剖宫产术后产妇母乳喂养影响因素的调查研究

An exploration of the breastfeeding behaviors of women aftercesarean section: A qualitative study

目的探究影响剖宫产术后产妇母乳喂养行为的因素。方法本研究采用半结构式访谈,于2019年7月至9月在中国1所妇女儿童医院,对19名接受剖宫产术后的产妇进行面对面访谈。信息饱和用来确定样本量的大小。依据计划行为理论提炼主题,并采用主题内容分析法进行数据分析。结果13例(68.42%)剖宫产是计划剖宫产,6例(31.58%)剖宫产是非计划或紧急剖宫产。本研究分析得出3个主题:对母乳喂养的矛盾态度、遵守传统文化规范以及障碍和挑战。促进剖宫产后母乳喂养的因素包括感知到母乳的益处,医疗保健专业人员的支持和母乳喂养的责任。剖宫产后母乳喂养所面临的挑战包括:身体不适、母乳喂养知识技能缺乏、泌乳不足以及缺乏管理剖宫产后抑郁情绪的知识和应对技能。有一些中性因素,如家庭和同伴的影响,这些因素可能对产妇产生积极的促进作用,也可能产生消极的障碍作用。结论这些发现可以为医护人员提供有价值的信息,以帮助剖宫产术后产妇进行母乳喂养。要促进母乳喂养行为,重要的是要改变产妇的态度、信仰体系和她们所居住的外部环境,并帮助她们更加自信。

Objectives:To explore the factors affecting breastfeeding behaviors in women after cesarean section.Methods:This is a qualitative study that used a phenomenological approach.This study used individual face-to-face interviews with 19 women who underwent a cesarean section in a Women and Children’s Hospital in China between July to September 2019.Information saturationwas used to determine sample size.Data were analyzed using a thematic content analysis method.Themes were developed based on the theory of planned behavior.Results:Thirteen(68.42%)had a planned cesarean section,and six(31.58%)cesarean sections were unplanned or emergent.Three major themes emerged:ambivalent attitude about breastfeeding,motivation to comply with the traditional cultural norms,and barriers and challenges.The motivating factors for breastfeeding after cesarean sections included perceived benefits of human milk,support from healthcare professionals,and responsibility for breastfeeding.The challenges for breastfeeding after cesarean sections included physical discomfort,knowledge and skills deficit of breastfeeding,lactation deficiency,and lack of knowledge and coping skills in managing their depressive mood after cesarean sections.There were a couple of neutral factors,such as the influences of family and peers.These factors could influence women either positively as facilitators or negatively as barriers.Conclusions:The findings can offer valuable information for healthcare professionals to help women breastfeed after cesarean sections.To promote women’s breastfeeding behaviors after cesarean sections,it is necessary to change women’s attitudes,belief systems,and the external environments and help them become more confident.