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. 2021 Jun 22;17(4):e13219. doi: 10.1111/mcn.13219

TABLE 1.

Instrument items: Health Professionals' Beliefs about Skin‐to‐Skin Care During a Cesarean (SSCB©)a

Stem: When I think about my beliefs related to skin‐to‐skin care in the OR during an uncomplicated caesarean for alert and responsive mothers and their newborns…
1. I believe that all healthy mothers and newborns should have immediate, uninterrupted SSC care (CB)
2. I believe that there is insufficient room on mother's chest to begin SSC care (B)
3. I believe that initial newborn assessments should be completed while mothers and newborns are SSC (S)
4. I believe that health professionals should inform mothers prenatally about the benefits of SSC (S)b
5. I believe that newborns who have SSC immediately after birth will be more likely to exclusively breastfeed at hospital discharge (CB)b
6. I believe that SSC care reduces maternal stress during a caesarean (CB)
7. I believe that equipment required during surgery (e.g., surgical drapes; EKG leads; maternal IV; and blood pressure cuff) makes SSC care difficult to provide (B)
8. I believe that health professionals should inform mothers on admission about the benefits of SSC (S)
9. I believe that SSC should begin after mother and newborn are in the recovery room (CB)
10. I believe that SSC improves newborn physiologic stability (e.g., blood glucose, temperature and oxygen saturation) (CB)b
11. I believe that mothers prefer to wait until after the first bath to hold their newborn skin‐to‐skin (B)
12. I believe that SSC care during surgery improves maternal satisfaction with the surgical experience (CB)
13. I believe that health outcomes of mothers and newborns are unaffected when SSC begins in the recovery room (CB)
14. I believe that SSC improves maternal and newborn attachment CB)
15. I believe that newborns will exhibit a series of instinctive breast‐seeking behaviours when placed skin‐to‐skin (CB)
16. I believe that mothers prefer to wait until they are in the recovery room to hold their newborn skin‐to‐skin (B)
17. I believe that SSC is not needed if mothers plan to bottle‐feed (CB)
18. I believe that SSC increases the risk of newborn hypothermia (CB)
19. I believe that mothers who have immediate SSC after birth breastfeed longer (CB)b
20. I believe that to increase safety, a nurse should be assigned to the newborn during SSC (S)
21. I believe that SSC increases maternal milk supply (CB)
22. I believe that SSC reduces newborn stress (CB)
23. I believe that SSC should begin after initial newborn assessments are completed in a warmer (S)
24. In your opinion, should SSC begin in the OR for alert and responsive mothers and their newborn? Please explain your answer (CB)
25. What are 3 main reasons to promote SSC in the OR for alert and responsive mothers and their newborn? (CB)
26. What are 3 main reasons not to promote SSC in the OR for alert and responsive mothers and their newborn? (CB)
27. If a hospital team wanted to promote SSC in the OR, what are the 3 main barriers that would need to be overcome? (B)
28. If a hospital team were to promote SSC in the OR, what would be your 3 main concerns? (B)
29. What are 3 strategies to increase the use of SSC in the OR? (S)
30. What are 3 strategies to promote safety during the use of SSC in the OR? (S)
31. Additional comments about SSC in the OR:

Abbreviations: B, barrier to SSC; CB, core beliefs; OR, operating room (operating theatre); S, strategies to increase SSC; SSC, skin‐to‐skin care.

a

© 2021, Jeannette T. Crenshaw & Ellise D. Adams. For permission to use this instrument, instructions, and scoring, please contact Jeannette.Crenshaw@ttuhsc.edu or Ellise.Adams@UAH.edu

b

Key drivers of SSC positive sentiment towards SSC during a caesarean (eigenvalues < 1.0). Participants were asked to indicate responses to Items 1–23, where 1 = strongly disagrees with my beliefs about SSC in the OR; 2 = disagrees; 3 = somewhat disagrees; 4 = somewhat agrees; 5 = agrees; and 6 = strongly agrees. Participants were asked to give narrative responses to open‐ended Items 24–30. Definitions were skin‐to‐skin care = mother cradles her naked newborn prone on her bare chest; exclusive breastfeeding = baby fed only breast milk from birth (no other liquids or solids except liquids with vitamins, minerals, medicines).

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