and six-months postpartum will provide estimates of the intervention's preliminary effects on self-efficacy and main outcomes. Research Ethics Committee approval was obtained in April 2019. Discussion: Breastfeeding support is a complex reality influenced by multiple factors. Therefore, approaches to breastfeeding are also, requiring interventions that address its multidimensional nature, including all actors involved. The proposed intervention will be applied by an interdisciplinary professional health team, allowing for its incorporation into standard practice and its perpetual maintenance. Impact: The study will produce an original, comprehensive, complex intervention addressing contextual, and organizational factors to promote breastfeeding support using an interdisciplinary and family-based approach; breastfeeding self-efficacy is the core concept. The program evaluation and feasibility study will permit exploration of the integration of the intervention's novel aspects into the daily work of professionals and reveal how to better use existing resources in a full-scale clinical trial. Trial registration: ClinicalTrials.gov ID: NCT03944642.
Open Access
Placing myself in a new normalized life: the process of becoming a first-time father. A grounded theory study
(Wiley, 2021) Vidaurreta, Marta; López de Dicastillo Sáinz de Murieta, Olga; Serrano-Monzó, Inmaculada; Belintxon, Maider; Bermejo-Martins, Elena; Mujika Zabaleta, Agurtzane; Ciencias de la Salud; Osasun Zientziak
Becoming a first-time father is an important transition period in men's lives that is frequently accompanied by joy and happiness. Engaging fathers has a broader impact on family and community and on fathers' own well-being. This study explores the process of men becoming first-time fathers and the experiences and challenges involved. Seventeen interviews with men in different stages of pregnancy, childbirth, and the postpartum period were conducted. Through a grounded theory design, a novel four-stage theoretical model emerged that represents the journey to first-time fatherhood. These stages are beginning the journey, fatherhood in limbo, facing reality, and settling down. Participants suggested that achieving a new normality was the final stage where they finally felt located with a sense of mastery in their journey to fatherhood. The novel theoretical approach of addressing the process of men's transition allowed more complete access to their perspectives. Men's needs are different at every phase of the transition to fatherhood, and the use of these findings can help care providers in caring for every man according to the stage he is facing.
Open Access
"Missed nursing care" in health promotion: raising awareness
(Wiley, 2020) López de Dicastillo Sáinz de Murieta, Olga; Zabaleta del Olmo, Edurne; Mujika Zabaleta, Agurtzane; Antoñanzas Baztán, Elena; Hernantes Colias, Naia; Pumar Méndez, María Jesús; Ciencias de la Salud; Osasun Zientziak
Aim(s): This commentary aims to raise awareness of the possible causes of “missed nursing care” in health promotion and to propose possible solutions. Background: Although health promotion is an essential function of nursing practice, “missed nursing care” has been scarcely studied in this area. It is crucial to know both its causes and possible strategies to prevent it. Evaluation: We used evidence to identify possible causes of “missed nursing care” in health promotion, and we classified them into categories. We suggested the concept of capacity building to address its underlying causes. Key issue(s): Four main factors are involved in “missed nursing care” in health promo-tion, that is intrapersonal, interpersonal, organisational and cultural. Capacity build-ing, including the development of knowledge, skills, commitment, structures, systems and leadership, could reduce missed care. Conclusion(s): “Missed nursing care” in health promotion is complex and is multifac-torial in its origins. Capacity building could be a way to address its causes. Implications for Nursing Management: Nursing care in health promotion is para-mount and a long-term investment that can contribute to the sustainability of the health system. Organisations and managers could view capacity building processes as a tool to prevent “missed nursing care” in health promotion.
Open Access
Six-month breastfeeding maintenance after a self-efficacy promoting programme: an exploratory trial
(Wiley, 2021) Antoñanzas Baztán, Elena; Belintxon, Maider; Marín Fernández, Blanca; Redín Areta, María Dolores; Mujika Zabaleta, Agurtzane; Pumar Méndez, María Jesús; López de Dicastillo Sáinz de Murieta, Olga; Ciencias de la Salud; Osasun Zientziak
Background: Breastfeeding care plays a fundamental role in establishing breastfeeding and longer duration after discharge. Practices though vary among professionals involved and are often inconsistent with good practices recommended, being a threat to women’s breastfeeding self-efficacy. Breastfeeding self-efficacy is considered a predictor for successful breastfeeding and a significant variable amenable to intervention for promoting lactation Aim: To evaluate the efficacy, feasibility and acceptability of a new breastfeeding self-efficacy promoting programme (SIALAC) on 6-month breastfeeding maintenance. Methods: In this exploratory multi-centre controlled trial, participants were allocated into control and intervention groups sequentially. Professionals in charge of the treatment groups were trained in between, with an especial focus on reducing practice variability. Control and intervention group women received usual care, and the intervention group received in addition SIALAC, a three-stage breastfeeding self-efficacy promoting programme. Primary outcome was breastfeeding maintenance up to 6 months analysed by Kaplan–Meier and Cox proportional hazard regression analysis. Student’s t-test or chi-square tests were also used for continuous and categorical variables. Data on breastfeeding status and breastfeeding self-efficacy were collected at baseline, and 4, 8 and 24 weeks after birth. Results: From May 2014 through November 2015, participants were enrolled. The sample consisted of 112 women. No relevant socio-demographic or obstetric difference was found between groups. The intervention achieved a significant difference between groups in breastfeeding survival (X2 = 4.94, p = 0.026). Six-month breastfeeding maintenance was significantly higher in the intervention group (67% vs. 55%; X2 = 5.384, p = 0.020). Breastfeeding dropout in the control group was 3.3 (CI 1.1, 10.1) times higher than that of the intervention group at 6 months. Breastfeeding self-efficacy scores were higher in the intervention group although without significant statistical difference. The programme showed good acceptability. Conclusion: Breastfeeding self-efficacy promoting programme SIALAC was beneficial in fostering 6-month breastfeeding survival. Full-scale trial should consider feasibility-related issues identified.
Open Access
Lactancia materna y alojamiento en el abordaje del síndrome deabstinencia neonatal. Revisión panorámica
(2023) Baeza Gozalo, Paula; Sola Cía, Sara; López de Dicastillo Sáinz de Murieta, Olga; Ciencias de la Salud; Osasun Zientziak
En la actualidad, el aumento del consumo de drogas en gestantes está provocando un incremento del síndrome de abstinencia neonatal (SAN). El abordaje de dicho síndrome varía en la práctica clínica y, en algunos centros, se tiende a suspender tanto la lactancia materna como el alojamiento conjunto. El objetivo de este trabajo es analizar los efectos de la lactancia materna y el alojamiento conjunto en neonatos con SAN mediante la realización de una revisión panorámica de trabajos publicados en PubMed y CINAHL. Según los once trabajos incluidos, tanto la lactancia ma- terna como el alojamiento conjunto reducen la estancia hospitalaria, así como la necesidad y la duración del tra- tamiento farmacológico. Además, el alojamiento conjunto disminuye la probabilidad de admisión en Cuidados Inten- sivos Neonatales, aunque no mejoró la severidad de los sig- nos del SAN. Los bebes alimentados con lactancia materna presentaron signos significativamente más leves de absti- nencia y, una mayor probabilidad, aunque no significativa, de ser reingresados. No hay evidencia de que el alojamiento conjunto disminuya la readmisión hospitalaria tras el alta. Los hallazgos justifican que tanto la cohabitación como la lactancia se deberían mantener siempre que sea posible en el abordaje de este síndrome para no empeorar las condiciones del neonato, tomando las medidas oportunas para garantizar la seguridad del niño y de la madre.
Open Access
Non-suicidal self-injury experiences for adolescents who self-injured: contributions of Winnicott's psychoanalytic theory
(Universidade Federal de Santa Catarina, 2021) Cesar Riani Costa, Luiza; Martins Gabriel, Isabela; Oliveira, Wanderlei Abadio de; Hortense, Priscilla; López de Dicastillo Sáinz de Murieta, Olga; Carlos, Diene Monique; Ciencias de la Salud; Osasun Zientziak
Objective: to identify and analyze the elements present in non-suicidal self-injury experiences by adolescents who self-injured. Method: a qualitative research, with data collection conducted from August to October 2019 through individual therapeutic consultations, mediated by the dialogical resource Drawing-Story with Theme Procedure. Participants were eight adolescents who reported self-injury in a school of a municipality in the countryside of São Paulo, Brazil. Thematic analysis was developed from data anchored in Winnicott’s psychoanalytic theory. Results: two thematic categories were identified: “I think nobody cares about me” and “I do not see the colors I used to see before”. The elements present in adolescents’ experiences on non-suicidal self-injury highlighted the importance of a physical and relational environment that offers holding and is able to integrate characteristics of the adolescence process itself. The importance of a family and peer support network, as well as the need for family, school and health professionals to be involved in coping with and preventing non-suicidal self-injury stands out. Conclusion: non-suicidal self-injury is a multiple phenomenon, closely related to the environment, which deserves attention and care in the field of child and adolescent health. The issues present in the process of becoming an adolescent emerge as essential elements for understanding and coping with non-suicidal selfinjury. Due to their multiple characteristics, coping and prevention policies should include several areas, such as health, education, and social assistance. The presence of mental health programs in schools is fundamental.
Open Access
Mapping health promotion practices across key sectors and its intersectoral approach at the local level: study protocol
(Wiley, 2024) Pumar Méndez, María Jesús; López de Dicastillo Sáinz de Murieta, Olga; Hernantes Colias, Naia; Antón-Solanas, Isabel; Zabaleta del Olmo, Edurne; Rodríguez-Roca, Beatriz; Subirón-Valera, Ana Belén; Juvinyà-Canal, Dolors; Mujika Zabaleta, Agurtzane; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Aims: This study outlines a protocol aimed at identifying and mapping health promotion practices in need of development from the perspectives of key sectors responsible for it at the local level and from an intersectoral perspective across four Spanish regions. Design: A complementary multi-method study combining survey methods and qualitative interviews will be adopted. Methods: Purposive snowball sampling will be employed to select potentially rich informants from city councils, primary care centres, primary and secondary schools, and public health and civil society organizations in 12 municipalities sensitive to local health. Data on the degree of execution of health promotion activities, the level of intersectorality in their implementation, and their origins will be collected using PromoACTIVA questionnaires, an intersectoral typology model and an interview protocol. A parallel mixed analysis encompassing descriptive statistics and a ‘framework analysis’ will be performed. Discussion: This study is expected to yield thorough and reliable insights into health promotion practices and omissions at the local level by focusing on key stakeholders, both individually and collaboratively. This information can enhance health promotion planning and improve its effectiveness, efficiency and contextual relevance. The development and testing of a methodology for the integration and interpretation of these data will ensure sustainable capacity building. Impact: Managers and practitioners interested in health promotion planning in the researched settings can benefit from a comprehensive map of the current state of their practices and insights into the starting points of collaboration. In addition, planners from other local settings will gain access to tools and methodologies to replicate and expand these maps to their own contexts. Stakeholder Engagement: Engaging key stakeholders with experience working in or with primary care centres, public health organizations, primary and secondary schools, civil society organizations, and city councils was vital to ensure the study's relevance and feasibility.