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哺乳期用药的共同决策:希腊的一项前瞻性纵向研究。

Shared decision-making about medication intake during lactation: A prospective longitudinal study in Greece.

作者信息

Tigka Maria, Metallinou Dimitra, Pardali Lemonia, Lykeridou Katerina

机构信息

Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece.

Obstetric Emergency Department, General and Maternity Hospital 'Helena Venizelou', Athens, Greece.

出版信息

Eur J Midwifery. 2022 Aug 1;6:48. doi: 10.18332/ejm/149830. eCollection 2022.

Abstract

INTRODUCTION

The need for medication intake during lactation may affect women's decision on breastfeeding initiation, duration or cessation. We investigated shared decision-making about medication intake (MI) during lactation by breastfeeding women.

METHODS

The study was conducted in five maternity hospitals in Greece (January-August 2020). A total of 283 mothers participated in the study. Data were obtained through a self-designed questionnaire. Mothers answered the questionnaire before discharge and were followed up by phone interviewing at one, three and six months postpartum. Information about breastfeeding status, reasons for cessation and MI during lactation were gathered.

RESULTS

In total, 30.7% of the mothers were receiving medication due to a pre-pregnancy chronic condition but only 23.7% maintained it during lactation; 48.4% of mothers stated that they would avoid MI during lactation as a personal attitude and 45.2% were satisfied with the information provided by healthcare professionals (HPs) concerning MI during lactation. But, 66.1% of the mothers indicated the necessity of further guidance. Mothers with higher education, Greek ethnicity and vaginal delivery participated significantly in the decision-making process concerning MI during lactation (p=0.001, p=0.001 and p=0.01, respectively). Mothers who shared decision-making, primarily consulted a pediatrician (p=0.02) and were more likely to maintain full and mixed breastfeeding for one month postpartum, rather than cease breastfeeding (p=0.005). Breastfeeding duration of all indicators was for a mean of 110 days (SD: 74.58).

CONCLUSIONS

Advancing HPs' evidence-based knowledge, communication skills, confidence and competence in breastfeeding management will contribute favorably to breastfeeding indicators and maternal satisfaction regarding professional counseling.

摘要

引言

哺乳期服药的需求可能会影响女性关于开始、持续或停止母乳喂养的决定。我们调查了哺乳期女性在药物摄入方面的共同决策情况。

方法

该研究在希腊的五家妇产医院进行(2020年1月至8月)。共有283名母亲参与了研究。数据通过自行设计的问卷获得。母亲们在出院前回答问卷,并在产后1个月、3个月和6个月接受电话随访。收集了有关母乳喂养状况、停止母乳喂养的原因以及哺乳期药物摄入的信息。

结果

总体而言,30.7%的母亲因孕前慢性病而服药,但哺乳期继续服药的仅占23.7%;48.4%的母亲表示,作为个人态度,她们会避免在哺乳期服药,45.2%的母亲对医护人员提供的有关哺乳期药物摄入的信息感到满意。但是,66.1%的母亲表示有必要获得进一步指导。受过高等教育、希腊族裔和顺产的母亲在哺乳期药物摄入的决策过程中参与度显著更高(分别为p = 0.001、p = 0.001和p = 0.01)。共同参与决策的母亲主要咨询儿科医生(p = 0.02),并且产后1个月更有可能保持纯母乳喂养和混合喂养,而不是停止母乳喂养(p = 0.005)。所有指标的母乳喂养持续时间平均为110天(标准差:74.58)。

结论

提高医护人员在母乳喂养管理方面基于证据的知识、沟通技巧、信心和能力,将对母乳喂养指标以及母亲对专业咨询的满意度产生积极影响。

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