The purpose of this study is to examine the effects of the Breastfeeding Self-Efficacy Resources Development Nurse Consultancy Program (EMÖZGEDAP), based on Dennis's Breastfeeding Self-Efficacy Theory along with the hypno-breastfeeding philosophy given to mothers and family relatives, on social support perception, breastfeeding self-efficacy and outcomes. The study will involve pregnant women and close others assigned randomly to the intervention (n=50) or control (n=50) groups in a state hospital in Turkey. Individual counseling will be provided to the intervention group within the scope of the EMÖZGEDAP, based on Denis's Breastfeeding Self-Efficacy theory and hypnobreastfeeding philosophy. EMÖZGEDAP, which will be applied to pregnant women and their family relatives, will consist of 5 sessions lasting 7.5 hours (2 sessions with the woman and her family relatives, two sessions with the woman alone, and one with her family relatives alone). The Antenatal Breastfeeding Self-Efficacy Scale will be evaluated before the counseling program is given in the antepartum period. Breastfeeding and Nutrition Results, Postpartum Breastfeeding Self-Efficacy Scale, Breastfeeding Self-Efficacy Scale for Fathers, Assessment Scale for Perceived Support of Close Others in Relation to Breastfeeding Self-Efficacy and Scale of Perception of Close Others' Support For Breastfeeding Self-Efficacy will be evaluated at the 1st, 3rd, and 6th months postpartum.
The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) recommend that babies start breastfeeding within the first hour after birth and be exclusively breastfed for the first six months. In this situation, the baby is not given any other food or liquid, including water, defined as "full breastfeeding." Breastfeeding schemes were developed by Labbok and Krosovec in 1990 to ensure consistency in research. According to this scheme, breastfeeding methods are divided into full, partial, and symbolic, according to the baby's nutritional characteristics. According to the Turkey Demographic and Health Survey (TNSA, 2018) data, 98% of children are breastfed at some point, and 42% receive food other than breast milk in the pre-lacteal (before breastfeeding) period. In Turkey, 71% of children under two are breastfed within the first hour after birth, and only 41% of babies under six months are exclusively breastfed. Self-efficacy is an essential factor in breastfeeding at the desired level. Influenced by Bandura's definition of self-efficacy, Cindy-Lee Dennis developed the "Breastfeeding Self-Efficacy Theory" by identifying the sources and influencing factors of Breastfeeding Self-Efficacy Perception. According to Dennis and Faux, a mother's breastfeeding self-efficacy includes whether she breastfeeds her baby, how much time she spends caring for her baby, her thoughts about breastfeeding, and her ability to cope with emotional difficulties during breastfeeding. Mothers with high self-efficacy encourage themselves to face challenges and try to solve events by thinking positively. These mothers prefer breastfeeding more, are more courageous, and act ultimately when they experience difficulties. Mother's breastfeeding self-efficacy is affected by four primary sources of information: The mother's previous experiences regarding breastfeeding, the examples the mother sees from others regarding breastfeeding, the support of the environment regarding breastfeeding, and the mother's psychological state regarding breastfeeding. Healthcare personnel should influence these factors to improve self-efficacy. Maternal breastfeeding self-efficacy has been identified as an important modifiable factor for successful breastfeeding. Various factors, such as breastfeeding self-efficacy and social support, affect the sustainability of breastfeeding. The studies stated that social and especially spousal support is adequate for successful breastfeeding and the mother's decision to breastfeed early at birth. According to some studies, those with more social support have higher breastfeeding self-efficacy rates. The studies emphasized that family support is an essential factor in encouraging breastfeeding. The failure of family members to provide adequate breastfeeding support and information to women resulted in the use of formula. It is stated that the older generation, especially the baby's grandmother or paternal grandmother, plays a central role in various aspects of pregnancy decision-making and child-rearing within the family structure. A study conducted among mothers-in-law in Nepal found that mothers-in-law "view themselves as key providers and decision makers of perinatal care practices." Therefore, the woman needs to receive support from her social circle through participation and encouragement during breastfeeding. Hypnobreastfeeding is a relaxation technique that helps improve the breastfeeding process by holistically caring for the mind, body, and spirit of breastfeeding mothers. Hypnobreastfeeding produces positive feedback by making the mother more relaxed, calm, and comfortable during breastfeeding, that is, an increase in the release of oxytocin and prolactin by the pituitary. In the hypnobreastfeeding philosophy, affirmation, relaxation, imagination, and visualization positively affect the subconscious. When the positive affirmations provided by hypnobreastfeeding are placed in the subconscious, they automatically affect daily life and actions and increase mothers' self-confidence. Therefore, hypnobreastfeeding is suitable for creating positive intention and motivation in breastfeeding, reducing anxiety and stress, maximizing the amount and quality of breast milk, increasing mother-baby bonding, and accelerating the involution process.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
DOUBLE
Enrollment
100
Breastfeeding Self-Efficacy Resources Developing Nurse Consultancy Program (EMÖZGEDAP) was developed based on Denis's Breastfeeding Self-Efficacy theory along with the hypnobreastfeeding philosophy. In the individual counseling program focusing on the philosophy of hypnobreastfeeding, it will be emphasized that breastfeeding is an intuitive, natural, and unique process. Techniques such as affirmations, breathing exercises, relaxation, endorphin, serotonin, and oxytocin-enhancing practices will be used. Concepts from Dennis' breastfeeding self-efficacy theory will be integrated into the training program. The individual counseling program will be carried out by adult education criteria, methods such as slide presentation, three-dimensional models, video, role-play, peer opinions with positive breastfeeding experiences, case discussion, and question and answer will be used.
Kars Harakani State Hospital
Kars, Center, Turkey (Türkiye)
RECRUITINGBreastfeeding and Nutrition Results
This form was prepared based on Labbok \& Krosovec's classification (Labbok \& Krasovec, 1990). It enables the evaluation of the characteristics of the baby's breastfeeding or feeding as complete, partial, and symbolic breastfeeding.
Time frame: This form will be evaluated at the 1st, 3rd, and 6th months postpartum.
Antenatal Breastfeeding Self-Efficacy Scale Short Form
The Breastfeeding Self-Efficacy Scale was developed by Dennis in 2003. Aluş Tokat, Okumus, and Dennis (2010) started to study the Turkish reliability standard of the Short Form of the Breastfeeding Self-Efficacy Scale. It is used to evaluate how competent pregnant women feel about breastfeeding. The scale, consisting of 14 items, is assessed on a 5-point Likert type. There are no reverse-scored items in the scale. A minimum of 14 points and a maximum of 70 points are obtained from the scale. A high score on the scale means that breastfeeding self-efficacy is also high (Dennis and Faux, 1999).
Time frame: This form will be administered to pregnant women at 28 weeks of gestation before the intervention.
Postpartum Breastfeeding Self-Efficacy Scale-Short Form
Dennis developed the Breastfeeding Self-Efficacy Scale. Aluş Tokat, Okumus, and Dennis (2010) started to study the Turkish reliability standard of the Short Form of the Breastfeeding Self-Efficacy Scale. It is used to evaluate how competent postpartum mothers feel about breastfeeding postpartum. The scale, consisting of 14 items, is assessed on a 5-point Likert type. There are no reverse-scored items in the scale. A minimum of 14 points and a maximum of 70 points are obtained from the scale. A high score on the scale means that breastfeeding self-efficacy is also high (Dennis and Faux, 1999).
Time frame: This form will be evaluated at the 1st, 3rd, and 6th months postpartum.
Breastfeeding Self-Efficacy Scale for Fathers Short Form
It was developed by Dennis, Brennenstuhl, and Abbass-Dick (2018) to evaluate fathers' perspectives and impact on breastfeeding. Its Turkish validity and reliability were tested by Küçükoğlu, Kurt Sezer, and Dennis in 2019. The scale, which can be applied to all fathers with newborns and breastfed babies, is a 5-point scale with no reverse-scored items. The lowest score is 14, and the highest score is 70 from the one-dimensional 14-item scale, and as the score increases, self-efficacy increases.
Time frame: This form will be evaluated at the 1st, 3rd, and 6th months postpartum.
Assessment Scale for Perceived Support of Close Others in Relation to Breastfeeding Self-Efficacy
This scale evaluates the mother's perception of support for breastfeeding self-efficacy provided by close others. The scale consisting of 14 items is a 4-point Likert type. Researchers and Dennis are developing it as part of her doctoral thesis.
Time frame: This form will be evaluated at the 1st, 3rd, and 6th months postpartum.
Scale of Perception of Close Others' Support For Breastfeeding Self-Efficacy
This scale evaluates the close others 's perception of support for breastfeeding self-efficacy. The scale consisting of 14 items is a 4-point Likert type. Researchers and Dennis are developing it as part of her doctoral thesis.
Time frame: This form will be evaluated at the 1st, 3rd, and 6th months postpartum.
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