Gestasyonel Diyabeti Olan ve Olmayan Kadınlarda Prenatal Emzirme Öz Yeterliliğinin Belirleyicileri: Türkiye'de hastane temelli bir vaka-kontrol çalışmasının sonuçları

Year 2025, Volume: 35 Issue: 1, 70 - 79, 28.02.2025

Ekin Dila Topaloğlu Ören , Gökşen Polat , Funda Sofulu , Elif Ünsal Avdal , Gülseren Pamuk

https://doi.org/10.54005/geneltip.1504267

Abstract

Giriş: Doğum öncesi emzirme öz yeterliliği, kadınların emzirme başarısını ve niyetini etkileyen önemli bir parametredir. Doğum öncesi emzirme öz yeterliliği GDM'si olan ve olmayan tüm kadınlarda değerlendirilmelidir.
Amaç: Çalışmanın amacı Gestasyonel Diyabeti (GDM) olan ve olmayan kadınların doğum öncesi emzirme öz yeterliliklerini incelemek ve doğum öncesi emzirme öz yeterliliğini yordayan faktörleri belirlemektir.
Yöntem: Araştırma hastane tabanlı bir vaka-kontrol çalışmasıdır. Çalışma, Türkiye'nin batısındaki bir üniversite hastanesinin endokrinoloji polikliniğine başvuran GDM'li 96 kadın ile GDM'si olmayan 98 kadının karşılaştırılmasıyla gerçekleştirilmiştir. Veriler "Birey Tanımlama Formu" ve "Prenatal Emzirme Öz Yeterlilik Ölçeği (PEÖTÖ)" kullanılarak toplanmıştır. İstatistiksel analiz için t testi ve Ki-kare testi kullanılmıştır. Regresyon analizleri doğum öncesi emzirme öz yeterliliğinin belirleyicilerini tanımlamak için kullanılmıştır. Bulgular: Olguların PEÖTÖ'i 79.64±15.12 ve kontrollerin 72.01±15.62’dir. Olguların PEÖTÖ puanları kontrollere göre anlamlı olarak daha yüksektir (p<0.05). GDM'li kadınlarda çalışma, aile tipi ve emzirme hakkında bilgi sahibi olma emzirme öz yeterliliği ile ilişkiliyken (p<0.05, R2=0.341); GDM'si olmayan kadınlarda eğitim düzeyi, çalışma, aile tipi, gelir düzeyi, trimester, emzirme hakkında bilgi sahibi olma ve daha önce emzirme süresi emzirme öz yeterliliği ile ilişkiliydi (p<0.05, R2=0.612). GDM, prenatal emzirme öz yeterlilik puanlarını 7,6 birim artırmıştır (B=7,636, R2=0,059).
Sonuçlar: Çalışma, doğum öncesi emzirme öz yeterliliğinin GDM'li kadınlarda daha yüksek olduğunu, her iki grupta da yüksek olduğunu ortaya koymuştur. Prenatal emzirme öz yeterliliği (PEÖY) bazı sosyodemografik, obstetrik ve emzirme ile ilgili özelliklerden etkilenmiştir. Sağlık profesyonelleri gebelerin emzirme öz yeterliliklerini belirlemeli, etkileyen faktörleri bilmeli ve eğitim ve danışmanlık verirken bunları göz önünde bulundurmalıdır. GDM'si olan ve olmayan kadınların emzirme öz yeterliliğini artırmak için doğum öncesi eğitim ve destek programları geliştirilmelidir.

Keywords

emzirme, öz yeterlilik, diyabet, gestasyonel, gebe

Predictors of Prenatal Breastfeeding Self-Efficacy of Women With and Without Gestational Diabetes: Results of a hospital based case-control study in Türkiye

Abstract

Background. Prenatal breastfeeding self-efficacy is an important parameter affecting the breastfeeding success and intention of women. Prenatal breastfeeding self-efficacy should be evaluated in all women with and without GDM.
Aim. The aim of the study was to examine the prenatal breastfeeding self-efficacy of women with and without Gestational Diabetes (GDM) and to determine the factors that predict prenatal breastfeeding self-efficacy.
Methods. The research is a hospital-based case-control study was conducted. The study was carried out with 96 women with GDM who were compared with 98 without GDM, who were admitted to the endocrinology policlinic of a university hospital, in western Türkiye. The data were collected using the “Individual Identification Form” and the "Prenatal Breastfeeding Self-Efficacy Scale (PBSES)”. For statistical analysis, t test and Chi-square test were used. Regression analyses were used to identify predictors of prenatal breastfeeding self-efficacy. Results. PBSES of cases was 79.64±15.12 and controls was 72.01±15.62. SQOL scores of cases were significantly higher than controls (p<0.05). Working, family type, and information about breastfeeding were associated with breastfeeding self-efficacy in women with GDM (p<0.05, R2=0.341); educational level, working, family type, income level, trimester, information about breastfeeding, and duration of previous breastfeeding were associated with breastfeeding self-efficacy in women without GDM (p<0.05, R2=0.612). GDM increased prenatal breastfeeding self-efficacy scores by 7.6 units (B=7.636, R2=0.059).
Conclusions. The study revealed that prenatal breastfeeding self-efficacy was higher in women with GDM, it was high in both groups. Prenatal breastfeeding self-efficacy (PBSE) was affected by some sociodemographic, obstetric, and breastfeeding-related characteristics. Health professionals should determine the breastfeeding self-efficacy of pregnant women, know the factors affecting them, and consider them when providing education and counseling. Prenatal education and support programs should be developed to increase the breastfeeding self-efficacy of women with and without GDM.

Keywords

breastfeeding, self-efficacy, diabetes, gestational, pregnant

Ethical Statement

Ethical approval was obtained from Izmir Katip Çelebi University Non-Interventional Clinical Research Ethics Committee (Date: 23.02.2023; IRB: 0058) and permission from the hospital where the study was conducted (Date: 05.04.2023). Permission was obtained from the researchers who conducted the Turkish validity and reliability of the scale used in the study. The purpose, nature, confidentiality, anonymity and right of women to refuse to participate in the study were explained to the participants. Written and verbal consent was obtained from women with and without GDM who voluntarily agreed to participate in the study and met the inclusion criteria. Informed consent was obtained from all women included in the study. The research was conducted in accordance with the Principles of the Declaration of Helsinki.

Supporting Institution

-

References

• 1. Aydın A, Pasinlioglu T. Reliability and validity of a Turkish version of the prenatal Breastfeeding Self-Efficacy Scale. Midwifery. 2018;64:11-6. doi:10.1016/j.midw.2018.05.007.
• 2. Wells KJ, Thompson NJ, Kloeblen-Tarver AS. Development and psychometric testing of the prenatal breast-feeding self-efficacy scale. American Journal of Health Behavior. 2006;30(2):177-87. doi:10.5993/AJHB.30.2.7.
• 3. Corby K, Kane D, Dayus D. Investigating predictors of prenatal breastfeeding self-efficacy. Canadian Journal of Nursing Research. 2021;53(1):56-63.
• 4. İnce T, Aktaş G, Aktepe N, Aydın A. Evaluation of the factors affecting mothers’ breastfeeding self-efficacy and breastfeeding success. Journal of Dr. Behcet Uz Children's Hospital. 2017;7(3):183-90.
• 5. Salarvand S, Ghazvineh S, Mousivand F, Ahmadi Gharaei H, Bitaraf S. Health literacy and its related factors as predictors for the breastfeeding self-efficacy in a western province in Iran. BMC Public Health. 2023;23(1):593.
• 6. Wu W, Zhang J, Silva Zolezzi I, Fries LR, Zhao A. Factors influencing breastfeeding practices in China: A meta‐aggregation of qualitative studies. Maternal & Child Nutrition. 2021;17(4):e13251.
• 7. Brockway M, Benzies K, Hayden KA. Interventions to improve breastfeeding self-efficacy and resultant breastfeeding rates: a systematic review and meta-analysis. Journal of Human Lactation. 2017;33(3):486-499.
• 8. Park S, Kim B, Paudel J, Park HO. Effects of Breastfeeding Knowledge and Health Beliefs Regarding Gestational Diabetes Mellitus on the Breastfeeding Intention of Pregnant Women. Research Square. 2023. https://doi.org/10.21203/rs.3.rs-3343250/v1
• 9. Battulga B, Benjamin MR, Chen H, Bat-Enkh E. The impact of social support and pregnancy on subjective well-being: A systematic review. Frontiers in Psychology. 2021;12:710858.
• 10. Chambers A, Emmott EH, Myers S, Page AE. Emotional and informational social support from health visitors and breastfeeding outcomes in the UK. International Breastfeeding Journal. 2023;18(1):14.
• 11. Nguyen PTH, Pham NM, Chu KT, Van Duong D, Van Do D. Gestational diabetes and breastfeeding outcomes: a systematic review. Asia Pacific Journal of Public Health. 2019;31(3):183-198.
• 12. Han RR, Xiang, ZX, Zhang SH, Gao LL. Predictors of anxiety among pregnant women with gestational diabetes mellitus and their partners: The mediating role of marital satisfaction. International Journal of Nursing Practice. 2024;30(1):e13155.
• 13. Alyousefi N, Alemam A, Altwaijri D, Alarifi S, Alessa H. Predictors of Prenatal Breastfeeding Self-Efficacy in Expectant Mothers with Gestational Diabetes Mellitus. International Journal of Environmental Research and Public Health. 2022;19(7):4115.
• 14. Piro SS, Ahmed HM. Impacts of antenatal nursing interventions on mothers’ breastfeeding self-efficacy: an experimental study. BMC Pregnancy and Childbirth. 2020;20:1-12.
• 15. Draffin C, Alderdice FA, McCance DR, Maresh M, Harper R, McSorley O, Holmes VA. Exploring the needs, concerns and knowledge of women diagnosed with gestational diabetes: A qualitative study. Midwifery. 2016;40:141-147.
• 16. Hirst JE, Tran TS, Do MAT, Rowena F, Morris JM, Jeffery HE. Women with gestational diabetes in Vietnam: a qualitative study to determine attitudes and health behaviours. BMC pregnancy and childbirth. 2012;12:1-10.
• 17. Peñacoba C, Catala P. Associations between breastfeeding and mother–infant relationships: a systematic review. Breastfeeding Medicine. 2016;14(9):616-629.
• 18. Shariat M, Abedinia N. The Effect of Psychological Intervention on MotherInfant Bonding and Breastfeeding. Iranian Journal of Neonatology. 2017;8(1). doi: 10.22038/ijn.2017.16673.1191
• 19. Abdolalipour S, Charandabi SMA, Mashayekh-Amiri S, Mirghafourvand M. The effectiveness of mindfulness-based interventions on self-efficacy and fear of childbirth in pregnant women: A systematic review and meta-analyses. Journal of Affective Disorders, 2023;333:257-270. https://doi.org/10.1016/j.jad.2023.04.020.
• 20. Jokić-Begić N, Žigić L, Nakić Radoš S. Anxiety and anxiety sensitivity as predictors of fear of childbirth: different patterns for nulliparous and parous women. Journal of Psychosomatic Obstetrics & Gynecology. 2014;35(1):22-28.
• 21. Duman FN, Gölbaşı, Z. Investigation of the Effect of Breastfeeding Education on Mothers' Breastfeeding Self-Efficacy Levels in Turkey. Turkish Journal of Family Medicine and Primary Care. 2022;16(1):140-150.
• 22. Şenol DK, Pekyiğit AÇ. Effects of Breastfeeding Education Given in Childbirth Preparation Classes for Primipara Women on Their Perceived Prenatal Breastfeeding Self-Efficacy. Bozok Medical Journal. 2021;11(2):15-21.
• 23. Konukoğlu T, Pasinlioğlu T. Breastfeedıng self-effıcacy ın pregnant women and evaluation of affectıng factors. J Midwifery and Health Sci. 2021;4(1):12-22.
• 24. Blyth R, Creedy D, Dennis CL. Effect of maternal confidence on breastfeeding duration: an application of breastfeeding self-efficacy theory. Birth. 2002;29:278-84. doi:10.1046/j.1523-536X.2002.00202.x
• 25. Dennis CL, Faux S. Development and psychometric testing of the Breastfeeding Self‐Efficacy Scale. Research in Nursing & Health. 1999;22(5):399-409. doi:10.1002/(SICI)1098-240X(199910)22:5<399::AID-NUR6>3.0.CO;2-4
• 26. Angerer S, Waibel C, Stummer H. Discrimination in health care: a field experiment on the impact of patients’ socioeconomic status on access to care. American Journal of Health Economics. 2019;5(4):407-427.
• 27. Gulliford MC, Sedgwick JEC, Pearce AJ. Cigarette smoking, health status, socio-economic status and access to health care in diabetes mellitus: a cross-sectional survey. BMC health services research. 2003;3:1-9.
• 28. McMaughan DJ, Oloruntoba O, Smith ML. Socioeconomic status and access to healthcare: interrelated drivers for healthy aging. Frontiers in public health. 2020;8:512143.
• 29. Maharlouei N. The importance of social support during pregnancy. Women’s Health Bulletin. 2016;3(1):1-1.
• 30. Georgas J, Mylonas K, Bafiti T, Poortinga YH, Christakopoulou S, Kagitcibasi C, et al. Functional relationships in the nuclear and extended family: A 16‐culture study. International Journal of Psychology. 2001;36(5):289-300.
• 31. Attah PA. Impact of the Extended Family System and Access to Health Care Services in Kogi State, Nigeria. KIU Journal of Social Sciences. 2023;9(1):143-149.
• 32. Mphego Z, Madiba S, Ntuli B. The influence of the family on adherence to exclusive breastfeeding: experiences of women living in extended family households in poorly resourced communities of Mpumalanga Province, South Africa: child nutrition and feeding practices. African Journal for Physical Health Education, Recreation and Dance. 2014;20(sup-1):279-290.
• 33. Mulyani S. Pregnant women with extended family on knowledge, motivation, and readiness in exclusive breastfeeding. International Journal of Emerging Trends in Social Sciences. 2017;1(2):104-107.
• 34. Koyuncu SB, Bülbül M. The impact of yoga on fear of childbirth and childbirth self-efficacy among third trimester pregnants. Complementary Therapies in Clinical Practice. 2021;44:101438.