Brockway Meredith, Benzies Karen, Hayden K Alix
1 Faculty of Nursing, University of Calgary, Calgary, AB, Canada.
2 Libraries and Cultural Resources, University of Calgary, Calgary, AB, Canada.
J Hum Lact. 2017 Aug;33(3):486-499. doi: 10.1177/0890334417707957. Epub 2017 Jun 23.
Maternal breastfeeding self-efficacy (BSE) is reflective of a mother's confidence in breastfeeding and is a modifiable factor that may improve breastfeeding rates. Breastfeeding self-efficacy theory purports that women with higher BSE will have better breastfeeding outcomes. Research aim: The aim of this systematic review was to explore the theoretical link between BSE and breastfeeding outcomes by investigating (a) if interventions to improve BSE were successful and (b) if improvements in BSE resulted in improved breastfeeding rates.
The authors performed a systematic search of 10 databases for studies that investigated the effect of interventions for mothers of full-term infants on BSE and breastfeeding rates. They used an inverse-variance, random-effects meta-analysis.
Of 1,366 titles and abstracts identified, 58 full-text articles were screened and 11 met the study criteria. Compared with mothers in control groups, mothers in intervention groups had significantly higher BSE, scoring 4.86 points higher, 95% confidence interval [3.11, 6.61], at 2 months postpartum. Mothers in the intervention groups were 1.56 and 1.66 times more likely to be breastfeeding at 1 month and 2 months postpartum, respectively. Interventions that were implemented in the postpartum period, used combined delivery settings, or were informed by BSE theory had the greatest influence on breastfeeding outcomes. Meta-regression indicated that for each 1-point increase in the mean BSE score between the intervention and control groups, the odds of exclusive breastfeeding increased by 10% in the intervention group.
Breastfeeding self-efficacy is a modifiable factor that practitioners can target to improve breastfeeding rates in mothers of full-term infants.
产妇母乳喂养自我效能感（BSE）反映了母亲对母乳喂养的信心，是一个可改变的因素，可能会提高母乳喂养率。母乳喂养自我效能感理论认为，BSE较高的女性母乳喂养效果会更好。研究目的：本系统评价的目的是通过调查（a）改善BSE的干预措施是否成功，以及（b）BSE的改善是否导致母乳喂养率提高，来探讨BSE与母乳喂养效果之间的理论联系。
作者对10个数据库进行了系统检索，以查找研究足月婴儿母亲干预措施对BSE和母乳喂养率影响的研究。他们采用了逆方差随机效应荟萃分析。
在识别出的1366篇标题和摘要中，筛选了58篇全文文章，11篇符合研究标准。与对照组母亲相比，干预组母亲的BSE显著更高，产后2个月时得分高4.86分，95%置信区间为[3.11, 6.61]。干预组母亲在产后1个月和2个月时进行母乳喂养的可能性分别是对照组的1.56倍和1.66倍。在产后实施、采用联合分娩环境或依据BSE理论的干预措施对母乳喂养效果影响最大。荟萃回归表明，干预组与对照组之间平均BSE得分每增加1分，纯母乳喂养的几率就增加10%。
母乳喂养自我效能感是一个可改变的因素，从业者可以针对这一因素提高足月婴儿母亲的母乳喂养率。
