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中国深圳与新生儿黄疸相关的产妇知识、态度和实践及其影响因素:一项基于医疗机构的横断面研究。

Maternal knowledge, attitudes and practices related to neonatal jaundice and associated factors in Shenzhen, China: a facility-based cross-sectional study.

机构信息

Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China.

School of Nursing, Southern Medical University, Guangzhou, Guangdong, China.

出版信息

BMJ Open. 2022 Aug 24;12(8):e057981. doi: 10.1136/bmjopen-2021-057981.

Abstract

OBJECTIVE

This study aimed to assess knowledge, attitudes and practices related to neonatal jaundice among mothers in Shenzhen, China, and analyse associated factors.

DESIGN

A cross-sectional study.

SETTING

This study was conducted in Shenzhen Hospital, Southern Medical University, a university-affiliated, tertiary level A, public hospital in China. On average, 4000 mothers are discharged from this hospital after childbirth each year, most of whom can access a mobile phone and the internet.

PARTICIPANTS

Participants were 403 mothers discharged from the study hospital within 48-72 hours after vaginal delivery or 96-120 hours after caesarean delivery between April and June 2021. Participants were recruited using convenience sampling.

PRIMARY OUTCOME

Mothers' knowledge, attitudes and practices related to neonatal jaundice, modelled using binary logistic regression.

SECONDARY OUTCOMES

Factors associated with mothers' knowledge, attitudes and practices related to neonatal jaundice.

RESULTS

The questionnaire was reliable (Cronbach's alpha=0.802) and valid (scale-level content validity index=0.958). The valid response rate was 96.4%. Only 46.4% of participating mothers had good knowledge about neonatal jaundice and 41.7% indicated they would seek information about neonatal jaundice. A binary logistic regression analysis showed good knowledge about jaundice was associated with a high education level (ie, master's degree or above; OR=5.977, 95% CI: 1.994 to 17.916, p=0.001), prior education on neonatal jaundice (OR=3.617, 95% CI: 1.637 to 7.993, p=0.001) and male babies (OR=1.714, 95% CI: 1.122 to 2.617, p=0.013). A positive attitude toward jaundice was associated with being cared for by a 'yuesao' (maternity matron specialised in caring for mothers and newborns) (OR=1.969, 95% CI: 1.264 to 3.066, p=0.003) and good knowledge about jaundice (OR=1.804, 95% CI: 1.194 to 2.726, p=0.005). Finally, good practices related to neonatal jaundice were associated with prior education on neonatal jaundice (OR=2.260, 95% CI: 1.105 to 4.625, p=0.026) and good knowledge about jaundice (OR=3.112, 95% CI: 2.040 to 4.749, p0.001).

CONCLUSION

Many mothers have poor knowledge about jaundice, especially regarding causes, danger signs and breast milk jaundice. Maternal information-seeking behaviour about neonatal jaundice needs to be improved. Medical staff should incorporate information about the causes/danger signs of jaundice and breast milk jaundice in maternal health education. It is also necessary to strengthen health education for mothers, especially those with low education and no yuesao, and provide reliable websites where mothers can obtain information about neonatal jaundice.

摘要

目的

本研究旨在评估中国深圳母亲对新生儿黄疸的知识、态度和实践,分析相关因素。

设计

横断面研究。

地点

本研究在南方医科大学附属深圳医院进行,这是一家中国的大学附属三级 A 等公立医院。平均每年有 4000 名母亲在该院分娩后出院,其中大多数人都能使用手机和互联网。

参与者

2021 年 4 月至 6 月期间,在阴道分娩后 48-72 小时或剖宫产 96-120 小时内从研究医院出院的 403 名母亲被纳入研究。采用便利抽样法招募参与者。

主要结局

采用二元逻辑回归模型评估母亲对新生儿黄疸的知识、态度和实践。

次要结局

与母亲对新生儿黄疸的知识、态度和实践相关的因素。

结果

问卷可靠(Cronbach's alpha=0.802)且有效(量表水平内容效度指数=0.958)。有效应答率为 96.4%。仅有 46.4%的参与母亲对新生儿黄疸有较好的了解,41.7%的母亲表示会寻找有关新生儿黄疸的信息。二元逻辑回归分析显示,对黄疸的良好认识与较高的教育水平(即硕士或以上学历;OR=5.977,95%CI:1.994 至 17.916,p=0.001)、新生儿黄疸的既往教育(OR=3.617,95%CI:1.637 至 7.993,p=0.001)和男婴(OR=1.714,95%CI:1.122 至 2.617,p=0.013)相关。对黄疸的积极态度与由“月嫂”(专门照顾母亲和新生儿的产褥期保姆)照顾(OR=1.969,95%CI:1.264 至 3.066,p=0.003)和对黄疸的良好认识(OR=1.804,95%CI:1.194 至 2.726,p=0.005)有关。最后,与新生儿黄疸相关的良好实践与新生儿黄疸的既往教育(OR=2.260,95%CI:1.105 至 4.625,p=0.026)和对黄疸的良好认识(OR=3.112,95%CI:2.040 至 4.749,p0.001)有关。

结论

许多母亲对黄疸的认识较差,尤其是对其病因、危险信号和母乳性黄疸的认识。需要改善产妇对新生儿黄疸的信息寻求行为。医务人员应在产妇健康教育中纳入黄疸的病因/危险信号和母乳性黄疸的信息。还需要加强对母亲的健康教育,特别是那些教育程度低且没有月嫂的母亲,并提供可靠的网站,使母亲能够获得有关新生儿黄疸的信息。

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