Hospital Rafael Méndez, Murcia Health Service, Lorca, Murcia, Spain.
Nursing Department, Faculty of Nursing, University of Murcia, Murcia, Spain.
Birth. 2019 Mar;46(1):146-156. doi: 10.1111/birt.12382. Epub 2018 Jul 26.
The prevalence and duration of breastfeeding are at low levels and may be improved by the support of health care professionals. Our objective was to determine the effect of implementing a breastfeeding clinical practice guideline on factors associated with breastfeeding support by health care professionals, adopting a Theory of Planned Behavior approach.
We conducted an observational, cross-sectional study during 2016 in a health area with implemented clinical practice guideline on breastfeeding, comparing the results with data from a previous cross-sectional study (2011) in the same area, in a standard-care area, and in a Baby-Friendly Hospital Initiative (BFHI)-accredited area. A validated questionnaire (four scales: attitudes, beliefs, subjective norms, and behavioral intention) was completed by professionals in each area. Descriptive analysis was followed by comparisons among the different settings using the chi-square test.
In the area with the implemented clinical practice guideline, the professionals scored significantly higher in subjective norms and beliefs than had been recorded in 2011 (preimplementation), and their scores for all four scales were significantly higher than in the standard-care area. Professionals obtained significantly higher scores for subjective norms in the BFHI-accredited area than in the other settings.
Clinical practice guideline implementation improved the responses of professionals on breastfeeding support in subjective norms and beliefs scales. There is a need for activities to assist breastfeeding in a practical manner and for more effective measures to ensure compliance with the International Code of Marketing of Breast-milk Substitutes.
母乳喂养的流行率和持续时间都处于较低水平，而医护人员的支持可能会对此有所改善。我们的目的是，采用计划行为理论方法，确定实施母乳喂养临床实践指南对医护人员提供母乳喂养支持相关因素的影响。
我们于 2016 年在一个实施了母乳喂养临床实践指南的卫生区域进行了一项观察性、横断面研究，将结果与同一区域（2011 年）的先前横断面研究数据、标准护理区域和婴儿友好医院倡议（BFHI）认证区域的数据进行了比较。在每个区域，专业人员都完成了一份经过验证的问卷（四个量表：态度、信念、主观规范和行为意向）。在进行描述性分析后，使用卡方检验对不同设置进行了比较。
在实施临床实践指南的区域，专业人员的主观规范和信念评分明显高于 2011 年（实施前）的记录，并且所有四个量表的评分均明显高于标准护理区域。在 BFHI 认证区域，专业人员的主观规范评分明显高于其他设置。
临床实践指南的实施改善了专业人员在支持母乳喂养的主观规范和信念量表方面的反应。需要采取切实可行的活动来协助母乳喂养，并采取更有效的措施来确保遵守《国际母乳代用品销售守则》。
