Journal of Korean Academy of Nursing

Original Articles

Prediction of Breastfeeding Intentions and Behavior: An Application of the Theory of Planned Behavior: Hea Sook Kim, Eun Sook Nam; Journal of Nurses Academic Society 1997;27(4):796-806. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1997.27.4.796

The majority of studies on breastfeeding consists of descriptive correlational studies identifying the incidence and correlates of breastfeeding. The theory of planned behavior has been shown to yield great predictive power for behavioral goals over which individuals have only limited control such as improving school grades and weight loss. The purpose of this study was to test the "theory of planned behavior" in the prediction of breastfeeding of mothers who delivered vaginally. One hundred mothers who delivered vaginally in one general hospital in Seoul and one general hospital and three private hospitals in Taejeon participated in this study. The instruments used for data collection in this study were developed by the researchers following the guidelines suggested by Ajzen and Fishbein(1980) and Ajzen and Madden(1986). The instruments included measurement of attitude, subjective norm, perceived behavioral control and intention. The collected data were analyzed using descriptive statistics, Pearson product moment correlation, hierachical multiple regression and logistic regression. The results are as follows : 1. Intention to breastfeed correlated significantly with attitude, subjective norm and perceived behavioral control. Both attitude and subjective norm did not make a significant contribution to the prediction of intention, but the addition of perceived behavioral control to the regression equation greatly improved the model's predictive power, increasing the R(2) from .05 to .52. 2. Intention to breastfeed alone had a significant predictive effect on actual breastfeeding, resulting in a regression coefficient of .16(x2=8.60, p<.01), but when perceived behavioral control was added to the equation, intention was not a significant predictive variable and only perceived behavioral control showed significant predictive power on actual breastfeeding, resulting in a regression coefficient of .12(x2=4.68, p<.05). In sum, breastfeeding behavior lent only partial support to the second version of the theory of planned to the second version of the theory of planned behavior, and because perceived behavioral control had a strong effect on intention to breastfeed and actual breastfeeding, it would be desirable to develop nursing intervention programs which focus on strengthening the perceived behavioral control for the promotion of breastfeeding.

Citations

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Examination of Predicting Factors for COVID-19 Vaccination Behaviors of University Students Utilizing the Theory of Planned Behavior
Yeon Jeong Heo, Hye-Jin Hyun
Journal of Korean Academy of Nursing.2024; 54(2): 178. CrossRef
The Factors related to Mothers' Intention to Vaccinate against Hepatitis A: Applying the Theory of Planned Behavior
Kyeong-Sook Cha, Kyung Mi Kim
Child Health Nursing Research.2019; 25(1): 1. CrossRef
Factors associated with Maternal Attachment of Breastfeeding Mothers
Sun-Hee Kim
Child Health Nursing Research.2019; 25(1): 65. CrossRef
A Structural Model for Primiparas' Breastfeeding Behavior
Hyun-Joo Yang, Ji-Min Seo
Journal of Korean Academy of Nursing.2013; 43(3): 399. CrossRef

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A Study of Primiparous Womens' Breastfeeding Experience: Shin Jeong Kim, Sook Ja Yang; Journal of Nurses Academic Society 1997;27(3):477-488. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1997.27.3.477

Abstract PDF

The purpose of this study was to understand the subjective breastfeeding experience of primiparous women to identify how breastfeeding was started and to explore the process of breastfeeding. The Grounded theory methodology was used. Data was collected from 6 primiparous women who had breastfeed their infants for at least over 8 weeks, recently breastfeeding or having breatfeed their infants within the last 6 months. With the permission of the subjects, the interviews were recorded and transcribed. The data were analysed in the framework of grounded theory method as mapped out by Strauss and Corbin(1990). 105 concepts and 21 subcategories were of data analysis. In the process of data analysis, "Identity as a mother" was found to be the core phenomenon. The 21 sub-categories were as follows : natural food, neighbour inducement, self purpose, good feeling, tenderness, breast pain, change of breast shape, physical discomfort, loss of physical energy, confirmation of adhesion, one body through coupling, tie, capacity, role performance, mental comfort, healthy mother, healthy infant, confidence of breast milk, feeling of satisfaction. The sub-categories were again grouped into 14 categories including infant nutritious food, formation of breastfeeding opportunity, feeling of satisfaction, injury of the breast, physical suffering, awareness of mothering, formation of maternal affection, connecting, coupling, acceptance, effort, emotional stability, mother and child health and feeling of achievement.

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Breastfeeding Success Experience of Primiparas
Sun Ok Lee, Sung Soon Na, Hee Sook Kim, Kyung Eui Bae, Mi Sun Youn, Eun Ju Oh
Journal of The Korean Society of Maternal and Child Health.2022; 26(4): 254. CrossRef

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Information and Social Support Regarding Breastfeeding: A Survey of Mothers in Seoul, South Korea: Heasook Kim, Andrea Crivelli Kovach; Journal of Korean Academy of Nursing 2001;31(7):1151-1159. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2001.31.7.1151

Abstract PDF

BACKGROUND: Pediatric societies throughout the world recommend breastfeeding as the optimal form of infant nutrition. This recommendation is based on extensive epidemiologic research that documents the health, developmental, psychological, social, economic, and environmental benefits to infants, mothers, families, and society. The purpose of this study was to examine breastfeeding information and emotional support received by mothers prenatally, hospital breastfeeding practices, and the relationship between information and support received and breastfeeding initiation and planned feeding method post discharge from the hospital.
METHODS
A 36-item questionnaire was distributed during the Spring 2000 to mothers who delivered babies at maternity centers in Seoul, South Korea. A sample of 52 mothers was surveyed at the time of hospital discharge. The questionnaire was developed based on the literature and reviewed by experts including internationally board certified lactation consultants, a nutritionist, and perinatal nurses. The survey instrument consists of five components: sociodemographic information, breastfeeding information received by mothers prenatally, emotional support regarding the mothers' infant feeding choice, breastfeeding initiation and supplementation, and hospital breastfeeding practices.
RESULTS
Fifty-two breastfeeding mothers at three hospitals completed the survey. The majority of the mothers were 26 to 35 years of age, college graduates, married, had uncomplicated vaginal or planned cesarean deliveries, and primiparas. Forty-nine mothers responded that they decided to breastfeed during their pregnancy. Mothers reported that the information they received during pregnancy was provided primarily by their mothers, or friends and other relatives. The majority of mothers reported that others influenced their infant-feeding decision. Forty mothers reported receiving emotional support for their infant feeding choice during their pregnancy with mothers or mothers-in-law and friends providing the greatest support.
DISCUSSION
Women obtain information prenatally about breastfeeding from many sources-family, friends, written materials, prenatal classes, and health care professionals. There are benefits and drawbacks to information received from multiple sources. Additionally, research has shown that a woman's infant-feeding decision is affected by the type of professional and social support the mother receives. Postpartum professional support for new breastfeeding mothers encompasses multiple dimensions ranging from a follow-up telephone call from the hospital nursing staff to referral to a community resource. Prenatal breastfeeding education on a community-wide basis can provide essential information for future mothers, families, and community support networks. Additional research needs to be done exploring the impact of prenatal, postpartum, and post-discharge support for women on breastfeeding initiation and duration rates.

Citations

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Postnatal women’s breastfeeding beliefs, practices, and support during the COVID-19 pandemic: a cross-sectional comparative study across five countries
K. P. Coca, E. Y. Lee, L. Y. Chien, A. C. P. Souza, P. Kittikul, S. A. Hong, Y. S. Chang
International Breastfeeding Journal.2022;[Epub] CrossRef
Effect of Postpartum Breast-feeding Support by Nurse on the Breast-feeding Prevalence
Gun Ja Jang, Sun Hee Kim, Kyung Soon Jeong
Journal of Korean Academy of Nursing.2008; 38(1): 172. CrossRef

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The Meaning of Breastfeeding in Korean Mothers: Shin Jeong Kim, Geum Hee Jeong; Journal of Korean Academy of Nursing 1999;29(5):1042-1048. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1999.29.5.1042

Abstract PDF: The Purpose of this study was to explore the meaning of breastfeeding using a phenomenological research methodology. The sample consisted of 9 primiparous mothers who had breastfed their babies at least for 3 consecutive months. Data were collected from January 10 to February 28, 1998 through interviewing. The research question was "What was the meaning of breastfeeding to breastfeeding mothers?" Responses to non-structured open-ended question was audio-recorded during the interview. Data were analyzed using the phenomenological method of Colazzi. From the protocols, significant statements about meaning of breastfeeding were clustered into 8 themes. Mothers perceived meaning of breastfeeding as feeling of unification through tie, expression of love, gift, nutritional supplement, duty as a mother, nurturing, mystery, and identity. From the results of this study, breastfeeding mothers perceived breastfeeding positively, so nurses need to encourage mothers to breastfeed her baby and develop program which can promote successful breastfeeding.

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Effects of Breastfeeding Empowerment Program on Breastfeeding Self-efficacy, Adaptation and Continuation in Primiparous Women: Seon Mi Song, Mi Kyung Park; J Korean Acad Nurs 2016;46(3):409-419. Published online June 30, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.3.409

Abstract PDF

Purpose

The purpose of this study was to develop a breastfeeding empowerment program and to investigate the effects of the breastfeeding empowerment program on self-efficacy, adaptation and continuation of breastfeeding for primiparous women.

Methods

The 5 session breastfeeding empowerment program was developed and a non-equivalent control group non-synchronized quasi-experiment design was used. Fifty-five participants were assigned to either the experimental group (n=27) or the control group (n=28). Effects were tested using repeated measures ANOVA and χ²-test.

Results

Scores for self-efficacy, adaptation and continuation of breastfeeding of in the experimental group after program were significantly higher than 1week, 4weeks, 8weeks scores in control group.

Conclusion

The effects of the breastfeeding empowerment program for elevating self-efficacy, adaptation and continuation of breastfeeding in primiparous women were validated. Therefore, this program can be recommended for vigorous use in clinical practice.

Citations

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Eunju Kwak, Seungmi Park
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Jennifer Kehinde, Claire O'Donnell, Annmarie Grealish
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Effectiveness of distance education program on mothers’ empowerment in exclusive breastfeeding
Zeynab Taheri, Fatemeh Bakouei, Mouloud Agajani Delavar, Mahbobeh Faramarzi, Afsaneh Bakhtiari, Fatemeh Nasiri Amiri
Journal of Education and Health Promotion.2022; 11(1): 420. CrossRef
Social policies and breastfeeding duration in South Korea: A survival analysis of the national data
Jung Hee Yeo, Eun-Young Kim
Midwifery.2022; 107: 103282. CrossRef
A Structural Model for Breastfeeding Behavior of First-Time Mothers
Seol Hui Park, Seang Ryu
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Sun Hwa Park, Kyung Ja June
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Breastfeeding Adaptation Scale-Short Form for mothers at 2 weeks postpartum: construct validity, reliability, and measurement invariance
Sun-Hee Kim
Korean Journal of Women Health Nursing.2020; 26(4): 326. CrossRef
Knowledge of and Attitude toward Breastfeeding among Medical Staff Working in the Neonatal Intensive Care Unit and Obstetric Unit
Eun Sook Kim, Young Hee Cho, Hyejung Lee
Journal of The Korean Society of Maternal and Child Health.2020; 24(2): 102. CrossRef
Knowledge and health beliefs about gestational diabetes and healthy pregnancy's breastfeeding intention
Seungmi Park, Jung Lim Lee, Jang In Sun, Youngji Kim
Journal of Clinical Nursing.2018; 27(21-22): 4058. CrossRef

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Associations of Breastfeeding Knowledge, Attitude and Interest with Breastfeeding Duration: A Cross-sectional Web-based Study: Nam Mi Kang, Yoon Ji Choi, Taisun Hyun, Jung Eun Lee; J Korean Acad Nurs 2015;45(3):449-458. Published online June 30, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.3.449

Abstract PDF

Purpose

Maternal knowledge, positive attitudes and interest toward breastfeeding may improve the sustainability of breastfeeding. This study examined the associations of knowledge, attitudes, and interest toward breastfeeding with the duration of breastfeeding in Korean mothers who used the internet.

Methods

We conducted a cross-sectional study of 604 Korean mothers who breastfed their babies. Mothers were recruited through the internet and their knowledge, attitudes and interest toward breastfeeding were assessed using a web-based self-administered questionnaire. Geometric means and odds ratio (OR) with 95% confidence intervals were calculated.

Results

Higher knowledge, attitudes, and interest toward breastfeeding were associated with longer duration of breastfeeding in Korean mothers. In particular, mothers who had optimal breastfeeding duration were more likely to be aware of the easiness of breast milk stimulation and breastfeeding, the development of attachment between mother and child, and pleasure from breastfeeding compared to those mothers with shorter duration. The association with optimal breastfeeding duration was more pronounced among mothers who graduated from high school for total attitude scores and total interest scores, compared to mothers who graduated from college or above.

Conclusion

The results of this study suggest that it is important to improve maternal knowledge, attitudes, and interest toward breastfeeding in Korean mothers who use the internet as a source of knowledge. Also, the study results imply that the development of strategies to target mothers with relatively low education levels may improve breastfeeding rates.

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Reliability and validity of the German version of the Iowa infant feeding attitude scale (IIFAS-G) and relations to breastfeeding duration and feeding method
Debora Suppiger, Giancarlo Natalucci, Tilman Reinelt
International Breastfeeding Journal.2024;[Epub] CrossRef
The role of emotions and injunctive norms in breastfeeding: a systematic review and meta-analysis
Pascale Sophie Russell, Debbie M. Smith, Michèle D. Birtel, Kathryn H. Hart, Sarah E. Golding
Health Psychology Review.2022; 16(2): 257. CrossRef
Survey on the Status of Breastfeeding in Korean Medical Institution Workers
Tae Hyeong Kim, Sung-Hoon Chung, Jun Hwan Kim, Youngmin Ahn, Son Moon Shin, Woo Ryoung Lee, Eui Kyung Choi, Juyoung Lee, Hye-Jung Shin, Euiseok Jung, Ju Sun Heo, Jin A Lee, Soon Min Lee, Seong Phil Bae, Jeonglyn Song, Chae-Young Kim, Dae Yong Yi
Journal of Korean Medical Science.2022;[Epub] CrossRef
Survey of Korean pediatrician’s perceptions of barriers to and improvements in breastfeeding
Seong Phil Bae, Woo Ryoung Lee, Won-Ho Hahn, Hye-Jung Shin, Young Min Ahn, Son Moon Shin, Yong Joo Kim, Ellen Ai-Rhan Kim, Youn Jeong Shin, Dae Yong Yi, Soon Min Lee, Juyoung Lee, Jin A Lee, Sung-Hoon Chung, Euiseok Jung, Eui Kyung Choi, Ju Sun Heo
Clinical and Experimental Pediatrics.2022; 65(11): 540. CrossRef
Factors Associated with the Need for Breastfeeding Information Among Women with Gestational Diabetes Mellitus: A Cross-sectional Study
Seungmi Park, In Sun Jang, Deulle Min
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Integrative Review of Antenatal Milk Expression and Mother–Infant Outcomes During the First 2 Weeks After Birth
Nina A. Juntereal, Diane L. Spatz
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Investigating Predictors of Prenatal Breastfeeding Self-Efficacy
Kathryn Corby, Debbie Kane, Deborah Dayus
Canadian Journal of Nursing Research.2021; 53(1): 56. CrossRef
Factors associated with exclusive breast-feeding: A cross-sectional survey in Kaiyuan, Yunnan, Southwest China
Yuan Ruan, Qiang Zhang, Juanjuan Li, Rong Wan, Jun Bai, Wenzhong Wang, Yutong Zhou, Qingqing Wan, Jiang Zhao, Siyang Yu, Min Peng, Zhitao Liu, Joann M. McDermid
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Prevalence of exclusive breastfeeding and barriers for its continuation up to six months in Kandy district, Sri Lanka
Himali Erandathie Ratnayake, Dhammica Rowel
International Breastfeeding Journal.2018;[Epub] CrossRef
Positive Effect of Baby-Friendly Hospital Initiatives on Improving Mothers' Intention for Successful Breastfeeding in Korea
Hyun Woo Park, Keun Ho Ryu, Yongjun Piao, Peipei Li, Jae Shik Hong, Hee Bum Kim, Hwanwook Chung, Jeong-Kyu Hoh, Yong Joo Kim
Journal of Korean Medical Science.2018;[Epub] CrossRef

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Breastfeeding Initiation and Continuation by Employment Status among Korean Women: Nam Mi Kang, Jung Eun Lee, Yeon Bai, Theo Van Achterberg, Taisun Hyun; J Korean Acad Nurs 2015;45(2):306-313. Published online April 15, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.2.306

Abstract PDF

Abstract Purpose

The objective of this study was to examine the factors associated with initiation and continuation of breastfeeding among Korean women in relation to their employment status.

Methods

Data were collected using a web-based self-administered questionnaire from 1,031 Korean mothers living in Seoul with babies younger than 24 months. Demographic characteristics, education on breastfeeding, rooming in, breastfeeding during hospital stay, and breastfeeding knowledge were examined. Multivariate logistic regression analyses were performed to identify factors associated with initiation and continuation at 1, 6 and 12 months according to mothers’ employment status.

Results

Breastfeeding initiation rates were similar regardless of mothers’ employment status. Continuation rates decreased for both groups of mothers, but were significantly lower among employed mothers at all duration points. Unemployed mothers who were able to keep their babies in the same room during the hospital stay were more likely to initiate breastfeeding. The factor that was consistently associated with breastfeeding continuation for all duration points among unemployed mothers was whether the mother breastfed during the hospital stay. Higher knowledge scores and having an infant with atopic dermatitis were also associated with breastfeeding continuation at 6 months and 12 months, respectively for unemployed mothers, and receiving education on breastfeeding was associated with 12-month continuation for employed mothers.

Conclusion

These results emphasize the significant roles of hospitals for breastfeeding initiation and continuation, with rooming-in, initial breastfeeding practice and education during hospital stay as important practices. In addition, for working mothers to continue their breastfeeding, significant support from the workplace is crucial.

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Exclusive breastfeeding among Indonesian working mothers: does early initiation of breastfeeding matter?
Isyatun Mardhiyah Syahri, Agung Dwi Laksono, Maya Fitria, Nikmatur Rohmah, Masruroh Masruroh, Mara Ipa
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Candice L. Thomas, Lauren D. Murphy, Maura J. Mills, Jing Zhang, Gwenith G. Fisher, Rebecca L. Clancy
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Journal of Korean Medical Science.2018;[Epub] CrossRef
Belief factors associated with breastfeeding intentions of single women: Based on the theory of planned behavior
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Journal of Nutrition and Health.2017; 50(3): 284. CrossRef
Infant Formula Feeding at Birth Is Common and Inversely Associated with Subsequent Breastfeeding Behavior in Vietnam
Tuan T Nguyen, Mellissa Withers, Nemat Hajeebhoy, Edward A Frongillo
The Journal of Nutrition.2016; 146(10): 2102. CrossRef

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Development and Evaluation of Breastfeeding Promotion Program for Mothers with Breast Engorgement following Cesarean Birth: Jeongsug Cho, Sukhee Ahn; J Korean Acad Nurs 2014;44(2):170-178. Published online April 30, 2014; DOI: https://doi.org/10.4040/jkan.2014.44.2.170

Abstract PDF

Purpose

This study was to develop a breastfeeding promotion program and to test effects of the program on levels of breast discomfort, breast size, sodium in breast milk, and type of feeding in mothers with breast engorgement following cesarean birth.

Methods

A non-synchronized non-equivalent control group pretest-posttest design was used in this study. The participants were 70 postpartum mothers who were admitted to a postpartum care center and experienced breast engorgement following cesarean birth. The planned nursing intervention was the breastfeeding promotion program consisting of breast massage and 1:1 breastfeeding education, counseling, and support focusing on individualized problem solving provided for 10 days. Fifty-three women completed the program (experimental group 26, control group, 27). Measurements were level of breast discomfort, breast size, sodium in breast milk and type of feeding at pre and posttest.

Results

Women who participated in the program experienced lower scores for breast discomfort, greater decrease in breast size, lower levels of sodium in breast milk, and practiced breastfeeding more than those in the control group.

Conclusion

Results indicate that this breastfeeding promotion program is effective in reducing breast engorgement and improving breastfeeding practices, and is therefore recommended to enhance breastfeeding promotion practice in postpartum care centers.

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Comparison of Lactation Problems, Knowledge, and Adaptation on Breastfeeding between Users and Non-Users of Lactation Clinic
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Journal of East-West Nursing Research.2014; 20(2): 112. CrossRef

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A Structural Model for Primiparas' Breastfeeding Behavior: Hyun-Joo Yang, Ji-Min Seo; J Korean Acad Nurs 2013;43(3):399-408. Published online June 28, 2013; DOI: https://doi.org/10.4040/jkan.2013.43.3.399

Abstract PDF

Purpose

The study was done to construct and test a structural model to explain primipara breastfeeding behavior.

Methods

The participants were 213 primiparas on postpartum wards. Data were analyzed using the PASW 18.0 and AMOS 19.0 programs.

Results

Fitness statistics for the hypothetical model were appropriate (χ² =38.50, p=.070, GFI=.96, RMSEA=.05, AGFI=.93, NFI=.95, TLI=.97, CFI=.98, PNFI=.57, χ²/df=1.43). Breastfeeding behaviors were directly influenced by intention to breastfeed, perceived effectiveness of breastfeeding, and the amount of supplementary feeding. The amount of supplementary feeding had the largest direct impact on breastfeeding behavior. The largest total effect on breastfeeding behavior was intention to breastfeed. The environment of the maternity hospital indirectly influenced breastfeeding behavior. These factors explained 18.9% of variance in the primipara breastfeeding behavior.

Conclusion

The results of the study indicate that in order to promote primipara breastfeeding the amount of supplementary feeding immediately after the birth should be limited and an environment that encourages exclusive breastfeeding in the hospital should be provided. The results also suggest it is necessary to provide nursing interventions that increase the intention to breastfeed and the perceived effectiveness of breastfeeding.

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Sawsan Abuhammad
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Sun-Hee Kim
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Seung Hui Heo, Yoon Goo Noh
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