美国妇产科医生对其患者母乳喂养率的估计。

U.S. obstetrician-gynecologists' estimates of their patients' breastfeeding rates.

机构信息

American College of Obstetricians and Gynecologists, Washington, DC, USA.

出版信息

Obstet Gynecol. 2012 Apr;119(4):838-44. doi: 10.1097/AOG.0b013e31824a08ef.

DOI:10.1097/AOG.0b013e31824a08ef

PMID:22433348

Abstract

OBJECTIVES

To estimate obstetrician-gynecologists' promotion and support of breastfeeding and their perception of patient breastfeeding practices to examine whether variation in physician practice contributes to low breastfeeding rates.

METHODS

We conducted a survey study of 290 members of the Collaborative Ambulatory Research Network, a sample of college fellows (response rate 48.3%). We compared the results with the Centers for Disease Control and Prevention state-by-state Breastfeeding Report Card data: 75% or more initiating breastfeeding termed high, 65-74% termed medium, and 64% or lower termed low. The survey consisted of questions regarding physician and patient demographics, physician satisfaction regarding breastfeeding practices, opinions and knowledge of breastfeeding, opinions of breastfeeding duration, and physicians' effort toward encouraging breastfeeding. An "effort" score was created from these questions.

RESULTS

Physicians' perceptions of breastfeeding initiation rates were consistent with Centers for Disease Control and Prevention data for high (77.3%±1.5%), medium (70.9%±2.7%), and low states (59.4%±3.4%). Physicians with a high proportion of African American or Medicaid-eligible patients reported lower rates of initiating breastfeeding; a high proportion of Medicaid-eligible patients was associated with lower breastfeeding at 3, 6, and 12 months. More physicians were satisfied in high breastfeeding states (72.7%) than in medium (60%) or low states (34.3%). We found no association between the effort score and physician age or patient demographics; however, women (10.2±0.2) scored higher than men (8.6±0.3, P=.001). Effort score did not differ among high, medium, or low breastfeeding states.

CONCLUSION

Physician satisfaction reflected perceived patient behavior. Physician effort scores were similar across patient breastfeeding behavior. Patient demographics rather than physician practice predicted low breastfeeding rates.

LEVEL OF EVIDENCE

III.

摘要

目的

评估妇产科医生对母乳喂养的促进和支持程度及其对患者母乳喂养实践的看法，以考察医生的实践差异是否导致母乳喂养率较低。

方法

我们对协作门诊研究网络的 290 名成员（回复率 48.3%）进行了一项调查研究。我们将结果与疾病控制与预防中心（CDC）各州母乳喂养报告卡数据进行了比较：75%或以上开始母乳喂养的州被称为高，65-74%被称为中，64%或更低被称为低。调查包括医生和患者人口统计学特征、医生对母乳喂养实践的满意度、对母乳喂养的看法和知识、对母乳喂养持续时间的看法以及医生鼓励母乳喂养的努力程度等问题。从这些问题中创建了一个“努力”评分。

结果

医生对母乳喂养起始率的看法与 CDC 数据一致，高（77.3%±1.5%）、中（70.9%±2.7%）和低（59.4%±3.4%）州。有大量非裔美国人和符合医疗补助条件的患者的医生报告母乳喂养率较低；有大量符合医疗补助条件的患者与 3、6 和 12 个月的母乳喂养率较低有关。在高母乳喂养州，更多的医生感到满意（72.7%），而在中（60%）或低母乳喂养州（34.3%）则不满意。我们没有发现努力评分与医生年龄或患者人口统计学特征之间的关联；然而，女性（10.2±0.2）得分高于男性（8.6±0.3，P=.001）。努力评分在高、中、低母乳喂养州之间没有差异。