AStudyontheFactorsAffectingtheInfantFeedingPractices

OfMothersinLasPiasCity
By[Author],UniversityofthePhilippines
2009

Abstract
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Abstract
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Introduction
Themelaminecontroversythateruptedduringthelastquarterofyear2008brought
peoplesattentionbacktothedebatesbetweenbreastfeedingandtheuseofbreastmilk
substituteslikecommercialinfantformula.Thiswasntthefirsttimethatinfantformula
hadcausedillnessesandevendeathstoinfantsworldwidehencethecontinuous
campaignofWorldHealthOrganization(WHO)andUNICEFalongwithother
breastfeedingadvocates,formotherstobreastfeedtheirchildrenatleastuntil6monthsof
age.
Infantfeedingpracticesrefergenerallytomeetthenutritionalandimmunologicalneeds
ofthebaby.Astudyofinfantfeedingpracticeswascarriedoutonasampleof100
motherandinfantpairs.Theresultsrevealedthatonly20%ofmothersinthestudy
currentlyexclusivelybreastfeedtheirbabies.Italsoshowsthatsocioeconomicfactors
likemothersworkstatus,maritalstatusandeducationalattainmenthaddirectbearingon
thesepractices.Employedmotherstendtoceasefrombreastfeedingtheirbabiesand
eventuallystopandjustresorttoformulafeedingastheygobacktowork.Thestudyalso
showedthatmotherswhoaremarriedandlivingwiththeirpartnersaremorelikelyto
breastfeedtheirinfantsthansinglemothers.Thosewithhighereducationalattainment
resortmoretoformulafeedingandmixedfeedingthanthosewithlowereducational
attainment.Healthcareprofessionalsinfluencemothersthemostwhenitcomestoinfant
feedingdecisions.
Methodology
TypeofResearch

Thetypeofresearchthatwillbeusedinthisstudyisqualitativeresearchandquantitative
research.Qualitativeresearchersaimtogatheranindepthunderstandingofhuman
behaviorandthereasonsthatgovernsuchbehavior.Thedisciplineinvestigatesthe
whyandhowofdecisionmaking.Besidesthis,theresearcherwillalsoexaminethe
phenomenonthroughobservationsinnumericalrepresentationsandthroughstatistical
analysis.Alongwithquestionnairesthatwillbegivenouttorespondentsforthe
statisticalrepresentationofthefindingsinthestudy,interviewswiththerespondentsand
afewexpertsinthisfieldwillalsobeconducted.
SamplingMethod
Theresearchsamplingmethodthatwillbeusedinthisstudyisrandomsamplingto
obtainamorescientificresultthatcouldbeusedtorepresenttheentiretyofthe
population.Alistofallhealthcarefacilities(maternityandlyinginclinics,publicand
privatehospitals,healthcenters)wasacquiredfromtheLasPiasCityHall.
From20barangays,3willbepickedthroughrandomsampling.Thehealthcarefacilities
andinstitutionsinthesethreebarangayswillthenbethetargetsourcesofrespondentsof
theresearcher.Thehealthcarefacilitiesandinstitutionswillbecontactedtoobtaina
verbalconsenttoadministerthequestionnairetomothersattheirplaces.Aletterof
consentwillalsobesenttothemalongwithasamplecopyofthequestionnairethatwill
beused,aswellastheprotocoloftheresearcher.AletterwasalsoaddressedtotheCity
HealthOfficertoobtainendorsementandconsenttoconductaresearchinselected
barangaysanddistributequestionnairestothemothersinthevicinity.
Datacollectionwasconductedthroughoutthefacilitiesandhealthcentersoperating
hoursfromMondaysthroughSundaysinordertoincludebothworkingandnonworking
mothers.
Respondents
TherespondentsinthisresearchwillallbecomingfromonesinglelocationLasPias
City,specificallytherandomlyselectedbarangaysofPamplonaI,CAA/BFInternational
andPamplonaIII.TheresearcherchoseLasPiasCitybecauseofthesocioeconomic
conditionspresentintheareathatisrelevanttothestudyandalsoasitfitsthetimeframe
andresourcesoftheresearcher.Therandomlysampledrespondentswillbeaskedbythe
researcherforconsentandapprovaltoanswerthequestionnaireuntilthedesirednumber
ofrespondentswhichis100isreached.Theopinionofexpertswillalsobesoughtinthis
researchtoprovideexplanationsregardingtherespondentsinfantfeedingbehaviorsand
practices.
Questionnaire
Thequestionnairerequiresinformationaboutthesocioeconomicanddemographic
backgroundofthemother.Italsohasquestionsrelatedtopreviousinfantfeeding
practicesandthebirthofheryoungestinfantandalsoregardingthebabysgeneralhealth
andage.
Statementsthatareperceivedtobefactorsthatinfluencemothersinfantfeeding
decisionswerepresented.Thedescriptionofthetypeofinfantformulagivenbyformula

andmixedfeedingmotherswillalsobeaskedinthematerial.
Conclusion
Majorityofthemothersformulafeedtheirchildandonlyaminorityexclusively
breastfeedstheirchildren,especiallyasperrecommendationoftheWorldHealth
Organization.Whilemajorityofthemothersinthisstudyshowedapositiveattitude
towardsbreastfeeding,mostofthemdecidedonlytoformulafeedduetothereasonsof
insufficientmilksupplyandwork.
Basedontheresultsofthestudy,theeducationalattainment,workstatus,maritalstatus,
andseminarsinthebarangaytherespondentsarepartof,aboutbreastfeeding,arethe
significantfactorsthataffecttheinfantfeedingdecisionofmothersinLasPiasCity.
Majorityofthemothersthatservedasrespondentsinthisstudyfallundertheagerange
of1730yearsold.Morethanhalfofthemwerealsocollegegraduateswhileasignificant
numberareundergraduatesandhaveonlyreacheduntilhighschool.Mostofthemothers
arehousewivesandtheothersremaininghavefulltimejobs,parttimejobsandself
employed.Afewofthemarestillstudents.Whilemajorityofthemweremarried,alot
werestillinastatusofliveinandaresingle.Morethanhalfofthemothersdidnothave
previouschildrenbeforethecurrentone.Majorityoftherespondentsalsohaveanannual
grosshouseholdincomethatdoesnotexceedP50,000.
Amongtheseveralinformationsourcesnamely,mediathroughtelevisions/radiosand
printed/publishedmaterials,thesocialsupportsystemcomprisedofthemothersfamily,
friendsandotherrelativesandhealthinstitutions,themotherswhogivetheirbabies
infantformulaareinfluencedthemostbyhealthcareinstitutionsthroughhealth
professionalsandotherhealthcarepersonnel.Theyinfluencethemothersindecidingto
feedthebabywithformulaandinchoosing,aswell,whichbrandofformulaisbestfor
theirbabies.Motherstrusttheirbabysdoctorbecauseoftheirexpertiseinthesaidfield
hencethiskindofrelationisachieved.
Motherswereoverallnotconcernedaboutthepossiblesideeffectsofbreastfeedingasa
fewwereonlyworriedasshowninthedatapresented.
Itcanbeconcludedthatnumerousinternalaswellasexternalfactorsinfluencea
motherinmakinginfantfeedingdecisions,andagreaterfractionoftheseissocio
economicinnature.

Rodgers' evolutionary concept analysis--a valid method for

developing knowledge in nursing science.
Tofthagen R1, Fagerstrm LM.

Author information
Abstract
In nursing science, concept development is a necessary prerequisite for meaningful
basic research. Rodgers' evolutionary concept analysis is a method for developing
knowledge in nursing science. The purpose of this article is to present Rodgers'
evolutionary concept analysis as a valid scientific method. A brief description of the
evolutionary process, from data collection to data analysis, with the concepts' context,
surrogate and related terms, antecedents, attributes, examples and consequences, is
presented. The phases used in evolutionary concept analysis are illustrated with eight
actual studies (1999-2009) from nursing research. The strength of the method is that it
is systematic, with a focus on clear-cut phases during the analysis process, and that it
can contribute to clarifying, describing and explaining concepts central to nursing
science by analysing how a chosen concept has been used both within the discipline
itself and other health sciences. While an interdisciplinary perspective which stresses
the similarities and dissimilarities of how a concept is used in various disciplines can
increase knowledge of a concept, it is important to clarify the specific with the discipline.
Nursing research should focus on the unambiguous use of concepts, for which Rodgers'
method constitutes a possible method. The importance of using quality criteria to
determine the inclusion of material should, however, be emphasised in the continued
development of the method.
Rodgers Evolutionary Concept Analysis Concept analysis is related to the
process of concept development. Rodgers asserts that the concept
development cycle considers the application, significance, and use of a
concept (2000). Rodgers (2000) evolutionary concept analysis involves the
use phase of development. There are six iterative phases that include the
following activities: 1) identifying the name and concept of interest and
association expressions, 2) identifying and selecting the appropriate setting,
3) collecting the data 4) analyzing the data, 5) identifying an exemplar of the
concept, and 6) identifying implications, hypotheses, and implications for
further development of the concept. The intention of this type of inductive
approach to concept analysis is to establish a10 foundation for future
development of the concept in contrast to a static, universal set of criteria
(Rodgers, 2000). These six phases will provide the framework to guide the
analysis of the concept of professional practice discussed in this paper.
Rationale for selecting Rodgers evolutionary concept analysis. The selection
of Rodgers (1989, 2000) evolutionary concept analysis to explore the
concept of nursing professional practice was made for several reasons. As
noted earlier, I believe the concept of nursing professional practice has

evolved through contextual influences; therefore, Rodgers approach would

be congruent with the development of the topic to date. The heuristic nature
of the method supports the intent of a masters program major project to
provide a foundation for further inquiry into the concept. Finally, the dynamic
and contextual nature of this method is congruent with the largely accepted
perspective in nursing (commonly associated with the interpretive
perspective) that humans are ever changing and interact with the
environment to establish their health (Rodgers, 2000).11 Chapter 2
Evolutionary Concept Analysis Step 1: Identify the Concept of Interest and
Associated Expressions Rodgers (2000) described a concept as an idea or
the characteristics associated with the word (p. 85) and not the word itself.
The concept of interest I have chosen is nursing professional practice.
Surrogate terms [words that say the same thing or have something in
common with the chosen concept (Rodgers, 1989)] for nursing professional
practice include professional nursing practice, professional practice,
nursing practice, professional or professionalism and practice. These
terms are considered antecedents in the analysis, but are discrete terms
from the combined concept of professional practice. Another important initial
decision of the evolutionary conceptual analysis process is to determine the
direction or context of the analysis (Rodgers, 2000). I have chosen to explore
the concept of nursing professional practice in the context of the Canadian
nursing perspective. Step 2: Identify and Select the Appropriate Setting
Rodgers (2000) defines the setting of an evolutionary concept analysis as the
time period to be explored and the type of disciplinary literature to be
included. I have selected nursing literature between 2005- 2011 as the
setting. I have selected this period to ensure I am informed by literature with
a recent health care context perspective. The type of disciplinary literature I
have used includes peer-reviewed literature and grey literature. To obtain the
peer reviewed literature sample for this concept analysis I searched the
CINAHL and ERIC online databases. I selected these databases as they are
recognized as repositories for nursing and education related12 literature. The
key words used for CIHAHL and ERIC included professional practice as title
and nursing as a subject. To obtain grey literature sources I used Library
and Archives of Canada, Google Canada as an internet search engine.
Rodgers (2000) identified the use of grey or popular literature as a strategy
to include in conducting a concept analysis. Grey literature are documents
that are not formally published or research based but provide key
information from a convergence of experience or ideas (RNAO, 2007). Grey
literature sources selected for this project were from established
government, health authority, professional association, union, and regulatory
college websites. Step 3: Collect the Data Due to the fore mentioned
indistinctness regarding the concept of nursing professional practice (Mark,

Salyer, & Wan, 2003) a multi step exploratory literature search was used to
determine the limits which included articles from 2005- 2011 and the search
terms professional practice as a title and nursing as a subject (Figure 1).
The final step of the search using these limits revealed 75 citations. I
determined which of the 75 peer reviewed literature citations and nursing
grey literature were ultimately included in the concept analysis using the
following criteria. Inclusion criteria. 1. Nursing professional practice should
be the focus of the article;
Materials &Methods: Rodgers' evolutionary concept analysis method was used to
facilitate clarification of transition concept in nursing. The search, performed on
scientific databases using the keywords: ' transition', 'nursing student' and ' new
graduate nurse' covering the period 1999 to 2010 represented concerning nursing.
Search limited to english-language articles and the full text and all research and
review articles were compiled. After applying the inclusion and exclusion criteria, a
total of 30 articles included for the final analysis. The process was audited by one
independent expert to ensure neutrality and credibility of the study and to reduce
the potentials for bias.
Result: This study showed that the concept of transition has five basic and global
properties: process, disconnectedness, personal perception, awareness, and human
responsepatterns. Thisconcepthasalsopositive &negative consequences.Positive
consequences of transition in novice nurses are from felt empowerment and more
power to promote quality of patient care and increased cost -effectiveness.
Negative consequences are anxiety, separation, incompetence to job
dissatisfaction, decreased quality of patient care.

Not a Concept. Concept learning must be distinguished from learning by reciting

something from memory (recall) or discriminating between two things that differ
(discrimination). However, these issues are closely related, since memory recall
of facts could be considered a "trivial" conceptual process where prior exemplars
representing the concept are invariant. Similarly, while discrimination is not the
same as initial concept learning, discrimination processes are involved in refining
concepts by means of the repeated presentation of exemplars.
Concrete or Perceptual Concepts vs Abstract Concepts
Defined (or Relational) and Associated Concepts

Complex Concepts. Constructs such as a schema and a script are examples of

complex concepts. A schema is an organization of smaller concepts (or features)
and is revised by situational information to assist in comprehension. A script on
the other hand is a list of actions that a person follows in order to complete a
desired goal. An example of a script would be the process of buying a CD. There
are several actions that must occur before the actual act of purchasing the CD
and a script provides a sequence of the necessary actions and proper order of
these actions in order to be successful in purchasing the CD.
Overview of Theory Construction

Theory (functional definition): A theory is a set of constructs, definitions, and

propositions that present a systematic view of phenomena by specifying relations
among variables for the purpose of explaining, describing, and predicting
phenomena.

Theory (formal definition): A theory is a collection of 1) primitive terms; 2) terms

defined on the basis of the primitives and/or previous definitions; 3) assumptions
about the nature of and relationships between the terms; and 4) propositions
derived from the various definitions, primitives, and assumptions, as well as from
previous propositions.