NICU住院早产儿母乳喂养影响因素研究

Research on influencing factors of breastfeeding for premature infants in NICU

目的：探讨影响NICU住院早产儿母乳喂养的相关因素。方法选取100例早产儿,采用一般资料调查问卷、疾病不确定感父母量表、焦虑和抑郁自评量表等进行测评,收集可能影响其母乳喂养的变量。结果将NICU住院早产儿分为纯母乳喂养49例和非母乳喂养51例两组,进行比较发现,两组早产儿的出生胎龄、出生体重、母亲的产假时间、是否做出母乳喂养计划、是否了解早产儿母乳喂养的重要性、是否接受过母乳喂养的帮助与指导、是否对母乳喂养充满信心、爱人对母乳喂养的态度、乳头情况、产后半小时内开奶、24 h挤奶次数、焦虑评分、抑郁评分和疾病不确定感评分差异均有统计学意义（P〈0.05）；Logistic回归分析的结果显示：疾病不确定感（OR=1.083,P=0.044）、抑郁（OR=1.059,P=0．023）、爱人对母乳喂养的态度（OR=0.099,P=0.022）、接受母乳喂养的帮助与指导（OR=0.055,P=0．038）和产后半小时内开奶（OR=0.020,P=0.007）是 NICU 住院早产儿母乳喂养的重要影响因素。结论 NICU住院早产儿的母乳喂养受疾病不确定感、抑郁、爱人对母乳喂养的态度、接受母乳喂养的帮助与指导和产后半小时内开奶等多种因素影响,应通过评估及时进行干预,从而促进母婴健康。

Objective To explore the influencing factors of breastfeeding for premature infants in neonatal intensive care unit （ NICU ） . Methods Totally 100 premature infants hospitalized in NICU were evaluated by the general information questionnaire, parents′ perception uncertainty scale-family （PPUS-FM）, self-rating anxiety scale （ SAS ） and self-rating depression scale （ SDS ） . The variables may influence breastfeeding were collected.Results Premature infants in NICU were divided into the pure breastfeeding group （ 49 cases） and the non-breastfeeding group （ 51 cases） . Through the comparison, we found that the differences in gestational age, birth weight, mother′s maternity leave time, whether mothers have the breastfeeding plan, whether they know the importance of breastfeeding for premature infants, whether they accept the guidance and help of breastfeeding, whether they have confidence in breastfeeding, lover′s attitude to breastfeeding, nipple condition, the time of milking in 30 minutes after child birth and milking time within 24 h, anxiety score, depression score and uncertainty in illness （P〈0.05）. Logistic regression analysis showed that： uncertainty in illness （OR=1.083,P=0.044）, depression （OR=1.059,P=0.023）, lover′s attitude to breastfeeding （OR=0. 099,P=0.022）, accept assistance and guidance of breastfeeding （OR=0.055,P=0.038） and milking in 30 minutes after child birth （ OR=0. 020, P=0. 007 ） were important influencing factors of breastfeeding for premature infants in NICU. Conclusions The uncertainty in illness, depression, lover′s attitude to breastfeeding, accept assistance and guidance of breastfeeding, and began milking in 30 minutes may affect the breastfeeding in premature infants. Nurses should take timely risk assessment and interventions to effectively improve infant′s breastfeeding measures, and promote the health of maternals and children.