Wu Jing-Ling, Pang Shu-Qin, Jiang Xiu-Min, Zheng Qing-Xiang, Lin Yan
School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
Midwifery. 2023 Apr;119:103603. doi: 10.1016/j.midw.2023.103603. Epub 2023 Jan 23.
The six weeks postpartum is the high-incidence period of stopping breastfeeding. The clarity of the internal mechanism of behaviour was an effective way to promote breastfeeding. The aim was to reach a consensus on indicators what should be used and prioritised in evaluating mothers' breastfeeding behaviour within six weeks postpartum in order to provide a theoretical reference for health workers to take targeted strategies toward promoting breastfeeding practices.
Two rounds of Delphi method and analytic hierarchy process was conducted in this study. The two-rounds Delphi was performed to select essential indicators and collect revised suggestion. The analytic hierarchy process was adopted for pairwise comparison to rank the significance of primary and secondary indicators.
The panel included twenty experts with rich breastfeeding information and different general characteristics from China.
Consensus was achieved to include three primary indicators, seven secondary indicators, and forty-five tertiary indicators in the final indicators system of the mothers' breastfeeding behaviour within six weeks postpartum. The weight sequence of primary indicators was self-regulation behaviour (0.401), at-the-breast feeding behaviour (0.383), and resource utilisation behaviour (0.216). The rank of the secondary indicators was breastfeeding operation skills (0.267), self-decision behaviour (0.144), self-control behaviour (0.130), self-coping behaviour (0.127), breastfeeding self-perception (0.116), resource acquisition behaviour (0.115), and resource coordination behaviour (0.101).
The study builds a new and reliable indicators system that intuitively reflects the constituent elements of the mothers' breastfeeding behaviour within six weeks postpartum and provides priorities in primary indicators and secondary indicators.
The study helps form a clear and scientific cognition on mothers' breastfeeding behaviour within six weeks postpartum and provides a new perspective and intuitive theoretical reference for health workers to take targeted measures to promote breastfeeding practices and achieve substantial public health gains.
产后六周是停止母乳喂养的高发期。明确行为的内在机制是促进母乳喂养的有效途径。目的是就评估产后六周内母亲母乳喂养行为时应使用和优先考虑的指标达成共识，以便为卫生工作者采取针对性策略促进母乳喂养实践提供理论参考。
本研究采用两轮德尔菲法和层次分析法。两轮德尔菲法用于选择基本指标并收集修订建议。采用层次分析法进行两两比较，以对主次指标的重要性进行排序。
该小组包括来自中国的20名具有丰富母乳喂养信息和不同一般特征的专家。
在产后六周内母亲母乳喂养行为的最终指标体系中，达成共识，纳入了3个一级指标、7个二级指标和45个三级指标。一级指标的权重顺序为自我调节行为（0.401）、亲喂行为（0.383）和资源利用行为（0.216）。二级指标的排序为母乳喂养操作技能（0.267）、自我决策行为（0.144）、自我控制行为（0.130）、自我应对行为（0.127）、母乳喂养自我认知（0.116）、资源获取行为（0.115）和资源协调行为（0.101）。
该研究构建了一个新的、可靠的指标体系，直观地反映了产后六周内母亲母乳喂养行为的构成要素，并给出了一级指标和二级指标的优先级。
该研究有助于对产后六周内母亲的母乳喂养行为形成清晰、科学的认识，为卫生工作者采取针对性措施促进母乳喂养实践并取得显著的公共卫生效益提供了新的视角和直观的理论参考。
