Smale Mary, Renfrew Mary J, Marshall Joyce L, Spiby Helen
Mother and Infant Research Unit, University of York, Department of Health Sciences, Heslington, York, UK.
Matern Child Nutr. 2006 Apr;2(2):103-13. doi: 10.1111/j.1740-8709.2006.00045.x.
Breastfeeding is increasingly recognized as a health policy priority. To achieve real change in breastfeeding rates, those who advise and support childbearing women need to be appropriately educated and trained so that they do not disrupt breastfeeding. The aim of this study was to conduct a needs analysis about breastfeeding training among a range of people who advise and support breastfeeding women, including breastfeeding women themselves, to contribute to future provision of education. A qualitative, interview-based study was conducted in one northern UK city with practitioners who support breastfeeding, and breastfeeding women, selected using purposive sampling. Individual (n = 73) and group (n = 9) interviews were conducted. Detailed notes were returned to each respondent for checking. Information was organized into themes. Coding was charted to enable comparison by theme and case. Four main themes emerged: perspectives of breastfeeding women; feeling (un)prepared to support breastfeeding; fragmentation of knowledge; and provision of education about breastfeeding. A deficit in education and training for all professional groups was identified. There was little evidence of informal shared learning among professional groups, and no evidence of usual mechanisms to ensure education and practice standards. Doctors received very little formal education; most relied on other health professionals to provide this expertise. Students encountered a chaotic learning environment where it was not possible to observe sound, consistent practice. Voluntary breastfeeding supporters felt well-prepared. The results call into question the potential for health services to respond to policy recommendations that support increased rates of breastfeeding.
母乳喂养日益被视为一项卫生政策重点。为切实改变母乳喂养率，为育龄妇女提供建议和支持的人员需要接受适当的教育和培训，以免干扰母乳喂养。本研究的目的是对包括母乳喂养女性自身在内的一系列为母乳喂养女性提供建议和支持的人员进行母乳喂养培训需求分析，为未来的教育提供助力。在英国北部的一个城市开展了一项基于访谈的定性研究，采用立意抽样法选取支持母乳喂养的从业者和母乳喂养女性。进行了个人访谈（n = 73）和小组访谈（n = 9）。详细记录返回给每位受访者进行核对。信息被整理成主题。进行编码以便按主题和案例进行比较。出现了四个主要主题：母乳喂养女性的观点；对支持母乳喂养的（未）准备感；知识碎片化；以及母乳喂养教育的提供。研究发现所有专业群体在教育和培训方面都存在不足。几乎没有证据表明专业群体之间存在非正式的共享学习，也没有确保教育和实践标准的常规机制的证据。医生接受的正规教育很少；大多数人依赖其他卫生专业人员提供这方面的专业知识。学生们面临着一个混乱的学习环境，无法观察到良好、一致的做法。志愿母乳喂养支持者感觉准备充分。研究结果对卫生服务机构响应支持提高母乳喂养率的政策建议的潜力提出了质疑。
