School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, Taipei, 11031, Taiwan; Kamuzu College of Nursing, Lilongwe, Malawi.
School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, Taipei, 11031, Taiwan.
Int J Nurs Stud. 2020 Sep;109:103675. doi: 10.1016/j.ijnurstu.2020.103675. Epub 2020 Jun 6.
Enhancing breastfeeding self-efficacy and intention is crucial for successful breastfeeding. Educational interventions highlighting breastfeeding self-efficacy and breastfeeding plans have been developed to help mothers initiate and sustain breastfeeding practices.
This study aimed to determine whether the use of theory-based educational interventions, i.e., the theory of breastfeeding self-efficacy or theory of planned behavior, is associated with improved breastfeeding outcomes and to identify key factors of effective breastfeeding educational programs.
We used electronic databases and reference lists of articles to identify published randomized controlled trials of educational programs that adopted the breastfeeding self-efficacy theory or theory of planned behavior.
In total, 24 randomized controlled trials were identified, and 5678 mothers were included in those studies, with 4178 mothers in the breastfeeding self-efficacy group and 1500 mothers in the theory of planned behavior group. Mothers who received theory-based interventions had better breastfeeding outcomes for up to 6 months postpartum (standardized mean difference =0.63, 95% confidence interval: 0.340.92 for self-efficacy scores at 12 months; odds ratio =1.82, 95% confidence interval: 1.272.61 for the exclusive breastfeeding rate at 12 months; and odds ratio =2.19, 95% confidence interval: 1.243.89 for the exclusive breastfeeding rate at 36 months). Mothers who were from non-Organization for Economic Co-operation and Development countries, were of older age, had participated in an educational program in a hospital setting, or had used an integrative class format had higher levels of self-efficacy and longer breastfeeding durations to 6 months.
Theory-based educational interventions are effective in improving breastfeeding self-efficacy and exclusive breastfeeding rates at 6 months. Future breastfeeding educational programs incorporating the theories of breastfeeding self-efficacy and planned behavior would be helpful in promoting sustained breastfeeding practices among mothers.
增强母乳喂养自我效能感和意愿对于成功母乳喂养至关重要。已经开发了强调母乳喂养自我效能感和母乳喂养计划的教育干预措施，以帮助母亲开始并维持母乳喂养行为。
本研究旨在确定使用基于理论的教育干预措施（即母乳喂养自我效能感理论或计划行为理论）是否与改善母乳喂养结果相关，并确定有效的母乳喂养教育计划的关键因素。
我们使用电子数据库和文章的参考文献列表来确定采用母乳喂养自我效能感理论或计划行为理论的教育计划的已发表随机对照试验。
共确定了 24 项随机对照试验，其中包括 5678 名母亲，其中 4178 名母亲在母乳喂养自我效能感组，1500 名母亲在计划行为理论组。接受基于理论的干预措施的母亲在产后 6 个月内母乳喂养结果更好（12 个月时自我效能感评分的标准化均数差=0.63，95%置信区间：0.340.92；12 个月时纯母乳喂养率的优势比=1.82，95%置信区间：1.272.61；36 个月时纯母乳喂养率的优势比=2.19，95%置信区间：1.243.89）。来自非经济合作与发展组织国家、年龄较大、在医院环境中参加教育计划或使用综合课堂形式的母亲自我效能感更高，母乳喂养持续时间更长至 6 个月。
基于理论的教育干预措施可有效提高母乳喂养自我效能感和 6 个月时的纯母乳喂养率。未来结合母乳喂养自我效能感和计划行为理论的母乳喂养教育计划将有助于促进母亲持续的母乳喂养行为。
