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Meedya S, Hocking J, Atchan M, Burns E. Publicly available Australian hospital data on infant feeding: A review and comparative analysis of outcomes. Women Birth 2024; 37:101658. [PMID: 39018605 DOI: 10.1016/j.wombi.2024.101658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/03/2024] [Accepted: 07/10/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Breastfeeding is the optimal method of providing infant nutrition. The Baby Friendly Health Initiative (BFHI) is a global strategy to promote breastfeeding. This study aimed to explore infant feeding data in Australian hospitals and compare outcomes between BFHI and non-BFHI accredited hospitals, and between public and private hospitals. METHODS We targeted publicly available Australian public and private hospital data on breastfeeding outcomes at discharge from 2018 to 2019. We linked the data to the BFHI accredited hospitals and used t tests to compare mean breastfeeding rates and Chi square or Fisher's exact test for categorical variables. FINDINGS Across all Australian states and territories, only New South Wales (NSW) and Victoria (VIC) provided the publicly available target data. Breastfeeding indicators were defined differently between these states. In NSW, breastfeeding at discharge was reported as a full breastfeeding rate among live born infants (71 %) whereas in VIC, it was reported as exclusive breastfeeding rates among term babies only (79 %). Comparing public with private hospitals, the rates of full breastfeeding at discharge in NSW and exclusive breastfeeding in VIC were significantly lower among private non-BFHI accredited hospitals compared to public non-BFHI accredited hospitals. CONCLUSION BFHI accreditation can be beneficial in decreasing the rates of commercial milk formula use. Consistent reinforcement of BFHI principles and implementation in both private and public hospitals is required. Regular state monitoring and national dissemination of aggregated data collected using standardised breastfeeding indicators is also essential.
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Affiliation(s)
- S Meedya
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, Australia.
| | - J Hocking
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, Australia
| | - M Atchan
- School of Nursing and Midwifery, Faculty of Health, University of Canberra, Australia
| | - E Burns
- School of Nursing and Midwifery, Western Sydney University, Australia
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Alahmed S, Frost S, Fernandez R, Win K, Mutair AA, Harthi MA, Meedya S. Evaluating a woman-centred web-based breastfeeding educational intervention in Saudi Arabia: A before-and-after quasi-experimental study. Women Birth 2024; 37:101635. [PMID: 38964228 DOI: 10.1016/j.wombi.2024.101635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 06/11/2024] [Accepted: 06/11/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Although digital educational resources are used worldwide to educate new parents, the impact of digital resources tailored specifically to women's needs on breastfeeding practices is not well explored. AIM The study aimed to evaluate the effectiveness of using a women-centred Web-Based Breastfeeding Educational Resource (WEBBER) in increasing the rate of exclusive breastfeeding at one month after birth. METHODS A quasi-experimental study with before and after intervention was conducted in one metropolitan hospital in Saudi Arabia. Participants were primiparous women (n=290) aged 18 or above who intended to breastfeed. The intervention involved introducing the WEBBER to pregnant women and reinforcing its uses as a routine breastfeeding educational resource. Women's characteristics and infant feeding data were collected at one month after birth via an online survey. FINDINGS The rate of exclusive breastfeeding at one month postpartum among the women who received the WEBBER intervention was nearly three times higher compared to the women prior to the introduction of the intervention (66 % vs. 26 %, p-value <.001). Furthermore, other predictors of exclusive breastfeeding at one month were the mother being unemployed, the baby not receiving infant formula in the hospital, and the mother having postnatal intention to continue breastfeeding for 6 months or more. DISCUSSION AND CONCLUSION Using WEBBER as a routine breastfeeding educational resource increased the rate of exclusive breastfeeding one month after birth. Embedding woman-centred digital resources into routine breastfeeding education is an effective intervention for women in Saudi Arabia.
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Affiliation(s)
- Salma Alahmed
- School of Nursing, University of Wollongong, Australia; College of Nursing, King Saud University, Riyadh, Saudi Arabia.
| | - Steve Frost
- School of Nursing, University of Wollongong, Australia
| | - Ritin Fernandez
- School of Nursing and Midwifery, University of Newcastle, Australia
| | - Khin Win
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Australia
| | - Abbas Al Mutair
- School of Nursing, University of Wollongong, Australia; Research Center, Almoosa Specialist Hospital, Saudi Arabia; College of Nursing, Princess Nourah Bent Abdulrahman University, Riyadh, Saudi Arabia
| | - Muna Al Harthi
- Breastfeeding Committee, Maternity and Children Hospital, Dammam, Eastern Province, Saudi Arabia
| | - Shahla Meedya
- School of Nursing, University of Wollongong, Australia; School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Australia
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Meedya S, Zedan H, Davis D. Writing for publication: Argument and evidence. Women Birth 2024; 37:101595. [PMID: 38508069 DOI: 10.1016/j.wombi.2024.101595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/01/2024] [Accepted: 03/01/2024] [Indexed: 03/22/2024]
Abstract
The rules for writing a research report are well defined but novice writers need more clarification on writing scholarly scientific papers for publication. The purpose of this paper is to enable novice writers to confidently apply the skills of scientific writing to the development of a scholarly paper for publication. We highlight the importance of having a clearly defined question or clarity in focus before moving on to consider the components of a scholarly paper including, the question, thesis, introduction, body, discussion, conclusion and finally, an abstract.
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Affiliation(s)
- S Meedya
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, Australia.
| | - H Zedan
- Department of Public Health, College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
| | - D Davis
- School of Nursing and Midwifery, Faculty of Health, University of Canberra, Australia
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Iwuagwu C, Chen MJ, Hoyt-Austin AE, Kair L, Fix M, Schwarz EB. Awareness of the Maternal Health Benefits of Lactation Among U.S. Pregnant Individuals. Womens Health Issues 2024; 34:283-290. [PMID: 38302344 DOI: 10.1016/j.whi.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 12/08/2023] [Accepted: 12/20/2023] [Indexed: 02/03/2024]
Abstract
INTRODUCTION We assessed awareness of the maternal health benefits of lactation among a sample of nulliparous pregnant individuals in the United States, identified variables associated with awareness of these benefits, and examined whether awareness of these benefits impacts breastfeeding attitudes or intentions. METHODS We administered a web-based survey to nulliparous U.S.-born individuals carrying a singleton gestation of at least 28 weeks. We assessed awareness of the maternal health benefits of lactation using 10 items to create a summative score. We examined variation in awareness of these benefits by demographic characteristics, health insurance, and personal or family health history and used multivariable models to estimate associations between awareness of the maternal health benefits of lactation and breastfeeding intentions. RESULTS Of the 675 individuals invited to complete surveys, 451 (67%) responded. Only 50% were aware that breastfeeding lowers maternal risk of breast cancer; fewer were aware that breastfeeding lowers the risk of ovarian cancer (35%), diabetes (27%), and hypertension and heart disease (26%). Awareness of the maternal benefits of lactation did not vary by age or race/ethnicity. However, significant regional variation was noted. In multivariable models, scores of awareness of the maternal health benefits of breastfeeding were significantly associated with intentions to breastfeed for at least 12 months (adjusted odds ratio, 1.23; 95% confidence interval, 1.11, 1.37). CONCLUSIONS Efforts to increase awareness of the maternal health benefits of lactation are still needed. Increasing awareness of the maternal health benefits of lactation may strengthen intentions to breastfeed as recommended.
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Affiliation(s)
- Caidon Iwuagwu
- Center for Healthcare Research and Policy, University of California, Davis, Sacramento, California
| | - Melissa J Chen
- Department of Obstetrics and Gynecology, University of California, Davis, Sacramento, California
| | | | - Laura Kair
- Department of Pediatrics, University of California, Davis, Sacramento, California
| | - Margaret Fix
- Center for Healthcare Research and Policy, University of California, Davis, Sacramento, California
| | - Eleanor Bimla Schwarz
- Department of Medicine, University of California, San Francisco, San Francisco, California.
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Dinour LM, Shefchik M. Representation Matters: Content Analysis of Breastfeeding Images in a Commercial Stock Image Bank. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01910-8. [PMID: 38286977 DOI: 10.1007/s40615-024-01910-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/05/2023] [Accepted: 01/07/2024] [Indexed: 01/31/2024]
Abstract
Several behavioral change theories posit that normative influences contribute to breastfeeding behaviors and disparities. Given that media has historically presented a narrow view of what is deemed normative in human milk feeding, this study describes who and what is represented in breastfeeding images available in a stock image bank, and whether differences exist based on the breastfeeding parent's skin color. Using content analysis, the most relevant 2% (n = 2284) of breastfeeding and lactation images in Adobe Stock were coded for 60 variables within 12 categories, such as skin color, ability, setting, skin exposure, etc. Descriptive statistics were used to characterize the sample, and the Chi-square test of independence and Mann-Whitney U test were used to compare images of breastfeeding parents with light and non-light skin color. Most images portrayed breastfeeding parents and breastfed children with light colored skin, only one child, an infant-aged child, and no other person. Scant images included accessories considered non-normative. Light skin parents were more frequently depicted with a wedding ring compared to non-light skin parents. Non-light skin parents were more often photographed outdoors compared to light skin parents. Images of light skin parents more frequently showed breast skin, whereas images of non-light skin parents more often showed nipple and/or areola skin. The paucity of diverse people and portrayals of breastfeeding in many ways mirror, and may even perpetuate, societal breastfeeding challenges and inequities. These findings highlight an immediate need for an expanded library of images showcasing a wider variety of breastfeeding experiences.
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Affiliation(s)
- Lauren M Dinour
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ, USA.
| | - Melanie Shefchik
- Department of Public Health, Montclair State University, Montclair, NJ, USA
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Schwarz EB, Hoyt-Austin A, Fix M, Kair LR, Iwuagwu C, Chen MJ. Prenatal Counseling on the Maternal Health Benefits of Lactation: A Randomized Trial. Breastfeed Med 2024; 19:52-58. [PMID: 38190278 PMCID: PMC11071093 DOI: 10.1089/bfm.2023.0219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
Objective: To assess the effects of prenatal counseling about the maternal health benefits of lactation on postpartum knowledge, breastfeeding intentions, and infant feeding behaviors. Materials and Methods: We conducted a randomized trial with 411 nulliparous U.S.-born women carrying a singleton gestation. Participants were recruited online; after completing a baseline survey that assessed breastfeeding knowledge and intentions, participants were randomized to receive a 10-minute virtual counseling session about the benefits of breastfeeding or attention-control counseling about smoke-free homes. We collected data on breastfeeding knowledge, intentions, and infant feeding behaviors through 12 months postpartum and conducted an intention-to-treat analysis. Results: On enrollment, awareness of the maternal health benefits of lactation was similarly low in both study groups. Postpartum, participants who received this prenatal counseling intervention had significantly greater awareness that breastfeeding decreases maternal risk of breast cancer, ovarian cancer, diabetes, heart disease, and rheumatoid arthritis (p < 0.001 for all). On enrollment, intended duration of breastfeeding was similar between groups (10.1 months versus 9.7 months, p = 0.41). At 1-month postpartum, intended duration of breastfeeding had increased from baseline among those who received this counseling (+0.7 months versus -0.7 months among controls, p = 0.004); among intervention participants intended duration of breastfeeding decreased less at 3 (-0.8 versus -1.6, p = 0.18), 6 (-2.0 versus -3.0, p = 0.06), 9 (-2.8 versus -4.2, p = 0.03), and 12 months postpartum (-4.8 versus -6.2, p = 0.09). Rates of exclusive breastfeeding and any breastfeeding were similar between groups. Conclusion: Prenatal counseling on the maternal health benefits of lactation increases awareness of these maternal health benefits and extends intended duration of breastfeeding. ClinicalTrials.gov Identifier: NCT04601987.
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Affiliation(s)
- Eleanor B. Schwarz
- Division of General Internal Medicine, University of California at San Francisco, San Francisco, California, USA
| | - Adrienne Hoyt-Austin
- Department of Pediatrics, University of California at Davis, Sacramento, California, USA
| | - Margaret Fix
- Center for Healthcare Policy and Research, University of California at Davis, Sacramento, California, USA
| | - Laura R. Kair
- Department of Pediatrics, University of California at Davis, Sacramento, California, USA
| | - Caidon Iwuagwu
- Center for Healthcare Policy and Research, University of California at Davis, Sacramento, California, USA
| | - Melissa J. Chen
- Department of Obstetrics and Gynecology, University of California at Davis, Sacramento, California, USA
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Ha EK, Lee SW, Kim JH, Lee E, Cha HR, Han BE, Shin J, Han MY. Associations between Delayed Introduction of Complementary Foods and Childhood Health Consequences in Exclusively Breastfed Children. Nutrients 2023; 15:3410. [PMID: 37571347 PMCID: PMC10421357 DOI: 10.3390/nu15153410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
The timing of complementary food (CF) introduction is closely related to childhood health, and it may vary depending on the region, culture, feeding type, or health condition. Despite numerous studies on the benefits of breastfeeding and the optimal timing of CF introduction, there have been limited investigations regarding delayed CF introduction in exclusively breastfed children. We compared an exposed group (CF introduction ≥7 months) with a reference group (CF introduction at 4 -< 7 months) regarding hospital admission, disease burden, and growth until age 10. Data from a nationwide population-based cohort study involving children born between 2008 and 2012 in the South Korea were analyzed. The final cohort comprised 206,248 children (165,925 in the exposed group and 40,323 in the reference group). Inverse probability of treatment weighting with propensity score matching was used to balance baseline health characteristics in the comparison groups. We estimated the incident risk ratios (IRR) for outcomes using modified Poisson regression and weighted odds ratios (weighted ORs) and their 95% confidence intervals (CIs) using multinomial logistic regression. The exposed group was associated with low height-for-age z-score (HAZ) (IRR (95% CI) for -1.64 < HAZ ≤ -1.03: 1.11 (1.08 to 1.14); HAZ ≤ -1.64: 1.21 (1.14 to 1.27)) and frequent (≥6 events) hospitalizations (weighted OR 1.18 (1.09 to 1.29). The rates of hospital admission, death, and specific medical conditions did not differ between groups. However, delaying the introduction of CF until seven months in exclusively breastfed infants was associated with frequent hospitalization events and lower heights.
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Affiliation(s)
- Eun Kyo Ha
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul 07441, Republic of Korea
| | - Seung Won Lee
- School of Medicine, Sungkyunkwan University, Suwon 16419, Republic of Korea; (S.W.L.); (H.R.C.)
| | - Ju Hee Kim
- Department of Pediatrics, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea;
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju 61469, Republic of Korea;
| | - Hye Ryeong Cha
- School of Medicine, Sungkyunkwan University, Suwon 16419, Republic of Korea; (S.W.L.); (H.R.C.)
| | - Bo Eun Han
- Department of Software, Sejong University, Seoul 05006, Republic of Korea;
| | - Jeewon Shin
- Department of Pediatrics, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam 13496, Republic of Korea;
| | - Man Yong Han
- Department of Pediatrics, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam 13496, Republic of Korea;
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Thorne R, Ivers R, Dickson M, Charlton K, Pulver LJ, Catling C, Dibley M, Eckermann S, Meedya S, Buck M, Kelly P, Best E, Briggs M, Taniane J. The Marri Gudjaga project: a study protocol for a randomised control trial using Aboriginal peer support workers to promote breastfeeding of Aboriginal babies. BMC Public Health 2023; 23:823. [PMID: 37143056 PMCID: PMC10161673 DOI: 10.1186/s12889-023-15558-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/29/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Breastfeeding protects against a range of conditions in the infant, including sudden infant death syndrome (SIDS), diarrhoea, respiratory infections and middle ear infections [1, 2]. The World Health Organization (WHO) recommends exclusive breastfeeding until six months of age, with continued breastfeeding recommended for at least two years and other complementary nutritious foods [3]. The 2017-18 National Health Survey (NHS) and 2018-19 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) reported that the proportion of breastfeeding in Aboriginal and Torres Strait Islander infants (0-2 years) were less than half that of non-Indigenous infants (21.2% vs. 45%, respectively)[4]. There is a lack of research on interventions supporting Aboriginal women to breastfeed, identifying an evaluation gap related to peer support interventions to encourage exclusive breastfeeding in Aboriginal women. METHODS We will evaluate the effect of scheduled breastfeeding peer support for and by Aboriginal women, on breastfeeding initiation and the prevalence of exclusive breastfeeding. This MRFF (Medical Research Future Fund) funded project is designed as a single-blinded cluster randomised controlled trial recruiting six sites across New South Wales, Australia, with three sites being randomised to employ a peer support worker or undertaking standard care. Forty pregnant women will be recruited each year from each of the six sites and will be surveyed during pregnancy, at six weeks, four and six months postnatally with a single text message at 12 months to ascertain breastfeeding rates. In-depth interviews via an Indigenous style of conversation and storytelling called 'Yarning' will be completed at pre- and post-intervention with five randomly recruited community members and five health professionals at each site" [5]. Yarns will be audio recorded, transcribed, coded and thematic analysis undertaken. Health economic analysis will be completed to assess the health system incremental cost and effects of the breastfeeding intervention relative to usual care. DISCUSSION Evidence will be given on the effectiveness of Aboriginal peer support workers to promote the initiation and continuation of breastfeeding of Aboriginal babies. The findings of this study will provide evidence of effectiveness and cost-effectiveness of including peer support workers in postnatal care to promote breastfeeding practices. TRIAL REGISTRATION ACTRN12622001208796 The impact of breastfeeding peer support on nutrition of Aboriginal infants.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Shahla Meedya
- University of Wollongong, Wollongong, Australia
- Australian Catholic University, Sydney, Australia
| | | | | | | | - Melanie Briggs
- Waminda - South Coast Women's Health & Welfare Aboriginal Corporation, Nowra, Australia
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Mitchell F, Walker T, Hill K, Browne J. Factors influencing infant feeding for Aboriginal and Torres Strait Islander women and their families: a systematic review of qualitative evidence. BMC Public Health 2023; 23:297. [PMID: 36759814 PMCID: PMC9912532 DOI: 10.1186/s12889-022-14709-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/23/2022] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Breastfeeding provides all the necessary energy and nutrients for an infant and provides many benefits for mothers and babies. The effects of colonisation have contributed to reduced prevalence and duration of breastfeeding among Australian Aboriginal women and widespread use of infant formula as a substitute for breastmilk. This review aimed to synthesise qualitative evidence about the factors that influence breastfeeding and infant feeding practices of Aboriginal and Torres Strait Islander women and their families. METHODS MEDLINE, CINAHL, Informit and Google Scholar were systematically searched for qualitative studies that included the perspective of Aboriginal and Torres Strait Islander women and their families about the factors influencing infant feeding decisions. Included studies were appraised using an Indigenous quality assessment tool and were synthesised via inductive thematic analysis informed by an ecological framework. RESULTS The search identified 968 studies with 7 meeting the inclusion criteria. Key factors influencing breastfeeding and infant feeding practices of Aboriginal women included cultural practices, normalisation of bottle feeding, shame associated with breastfeeding in public, access to culturally safe nutrition education, support services and health professionals, family/partner support, knowledge of the benefits of breastfeeding, experiences with previous babies and concern that the baby was not getting enough milk. CONCLUSION The perspectives of Aboriginal and Torres Strait Islander women must be considered when providing breastfeeding and infant feeding advice. This can be achieved through Aboriginal and Torres Strait Islander people designing, implementing, and leading the delivery of education and information regarding breastfeeding and health infant feeding practices that have been influenced by the priorities of Aboriginal and Torres Strait Islander communities.
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Affiliation(s)
- Fiona Mitchell
- Deakin Rural Health, School of Medicine, Deakin University, PO Box 423, 3280, Warrnambool, VIC, Australia. .,Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, 3125, Burwood, VIC, Australia.
| | - Troy Walker
- grid.1021.20000 0001 0526 7079Institute for Health Transformation, School of Health and Social Development, Deakin University, Locked Bag 20000, 3220 Geelong, VIC Australia
| | - Karen Hill
- grid.1021.20000 0001 0526 7079Institute for Health Transformation, School of Health and Social Development, Deakin University, Locked Bag 20000, 3220 Geelong, VIC Australia
| | - Jennifer Browne
- grid.1021.20000 0001 0526 7079Institute for Health Transformation, School of Health and Social Development, Deakin University, Locked Bag 20000, 3220 Geelong, VIC Australia
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Marques MJP, Zangão O, Miranda L, Sim-Sim M. Childbirth Experience Questionnaire: Cross-cultural validation and psychometric evaluation for European Portuguese. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221128121. [PMID: 36255072 PMCID: PMC9583229 DOI: 10.1177/17455057221128121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Self-reported measures are relevant both for the clinic and for health evaluation because they provide an interpretation of quality parameters. Women who experience labour can express themselves through these measures, identifying indicators that need improvement. OBJECTIVE The objective of this study is to adapt the Childbirth Experience Questionnaire to the Portuguese context and to determine its psychometric properties. METHOD A methodological study carried out with a convenience sample where the participants were 161 female users of a hospital in southern Portugal. They were aged between 20 and 43 years (M = 31.05, SD = 4.87) and answered a questionnaire approximately 48 h postpartum, preserving the ethical principles. The original instrument, with 22 items, underwent the linguistic and cultural adequacy process. RESULTS Factor analysis with Varimax rotation was performed, revealing a set of 19 items with factor weights above .400. The set of items remained four-dimensional as the original, explaining 62.517% of the variance. In the retest, the reliability results showed that similar characteristics to the original study are maintained in the two subscales that express 'Participation' (three items) and 'Professional Support' (four items), with internal consistency values of .807 and .782. The 'Own Performance' and 'Own Threshold' subscales were elaborated from the results of the Varimax rotation, presenting Cronbach's alpha coefficients of .840 and 714, respectively. The total scale showed alpha values of .873 and .823 in the test and retest, respectively. Time stability showed a positive association, with r = .659 (p < .001). Accuracy through the split-half method reached an alpha value of .880 with Spearman-Brown correction. The floor effect was high in the 'Participation' subscale, both in the test and in the retest. Convergent validity between the instrument and the 'Index of Strategies for Pain Relief in Labour' discrete variable showed a Spearman's rho value of .209 (p = .011) in the total scale. In discriminating validity, the Mann-Whitney test reveals that the women who recognize interactions with the midwife have more favourable scores in Childbirth Experience Questionnaire (U = 2748.000; Z = 2.905; p = .004). CONCLUSION The current version in European Portuguese suggests that it is a valid and reliable measure. This study may facilitate other validation processes in Lusophony countries.
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Affiliation(s)
| | - Otília Zangão
- Comprehensive Health Research Centre
(CHRC), University of Évora, Évora, Portugal,Nursing Department, University of
Évora, Évora, Portugal,Otília Zangão, Nursing Department,
University of Évora, 7000-811 Évora, Portugal.
| | - Luis Miranda
- Centro Hospitalar Barreiro Montijo
(CHBM), Hospital do Barreiro, Barreiro, Portugal
| | - Margarida Sim-Sim
- Comprehensive Health Research Centre
(CHRC), University of Évora, Évora, Portugal,Nursing Department, University of
Évora, Évora, Portugal
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Dowling S, Douglass E, Lucas G, Johnson C. Supporting women with learning disabilities in infant feeding decisions: UK health care professionals' experiences. MATERNAL & CHILD NUTRITION 2022; 19:e13432. [PMID: 36147016 PMCID: PMC9749617 DOI: 10.1111/mcn.13432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/30/2022] [Accepted: 09/01/2022] [Indexed: 12/15/2022]
Abstract
Women with learning disabilities are less likely to breastfeed than other women. They may find it hard to understand or learn feeding techniques or know that they have infant feeding choices. This population may be supported during their pregnancies by a range of professionals with differing priorities and responsibilities towards both the mother and the baby. This puts considerable pressure on health care professionals including, but not limited to, midwives, infant feeding specialists, health visitors and learning disability nurses. Those who support women with learning disabilities through their journey into motherhood have a responsibility to ensure the women in their care have the information they need to make decisions about a range of issues, including infant feeding. In the absence of dedicated lactation consultants, this is one of many issues to be discussed within time-limited appointments. Little is known about the experience of supporting women with learning disabilities to make infant feeding decisions from the point of view of health professionals. Using a qualitative descriptive research design, we conducted online, semistructured interviews with seven UK health professionals about their experience of supporting women with learning disabilities in infant feeding. Thematic analysis identified three themes: the importance of health professionals' having unconditional, positive regard; the need for an individualised approach to supporting women to make infant-feeding decisions; and being part of the support network. This suggests that women with learning disabilities can make and put into practice infant feeding decisions if they have access to the right support at the right time.
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Affiliation(s)
- Sally Dowling
- School of Health and Social Wellbeing, Centre for Public Health and Wellbeing, University of the West of EnglandGlenside CampusBristolUK,Bristol Medical School, Faculty of Health SciencesUniversity of BristolBristolUK
| | - Emma Douglass
- School of Health and Social Wellbeing, University of the West of EnglandGlenside CampusBristolUK
| | - Geraldine Lucas
- School of Health and Social Wellbeing, University of the West of EnglandGlenside CampusBristolUK
| | - Clare Johnson
- Faculty of Arts, Creative Industries and EducationUniversity of the West of England, ArnolfiniBristolUK
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