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Caring for crying babies: A mixed‐methods study to understand factors influencing nurses' and doctors' management of infant colic
Author(s) -
McGann James,
Manohar Jaqueline,
Hiscock Harriet,
O'Connor Denise,
Hodgson Jan,
Babl Franz,
Sung Valerie
Publication year - 2018
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.13858
Subject(s) - crying , medicine , confusion , limiting , emergency department , infant crying , psychological intervention , nursing , reflux , family medicine , psychiatry , psychology , disease , mechanical engineering , psychoanalysis , engineering , pathology
Aim The aim of this study was to determine the barriers and enablers influencing the uptake of two recommendations from a tertiary paediatric hospital's clinical practice guidelines by maternal and child health nurses (MCHNs) and emergency department (ED) doctors: (i) explaining normal crying; and (ii) avoiding attributing crying to gastro‐oesophageal reflux (GOR) and limiting anti‐reflux medication use. Methods The study was designed as 1‐h focus group discussions, guided by the Theoretical Domains Framework, and a short questionnaire, with a purposive sample of MCHNs and ED doctors in Victoria, Australia in (March to September) 2015. Analyses were conducted by inductive content analysis to identify key barriers and enablers. Results A total of 53 MCHNs and 25 ED doctors participated in 11 discussions. For explaining normal crying, key enablers were: adequate experience/competency, perceiving it was their role to explain and belief it prevented over‐medicalisation. The main barriers were time restriction and beliefs about parents' perceptions. For MCHNs, key barriers to avoid attributing crying to GOR were: lack of knowledge and confusion around their role in diagnosing GOR. For ED doctors, key barriers to limiting anti‐reflux medication were: parents requesting medication, concern about disrupting the parent–primary‐care practitioner relationship and belief it was not their role to cease anti‐reflux medication. Conclusions Overall, MCHN and ED doctors were proficient in describing normal crying. However, several barriers to best practice were identified, including time constraints and belief about consequences of intervening. These results will be used to develop effective interventions to address the identified barriers and enablers to optimise the management of infant colic.