BackgroundThis study aimed to evaluate the factors that influence breastfeeding throughout the hospital stay, including prenatal preparation, early skin-to-skin contact directly after delivery, rooming-in, feeding before the first breastfeed, time to first breastfeed, and postpartum support. This study also aimed to verify whether these factors were significant after adjusting for the mother’s characteristics, the newborn’s characteristics, and the delivery characteristics.MethodsA retrospective survey was used to collect the data. Factors that influenced breastfeeding throughout the hospital stay, and differences between the types of newborns were analyzed.ResultsAmong twins, a higher likelihood of breastfeeding throughout the hospital stay was associated with not feeding before the first breastfeeding and an earlier start time for the first breastfeeding. Among singletons, a higher likelihood of breastfeeding throughout the hospital stay was associated with early skin-to-skin contact, no other feeding before the first breastfeed, and an earlier commencement of the first breastfeed.ConclusionsEffort should encourage early breastfeeding, without restriction, to improve the breastfeeding rate among mothers of twins. Moreover, an individualized approach that addresses the factors that influence breastfeeding for each type of newborn may help improve the corresponding rates of breastfeeding throughout the hospital stay.

Background:Many patients facing spinal surgery experience fear and anxiety about surgery, anesthesia, risk of postoperative pain or complications, or even death. Spinal surgery patients often experience mobility disorders due to lasting postoperative pain and require aids such as spinal braces, which can induce depression. Alleviating patients’ anxiety and depression during the perioperative period by utilizing consistent and standardized information is required for high-quality care.Objective:We developed and assessed a standardized care protocol for degenerative spinal surgery patients.Methods:The protocol was developed through focus group interviews with spinal surgery patients and the recommendations of an expert panel. Then, a quasi-experimental design was employed to comparatively study patients undergoing spinal surgery. Ninety-eight Patients were assigned to either a treatment group (n= 49) or a control group (n= 49). The treatment group received an intervention based on the newly developed standardized care protocol, while the control group received traditional care. After treatment, participants’ anxiety, depression, uncertainty, and care satisfaction were compared between groups.Results:Patients who had received the care protocol-based intervention showed lower anxiety, depression, and uncertainty, and higher satisfaction than did those who received traditional care.Conclusion:The developed care protocol may be useful for reducing anxiety and depression and for improving the healthcare provided to spinal surgery patients, as it involves the proactive dissemination of accurate information throughout the hospitalization process. The protocol also positively affected patients’ uncertainty and satisfaction with their medical care.