Theoretical and operational definitions
This section of the paper includes the definitions and measurements of those variables that are going to be investigated. The key objective of this study is to determine how antenatal education impacts the perceptions about breastfeeding and breastfeeding practices.
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In part, the operational definitions, provided in this paper, will rely on the research article, written by a group of authors under direction of Citra Mattar who investigated the affects of antenatal education on breastfeeding practices (2006).
The first set of dependent variables includes breastfeeding initiation and breast feeding. In this context, initiation can be interpreted as the period of time after which mother begins to breastfeed the child. Citra Mattar et al define breastfeeding initiation as any breastfeeding that occurs within the first two weeks after delivery (2006, p 76).
In turn, the duration of breastfeeding is the timeframe within which the mother breastfeeds the child. This definition may appear to be self-evident; yet, it has been provided in this paper because the duration of breastfeeding can also be understood as the length of a breastfeeding session. Largely, my research will be analogous to that one conducted by Citra Mattar et al (2006).
The second variable is parental feelings and perceptions of breastfeeding. This variable consists of such elements as maternal breastfeeding self-efficacy, paternal self-efficacy and parental confidence. These are the main psychological parameters that need to be measured.
Breastfeeding self-efficacy can be defined as mother’s belief or conviction that she is capable of breastfeeding the baby (Wells & Thompson, 2006). It should be measured by the so-called Breastfeeding Self-Efficacy Scale (BSES) consisting of twenty-five Likert scale items; the reliability or internal consistency of this tool constitutes 89 by Cronbach Alpha measurement (Wells & Thompson, 2006, p 181).
Paternal self-efficacy is another important component of parents’ perceptions about breastfeeding. It can be interpreted as father’s belief that he should be present at breastfeeding and that he is able to assist his wife (Wolfberg et al, 2004). Under the circumstances, one has to apply Paternal Self-Efficacy Scale, comprising 31 Likert scale items; the internal consistency of this scale is 78 (Guimond et al, 2008, p 34).
As regards parental confidence, we can adopt the definition proposed by Judith Lauwers and Anna Swisher; they argue that it is a belief that such practice as breastfeeding is healthful and beneficial to both child and mother. It should be assessed by using Karitane Pareting Confidence Scale that comprises fifteen items. The reliability of this scale is 81 by Cronbach Alpha rating (Crncec et al, 2008, p 449).
These are the dependent variables which need to be measured. In turn, the independent variable is antenatal breastfeeding education.
It has been defined as those training and counseling providing to the family (not only the mother of the child) as the most effective breastfeeding techniques (Mattar et al, 2006). It can be evaluated by means of health options scale that has been specifically designed to measure the effectiveness of health work.
Overview of methods
This study will be based on the use of both quantitative and qualitative research methods. To some extent, it will resemble the study, carried out by a group of authors under the direction of Citra Mattar. They also examined the effects of antenatal educational interventions on breastfeeding practices (Citra et al, 2007 p 173 ).
However, unlike this study, my research will have two sets of variables
- the impact of antenatal education on parental feelings and perceptions about breastfeeding;
- the influence of parental perceptions about breastfeeding and on breastfeeding initiations and duration.
This research will be a longitudinal study, which means that the data will be repeatedly collected throughout a certain period of time. In this case, this period will constitute two years. The thing is that we need to compare people’s perceptions about breastfeeding before receiving antenatal education, after receiving this training, and after pregnancy. It might be prudent to show how these notions evolve.
In the majority of cases, the reliability of research findings is directly proportionate to the sample size (Polit & Beck, 2004). In other words, the scholars can obtain accurate results only if his sample size is sufficient. In order to estimate the required sample size, one has to take into account the number of groups within the sample, and the number of data sets which the researcher needs to derive from these population.
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We expect that at least four hundred subjects will participate in this study. The participants will be selected according to the inclusion. For instance, only nulliparous mothers and their families will be eligible for the participation in this study.
This detail also distinguishes this research from the study, carried out by Citra Mattar et al. In addition to that, we need to point out that this will be a randomized sample the participants will be allocated to their groups without any pre-arranged order. Such approach has been taken because it helps to avoid biased interpretation of the results.
Another point that needs to be specified is the segmentation of the sample. The participants will be split in tree groups as it was done in the study, carried out by Citra Mattar et al (2007). Group A will watch an educational video about breastfeeding practices and counseling from a lactation specialist. Group B will receive a booklet, explaining breastfeeding practices and their benefits.
Finally Group C will receive routine antenatal care only (Mattar et al, 2007). Again we need to say that this research is similar to that one, carried out by Citra Mattar et al (2007). The main difference is that we are going to focus not only on the breastfeeding practices, but also on the attitudes toward them. The names of the subjects or any other confidential information will be disclosed.
The main procedures for data collection will be surveys, containing various measurement scales; in particular: Breastfeeding Self-Efficacy Scale, Paternal Self-Efficacy Scale, and Karitane Parenting Confidence Scale. They are specifically designed to evaluate and measure people’s perceptions about breastfeeding.
The data is going to be unanalyzed by means of Bonferroni correction, the method which is particularly useful when the study population is split in two or more groups. Furthermore, I intend to use ANNOVA analysis as this technique is very useful for understanding the differences, existing within the groups of subjects and within these groups.
It should also be mentioned that these research will include much qualitative information, especially if we are speaking about perceptions of breastfeeding. These perceptions are going to be measured by means of Likert scale items.
The analysis of such items can be done with the help of chi-square test or Wilcoxon signed-rank test. The major advantage of Likert scale is that it can effectively transform qualitative information into numerical data set.
Thus, these are the main procedures and methods that we are going to adopt in the course of this investigation. Overall, it is possible to argue that human perceptions and feelings are the key forces that shape breastfeeding activities.
In some circumstances, low levels of maternal self-efficacy and parental confidence are the main reasons for late breastfeeding initiation and short duration of this practice. This is one of the assumptions that are going to be tested in this research.
Guimond A. Wilcox M. Lamorey S. (2008). The Early Intervention Parenting Self-
Efficacy Scale (EIPSES) : Scale Construction: and Initial Psychometric Evidence. Journal of Early Intervention pp 295-321.
Lauwers J. (2004) Counseling the Nursing Mother: A Lactation Consultant’s Guide. NY: Jones & Bartlett Learning.
Mattar, C.N., Chong, Y.S., Chan ,Y.S., Chew, A., Tan, P., Chan, Y.H. & Rauff, M.H.J. (2007). Simple antenatal preparation to improve breastfeeding practice a randomized controlled trial. The American College of Obstetricians and Gynecologists, 109(1), 73-80.
Polit, D. F. & Beck, C. T. (2004). Nursing research: Principles and methods (7th ed). Philadelphia: Lippincott, Williams & Wilkins.
Wells K. & Thompson. N. (2006) Development and Psychometric Testing of the Prenatal Breast-feeding Self-efficacy Scale. American Journal of Health Behavior (30) 2. Pp 177-187.
Wolfberg, A. J., Michels, K. B., Shields, W., O’Campo, P., Bronner, Y., & Bienstock, J. (2004). Dads as breastfeeding advocates: Results from a randomized controlled trial of an educational intervention. American Journal of Obstetrics and Gynecology, 191, 708–712.