Hauck Yvonne, Hall Wendy A, Jones Christine
School of Nursing and Midwifery, Curtin University of Technology, Perth, Western Australia, Australia.
J Adv Nurs. 2007 Feb;57(3):306-17. doi: 10.1111/j.1365-2648.2006.04136.x.
This paper reports an assessment of the effects of a breastfeeding journal on breastfeeding prevalence and perceptions of conflicting advice, self-management and self-efficacy.
Breastfeeding prevalence rates in most developed countries are not meeting recommendations. Women's concerns about inconsistent advice, limited involvement in decision-making, accessibility of information and inappropriate follow-up have been recognized. Research on evaluation of interventions addressing these concerns and including antenatal and early postnatal periods is required. Method. An intervention study was conducted from July 2003 to April 2004, with control and intervention groups recruited sequentially. The intervention group received a breastfeeding journal at 36 weeks antenatally in breastfeeding classes that were attended at different times by intervention and control group members. The intervention and control groups were compared during postpartum hospitalization and 12 weeks for breastfeeding prevalence and perceptions of self-efficacy, conflicting advice and self-management.
No statistically significant differences were noted between the intervention and control groups in breastfeeding prevalence at 12 weeks or self-efficacy during hospitalization. There was a statistically significant difference between groups in conflicting advice at both times. Although conflicting advice continues to present a dilemma for women, levels of conflicting advice did not explain breastfeeding self-efficacy. Breastfeeding self-management was a statistically significant contributor to breastfeeding prevalence prior to the addition of breastfeeding self-efficacy.
Women's perceptions of their ability to manage and be actively involved in decision-making explained breastfeeding prevalence at 12-week postpartum. Efforts to encourage women's involvement in decision-making about breastfeeding are a useful strategy to promote breastfeeding.
本文报告了一项关于母乳喂养日志对母乳喂养率以及对相互冲突的建议、自我管理和自我效能感认知的影响的评估。
大多数发达国家的母乳喂养率未达建议水平。女性对建议不一致、参与决策受限、信息获取以及后续跟进不当的担忧已得到认可。需要开展针对这些问题且涵盖产前和产后早期的干预措施评估研究。方法。2003年7月至2004年4月进行了一项干预研究,对照组和干预组依次招募。干预组在产前36周的母乳喂养课程中收到一本母乳喂养日志,干预组和对照组成员在不同时间参加该课程。在产后住院期间以及产后12周,对干预组和对照组的母乳喂养率以及自我效能感、相互冲突的建议和自我管理的认知进行比较。
在产后12周的母乳喂养率或住院期间的自我效能感方面,干预组和对照组之间未发现统计学上的显著差异。在两个时间点上,两组在相互冲突的建议方面存在统计学上的显著差异。尽管相互冲突的建议继续给女性带来困境,但相互冲突的建议水平并不能解释母乳喂养自我效能感。在纳入母乳喂养自我效能感之前,母乳喂养自我管理是母乳喂养率的一个具有统计学意义的影响因素。
女性对自身管理能力和积极参与决策的认知解释了产后12周的母乳喂养率。鼓励女性参与母乳喂养决策的努力是促进母乳喂养的一项有效策略。