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To examine the factors affecting employed mothers' exclusive breastfeeding by testing Bronfenbrenner's Ecological Systems Theory.
A cross-sectional study was conducted.
A random sample of 201 employed mothers who had given birth 6 months ago was recruited from two hospitals and two primary healthcare centres in Saudi Arabia. Data were collected using self-reported questionnaires that included background characteristics and valid and reliable Arabic measures. Hierarchical logistic regression was used to analyse the data across ecological levels.
More than a third (36.8%) of employed mothers did not practice exclusive breastfeeding. The logistic regression with four ecological levels (individual characteristics, microsystem, exosystem, and macrosystem) explained 42.9% of the variance in employed mothers' exclusive breastfeeding. In the final model, the significant gendered predictors of exclusive breastfeeding were perception of milk supply (OR = 1.029), mental health status (OR = 0.931), workplace support (OR = 1.024), and social norms (OR = 2.009).
Breastfeeding among employed mothers is predicted by gender-based factors, including perceived milk insufficiency, maternal mental health burden, workplace conditions, and social norms. This underscores the importance of developing multi-level programmes that empower women to follow the recommended breastfeeding practices.
During routine care, healthcare providers should assess the perception of milk supply and maternal mental health. They should advocate for flexible workplace policies that enable women to breastfeed and develop community campaigns targeting social norms.
The findings show the effect of key gendered factors on exclusive breastfeeding among employed mothers. These findings can inform maternal healthcare practices, gender-sensitive workplace policies, and social norm transformation.
The study follows STROBE reporting guidelines.
No patient or public contribution.
Both nurses' well-being and quality of care are top priorities of the healthcare system. Yet, there is still a gap in understanding the extent and how authentic leadership influences them. This information is needed to inform the development of effective interventions, organizational practices, and policies. Thus, this study aimed to test the mechanism by which nurses' perception of their managers' authentic leadership impacts nurses' well-being and perception of quality of care, given the role of the nursing practice environment and nurses' psychological capital.
A cross-sectional design was used.
This study recruited a random sample of 680 nurses from six hospitals in Saudi Arabia. A final sample of 415 completed the surveys, with a response rate of 61%. Structural equation modeling was performed to test the hypothesized model.
The study showed that nurses' perceptions of authentic leadership in their managers positively and directly affect their perceptions of quality of care but do not directly affect nurses' well-being. Both the nursing practice environment and psychological capital fully mediated the relationship between authentic leadership and nurses' well-being. However, the nursing practice environment partially mediated the relationship between authentic leadership and perceptions of quality of care.
The findings contribute to understanding the crucial role of authentic leaders' style in nurses' well-being and quality of care through its positive impact on the nursing practice environment and psychological capital.
Designing interventions and policies that specifically target nursing managers' authentic leadership style has implications for enhancing nurses' well-being and the quality of patient care. Institutional measures are needed to help leaders practice an authentic leadership style to create a positive nursing practice environment and cultivate nurses' psychological capital, both of which contribute to nurses' well-being and attaining a better quality of care. Further work is required to highlight the outcomes of implementing an authentic leadership style relevant to other leadership styles.
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