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Evaluación de prácticas hospitalarias de lactancia: una perspectiva comunitaria
Evaluation of supportive breastfeeding hospital practices: a community perspective
Avaliação de práticas hospitaleres de lactancia de apoio: uma perspectiva comunitária
Keywords:
lactancia materna, conducta alimentaria, atención posnatal, hospitales (fuente, DeCS, BIREME). (es)breast feeding, feeding behavior, postnatal care, hospitals (en)
aleitamento materno, comportamento alimentar, cuidado pós-natal, hospitais (pt)
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Objetivos del estudio: (1) describir las prácticas de lactancia hospitalaria de apoyo en una gran región urbana y (2) determinar si las prácticas de lactancia hospitalaria de apoyo están bajo la influencia de características hospitalarias.
Métodos: entre los meses de julio de 2009 y marzo de 2010 se realizó una encuesta telefónica transversal en todos los hospitales con servicios de maternidad (N = 21) en el Condado de Maricopa, Arizona (USA). Este gran condado urbano, que incluye Phoenix, es la cuarta ciudad más grande de Estados Unidos. Las prácticas de lactancia de apoyo se refirieron a 12 prácticas de cuidados de maternidad acordes con los Diez Pasos e Iniciativas Hospitalarias Amigables para el Bebé de la OMS. Las características hospitalarias medidas fueron: servicios de lactancia disponibles, propiedad institucional, número de nacimiento al año, nacimientos pagados por fondos públicos, y el nivel de atención suministrado. Se realizaron estadísticas descriptivas e inferenciales.
Resultados: El número total de las prácticas de apoyo variaba de 5 a 10 (M = 7.52; SD = 1.53). Se aplicaron de forma uniforme dos prácticas; el resto variaba entre niveles de implementación bajo (> 25%) y moderado (50-75%). Ochenta y seis por ciento de los hospitales utilizan ampliamente suplementos y dan bolsas de regalo con leche de fórmula. El número de de Consultores de Lactancia Certificados (IBCLC por sus siglas en inglés) empleados por un hospital fue la única variable que predecía mayores niveles de prácticas de apoyo. El estatus de propiedad de la instalación estaba ampliamente relacionado con el número de IBCLC.
Discusión: Las diferencias en las prácticas hospitalarias de apoyo entre hospitales sugieren la efectividad del IBCLC en cuanto al cambio de prácticas; sin embargo, se necesita investigación adicional para explorar aún más esta tesis. Los hallazgos de este estudio, únicos para la comunidad estudiada, eran consistentes con varios de los hallazgos reportados por investigadores en todo el mundo.
Study objectives: (1) describe the existing supportive hospital breastfeeding practices in a major urban region and (2) determine if supportive hospital breastfeeding practices are influenced by hospital characteristics.
Methods: A cross-sectional telephone survey of all hospitals with maternity services (N = 21) in Maricopa County, Arizona (USA), was conducted between July 2009 and March 2010. This major urban county, which includes Phoenix, is the fourth largest city in the USA. Supportive breastfeeding practices were 12 maternity care practices consistent with WHO Baby Friendly Hospital Initiative Ten Steps. Hospital characteristics measured were professional breastfeeding services available, institutional ownership, number of births per year, births paid for by public funds, and the level of care provided. Descriptive and inferential statistics were conducted.
Results: The total number of supportive practices ranged from 5 to 10 (M = 7.52; SD = 1.53). Two practices were uniformly implemented; the remainder varied from low (> 25%) to moderate (50-75%) levels of implementation. 86% of hospitals had widespread use of supplements and provided gift bags containing formula. The number of Board Certified Lactation Consultants (IBCLCs) employed by a hospital was the only variable predicting higher levels of supportive practices. Facility ownership status was significantly correlated with the number of IBCLCs.
Discussion: The differences in supportive hospital practices among hospitals suggest the effectiveness of IBCLCs in changing practice; however, additional research is needed to further explore this thesis. Findings of this study, while unique to the community studied, were consistent with a number of findings reported by researchers around the globe.
Objetivos do estudo: (1) descrever as práticas de lactância hospitalar de apoio em uma importante região urbana e (2) determinar se as práticas de lactância hospitalar de apoio são influenciadas pelas características hospitalares.
Métodos: entre os meses de julho de 2009 e março de 2010 foi realizado um questionário telefônico transversal em todos os hospitais com serviços de maternidade (N = 21) no Condado de Maricopa, Arizona (USA). Este importante condado, que inclui Phoenix, é a quarta maior cidade dos Estados Unidos. As práticas de lactância de apoio eram 12 práticas de cuidados de maternidade congruentes com os Dez Passos e Iniciativas Hospitalares Amigáveis para o Bebê da OMS. As características hospitalares medidas foram as seguintes: serviços de lactância disponíveis, propriedade institucional, número de nascimentos por ano, nascimentos pagos por fundos públicos, e o nível de atenção fornecido. Realizaram-se estatísticas descritivas e inferenciais.
Resultados: O número total das práticas de apoio variava de 5 a 10 (M = 7.52; SD = 1.53). Aplicaram-se de forma uniforme duas práticas; o resto variava entre níveis de implementação baixo (> 25%) e moderado (50-75%). Oitenta e seis por cento dos hospitais utilizam amplamente suplementos e dão sacolas de presente que contêm leite formulado. O número de Consultores de Lactância Certificados (IBCLC pelas siglas em inglês) empregados por um hospital foi a única variável que predizia maiores níveis de práticas de apoio. O estado de propriedade da instalação estava amplamente relacionado com o número de IBCLC.
Discussão: As diferenças nas práticas hospitalares de apoio entre hospitais sugerem a efetividades do IBCLC quanto à mudança de práticas; contudo, é preciso fazer outras pesquisar para explorar ainda mais esta tese. Os achados deste estudo, únicos para a comunidade estudada, eram congruentes com vários dos achados mostrados por pesquisadores no mundo inteiro.
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