Introduction:: Current studies have established that there are numerous facilitators and challenges of exclusive breastfeeding. There are limited studies that explore working mothers‟ experiences on what empowers them to continue and sustain exclusive breastfeeding. Methods:: A qualitative exploratory study was conducted by means of in-depth semi-structured focus group with 16 working mothers purposively selected from all four public universities in Brunei Darussalam. Data was analysed thematically. Results:: Three themes emerged that influenced mothers‟ empowerment to initiate and sustain exclusive breastfeeding: 1) self-determination; 2) psychosocial support system; and 3) the real world. Mothers‟ determination to embrace breastfeeding is socio-culturally and religiously shaped, which is further strengthened by motherly instinct that primarily empowered mothers to exclusive breastfeeding. Psychosocial support system comprising husband, family, friends, support groups and social media are positively viewed as vital enhancer of mothers‟ empowerment. Mismatch of mothers‟ expectations and the actual experiences, non-breastfeeding friendly work environment and unsupportive co-workers hindered them from feeling fully empowered to exclusively breastfeeding. Conclusion: Holistic strategies should be implemented to continuously enhance and empower working mothers to achieve at least a minimum of six months exclusive breastfeeding once they return to work. This includes provision of dedicated private breastfeeding room and allocated time for pumping of breast milk. Working mothers also required support for their transition from breastfeeding the babies on their breast during the allocated extended maternity leave to different methods of giving expressed breast milk to their babies when they return to work.

PURPOSE: Little evidence estimated the exposure of psychosocial work stressors, work-related fatigue, and musculoskeletal disorders for nurses working in South-East Asian region, and research on this subject is almost nonexistent in Brunei. The main aim of our study was to provide a comprehensive exploration and estimate exposure of the study variables amongst emergency (ER) and critical care (CC) nurses in Brunei. The study also aims to compare whether experiences of ER nurses differ from those of CC nurses. METHODS: This cross-sectional study was implemented in the ER and CC departments across Brunei public hospitals from February to April 2016 by using Copenhagen Psychosocial Questionnaire II, Occupational Fatigue Exhaustion Recovery scale, and Cornell Musculoskeletal Discomfort Questionnaire. RESULTS: In total, 201 ER and CC nurses (82.0% response rate) participated in the study. Quantitative demands of CC nurses were significantly higher than ER nurses. Even so, ER nurses were 4.0 times more likely [95% confidence interval (2.21, 7.35)] to experience threats of violence, and 2.8 times more likely [95% confidence interval: (1.50, 5.29)] to experience chronic fatigue. The results revealed that nurses experienced high quantitative demands, work pace, stress, and burnout. High prevalence of chronic and persistent fatigue, threats of violence and bullying, and musculoskeletal pain at the neck, shoulder, upper and lower back, and foot region, was also reported. CONCLUSION: This study has provided good estimates for the exposure rate of psychosocial work stressors, work-related fatigue, and musculoskeletal disorders among nurses in Brunei. It provided important initial insight for nursing management and policymakers to make informed decisions on current and future planning to provide nurses with a conducive work environment.
Asian Continental Ancestry Group ; Brunei* ; Bullying ; Critical Care Nursing ; Critical Care* ; Cross-Sectional Studies ; Emergencies* ; Emergency Nursing ; Fatigue* ; Foot ; Hospitals, Public* ; Humans ; Musculoskeletal Pain ; Neck ; Nursing ; Occupational Health ; Prevalence ; Shoulder ; Social Support ; Violence