Cricco-Lizza Roberta
Center for Health Disparities Research, University of Pennsylvania School of Nursing, PA, USA.
MCN Am J Matern Child Nurs. 2009 Jul-Aug;34(4):236-42. doi: 10.1097/01.NMC.0000357916.33476.a3.
To explore the formative infant feeding experiences and education of NICU nurses.
An ethnography was undertaken over 14 months in a level IV NICU in a free standing pediatric hospital in the Northeastern U.S. Purposeful sampling was used to select informants. General informants included 114 NICU nurses who were observed and informally interviewed an average of 3.5 times. Eighteen of these served as key informants and each was formally interviewed once with an additional average of 12 observations/informal interviews. Descriptions of feeding experiences and education were coded and analyzed for recurring patterns using NUD*IST software.
The NICU nurses identified a norm for formula feeding during their formative experiences as children. The nurses described increased exposure to varied feeding methods during their adulthood, but breastfeeding was often associated with difficulties among their families and friends. The nurses in this study recounted minimal exposure to breastfeeding in nursing school. The nurses' personal experiences with breastfeeding were laden with strong emotional reactions intertwined with their feelings about motherhood.
Nurses' past experiences and education must be addressed if efforts are to be made to promote breastfeeding in the NICU. Breastfeeding education programs for nurses should include reflective components to help nurses identify structural barriers and reframe any negative personal experiences.
探讨新生儿重症监护室(NICU)护士的婴儿喂养经历及相关教育情况。
在美国东北部一家独立儿童医院的四级新生儿重症监护室进行了为期14个月的人种志研究。采用目的抽样法选择研究对象。一般研究对象包括114名新生儿重症监护室护士,对其进行观察并平均进行3.5次非正式访谈。其中18人作为关键研究对象,每人接受一次正式访谈,并平均额外进行12次观察/非正式访谈。使用NUD*IST软件对喂养经历和教育情况的描述进行编码,并分析其反复出现的模式。
新生儿重症监护室护士在童年成长经历中形成了配方奶喂养的规范。护士们表示,成年后接触到的喂养方式有所增加,但母乳喂养在他们的家人和朋友中往往伴随着困难。本研究中的护士称在护理学校很少接触到母乳喂养相关内容。护士们个人的母乳喂养经历充满了强烈的情感反应,且与她们对母亲身份的感受交织在一起。
如果要在新生儿重症监护室推广母乳喂养,就必须考虑护士过去的经历和教育情况。针对护士的母乳喂养教育项目应包括反思环节,以帮助护士识别结构性障碍,并重新审视任何负面的个人经历。