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The Impact of Baby Massage Training on Awareness, Perceived Stress http:// ijp.mums.ac.ir Original Article (Pages: 8297-8306) The Impact of Baby Massage Training on Awareness, Perceived Stress and Breastfeeding Self-Efficacy of Mothers with Hospitalized Neonate Leili Rahmatnezhad1, Siamak Sheikhi2, *Alireza Didarloo3, Zahra Fakoor4, Maryam Iranidokht51 1MSc in Midwifery, Department of Midwifery, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran. Iran. 2Associate Professor, Department of Psychiatry, Faculty of Medicine, Urmia University of Medical Sciences. Urmia, Iran. 3Associate Professor, Social Determinants of Health Research Center, Department of Public Health, School of Health, Urmia University of Medical Sciences, Urmia, Iran. 4Assistant Professor of Pediatrics, Department of Pediatrics, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran. 5BSc Student in Midwifery, Department of Midwifery, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran. Abstract Background: Despite the positive and remarkable effects of baby massage on both mothers and infants, mothers are less likely to use this health behavior. This study was designed to evaluate the impact of baby massage training on awareness, perceived stress and breastfeeding self-efficacy of mothers with hospitalized neonate. Materials and Methods: This study, as a quasi-experimental design, was carried out on 120 mothers with hospitalized neonates (60 in the experimental group, 60 in the control group). Data were collected using a valid and reliable four -part instrument including Social-demographic information, Awareness’s scale about baby massage, Cohen’s Perceived Stress Questionnaire (PSS), and the Breastfeeding self-efficacy scale (BSES). Baby massage training was conducted on the intervention group for 3 days by a trained midwife, and changes were compared in two groups using suitable statistical tests three days after educational intervention. Results: Before education, the mean score of awareness, perceived stress, and breastfeeding self- efficacy of intervention group were 6.47±2.23, 33.42±6.85, 131.50±19.34, respectively. After education, the mean scores of the above variables were orderly changed into 8.33±1.28, 27.10±1.85, 145.77±15.80, and these changes were statistically significant (P < 0. 01); while, no statistical significant difference was observed in awareness, perceived stress, and breastfeeding self-efficacy in the control group after the intervention (P > 0.05). In addition, there was a significant difference between groups (p <0.05). Conclusion: The results of the study indicated that baby massage training (BMT) is effective in increasing the mothers’ awareness, breastfeeding self-efficacy, and in decreasing their perceived stress. Therefore, applying this approach to improve mothers’ stress and breastfeeding self-efficacy was recommended and emphasized. Key Words: Awareness, Breastfeeding, Infant massage, Mothers, Self-efficacy Stress. *Please cite this article as: Rahmatnezhad L, Sheikhi S, Didarloo A, Fakoor Z, Iranidokht M. The Impact of Baby Massage Training on Awareness, Perceived Stress and Breastfeeding Self-Efficacy of Mothers with Hospitalized Neonate. Int J Pediatr 2018; 6(10): 8297-8306. DOI: 10.22038/ijp.2018.32043.2833 *Corresponding Author: Alireza Didarloo, Social Determinants of Health Research Center, Department of Public Health, Faculty of Health Sciences, Urmia University of Medical Sciences, Iran P. O. Box: 57561-15111, Urmia, IR Iran. Email: [email protected] Received date: Mar.17, 2018; Accepted date: Apr. 22, 2018 Int J Pediatr, Vol.6, N.10, Serial No.58, Oct. 2018 8297 Baby Massage Training and Breastfeeding Self-efficacy of Mothers 1- INTRODUCTION and eliminate barriers of breastfeeding Proper feeding in infancy and early (10). The most important factor influences childhood periods is essential to ensure the breastfeeding behavior is the education of growth, health and development of mothers. Other factors also affect the children (1). Evidence has indicated that length of lactation, including: mother's breastfeeding is beneficial for both mother education and age, family income, family and baby, and exclusive breastfeeding is support, prenatal actions, decision-making considered as the best source of food (2). time for the first lactation, the time of the Breastfeeding also acts as a key protective first feeding, as well as the skill and self- factor against common infectious diseases efficacy of breastfeeding (11). Self- in childhood and has short and long term efficacy for lactation, as a construct of positive health outcomes for both children social cognitive theory of Bandura, is the and mothers (3). The World Health belief and confidence of a woman in her Organization (WHO) recommends to ability to behave exclusive breastfeeding mothers of throughout the world (12). Self-efficacy is affected by four main exclusively breastfeeding of babies up to sources of information: the first six months of the year to achieve 1. Mastery experiences, the most effective optimal growth, development and well- way of developing a strong sense of being (4-6). However, global estimates efficacy is through mastery experiences. suggest that only 36 percent of newborns Performing a task successfully strengthens born in 2015 were breastfed exclusively our sense of self-efficacy, 2. Social (6). Breastfeeding is a learning skill that its modeling, for example seeing people initiation and continuity are influenced by similar to oneself succeed by sustained physiological and psychological factors, effort raises observer’s beliefs that they too knowledge and attitude of women toward possess the capabilities to master breastfeeding (7). comparable activities, 3. Verbal persuasion, Bandura also asserted that Known barriers to breastfeeding include socio-cultural factors, poor health people could be persuaded to believe that education, and inaccurate information they have the skills and capabilities to about the benefits of dry milk (8, 9). succeed. Getting verbal encouragement Breastfeeding will be very different when from other people such as friends, family infants are hospitalized due to different can accelerate sense of individual self- illnesses and health problems. In the other efficacy, and 4. Physiological responses, words, hospitalization of the baby due to a our own responses and emotional reactions disease, physical abnormality and to situations also play an important role in immaturity may impair the onset of self-efficacy. Moods, emotional states, breastfeeding and its continuation in physical reactions and stress levels can all mothers. Eliminating barriers to exclusive impact on how a person feels about their breastfeeding and encouraging women to personal capabilities to a particular feed infants with their milk are correlated situation (12). with promoting health of babies. In Since stress, as one of the most important addition, the support of mothers with issues studied in mental health, has premature infants may increase the negative effect on the physiological tendency for exclusive breastfeeding in function of human beings (13). In addition, mothers (9). Whenever a neonate is the stress experienced by the mother admitted to the intensive care unit (ICU), during pregnancy, delivery, and ward staff must encourage her/his mother postpartum period can significantly to start and continue breastfeeding of baby influence lactation self-efficacy in women Int J Pediatr, Vol.6, N.10, Serial No.58, Oct. 2018 8298 Rahmatnezhad et al. (14). The birth of a healthy baby is the best massage can improve weight gain, sleep divine gift for a mother, while patterns, and the development of the baby encountering a hospitalized baby causes a (22, 23). On the other hand, the contact severe mental disaster for parents. New between the parents and the infants reproductive technologies, high maternal through the touch (massage) increases age, and improvements in care during and care, attention, self-efficacy of parents and after pregnancy have led to an increase in stabilizes the biological relationship the birth rate of premature infants and between them (24). In addition, the babies with severe anomalies in massage of premature babies by their industrialized countries (15). Most parents mothers on a daily basis can strengthen are unaware of complicated problems and maintain a feeling of dependence caused by premature infant. Hence, the between mother and baby (25). Therefore, lack of a clear understanding of the future the purpose of this study was to determine condition of the baby and the uncertainty the effect of infant massage training about recovery of infant are considered the program on awareness, stress and most important stressors for parents (16). breastfeeding self-efficacy of mothers with When the baby hugs a mother with anxiety hospitalized neonate. and cardiac palpitations, she/he feels 2- MATERIALS AND METHODS inconsequent and thinks that the source of anxieties and cardiac disorders of mother 2-1. Study design and population is her/his own, in turn it creates an This research work was a quasi- unbelievable feeling in infant (17). experimental study which carried out on a Therefore, the medical and nursing staff sample of mothers with hospitalized babies should prevent interruption of in Shahid Motahhari Hospital in Urmia, communication between the mother and North West of Iran. The aim of this study the baby and provide comprehensive was to investigate the effect of baby information to mothers on the care of the
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