Nardella Deanna, Morales Sofia I, Pérez-Escamilla Rafael, Vicente Genesis, Brown Leslie, Ray Natasha, Duffany Kathleen O'Connor, Rhodes Elizabeth C
Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, United States of America.
Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America.
PLoS One. 2025 Jun 26;20(6):e0325592. doi: 10.1371/journal.pone.0325592. eCollection 2025.
Despite effective communication being critical to providing person-centered care, little is known of effective communication in breastfeeding care from the perspective of Latina women in the United States (U.S.) who experience breastfeeding inequities. Our study identifies (a) what constitutes effective communication and (b) which provider practices promote or hinder effective communication in the context of breastfeeding care delivered within the pregnancy, delivery, and postpartum periods to Latina women in the U.S.
We analyzed data from a community-engaged study that included semi-structured interviews in English or Spanish with Latina women from low-income households in Connecticut. Women were asked about communication experiences with healthcare providers during their breastfeeding care across the pregnancy, delivery, and postpartum periods. Reflexive thematic analysis was used to analyze the data and develop a framework depicting key themes.
Of the 21 women interviewed, approximately half were 25-31 years of age (48%), were born outside of the U.S. (52%), and most had prior children (86%). We identified two themes of what constitutes effective communication in breastfeeding care to Latina women: personalized breadth and depth of breastfeeding information (theme 1) and bidirectional exchange of information with providers (theme 2). Provider use of open-ended questions that explored women's breastfeeding experiences, goals, and challenges asked across the breastfeeding care continuum promoted effective communication. Conversely, providers who asked about breastfeeding at a single visit and/or used rushed, checklist-style questioning left women with unmet information needs and hindered effective communication. While some women preferred communication aligned with their cultural and language preferences, others appreciated providers who engaged with non-fluent Spanish, seen as a supportive gesture. Our "Framework for Effective Communication in Breastfeeding Care" illustrates our findings.
Our findings could inform provider and systems level efforts to promote more effective communication in breastfeeding care, ultimately enhancing care quality and person-centeredness.
尽管有效的沟通对于提供以患者为中心的护理至关重要,但从美国经历母乳喂养不平等的拉丁裔女性的角度来看,对于母乳喂养护理中的有效沟通却知之甚少。我们的研究确定了(a)什么构成有效的沟通,以及(b)在为美国拉丁裔女性提供孕期、分娩期和产后母乳喂养护理的背景下,哪些提供者的做法促进或阻碍了有效的沟通。
我们分析了一项社区参与研究的数据,该研究包括对康涅狄格州低收入家庭的拉丁裔女性进行的英语或西班牙语半结构化访谈。询问了女性在孕期、分娩期和产后母乳喂养护理期间与医疗保健提供者的沟通经历。采用反思性主题分析来分析数据并构建一个描绘关键主题框架。
在接受访谈的21名女性中,约一半年龄在25 - 31岁(48%),出生在美国境外(52%),且大多数有过子女(86%)。我们确定了在为拉丁裔女性提供母乳喂养护理中构成有效沟通的两个主题:母乳喂养信息的个性化广度和深度(主题1)以及与提供者的双向信息交流(主题2)。提供者在母乳喂养护理连续过程中使用开放式问题来探究女性的母乳喂养经历、目标和挑战,促进了有效的沟通。相反,在单次就诊时询问母乳喂养情况和/或使用匆忙的清单式提问的提供者,使女性的信息需求未得到满足,并阻碍了有效的沟通。虽然一些女性更喜欢与她们的文化和语言偏好一致的沟通方式,但另一些女性则欣赏那些使用不流利西班牙语交流的提供者,这被视为一种支持的姿态。我们的“母乳喂养护理有效沟通框架”阐述了我们的研究结果。
我们的研究结果可为提供者和系统层面促进母乳喂养护理中更有效沟通的努力提供参考,最终提高护理质量和以患者为中心的程度。