The effect of self-regulation on breastfeeding duration in primiparous mothers
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Deborah L. Pollard, PhD, RNC, CNE, IBCLC
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- Xi Phi
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Eighty-six primiparous breastfeeding mothers were recruited from a community hospital in the northern panhandle of West Virginia. A randomized, controlled, two-group experimental design was used to examine the association between the self-regulation intervention, encompassing self-monitoring and reinforcement, and breastfeeding duration over 6 months. Subjects were randomized to their protocol assignment using a permuted block within strata randomization using mode of delivery and return to work/school as stratifying factors. Both the treatment and control groups received standardized education on breastfeeding and only the treatment group received the self-regulation intervention guided by social cognitive learning theory. Survival analyses and Cox proportional hazards regression procedures were used for hypotheses testing. Using the intention-to-treat approach, subjects in the treatment group did not breastfeed significantly longer than the control group. However, some subjects in the treatment group (n = 10) chose not to complete the self-monitoring component of the intervention and had a statistically significant shorter breastfeeding duration, tended to be lower income, enrolled in WIC, single, younger, and less educated. The mean duration of breastfeeding for the treatment group who completed the self-regulation intervention (n = 33), for the subjects in the treatment group who chose not to complete self-monitoring (n = 10), and the control group (n = 43), were 15.70, 4.52, and 12.12 weeks, respectively. Subjects who completed the self-regulation intervention as per protocol were more than three times as likely to breastfeed longer (Cox LR:.0082, p =.007, Hazard Ratio: 3.17). Perceived social support, returning to work/school, timing of the initial breastfeeding, and mode of delivery were not statistically significant predictors of breastfeeding duration. WIC enrollment, planned duration of breastfeeding, feeding frequency and length were statistically significant predictors of breastfeeding duration. The self-regulation intervention received many positive accolades from the subjects and demonstrated that it may improve breastfeeding outcomes particularly in the breastfeeding mother who is older, higher-educated, higher-income, and who are more strongly motivated to succeed. This research emphasizes the need for individualizing nursing interventions based on clients' sociodemographic factors and for future research to evaluate alternative interventions for the low-income, single mother.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 9906280; ProQuest document ID: 304459176. The author still retains copyright.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
Type | Dissertation |
Acquisition | Proxy-submission |
Review Type | None: Degree-based Submission |
Format | Text-based Document |
Evidence Level | Other |
Research Approach | Quantitative Research |
Keywords | Breastfeeding Mothers; Reinforcement; Patient Education |
CINAHL Subject(s) | Breast Feeding; Self Regulation; Time Factors |
Grantor | University of Pittsburgh |
Advisor | Albrecht, Susan A. |
Level | PhD |
Year | 1998 |
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