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两种产前母乳喂养教育方法的比较。

A comparison of two methods of antenatal breast-feeding education.

作者信息

Sheehan A

机构信息

Family Health Research Unit, St George Hospital, Gray St, Kogarah NSW, Australia 2217.

出版信息

Midwifery. 1999 Dec;15(4):274-82. doi: 10.1054/midw.1999.0186.

Abstract

OBJECTIVE

To compare a woman-centered antenatal breast-feeding programme based on concepts of peer and husband/partner support with a control group, who received antenatal breast-feeding education led by a midwife childbirth educator.

DESIGN

Longitudinal, quasi-experimental study.

SETTING

A large private hospital in Sydney.

PARTICIPANTS

A convenience sample of 179 primiparous women who attended childbirth education classes were recruited. One hundred and fifty-four participants remained following attrition and the application of selection criteria. There were 86 participants in the control group and 68 in the experimental group. The study population had a mean age of 30.4 years, were all married or living with a partner, were predominantly Australian born citizens (84%), and recorded a higher than average level of education than the population in general (Australian Bureau of Statistics 1997).

INTERVENTION

Nursing Mothers Association Australia (NMAA) representatives, their male partners and a mother who was willing to demonstrate breast-feeding, facilitated the experimental group.

MEASUREMENTS AND FINDINGS

Maternal perceptions of success using the Maternal Breastfeeding Evaluation Scale (MBFES) (Leff et al. 1994) and breast-feeding duration rates up to 25 weeks after birth were the outcome measures. No differences were found between groups in relation to maternal perceptions of success or duration rates. A difference was, however, detected in the qualitative data used to explore questions related to breast-feeding support and are to be reported elsewhere. Overall, breast-feeding duration rates were very high when compared to previously reported breast-feeding duration rates in Australia. There were no differences in breast-feeding duration rates or in maternal perceptions of success between those babies given supplementary feeds in hospital and those who were not, although early supplementation at home appeared to reduce breast-feeding duration.

IMPLICATIONS FOR PRACTICE

While no differences were found between groups in relation to breast-feeding duration and maternal perceptions of success, the homogeneity of the sample limits its extrapolation. The extraordinary rates of breast-feeding and the lack of research into antenatal breast-feeding education, warrants further investigation of these teaching styles across other populations. Importantly, this research found that a peer-led model of breast-feeding education was as effective as a midwife-led group in producing breast-feeding initiation and duration rates higher than other previously reported breast-feeding rates with the potential to enhance social support networks.

摘要

目的

将一项基于同伴及丈夫/伴侣支持理念的以女性为中心的产前母乳喂养项目与接受助产士分娩教育者主导的产前母乳喂养教育的对照组进行比较。

设计

纵向准实验研究。

地点

悉尼一家大型私立医院。

参与者

招募了179名参加分娩教育课程的初产妇作为便利样本。经过损耗和应用选择标准后,有154名参与者留存。对照组有86名参与者,实验组有68名参与者。研究人群的平均年龄为30.4岁,均已婚或与伴侣同居,主要是在澳大利亚出生的公民(84%),且教育水平高于总体人群平均水平(澳大利亚统计局,1997年)。

干预措施

澳大利亚母乳协会(NMAA)代表、她们的男性伴侣以及一位愿意示范母乳喂养的母亲为实验组提供帮助。

测量与结果

采用母乳喂养母亲评价量表(MBFES)(莱夫等人,1994年)评估母亲对成功的认知,并将出生后25周内的母乳喂养持续率作为结果指标。两组在母亲对成功的认知或持续率方面未发现差异。然而,在用于探索与母乳喂养支持相关问题的定性数据中发现了差异,将在其他地方报告。总体而言,与澳大利亚先前报告的母乳喂养持续率相比,本研究中的母乳喂养持续率非常高。在医院接受补充喂养的婴儿和未接受补充喂养的婴儿之间,母乳喂养持续率或母亲对成功的认知没有差异,不过在家中早期进行补充喂养似乎会缩短母乳喂养持续时间。

对实践的启示

虽然两组在母乳喂养持续时间和母亲对成功的认知方面未发现差异,但样本的同质性限制了其外推性。母乳喂养的异常高比率以及对产前母乳喂养教育缺乏研究,有必要对其他人群的这些教学方式进行进一步调查。重要的是,本研究发现,由同伴主导的母乳喂养教育模式与由助产士主导的小组在促使母乳喂养启动和持续率高于先前报告的其他母乳喂养率方面同样有效,且有可能加强社会支持网络。

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