Breastfeeding knowledge in university nursing students. A multicentre study in Spain

Applying Legitimation Code Theory to teach breastfeeding in nurse education: A case study

AIM

To use Legitimation Code Theory as a framework to inform the design of nursing education and gain insights into student perspectives of this design.

BACKGROUND

Internationally, the World Health Organization's breastfeeding recommendations are not being met. One contributing factor is that healthcare providers including registered nurses lack the knowledge to support breastfeeding women on an ongoing basis and rely on their personal experiences to inform the care they provide. Undergraduate nursing students should receive education to assist breastfeeding women in practice.

DESIGN

The study is underpinned by case-study methodology. The Legitimation Code Theory (LCT) dimension of Semantics and the concepts of semantic gravity and semantic density were used to theoretically frame and develop an intervention module to teach undergraduate nurses about breastfeeding.

METHODS

This module was part of an elective seven-week paediatric nursing course. University Human Research Ethics Committee (HREC201/203) reviewed the study. Participants (n = 9) completed semi-structured interviews and thematic analysis helped us to understand their experiences of the module. The Template for Intervention and Description and Replication (TIDeR) framework was used to report the intervention.

RESULTS

The breastfeeding module was positively received by participants who noted the module's structure differed from previous courses. Three main themes were identified in the student experience. These are: a) threads and links; b) engaging structure; and c) seedlings.

CONCLUSION

Legitimation Code Theory is an effective course development framework to harness the learners' prior informal knowledge and weave learning activities between theory and contextual practice to develop cumulative knowledge.

IMPACT

With an increased understanding of how undergraduate nursing students develop knowledge, the LCT dimension of Semantics can be ussed to structure content knowledge in instructional design. This approach builds explicit bridges between knowledge development in the nursing curriculum and learners' informal knowledge and contextual practice in clinical settings.

Breastfeeding knowledge & attitudes: Comparison among post-licensure undergraduate and graduate nursing students

RESEARCH AIMS

The aims of this study are to compare the knowledge and attitude scores between undergraduate and graduate nursing students and to identify the variables associated with higher breastfeeding knowledge and attitudes.

BACKGROUND

Nurses' knowledge and attitudes towards breastfeeding greatly impact their roles in promoting and supporting breastfeeding. However, they may not have sufficient knowledge and/or positive attitudes to support and advocate for these families. Many studies focused on professional nurses or undergraduate students' knowledge, attitudes, and beliefs. Few studies included registered nurses enrolled in post licensure undergraduate and graduate nursing programs.

DESIGN

A cross-sectional, prospective, and descriptive study.

METHODS

A convenient sample of 95 nursing students (50 undergraduate and 45 graduate) was recruited from an ethnically diverse, urban university in Southern California. Students voluntarily completed an online survey adapted from Brodribb, et al. (2008). Bivariate analysis was conducted to identify relationships between study variables.

RESULTS

Compared to undergraduates, graduate students scored higher on knowledge and attitudes towards breastfeeding (p < 0.001). Students' perception of their prior academic breastfeeding preparation was not related to their current knowledge and attitudes. Age, having children, exclusively breastfed own baby, and duration of personal breastfeeding were positively associated with attitudes and knowledge (p < 0.05 for all variables). Years of nursing experience (p = .01) was positively associated with attitudes only.

CONCLUSIONS

Compared to academic preparation, age, having children, and personal breastfeeding experiences seem to be better indicators of breastfeeding knowledge and attitudes. Nursing programs should exert more effort in enhancing curricular evidence based breastfeeding education. More research is needed to support these efforts.

Educational intervention for the main caregiver of primiparous women to promote breastfeeding and the association between prolactin and nutritional parameters

Background

In the last two years, breastfeeding rates have experienced a notable decline worldwide. Only 46% of women breastfeed their children, the figure being much lower in primiparous women. Breastfed milk is the ideal food for babies; its benefits for the health of mothers and babies are scientifically proven. Several studies show that babies who are not breastfed have a higher risk of getting sick. This fact gives rise to an important public health problem. The aim of this paper is to describe the association between presence of the caregiver in health education and increasing rates of breastfeeding.

Methods

We conducted an observational study (cohort) in a population of primiparous pregnant women (n = 88), and their main caregivers belonging to a region of central Spain. The development, content and implementation of the intervention consisted of: 1) obtaining the blood levels of pregnant women (prolactin, folic acid, vitamin B12 and transferrin) before health education (13-26 weeks of pregnancy), 2) carry out health education with two groups: A (44 pregnant women with caregivers) and B (44 without caregivers), 3) obtain the same blood levels as in the first intervention, 15 days after delivery, and finally the evaluation of the intervention with breastfeeding rates.

Results

The levels of prolactin (288.57 ± 107.46 nanogrammes per millilitre (ng / ml)), folic acid (16.93 ± 4.09 ng / ml), vitamin B12 (505.05 ± 213.97 picogrammes (pg) / ml) and transferrin (296.82 ± 67.61 milligrammmes per decilitre (mg / dl)) were higher in pregnant women who attended the health education program with a caregiver than in pregnant women who attended alone: prolcoactin (103.61 ± 45.48 ng / ml), folic acid (7.16 ± 5.88 ng / ml), vitamin B12 (160.59 ± 36.92 pg / ml) and transferrin (223.86 ± 44.14 mg / dl). Of the sample size of 44 primiparous people who attended the talks with caregivers, 35 (79.54%) breastfed their babies, while the other 44 primiparous women who attended alone, only seven (15.91%) established breastfeeding successfully.

Conclusions

The implications for public health research are that the presence of a caregiver in health education programs modifies levels of prolactin, folic acid, vitamin B12, and transferrin, as well as increasing breastfeeding rates.

The Current Status of Breastfeeding Knowledge and Its Influencing Factors in Nursing Undergraduates: A Cross-Sectional Study in China

The aim of this study was to explore the breastfeeding knowledge of nursing undergraduates and the influencing factors. Human milk (HM) is one of the most effective nutritional supplies to improve early development and physical health, but the current status of breastfeeding in China is still not optimal. The breastfeeding knowledge of perinatal women influences their feeding beliefs and behavior. Nursing undergraduates, as core professionals who will care for perinatal women and provide feeding guidance in the future, can significantly affect feeding behavior of mothers and their babies, so their knowledge of breastfeeding may have a potential impact on breastfeeding in China. However, studies on breastfeeding knowledge among nursing undergraduates in China are limited. A convenience sampling method was conducted in four medical universities in China, and eligible nursing undergraduates were selected. An online survey was collected from 5 July 2022 to 5 August 2022. Categorical data were reported as number and percentage, while continuous data were reported as mean ± SD. Multivariate linear regression was used to evaluate the association between influencing factors and breastfeeding knowledge. The overall mean score of the 460 returned questionnaires was 43.991 out of 100. The pass rate of the questionnaire was only 23.04%. Nursing undergraduates had a relatively better grasp of the benefits of breastfeeding and related advice (correct rates: 67.83%). Birthplace, only child or not, the course in obstetrics and gynecological nursing, the course in pediatrics nursing, and placements in maternity or neonatology units were relevant factors for breastfeeding knowledge (p < 0.05). Nursing undergraduates showed unsatisfactory breastfeeding knowledge. It is urgent to raise the knowledge level of breastfeeding among nursing undergraduates. Medical colleges should optimally structure a curriculum of breastfeeding knowledge. Furthermore, it is also necessary to improve the public’s understanding of breastfeeding and the whole society’s attention to breastfeeding in China.