Rainbow Babies and Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, Ohio (Dr Blatz and Ms Huston); Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio (Dr Blatz); and Nursing Research, University Hospitals Cleveland Medical Center, Ohio, and College of Nursing, Kent State University, Ohio (Dr Anthony).
Adv Neonatal Care. 2020 Aug;20(4):314-323. doi: 10.1097/ANC.0000000000000702.
Preterm infants' outcomes improve when fed their mothers' milk. Low percentages of neonatal intensive care unit (NICU) nurses support mothers facing barriers to establishing and sustaining adequate milk supplies. Nurses' motivations and attitudes are instrumental, but understudied, factors in their intention to promote maternal lactation.
Using the Theory of Reasoned Action, this study explored (1) NICU nurses' attitudes, social pressures, feelings of preparedness, perceptions of comfort, and intention to support lactation; and (2) magnitude of relationships among these concepts before and after undertaking an educational module.
A descriptive pre-/postintervention design included a sample of 24 NICU nurses who completed a module, including general lactation and hands-on expressing information. The Nursing Support for Breastfeeding Questionnaire was administered before and after completing the module.
Attitudes, social norms, perception of preparedness, and intention were moderate to high before and after completion of the module. Perception of comfort was moderate. When comparing pre- and postintervention, effect sizes for intention and perception of comfort were moderate. Magnitude of the relationship between attitudes and intention was strong before intervention and moderate after intervention. Subjective norms demonstrated stronger relationships with attitudes and intention after intervention. Preparedness and comfort had stronger relationships with attitudes than with intention both before and after intervention.
Nurses' attitudes, perception of preparedness, and comfort are modifiable considerations in developing strategies to support evidence-based lactation techniques.
Additional studies are needed with fully powered and stronger designs to validate findings to guide interventions for nurse support for NICU mothers to optimize lactation.
早产儿的预后在其食用母亲的乳汁时会得到改善。然而，仍有较低比例的新生儿重症监护病房（NICU）护士能够支持面临建立和维持充足母乳供应障碍的母亲。护士的动机和态度是促进母乳喂养的重要因素，但这方面的研究还很不足。
本研究使用理性行为理论，探讨了（1）NICU 护士对支持母乳喂养的态度、社会压力、准备感、舒适度感知和支持母乳喂养的意愿；以及（2）在接受教育模块前后这些概念之间关系的程度。
本研究采用描述性预/后干预设计，纳入了 24 名完成模块（包括一般母乳喂养和实际挤奶信息）的 NICU 护士。在完成模块前后，使用母乳喂养支持问卷进行了调查。
在完成模块前后，态度、社会规范、准备感和意愿的得分都处于中等偏高水平。舒适度感知的得分中等。在比较干预前后，意图和舒适度感知的效应量适中。干预前，态度与意图之间的关系较强，干预后，态度与意图之间的关系适度。主观规范与态度和意图的关系在干预后更强。准备感和舒适度与态度的关系比与意图的关系更强，干预前后均如此。
在制定支持基于证据的母乳喂养技术的策略时，护士的态度、准备感和舒适度是可以改变的考虑因素。
需要进行更多具有充分功率和更强设计的研究，以验证这些发现，从而为支持 NICU 母亲的护士提供指导，以优化母乳喂养。
