教育材料能否改变关于哭闹和摇晃婴儿综合征的知识及行为？一项随机对照试验。
Do educational materials change knowledge and behaviour about crying and shaken baby syndrome? A randomized controlled trial.
作者信息
Barr Ronald G, Barr Marilyn, Fujiwara Takeo, Conway Jocelyn, Catherine Nicole, Brant Rollin
机构信息
Centre for Community Child Health Research, Child and Family Research Institute, University of British Columbia, Vancouver, BC.
出版信息
CMAJ. 2009 Mar 31;180(7):727-33. doi: 10.1503/cmaj.081419. Epub 2009 Mar 2.
BACKGROUND
Shaken baby syndrome often occurs after shaking in response to crying bouts. We questioned whether the use of the educational materials from the Period of PURPLE Crying program would change maternal knowledge and behaviour related to shaking.
METHODS
We performed a randomized controlled trial in which 1279 mothers received materials from the Period of PURPLE Crying program or control materials during a home visit by a nurse by 2 weeks after the birth of their child. At 5 weeks, the mothers completed a diary to record their behaviour and their infants' behaviour. Two months after giving birth, the mothers completed a telephone survey to assess their knowledge and behaviour.
RESULTS
The mean score (range 0-100 points) for knowledge about infant crying was greater among mothers who received the PURPLE materials (63.8 points) than among mothers who received the control materials (58.4 points) (difference 5.4 points, 95% confidence interval [CI] 4.1 to 6.5 points). The mean scores were similar for both groups for shaking knowledge and reported maternal responses to crying, inconsolable crying and self-talk responses. Compared with mothers who received control materials, mothers who received the PURPLE materials reported sharing information about walking away if frustrated more often (51.5% v. 38.5%, difference 13.0%, 95% CI 6.9% to 19.2%), the dangers of shaking (49.3% v. 36.4%, difference 12.9%, 95% CI 6.8% to 19.0%), and infant crying (67.6% v. 60.0%, difference 7.6%, 95% CI 1.7% to 13.5%). Walking away during inconsolable crying was significantly higher among mothers who received the PURPLE materials than among those who received control materials (0.067 v. 0.039 events per day, rate ratio 1.7, 95% CI 1.1 to 2.6).
INTERPRETATION
The receipt of the Period of PURPLE Crying materials led to higher maternal scores for knowledge about infant crying and for some behaviours considered to be important for the prevention of shaking.
背景
摇晃婴儿综合征常因对婴儿哭闹发作进行摇晃而发生。我们质疑使用“紫色哭泣期”项目的教育材料是否会改变母亲与摇晃相关的知识和行为。
方法
我们进行了一项随机对照试验，1279名母亲在孩子出生后2周内由护士进行家访时，收到了“紫色哭泣期”项目的材料或对照材料。在5周时，母亲们完成一份日记以记录她们自己以及婴儿的行为。分娩后两个月，母亲们完成一项电话调查以评估她们的知识和行为。
结果
收到“紫色”材料的母亲对婴儿哭闹知识的平均得分（范围0 - 100分）（63.8分）高于收到对照材料的母亲（58.4分）（差值5.4分，95%置信区间[CI] 4.1至6.5分）。两组在摇晃知识以及报告的母亲对哭闹、无法安抚的哭闹和自我对话反应方面的平均得分相似。与收到对照材料的母亲相比，收到“紫色”材料的母亲报告更频繁地分享如果感到沮丧就走开的信息（51.5%对38.5%，差值13.0%，95% CI 6.9%至19.2%）、摇晃的危险（49.3%对36.4%，差值12.9%，95% CI 6.8%至19.0%）以及婴儿哭闹（67.6%对60.0%，差值7.6%，95% CI 1.7%至13.5%）。在无法安抚的哭闹期间走开的情况，收到“紫色”材料的母亲显著高于收到对照材料的母亲（每天0.067次对0.039次事件，率比1.7，95% CI 1.1至2.6）。
解读
收到“紫色哭泣期”材料使母亲在婴儿哭闹知识以及一些被认为对预防摇晃很重要的行为方面得分更高。
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