Fatores paternos influenciadores do diagnóstico de enfermagem amamentação interrompida

Abstract

Breastfeeding is one of the main actions to promote health. However, the process on itself is a difficult task for many women. The presence of the father is a relevant aid for Breastfeeding in the maternal perspective. The role of the father in the Breastfeeding context is permeated by uncertainty and hardships, since the health assistance has a more intense grasp on the maternal-child binomial, thus there is no paternal inclusion in the follow-up programs of the pregnancy-puerperal cycle. This fact generates a lack of knowledge and inadequacy of the father in relation to Breastfeeding, which can influence nursing diagnosis such as interrupted Breastfeeding. In the context above mentioned, the general objective of this research was to identify the paternal variables that act as related factors from the nursing point of view as to diagnosis interrupted Breastfeeding. A clinical case-control and observational study was conducted. The research was developed in the city of Juazeiro do Norte-CE. The study population consisted of the mother-father-son trinomials, who lived in the urban area and were enrolled in the Family Health Strategy of that city. Data collection took place from June to December 2017. The study sample consisted of 220 mother-father-child trinomials, being 101 cases and 119 controls. The data were collected by the researcher as well as nursing students enrolled in the Universidade Regional do Cariri, using an instrument to determine the diagnosis of interrupted Breastfeeding in the mother-child binomial, and an instrument for the fathers, in order to evaluate the occurrence of the paternal variables related to the diagnosis, which was constructed based on the indicators found in the review of literature. The researcher determined the presence or absence of the defining characteristics using a standard operating procedure protocol. The study received approval from the Research Ethics Committee of Universidade Regional do Cariri under ruling 2.081.313. The data were organized and tabulated using 2013 Excel® and presented in tables. For statistical data processing and analysis, IBM SPSS version 21.0 for Windows® and R version 3.2 were used. The descriptive analysis included absolute and percentage values with respective 95% confidence intervals for nominal variables, and the presentation of central trend and dispersion measures for quantitative variables. For bivariate analysis, the Chi-square test was used to compare proportions when analyzing the relation of nominal variables with the occurrence of the nursing diagnosis of interrupted Breastfeeding. To check the differences in the average, Student's t-test was applied after checking the normal distribution by applying the Kolmogorov-Smirnov test with Lilliefors correction. In case of non-compliance with the normal distribution, the Mann-Whitney test was administered. In order to determine the nursing diagnosis of interrupted Breastfeeding in the mother-child binomials and to verify the sensitivity and specificity measures of the most prevalent defining characteristics, the latent class model adjusted with random effects was used. Posterior probabilities based on the adjusted latent class model were used to verify the association of the defining characteristics with the diagnosis under study. As to evaluate the paternal variables related to the interrupted Breastfeeding diagnosis, it was presented the adjusted Odds Ratios for each variable with the respective 95% confidence intervals. Significance was set at 5%. Fisher's exact test was used to verify the association between parental variables and the occurrence of the nursing diagnosis of interrupted Breastfeeding. The most prevalent defining characteristics of the nursing diagnosis of interrupted Breastfeeding were: Mother's desire to offer her milk to meet the nutritional needs of the child, Mother's desire to maintain Breastfeeding to meet the nutritional needs of the child, Lack of knowledge in relation to the storage of breast milk, Lack of knowledge regarding the expression (milking) of breast milk and non exclusive Breastfeeding; and the defining characteristic of separation between mother and child to a lesser extent. The paternal variables that contributed to the occurrence of the nursing diagnosis of interrupted Breastfeeding found in this study can be classified as reinforcing etiological factors, among which we can mention: fathers who have showed to believe that their child cries with hunger even though they have been breastfed, fathers who argued that their child needs water, tea or artificial milk to supplement Breastfeeding, fathers who said they encouraged water, tea, artificial milk and other foods and fathers who argued that the most appropriate way to feed their child is with the bottle. It is concluded that there are parental reinforcing etiological factors, which lead to the increase of the susceptibility to the nursing diagnosis of interrupted Breastfeeding, which are not listed in the current version of the NANDA-I taxonomy.