Although a complexity of factors explain early cessation of breastfeeding, the encounter of a problem is often a critical point in this decision. For this reason, breastfeeding self-efficacy, a mother's evaluations of her ability to successfully overcome challenges, is an effective target in interventions to sustain breastfeeding. This study examined factors affecting the success of one such intervention, reactive telephone support. Across a 4-week period, recordings of all calls to a nurse-staffed parent helpline in Queensland, Australia were made. Of these calls, 60 were from mothers encountering a breastfeeding problem. Using a standard protocol, each call was scored for trajectories of mother's breastfeeding self-efficacy from opening to close of call. Calls showing an upward trajectory were defined as supporting (53%), those with no change were defined as ineffective (25%), and those with downward trajectory as undermining (22%). Using trajectory scores, case exemplars were purposively selected for detailed analysis of interactional sequences to identify strategies that distinguished outcome. The supportive call was distinguished by information sharing, mutual trust and respectful relationships, and personalized affirmation and advice. The ineffective call focused on technical aspects of breastfeeding, whereas the undermining call made moral judgements of mother's behaviour. The findings identify interactional quality of telephone support, not simply provision, as the key success factor in reactive telephone support. The findings also present interactional quality as a potential explanation for inconsistent outcomes in evaluation of reactive telehealth interventions to support breastfeeding.

中文翻译：

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支持，未能支持和破坏母乳喂养的自我效能：热线服务电话分析。

尽管复杂的因素可以解释早期停止母乳喂养，但遇到问题通常是该决定的关键点。因此，母乳喂养的自我效能感（母亲对其成功克服挑战的能力的评估）是维持母乳喂养干预措施的有效目标。这项研究检查了影响一种干预措施（反应式电话支持）成功的因素。在为期4周的时间内，记录了澳大利亚昆士兰州一名由护士组成的父母求助热线的所有通话记录。在这些电话中，有60个来自遇到母乳喂养问题的母亲。使用标准协议，对每次通话进行打分，以评估通话开始到结束之间母亲的母乳喂养自我效能的轨迹。显示上升轨迹的来电被定义为支持（53％），那些没有变化的被定义为无效（25％），那些轨迹下降的被定义为无效（22％）。使用轨迹评分，有目的地选择案例样本进行相互作用序列的详细分析，以鉴定可区分结果的策略。支持电话的特点是信息共享，相互信任和相互尊重的关系以及个性化的确认和建议。无效的呼吁集中在母乳喂养的技术方面，而破坏性的呼吁则对母亲的行为做出了道德判断。调查结果确定了电话支持（而不是简单地提供）的交互质量是响应式电话支持的关键成功因素。