Introduktion: Att bli förälder kan upplevas överväldigande och påfrestande särskilt under barnets första levnadsår. Nyblivna föräldrar kan känna sig osäkra i sitt föräldraskap och känna sig hjälplösa i samspelet med det nyfödda barnet. Barnhälsovården (BHV) erbjuder stöd och vägledning i föräldraskapet med syftet att stärka delaktighet och tillit till den egna förmågan att skapa goda livsvillkor som gynnar utvecklingen för barnet. Föräldrars egenförmåga handlar om självkännedom om sin egen kompetens, styrka och sårbarhet. Det finns samband mellan hög egenförmåga och hälsoutfall hos föräldrar och barn.Syfte: Syftet med studien var att undersöka faktorer som främjar eller hindrar föräldrars upplevda egenförmåga under barnets första år.Metod: Studien var en litteraturstudie med deskriptiv kvantitativ ansats som inkluderade 22 artiklar som studerar faktorer som påverkade egenförmågan hos föräldrar med barn 0–12 månader. Artiklarna kvalitetsgranskades och analyserades. Resultatet delades i huvudområden och kategorier.Resultat: I resultatet presenteras fyra huvudområden med kategorier. Exempel på främjande samband som sågs var socialt stöd, att vara flergångsförälder samt medföräldraskap. Exempel på faktorer som hade negativt samband med egenförmåga var förälderns postpartum hälsa, socioekonomisk utsatthet samt svårhanterligt barn.Slutsats: Föreliggande litteraturöversikt beskriver olika faktorer som främjar och hindrar egenförmåga hos föräldrar under barnets första år. Resultatet ökar BHV-sjuksköterskans kunskap om hur egenförmåga påverkar föräldrar och barn och kan underlätta identifiering av familjer som kan behöva förstärkta insatser. Med anledning av förälderns betydelse för barns hälsa och utveckling behövs fler interventionsstudier för att stödja olika föräldrar i föräldraskapet. / Introduction: Becoming a parent can be overwhelming and stressful during the child's first year of life. New parents may feel insecure in their parenting and feel helpless in their interactions with the newborn. Child Health Services offers support and guidance in parenthood with the aim of strengthening participation and confidence in one's own ability to create good living conditions that benefit the child's development. Parental self-efficacy is about self-awareness of one's own competence, strength, and vulnerability. There is a correlation between high self-efficacy and health outcomes in parents and children.Aim: The aim of this study was to investigate factors that promote or hinder parental self-efficacy during the child's first year.Method: This study was a literature review with a descriptive quantitative approach that included 22 articles that studied factors that affected parental self-efficacy of parents with children 0-12 months. The articles were quality reviewed and analyzed. The results were divided into main areas and categories.Results: The result presents four main areas with categories. Examples of positive correlations that were seen were social support, being multipara and co-parenting. Examples of factors that had a negative correlation with self-efficacy were the parent's postpartum health, socioeconomic vulnerability and fussy infant.Conclusion: The present literature review describes various factors that promote and hinder parental self-efficacy during the child's first year. The result increases the knowledge of child health nurses on how self-efficacy affects parents and children and can facilitate the identification of families who may need enhanced interventions. Due to the importance of the parent for children's health and development, more intervention studies are needed to support different parents in parenthood.

京都大学 / 新制・論文博士 / 博士(医学) / 乙第13580号 / 論医博第2302号 / 新制||医||1069(附属図書館) / (主査)教授 平井 豊博, 教授 江木 盛時, 教授 齋藤 潤 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

Thesis (Ed.M.)--Boston University

Preterm infants frequently suffer from respiratory distress syndrome (RDS), possibly due to lower expression of epithelial Na+ channels (ENaC). RDS incidence is sex-specific, affecting males almost twice as often. Despite the use of antenatal glucocorticoids (GCs), the sex difference persists. It is still controversial whether both sexes benefit equally from GCs. We previously showed that Na+ transport is higher in female compared with male fetal distal lung epithelial (FDLE) cells. Since GCs increase Na+ transport, we hypothesized that their stimulating effect might be sex-specific. We analyzed FDLE cells with Ussing chambers and RT-qPCR in the presence or absence of fetal serum. In serum-free medium, GCs increased the ENaC activity and mRNA expression, independent of sex. In contrast, GCs did not increase the Na+ transport in serum-supplemented media and abolished the otherwise observed sex difference. Inhibition of the GC receptor in the presence of serum did not equalize Na+ transport between male and female cells. The GC-induced surfactant protein mRNA expression was concentration and sex-specific. In conclusion, female and male FDLE cells exhibit no sex difference in response to GCs with regard to Na+ transport, and GR activity does not contribute to the higher Na+ transport in females.

Urinary tract infections (UTI) in neonates are caused by many types of risk factors such as increased length of maternal labor, physiologic maternal conditions, prematurity, and decreased birth weight. Identification of potential risk factors for UTI in neonates can lead to rapid assessment and early interventions to treat urinary infection in the neonate before it transitions to a severe or life-threatening condition, such as a kidney infection or septicemia. The primary purpose of this literature review was to examine risk factors predisposing neonates to UTI. The secondary purpose was to identify if length of time to drug therapy used to treat UTI in neonates decreased complications and recurrence in the preterm infant. A comprehensive literature review was performed using research articles available from 2007 to 2021 regarding the factors influencing the occurrence of urinary tract infections in neonates. Databases used to search for articles include EBSCOhost databases, Medical Literature On-Line (Medline), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar. Searches used a combination of the following terms: ‘UTI’, OR ‘urinary tract infection’, AND ‘neonates’, OR ‘infants’, ‘risk factors’. Of the articles reviewed, 15 met the inclusion criteria and answered the research questions. Two studies showed circumcision in male infants increases the risk of urinary tract infection in infants. Two studies revealed vesicourethral reflux in female infants compared to male infants increases the risk of UTIs. One article suggested women with longer labor (>24 hours) from onset had an increased likelihood of the newborn having a UTI within the first week of life. Preliminary data suggests there are significant precursors and risk factors that can be identified to diagnosis UTIs early and having them treated promptly. All the reviewed articles focused on collection of urine samples within hours of birth and physiologic findings of a UTI can decrease the length of stay and costs related to infection treatment. Antibiotic therapy being administered empirically due to rapid assessment of risk factors for UTI in the neonate decreases time to treatment by three to five days, which improves health outcomes. Rapid assessment and diagnosis of UTI is of value for preventable measures to be ordered sooner to avoid repeat and resistant UTIs in the neonate.

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