Pridham K F, Schroeder M, Brown R, Clark R
School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin 53792, USA.
J Adv Nurs. 2001 Sep;35(5):741-50. doi: 10.1046/j.1365-2648.2001.01906.x.
This study aimed to examine the difference the attunement of a mother's working model of feeding to her infant makes for her positive feeding affect and behaviour, accounting for infant and mother conditions.
BACKGROUND/RATIONALE: The concept of a mother's working model of feeding is derived from attachment theory. Caregiving, including feeding, is a component of this theory. The conditions that may influence the attunement of a mother's working model of feeding to her infant include infant birth maturity status (premature, full-term), age at assessment, and robustness, indexed by weight-for-age z score (WAZ). Mother conditions include symptoms of depression and feeding practice (breast feeding or exclusive bottle feeding).
DESIGN/METHODS: Participants in this longitudinal study were 99 mothers and their infants (47 full-term, 52 premature, very low birth weight). After written informed consent was given, home assessments were made when infants were approximately 1, 4, 8 and 12 months old (adjusted age for premature infants). Working model attunement was assessed with a video-assisted interview. A mother's positive affect and behaviour, including sensitivity and responsiveness, were rated from videotaped feeding interaction.
RESULTS/FINDINGS: Repeated measures analysis with a general linear mixed model showed a significant positive relationship with positive affect and behaviour for both working model attunement and the WAZ score and a significant negative relationship for symptoms of depression. Neither birth maturity status, infant age, nor feeding practice had a significant effect on mother's positive affect and behaviour during feeding.
Nurses' efforts to enhance the attunement of a mother's working model of feeding may help mothers feed with greater positive affect and behaviour. Further study of how the attunement of a mother's feeding expectations and intentions are related to her symptoms of depression and with what she makes of the infant's growth and well-being is needed. The theoretical model needs testing with infants from the entire premature population.
本研究旨在探讨母亲喂养工作模式与婴儿的契合度对其积极喂养情感和行为的差异,并考虑婴儿和母亲的状况。
背景/理论依据:母亲喂养工作模式的概念源于依恋理论。包括喂养在内的照料是该理论的一个组成部分。可能影响母亲喂养工作模式与婴儿契合度的状况包括婴儿出生时的成熟状态(早产、足月)、评估时的年龄以及以年龄别体重Z评分(WAZ)为指标的健康状况。母亲的状况包括抑郁症状和喂养方式(母乳喂养或纯奶瓶喂养)。
设计/方法:这项纵向研究的参与者为99位母亲及其婴儿(47名足月婴儿,52名早产、极低出生体重婴儿)。在获得书面知情同意后,分别在婴儿大约1个月、4个月、8个月和12个月大时(早产婴儿为矫正年龄)进行家庭评估。通过视频辅助访谈评估工作模式的契合度。从录像的喂养互动中对母亲的积极情感和行为,包括敏感性和反应性进行评分。
结果/发现:采用一般线性混合模型进行的重复测量分析显示,工作模式契合度和WAZ评分与积极情感和行为呈显著正相关,与抑郁症状呈显著负相关。出生成熟状态、婴儿年龄和喂养方式对母亲喂养期间的积极情感和行为均无显著影响。
护士努力提高母亲喂养工作模式的契合度可能有助于母亲以更积极的情感和行为进行喂养。需要进一步研究母亲喂养期望和意图的契合度如何与其抑郁症状相关,以及她如何看待婴儿的成长和幸福。该理论模型需要在整个早产人群的婴儿中进行测试。