University of Hawaií at Hilo, 200 W. Kawili Street UCB 237, Hilo, HI 96720, USA.
J Midwifery Womens Health. 2010 Mar-Apr;55(2):162-70. doi: 10.1016/j.jmwh.2009.04.009.
Despite recommendations and numerous health benefits attributed to breastfeeding, rates in the United States are below desired levels, particularly within vulnerable populations. In Hawaií, breastfeeding rates are higher than national averages except in Native Hawaiian and other Pacific Islander populations. Health care and social service providers are integral to successful breastfeeding promotion efforts. They are in an ideal position to reflect on the context in which their clients live and on its relationship to breastfeeding activities. The aim of this study was to describe health care and social service providers' perceptions of the influences on the breastfeeding patterns of Pacific Islander women.
Focus ethnographic methods were used to collect interview data from health care and social service providers (N=20) serving Native Hawaiian and Pacific Islander women in one rural community. An iterative analysis process of coding and categorizing, followed by conceptual abstraction into patterns, was completed.
Four patterns emerged: shaped by connections, lived unfamiliarity, stressed by circumstance, and missed opportunities. Participants' insights concerning the needs of this population yielded population-specific issues and health care system issues affecting breastfeeding promotion. A number of gaps in breastfeeding services were identified.
Sociocultural, maternal knowledge, and workload barriers to successful breastfeeding predominated providers' perspectives. Broader system and community level issues were implied, but not directly addressed. The nature of successful breastfeeding support and promotion requires inclusion of this broader level perspective.
尽管有推荐意见和许多与母乳喂养相关的健康益处，但美国的母乳喂养率仍低于预期水平，尤其是在脆弱人群中。在夏威夷，母乳喂养率高于全国平均水平，但在夏威夷原住民和其他太平洋岛民中除外。医疗保健和社会服务提供者是成功促进母乳喂养的重要组成部分。他们处于理想的位置，可以反思客户所处的环境及其与母乳喂养活动的关系。本研究旨在描述医疗保健和社会服务提供者对影响太平洋岛民妇女母乳喂养模式的因素的看法。
采用聚焦民族志方法，从为一个农村社区的夏威夷原住民和太平洋岛民妇女提供服务的医疗保健和社会服务提供者（N=20）处收集访谈数据。完成了编码和分类的迭代分析过程，然后进行概念抽象，形成模式。
出现了四个模式：由联系塑造、生活的不熟悉、环境压力和错失机会。参与者对这一人群需求的见解产生了影响母乳喂养促进的特定于人群的问题和医疗保健系统问题。确定了母乳喂养服务中的许多差距。
成功母乳喂养的社会文化、产妇知识和工作量障碍主导了提供者的观点。暗示了更广泛的系统和社区层面的问题，但没有直接解决。成功的母乳喂养支持和促进的性质需要包括这一更广泛的视角。
