Breastfeeding knowledge and attitudes of baccalaureate nursing students in Taiwan : (The BONUS Project)

Abstract

Background: Optimal nutrition during the first year of life is critical to an infant's healthy growth and development. Hence, it is vital that undergraduate health professional curricula provide opportunities for quality theoretical and clinical learning related to breastfeeding to enable students to acquire the necessary knowledge and skills to support breastfeeding mothers. There is evidence that theoretical and clinical education can improve such knowledge bases and attitudes among nursing students prior to clinical placement. Aims: The aim of this research project was to examine, in relation to breastfeeding, the effects of the theoretical and clinical learning experiences of Taiwanese nursing students' knowledge and attitudes. This research project also explored the role and experiences of nursing students in supporting breastfeeding from the perspectives of the students themselves, new mothers, nursing staff and teachers. Methodology: A mixed-methods design was used and involved both quantitative and qualitative data collection and analysis. First, a systematic review reporting on outcomes for nursing students was conducted. Accordingly, the Australian Breastfeeding Knowledge and Attitude Questionnaire (Short-Form) (ABKAQ-SF) was selected as an appropriate tool to examine the current knowledge and attitudes of Taiwanese nursing students. This questionnaire was further validated in Chinese, the approach to which is presented in Paper 2. Second, quantitative data were collected using a pre- and post-test survey design with two cohorts of nursing students. Knowledge and attitude were assessed before and after students' theoretical learning and clinical placement. Third, qualitative data were collected by conducting focus groups and small group interviews with four participant groups. Ethics approval was obtained prior to data collection. Findings: The findings of this research project are presented in four published papers. The systematic review of the literature indicated that health professional students demonstrated mid-range scores on breastfeeding attitudes, and their knowledge of breastfeeding was limited. The review also highlights the need to determine how breastfeeding knowledge and skills are best facilitated in undergraduate curricula to help students relate theoretical breastfeeding knowledge to practice (Paper 1). The results of the study determined the effect of breastfeeding education in a Baccalaureate of Nursing (BN) program on students' knowledge and attitude towards breastfeeding. Students demonstrated significant improvements in both areas following theoretical and clinical intervention (Paper 3). The final paper explored the experiences of nursing students in supporting breastfeeding mothers in a postpartum unit. Students highlighted the importance of establishing trust to effectively support mothers and a need to feel confident to provide breastfeeding information, in turn. The study also identified nursing students' need for further support, to develop effective communication skills and to build confidence prior to clinical placement. Conclusion: Results revealed that the current breastfeeding education program in Taiwan, both its theoretical and clinical components, increased nursing students' knowledge and improved positive attitudes towards breastfeeding. Any sociodemographic differences in knowledge and attitude about breastfeeding were ameliorated following theoretical and clinical learning. The findings also demonstrated the need for further support in developing effective communication skills and building confidence prior to clinical placement.

Date of Award	2019
Original language	English