title: Maternity staff perspectives regarding resource demands of breastfeeding supportive practices in accordance with the Baby-Friendly Hospital Initiative accreditation: a Q methodology approach.
abstract: OBJECTIVE
  To explore the resource demands of implementing the Baby-Friendly Hospital Initiative among maternity staff.
  
  
  BACKGROUND
  Implementing the Baby-Friendly Hospital Initiative is the most recognized global strategy for ensuring that hospital routines support breastfeeding. The maternity services of Baby-Friendly Hospital Initiative accredited hospitals are evaluated according to the Ten Steps to Successful Breastfeeding.
  
  
  METHODS
  Q methodology was applied to investigate the perspectives of 60 maternity staff in Northern Taiwan.
  
  
  METHODS
  Data were collected from May - December 2014. An online Q-sort platform was designed for the participants to perform sorting. The Q-sorts were subjected to factor analysis by using PQ Method software. Factors were extracted using principal component analysis with a varimax rotation. A combination of eigenvalues and a scree plot were employed to determine the number of retained factors.
  
  
  RESULTS
  Four factors retained in the final model accounted for 56% of the total variance: (1) emphasis on implementing an institutional policy; (2) emphasis on providing supportive practices for breastfeeding mothers; (3) emphasis on establishing continual breastfeeding support; and (4) emphasis on managing breastfeeding supportive practices concerning a designated time period. The participants that were associated with Factors 1 and 3 emphasized the necessity of allocating resources to Steps 1, 2 and 10 of the Ten Steps. The participants associated with Factors 2 and 4 emphasized allocating resources to Steps 2-5 and 7.
  
  
  CONCLUSIONS
  This study revealed the various perspectives of maternity staff regarding the resource demands of implementing the Baby-Friendly Hospital Initiative. These perspectives may serve as a reference for decision-makers in prioritizing resource allocation.
authors.affiliation: School of Nursing, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chiu-Mieh
authors.initials: CM
authors.lastname: Huang
authors.affiliation: Division of Obstetrics & Gynecology, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Wei-Shu
authors.initials: WS
authors.lastname: Hung
authors.affiliation: Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Jung-Nien
authors.initials: JN
authors.lastname: Lai
authors.affiliation: Graduate Institute of Health Allied Education, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
authors.forename: Yu-Hsiu
authors.initials: YH
authors.lastname: Kao
authors.affiliation: Department of Nursing, National Yang-Ming University Hospital, Yilan, Taiwan.
authors.forename: Ching-Ling
authors.initials: CL
authors.lastname: Wang
authors.affiliation: Department of Health Promotion and Health Education, University of National Taiwan Normal University, Taipei, Taiwan.
authors.forename: Jong-Long
authors.initials: JL
authors.lastname: Guo
mesh_terms: D000068:Accreditation; D001942:Breast Feeding; D006293:Health Promotion; D006761:Hospitals; D006801:Humans; D016134:Organizational Policy; D011779:Q-Sort; D013624:Taiwan
keywords: Baby-Friendly Hospital Initiative; Q methodology; accreditation; breastfeeding; nursing