Purpose
Primarily the study serves to evaluate the efficiency of the breastfeeding self-management intervention. The study analyses the intervention by testing its acceptability, efficacy, and feasibility among women initiating breastfeeding. Also, through the research, we assess the effects of breastfeeding self-management intervention on the frequency, duration, and exclusivity of breastfeeding and pain severity, and the general well-being during breastfeeding. Through the research, an extensive exploration of the individual and family protective and risk factors, self-management process factors proximal results, and distal results will be conducted
Sampling
Based on the fact that the study is a feasibility study, sampling was not conducted through formal hypothesis testing. Selection, therefore, was done to attain a high precision for the approximation of correlation coefficients and the differential means amongst groups. A sample size of 50 females was presumed to be enough to give a 97.5% chance that correlation statistics calculated from the study could show the correct direction of any bivariate association of the broader population, provided their magnitude is 0.25 or more (Lucas et al., 2019).
Participant Description
The study participants were randomized from the local health facility. Participant sampling was based on the inclusion and exclusion criteria. The inclusion criteria required that the participant be a woman aged between 18 to 45 years of age. All the participants had to be able to read and write. Each member should have given birth less than 48 hours before the enrollment. She should be able to access a phone or computer daily.
To be a participant, one had to have delivered a singleton infant of more than 37 weeks gestation generally without complications, and she is willing to breastfeed for six weeks. The members should be assessed before discharge by a certified lactation consultant. Additionally, all members had to be willing to participate in the study voluntarily and fully informed. Any underage member who had mental issues had underlying medical conditions, or delivered a child with complications was excluded from the study. Anyone with skin conditions on the non-dominant forearm, such as dermatographism that could interfere with pain assessment, was disqualified.
Instruments and Tools Used
The women were required to fill in demographic and general questionnaires for the study period and provide information on fatigue, sleep disturbance, pain and cognition, and depression during the breastfeeding period. A self-report history form filled by the participants examined their experiences in breastfeeding weekly. It takes into account specific breastfeeding factors such as height, parity, and body mass index. Coping stress questionnaire aided in analyzing the participants’ cognitive coping mechanisms to pain, including players, ignoring the pain, coping self-statement, distancing from the pain, catastrophizing, and distraction (Lucas et al., 2019). Kohn’s Reactivity scale assesses the participants’ reactivity through the “agree, strongly agree, disagree, strongly disagree, neither agree nor disagree.” The perceived stress scale is an instrument that measured the participants’ perception of life regarding the amount of stress, how controllable life is, and its unpredictability.
The members filled the brief pain inventory, which helped determine the severity of the pain and its interference. The Edinburg postnatal depression scale was used to screen for postnatal depression in mothers. To measure the participants’ effort, cognitive choice, and emotional response to breastfeeding initiation, the Breastfeeding Self-Efficacy Scale’s challenges, and duration were used. An Ongoing Breastfeeding Assessment Survey with multiple choice and Likert-type questions. Through the survey, the participants reported back any breastfeeding factors that came up after discharge. Maternal perception of Breastfeeding experience report provided information on the infant’s wake/sleep patterns, the strength of sucking, maternal pain, breastfeeding durations, and the suck/pause pattern. Efficacy of the intervention questionnaire was used to determine the feasibility, and acceptability of the study.
Intervention Details
The participants were provided with a paper journal to record five breastfeeding sessions daily for the first two weeks and two sessions for four weeks. To manage the pain, the women were encouraged to comply with the feeding algorithm, and the Maternal Assessment of Infant Breastfeeding Behaviours journal prompts. Through the prompts, the members were able to relate the pain experienced to the infants breastfeeding behaviors. The women were given six weeks to return the journals. An entirety of the whole period study was conducted upon the Vaseline data collection. The women were contacted on a biweekly basis. Based on a standard text script, the women were given a five-word option that best described their breastfeeding experience: joyful, sore, average, constantly feeding, and engorged. Depending on the participants’ replies, the nurses responded with a supportive text script that changed weekly to meet the required changes and outcomes in lactation and pain management
The women were encouraged to keep in touch with the study team and inform them of any concerns that needed attention. The education intervention also provided self-regulation skills for the women. Each of them was given seven educational modules on pain self-management, and additional online links were provided to enable them to access online resources. The modules provided were: nonpharmaceutical strategies for breast and nipple pain and pain neurophysiology related to the breastfeeding process, and they are often issued during breastfeeding. The interventions, general lactation, stress reactivity, guided imagery, pain catastrophizing, and community resources were included too. Each module was emailed to the participants and monitored daily for competition. The study members also sent reminder messages to the women to encourage them to stick to the modules.
Outcomes
From the study, it is evident that the patients and nurses face many challenges in baseline data collection before discharge. More women perceived the degree of life as very stressful. From the study, postnatal women are at higher risk of experiencing depression and suffering from depressive disorders. The pre-intervention knowledge was poor among most of the women. 78% of the women experienced moderate pain during breastfeeding. The women reported that after the intervention pain was managed completely.
Outcome Analysis
From the study, it was clear that baseline data was a burden to obtain from the patients. This was caused by the overload of clinical procedures, assessments, and care the nursing staff was required to attend (Lucas et al., 2019). Mothers reported high levels of stress during their breastfeeding period. Challenges mothers face during the period they are breastfeeding were the significant risk factors this including family and work pressure. Due to the high levels of stress, most mothers developed depression and depressive disorders. Due to the work overload clinical staff experienced, it was evident that they overlooked the preliminaries of antenatal care. Most mothers were not well educated on antenatal care, making them lack the pre-intervention knowledge. Lack of education from the clinical nurses made the mother do the breastfeed wrongly causing then the pain. Because of the BFSM intervention, the participants were able to resolve their breastfeeding challenges such as pain.
The Rationale of the Study
Each child requires breastmilk for his or her proper growth. The study aimed at helping the mother understand the relevance of breastfeeding to both the child and the mother. We also targeted helping the mothers master breastfeeding technique to ensure that the severity of pain was managed through the research. The study also aimed to evaluate how different infants grow during the breastfeeding period by assessing their health. Through the investigation, it was expected that mothers could reveal their acceptability and feasibility of breastfeeding.
Usefulness
The research educated the mother on how to self-manage themselves during breastfeeding. It also taught the mothers the relevance of breast milk to the child’s health. The clinical staff also gained data collection techniques to aid inpatient care. The research was of financial benefits as the mother learned self-care skills, therefore, reducing hospital visits. Due to the study, postnatal complications were also reduced, thus solving a medical difficulty.
Nursing Implications
As a nurse, one can advocate for supportive breastfeeding policies at work and in public environments. The nurse can also initiate local breastfeeding support programs in their places of residence. By encouraging strict adherence for the six months of exclusive breastfeeding, the nurse could have promoted breastfeeding efficacy. As a clinical staff in the labor wards, the nurse can offer emotional and physical support to breastfeeding mothers (Hill, 2019). Nurses can also promote antenatal education by providing training for breastfeeding and expectant mothers.
Reference
Hill, R. (2019). Implications of ankyloglossia on breastfeeding. MCN: The American Journal of Maternal/Child Nursing, 44(2), 73-79. Web.