Zhu Yu, Zhang Zhihong, Ling Yun, Wan Hongwei
Department of Nursing, Shanghai Proton and Heavy Ion Center, Kangxin Road, Pudong, Shanghai 201321, China.
Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 200040, China.
Women Birth. 2017 Apr;30(2):146-152. doi: 10.1016/j.wombi.2016.09.011. Epub 2016 Oct 20.
Breastfeeding knowledge, attitude, subjective norm, and perceived control are significant determinants of breastfeeding, according to the theory of planned behavior (TPB). However, evidence concerning the effectiveness of the TPB-based intervention in breastfeeding promotion is sparse. Meanwhile, the changes of these determinants with time have not been examined in previous studies.
To investigate the effectiveness of the TPB-based intervention program in improving exclusive breastfeeding, and the interaction of time and intervention on these determinants of breastfeeding.
285 primiparous mothers were included, with 157 mothers in the experimental group and 128 mothers in the control group. The experimental group received the TPB-based intervention program delivered during 6 weeks postpartum, while both the experimental and control groups received the standard obstetric care.
Scores of breastfeeding knowledge, attitude and breastfeeding control increased with time from baseline to 6 weeks postpartum, while breastfeeding subjective norm decreased at 6 weeks both in the experimental and the control groups. Besides, scores of the four determinants were significantly higher in the experimental group than these in the control group at 3days and 6 weeks, except for breastfeeding control at 6 weeks, which resulted in the higher exclusive breastfeeding rates at 3days and 6 weeks in the experimental group than the control group.
The TPB-based intervention was effective in promoting exclusive breastfeeding during 6 weeks postpartum. Future interventions are recommended to adjust intervention strategies with time, and give more focus on providing continued breastfeeding support after discharge.
根据计划行为理论(TPB),母乳喂养知识、态度、主观规范和感知控制是母乳喂养的重要决定因素。然而,关于基于TPB的干预措施在促进母乳喂养方面有效性的证据很少。同时,以往研究尚未考察这些决定因素随时间的变化情况。
探讨基于TPB的干预项目在提高纯母乳喂养率方面的有效性,以及时间和干预对这些母乳喂养决定因素的交互作用。
纳入285名初产妇,其中实验组157名母亲,对照组128名母亲。实验组在产后6周接受基于TPB的干预项目,而实验组和对照组均接受标准产科护理。
从基线到产后6周,母乳喂养知识、态度和母乳喂养控制得分随时间增加,而实验组和对照组在产后6周时母乳喂养主观规范得分均下降。此外,除产后6周母乳喂养控制外,实验组在产后3天和6周时这四个决定因素的得分均显著高于对照组,这导致实验组在产后3天和6周时的纯母乳喂养率高于对照组。
基于TPB的干预措施在促进产后6周内纯母乳喂养方面有效。建议未来的干预措施根据时间调整干预策略,并更加注重在出院后提供持续的母乳喂养支持。