Constructing a core competency index system for breastfeeding consultant nurses in China: A phenomenological study using the Delphi method

This study aimed to construct a core competency index system for breastfeeding consultant nurses based on the Onion Model to improve their consulting abilities and promote breastfeeding rates. This study adopted a phenomenological approach to explore the experiences of breastfeeding consultant nurses and lactating women through semi-structured interviews. The Delphi method was then used for expert validation of the initial competency framework. We focused on the core competencies of nurses and midwives who provide breastfeeding consultation in clinics, maternity wards, and Internet hospitals in China to improve their breastfeeding consultation ability and promote the improvement of breastfeeding rates. Through a literature review, competency items were extracted based on the clinical competencies of International Board-Certified Lactation Consultants (IBCLCs), and an initial competency framework was developed. In this study, 18 breastfeeding consultant nurses and 11 lactating women participated in semi-structured interviews to provide in-depth feedback on their experiences and challenges in breastfeeding consultation. Two rounds of Delphi expert consultations were conducted, and the Analytic Hierarchy Process (AHP) was used to determine the core competency indices and their weights. The final core competency index system for breastfeeding consultant nurses in China consisted of four first-level, 15 ​second-level, and 95 third-level indices. The positive coefficients of the two rounds of expert consultation were both 100%; expert authority (Cr ​= ​0.92) was high, and Kendall's W values were 0.206 ( χ 2 ​= ​293.69) and 0.296 ( χ 2 ​= ​62.07), with statistical significance ( P ​< ​0.01). The weight rankings of the first-level indices were as follows: core knowledge and skills (0.3498), professional ability (0.2858), maintenance of professional standards (0.1915), and professional and personal traits (0.1728). All consistency tests were passed (CR ​< ​0.10). The core competency index system for breastfeeding consultant nurses developed in this study is scientifically grounded, systematic, and authoritative. It provides strong support for the education and practice of breastfeeding consultant nurses in China and offers a theoretical foundation and practical framework to improve breastfeeding rates and nursing quality. • Adding the index of “Different periods of correct breast massage techniques including traditional Chinese medicine such as auricular point pressing therapy and breast acupoint application”, which is an effective method with Chinese characteristics to make mothers' comfort. • The competency index of “Early breastfeeding support strategies” was suggested because we emphasize the importance of breastfeeding education during perinatal period in hospital, especially in China. • The point is that this article provides the holistic competency framework as the breastfeeding consulting professionals, especially for Chinese.