产妇产后母乳喂养自我效能现状调查及影响因素分析

Current self-efficacy and its influencing factors analysis of breastfeeding among puerperas after delivering

目的：调查产后母乳喂养自我效能现状及其影响因素，为临床制定干预措施提供科学依据。方法采用一般资料问卷、抑郁自评量表、社会支持评定量表、母乳喂养知识量表、母乳喂养自我效能简式量表，对上海市第一妇婴保健院产科2014年5—9月815名分娩后产妇进行问卷调查，对影响母乳喂养自我效能的因素进行单因素和多元回归分析。结果815名产妇产后抑郁自评量表评分为25~71分，平均（44.14±8.865）分；社会支持量表评分为23~63分，平均（43.03±6.428）分。母乳喂养知识量表评分为51~125分，平均（99.40±12.299）分；母乳喂养自我效能简式量表评分为14~70分，平均（49.73±10.713）分。单因素分析显示，不同家庭收入、分娩方式、分娩次数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）。相关分析显示，产妇产后母乳喂养自我效能与产后抑郁呈负相关（P〈0.01），与社会支持水平、母乳喂养知识了解情况均呈正相关（P〈0.01）；多元回归分析得出母乳喂养自我效能的预测因素有分娩方式、住院期间使用奶瓶、住院期间每天吸吮次数、打算选择喂养方式、计划母乳喂养时间、产后抑郁、社会支持水平。结论本组产妇母乳喂养自我效能水平处于中等水平，医疗机构可针对相关影响因素制定干预措施，进一步提高母乳喂养自我效能水平，从而提高母乳喂养率，促进母婴健康。

Objective To investigate current self-efficacy and its influencing factors of breastfeeding among puerperas after delivering, so as to provide scientific evidence for formulating interventions. Methods The general information questionnaire, self-rating depressive scale （SDS）, social support revalued scale （ SSRS） , breast feeding knowledge scale, breastfeeding self-efficacy scale-short form were used to survey 815 delivered puerperas in Shanghai First Maternity and Infant Hospital from May to September 2014, and the influencing factors of breastfeeding self efficacy had been carried out single factor analysis and multiple regression analysis. Results The scores of SDS for 815 puerperas were from 25 to 71 with average score （44. 14 ± 8. 865）;the scores of SSRS were from 23 to 63 with average score （43. 03 ± 6. 428）; the scores of breastfeed knowledge scale were from 51 to 125 with average score （ 99. 40 ± 12. 299 ）; the scores of breastfeeding self-efficacy scale-short form were from 14 to 70 with average score （49. 73 ± 10. 713）. The correlation analysis represented that the breastfeeding self-efficacy for delivered pureperas was negatively correlated with postpartum depression （P〈0. 01）, but it was positively correlated with SSRS and breastfeeding knowledge （P〈0. 01）;multiple regression analysis obtained that predictive factors of breastfeeding self-efficacy included delivery method, using feeding bottle during hospitalization, sucking frequency everyday during hospitalization, planned feeding method, planned length of breastfeeding, postpartum depression, and social support level. Conclusions The level of breastfeeding self-efficacy of this group is in medium level, so medical department can focus on these influencing factors to take targeted actions to improve the breastfeeding self-efficacy, then enhance breastfeeding rate to protect the health of mothers and infants.