Preterm Newborn Mothers' Anxiety and Self-Efficacy

Education Clinical Trial

Official title:

Effect of QR Code Supported Infant Care Training Given to Preterm Newborn Mothers on Motherhood Self-Efficacy and Anxiety

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT06359288
• Other study ID #: 2023/01.11/2023/6
• Status: Completed
• Phase: N/A
• Start date: January 1, 2023
• Est. completion date: March 23, 2024

Study information

• Verified date: April 2024
• Source: Kocaeli University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The aim of this study was to evaluate the effect of QR code supported infant care training given to mothers of preterm newborns on maternal self-efficacy and maternal anxiety level .

Description:

Maternal and child health is an important health indicator of societies. According to the World Health Organisation, almost half of all under-five child deaths are neonatal deaths. In order to reduce these deaths, especially in the neonatal period, it is very important for mothers to learn and correctly apply infant care. In studies conducted with mothers of preterm newborns, it was determined that mothers felt themselves inadequate after taking care responsibilities after discharge, expressed that they needed training for the care of the baby, and preferred to remain bystanders because they were less confident in the care of the baby. However, other studies have reported that preterm and hospitalised infants have a negative impact on the development of the mothering role. Prematurity may increase maternal anxiety and negatively affect perceived maternal self-efficacy. At the same time, the mother's intense anxiety and inadequate perceived maternal self-efficacy negatively affect infant care.

Maternal self-efficacy perception is mothers' beliefs about being successful in their parenting role and is an important mechanism guiding the interactions of preterm newborns and their mothers in the hospital. In order for this mechanism to continue in a healthy way, the nurse should identify the aspects that mothers perceive themselves as adequate or that mothers perceive as negative from birth and observe all their interventions towards the baby. Self-efficacy, which can be gained through learning by observation, can be maximised in the postnatal period by nurses demonstrating the principles they want to teach. Therefore, nurses should clearly show the practices for infant care to mothers and support the perception of maternal self-efficacy.

Today, traditional materials used in the educational process (blackboard, book, etc.) are replaced by smart and portable devices (e-book, smart board, tablet, etc.). In this context, QR codes serve as a bridge between old and new education models. In other words, QR codes increase the effectiveness of mobile education by integrating mobile devices into traditional educational materials. QR codes are a cheap and easy process for delivering information to individuals. When the literature is analysed, it is seen that the interest and motivation in the subject increases when the training sessions offered through the internet and printed learning materials are used together. QR codes are frequently used in educational activities due to their versatility and their ability to enable different learning environments. When the benefits of QR codes are analysed in studies conducted on healthcare professionals, students, and educators in the literature, they can be listed as ease of use and ease of access, adaptability, simplicity of development and potential environmental benefits compared to other access methods. However, studies on the use of QR codes in patient education in the field of nursing are limited.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 80
• Est. completion date: March 23, 2024
• Est. primary completion date: December 1, 2023
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Female
• Age group: 19 Years to 45 Years

Eligibility

Inclusion Criteria:

• Preterm infant who were born between 28-36+6 gestational weeks

• Preterm infant with a low birth weight at hospitalization (between 1500-2500 g)

• Preterm infant weight of 2500 g or more at discharge,

• Preterm infant who had stable vital signs,

• Preterm infant who do not use muscle relaxants, analgesics, sedatives or inotropic drugs,

• Preterm infant who do not have a serious neurological disease

• Mothers who stay with the baby for at least one month after discharge,

• Mothers who voluntarily accepting the study,

• Mothers who not being diagnosed with a psychiatric illness.

Exclusion Criteria:

• Mothers who did not have the ability to read and understand Turkish,

• Mothers who did not use/access the internet,

• Mothers who had twin babies

• Mothers whose babies with a disease that would prevent post-discharge care

Related Conditions & MeSH terms

• Education
• Mother-Infant Interaction
• Nursing Care
• Premature Birth

Intervention

Other:
• Group receiving QR code supported training
During the training process, QR codes were integrated into the sections related to the care of the newborn in the guide to provide mothers with the opportunity to watch the video simultaneously while reading the guide in practices requiring skills related to hygienic care of the newborn and nutrition / communication / sleep, and to allow them to watch it repeatedly as long as they feel the need. In these videos, the application steps were shown one by one. When the code is scanned with a smartphone, it automatically redirects the user to the specified URL. The QR codes in the Implementation Guide on the Care of the Newborn consist of eight videos) that allow mothers to watch the hygienic care of the newborn in practice. After the end of this phase of the training, the questionnaires were re-administered to the mothers in both groups one month after discharge.

Locations

Country	Name	City	State
Turkey	Kocaeli University	Kocaeli	Izmit

Sponsors (1)

Lead Sponsor	Collaborator
Kocaeli University

Country where clinical trial is conducted

Turkey, 

References & Publications (14)

Afand N, Keshavarz M, Fatemi NS, Montazeri A. Effects of infant massage on state anxiety in mothers of preterm infants prior to hospital discharge. J Clin Nurs. 2017 Jul;26(13-14):1887-1892. doi: 10.1111/jocn.13498. Epub 2017 Mar 24. — View Citation

Barnes CR, Adamson-Macedo EN. Perceived Maternal Parenting Self-Efficacy (PMP S-E) tool: development and validation with mothers of hospitalized preterm neonates. J Adv Nurs. 2007 Dec;60(5):550-60. doi: 10.1111/j.1365-2648.2007.04445.x. — View Citation

Bellot J, Shaffer K, Wang M. Use of quick response coding to create interactive patient and provider resources. J Nurs Educ. 2015 Apr;54(4):224-7. doi: 10.3928/01484834-20150318-07. — View Citation

Kadiroglu T, Guducu Tufekci F. Effect of Infant Care Training on Maternal Bonding, Motherhood Self-Efficacy, and Self-Confidence in Mothers of Preterm Newborns. Matern Child Health J. 2022 Jan;26(1):131-138. doi: 10.1007/s10995-021-03287-0. Epub 2021 Nov 27. — View Citation

Pazarcikci F, Efe E. (2017). Preterm Bebeklerin Taburculuk Sonrasi Evde Bakiminin Saglanmasinda Hemsirenin Rolü. MAKÜ Sag. Bil. Enst. Derg, 5 (1), 45-52.

Pisoni C, Garofoli F, Baiardini I, Tzialla C, Stronati M. The development of parents-infant relationship in high-risk pregnancies and preterm birth. JPNIM, 2014, 3: e030233.

Rawlins LN, Seaman KA. The Use of QR Codes to Engage Nursing Students With Next Generation NCLEX. J Nurs Educ. 2024 Mar;63(3):186-187. doi: 10.3928/01484834-20240108-02. Epub 2024 Mar 1. — View Citation

Ritchie SK. Primary care of the premature infant discharged from the neonatal intensive care unit. MCN Am J Matern Child Nurs. 2002 Mar-Apr;27(2):76-85. doi: 10.1097/00005721-200203000-00004. — View Citation

Shorey S, Chan SW, Chong YS, He HG. Maternal parental self-efficacy in newborn care and social support needs in Singapore: a correlational study. J Clin Nurs. 2014 Aug;23(15-16):2272-82. doi: 10.1111/jocn.12507. Epub 2013 Dec 26. — View Citation

Shrestha S, Adachi K, Petrini MA, Shrestha S, Rana Khagi B. Development and evaluation of a newborn care education programme in primiparous mothers in Nepal. Midwifery. 2016 Nov;42:21-28. doi: 10.1016/j.midw.2016.09.006. Epub 2016 Sep 15. — View Citation

Silva, I. O. A. M. D., Aredes, N. D. A., Bicalho, M. B., Delácio, N. C. B., Mazzo, L. D. L., & Fonseca, L. M. M. (2018). Booklet on premature infants as educational technology for the family: quasi-experimental study. Acta Paulista de Enfermagem, 31, 334-341. https://doi.org/10.1590/1982-0194201800048

Tognasso G, Gorla L, Ambrosini C, Figurella F, De Carli P, Parolin L, Sarracino D, Santona A. Parenting Stress, Maternal Self-Efficacy and Confidence in Caretaking in a Sample of Mothers with Newborns (0-1 Month). Int J Environ Res Public Health. 2022 Aug 5;19(15):9651. doi: 10.3390/ijerph19159651. — View Citation

Wolke D, Eryigit-Madzwamuse S, Gutbrod T. Very preterm/very low birthweight infants' attachment: infant and maternal characteristics. Arch Dis Child Fetal Neonatal Ed. 2014 Jan;99(1):F70-5. doi: 10.1136/archdischild-2013-303788. Epub 2013 Jun 21. — View Citation

Yayan, E. H., Özdemir, M., Düken, M. E., Suna Dag, Y. (2019). Yenidogan Yogun Bakim Ünitesinde Bebegi Yatan Ebeveynlerin Stres Düzeylerinin Belirlenmesi, Gümüshane Üniversitesi Saglik Bilimleri Dergisi (GÜSBD), 8(1), 82-89.

* Note: There are 14 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Perceived Maternal Self-Efficacy Scale (PMES)- Survey	QR code-supported education given to mothers of preterm newborns improves. The scale assesses the perceived maternal self-efficacy levels of mothers of hospitalised preterm infants. The scale, which consisted of 19 items, was graded between 1 and 4 (1 = strongly disagree, 2 = disagree, 3 = agree, 4 = strongly agree). Scoring of the scale was calculated by adding the obtained scores. The score obtained from the scale is between 19 and 76. A high score indicates that the mother's self-efficacy is high. The reliability coefficient of the scale in mothers of hospitalised preterm infants was 0.98. In this study, the internal consistency coefficient of the scale was found to be 0.95.	Before the recruit pre-test (PMES- survey scale) will be applied. One months after the intervention post-test (PMES survey scale) again will be applied.
Secondary	State-Trait Anxiety Inventory (STAI)- Survey Scale	QR code-supported education given to mothers of preterm newborns decreases the mother's anxiety level.The STAI provides information about state anxiety. The STAI consists of 20 items and is graded between 1-4 according to the anxiety level of the person. The scale includes plain and inverted statements (items: 1., 2., 5., 8., 10., 11., 15., 16., 19. and 20.) determining positive and negative emotions. Scores between 20-80 are obtained from the scale. A higher score means higher anxiety. In scoring, the total score of the negative statements is subtracted from the total score of the positive statements. A predetermined and unchanged 50 points are added to this score. The score obtained indicates the anxiety level of the person. In this study, the internal consistency coefficient of the scale was found to be 0.88.	Before the recruit pre-test (STAI- survey scale) will be applied. One months after the intervention post-test (STAI survey scale) again will be applied.