农村母乳喂养母亲远程哺乳的使用情况及体验：一项随机对照试验的二次分析
The Use of and Experiences With Telelactation Among Rural Breastfeeding Mothers: Secondary Analysis of a Randomized Controlled Trial.
作者信息
Kapinos Kandice, Kotzias Virginia, Bogen Debra, Ray Kristin, Demirci Jill, Rigas Mary Ann, Uscher-Pines Lori
机构信息
RAND Corporation, Arlington, VA, United States.
University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
出版信息
J Med Internet Res. 2019 Sep 3;21(9):e13967. doi: 10.2196/13967.
BACKGROUND
Telelactation services connect breastfeeding mothers to remotely located lactation consultants through audio-visual technology and can increase access to professional breastfeeding support in rural areas.
OBJECTIVE
The objective of this study was to identify maternal characteristics associated with the demand for and use of telelactation and to describe visit characteristics.
METHODS
We conducted a descriptive study within the context of a randomized controlled trial. Participant survey data and vendor electronic medical record data were used to assess video call characteristics like timing, duration, topics discussed, and participant satisfaction. Recruitment occurred from 2016-2018 at a rural critical access hospital in Pennsylvania. The 102 women enrolled in the study were given access to unlimited, on-demand video calls with lactation consultants through a mobile phone app and were tracked for 12 weeks following their postpartum hospitalization.
RESULTS
A total of 94 participants out of 102 recruits (92%) participated in the final, 12-week survey assessment were included in the analysis. Of those, 47 (50%) participants reported participating in one or more video calls, and 31 (33%) completed one or more calls that included a substantive discussion of a breastfeeding challenge. Participants who used telelactation (21/31, 68%; P=.02) were more likely to be working at 12 weeks postpartum compared to others (26/63, 41%), were less likely (12/31, 39%; P=.02) to have prior breastfeeding experience on average compared to nonusers (41/63, 65%), and were less likely to have breastfed exclusively (16/31, 52%; P<.001) prior to hospital discharge compared to mothers who didn't use telelactation services (51/63, 81%). Most video calls (58/83, 70%) occurred during the infant's first month of life and 41% (34/83) occurred outside of business hours. The most common challenges discussed included: breast pain, soreness, and infection (25/83, 30%), use of nipple shields (21/83, 25%), and latch or positioning (17/83, 24%). Most telelactation users (43/47, 91%) expressed satisfaction with the help received.
CONCLUSIONS
Telelactation is an innovation in the delivery of professional breastfeeding support. This research documents both demand for and positive experiences with telelactation in an underserved population.
TRIAL REGISTRATION
ClinicalTrials.gov NCT02870413; https://clinicaltrials.gov/ct2/show/NCT02870413.
背景
远程哺乳服务通过视听技术将母乳喂养的母亲与远程的哺乳顾问联系起来，可增加农村地区获得专业母乳喂养支持的机会。
目的
本研究的目的是确定与远程哺乳需求和使用相关的母亲特征，并描述就诊特征。
方法
我们在一项随机对照试验的背景下进行了一项描述性研究。参与者调查数据和供应商电子病历数据用于评估视频通话的特征，如时间、时长、讨论的话题和参与者满意度。招募工作于2016年至2018年在宾夕法尼亚州的一家农村急救医院进行。参与研究的102名女性通过手机应用程序可无限次按需与哺乳顾问进行视频通话，并在产后住院12周后接受跟踪。
结果
102名招募者中有94名参与者（92%）参加了最后的12周调查评估并纳入分析。其中，47名（50%）参与者报告参加了一次或多次视频通话，31名（33%）完成了一次或多次包含对母乳喂养挑战进行实质性讨论的通话。与其他人相比，使用远程哺乳的参与者（21/31，68%；P=0.02）在产后12周更有可能工作（26/63，41%），与未使用者相比，平均而言更不太可能有母乳喂养经验（12/31，39%；P=0.02）（41/63，65%），与未使用远程哺乳服务的母亲相比，出院前纯母乳喂养的可能性更小（16/31，52%；P<0.001）（51/63，81%）。大多数视频通话（58/83，70%）发生在婴儿出生后的第一个月，41%（34/83）发生在工作时间之外。讨论的最常见挑战包括：乳房疼痛、酸痛和感染（25/83，30%）、乳头罩的使用（21/83，25%）以及衔接或姿势（17/83，24%）。大多数远程哺乳使用者（43/47，91%）对获得的帮助表示满意。
结论
远程哺乳是提供专业母乳喂养支持的一项创新。本研究记录了服务欠缺人群对远程哺乳的需求和积极体验。
试验注册
ClinicalTrials.gov NCT02870413；https://clinicaltrials.gov/ct2/show/NCT02870413 。
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