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培育网络:一项关于影响社会经济地位低下母亲求助行为因素的前瞻性纵向研究。

Nurturing networks: A prospective longitudinal study of factors influencing help-seeking behaviours among mothers from low socioeconomic status.

作者信息

Shorey Shefaly, Ng Jamie Qiao Xin, Liu Verity Chandelle, Chan Yiong Huak, Chee Cornelia Yin Ing

机构信息

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

出版信息

J Adv Nurs. 2025 Apr;81(4):1884-1901. doi: 10.1111/jan.16382. Epub 2024 Aug 13.

Abstract

AIM

To explore the factors influencing help-seeking behaviours amongst mothers with low socioeconomic status at pregnancy, 1 month postpartum and 3 months postpartum.

METHODS

A prospective cohort study was conducted from September 2022 to August 2023. A total of 209 mothers aged 21 years and above, with low socioeconomic status and irrespective of parity, were recruited from a local hospital using convenience sampling. Self-administered questionnaires were used to collect data at (1) third trimester of pregnancy, (2) 1 month postpartum and (3) 3 months postpartum. Multiple regression analysis was used to identify significant factors influencing help-seeking behaviour at 3 months postpartum. Sub-analyses were conducted between primiparous mothers and multiparous mothers. General linear model repeated measures were used to identify longitudinal trends in outcomes of help-seeking behaviour.

RESULTS

Help-seeking behaviour at pregnancy and 1 month postpartum, sources of social support at 3 months postpartum, birth order of the child, attendance of antenatal classes, paternal involvement in feeding and changing diapers and mode of delivery significantly predicted mothers' help-seeking behaviour at 3 months postpartum. Amongst primiparous mothers, help-seeking behaviour at pregnancy at 1 month, social support at 3 months postpartum, employment in part-time jobs and exclusively breastfeeding their infant were significant factors in influencing their help-seeking behaviours at 3 months postpartum. For multiparous mothers, help-seeking behaviour at pregnancy and 1 month postpartum, number of hours of antenatal class attended, Malay ethnicity, educational background, parental satisfaction at 3 months postpartum and infant bonding at both time points were significant factors influencing their help-seeking behaviours at 3 months postpartum.

CONCLUSION

Primiparous mothers with low socioeconomic status who underwent caesarean section exhibited less help-seeking behaviours. Attendance of antenatal classes and greater paternal involvement in infant care encouraged mothers with low socioeconomic status to help-seeking behaviours. A tailored approach is needed to support mothers with low socioeconomic status by providing additional support in improving the accessibility of antenatal classes and involving fathers in infant care.

IMPACT

What Problem Did the Study Address? Mothers with low socioeconomic status tend to exhibit lower help-seeking behaviours due to limited support and access to care services. What Were the Main Findings? First-time mothers who underwent caesarean section, did not attend antenatal classes, and had husbands uninvolved in feeding and diaper changing were significantly less likely to seek help in the third month postpartum. One and 3 months postpartum are crucial time points when mothers with low socioeconomic status could benefit from additional support. Hospitals should explore online informational resources, forums, teleconsultations and virtual antenatal classes as possible alternative options to improve accessibility for mothers with low socioeconomic status. Where and on Whom Will the Research Have an Impact? Mothers with low socioeconomic status and healthcare providers of mothers with low socioeconomic status will benefit from the findings of this research. This study was conducted within the Singapore context. Findings could be generalizable to other cultural contexts with similar multi-ethnic populations.

REPORTING METHOD

STROBE checklist.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

摘要

目的

探讨影响社会经济地位低下的母亲在孕期、产后1个月和产后3个月寻求帮助行为的因素。

方法

于2022年9月至2023年8月进行了一项前瞻性队列研究。采用便利抽样的方法,从当地一家医院招募了209名年龄在21岁及以上、社会经济地位低下且不考虑胎次的母亲。在(1)妊娠晚期、(2)产后1个月和(3)产后3个月,使用自填式问卷收集数据。采用多元回归分析确定影响产后3个月寻求帮助行为的显著因素。在初产妇和经产妇之间进行了亚组分析。使用一般线性模型重复测量来确定寻求帮助行为结果的纵向趋势。

结果

孕期和产后1个月的寻求帮助行为、产后3个月的社会支持来源、孩子的出生顺序、参加产前课程情况、父亲参与喂养和换尿布情况以及分娩方式显著预测了母亲产后3个月的寻求帮助行为。在初产妇中,孕期和产后1个月的寻求帮助行为、产后3个月的社会支持、从事兼职工作以及纯母乳喂养婴儿是影响其产后3个月寻求帮助行为的重要因素。对于经产妇,孕期和产后1个月的寻求帮助行为、参加产前课程的小时数、马来族裔、教育背景、产后3个月的父母满意度以及两个时间点的母婴亲密关系是影响其产后3个月寻求帮助行为的重要因素。

结论

社会经济地位低下且接受剖宫产的初产妇寻求帮助的行为较少。参加产前课程以及父亲更多地参与婴儿护理鼓励了社会经济地位低下的母亲寻求帮助的行为。需要采取针对性的方法来支持社会经济地位低下的母亲,通过提供额外支持以提高产前课程的可及性并让父亲参与婴儿护理。

影响

该研究解决了什么问题?社会经济地位低下的母亲由于支持有限和获得护理服务的机会有限,往往表现出较低的寻求帮助行为。主要发现是什么?接受剖宫产、未参加产前课程且丈夫未参与喂养和换尿布的初产妇在产后第三个月寻求帮助的可能性显著降低。产后1个月和3个月是社会经济地位低下的母亲可以从额外支持中受益的关键时间点。医院应探索在线信息资源、论坛、远程会诊和虚拟产前课程等可能的替代选项,以提高社会经济地位低下的母亲的可及性。该研究将对哪些人产生影响?社会经济地位低下的母亲以及社会经济地位低下的母亲的医疗服务提供者将从本研究的结果中受益。本研究是在新加坡背景下进行的。研究结果可能适用于其他具有类似多民族人口的文化背景。

报告方法

STROBE清单。

患者或公众贡献

无患者或公众贡献。

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