基于随机森林模型的产后早期母乳喂养自我效能现状及影响因素分析

Analysis of current status of and factors associated with early postpartum breastfeeding self-efficacy based on random forest model

目的 了解产后早期母乳喂养自我效能的现状及影响因素,探索提高产妇母乳喂养早期阶段的自我效能,进而提高产后6个月内纯母乳喂养率的可行方案。方法 对2022年3—8月在上海市复旦大学附属妇产科医院分娩的477例产后7 d内的产妇开展问卷调查。使用随机森林算法、多元线性回归等筛选、分析母乳喂养自我效能的主要影响因素。结果 477例产妇母乳喂养自我效能量表得分为(43.98±12.80)分。随机森林算法显示,影响产妇产后早期母乳喂养自我效能的变量中,位于前3位的是家庭人均月收入、喂养方式和夜间哺乳。多元线性回归分析结果显示,自觉乳汁不足、母乳喂养困难、产妇态度、母乳喂养质量评定量表总分和爱丁堡产后抑郁量表得分是产妇产后早期母乳喂养自我效能的影响因素(均P <0.05)。结论 医护人员可从改变产妇认知误区、强化母乳喂养早期阶段指导、关注产后抑郁、鼓励配偶或其他成员的支持来提高母乳喂养的自我效能,从而促进产后6个月内纯母乳喂养。

Objective To investigate the current situation and factors associated with self-efficacy of early postpartum breastfeeding,aiming at exploring the feasible ways to enhance breastfeeding self-efficacy in the early stage and improve the rate of exclusive breastfeeding within 6 months.Methods Totally 477 women who delivered in Shanghai Obstetrics and Gynecology Hospital of Fudan University from March to August 2022 were investigated through questionnaire survey within 7 days postpartum.Factors associated with self-efficacy of breastfeeding were analyzed through random forest algorithm and multiple linear regression.Results The average score of breastfeeding self-efficacy of 477 participants was 43.98±12.80.Random forest algorithm analysis showed that the top three variables affecting maternal breastfeeding self-efficacy in the early postpartum period were per capita monthly household income,breastfeeding method,and overnight breastfeeding.Multiple linear regression analysis showed that subjective insufficient breast milk,difficulties in breastfeeding,attitudes of postpartum women,scores of Breastfeeding Evaluation Scales(BES)and Edinburgh Postnatal Depression Scale(EPDS)were factors associated with breastfeeding self-efficacy(P<0.05).Conclusion Health professionals can improve women’s self-efficacy of breastfeeding and promote exclusive breastfeeding within 6 months postpartum by changing their misconceptions,strengthening guidance in the early stages of breastfeeding,paying attention to postpartum depression,and encouraging family members’support.