Development and validation of the maternal role adaptation system model (MRASM) to improve breastfeeding success
Dublin Core
Title
Development and validation of the maternal role adaptation system model (MRASM) to improve breastfeeding success
Subject
breastfeeding success; maternal role adaptation; mercer's theory; postpartum care; roy adaptation model
Description
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.
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.
Creator
Nurus Safaah1* , Miftahul Munir1
, Umu Qonitun1
, Ilmiatus Qoyimah1
, and Erna Eka
Wijayanti1
, Umu Qonitun1
, Ilmiatus Qoyimah1
, and Erna Eka
Wijayanti1
Source
http://dx.doi.org/10.20473/jn.v20i4.77929
Date
21 November 2025
Contributor
peri irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Nurus Safaah1* , Miftahul Munir1
, Umu Qonitun1
, Ilmiatus Qoyimah1
, and Erna Eka
Wijayanti1, “Development and validation of the maternal role adaptation system model (MRASM) to improve breastfeeding success,” Repository Horizon University Indonesia, accessed February 21, 2026, https://repository.horizon.ac.id/items/show/11162.