Autoeficácia em amamentar no pós-parto imediato: Fatores associados e intervenção educativa

Abstract

The promotion of breastfeeding is the most cost-effective public health intervention and one of the priority strategies for reducing child mortality worldwide. Research involving participatory strategies aimed at women who breastfeed through educational technology can contribute to expanding the care of nursing mothers and their children, as an extension of maternity care, mainly in the sense of supporting them in different areas, such as the emotional and the educational. In this context, this study aimed to analyze factors associated with self-efficacy in breastfeeding and with educational intervention in the immediate postpartum period in a maternity hospital of reference to maternal and child health in Northeastern Brazil. The research proposal was divided into two methodological strands, the first with a cross- sectional design and the second consisting of a quasi-experimental study of a pre- test/post-test model with a self-controlled group. The study included women over 18 years of age, in the immediate postpartum period, hospitalized in Rooming-in and undergoing exclusive breastfeeding. The selection of women was done by convenience, and data collection was carried out between the months of January andMarch 2021, through interviews and educational intervention carried out individually. The samples consisted of 240 postpartum women for a cross-sectional design and 120 for a quasi-experimental study. In the first stage, related to the crosssectional design, sociodemographic data, obstetric history and data on current pregnancy and immediate puerperium were collected, in addition to applying the Breastfeeding Self- Efficacy Scale-Short Form, with an average estimated duration of 20 minutes. In the second phase, referring to the intervention, a collective educational activity was developed with the help of the serial album “I can breastfeed my child”, the artificial breast and the rag doll, in addition to the delivery of the Ministry of Health folder for the campaign on 2019 breastfeeding with the theme Breastfeeding: Encourage the Family, Feed Life. In the third stage, still referring to the educational intervention, the Breastfeeding SelfEfficacy Scale-Short Form was reapplied after 24 hours. To assess possible associations between self-efficacy and the variables under investigation, simple and multiple logistic regression models were used to estimate odds ratios, with 95% confidence intervals and 5% significance level. Before and after were compared for each question of the instrument, using the Wilcoxon paired nonparametric test with 5% significance. Most respondents showed high selfefficacy in breastfeeding. Ages from 26 to 35 and over 36 years old, being married or living in a stable relationship, not having a job, having breastfed in the first hour of thenewborn's life, receiving guidance on breastfeeding at the Basic Health Unit and offering only breast milk to the newborn in the maternity hospital were the factors associated with high self-efficacy in breastfeeding (p<0.05). The educational intervention proved to be effective in terms of self-efficacy in breastfeeding, raisingthe scores of all items evaluated, especially those related to breastfeeding technique, adaptation to the social context, motivation and satisfaction, and correct attachment. Breastfeeding self-efficacy is an aspect that can change, and follow-up is necessary throughout the breastfeeding period so that it remains at high levels, and so that women with low selfefficacy can improve these rates and favor breastfeeding.