Swanson关怀理论对母婴分离产妇乳汁分泌情况的影响

Influence of Swanson′ s theory of care on the milk secretion of mothers separated from their mothers

目的分析Swanson关怀理论对母婴分离产妇乳汁分泌情况的影响。方法将2017年1月~2018年12月重庆市妇幼保健院产科分娩的327例母婴分离产妇,根据随机数字表法分为Swanson组(163例)及对照组(164例),对照组产后予常规护理,Swanson组根据Swanson关怀理论进行照拂。对两组产妇的一般资料、乳汁分泌情况及产后72 h内的泌乳量进行比较,并根据产妇72 h内乳汁分泌量分为≥50 mL及<50 mL两组,对影响乳汁分泌的因素进行比较及Logistic回归分析。结果两组产妇一般资料比较,差异均无统计学意义(均P>0.05);Swanson组的乳汁始动时间、产后3 d乳房肿痛人数、状态-特质焦虑问卷(STAI)及爱丁堡产后抑郁量表(EPDS)评分均明显低于对照组,产后24 h、>24~48 h及>48~72 h泌乳量及产后42 d母乳喂养率均明显多于对照组(均P<0.05),分娩方式、产后24 h睡眠时间、产后2 h乳头刺激、24 h内挤奶次数、夜间挤奶次数、每次挤奶时间及EPDS评分、Swanson关怀理论均对乳汁分泌有显著影响(均P<0.05)。且logistic回归分析示Swanson关怀理论是促进产妇乳汁分泌的独立保护因素(OR=0.454,95%CI:0.221~0.932,P=0.031)。结论Swanson关怀理论能有效增加母婴分离产妇的乳汁分泌量,提高其产后母乳喂养率,有效改善产妇焦虑、紧张情绪。

Objective To analyze the influence of Swanson′s care theory on the milk secretion of maternal and child separation.Methods From January 2017 to December 2018,327 cases of Department of Obstetrics in Chongqing Maternal and Child Health Care Hospital were separated.Swanson group(163 cases)and control group(164 cases)were divided according to the random number table method.The control group received routine nursing,and Swanson group reeeived nursing based on Swanson′s care theory.The general information,milk secretion and milk volume within 72 h postpartum were compared between the two groups.According to the maternal milk secretion within 72 h,the patients were divided into two groups,≥50 mL and<50 mL,the factors influencing milk secretion were compared and Logistic analysis was conducted.Results There was no significant difference in general information between the two groups(all P>0.05).The milk starts in time,postpartum 3 d breast swelling pain number,status-trait anxiety questionnaire(STAI),Edinburgh postnatal depression scale(EPDS)score of Swanson group were significantly lower than the control group,the lactation volume at 24 h,>24-48 h and>48-72 h postpartum and the breastfeeding rate at 42 d postpartum were significantly higher than the control group(all P<0.05).The mode of delivery,sleep time 24 h postpartum,nipple stimulation 2 h postpartum,frequency of milking within 24 h,frequency of milking at night,time of milking each time and EPDS score all had significant effects on milk secretion(all P<0.05).Logistic regression analysis showed that Swanson care theory was an independent protective factor for maternal milk secretion(OR=0.454,95%CI:0.221-0.932,P=0.031).Conclusion Swanson′s care theory can effectively increase the milk secretion of maternal and child separation,improve the rate of postpartum breastfeeding,and effectively improve maternal anxiety and tension.