基于健康信念模型促进中国剖宫产妇女母乳喂养：一项随机对照试验。
Promoting breastfeeding in Chinese women undergoing cesarean section based on the health belief model: A randomized controlled trial.
作者信息
Hu Lei, Ding Tingting, Hu Juan, Luo Biru
机构信息
Department of Nursing, West China Second University Hospital, Sichuan University.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education.
出版信息
Medicine (Baltimore). 2020 Jul 10;99(28):e20815. doi: 10.1097/MD.0000000000020815.
BACKGROUND
The high rate of cesarean section is an important factor affecting breastfeeding in China. To improve the nation's current situation of breastfeeding, promoting breastfeeding in women undergoing cesarean section is essential.
OBJECTIVE
To explore the effects of health belief model-based interventions on breastfeeding knowledge, breastfeeding behaviors, and breastfeeding satisfaction of Chinese cesarean women.
METHODS
A total of 346 cesarean section women were enrolled in the randomized controlled trial conducted at a center in Chengdu, China, between July 1, 2018 and August 31, 2018. While the control group (n = 173) received conventional breastfeeding guidance only, the intervention group (n = 173) received additional interventions based on the health belief model. Questionnaires were distributed to assess breastfeeding knowledge, breastfeeding behavior, and breastfeeding satisfaction at discharge, 42 days postpartum, and 4 months postpartum, respectively.
RESULTS
At discharge from hospital, the breastfeeding knowledge score of the intervention group was higher than that of the control group (Z = -11.753, P < .001). The exclusive breastfeeding rates in the intervention group at the time of discharge, 42 days postpartum, and 4 months postpartum were 67.3%, 60.7%, and 52.9%, respectively, while those of the control group were 41.2%, 41.6%, and 40.4%, respectively. The differences were statistically significant (χ = 23.353, P < .001; χ = 11.853, P < .001; χ = 4.805, P = .03). The breastfeeding satisfaction of the intervention group was also higher than the control group at the time of discharge, 42 days postpartum and 4 months postpartum (t = 4.955, P < .001; t = 3.051, P = .002; Z = -3.801, P < .001).
CONCLUSION
The health belief model-based interventions can effectively increase breastfeeding knowledge for Chinese cesarean women and improve their breastfeeding behaviors and breastfeeding satisfaction within 4 months after delivery.
CLINICAL TRIAL REGISTRATION
ChiCTR1900026006 http://www.chictr.org.cn/usercenter.aspx.
背景
剖宫产率高是影响我国母乳喂养的重要因素。为改善我国目前的母乳喂养状况，促进剖宫产妇女的母乳喂养至关重要。
目的
探讨基于健康信念模式的干预措施对我国剖宫产妇女母乳喂养知识、母乳喂养行为及母乳喂养满意度的影响。
方法
选取2018年7月1日至2018年8月31日在成都某中心进行的随机对照试验中的346例剖宫产妇女。对照组（n = 173）仅接受常规母乳喂养指导，干预组（n = 173）在常规指导的基础上接受基于健康信念模式的额外干预。分别在出院时、产后42天和产后4个月发放问卷，评估母乳喂养知识、母乳喂养行为及母乳喂养满意度。
结果
出院时，干预组的母乳喂养知识得分高于对照组（Z = -11.753，P <.001）。干预组出院时、产后42天和产后4个月的纯母乳喂养率分别为67.3%、60.7%和52.9%，而对照组分别为41.2%、41.6%和40.4%。差异有统计学意义（χ = 23.353，P <.001；χ = 11.853，P <.001；χ = 4.805，P =.03）。干预组在出院时、产后42天和产后4个月的母乳喂养满意度也高于对照组（t = 4.955，P <.001；t = 3.051，P =.002；Z = -3.801，P <.001）。
结论
基于健康信念模式的干预措施可有效增加我国剖宫产妇女的母乳喂养知识，并在产后4个月内改善其母乳喂养行为和母乳喂养满意度。
临床试验注册
ChiCTR1900026006 http://www.chictr.org.cn/usercenter.aspx。
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