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The experiences and perceptions of midwives at Provincial Hospitals in the Nelson Mandela Metropolitan Municipality regarding exclusive breastfeeding by HIV positive first-time mothers

机译：纳尔逊曼德拉大都会市省立医院助产士对艾滋病毒阳性初次母亲纯母乳喂养的经验和看法

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摘要

The Department of Health in South Africa, as in many countries, has developed a policy guideline and recommendations for feeding of infants of HIV positive mothers. This is aimed at providing midwives with detailed and sound information about HIV and infant feeding practices based on current understanding of HIV and exclusive breastfeeding for the first six months of the infant’s life. The policy states that breastfeeding is a significant and preventable mode of HIV transmission to infants and there is an urgent need to educate, counsel and support women and families, so that they can make decisions about how best to feed infants in the context of HIV (http://www.doh.gov.za/aids/doc/feeding/html.2005-03-07). Speaking to midwives from the Provincial Hospitals in the Nelson Mandela Metropole, the researcher became aware of the midwives’ often-expressed unhappiness about the new policy from the Department of Health on exclusive breastfeeding. Midwives complained about the dilemma with which they are faced regarding infant feeding practices. They could not understand the advocacy of exclusive breastfeeding, when breastfeeding is recognised as one of the modes of Mother-to-Child Transmission (MTCT) of HIV. The aim of the study was to help, support and encourage midwives to implement the policy of exclusive breastfeeding. The objectives of the study were to: • Explore and describe the experiences and perceptions of midwives related to promoting exclusive breastfeeding in HIV positive first-time mothers. • Make recommendations to the Department of Health regarding the support and help that can be given to midwives to encourage their implementation of the exclusive breastfeeding policy. The researcher made use of a qualitative, phenomenological, descriptive, explorative and contextual design. Permission for conducting the research was iv obtained from relevant authorities, and participants were asked to sign a consent form before the researcher proceeded with the study. Collection of data was done by means of unstructured interviews using an audiotape recorder. Once data was saturated, the interviews were transcribed verbatim and analysed, using the steps described by Tesch’s (1990 in Creswell, 1994: 153) method of descriptive analysis. Field notes were also taken to record non-verbal communication during the interviews. In order to ensure trustworthiness of the study, the ethical principles of Guba’s model (in Krefting, 1991:215), namely truth-value, applicability, consistency and neutrality were used. The services of an independent coder were utilised and a consensus meeting was held between the researcher and the independent coder in order to discuss the identified themes. Prior to the consensus meeting, the independent coder was provided with interview transcripts and a protocol to guide the data analysis. Following the data analysis, a literature control was undertaken to highlight the similarities and differences found in the data analysis. Three themes with sub-themes were identified. The participants expressed positive views on the policy of exclusive breastfeeding in HIV positive first-time mothers. They were satisfied with the policy and viewed the policy of exclusive breastfeeding as an effective contribution to feeding options of babies born of HIV positive first-time mothers. However, the participants identified several factors hindering the effective implementation of the policy of exclusive breastfeeding in HIV positive first-time mothers. Factors identified were staffshortages, lack of cooperation among staff members regarding promotion of exclusive breastfeeding, lack of information regarding the CD4 count of patients on admission in the ward, cultural beliefs, lack of training among staff members and inadequate counseling facilities to ensure privacy and confidentiality for mothers. Participants also experienced a variety of emotions related to exclusive breastfeeding such as happiness, confidence, helplessness, frustration, worry and concern, stress and exhaustion. Based on the findings of the study, guidelines were developed and recommendations made concerning nursing practice, nursing education and nursing research.
机译：与许多国家一样，南非卫生部已经制定了一项政策指南和建议，以喂养艾滋病毒呈阳性母亲的婴儿。目的是根据当前对婴儿出生后头六个月对艾滋病毒和纯母乳喂养的了解，为助产士提供有关艾滋病毒和婴儿喂养方法的详细，合理的信息。该政策指出，母乳喂养是艾滋病毒向婴儿传播的一种重要且可预防的方式，迫切需要对妇女和家庭进行教育，咨询和支持，以便她们可以就如何在艾滋病毒的情况下最佳喂养婴儿做出决定（ http://www.doh.gov.za/aids/doc/feeding/html.2005-03-07）。在与纳尔逊·曼德拉都会区的省级医院的助产士交谈时，研究人员意识到，助产士通常对卫生部关于纯母乳喂养新政策的不满表示担忧。助产士抱怨他们在婴儿喂养方式方面面临的困境。当母乳喂养被认为是艾滋病毒母婴传播（MTCT）的一种方式时，他们无法理解纯母乳喂养的提倡。该研究的目的是帮助，支持和鼓励助产士实施纯母乳喂养政策。该研究的目的是：•探索和描述助产士的经验和观念，这些观念和观念与在HIV阳性初次母亲中促进纯母乳喂养有关。 •就可以对助产士提供的支持和帮助向卫生部提出建议，以鼓励其实施独家母乳喂养政策。研究人员利用了定性，现象学，描述性，探索性和上下文相关的设计。已从有关当局处获得了进行研究的许可，并要求参与者在研究者进行研究之前签署同意书。数据收集是通过使用录音带的非结构化采访进行的。一旦数据达到饱和，就可以采用Tesch（1990，在Creswell，1994：153）描述方法中描述的步骤，逐字记录和分析访谈内容。采访中还记录了现场记录，以记录非语言交流。为了确保研究的可信度，使用了古巴模型的道德原则（在Krefting，1991：215中），即真值，适用性，一致性和中立性。利用独立编码器的服务，并在研究人员和独立编码器之间举行共识会议，以讨论确定的主题。在共识会议之前，向独立编码员提供了采访记录和指导数据分析的协议。数据分析之后，进行文献对照以突出显示数据分析中发现的异同。确定了三个带有子主题的主题。与会者对首次感染艾滋病毒的母亲纯母乳喂养的政策表示了积极的看法。他们对该政策感到满意，并认为纯母乳喂养政策对艾滋病毒呈阳性首次母亲所生婴儿的喂养方式做出了有效贡献。但是，参与者发现了几个因素，这些因素阻碍了HIV阳性初次母亲有效实施纯母乳喂养政策。确定的因素包括人员短缺，工作人员之间在促进纯母乳喂养方面缺乏合作，缺乏有关病房入院患者CD4计数的信息，文化信仰，工作人员缺乏培训以及确保隐私和机密性的咨询设施不足为母亲。参与者还经历了与纯母乳喂养有关的各种情绪，例如幸福，自信，无助，沮丧，担忧和担忧，压力和疲惫。根据研究结果，制定了有关护理实践，护理教育和护理研究的指南并提出了建议。

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  • 作者

    Moobi Emily Keadimilwe;

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  • 年度 2006
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  • 原文格式 PDF
  • 正文语种 English
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  • 入库时间 2022-08-31 16:25:34

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