Open Access
Six-month breastfeeding maintenance after a self-efficacy promoting programme: an exploratory trial
(Wiley, 2021) Antoñanzas Baztán, Elena; Belintxon, Maider; Marín Fernández, Blanca; Redín Areta, María Dolores; Mujika Zabaleta, Agurtzane; Pumar Méndez, María Jesús; López de Dicastillo Sáinz de Murieta, Olga; Ciencias de la Salud; Osasun Zientziak
Background: Breastfeeding care plays a fundamental role in establishing breastfeeding and longer duration after discharge. Practices though vary among professionals involved and are often inconsistent with good practices recommended, being a threat to women’s breastfeeding self-efficacy. Breastfeeding self-efficacy is considered a predictor for successful breastfeeding and a significant variable amenable to intervention for promoting lactation Aim: To evaluate the efficacy, feasibility and acceptability of a new breastfeeding self-efficacy promoting programme (SIALAC) on 6-month breastfeeding maintenance. Methods: In this exploratory multi-centre controlled trial, participants were allocated into control and intervention groups sequentially. Professionals in charge of the treatment groups were trained in between, with an especial focus on reducing practice variability. Control and intervention group women received usual care, and the intervention group received in addition SIALAC, a three-stage breastfeeding self-efficacy promoting programme. Primary outcome was breastfeeding maintenance up to 6 months analysed by Kaplan–Meier and Cox proportional hazard regression analysis. Student’s t-test or chi-square tests were also used for continuous and categorical variables. Data on breastfeeding status and breastfeeding self-efficacy were collected at baseline, and 4, 8 and 24 weeks after birth. Results: From May 2014 through November 2015, participants were enrolled. The sample consisted of 112 women. No relevant socio-demographic or obstetric difference was found between groups. The intervention achieved a significant difference between groups in breastfeeding survival (X2 = 4.94, p = 0.026). Six-month breastfeeding maintenance was significantly higher in the intervention group (67% vs. 55%; X2 = 5.384, p = 0.020). Breastfeeding dropout in the control group was 3.3 (CI 1.1, 10.1) times higher than that of the intervention group at 6 months. Breastfeeding self-efficacy scores were higher in the intervention group although without significant statistical difference. The programme showed good acceptability. Conclusion: Breastfeeding self-efficacy promoting programme SIALAC was beneficial in fostering 6-month breastfeeding survival. Full-scale trial should consider feasibility-related issues identified.
Open Access
Design, implementation and evaluation of an education course to promote professional self-efficacy for breastfeeding care
(Elsevier, 2020) Antoñanzas Baztán, Elena; Pumar Méndez, María Jesús; Marín Fernández, Blanca; Redín Areta, María Dolores; Belintxon, Maider; Mujika Zabaleta, Agurtzane; López de Dicastillo Sáinz de Murieta, Olga; Ciencias de la Salud; Osasun Zientziak
The objective of this study was to determine the effect of an education short course on professional’ self-efficacy in the area of breastfeeding care. The intervention had a pre-post design. A total of 43 healthcare professionals attended the course. The Kirkpatrick model for the development, implementation and evaluation of education actions was used for a 4.5-h course. The aspects evaluated included professionals’ satisfaction and learning regarding confidence to support lactating mothers, perceived transfer of knowledge to the workplace and organizational changes. Data were collected using self-administered questionnaires (participants, unit managers, and education planners), before and after the intervention. Participants' satisfaction with the education action was high in all of the aspects measured (greater than 3.9 in scores of 0–5). Professionals showed a significant increase in self-efficacy levels for supporting breastfeeding (Wilcoxon test p-value = < 0.05, before intervention: median = 55, [IQR] = 11; after intervention: median = 60, [IQR] = 14). Participants, managers and organizers of the course identified changes in the way that professionals cared for breastfeeding mothers. In conclusion, this educational intervention enhanced professional self-efficacy and performance in breastfeeding care.
Open Access
Development of a taxonomy of activities in health prevention and promotion for primary care
(Wiley, 2022) Pumar Méndez, María Jesús; López de Dicastillo Sáinz de Murieta, Olga; Hernantes Colias, Naia; Iriarte Roteta, Andrea; Belintxon, Maider; García-Iriarte, Antonio; Mujika Zabaleta, Agurtzane; Ciencias de la Salud; Osasun Zientziak
Aim: To develop a taxonomy of activities in health prevention and promotion for primary care. Background: Despite health promotion being considered a keystone for popula-tion health and health care sustainability, its implementation remains insufficient. Customized evaluation tools are needed to address prevention and promotion omis-sions in primary care. Method: A taxonomy was designed using documentary analysis. Documents describ-ing frontline primary care professionals' health prevention and promotion activities or omissions were identified and analysed using framework analysis. Results: The ‘Taxonomy of Activities in Health Prevention and Promotion for Primary Care’ (TaxoPromo) includes 43 activities grouped into eight categories: planification, situational analysis, capacity building, development of awareness/public opinion, advocacy, development of networks, development of partnerships and intervention strategies. Conclusion: By contrasting the usual practices with the activities collected in the TaxoPromo, opportunities for improvement can be unveiled. Implications for Nursing Management: The TaxoPromo can be used at organisational and system levels to identify actions to integrate health prevention and promotion activities into a systematic, data-driven process; design implementation plans and tailor-made strategies for capacity building; enable benchmarking; and address omis-sions. The TaxoPromo can serve as a catalyst tool for the clarification and expansion of the nursing role in health prevention and promotion.
Open Access
Encounters between children's nurses and culturally diverse parents in primary health care
(Wiley, 2020) Belintxon, Maider; Dogra, Nisha; McGee, Paula; Pumar Méndez, María Jesús; López de Dicastillo Sáinz de Murieta, Olga; Ciencias de la Salud; Osasun Zientziak
The objective of this study was to analyze the healthcare encounters between nursesand parents of different cultural backgrounds in primary health care. An ethnographicstudy was carried out using participant observations in health centers and interviews withnurses. Data were analyzed using thematic content analysis and constant comparativemethod. Four main themes were identified when nurses met parents of other culturalbackgrounds: lack of mutual understanding, electronic records hamper the interaction,lack of professionals' cultural awareness and skills, and nurses establish superficial or dis-tant relationships. The concepts of ethnocentrism and cultural imposition are behindthese findings, hampering the provision of culturally competent care in primary healthservices. There were difficulties in obtaining and registering culturally related aspects thatinfluence children's health and development. This was due to e-records, language barriers,and the lack of cultural awareness and skills in health professionals making the encoun-ters difficult for both nurses and parents. These findings show that there is a clear threatfor health equity and safety in primary care if encounters between nurses and parents donot improve to enable nursing care to be tailored to any individual family needs.
Open Access
A valid and reliable scale to assess cultural sensibility in nursing
(Elsevier, 2021) Belintxon, Maider; Carvajal, Ana; Pumar Méndez, María Jesús; Rayón Valpuesta, Esperanza; Velasco, Tamara Raquel; Belintxon Martin, Unai; Dogra, Nisha; Vidaurreta, Marta; Bermejo-Martins, Elena; López de Dicastillo Sáinz de Murieta, Olga; Derecho; Zuzenbidea
Background: cultural sensibility is an important concept linked to the achievement of cultural competence. Health professionals must first improve their cultural sensibility to become culturally competent and to be able to offer competent care to culturally diverse populations. Aim To develop and psychometrically test the Cultural Sensibility Scale for Nursing (CUSNUR), a cultural sensibility scale that can be used in nursing for the achievement of competencies needed to care for culturally diverse populations. Design and methods: the cross-sectional survey was conducted over two stages. The first stage involved the cross-cultural and discipline-specific adaptation of an existing scale addressing this concept in the field of law using the reverse translation method. Second, validation of the scale was carried out from October 2016–June 2017 by studying the psychometric properties of the questionnaire through an analysis of content acceptability and reliability and through exploratory factor analysis (EFA). Results: the questionnaire was designed to be clear, easy to understand, and of adequate length, and experts involved in content validation agreed that the scale meets these criteria. A total of 253 nursing students participated in the validation stage. Four factors were identified from the EFA: (1) patient and health professional behaviours, (2) self-assessments, (3) self-awareness, and (4) cultural influence. Two items were excluded. Factorial saturation is adequate for all factors (>0.30). The Cronbach alpha was measured as 0.75. Conclusions: this study presents the first version of the CUSNUR and demonstrates that the scale is valid and reliable.