ABSTRACT
Purpose@#This study aimed to develop a structural model to explain breastfeeding behavior of primipara based on information-motivation-behavioral skills. Variables were breastfeeding knowledge, breastfeeding motivation, breastfeeding self-efficacy, and parenting stress. @*Methods@#Participants were first-time mothers who were breastfeeding infants from birth to 6 months. Data were collected from 5 pediatric hospitals and 1 public health center in Jeollanam-do from December 24, 2018 to February 28, 2019. A total of 285 questionnaires were included in the analysis. Data were analyzed using IBM SPSS Statistics ver. 20.0 and AMOS 20.0 programs. @*Results@#Fitness statistics for the hypothetical model were appropriate (χ2=48.30 [degrees of freedom= 14, p<0.001], goodness of fit index=0.96, normed fit index=0.89, comparative fit index=0.92, standardized root mean square residual=0.06). Breastfeeding self-efficacy had the most direct and total impact on breastfeeding behaviors (β=0.38, p=0.01). Breastfeeding self-efficacy was directly and totally influenced by breastfeeding knowledge (β=-0.18, p=0.01), breastfeeding motivation (β=0.26, p=0.01). Parenting stress showed a direct effect on breastfeeding self-efficacy (β=-0.14, p=0.02) and breastfeeding behavior (β=0.20, p=0.01), confirming its modulating effect on both variables. @*Conclusion@#Since breastfeeding self-efficacy was the most important variable for the breastfeeding behavior in first-time mothers, nursing interventions should be developed to promote breastfeeding selfefficacy including accurate breastfeeding information and enhanced breastfeeding motivation. Strategies that could relieve or adjust parenting stress should be considered since parenting stress had a causal relationship with breastfeeding self-efficacy and breastfeeding behavior.
ABSTRACT
Purpose@#This study aimed to develop a structural model to explain breastfeeding behavior of primipara based on information-motivation-behavioral skills. Variables were breastfeeding knowledge, breastfeeding motivation, breastfeeding self-efficacy, and parenting stress. @*Methods@#Participants were first-time mothers who were breastfeeding infants from birth to 6 months. Data were collected from 5 pediatric hospitals and 1 public health center in Jeollanam-do from December 24, 2018 to February 28, 2019. A total of 285 questionnaires were included in the analysis. Data were analyzed using IBM SPSS Statistics ver. 20.0 and AMOS 20.0 programs. @*Results@#Fitness statistics for the hypothetical model were appropriate (χ2=48.30 [degrees of freedom= 14, p<0.001], goodness of fit index=0.96, normed fit index=0.89, comparative fit index=0.92, standardized root mean square residual=0.06). Breastfeeding self-efficacy had the most direct and total impact on breastfeeding behaviors (β=0.38, p=0.01). Breastfeeding self-efficacy was directly and totally influenced by breastfeeding knowledge (β=-0.18, p=0.01), breastfeeding motivation (β=0.26, p=0.01). Parenting stress showed a direct effect on breastfeeding self-efficacy (β=-0.14, p=0.02) and breastfeeding behavior (β=0.20, p=0.01), confirming its modulating effect on both variables. @*Conclusion@#Since breastfeeding self-efficacy was the most important variable for the breastfeeding behavior in first-time mothers, nursing interventions should be developed to promote breastfeeding selfefficacy including accurate breastfeeding information and enhanced breastfeeding motivation. Strategies that could relieve or adjust parenting stress should be considered since parenting stress had a causal relationship with breastfeeding self-efficacy and breastfeeding behavior.
ABSTRACT
PURPOSE: This study was a systematic review and meta-analysis designed to evaluate the effects of breastfeeding intervention on breastfeeding rates. METHODS: Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), a systematic search was conducted using eight core electronic databases and other sources including gray literature from January 9 to 19, 2017. Two reviewers independently select the studies and assessed methodological risk of bias of studies using the Cochrane criteria. The topics of breastfeeding interventions were analyzed using descriptive analysis and the effects of intervention were meta-analyzed using the Review Manager 5.2 software. RESULTS: A total of 16 studies were included in the review and 15 were included for meta-analysis. The most frequently used intervention topics were the importance of good latch-on and frequency of feeding and determining adequate intake followed. The pooled total effect of breastfeeding intervention was 1.08 (95% CI 1.03~1.13). In the subgroup analysis, neither pre-nor post-childbirth intervention was effective on the breastfeeding rates at 1, 3, and 6 months, and neither group nor individual interventions had an effect. Only the 1 month breastfeeding rate was found to be affected by the individual intervention with the persistent strategies 1.21 (95% CI 1.04~1.40). CONCLUSION: Effective breastfeeding interventions are needed to help the mother to start breastfeeding after childbirth and continue for at least six months. It should be programmed such that individuals can acquire information and specific breastfeeding skills. After returning home, there should be continuous support strategies for breastfeeding as well as managing various difficulties related to childcare.
Subject(s)
Humans , Bias , Breast Feeding , Mothers , Parturition , Postpartum PeriodABSTRACT
PURPOSE: This study was done to examine the effect of direct practice of newborn health assessment on nursing student's clinical competence and self-efficacy and to propose effective strategies for clinical education on newborn care. METHODS: Design was a nonequivalent control group quasi-experimental study. The direct practice program was composed of a lecture, demonstration, drill and feedback using a manikin, and repeated direct practice regarding newborn health assessment. Participants were 65 student nurses taking the pediatric nursing practicum in the nursery room at M hospital. The experimental group (n=33) participated in the direct practice program for newborn health assessment and the control group (n=32) received the traditional practice method. Nursing clinical competence was assessed by two nurse investigators and structured questionnaires were used to measure self-efficacy. RESULTS: The experimental group's clinical competence was significantly higher than that of the control group (t=-4.82, p=.000). However no significant difference was found between the two groups for self-efficacy (t=1.264, p=.211). CONCLUSION: These findings indicate that the direct practice program is effective in improving nursing student's clinical competence, but it was not effective in increasing self-efficacy. Direct practice in various clinical education settings is recommended and longitudinal effects be evaluated.