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Miftahul Munir, Miftahul
Institut Ilmu Kesehatan Nahdlatul Ulama Tuban
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Development and validation of the maternal role adaptation system model (MRASM) to improve breastfeeding success Safaah, Nurus; Munir, Miftahul; Qonitun, Umu; Qoyimah, Ilmiatus; Wijayanti, Erna Eka
Jurnal Ners Vol. 20 No. 4 (2025): VOLUME 20 ISSUE 4 (NOVEMBER 2025)
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jn.v20i4.77929

Abstract

Introduction: The success of breastfeeding is a critical indicator of comprehensive adaptation during the maternal transition. Existing theoretical models address maternal adaptation separately, resulting in a lack of integration in predicting breastfeeding success. This research aimed to develop and validate the Maternal Role Adaptation System Model (MRASM) using Structural Equation Modeling. Methods: A cross-sectional study was conducted with 150 postpartum women recruited through purposive sampling from five community health centers in East Java, Indonesia. Eight latent constructs measured using validated instruments: focal stimuli (breast pain, fatigue, nutrition), contextual stimuli (spousal and healthcare support, information access, economic status), residual stimuli (social norms, cultural values, beliefs), coping mechanisms, emotional responses, self-concept, role function, and breastfeeding success. Data were analyzed using Structural Equation Modeling with Partial Least Squares (SEM-PLS) via Smart-PLS 4.0. Results: The MRASM demonstrated excellent psychometric properties (Cronbach's α > 0.678, composite reliability > 0.802, AVE > 0.508). Environmental stimuli (focal, contextual, and residual) significantly influenced maternal coping mechanisms, which in turn affected emotional responses, self-concept, and role function. Emotional responses (β = 0.356, p = 0.001) and self-concept (β = 0.268, p<0.001) are the strongest predictors of breastfeeding success, explaining 26.7% of outcome variance. These findings provide healthcare professionals with specific intervention targets: managing physical symptoms, enhancing coping resources, and supporting maternal emotional well-being and self-efficacy. Conclusions: MRASM integrates Roy's and Mercer's models to address postpartum adaptation holistically, providing healthcare professionals with an evidence-based framework to support maternal role transition and breastfeeding success.
Co-Authors Abdillah, Moh. Firman Adibah Enggar Adibah Enggar Afriasdiyanto, Okta Agung Pambudi Mahaputra Ahmad Agus Tri Mulyono Ahmad David Royyifi Arifin Ahmad Fauziansyah Zian ahmad yani Alvianto Nuha Syairul Anam Anafitriyah, Dwi Angga Permana Mahaputra Anisa Patrisia Anita Sumelvia Anita Sumelvia D Anita Sumelvia Dewi Aprilia Suryani Arif, Ach Farhan Aris Puji Utami Ayuanti, Rafikhein Novia Diana Ambarwati Didik Suharsoyo Dwi Kurnia Purnama Sari Endah Kurniawati Enggar, Adibah Eris Elvinta Lova Eva Silviana Rahmawati Eva Silviana Rahmawati Evi Nur Indah Sari Fauziah, Lilia Faridatul Fauziyah, Latifah Ismatul Filardhi, Khalif Filia Alia Rahma Fira Yunia Ersanti Herowati Poesoko Herowati Poesoko, Herowati Hikmah, Lailatul Idris, Ahmad Ifa Sholihatin Ilmiatus Qoyimah Ilmiyah, Surotul Imanita Nur Widyaningsih Ina Sholikhatin Insani, Beta Nur Irma Fitria Isretno Israhadi, Evita Julaicha, Siti Khoirur Rosyita Kusumaningati, Wanudya Lailiyah, Ella Janatul Latifah Ismatul Fauziyah Lilik nur hidayah Lukman Hakim Moh Abror Moh. Ubaidillah Faqih, Moh. Ubaidillah Moh. Zeinudin Muhammad Aldy Alamsyah Muhammad Sudrajat Nikmah, Siti Ima'tul Nur Astuti, Qorina Alfada Nur Maziyah Hurin’in nurhadi, mokhamad Nuril Aulia Munawaroh patrisia, anisa Pebpy Eko Handayani Permadi, Rosi Gilang PRAMANA, ARDI Pratama, Christanova Andika Putri, Berlian Maharani Febrina Rini Apriyani Ristanti , Idcha Kusma Riswadi Riswadi, Riswadi Safaah, Nurus Silviana Rahmawati, Eva Siti Ima'tul Nikmah Slamet Suhartono Sri Indarwati Mista'i Sjaf Srikalimah, Srikalimah Sriutami, Ika Sudrajad, Muhammad sugiyono Suhartono Suhartono Suhartono Suprayitno, Agus Surotul Ilmiah Syaiful Bahri Syukron Jazuli Taufik Akbar Tiara Putri Ryandini Tri Yunita FD Umu Qonitun Utami, Aris Puji Widyastuti, Endah Ratna Wijayanti, Erna Eka Zainuri Zainuri, Zainuri