Watkins Amanda L, Dodgson Joan E, McClain Darya Bonds
1 Global Lactation Education Associates, Raleigh, NC, USA.
2 School of Nursing, Saint Louis University, Saint Louis, MO, USA.
J Hum Lact. 2017 Nov;33(4):725-735. doi: 10.1177/0890334417724348. Epub 2017 Sep 22.
Breastfeeding competencies are not standardized in healthcare education for any of the health professions. A few continuing education/professional development programs have been implemented, but research regarding the efficacy of these programs is scarce. Research aim: After a 45-hour lactation course, (a) Does breastfeeding knowledge increase? (b) Do beliefs and attitudes about infant feeding improve? (c) Does perceived behavioral control over performance of evidence-based lactation support practices increase? and (d) Do intentions to carry out evidence-based lactation support practices increase?
A nonexperimental pretest-posttest self-report survey design was conducted with a nonprobability sample of participants ( N = 71) in a lactation course. Theory of Planned Behavior variables were measured and a before-after course analysis was completed.
Significantly higher scores were found on the posttests for knowledge, beliefs about breastfeeding scale, and the perceived behavioral control scale. Participants' self-efficacy increased after the course; their beliefs about social norms and their ability to effect change in their workplaces did not change significantly. Participants' intention to perform actions that are consistent with the evidence-based breastfeeding supportive behaviors increased significantly. Positive beliefs about formula feeding significantly increased; this was unexpected.
The Theory of Planned Behavior provided a useful approach for examining more meaningful learning outcomes than the traditional knowledge and/or satisfaction outcomes. This study was the first to suggest that more meaningful learning outcomes are needed to evaluate lactation programs. However, it is not enough to educate healthcare providers in evidence-based practice; the places they practice must have the infrastructure to support evidence-based practice.
在任何健康专业的医疗保健教育中，母乳喂养能力都没有标准化。已经实施了一些继续教育/专业发展项目，但关于这些项目效果的研究却很少。研究目的：在参加为期45小时的泌乳课程后，（a）母乳喂养知识是否增加？（b）对婴儿喂养的信念和态度是否改善？（c）对基于证据的泌乳支持实践的感知行为控制是否增加？以及（d）实施基于证据的泌乳支持实践的意图是否增加？
对参加泌乳课程的非概率样本参与者（N = 71）进行了非实验性的前测-后测自我报告调查设计。测量了计划行为理论变量并完成了课程前后分析。
在后测中，知识、母乳喂养信念量表和感知行为控制量表的得分显著更高。课程结束后，参与者的自我效能感有所提高；他们对社会规范的信念以及在工作场所实现变革的能力没有显著变化。参与者实施与基于证据的母乳喂养支持行为一致的行动的意图显著增加。对配方奶喂养的积极信念显著增加；这是出乎意料的。
与传统的知识和/或满意度结果相比，计划行为理论为检验更有意义的学习成果提供了一种有用的方法。本研究首次表明，需要更有意义的学习成果来评估泌乳项目。然而，仅对医疗保健提供者进行循证实践教育是不够的；他们工作的场所必须具备支持循证实践的基础设施。
