Wen Juan, Yu Guiling, Kong Yan, Wei Holly, Zhao Shuran, Liu Furong
Qingdao Women and Children's Hospital, Qingdao, China.
College of Nursing at East Carolina University, Greenville, NC, USA.
Int J Nurs Sci. 2021 Mar 24;8(2):152-160. doi: 10.1016/j.ijnss.2021.03.012. eCollection 2021 Apr 10.
To examine the efficacy of an intervention based on the theory of planned behavior (TPB) in improving breastfeeding behavior among women with cesarean sections (C-sections).
This research was a randomized controlled trial. Women with planned elective C-sections were recruited to participate in a randomized controlled trial between June and September 2020. One hundred thirty-two women were divided randomly into the intervention ( = 66) and control group ( = 66) by systematic random sampling. In the intervention group, an intervention project was implemented after the C-section to establish positive breastfeeding attitudes, cultivate supportive subjective norms, enhance perceived behavioral control, and strengthen breastfeeding intention to change behaviors. Those in the control group received routine pre-and post-delivery care. Exclusive breastfeeding rate and breast problem were collected at 5 days, 2 weeks, and 1 month after C-section. The modified Breastfeeding Attrition Prediction Tool (BAPT) on the first day in the hospital, two weeks, and one month after C-section and Numerical Rating Scale (NRS) 24 h postoperatively were used to compare the intervention effect between the two groups.
After the intervention, the intervention group had significantly higher exclusive breastfeeding rates than the control group at five days (86.4% vs. 60.6%), two weeks (77.3% vs. 57.6%), and one month (74.2% vs. 50.0%) after the C-section. Besides, the intervention group was less likely to have sore nipples at five days (6.1% vs. 18.2% in the control group, < 0.05) and two weeks (9.1% vs. 12.1% in the control group, < 0.05). After two weeks of intervention, attitude scores (90.64 ± 8.31 vs. 87.20 ± 8.15, < 0.05), subjective norm scores (88.07 ± 24.65 vs. 79.42 ± 19.47, < 0.05）and behavior control scores in the intervention group were significantly higher than those in the control group. After one month of intervention, attitude scores (90.34 ± 10.35 vs. 84.22 ± 10.51, < 0.05) and behavior control scores (43.13 ± 5.02 vs. 39.15 ± 4.69, < 0.05）in the intervention group were significantly higher than those in the control group, which resulted in the higher breastfeeding intention in the intervention group.
This study indicated that the TPB-based interventions effectively improved women's breastfeeding behaviors after C-sections.
探讨基于计划行为理论（TPB）的干预措施对改善剖宫产妇女母乳喂养行为的效果。
本研究为随机对照试验。招募计划择期剖宫产的妇女参与2020年6月至9月的随机对照试验。通过系统随机抽样将132名妇女随机分为干预组（n = 66）和对照组（n = 66）。干预组在剖宫产后实施干预项目，以建立积极的母乳喂养态度，培养支持性的主观规范，增强感知行为控制，并强化母乳喂养意愿以改变行为。对照组接受常规的产前和产后护理。在剖宫产后5天、2周和1个月收集纯母乳喂养率和乳房问题。使用改良的母乳喂养流失预测工具（BAPT）在剖宫产后住院第一天、两周和一个月以及术后24小时的数字评分量表（NRS）来比较两组间的干预效果。
干预后，干预组在剖宫产后5天（86.4%对60.6%）、2周（77.3%对57.6%）和1个月（74.2%对50.0%）的纯母乳喂养率显著高于对照组。此外，干预组在5天（6.1%对对照组的18.2%，P < 0.05）和2周（9.1%对对照组的12.1%，P < 0.05）时乳头疼痛的可能性较小。干预两周后，干预组的态度得分（90.64 ± 8.31对87.20 ± 8.15，P < 0.05）、主观规范得分（88.07 ± 24.65对79.42 ± 19.47，P < 0.05）和行为控制得分显著高于对照组。干预一个月后，干预组的态度得分（90.34 ± 10.35对84.22 ± 10.51，P < 0.05）和行为控制得分（43.13 ± 5.02对39.15 ± 4.69，P < 0.05）显著高于对照组，这导致干预组的母乳喂养意愿更高。
本研究表明基于TPB的干预措施有效地改善了剖宫产妇女的母乳喂养行为。
