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Document Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Degree Program

Nursing

Year Degree Awarded

2015

Month Degree Awarded

February

First Advisor

Lisa Chiodo

Second Advisor

Linda Lewandowski

Third Advisor

Lindiwe Sibeko

Subject Categories

Pediatric Nursing

Abstract

Background/ Purpose: Cup feeding has been identified as a safe alternative for preterm infants who are not able to fully breastfeed, and it has been recommended by international organizations like World Health Organization, yet the practice is limited worldwide. One potential reason this alternative is underutilized is lack of health care providers’ (HCP) knowledge and negative beliefs regarding cup feeding. Jordan and the United States have different health systems, languages, cultures, and economies. A cross cultural comparison of HCP’s knowledge and beliefs in these two contrasting countries may yield some interesting and valuable findings that may further inform clinicians and educators. The purpose of this study is to examine the impact of country, occupation, neonatal health care experience, and level of education on knowledge, beliefs, preference, and past behavior regarding feeding types.

Theoretical Framework: The Knowledge-Attitude-Behavior Model was used as a guidance.

Methods: A non-experimental cross-cultural correlational design was used to evaluate study goals. A convenient sample of 160 neonatal nurses and physicians from US and Jordan was recruited to complete a web-based survey. Recruitment strategies included Email, website links, and snowballing. Analysis included descriptive, t-test, crosstabs, and Multiple regression analysis.

Results: 178 eligible participants submitted the questionnaire online. Among the respondents, 85 were from Jordan and 70 were from US. The average number of years in neonatal health care experience was 13.7 (SD = 12.3), and almost half of the participants (47.7%) had at least 10 years of neonatal health care experience. Almost half of the participants had a BSN or less (55.1%). US sample had more knowledge and positive beliefs about all feeding types, and reported higher overall cup feeding use than Jordanian sample. Physicians had more knowledge and positive believes regarding breast- and cup-feeding, and reported higher feeding preference and practice variables scores than nurses. Participants with at least 10 years of neonatal experience had more knowledge and positive beliefs regarding all feeding types and reported higher overall cup feeding use scores than participants with less than 10 years of neonatal experience. Participants with an advanced degree had more knowledge and positive beliefs regarding all feeding types, and they reported higher cup feeding preference and practice scores than participants with a BSN degree or lower.

Conclusions: US Neonatal HCPs have more knowledge and more positive beliefs about preterm infant feeding, and they prefer and use cup feeding more than Jordanian neonatal HCPs. Physicians have more knowledge and more positive beliefs regarding preterm infant feeding, and they prefer and use cup feeding more than Jordanian neonatal HCPs. Also, more experience leads to more knowledge and more positive beliefs regarding preterm infant feeding, and to more preference and use of cup feeding. And advanced education leads to more knowledge and more positive beliefs regarding preterm infant feeding, and to more preference and use of cup feeding.

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