Departmental Bulletin Paper Development of a tool to evaluate the ability of health providers’ assessment skills in breastfeeding

小西, 佳世乃

39 ( 1 )  , pp.23 - 34 , 2015-07-28 , 金沢大学つるま保健学会 = Tsuruma Health Science Society, Kanazawa University
 To support breastfeeding, which is recommended around the world, it is vital for healthcare providers to conduct accurate assessments when observing breastfeeding. Therefore, a means of evaluating this ability is required to improve assessment by healthcare providers. This study was performed to develop a tool for evaluating the ability to assess breastfeeding by mothers in the early postpartum period and to investigate the reliability and validity of this tool. Using seven existing assessment tools, observation items required for assessment and evaluation criteria were organized and summarized into 11 compositional elements. Content was put into two composition levels. In the first half, compositional elements were freely described, and in the second half, images of breastfeeding scenes were used to examine assessment of the 11 compositional elements. The tool was scored from 0 to 61 points, with higher scores indicating greater assessment ability. A total of 105 subjects participated in this study. They consisted of 17 International Board Certified Lactation Consultants (IBCLCs), 57 midwives, and 31 midwifery students in the Chubu region, Japan, and the response rate was 100.0%. Scores (mean±standard deviation) for the three groups were as follows: IBCLCs, 42.9±5.4 points; midwives, 35.3 ± 5.5 points; and midwifery students, 38.2±5.5 points. Significant differences of 0.1% and 5% were observed between the groups. Scores for midwives in workplaces with IBCLCs present were significantly high. Furthermore, scores were significantly higher for midwives that worked at facilities with high rates of mothers continuing breastfeeding after hospital discharge than midwives and midwifery students working at other facilities. The reliability of the tool was supported by a consistency of 0.93 – 1.00 between scorers for the free description portion and the Kuder– Richardson formula (KR-20) alpha coefficient of 0.78. Scores for IBCLCs appeared to be higher because they had undergone continuous education as breastfeeding specialists and had a great deal of experience. The lack of significant differences between midwives and midwifery students may have been affected by subject background factors, such as whether they were undergoing continuous training and attitudes regarding breastfeeding support. The results suggest that the tool developed here has a constant level of reliability and could be utilized for evaluating the ability of healthcare providers to assess breastfeeding.

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