This study investigated self-efficacy in breastfeeding support among public health nurses (PHNs) working at maternal and child health (MCH) services in Japanese municipalities, and its related factors such as education, working experience, breastfeeding experience, and postgraduate/continuous education. Directors of the MCH divisions were requested to select one PHN to answer the self-report questionnaires sent. The questionnaires were collected from October 2010 to January 2011. Of the 1750 questionnaires sent, 831 were returned (response rate: 47.5%); 102 were excluded from analysis because of missing data (valid response rate: 41.7%). After adjusting the weights of PHN sampling and collection rates by prefecture and population size, Model 1 of the multiple regression analysis showed that the self-efficacy in breastfeeding support was significantly higher in large/urban municipalities (β = 0.13) and in the Kanto district. Model 2 revealed that self-efficacy was significantly associated with working experience (β = 0.13) and breastfeeding experience (β = 0.22) but not with educational background. Model 3 showed that self-efficacy was significantly associated with postgraduate education (β = 0.14) and continuous education (β = 0.12). This suggested that PHNs’ self-efficacy increased through self-enrichment. It is necessary to create training opportunities about breastfeeding support for PHNs—especially those working in remote and/or small municipalities— and to provide them with new and important information.
Cite this paper
Toyama, N. , Kurihara, K. , Muranaka, M. and Kamibeppu, K. (2013) Factors influencing self-efficacy in breastfeeding support among public health nurses in Japan. Health
, 2051-2058. doi: 10.4236/health.2013.512278
 Gartner, L.M., Morton, J., Lawrence, R.A., Naylor, A.J., O’Hare, D., Schanler, R.J. and Eidelman, A.I. (2005) Breastfeeding and the use of human milk. Pediatrics, 115, 496-506. http://dx.doi.org/10.1542/peds.2004-2491
 Horta, B.L., Bahl, R., Martinés, J.C. and Victora, C.G. (2007) Evidence on the long-term effects of breastfeeding: Systematic reviews and meta-analysis. World Health Organization, Geneva.http://whqlibdoc.who.int/publications/2007/9789241595230_eng.pdf
 Ip, S., Chung, M., Raman, G., Chew, P., Magula, N., DeVine, D., Trikalinos, T. and Lau, J. (2007) Breastfeeding and maternal and infant health outcomes in developed countries. Evidence Report—Technology Assessment, 153, 1-186.
 WHO (2002) Global strategy for infant and young child feeding. WHO, Geneva.http://www.who.int/nutrition/publications/gs_infant_feeding_text_eng.pdf
 Mother’s and Children’s Health and Welfare Association (2008) Maternal and child health statistics of Japan. MCHWA, Tokyo, 131-133.
 Ministry of Health, Labour and Welfare (2007) Guide for feeding and weaning infants and young children.http://www.mhlw.go.jp/shingi/2007/03/dl/s0314-17.pdf
 Britton, C., McCormick, F., Renfrew, M., Wade, A. and King, S.E. (2007) Support for breastfeeding mothers. The Cochrane Collaboration.http://apps.who.int/rhl/reviews/CD001141.pdf
 Bandura, A. (1977) Self-efficacy: Toward a unifying theory of behavioral change. Psychology Review, 84, 191-215. http://dx.doi.org/10.1037/0033-295X.84.2.191
 Kronborg, H., Vaeth, M., Olsen J. and Harder I. (2008) Health visitors and breastfeeding support: Influence of knowledge and self-efficacy. European Journal of Public Health, 18, 283-288.http://dx.doi.org/10.1093/eurpub/ckm121
 Brodribb, W., Fallon, A., Jackson, C. and Hegney, D. (2008) The relationship between personal breastfeeding experience and the breastfeeding attitudes, knowledge, confidence and effectiveness of Australian GP registrars. Maternal & Child Nutrition, 4, 264-274.http://dx.doi.org/10.1111/j.1740-8709.2008.00141.x
 Freed, G.L., Clark, S.J., Lohr, J.A. and Sorenson, J.R. (1995) Pediatrician involvement in breast-feeding promotion: A national study of residents and practitioners. Pediatrics, 96, 490-494.
 Nonaka, S. and Matsuda, M. (2009) Understanding the abilities of public health nurses working for municipalities and their related factors. The Japanese Journal for Public Health Nurse, 65, 484-492.
 Japanese Nursing Association (2010) Promotion project of advanced public health activity in Heisei 21 fiscal year—Research report of public health nurse basic activity. http://www.nurse.or.jp/home/publication/pdf/senkuteki/22-houkoku-2.pdf
 Hirano, K., Ikeda, N. and Kanagawa, K. (2005) Public health nurse education of nursing university, nursing junior college and vocational school—Research on understanding of public health nurse activity among faculty and students. Japanese Journal of Public Health, 52, 746-755.
 Hellings, P. and Howe, C. (2000) Assessment of breastfeeding knowledge of nurse practitioners and nurse-midwives. Journal of Midwifery & Women’s Health, 45, 264-270. http://dx.doi.org/10.1016/S1526-9523(00)00010-6
 Ingram, J., Johnson, D. and Condon, L. (2011) The effects of baby friendly initiative training on breastfeeding rates and the breastfeeding attitudes, knowledge and selfefficacy of community health-care staff. Primary Health Care Research & Development, 12, 266-275.http://dx.doi.org/10.1017/S1463423610000423
 Kusunome, N. (2007) Self efficacy of breast feeding support. Journal of Nursing Research Society of Kochi University, 1, 15-20.
 Hirano, K. (2000) Prospective of public health nursing. Research on Public Health, 49, 116-124.
 Tsumura, C. (2003) Procedure of public health nurse basic education—Issue of public health nurse basic education. Community Health, 34, 70-71.