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创新的连续护理模式在巴基斯坦促进纯母乳喂养:一项试点随机对照试验方案。

Innovative continuum of care to promote exclusive breast feeding in Pakistan: protocol of a pilot randomised controlled trial.

机构信息

Department of Community Medicine & Public Health, UOG Nawaz Sharif Medical College, Gujrat, Pakistan

Department of Gynecology & Obstetrics Aziz Bhatti Shaheed Teaching Hospital, UOG Nawaz Sharif Medical College, Gujrat, Pakistan.

出版信息

BMJ Paediatr Open. 2024 May 20;8(1):e002562. doi: 10.1136/bmjpo-2024-002562.

Abstract

BACKGROUND

Breastmilk being the ideal nutrition from birth to 2 years and beyond has many health benefits for both newborn and mothers. This study will assess the feasibility and acceptability of a continuum of care programme, which is a health facility and community based till 6 months post partum to encourage ideal breastfeeding practices.

METHODS AND ANALYSIS

A pilot randomised control trial having two-parallel arms of intervention and control groups was conducted in gynaecology and obstetrics department of Aziz Bhatti Shaheed Teaching Hospital with a community outreach component of 6 months. 50 women between 28 and 32 weeks of gestation fulfilling inclusion criteria will be allocated in 1:1 randomly into intervention and control groups through computer-generated random number generator software. 25 participants in intervention group will receive counselling and training on breast feeding during antenatal visits along with a family member of support by a trained female doctor within the hospital, at birth by a trained nurse and at home for 6 months by a trained lady health worker. It will be supported by reading materials and videos through a mobile phone WhatsApp application. The 25 participants in control group will receive the support already provided within the hospital and at home. The primary outcomes feasibility and acceptability will be determined at 6 months post partum from participants and providers by a semistructured questionnaire. The secondary outcomes are rates of infant early initiation and exclusive breast feeding at 2 weeks, 1, 3 and 6 months, Infant Feeding Attitude at 1 month and Breastfeeding Self-Efficacy at 3 months. Quantitative and qualitative data will be analysed via SPSS software V.20 and thematic analysis, respectively.

CONCLUSION

This pilot randomised controlled trial (RCT) will guide the interventions for the definite RCT.

ETHICS AND DISSEMINATION

Approved by institutional ethical committee, informed consent from all participants and results will be disseminated in peer-reviewed journal.

TRIAL REGISTRATION NUMBER

NCT05951868.

摘要

背景

母乳是出生后至 2 岁及以上的理想营养来源,对新生儿和母亲都有许多健康益处。本研究将评估一种连续护理方案的可行性和可接受性,该方案是一种在产后 6 个月内以卫生机构和社区为基础的方案,旨在鼓励理想的母乳喂养实践。

方法和分析

在阿齐兹·巴蒂·谢赫教学医院的妇产科进行了一项试点随机对照试验,该试验有两个平行的干预组和对照组,同时还有 6 个月的社区外展部分。将 50 名符合纳入标准的 28 至 32 周妊娠的妇女通过计算机生成的随机数生成器软件以 1:1 的比例随机分配到干预组和对照组。干预组的 25 名参与者将在产前访视期间接受母乳喂养咨询和培训,并由一名经过培训的女医生在医院内、分娩时由一名经过培训的护士以及在产后 6 个月内由一名经过培训的女保健员为一名家庭成员提供支持。这将通过手机 WhatsApp 应用程序提供阅读材料和视频来支持。对照组的 25 名参与者将在医院内和家中获得已经提供的支持。主要结局的可行性和可接受性将在产后 6 个月时由参与者和提供者通过半结构化问卷确定。次要结局是婴儿在 2 周、1 个月、3 个月和 6 个月时的早期启动和纯母乳喂养率、1 个月时的婴儿喂养态度和 3 个月时的母乳喂养自我效能感。定量和定性数据将分别通过 SPSS 软件 V.20 和主题分析进行分析。

结论

这项试点随机对照试验 (RCT) 将为确定的 RCT 提供干预指导。

伦理和传播

该研究已获得机构伦理委员会的批准,所有参与者都已获得知情同意,研究结果将在同行评议的期刊上发表。

试验注册号

NCT05951868。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5428/11110549/e3ad70fe2afe/bmjpo-2024-002562f01.jpg

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