Editorial: changes in Neonatal, Paediatric and Child Health Nursing
Linda Shields

Guest editorial: maintaining safe environments for hospitalised children
Professor David Bennett

Standards for the care of children and adolescents in health services
RACP, AWCH and CHA.

Support needs of parents of sick and/or preterm infants admitted to a neonatal unit
Catherine Tran, Alison Medhurst & Beverly O’Connell

The sudden unexpected delivery of a preterm infant elicits many emotional responses from parents, with studies confirming the importance of providing parents with nursing support. The purpose of this study was to measure parents’ perception of the type and level of support that nurses provided in an Australian neonatal unit, and to determine the extent to which parents were satisfied with the support currently provided. A convenience sample of 112 parents in an Australian tertiary neonatal unit were invited to complete the nurse parent support tool (NPST), which is a 21-item questionnaire used to measure the level of nursing support. The NPST consists of four domains – emotional, informational, appraisal and instrumental support. A second tool was used to assess parent satisfaction with nurse-to-parent support. A total of 62 parents completed the NPST and satisfaction tool.
Results showed that instrumental support had the highest mean score for both nurse-to-parent support 4.51 (out of 5) and 4.36 for satisfaction. The mean score for nursing support was 4.21 followed by satisfaction with nurse-to-parent support at 4.16. In contrast, emotional support had the lowest mean score for both nurse-to-parent support at 3.94 and 3.97 for satisfaction. Parents indicated that they needed further support with lactation, breastfeeding and assistance with parenting skills. Overall, results indicated that parent perception of nursing support was positive and that parents were highly satisfied with the nursing support provided in the neonatal unit. However, some attention needs to be given to providing more support and information on breastfeeding and parenting skills.

Mothers‘ employment and breastfeeding continuation: global and Pakistani perspectivesfrom the literature
Shela Akbar Ali Hirani & Shahirose Sadrudin Premji|

Exclusive breastfeeding during the first 6 months of life, with continuation of breastfeeding up to 2 years of life with complementary feedings, offers protection against infectious disease which could potentially avert mortality and morbidity. In Pakistan the decline in breastfeeding prevalence has been attributed to the increased proportion of women in the labour force and lack of breastfeeding support in the workplace. This paper reviews the literature to explore the association of mothers’ employment on the continuation of breastfeeding, and barriers and facilitators for breastfeeding at the workplace.
A systematic search of peer-reviewed databases including MEDLINE, CINAHL, Pub Med and the Cochrane Database of Systematic Reviews was undertaken. The search was augmented by reviewing the WHO and UNICEF websites, government reports available on the website, books, sociological abstracts, and reference lists of articles thought to be relevant.
An association is evident between early return to work or timing of return to work and breastfeeding continuation. From a global perspective, barriers and facilitators for breastfeeding at the workplace include maternal behaviours and characteristics, support at the workplace, healthcare or work environment, and policy and law. It is difficult to glean if these same factors exist in the workplace of Pakistani lactating women. There is therefore a need to identify evidence-based strategies to support breastfeeding continuation for Pakistani women returning to the workplace shortly after the birth of their babies.

Perceptions of family-centred care: a UK pilot study of the Shields and Tanner questionnaires
Smeer Aggarwal, Puneet Chadha, Sanjeev Kalia, Scott Richardson, Lucy Winterbottom & Linda Shields

The aim of this study was to test the content, reliability, validity, applicability and ease of use of a pair of questionnaires (Shields and Tanner questionnaires) which examine the perceptions of family-centred care (FCC) held by parents of hospitalised children and the staff who care for them. FCC, while a cornerstone of current paediatric practice, is not always implemented effectively, as it depends on the perceptions held by both those who administer it, the staff, and those who receive it, the parents.
In this cross-sectional study with convenience samples in three hospitals in north-east England, five medical students collected, entered, analysed and interpreted the data using SPSS and Cronbach’s alpha. The Cronbach’s alpha for each questionnaire was 0.79 (staff) and 0.72 (parents). These questionnaires proved to be reliable and valid, easy to use, and were relevant for use in studies about FCC. While the reliability was tested, the samples were not large enough to do any other statistical tests such as factor analysis. This will be part of a subsequent study. This study can now be used for larger studies, the results of which will inform the delivery of care to children and families in hospitals.

Ten tips to presenting
Denise Harrison

Vale Judy Butt • 1929-2009
Jeanette Robertson