情景式营养教育对婴儿喂养状况的影响

Effects of situational nutrition education on patterns of infant feeding

目的探讨情景式营养教育,对婴儿监护人的营养知识水平和婴儿喂养状况的影响,以探索婴儿食物转换指导新模式。方法选择2014年4月至12月,于江苏省淮安市妇幼保健院儿童保健门诊进行健康体检的272例1~2个月龄婴儿为研究对象。采用随机数字表法,将其分别纳入干预组(n=140)和对照组(n=132)。干预组婴儿于3~4个月龄时,由儿童营养专科医师和营养师,在营养厨房内,对婴儿监护人以10~15人小组形式,进行情景式营养教育;对照组则由门诊体检医师进行常规营养指导。2组婴儿12个月龄时,对其监护人采用本研究自行设计的《淮安市妇幼保健院婴儿喂养状况调查表》进行调查。采用χ^2检验,对2组婴儿喂养状况,如母乳喂养率、食物转换合理率等,进行统计学比较。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求,并与受试儿监护人签署临床研究知情同意书。结果①2组婴儿4个月龄时纯母乳喂养率、混合喂养率及人工喂养率比较,差异均无统计学意义(P>0.05)。干预组婴儿6、12个月龄时,继续母乳喂养率分别为88.6%、37.1%,均显著高于对照组的78.0%、23.5%,并且差异均有统计学意义(χ^2=5.468、P=0.022,χ^2=5.977、P=0.018)。②干预组婴儿监护人对食物转换指导模式的满意度、食物转换合理率,以及3类补充食品(谷类、果蔬类、动物性食物)均合理添加率,添加动物性食物合理率及监护人专用料理机使用率分别为90.0%、87.1%、77.1%、82.9%、50.0%,均显著高于对照组的77.3%、60.6%、54.5%、65.2%、25.8%,并且差异均有统计学意义(χ^2=8.116、P=0.005,χ^2=25.033、P<0.001,χ^2=15.500、P<0.001,χ^2=11.114、P=0.001,χ^2=16.908、P<0.001)。结论情景式营养教育的婴儿食物转换指导新模式,可提高婴儿监护人的营养知识水平,改善婴儿喂养状况。

Objective To explore a new pattern of infant complementary feeding by analyzing the impact of situational nutrition education on the nutritional knowledge of infant guardians and patterns of infant feeding.Methods A total of 272 infants aged from 1 to 2 months who underwent a health checkup at the Child Health Care,Jiangsu Huai′an Maternal and Child Health Hospital from April to December in 2014 were chosen as research subjects.They were divided into intervention group(n=140)and control group(n=132),respectively by random digits table method.Age ranging from 3 to 4 months of infants in intervention group,their guardians were taken situational nutrition education measure by a child nutrition specialist and a dietitian in a group of 10 to 15 guardians in a nutrition kitchen;The guardians of infants in control group were conducted routine nutrition guidance operations by an outpatient medical examiner.At age of 12 months of all infants in this study,their guardians were conducted questionnaire survey with self designed Infant Feeding Status Questionnaire of Huai′an Maternal and Child Health Hospital to collect data for our research.The chi-square test was used to compare the situations of infant feeding between two groups of infants,such as breast feeding rate and reasonable rate of food conversion,etc..This study was in line with World Medical Association Declaration of Helsinki revised in 2013 and informed consent forms were signed for clinical research from the guardians of all infants.Results①There were no significant differences between two groups of infants at age of 4 months old in the rates of exclusive breast feeding,mixed feeding and artificial feeding(P>0.05).The breast feeding rates in intervention group were 88.6%and 37.1%at age of 6 and 12 months old of infants,respectively,which were significantly higher than those of 78.0%and 23.5%in control group,and the differences were statistically significant(χ^2=5.468,P=0.022;χ^2=5.977,P=0.018).②The satisfaction rate of guardians on the food conversion guidance mode,the reasonable rate of food conversion,the reasonable rate of adding all the three types of supplementary foods(cereals,fruits and vegetables,animal foodstuff),the reasonable rate of adding animal foodstuff,and the usage rate of specific food machine of the guardians in intervention group were 90.0%,87.1%,77.1%,82.9%,50.0%,respectively,which were significantly higher than those of 77.3%,60.6%,54.5%,65.2%,25.8%in control group,and all the differences were statistically significant(χ^2=8.116,P=0.005;χ^2=25.033,P<0.001;χ^2=15.500,P<0.001;χ^2=11.114,P=0.001;χ^2=16.908,P<0.001).Conclusions Situational nutrition education as a new pattern of infant complementary feeding guidance can improve the nutritional knowledge of infant guardians and improve infant feeding status.