社区初产妇母乳喂养自我效能调查及影响因素研究

Influencing Factors of Primiparas' Breastfeeding Self-efficacy in Community

目的调查社区初产妇母乳喂养自我效能的现状及影响因素,为促进母乳喂养的护理干预提供依据。方法 2013年12月—2014年3月采用统一问卷(一般情况调查表、新生儿喂养方法调查表、母乳喂养自我效能量表、母乳喂养知识问卷、社会支持量表、产后抑郁量表)对合肥市4所社区卫生服务中心访视的158名产后28 d内的初产妇进行母乳喂养自我效能及影响因素的调查研究。结果初产妇母乳喂养自我效能总分为(107.8±21.6)分,纯母乳喂养率为30.4%(48/158),纯母乳喂养初产妇母乳喂养自我效能总分为(126.5±14.4)分,均高于高比例、中比例、低比例母乳喂养者〔(111.4±16.1)、(92.2±14.4)、(72.3±17.3)分,P<0.05〕;不同的社会支持水平、产后抑郁程度、母乳喂养知识情况、爱人对母乳喂养的态度、和谁共同居住、产后开始哺乳时间及住院期间是否喂过奶粉的初产妇母乳喂养自我效能评分比较,差异均有统计学意义(P<0.05)。多元逐步回归分析显示,社会支持水平、产后抑郁程度、产后开始哺乳时间、住院期间是否喂过奶粉是母乳喂养自我效能的影响因素(标准化偏回归系数=0.338、-0.243、-0.233、0.155,P<0.05)。结论合肥地区社区初产妇产后28 d内母乳喂养自我效能总体处于中等水平,纯母乳喂养率低于国家标准,纯母乳喂养初产妇母乳喂养自我效能评分高于喂过奶粉的产妇,故医务人员应采取措施提升产妇母乳喂养效能,提高纯母乳喂养率。

Objective To investigate the current situation of primiparasˊ breastfeeding self - efficacy and its influencing factors. Methods From December 2013 to March 2014,unified questionnaires were used to investigate the self -efficacy of 158 primiparas who had breastfeeding within 28 d after delivery and its influencing factors in 4 community health service centers in Hefei. Results The total score of breastfeeding self - efficacy was（107. 8 ± 21. 6）,the rate of exclusive breastfeeding was 30. 4%（48 / 158）,the total score of breastfeeding self - efficacy was（126. 5 ± 14. 4）in primiparas who performed exclusive breastfeeding,higher than in those who performed breastfeeding at high proportion,at medium proportion, at low proportion〔（111. 4 ± 16. 1）, （92. 2 ± 14. 4）, （72. 3 ± 17. 3）,P 〈 0. 05〕. There was significant difference in breastfeeding self - efficacy between primiparas with different social supports,postpartum depression,breastfeeding knowledge, husbandsˊ attitude to breastfeeding, joint habitation, postpartum starting time of nursing, milk powder feeding during hospitalization（P 〈 0. 05）. Multiple regression analysis showed that social support,postpartum depression,postpartum lactation start time,milk powder feeding during hospitalization were influencing factors of primiparasˊ breastfeeding self - efficacy（ β =0. 338,- 0. 243,- 0. 233,0. 155,P 〈 0. 05）. Conclusion In Hefei district,the total score of self - efficacy of primiparas who have breastfeeding within 28 d after delivery is at middle level,the exclusive breastfeeding rate is lower than the national standard. The self - efficacy score of the primiparas who have exclusive breastfeeding is higher than those of the primiparas who have milk powder feeding.