Breast feeding basic competence in primary care: Development and validation of the CAPA questionnaire

Breastfeeding Basic Competence in Primary Care: A Spanish Translation and Cross-Cultural Validation of the CAPA Questionnaire

BACKGROUND

The number of validated questionnaires that assess the level of breastfeeding competence of primary care professionals who attend lactating mothers is limited.

RESEARCH AIM

To validate the CAPA (Competència en l'Atenció Primària sobre Alletament [Breastfeeding Competence in Primary Care]) questionnaire into Spanish in collaboration with professionals from the primary care services of the Comunidad de Madrid (Spain).

METHODS

In this multicentric study, four bilingual healthcare professionals translated the CAPA questionnaire into Spanish and back-translated it into Catalan. The cross-cultural adaptation included a discussion by an expert committee, a review by a philologist, and a pilot study that involved 13 healthcare residents. We randomly selected professionals from specialties involved in breastfeeding. The re-test was conducted 3 weeks later, aiming to avoid changes in the studied population. We performed a factor analysis to identify underlying constructs and hypothesis-testing to assess the validity of the questionnaire and estimated the Cronbach Alpha and intraclass correlation coefficient (ICC) to assess its reliability.

RESULTS

A total of 198 professionals participated by responding to the questionnaire. Factorial analysis showed that the questionnaire was unidimensional. Hypothesis testing showed that, of all the considered professional groups, midwives achieved the highest mean score (M = 131.7, SD = 10.9, p < 0.001). Amongst the other professionals, only 26.5% achieved a basic level of breastfeeding competence. The Cronbach alpha and ICC were 0.852 (95% CI [0.821, 0.880]) and 0.890 (95% CI [0.800. 0.937]).

CONCLUSIONS

The Spanish CAPA questionnaire is a valid and reliable tool for assessing breastfeeding basic competence among primary care professional groups who attend lactating mothers.

Barriers and Facilitators for Exclusive Breastfeeding within the Health System and Public Policies from In-Depth Interviews to Primary Care Midwives in Tenerife (Canary Islands, Spain)

The aim of this study is to describe the perspectives of Primary Care midwives regarding factors that benefit or are detrimental to exclusive breastfeeding (EBF) within the health system and public policies. The study was carried out in Tenerife (Canary Islands, Spain) and is based on qualitative methodology. Twenty in-depth interviews were carried out with midwives who work in Primary Care centres in Tenerife, using a content analysis approach. The transcript data were then encoded following an inductive approach. The factors, according to midwives, that affect EBF, with regard to the healthcare system, are related to training of healthcare professionals in breastfeeding and their support to women during pregnancy, childbirth and postnatal care. Regarding public policies, midwives believe the maternity leave periods in Spain, together with a lack of laws and social policies to protect EBF are detrimental. The findings from our study show that there is a need to boost training and the role of professionals in EBF and, at the same time, promote protective policies that foster equality, favouring, among other issues, the work-life balance.

Barriers and Facilitators for Exclusive Breastfeeding in Women's Biopsychosocial Spheres According to Primary Care Midwives in Tenerife (Canary Islands, Spain)

(1) The objective of our study is to determine, from a primary care midwife's perspective, which biopsychosocial factors can favour or be detrimental to exclusive breast feeding. (2) The study was carried out in Tenerife (Canary Islands, Spain) and is based on qualitative methodology. Twenty in-depth interviews were carried out with midwives working in primary care centres in Tenerife, using a content analysis approach. The transcript data was then encoded following an inductive approach. (3) According to the perceptions of the primary care midwives who were interviewed, the barriers and facilitators that influence exclusive breastfeeding related to the biopsychosocial spheres of women are, at an individual level, the physical and emotional aspects during the postnatal period; at the relationship level, the presence or not of support from the close family and partner; at the community level, the environment and social networks the new mothers may have; and at the work level, characteristics of jobs and early return to work. (4) The findings of our research can help healthcare professionals to approach the promotion and encouragement of exclusive breast feeding at each of the levels studied, with the aim of increasing rates following recommendations issued by The World Health Organization.

Self-efficacy in breastfeeding support: a research on Italian midwifery students

BACKGROUND AND AIM OF THE STUDY

Maternal breastmilk represents the best nourishment for the newborn baby during its first six months, as it offers several benefits for the health and well-being of babies and mothers. In order to promote, protect and support effectively mother and child during breastfeeding, it is essential for midwives to be properly educated and to acquire highly professionalizing skills. This study aimed to evaluate the level of self-efficacy of the students attending the Degree Course of Midwifery, regarding the support of mother and child in breastfeeding.

METHOD

A questionnaire of 37 items (Blackmanet al, 2015) validated in Italian by Mazzeo Melchionda (2019), was sent on-line to students of ten different Midwifery Degree Courses to assess their level of self-efficacy regarding the management of breastfeeding. Statistical analysis was carried out using statistic software R3.4.3 (The Foundation for Statistical Computing).

RESULTS

158 questionnaires were collected from ten Italian Midwifery Degree Courses. The areas in which students showed a high level of self-efficacy in managing breastfeeding include: the benefits of breastfeeding; the child's tendency to take the breast within an hour from childbirth and the relevance of skin to skin contact and rooming-in. Low levels of self-efficacy concerned the comfortably breastfeeding in public places and avoiding giving formula to the baby in its first six weeks of life.

CONCLUSIONS

Generally the students attending Midwifery Degree Courses show a high level of self-efficacy in assisting mothers during breastfeeding and they prove to have a good knowledge of the benefits of breastfeeding to improve the health of mothers and their children. (www.actabiomedica.it).

Conducting Online Surveys

There is an established methodology for conducting survey research that aims to ensure rigorous research and robust outputs. With the advent of easy-to-use online survey platforms, however, the quality of survey studies has declined. This article summarizes the pros and cons of online surveys and emphasizes the key principles of survey research, for example questionnaire validation and sample selection. Numerous texts are available to guide researchers in conducting robust survey research online, however this is neither a quick nor easy undertaking. While online survey websites and software are useful for assisting in questionnaire design and delivery, they can also introduce sources of bias. Researchers considering conducting online surveys are encouraged to read carefully about how the principles of survey research can be applied to online formats in order to reduce bias and enhance rigor. In addition to alerting researchers to the pitfalls of online surveys this article also aims to equip readers of this journal with the knowledge of how to critically appraise publications based on online surveys.

Validation of self-assessment instrument for the Patient Safety Center

ABSTRACT Objective: To develop and validate an instrument for the self-assessment of the Patient Safety Centers in health care institutions. Method: Non-experimental methodological study. Divided in the following stages: literature review and construction of the preliminary instrument; content validation by nine professionals with experience in Quality Management and patient safety, who contributed to the adequacy of the items in terms of clarity and relevance; finally, 12 PSC coordinators, which conducted the reliability validation of the final instrument, using Cronbach's Alpha. Results: The instrument presented content validity regarding clarity and relevance, evidenced by an agreement level greater than 70%. The internal consistency presented high reliability, with a Cronbach's alpha of 0.857 for the general instrument, 0.825 for the domain Structure, and 0.809 for the domain Process. Conclusion: The instrument presented evidence of content validity and reliability for self-assessment, implementation and evaluation of the PSC in health institutions.