Hadjiona Vasiliki, Middleton Nicos, Kouta Christiana, Hadjigeorgiou Eleni, Lambrinou Ekaterini, Kolokotroni Ourania
Archbishop Makarios III Hospital, 6, Korytsas Str, 2012 Nicosia, Cyprus.
Department of Nursing, School of Health Sciences, Cyprus University of Technology, 15, Vragadinou Str, 3041 Limassol, Cyprus.
Midwifery. 2016 May;36:43-52. doi: 10.1016/j.midw.2016.02.021. Epub 2016 Mar 8.
more than two decades after the launch of the '10 steps' for successful breast feeding, there is still concern that implementation is suboptimal. Commonly, studies assess the level of implementation based on self-assessments from maternity staff and more rarely based on the mothers' own experience. To date, there has been only anecdotal evidence with regards to the implementation of the '10 steps' in Cyprus while there is general lack of research data on breast feeding in this country.
this study assessed breast feeding self-efficacy among mothers during the first 48hours after birth and explored their views with regards to the implementation of the '10 steps' across public and private maternity units in Nicosia, Cyprus.
this is a descriptive study with a consecutive sample of 216 mothers, aged at least 18, who gave birth to a full-term healthy infant between January and April 2014. Two data collection tools were used: Section 4 of the BFHI (Baby Friendly Hospital Initiative) questionnaire referring to mothers' self-assessment of maternity unit practices and the BSES-SF (Breast feeding Self-Efficacy Scale - Short Form) which measures perceived self-efficacy in bryeast feeding.
midwifery assistance for breast feeding skills development along with encouragement of breast feeding on demand (steps 5 and 8) were identified by mothers as the steps they were more likely to have experienced. In addition, there appeared to be relatively good adherence to the International Code of Marketing of Breast-milk Substitutes. In contrast, it seems that step 7(rooming-in), step 9 (no pacifiers) and step 10 (breast feeding support after discharge) were not systematically practiced. While a higher percentage of mothers in public maternity units reported being informed about the importance of skin-to-skin contact compared to the private sector (51.5% versus 25.7%), there does not appear to be much difference in terms of its actual practice which is generally low (29.0% versus 25.4%). Exclusive breast feeding (step 6) was low (21.7%) while the mean score of breast feeding self-efficacy at 48hours was 3.33 (0.87SD) on a 5-point Likert scale.
it appears that mothers in Cyprus had limited experience of the '10 steps' during their stay Nicosia maternity units. This, along with the fact that exclusive breast feeding and breast feeding self-efficacy were rather low, suggests the need for interventions that will enhance breastfeeding self-efficacy and empower mothers to initiate breast feeding while at the maternity unit. In particular, the limited information to mothers upon leaving the maternity unit highlights the lack of maternal support services in the community.
在成功母乳喂养“十步骤”推出二十多年后，人们仍担心其实施效果欠佳。通常，研究是基于产科工作人员的自我评估来衡量实施水平，很少基于母亲自身的经历。迄今为止，关于塞浦路斯“十步骤”的实施仅有轶事证据，而且该国普遍缺乏母乳喂养的研究数据。
本研究评估了母亲产后48小时内的母乳喂养自我效能，并探讨了她们对塞浦路斯尼科西亚公立和私立产科单位实施“十步骤”的看法。
这是一项描述性研究，连续选取了216名年龄至少18岁的母亲作为样本，她们于2014年1月至4月间生下了足月健康婴儿。使用了两种数据收集工具：《爱婴医院倡议》问卷的第4部分，涉及母亲对产科单位做法的自我评估；以及《母乳喂养自我效能量表简版》，用于测量母乳喂养中的自我效能感。
母亲们认为，助产士对母乳喂养技能发展的协助以及按需母乳喂养的鼓励（步骤5和8）是她们最有可能经历的步骤。此外，对《母乳代用品销售国际守则》的遵守情况似乎较好。相比之下，步骤7（母婴同室）、步骤9（不使用安抚奶嘴）和步骤10（出院后母乳喂养支持）似乎没有得到系统实施。虽然与私立产科单位相比，公立产科单位中有更高比例的母亲报告被告知皮肤接触的重要性（51.5%对25.7%），但其实际实施情况似乎没有太大差异，总体实施率较低（29.0%对25.4%）。纯母乳喂养（步骤6）比例较低（21.7%），而产后48小时母乳喂养自我效能的平均得分为3.33（标准差0.87），采用5分李克特量表。
塞浦路斯的母亲在尼科西亚产科单位期间对“十步骤”的体验似乎有限。这一点，再加上纯母乳喂养和母乳喂养自我效能较低的事实，表明需要采取干预措施来提高母乳喂养自我效能，并使母亲在产科单位时能够自主开始母乳喂养。特别是，母亲离开产科单位时获得的信息有限，凸显了社区中缺乏产妇支持服务。
