In a message dated 9/26/2005 8:49:19 PM Eastern Daylight Time,
[log in to unmask] writes:
I don't think the teaching tool or tactic itself need be evidence-based.
Dear Colleagues:
Liz makes a lovely point about belly balls, and teaching tips that have
clearly reached mothers and parents, thus increasing their understanding.
I wonder about evidence-based teaching practices though. For
example,there are studies that show that printed materials don't make create the
outcomes we want, i.e. increased breastfeeding duration. Where is a study that shows
that printed materials are useful, and create change, which is the outcome
of learning?
This is just one of those studies. I have seen others, and as usual,
can't put my finger on them at the moment.
----------------------------------------------------------------------------
Evaluation of an information booklet on breastfeeding duration: a clinical
trial
Journal of Advanced Nursing
Volume 20 Issue 5 Page 836 - November 1994
Yvonne L. Hauck BScN MSc RN FCNA, Lecturerand Joan E. Dimmock B AppSc MAppSc
RN FCNA, Nursing Consultant
Since very few tools used in health education are carefully evaluated, the
aim of this study was to examine the effect that a breastfeeding information
booklet had on breastfeeding behaviour. Feedback about breastfeeding
information needs from a preliminary study of 58 Perth mothers at 3 months postpartum
provided the basis for the development of an information booklet. The sample
consisted of 150 mothers of full-term infants who were breastfeeding for the
first time. Upon discharge from hospital, a random sample of 75 mothers were
sent the booklet. These mothers and a control group (n = 75) were surveyed
for 52 weeks to compare breastfeeding duration. Although the breastfeeding
information booklet was found to be useful by 97% of the experimental group,
there was no significant difference noted for breastfeeding duration between
groups.
---------------------------------------------------------------------------
My experience with printed materials in the home has been that most
women don't even look through that pile of paper until weeks after they come home
with their new baby. And women do get a PILE of paper: documents about
paternity, shaken baby syndrome, vaccines, breastfeeding, infant care, postpartum
depression. I've seen nurses come in and hand a pile of papers to a newly
delivered mother, then leave her room. Literacy level is not assessed; the
nurse isn't even considering the level of learning or readiness of the learner.
The nurse is thinking about all the work that has to be done for this mother,
and getting her work done. Whether it is effective or not and teaches this
mother isn't considered; the nurse's job is done when she hands the packet over.
In my work as mother-baby community nurse, the mother has to sign 7
pieces of paper as part of my visit. Does she even look at what she is signing?
99% of the time not; I give her a brief sentence about each piece of paper
("This one is for the insurance billing, this one says that I have checked you,
this one says that I have examined your baby............") Meanwhile trees
are cut down and factories produce tons of reams of paper products,
contributing to the waste stream.
I know that good videos and good materials make me feel good as a
teacher; I wonder about all their effectiveness though, especially since the most
recent Ross survey shows that breastfeeding initiation is down 4% (to 66% in
2003 from 70% in 2002).
In all fairness, the CDC data show an increase: from 59.3% exclusive at
7 days in 2001 to 62.5 exclusive at 7 days in 2003.
What do you all think?
warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct Faculty Union Institute and University
Film Reviews Editor, Journal of Human Lactation
www.breastfeedingalwaysbest.com
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