CLINICAL INTRODUCTION AND EVALUATION OF THE EXISTENTIAL BREASTFEEDING DIFFICULTY SCALE (EXBREASTS) IN THE CONTEXT OF CHILD HEALTH CARE

Ida Gustafsson RN, RM, Lecturer, PhD-student

Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden

Malin Spångby RN, MNSc

Child Health Services, Region Jönköping County, Jönköping, Sweden

Ann Arvidsdal RN, MNSc

Child Health Services, Region Jönköping County, Jönköping, Sweden

Marie Golsäter RN, PhD, Docent

Child Health Services, Region Jönköping County, Jönköping, Sweden

CHILD Research Group, School of Health and Welfare, Jönköping University, Jönköping, Sweden

Department of Health, Medicine and Caring, Linköping University, Linköping, Sweden

Lina Palmér RN, RM, Associate Professor, Docent

Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden

Background: Breastfeeding, both with and without perceived difficulties, can be experienced as an existential journey. Therefore, care needs to be based on the woman's breastfeeding story and carers need to be prepared to handle the existential questions that may arise. Previous research shows that healthcare professionals struggle with providing individually tailored care. The Existential Breastfeeding Difficulty Scale (ExBreastS) was developed based on lifeworld theoretical research on women's experiences of initiating breastfeeding with or without breastfeeding difficulties and was in this study introduced in child healthcare in a Swedish region. This was done to evaluate its ability to support child healthcare nurses to conduct existentially oriented caring dialogues with the breastfeeding story in focus. 

Aim: Describe child healthcare nurses’ lived experience of how ExBreastS influences the caring dialogue.

Methods: Lifeworld interviews were conducted with 17 child healthcare nurses about their experience of using ExBreastS to support caring dialogues with breastfeeding women. The interviews were conducted either individually, in pairs or in groups. The material was analyzed through thematic analysis based on descriptive phenomenology.

Results: The results show that ExBreastS contributes to the re-evaluation of the importance of the caring dialogue because the existential significance of breastfeeding is given more space. ExBreastS also makes new perspectives of the breastfeeding story visible for both woman and carer. However, if the instrument itself receives too much of the nurse’s focus, there is a risk that the caring dialogue will be overshadowed.

Conclusions: ExBreastS supports caring dialogues based on the breastfeeding story through its focus on the existential aspects of breastfeeding. However, this requires time, support from the organization and an awareness that caring dialogues can have no manual.