Assessing the impact of midwives’ instruction: the breastfeeding motivational instructional measurement scale

Janine Stockdale, Marlene Sinclair, George Kernohan, Lynn Dunwoody, Brian Cunningham, Lorna Lawther

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background. It has been reported that professional support is an important motivational factor in breastfeeding outcomes, however evidence suggests this is not necessarily the case. For women to be motivated through routine instruction, the optimal balance between value of breastfeeding with expectancy for success must be achieved. Aim. To develop and test the breastfeeding motivational instructional measurement scale (BMIMS) as a means of exploring the value and expectancy for success (confidence) that breastfeeding women experience when receiving best breastfeeding practice. Method. Informed by current literature and previous exploratory work, four motivational theories were incorporated into the BMIMS. A total of 14 items represented the Breastfeeding Self-efficacy Scale – Short Form. The remaining 37 items were transcribed from a previous task-motivation study. The resulting 51-item scale was exposed to expert review. Following ethical approval and verbal consent, the scale was pilot-tested (n=20) and completed via structured interview by a further convenience sample of breastfeeding women (n=182). Results. Exploratory factor analysis – an analytic technique for exploring underlying constructs or factors – was performed. Parity was used as a selection variable. The results revealed that first-time mothers highly valued the experience of breastfeeding, but low expectancy for success and a low perception of midwife support. Experienced mothers differed in that they reported a positive expectancy for success and were more moderate about the value they placed on breastfeeding. Conclusions. When value is high and expectancy for success is low, feelings of stress related to the behaviour often results. Although all mothers reported a perceived lack of midwife support, experienced mothers were empowered to sustain their expectancy for success. Current best practice must work to achieve the optimal motivational balance between value and expectancy for success in primigravida women.
LanguageEnglish
Pages27-34
JournalEvidence Based Midwifery
Volume6
Issue number1
Publication statusPublished - 2008

Fingerprint

Midwifery
Breast Feeding
Mothers
Practice Guidelines
Self Efficacy
Parity
Statistical Factor Analysis
Motivation
Emotions
Interviews

Keywords

  • Motivation
  • breastfeeding
  • midwife instruction
  • tool development
  • factor analysis
  • value and expectancy for success

Cite this

@article{97b8a9c977ab471c9e1f159bed8c8e49,
title = "Assessing the impact of midwives’ instruction: the breastfeeding motivational instructional measurement scale",
abstract = "Background. It has been reported that professional support is an important motivational factor in breastfeeding outcomes, however evidence suggests this is not necessarily the case. For women to be motivated through routine instruction, the optimal balance between value of breastfeeding with expectancy for success must be achieved. Aim. To develop and test the breastfeeding motivational instructional measurement scale (BMIMS) as a means of exploring the value and expectancy for success (confidence) that breastfeeding women experience when receiving best breastfeeding practice. Method. Informed by current literature and previous exploratory work, four motivational theories were incorporated into the BMIMS. A total of 14 items represented the Breastfeeding Self-efficacy Scale – Short Form. The remaining 37 items were transcribed from a previous task-motivation study. The resulting 51-item scale was exposed to expert review. Following ethical approval and verbal consent, the scale was pilot-tested (n=20) and completed via structured interview by a further convenience sample of breastfeeding women (n=182). Results. Exploratory factor analysis – an analytic technique for exploring underlying constructs or factors – was performed. Parity was used as a selection variable. The results revealed that first-time mothers highly valued the experience of breastfeeding, but low expectancy for success and a low perception of midwife support. Experienced mothers differed in that they reported a positive expectancy for success and were more moderate about the value they placed on breastfeeding. Conclusions. When value is high and expectancy for success is low, feelings of stress related to the behaviour often results. Although all mothers reported a perceived lack of midwife support, experienced mothers were empowered to sustain their expectancy for success. Current best practice must work to achieve the optimal motivational balance between value and expectancy for success in primigravida women.",
keywords = "Motivation, breastfeeding, midwife instruction, tool development, factor analysis, value and expectancy for success",
author = "Janine Stockdale and Marlene Sinclair and George Kernohan and Lynn Dunwoody and Brian Cunningham and Lorna Lawther",
note = "Reference text: Janine Stockdale 1 PhD, BSc, RM, RN. Marlene Sinclair 2 PhD, MEd, DASE, BSc, RNT, RM, RN. W George Kernohan 3 PhD, CPhys, CMath, FIMA, BSc. Lynn Dunwoody 4 PhD, BSc, PGCUT, Dip Acupuncture. Joseph B Cunningham 5 MSc, BEd, RNT, RGA, RNLD, RNMH, DipN. Lorna Lawther 6 BSc, RM, RN. Patricia Weir 7 BSc, RM, RN. Ajzen I, Madden TJ. (1986) Prediction of goal-directed behaviour: attitudes, intentions and perceived behavioural control. Journal of Experimental Social Psychology 22: 453-74. Avery M, Duckett L, Dodgson J, Savik K, Henly SJ. (1998) Factors associated with very early weaning among primparas intending to breastfeed. Maternal and Child Health Journal 2(3): 167-79. Cattell RB, Schuerger JM. (1978) Personality theory in action: handbook for the O-A (objective-analytic) test kit. Institute for Personality and Ability Testing: Champaign, Illinois. Chezem J, Friesen C, Boettcher J. (2003) Breastfeeding knowledge, breastfeeding confidence, and infant-feeding plans: effects on actual feeding practices. JOGNN 32(1): 40-7. Comrey AL, Lee HB. (1992) A first course in factor analysis (second edition). Lawrence Erlbaum Associates: Hillsdale, New Jersey. Dennis CL. (2003) Breastfeeding self-efficacy scale: psychometric assessment. Journal of Obstetric, Gynecologic and Neonatal Nursing 32(6): 734-44. Dick MJ, Evans ML, Arthurs JB, Barnes JK, Caldwell RS, Hutchins SS, Johnson LK. (2002) Predicting early breastfeeding attrition. Journal of Human Lactation 18(1): 21-8. Dodgson JE, Henly SJ, Duckett L, Tarrant M. (2003) Theory of planned behaviour-based models for breastfeeding duration among Hong Kong mothers. Nursing Research 52(3): 148-58. Duckett L, Henly S, Avery M, Potter S, Hills-Bonczyk S, Hulden R, Savik K. (1998) A theory of planned behaviour-based structural model for breastfeeding. Nursing Research 47(6): 325-36. Dykes F, Williams C. (1999) Falling by the wayside: a phenomenogical exploration of perceived breastmilk inadequacy in lactating women. Midwifery 15: 232-46. Dykes F. (2006) Breastfeeding in hospital: mothers, midwives and the production line. Routledge: Abingdon. Ertem IO, Votto N, Leventhal JM. (2001) The timing and prediction of the early termination of breastfeeding. Pediatrics 107: 543-8. European Public Health Alliance. (2004) Protection, promotion and support of breastfeeding in Europe: a blueprint for action. See: www.epha.org/a/1301 (accessed 11 February 2008). Feather N. (1982) Expectations and actions: expectancy-value models in psychology. Lawrence Erlbaum Associates: Hillsdale, New Jersey. Flesch-Kincaid Grade Readability Statistics Microsoft Word (1997). Gill SL. (2001) The little things: perceptions breastfeeding support. Journal of Obstetric, Gynecologic and Neonatal Nursing 30(4): 401-9. Hanss K. (2004) Confidence and breastfeeding: a view from the front line. Journal of Family Health Care 14(1): 21-4. Hong TM, Callister LC, Schwartz R. (2003) First-time mothers’ view of breastfeeding support. MCN 28(1): 10-5. Information Centre for Health and Social Care. (2007) Infant feeding survey 2005. See: www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/ infant-feeding/infant-feeding-survey-2005 (accessed 11 February 2008). Irwing P. (1991) Towards an integrated theory of task motivation: the influence of task characteristics, goals and self-concept on performance and satisfaction. Unpublished PhD study. University of Ulster: Jordanstown. Jacobs JE, Eccles JS. (2000) Parents, task values, and real-life achievement-related choices: In: Sansone C, Harackiewicz JM. (Eds.). Intrinsic and extrinsic motivation: the search for optimal motivation and performance. Academic Press: Oxford. Janke JR. (1994) Development of the breastfeeding attrition prediction tool. Nursing Research 43: 100-4. Kaiser HF. (1960) The application of electronic computers to factor analysis. Educational and Psychological Measurement 20: 141-51. Keller JM. (1987) Development and use of the ARCS model of instructional design. Journal of Instructional Development 10(3): 2-9. Kline P. (1998) An easy guide to factor analysis. Routledge: Sussex. Locke EA, Latham GP. (1990) A theory of goal setting and task performance. Prentice-Hall: Englewood Cliffs, New Jersey. Loiselle CG, Semenic SE, Cote B, Lapointe M, Gendron R. (2001) Impressions of breastfeeding information and support among first-time mothers within a multiethnic community. Canadian Journal of Nursing Research 33(3): 31-46. Mozingo J, Davis MW, Droppleman PG, Merideth A. (2000) It wasn’t working: women’s experiences with short-term breastfeeding. American Journal of Maternal and Child Nursing 25: 3. National Institute for Health and Clinical Excellence. (2005) Routine postnatal care of women and their babies. Clinical Guideline 37. National Institute for Health and Clinical Excellence: London. See: www.nice.org.uk/download. aspx?o=CG37NICEguideline (accessed 14 February 2008). Nieswiadomy RM. (2001) Foundations of nursing research (fourth edition). Prentice Hall: Paramus, New Jersey. Pett MA, Lackey NR, Sullivan JJ. (2003) Making sense of factor analysis: the use of factor analysis for instrument development in healthcare research. Sage: London. Schmied V, Sheenan A, Barclay L. (2001) Contemporary breastfeeding policy and practice: implications for midwives. Midwifery 17: 44-54. Stockdale DJ, Sinclair M, Kernohan WG. (2005) Observation of breastfeeding de-motivation: In: International Confederation of Midwives. (Ed.). Conference proceedings: 27th Congress of the International Confederation of Midwives. Brisbane, Australia: 350-3. Stockdale J, Sinclair M, Kernohan WG, Keller JM. (2007) Exploring the potential of the internet to motivate breastfeeding. Evidence Based Midwifery 5(1): 10-5. Tabachnick BG, Fidell LS. (2001) Using multivariate statistics (fourth edition). Allyn and Bacon: Pearson Education: Harlow. UNICEF UK Baby Friendly Initiative. (1998) Implementing the ten steps to successful breastfeeding – a guide for UK maternity service providers working towards Baby Friendly accreditation. UK Committee for UNICEF: London. Wambach KA. (1997) Breastfeeding intention and outcome: a test of the theory of planned behaviour. Research in Nursing and Health 20: 51-9.",
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Assessing the impact of midwives’ instruction: the breastfeeding motivational instructional measurement scale. / Stockdale, Janine; Sinclair, Marlene; Kernohan, George; Dunwoody, Lynn; Cunningham, Brian; Lawther, Lorna.

In: Evidence Based Midwifery, Vol. 6, No. 1, 2008, p. 27-34.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Assessing the impact of midwives’ instruction: the breastfeeding motivational instructional measurement scale

AU - Stockdale, Janine

AU - Sinclair, Marlene

AU - Kernohan, George

AU - Dunwoody, Lynn

AU - Cunningham, Brian

AU - Lawther, Lorna

N1 - Reference text: Janine Stockdale 1 PhD, BSc, RM, RN. Marlene Sinclair 2 PhD, MEd, DASE, BSc, RNT, RM, RN. W George Kernohan 3 PhD, CPhys, CMath, FIMA, BSc. Lynn Dunwoody 4 PhD, BSc, PGCUT, Dip Acupuncture. Joseph B Cunningham 5 MSc, BEd, RNT, RGA, RNLD, RNMH, DipN. Lorna Lawther 6 BSc, RM, RN. Patricia Weir 7 BSc, RM, RN. Ajzen I, Madden TJ. (1986) Prediction of goal-directed behaviour: attitudes, intentions and perceived behavioural control. Journal of Experimental Social Psychology 22: 453-74. Avery M, Duckett L, Dodgson J, Savik K, Henly SJ. (1998) Factors associated with very early weaning among primparas intending to breastfeed. Maternal and Child Health Journal 2(3): 167-79. Cattell RB, Schuerger JM. (1978) Personality theory in action: handbook for the O-A (objective-analytic) test kit. Institute for Personality and Ability Testing: Champaign, Illinois. Chezem J, Friesen C, Boettcher J. (2003) Breastfeeding knowledge, breastfeeding confidence, and infant-feeding plans: effects on actual feeding practices. JOGNN 32(1): 40-7. Comrey AL, Lee HB. (1992) A first course in factor analysis (second edition). Lawrence Erlbaum Associates: Hillsdale, New Jersey. Dennis CL. (2003) Breastfeeding self-efficacy scale: psychometric assessment. Journal of Obstetric, Gynecologic and Neonatal Nursing 32(6): 734-44. Dick MJ, Evans ML, Arthurs JB, Barnes JK, Caldwell RS, Hutchins SS, Johnson LK. (2002) Predicting early breastfeeding attrition. Journal of Human Lactation 18(1): 21-8. Dodgson JE, Henly SJ, Duckett L, Tarrant M. (2003) Theory of planned behaviour-based models for breastfeeding duration among Hong Kong mothers. Nursing Research 52(3): 148-58. Duckett L, Henly S, Avery M, Potter S, Hills-Bonczyk S, Hulden R, Savik K. (1998) A theory of planned behaviour-based structural model for breastfeeding. Nursing Research 47(6): 325-36. Dykes F, Williams C. (1999) Falling by the wayside: a phenomenogical exploration of perceived breastmilk inadequacy in lactating women. Midwifery 15: 232-46. Dykes F. (2006) Breastfeeding in hospital: mothers, midwives and the production line. Routledge: Abingdon. Ertem IO, Votto N, Leventhal JM. (2001) The timing and prediction of the early termination of breastfeeding. Pediatrics 107: 543-8. European Public Health Alliance. (2004) Protection, promotion and support of breastfeeding in Europe: a blueprint for action. See: www.epha.org/a/1301 (accessed 11 February 2008). Feather N. (1982) Expectations and actions: expectancy-value models in psychology. Lawrence Erlbaum Associates: Hillsdale, New Jersey. Flesch-Kincaid Grade Readability Statistics Microsoft Word (1997). Gill SL. (2001) The little things: perceptions breastfeeding support. Journal of Obstetric, Gynecologic and Neonatal Nursing 30(4): 401-9. Hanss K. (2004) Confidence and breastfeeding: a view from the front line. Journal of Family Health Care 14(1): 21-4. Hong TM, Callister LC, Schwartz R. (2003) First-time mothers’ view of breastfeeding support. MCN 28(1): 10-5. Information Centre for Health and Social Care. (2007) Infant feeding survey 2005. See: www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/ infant-feeding/infant-feeding-survey-2005 (accessed 11 February 2008). Irwing P. (1991) Towards an integrated theory of task motivation: the influence of task characteristics, goals and self-concept on performance and satisfaction. Unpublished PhD study. University of Ulster: Jordanstown. Jacobs JE, Eccles JS. (2000) Parents, task values, and real-life achievement-related choices: In: Sansone C, Harackiewicz JM. (Eds.). Intrinsic and extrinsic motivation: the search for optimal motivation and performance. Academic Press: Oxford. Janke JR. (1994) Development of the breastfeeding attrition prediction tool. Nursing Research 43: 100-4. Kaiser HF. (1960) The application of electronic computers to factor analysis. Educational and Psychological Measurement 20: 141-51. Keller JM. (1987) Development and use of the ARCS model of instructional design. Journal of Instructional Development 10(3): 2-9. Kline P. (1998) An easy guide to factor analysis. Routledge: Sussex. Locke EA, Latham GP. (1990) A theory of goal setting and task performance. Prentice-Hall: Englewood Cliffs, New Jersey. Loiselle CG, Semenic SE, Cote B, Lapointe M, Gendron R. (2001) Impressions of breastfeeding information and support among first-time mothers within a multiethnic community. Canadian Journal of Nursing Research 33(3): 31-46. Mozingo J, Davis MW, Droppleman PG, Merideth A. (2000) It wasn’t working: women’s experiences with short-term breastfeeding. American Journal of Maternal and Child Nursing 25: 3. National Institute for Health and Clinical Excellence. (2005) Routine postnatal care of women and their babies. Clinical Guideline 37. National Institute for Health and Clinical Excellence: London. See: www.nice.org.uk/download. aspx?o=CG37NICEguideline (accessed 14 February 2008). Nieswiadomy RM. (2001) Foundations of nursing research (fourth edition). Prentice Hall: Paramus, New Jersey. Pett MA, Lackey NR, Sullivan JJ. (2003) Making sense of factor analysis: the use of factor analysis for instrument development in healthcare research. Sage: London. Schmied V, Sheenan A, Barclay L. (2001) Contemporary breastfeeding policy and practice: implications for midwives. Midwifery 17: 44-54. Stockdale DJ, Sinclair M, Kernohan WG. (2005) Observation of breastfeeding de-motivation: In: International Confederation of Midwives. (Ed.). Conference proceedings: 27th Congress of the International Confederation of Midwives. Brisbane, Australia: 350-3. Stockdale J, Sinclair M, Kernohan WG, Keller JM. (2007) Exploring the potential of the internet to motivate breastfeeding. Evidence Based Midwifery 5(1): 10-5. Tabachnick BG, Fidell LS. (2001) Using multivariate statistics (fourth edition). Allyn and Bacon: Pearson Education: Harlow. UNICEF UK Baby Friendly Initiative. (1998) Implementing the ten steps to successful breastfeeding – a guide for UK maternity service providers working towards Baby Friendly accreditation. UK Committee for UNICEF: London. Wambach KA. (1997) Breastfeeding intention and outcome: a test of the theory of planned behaviour. Research in Nursing and Health 20: 51-9.

PY - 2008

Y1 - 2008

N2 - Background. It has been reported that professional support is an important motivational factor in breastfeeding outcomes, however evidence suggests this is not necessarily the case. For women to be motivated through routine instruction, the optimal balance between value of breastfeeding with expectancy for success must be achieved. Aim. To develop and test the breastfeeding motivational instructional measurement scale (BMIMS) as a means of exploring the value and expectancy for success (confidence) that breastfeeding women experience when receiving best breastfeeding practice. Method. Informed by current literature and previous exploratory work, four motivational theories were incorporated into the BMIMS. A total of 14 items represented the Breastfeeding Self-efficacy Scale – Short Form. The remaining 37 items were transcribed from a previous task-motivation study. The resulting 51-item scale was exposed to expert review. Following ethical approval and verbal consent, the scale was pilot-tested (n=20) and completed via structured interview by a further convenience sample of breastfeeding women (n=182). Results. Exploratory factor analysis – an analytic technique for exploring underlying constructs or factors – was performed. Parity was used as a selection variable. The results revealed that first-time mothers highly valued the experience of breastfeeding, but low expectancy for success and a low perception of midwife support. Experienced mothers differed in that they reported a positive expectancy for success and were more moderate about the value they placed on breastfeeding. Conclusions. When value is high and expectancy for success is low, feelings of stress related to the behaviour often results. Although all mothers reported a perceived lack of midwife support, experienced mothers were empowered to sustain their expectancy for success. Current best practice must work to achieve the optimal motivational balance between value and expectancy for success in primigravida women.

AB - Background. It has been reported that professional support is an important motivational factor in breastfeeding outcomes, however evidence suggests this is not necessarily the case. For women to be motivated through routine instruction, the optimal balance between value of breastfeeding with expectancy for success must be achieved. Aim. To develop and test the breastfeeding motivational instructional measurement scale (BMIMS) as a means of exploring the value and expectancy for success (confidence) that breastfeeding women experience when receiving best breastfeeding practice. Method. Informed by current literature and previous exploratory work, four motivational theories were incorporated into the BMIMS. A total of 14 items represented the Breastfeeding Self-efficacy Scale – Short Form. The remaining 37 items were transcribed from a previous task-motivation study. The resulting 51-item scale was exposed to expert review. Following ethical approval and verbal consent, the scale was pilot-tested (n=20) and completed via structured interview by a further convenience sample of breastfeeding women (n=182). Results. Exploratory factor analysis – an analytic technique for exploring underlying constructs or factors – was performed. Parity was used as a selection variable. The results revealed that first-time mothers highly valued the experience of breastfeeding, but low expectancy for success and a low perception of midwife support. Experienced mothers differed in that they reported a positive expectancy for success and were more moderate about the value they placed on breastfeeding. Conclusions. When value is high and expectancy for success is low, feelings of stress related to the behaviour often results. Although all mothers reported a perceived lack of midwife support, experienced mothers were empowered to sustain their expectancy for success. Current best practice must work to achieve the optimal motivational balance between value and expectancy for success in primigravida women.

KW - Motivation

KW - breastfeeding

KW - midwife instruction

KW - tool development

KW - factor analysis

KW - value and expectancy for success

UR - http://www.doctoralmidwiferysociety.org/docs/27-34_Stockdale.pdf

M3 - Article

VL - 6

SP - 27

EP - 34

JO - Evidence Based Midwifery

T2 - Evidence Based Midwifery

JF - Evidence Based Midwifery

SN - 1479-4489

IS - 1

ER -