The Construction Of Core Competency Index System Of Breastfeeding Consulting Nurses In China

Background:The benefits of breastfeeding are unmatched by any other form of feeding.The World Health Organization(WHO)is calling on worldwide governments to focus on breastfeeding,increase breastfeeding rates,train health care workers such as midwives and nurses,and provide skilled breastfeeding guidance to mothers and families.However,at present,there are still deficiencies in breastfeeding knowledge of medical staff and the training of breast-feeding consulting professionals in China,and the corresponding competency index system construction research is lacking.Objectives:We aims to construct the index system of core competencies of breastfeeding consulting nurses in China based on onion model.Methods:In our study,we used literature analysis,semi-structured interview,Delphi method.Clinical Competencies for the Practice of International Board Certified Lactation Consultants and literatures on the construction of competency index system related to breastfeeding consulting and guidance nurses at home and abroad were retrieved to extract competency entries in domestic and abroad database such as Wan Fang,PubMed etc.from the establish of database to September 2022.Combined with semi-structured interviews,competency characteristics were explored from the dual perspectives of breastfeeding counseling nurses(n=18)and lactating women(n=11),the core competency framework of Chinese breastfeeding counseling nurses was established.Finally,through two rounds of Delphi,in which 15 experts in related fields were invited,the core competency index system contents and index weight were determined with analytic hierarchy process.Results:1.Through literature analysis,15 categories and 78 specific competency indicators were extracted from IBCLC clinical competence and 14 included literatures.One category and 22 competency indicators were added through semi-structured interview.After integration analysis based on the onion model,the core competency framework of Chinese breastfeeding consulting nurses was preliminarily constructed,including 4 first-level indexes,16 second-level indexes and 100 third-level indexes.2.Through two rounds of Delphi,the positive coefficients of the two rounds of expert consultation were both 100%;the degree of expert authority was high(Cr=0.92);the Kendall’s W of two rounds of experts was between 0.206(χ2=293.69)and 0.296(χ2=62.07),and the difference was statistically significant by χ2 test(P<0.01),indicating that the coordination of expert opinions was good,with CV ranging from 0.00 to 0.23.In the first round of consultation,the average importance score of each item was 4.63(3.93-5.00)±0.305,and the full score ratio was 0.667-1.The average importance score of each item in the second round of consultation was 4.54(4.20-5.00)±0.297,and the full score ratio was 0.80-1.Finally,the index system of core competence of breastfeeding consulting nurses in China was finally formed,including 4 first-level indicators(core knowledge and skills,professional competence,maintaining professional standards,professional and personal traits),15 second-level indicators and 95 third-level indicators.The weight ranking of each level I index is as follows:core knowledge and skills(0.3498),professional ability(0.2858),maintenance of professional standards(0.1915),and professional and personal traits(0.1728),all of which pass the consistency test CR<0.10.Conclusions:The core competency index system for Chinese breastfeeding counseling nurses constructed in this study is comprehensive,scientific,systematic and authoritative.The index system can provide a reference for the training or certification of breastfeeding counseling professionals in China,improve their breastfeeding counseling ability and promote the improvement of breastfeeding rate.