Terminological subset of the International Classification for Nursing practice (ICNP<sup>®</sup>) for breastfeeding support: content validation study

Resende, Fabíola Zanetti; Almeida, Márcia Valéria de Sousa; Leite, Franciele Marabotti Costa; Brandão, Marcos Antônio Gomes; Cubas, Marcia Regina; Araújo, Jhonathan Lucas; Primo, Cândida Caniçali

doi:10.1590/1982-0194201900006

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Original Article • Acta Paul Enferm. 32 (1) • Jan-Feb 2019 • https://doi.org/10.1590/1982-0194201900006 copy

Terminological subset of the International Classification for Nursing practice (ICNP^®) for breastfeeding support: content validation study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to carry out the content validation of nursing diagnoses, results and interventions contained in the terminology subset of the International Classification for Nursing Practice (ICNP^®) to assist women, children and families in the process of breastfeeding.

Methods:

content validation study with 74 judges evaluating 98 diagnoses/results from 396 interventions related to validated diagnoses/results.

Results:

13 diagnoses/results obtained a CVI≥0.8 (13.3%); 34 with a CVI ranging from 0.6 to 0.79 (34.7%) and; 51 with CVI<0.6 (52%). After validation, for the diagnoses “Lack of privacy”, “Decision making for breastfeeding: effective”, “Performing the mother role: effective” and “Performing the mother role: improved” three statements of nursing outcomes statements were stablished. In the second stage, 350 nursing interventions obtained a CVI≥0.80.

Conclusion:

50 diagnoses/results and 350 nursing interventions were validated.

Keywords
Nursing process; Classification; Standardized nursing terminology; Validation studies; Breast feeding

Concepts of the Theory	Nursing Diagnoses/Results	Nursing Interventions
Mother-child dynamic interaction in breastfeeding	08	65
{Women's perceptions on breastfeeding	06	38
Children's perceptions on breastfeeding	0	^-* -* No nursing interventions were sent, because nursing diagnoses referring to these concepts were not validated
Biological conditions of women	15	106
Biological conditions of children	11	77
Body image of women	0	^-* -* No nursing interventions were sent, because nursing diagnoses referring to these concepts were not validated
Places to breastfeed	02	14
The mother's role	03	19
Organizational systems for the protection, promotion and support for breastfeeding	03	17
Family and social authority	0	^-* -* No nursing interventions were sent, because nursing diagnoses referring to these concepts were not validated
Women's decision making	02	14

Concepts of the theory, diagnoses and interventions	CVI
Concept: Mother-child dynamic interaction
Nursing Diagnoses
Breastfeeding: improved	0.73
Breastfeeding: harmed	0.70
Exclusive breastfeeding: improved	0.70
Risks of breastfeeding: harmed	0.63
Risks of exclusive breastfeeding: harmed	0.63
Exclusive breastfeeding: harmed	0.61
Nursing Interventions
Assess the child's ability to grasp the areola mammae area	1.00
Assess the interaction between mother and child during breastfeeding	1.00
Assess the searching and sucking reflex of the newborn	1.00
Encourage the mother to verbalize feelings and concerns	1.00
Incentive breastfeeding on demand	1.00
Guide on the benefits of breastfeeding	100
Assess the positioning of the mother and the newborn during breastfeeding	0.97
Facilitate skin-to-skin contact	0.97
Guide on the care for breasts and nipples	0.97
Hear the mother's complaints	0.97
Reinforce to mothers the importance of correct handling and positioning the newborn on the breast	0.97
Encourage exclusive breastfeeding until the baby is six months	0.95
Avoid using pacifiers and artificial nipples	0.95
Examine the mother's breasts	0.95
Guide on how to hatch on and remove the newborn from the breast	0.95
Reinforce the benefits of breastfeeding	0.95
Reinforce the different mother/baby positions for breastfeeding	0.95
Reinforce the correct technique for breastfeeding	0.95
Assess factors that influence in maternal difficulty or dissatisfaction with breastfeeding	0.92
Teach the mother the different positions mother/baby for breastfeeding	0.92
Compliment the mother during breastfeeding	0.92
Monitor the child's weight (daily/weekly/monthly)	0.92
Reinforce the need for complete emptying the breasts	0.92
Reinforce the care for breasts and nipples	0.92
Initiate breastfeeding within the first half hour after birth	0.89
Guide the mother on the importance of complete emptying the breasts	0.89
Guide the mother on how to hold her big breasts during breastfeeding	0.89
Evaluate the emptying of the breasts after feeding	0.86
Encourage frequent rest periods for the mother	0.86
Encourage breastfeeding at various times, including at night	0.86
Encourage the mother to massage her breasts before breastfeeding	0.86
Guide on the method to store breast milk	0.86
Guide on the importance of the frequent use of “double-straps” bras to support and maintain the breasts firm	0.86
Encourage the mother to offer one breast at each breastfeeding	0.84
Encourage the mother to complete emptying her breasts	0.84
Guide on the technique for thawing breast milk	0.84
Guide on the technique of cup feeding	0.84
Reinforce the importance of massaging and milking the breasts	0.84
Assess the technique of massaging and milking the breasts manually	0.81
Teach the technique of massaging and milking the breasts	0.81
Maintain adequate opening of the baby's mouth during feeding	0.81
Massage and milk the breasts whenever needed	0.81
Guide the mother to open the baby's mouth to breastfeed	0.81
Guide to start the next feeding from the last breast used	0.81
Guidance on the technique of translactation	0.81
Reinforce the importance of offering one breast at each breastfeeding	0.81
Nursing Diagnoses
Exclusive breastfeeding, effective	0.98
Breastfeeding, effective	0.89
Nursing Interventions
Reinforce the benefits of breastfeeding	1
Assess the positioning of the mother and the newborn during breastfeeding	1
Assess the child's ability to grasp the areola mammae area	0.97
Assess the interaction between mother and child during breastfeeding	0.97
Assess the positioning of the mother and the newborn during breastfeeding	0.97
Encourage exclusive breastfeeding until the baby is six months	0.97
Incentive breastfeeding on demand	0.97
Guide the possible positions of the mother and the newborn during breastfeeding	0.97
Reinforce the care for breasts and nipples	0.97
Supervise the right technique for breastfeeding	0.97
Supervise the sucking reflex of the newborn	0.94
Evaluate the emptying of the breasts after feeding	0.91
Assess the searching and sucking reflex of the newborn	0.91
Encourage frequent rest periods for the mother	0.91
Reinforce the importance of offering one breast at each breastfeeding	0.91
Assess the technique of massaging and milking the breasts manually	0.89
Assess factors that influence in maternal difficulty or dissatisfaction when breastfeeding	0.89
Guide the mother on how to hold her big breasts during breastfeeding	0.89
Supervise the mother's ability to massage and milk her breasts	0.86
Concept: Biological conditions of women
Nursing Diagnoses
Pain when breastfeeding;	0.88
Breast pain	0.78
Nipple fissures	0.78
Risk of nipple fissures	0.75
Nursing Interventions
Put on human milk on the nipples after each breastfeeding and wait until it dries	1
Assess the child's ability to grasp the areola mammae area	1
Assess the positioning of the mother and the newborn during breastfeeding	1
Examine the mother's breasts and nipples daily	1
Avoid using soaps, alcohol, creams/ointments or any abrasive substances on the breasts	1
Offer milk in an urethral catheter, attached to the finger, to the newborn (finger-feeding)	1
Guide the mother to open the baby's mouth to breastfeed	1
Teach the mother the different mother/baby positions for breastfeeding	0.97
Avoid using pacifiers and artificial nipples	0.97
Examine characteristics of the nipple fissures	0.97
Guide the mother on the importance of not interrupting breastfeeding	0.97
Guide the mother on massaging and milking manually her breasts	0.97
Examine the newborn's tongue as for its positioning and tonus	0.94
Maintain adequate opening of the baby's mouth during feeding	0.94
Offer milk using the technique of translactation	0.94
Guide on the importance of correct handling by the newborn during breastfeeding	0.94
Encourage exclusive breastfeeding until the baby is six months	0.91
Guide the mother on the importance of alternating the breasts	0.91
Guide on the possible causes of breast pain	0.91
Massage and milk the breasts whenever needed	0.89
Assess the technique of massaging and milking the breasts manually	0.86
Encourage breastfeeding in the harmed breast	0.86
Stimulate the cheek and/or lips of the newborn	0.86
Encourage the mother to expose her nipples to the sun	0.86
Teach the technique of massaging and milking the breasts	0.83
Evaluate pain after administering medications	0.81
Teach the technique of cup feeding	0.81
Change the position of the newborn in the breast at each breastfeeding	0.81
Nursing Diagnoses
Breastfeeding pain: improved	0.75
Breast pain: improved	0.73
Nipple fissures: improved	0.73
Nursing Interventions
Reinforce to mothers the importance of correct handling by the newborn on the breast	1
Reinforce the care for breasts and nipples	1
Reinforce the correct technique for breastfeeding	1
Supervise the handling by the newborn during feeding	1
Assess the child's ability to grasp the areola mammae area	0.97
Assess breastfeeding	0.97
Examine the mother's breasts and nipples daily	0.97
Examine characteristics of the nipple fissures	0.97
Assess the positioning of the mother and the newborn during breastfeeding	0.97
Supervise the sucking reflex of the newborn	0.97
Put on human milk on the nipples after each breastfeeding and wait until it dries	0.94
Reinforce how to remove the newborn from the breast	0.94
Reinforce changing the position of the newborn in the breast at each breastfeeding	0.89
Supervise the mother's ability to massage and milk her breasts	0.89
Reinforce the importance of massaging and milking the breasts	0.86
Encourage the mother to expose her nipples to the sun	0.83
Nursing Diagnoses
Breast engorgement	0.89
Breast engorgement: improved	0.81
Risk of breast engorgement	0.75
Lactation: increased	0.73
Nursing Interventions
Assess the child's ability to grasp the areola mammae area	1
Examine the mother's breasts and nipples daily	1
Encourage exclusive breastfeeding until the baby is six months	1
Guide on the importance of correct handling by the newborn during breastfeeding	1
Guide the mother on the importance of breast milk donation	1
Evaluate the emptying of the breasts after feeding	0.97
Assess the sucking reflex of the newborn	0.97
Teach the technique of massaging and milking the breasts	0.97
Guide the mother on the importance of alternating the breasts	0.97
Guide on the method to store breast milk	0.97
Guide on the factors that favor or harm milk production	0.97
Reinforce to mothers the importance of correct handling by the newborn on the breast	0.97
Advise the mother to register as a milk donor	0.94
Asses the type and place of breast engorgement	0.94
Encourage the mother to complete emptying her breasts	0.94
Massage and milk the breasts before breastfeeding	0.94
Guide the mother on the importance of not interrupting breastfeeding	0.94
Reinforce the need for complete emptying the breasts	0.94
Evaluate lactation	0.91
Teach the mother different positions (sitting, lying down and inverted) of the newborn for breastfeeding	0.91
Offer one breast at each breastfeeding	0.91
Guide the mother to open the baby's mouth to breastfeed	0.91
Guide the mother as for the maintenance of lactation	0.91
Reinforce the importance of massaging and milking the breasts	0.89
Reinforce changing the position of the newborn in the breast at each breastfeeding	0.89
Change the position of the newborn in the breast at each breastfeeding	0.89
Advise the mother to avoid drinking alcohol during lactation	0.86
Advise the mother to avoid smoking during lactation	0.81
Apply a cold compress, under professional supervision	0.81
Guide the mother to avoid using breast pads	0.81
Perform tests of areolar conditions or protractibility before breastfeeding	0.81
Nursing Diagnoses
Lactation: lowered	0.67
Nursing Interventions
Guide the mother on the importance of not interrupting breastfeeding	1
Guide the mother as for the maintenance of lactation	1
Guide on the factors that favor or harm milk production	1
Assess the child's ability to grasp the areola mammae area	0.97
Encourage exclusive breastfeeding until the baby is six months	0.97
Incentive breastfeeding on demand	0.97
Guide the mother on Liquid Intake	0.97
Evaluate lactation	0.94
Guide the mother on a proper food intake pattern	0.94
Teach the technique of translactation	0.91
Encourage breastfeeding at various times, including at night	0.91
Advise the mother to avoid smoking during lactation	0.83
Teach the technique of massaging and milking the breasts	0.83
Encourage the mother to perform the technique of massaging and milking her breasts	0.83
Advise the mother to avoid drinking alcohol during lactation	0.81
Nursing Diagnoses
Lactation: effective	0.83
Lactation: improved	0.77
Breast engorgement: not existing	0.63
Nursing Interventions
Reinforce the correct technique for breastfeeding	1
Encourage exclusive breastfeeding until the baby is six months	0.97
Reinforce guidelines on factors that favor or harm lactation	0.97
Reinforce the importance of fluid intake	0.97
Reinforce to mothers the importance of correct handling by the newborn on the breast	0.94
Reinforce the care for breasts and nipples	0.94
Reinforce the importance of the maintenance of lactation	0.94
Assess the sucking reflex of the newborn	0.89
Reinforce the need for complete emptying the breasts	0.89
Supervise the mother's ability to massage and milk her breasts	0.89
Evaluate lactation	0.86
Evaluate the emptying of the breasts after feeding	0.86
Reinforce the importance of massaging and milking the breasts	0.86
Supervise the sucking reflex of the newborn	0.83
Examine the mother's breasts and nipples daily	0.81
Reinforce changing the position of the newborn in the breast at each feeding	0.81
Concept: Biological conditions of children
Nursing Diagnoses
Sucking: improved	0.89
Sucking reflex: improved	0.83
Sucking reflex: harmed	0.73
Sucking: harmed	0.72
Nursing Interventions
Assess the child's ability to grasp the areola mammae area	0.97
Assess the positioning of the mother and the newborn during breastfeeding	0.97
Evaluate the emptying of the breasts after feeding	0.97
Assess whether the baby's mouth is in the proper position	0.97
Avoid using pacifiers and artificial nipples	0.97
Identify signs of agitation/irritability of the newborn	0.97
To guide the possible positions of the mother and the newborn during breastfeeding	0.97
Guidance on the importance of avoiding the use of pacifiers, bottles and artificial nipples	0.97
Assess breastfeeding	0.94
Assess the swallowing pattern of the baby	0.94
Assess the sucking reflex of the newborn	0.94
Monitor the child's weight (daily/weekly/monthly)	0.94
Assess the psychomotor development of the newborn	0.91
Wash the child's nostrils before breastfeeding whenever needed	0.91
Maintain adequate opening of the baby's mouth during feeding	0.91
Guide the mother to monitor the sucking of the newborn	0.91
Examine the newborn's tongue as for its positioning and tonus	0.89
Stimulate the cheek and/or lips of the newborn	0.89
Stimulate the sucking reflex of the newborn before breastfeeding	0.89
Guide the mother to open the baby's mouth to breastfeed	0.89
Teach how to was the baby's nostrils	0.86
Stimulate the tip of the tongue and palate of the newborn	0.86
Stimulate milk ejection reflex before starting breastfeeding	0.86
Guide on the importance of washing the baby's nostrils	0.83
Nursing Diagnoses
Sucking: effective	0.95
Sucking reflex: effective	0.94
Nursing Interventions
Avoid using pacifiers and artificial nipples	1
Reinforce to mothers the importance of correct handling by the newborn on the breast	1
Assess the positioning of the mother and the newborn during breastfeeding	1
Supervise the sucking reflex of the newborn	1
Assess breastfeeding	0.97
Assess the child's ability to grasp the areola mammae area	0.97
Assess the positioning of the mother and the newborn during breastfeeding	0.97
Evaluate the emptying of the breasts after breastfeeding	0.91
Stimulate the sucking reflex of the newborn before breastfeeding	0.83
Stimulate milk ejection reflex before starting breastfeeding	0.81
Nursing Diagnoses
Weight: harmed	0.63
Weight: improved	0.75
Nursing Interventions
Assess breastfeeding	0.97
Assess the child's ability to grasp the areola mammae area	0.97
Offer milk in an urethral catheter, attached to the finger, to the newborn (finger-feeding)	0.97
Guide the mother to monitor the sucking of the newborn	0.97
Guide the mother on the signs of the newborn's hunger and satiety	0.97
Correctly position the newborn	0.97
Assess the positioning of the mother and the newborn during breastfeeding	0.94
Evaluate the emptying of the breasts after breastfeeding	0.94
Assess the swallowing pattern of the baby	0.94
Assess the suckling reflex of the newborn	0.94
Guidance on the importance of avoiding the use of pacifiers, bottles and artificial nipples	0.94
Assess the psychomotor development of the newborn	0.91
Position upper and lower lips to the outside	0.90
Teach the technique of translactation	0.89
Milk the previous milk and offer it using translactation and/or cup feeding (after breastfeeding)	0.89
To guide the possible positions of the mother and the newborn during breastfeeding	0.89
Teach the technique of cup feeding	0.86
Offer the milk in a cup	0.86
Monitor the child's weight (daily/weekly/monthly)	0.86
Encourage the mother to complete emptying her breasts	0.83
Guide to start the next feeding from the last breast used	0.83
Encourage the mother to massage her breasts before breastfeeding	0.81
Nursing Diagnoses
Weight on the Regular Limits	0.81
Nursing Interventions
Reinforce to mothers the importance of correct handling by the newborn on the breast	0.97
Monitor the child's weight (daily/weekly/monthly)	0.94
Assess the suckling reflex of the newborn	0.91
Reinforce the need for complete emptying the breasts	0.91
Assess the positioning of the mother and the newborn during breastfeeding	0.91
Supervise the sucking reflex of the newborn	0.91
Assess breastfeeding	0.89
Assess the positioning of the mother and the newborn during breastfeeding	0.89
Evaluate the emptying of the breasts after breastfeeding	0.86
Assess the child's ability to grasp the areola mammae area	0.83
Nursing Diagnoses
Drowsiness in the newborn	0.72
Nursing Interventions
Assess the psychomotor activity and reactivity of the newborn	0.97
Perform tactile stimulation on the newborn's chest, face and feet	0.94
Encourage the family to talk to the child	0.89
Manage Blood Sugar Levels if needed	0.86
Place the baby in the cradle position to breastfeed	0.86
Talk to the newborn	0.83
Place the baby in the side-lying position to breastfeed	0.83
Undress the newborn in case of drowsiness	0.83
Nursing Diagnoses
Drowsiness in the newborn: improved	0.63
Nursing Interventions
Assess the psychomotor activity and reactivity of the newborn	0.97
Encourage the family to talk to the child	0.89
Undress the newborn in case of drowsiness	0.86
Concept: Women's perceptions on breastfeeding
Nursing Diagnoses
Ability to breastfeed: improved	0.75
Ability to breastfeed: harmed	0.63
Nursing Interventions
Encourage breastfeeding at various times, including at night	0.97
Assess the interaction between mother and child during breastfeeding	0.94
Assess the mother's ability to position the newborn during breastfeeding	0.94
Assess the mother's ability to breastfeed	0.94
Teach the mother's and the newborn's positioning during breastfeeding	0.94
Compliment the mother during breastfeeding	0.94
Refer parents to breastfeeding support groups	0.94
Encourage the mother to verbalize feelings and concerns	0.94
Identify problems in the ability to breastfeed	0.94
Identify the factors that increase the sense of safety/unsafety	0.94
Assess the mother's ability to position herself for breastfeeding	0.91
Assess the mother's comfort during breastfeeding	0.91
Refer the mother to a breastfeeding consultation	0.91
Refer the patient to other professionals when suitable	0.89
Assess the mother's ability to massage and milk her breasts	0.86
Nursing Diagnoses
Ability to breastfeed: effective	0.78
Nursing Interventions
Reinforce exclusive breastfeeding until the baby is six months	1
Supervise the mother's ability to breastfeed	0.97
Supervise the mother's ability to position the newborn during breastfeeding	0.97
Assess the mother's ability to position herself for breastfeeding	0.97
Assess the mother's comfort during breastfeeding	0.94
Reinforce frequent rest periods for the mother	0.91
Reinforce breastfeeding until the baby is 2 or older	0.89
Supervise the mother's ability to massage and milk her breasts	0.89
Nursing Diagnoses
Breastfeeding knowledge: decreased	0.78
Lack of breastfeeding knowledge	0.73
Nursing Interventions
Develop educational activities on breastfeeding	1
Refer parents to breastfeeding support groups	1
Assess knowledge on the breastfeeding process	0.97
Refer the patient to other professionals when suitable	0.97
Identify breastfeeding content deficits	0.97
Offer written material on breastfeeding	0.97
Evaluate understanding of the given orientation	0.94
Explain the poor content on breastfeeding	0.94
Listen carefully to the nurse/family	0.94
Refer the mother to a breastfeeding consultation	0.89
Assess knowledge on the breastfeeding process	0.89
Encourage participation in breastfeeding education activities	0.89
Explain the poor content on breastfeeding	0.89
Encourage participation in breastfeeding education activities	0.86
Evaluate understanding of the given orientation	0.83
Concept: Places to breastfeed
Nursing Diagnoses
Lack of privacy to breastfeed	0.63
Privacy to breastfeed: effective	0.47
Nursing Interventions
Evaluate the woman's perception about breastfeeding places	0.97
Identify the mother's feelings about breastfeeding in public spaces	0.97
Promote a quiet, safe and comfortable environment for breastfeeding	0.97
Encourage the family to provide a calm, comfortable and safe environment for breastfeeding	0.94
Promote a quiet, safe and comfortable environment for breastfeeding	0.94
Guide the family about the need to have privacy during breastfeeding	0.94
Provide a private place for breastfeeding	0.94
Adjust physical space for the needs of the mother-child	0.91
Dim direct light	0.91
Reduce noises	0.91
To reinforce, together with the health team, the need for privacy during breastfeeding	0.91
Evaluate physical space as for lighting, noises, comfort and privacy	0.89
To reinforce, together with the family, the need for privacy during breastfeeding	0.89
Adjust physical space for the needs of the mother-child	0.89
Concept: The mother's role
Nursing Diagnoses
Performance of the mother's role: harmed	0.59
Performance of the mother's role: improved	0.70
Nursing Interventions
Assess the interaction between mother and child during breastfeeding	0.97
Encourage the mother's self-confidence	0.97
Encourage the mother to talk to and touch on the newborn during breastfeeding	0.97
Offer opportunities for the mother to express her doubts about abilities as a mother	0.97
Listen to the mother's perceptions and beliefs about the ability to perform her role in the family	0.97
Compliment the mother during breastfeeding	0.94
Encourage the mother to verbalize feelings and concerns	0.94
Encourage the mother to perform the care to her baby	0.94
Teach how to perform the care the baby needs	0.91
Compliment the mother during her performance of the mother's role	0.91
Assess her ability to perform the mother's role	0.89
Encourage the patient to perform the mother's role	0.83
Prepare the woman do perform the mother's role	0.83
Nursing Diagnoses
Performance of the mother's role: effective	0.80
Nursing Interventions
Listen to the mother's perceptions and beliefs about the ability to perform her role in the family	1
Supervise the interaction between mother and child	0.97
Compliment the mother during her performance of the mother's role	0.94
Supervise the care given to the baby	0.94
Offer opportunities for the mother to express her doubts about abilities as a mother	0.91
Supervise her ability to perform the mother's role	0.81
Concept: Organizational systems for the protection, promotion and support for breastfeeding
Nursing Diagnoses
Family support for breastfeeding: harmed	0.75
Family support for breastfeeding: improved	0.75
Nursing Interventions
Advise the family to support the mother during breastfeeding	0.94
Advise the family to understand the mother's behaviors during breastfeeding	0.94
Adjust conflicting issues, respecting ethical aspects	0.94
Support the mother and family members to understand the value of discussing the mother's feelings about breastfeeding	0.94
Assess the family's understanding/behavior about breastfeeding	0.94
Assess the history of breastfeeding in the family	0.94
Assess the causes of conflicting attitudes towards breastfeeding	0.94
Encourage the family to support the mother during breastfeeding	0.94
Explain the importance of breastfeeding	0.94
Identify attitudes that may negatively affect breastfeeding	0.94
Identify the feeding practices in childhood performed by the family	0.94
Inform the family about their importance during breastfeeding	0.94
Nursing Diagnoses
Family support for breastfeeding: positive	0.84
Nursing Interventions
Praise the support of the family offered to the mother during breastfeeding	0.97
Encourage the family to support the mother during breastfeeding	0.97
Encourage the family to understand the mother's behaviors during breastfeeding	0.97
Supervise the family's understanding/behavior about breastfeeding	0.89
Supervise the family's attitudes towards breastfeeding	0.89
Concept: Women's decision making
Nursing Diagnoses
Decision-making for breastfeeding: effective	0.73
Decision-making for breastfeeding: harmed	0.53
Nursing Interventions
Support the decision-making process of the mother towards breastfeeding	0.97
Encourage the mother to verbalize feelings and concerns	0.97
Encourage the mother to make decisions regarding care to herself and her newborn	0.97
Identify previous experiences with breastfeeding	0.97
Identify factors that interfere in the breastfeeding decision-making	0.97
Guide on the benefits of breastfeeding	0.97
Listen to the patient attentively and support her	0.97
Advise the family to understand the mother's behaviors during breastfeeding	0.94
Support the mother's decision-making process regarding care needed by her newborn	0.94
Encourage the mother's self-confidence	0.94
Identify cultural issues that interfere with the breastfeeding decision-making	0.94
Identify factors that interfere in the breastfeeding decision-making	0.94
Establish confidence with the mother	0.91
Avoid using pacifiers and artificial nipples	0.91

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
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[1] Corresponding author Fabíola Zanetti Resende E-mail: fabiolazanetti@gmail.com

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Brasil

Terminological subset of the International Classification for Nursing practice (ICNP®) for breastfeeding support: content validation study

Abstract

Objective:

Methods:

Results:

Conclusion:

Terminological subset of the International Classification for Nursing practice (ICNP^®) for breastfeeding support: content validation study