Fact-finding survey of the infant cleaning care and explore of the selection of care in Japan

—A mixed method approach—

Abstract

Purpose
The purpose of this study is fact-finding survey of the infant cleaning care and elucidate midwives thought and practice of early infant cleaning care by mixed methods research. The quantitative data are to elucidate on trends in the selection of early infant cleaning care by obstetrics facilities across Japan, as well as to elucidate on the selection of cleaning care by qualitatively extracting the opinions of midwives on cleaning care, such as their ideology, difficulties, as well as the background of these social factors.
Methods
An explanatory mixed-methods design was used. Quantitative data was sent to obstetrics facilities across Japan for self-administered questionnaires to be sampled with probability proportionate to size. Correlated factor analysis of cleaning care was implemented using logistic regression analysis and a chi-square test for items such as attributes, cleaning care based on number of days, care implementation time, and so on. In the qualitative survey, semi-structured interviews were conducted for five midwives practicing infant cleaning care and the verbatim records were used to conduct qualitative and inductive analyses.
Results
Responses were collected from 256 institutions in the nation-wide cross-sectional survey. Most respondents opted for a dry technique (65.3%) for cleaning on the day of delivery, and for bathing (67.9∼92.2%) from one day after delivery. A bathing needed more time than a dry technique. In logistic regression analysis, Kanto area (p<0.05; OR= 2.1) and each number of nurse and midwives (p<0.05, p<0.01; OR=1.1, 1.1) increased significantly associated with a dry technique choice. As for infant cleaning care of the qualitative survey were showed four categories. Four categories were extracted, namely, "infant-centered cleaning care," "parents-centered cleaning care," "cleaning care in consideration of medical personnel's burden," and "switching between the two infant cleaning techniques."
Conclusion
The infant cleaning care selection had contributed to the number of nurses, midwives, and area with facilities. The midwife was performing the infant cleaning care for the infant's assessment to top priority. The bathing or the dry technique are defined by the facility cleaning care of current, time load, and the culture of Japan. So midwife was wavering in care selection.