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      Interactive breastfeeding theory: fawcettʼs pragmatic adequacy assessment Translated title: Teoría interactiva de la lactancia materna: Evaluación de la adecuación pragmática de Fawcett

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          ABSTRACT

          Objective:

          To assess the pragmatic adequacy of the Interactive Theory of Breastfeeding based on the Fawcett’s Model.

          Method:

          Theoretical study, according to evaluation criteria proposed by Fawcett. The six questions suggested in the model were used, answered based on searches in scientific literature, consultation in legislation supporting nursing professional practice and information from the authors of the theory.

          Results:

          It was observed that during their training, Nurses acquire skills for care, but clinical management focused on breastfeeding should be emphasized. Since its creation, the theory has been applied in an ascending manner, proving its application in clinical practice to be viable. The existence of laws and resolutions guarantee clinical nurses the legal support necessary to develop a practice based on the Interactive Theory of Breastfeeding.

          Conclusion:

          The pragmatic adequacy of the theory was observed, showing that the Interactive Theory of Breastfeeding subsidizes a care directed at the mother and child binomial, supporting the nurse in their decision-making, contributing to the protection, promotion, and support of breastfeeding.

          RESUMEN

          Objetivo:

          Realizar una evaluación de la adecuación pragmática de la Teoría de la Lactancia Materna Interactiva basada en el Modelo de Fawcett.

          Método:

          Estudio teórico, según criterios de evaluación propuestos por Fawcett. Se utilizaron las seis preguntas sugeridas en el modelo, respondidas a partir de una búsqueda en la literatura científica, consulta de la legislación que sustenta el ejercicio profesional de la enfermería e información de los autores de la teoría.

          Resultados:

          Se observó que durante su formación el enfermero adquiere habilidades de cuidado, pero es necesario intensificar la gestión clínica enfocada a la lactancia materna. Desde su creación, la teoría se ha aplicado de forma ascendente, demostrando que su aplicación en la práctica clínica es viable. La existencia de leyes y resoluciones garantizan a las enfermeras clínicas el respaldo legal necesario para el desarrollo de una práctica sustentada en la Teoría de la Lactancia Materna Interactiva.

          Conclusión:

          Se observó la adecuación pragmática de la teoría, demostrando que la Teoría de la Lactancia Materna Interactiva subvenciona atención dirigida al binomio madre e hijo, apoyando al enfermero en su toma de decisiones, contribuyendo a la protección, promoción y apoyo a la lactancia materna.

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          Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil

          Summary Background Breastfeeding has clear short-term benefits, but its long-term consequences on human capital are yet to be established. We aimed to assess whether breastfeeding duration was associated with intelligence quotient (IQ), years of schooling, and income at the age of 30 years, in a setting where no strong social patterning of breastfeeding exists. Methods A prospective, population-based birth cohort study of neonates was launched in 1982 in Pelotas, Brazil. Information about breastfeeding was recorded in early childhood. At 30 years of age, we studied the IQ (Wechsler Adult Intelligence Scale, 3rd version), educational attainment, and income of the participants. For the analyses, we used multiple linear regression with adjustment for ten confounding variables and the G-formula. Findings From June 4, 2012, to Feb 28, 2013, of the 5914 neonates enrolled, information about IQ and breastfeeding duration was available for 3493 participants. In the crude and adjusted analyses, the durations of total breastfeeding and predominant breastfeeding (breastfeeding as the main form of nutrition with some other foods) were positively associated with IQ, educational attainment, and income. We identified dose-response associations with breastfeeding duration for IQ and educational attainment. In the confounder-adjusted analysis, participants who were breastfed for 12 months or more had higher IQ scores (difference of 3·76 points, 95% CI 2·20–5·33), more years of education (0·91 years, 0·42–1·40), and higher monthly incomes (341·0 Brazilian reals, 93·8–588·3) than did those who were breastfed for less than 1 month. The results of our mediation analysis suggested that IQ was responsible for 72% of the effect on income. Interpretation Breastfeeding is associated with improved performance in intelligence tests 30 years later, and might have an important effect in real life, by increasing educational attainment and income in adulthood. Funding Wellcome Trust, International Development Research Center (Canada), CNPq, FAPERGS, and the Brazilian Ministry of Health.
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            Interactive Theory of Breastfeeding: creation and application of a middle-range theory

            ABSTRACT Objective: To describe a breastfeeding theory based on King's Conceptual System. Method: Theoretical study that used analysis of concept, assertion synthesis, and derivation of theory for the creation of a new theory. Results: King's system components were associated with elements of the breastfeeding process and a middle-range theory was created, which describes, explains, predicts, and prescribes breastfeeding by analyzing factors that precede and affect it, as well as their consequences on the breastfeeding process. Conclusion: The Breastfeeding Interactive Model is abstract enough to be applied in different social, cultural, political, and economic contexts, because it conceptualizes breastfeeding in systemic, dynamic, and procedural aspects. Based on a conceptual model of nursing, it contributes to the scientific construction of the subject; however it can also potentially be applied by other professionals involved in breastfeeding assistance.
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              REFLEXÕES TEÓRICAS E METODOLÓGICAS PARA A CONSTRUÇÃO DE TEORIAS DE MÉDIO ALCANCE DE ENFERMAGEM Translated title: THEORETICAL AND METHODOLOGICAL REFLECTIONS FOR THE CONSTRUCTION OF MIDDLE-RANGE NURSING THEORIES Translated title: REFLEXIONES TEÓRICAS Y METODOLÓGICAS PARA LA CONSTRUCCIÓN DE TEORÍAS DE MEDIO ALCANCE DE ENFERMERÍA

              RESUMO Objetivo: refletir sobre estratégias e procedimentos para o desenvolvimento de teorias de médio alcance e as contribuições dessas teorias em conectar níveis abstratos e empíricos da disciplina à prática da enfermagem. Método: estudo de reflexão com característica analítica. Resultados: são apresentadas considerações sobre o desenvolvimento de teorias de médio alcance de enfermagem, tendo por ilustração a Teoria Interativa de Amamentação derivada do Modelo Conceitual de Sistemas Abertos de Imogene King. São tratados aspectos reflexivos do não aproveitamento dos elementos teóricos contidos na produção de enfermagem brasileira, especialmente em teses de doutorado. Defende-se a relevância do debate sobre estratégias para a expansão do desenvolvimento de teorias de médio alcance de enfermagem no Brasil. Conclusão: as teorias de médio alcance, por estarem a meio caminho das grandes teorias e da prática, guardam características de referenciais teóricos e também metodológicos. Fornecem uma maneira prática para os enfermeiros conectarem as perspectivas filosóficas da disciplina com o mundo real e as aplicações da teoria à prática clínica, sendo assunto de alta relevância. ABSTRACT Objective: to reflect on strategies and procedures for the development of middle-range theories and these theories’ contributions to connect abstract and empirical levels of the discipline to nursing pratice. Method: analytic reflection study. Results: considerations on the development of middle-range nursing theories are presented, exemplified by the Interactive Breastfeeding Theory, derived from the Conceptual Model of Open Systems, by Imogene King. Some subjects addressed are the reflexive aspects of lack of use of theoretical elements contained in the scientific literature of Brazilian nursing, especially in doctoral theses. The relevance of the debate on strategies for expanding the development of middle-range nursing theories in Brazil is defended. Conclusion: middle-range theories, which are located at the mid-point between grand theories and practice, present characteristics of theoretical and methodological references. They enable a practical way for nurses to connect philosophical perspectives to the real world and make applications of the theory to the clinical practice, and are thus a highly relevant subject. RESUMEN Objetivo: reflexionar sobre estrategias y procedimientos para el desarrollo de teorías de medio alcance y las contribuciones de esas teorías en conectar niveles abstractos y empíricos de la disciplina en la práctica de la enfermería. Método: estudio de reflexión con característica analítica. Resultados: se presentan consideraciones sobre el desarrollo de teorías de mediano alcance de Enfermería, teniendo por ejemplo la Teoría Interactiva de Lactancia derivada del Modelo Conceptual de Sistemas Abiertos de Imogene King. Se tratan aspectos reflexivos del no aprovechamiento de los elementos teóricos contenidos en la producción de enfermería brasileña, especialmente en tesis de doctorado. Se defiende la relevancia del debate sobre estrategias para la expansión del desarrollo de teorías de medio alcance de enfermería en Brasil. Conclusión: las teorías de medio alcance, por estar a medio camino de las grandes teorías y de la práctica, guardan características de referenciales teóricos y también metodológicos. Proporcionan una manera práctica para que los enfermeros conecten las perspectivas filosóficas de la disciplina con el mundo real y las aplicaciones de la teoría a la práctica clínica, siendo asunto de alta relevancia.
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                Author and article information

                Journal
                Rev Esc Enferm USP
                Rev Esc Enferm USP
                reeusp
                Revista da Escola de Enfermagem da USP
                Universidade de São Paulo, Escola de Enfermagem
                0080-6234
                1980-220X
                02 December 2024
                2024
                : 58
                : e20240144
                Affiliations
                [1 ]Universidade Federal do Ceará, Departamento de Enfermagem, Fortaleza, CE, Brazil.
                [1 ]Universidade Federal do Ceará, Departamento de Enfermagem, Fortaleza, CE, Brasil.
                Author notes
                Corresponding author: Samara Calixto Gomes, Alexandre Baraúna, 1115, Rodolfo Teófilo, 60430-160 – Fortaleza, CE, Brazil. samaracalixto@ 123456hotmail.com

                ASSOCIATE EDITOR: Ivone Evangelista Cabral

                Autor correspondente: Samara Calixto Gomes, Alexandre Baraúna, 1115, Rodolfo Teófilo, 60430-160 – Fortaleza, CE, Brasil. samaracalixto@ 123456hotmail.com

                EDITOR ASSOCIADO: Ivone Evangelista Cabral

                Author information
                https://orcid.org/0000-0002-7929-3648
                https://orcid.org/0000-0001-5040-2401
                https://orcid.org/0000-0001-5867-8023
                https://orcid.org/0000-0002-8033-8831
                https://orcid.org/0000-0003-0405-7517
                https://orcid.org/0000-0001-7022-8391
                Article
                00605
                10.1590/1980-220X-REEUSP-2024-0144en
                11613921
                39625236
                e58ee54f-1cf5-4762-b839-1e060cbc99b3

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 May 2024
                : 03 September 2024
                Page count
                Figures: 04, Tables: 00, References: 30
                Funding
                Funded by: Coordination for the Improvement of Higher Education Personnel
                Award ID: 001
                The present work was carried out with the support of the Coordination for the Improvement of Higher Education Personnel - Brazil (CAPES) - Funding Code 001.
                Categories
                Theoretical Study

                nursing theory,evaluation study,maternal and child health,breast feeding,teoría de enfermería,estudio de evaluación,salud materno-infantil,lactancia materna

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