Breastfeeding Support Guided by Swanson's Theory of Caring

Abstract

Purpose: Many women struggle with initiation of breastfeeding. The purpose of this study was to explore mothers' perceptions of care and support received from clinicians during breastfeeding initiation and the utility of Swanson's (1991) Theory of Caring to provide person-centered care to breastfeeding mothers and infants. Study Design and Methods: Directed content of secondary analysis of data obtained from 11 women via in-person interviews at three time points: before birth, a week after giving birth, and 6 to 8 weeks after giving birth. All women were breastfeeding at the end of the study interview series. Swanson's Theory of Caring provided the theoretical framework for the analysis. Results: Two overarching themes The Acts of Caring and The Lapses in Caring summarized women's experiences of care received during the initiation of breastfeeding. Five subthemes supported the Acts of Caring theme, and three subthemes supported the Lapses in Caring theme. Clinical Implications: Although all study participants chose to breastfeed after hospital discharge and the majority felt well supported, some received care that was perceived as uncaring, unsupportive, or harmful. Providing breastfeeding support consistent with research evidence and underpinnings of Swanson's Theory of Caring may help women build trusting relationships with clinicians and feel confident in meeting their breastfeeding goals.

Experiences of High-Risk Parturient Women With the Use of Non-Invasive Care Technologies

“…For Kristen Swanson, nursing care presupposes a fundamental belief in people and their ability to meaningfully experience vital life transition events, such as pregnancy, childbirth, breastfeeding and motherhood itself [13][14][15][16] . This stance of conviction in the existence of personal and intimate meanings to be revealed in health-related situations allows nurses to develop care processes that promote well-being, demonstrating ethical commitment and humanistic attitudes towards a person's values and feelings 17,21 .…”

“…These experiences reveal the STC "maintaining belief" process, which begins with understanding women's values, beliefs and life context, which requires nurses to have relational skills to embrace their subjectivities and understand their biological needs, emotional and social aspects in the parturition process, enabling building a care relationship that sees this phenomenon in its entirety [13][14][15]17 .…”

“…From this perspective, nurses support others in their decisions, respecting their beliefs and limits, maintaining active and sensitive listening to their concerns and establishing a dialogical relationship that allows exchanges during care [13][14][15]17,21 . In the case of the high-risk parturient women in this research, they noticed that nurses were available and attentive to the meanings attributed to their clinical-obstetric condition, demonstrating sensitivity to their feelings and emotions, identifying their demands, offering support and clarifications, and expressing the second STC process.…”

“…The "doing for" process, which involves anticipating needs, comforting and acting competently in the development of therapeutic acts, with protection and respect for the dignity and autonomy of the person being cared for, and the "enabling" process, concerning actions that facilitate the experience of being cared for through life transitions and unknown events, involve presence with and for others, using sharing, reflections and feedback in the elaboration and implementation of an individualized care plan [13][14][15]17,21,26 .…”

“…In this regard, the application of Kristen Swanson's Theory of Caring (STC) is very appropriate for nurses' work in prenatal care and childbirth, as it enables the construction of an empathetic relationship based on culturality. In this relationship, professionals respect the meanings attributed by women to pregnancy and childbirth, demonstrating availability, support and involvement, sharing decisions regarding unique therapeutic actions and maintaining belief in their ability to experience the processes with autonomy, safety and well-being [13][14][15] .…”