| 摘要: | 背景：母乳哺育對新生兒及母親健康有極大益處，然而達到成功母乳哺育並非容易。產後婦女往往因缺乏母乳哺育知能或專業人員支持而影響持續母乳哺育之實踐，因此發展有效的產前母乳教育課程，提升孕產婦女的母乳哺育自我效能乃是母嬰健康重要議題。
目的：探討以自我效能理論為基礎的母乳教育方案對母乳哺育自我效能及母乳哺育結果之成效。
方法：本研究採用臨床隨機試驗研究，研究對象為北部某教學區域醫院懷孕初產婦女，以隨機分派受試者進入實驗組，接受以自我效能理論為基礎的產前母乳教育課程，控制組婦女則接受一般母乳常規衛教照護。研究資料採多點時間重複測量，包括基線資料、第三孕期、產後一週及產後一個月等四個時間點的資料收集。研究工具包括母乳哺育自我效能量表 (Breastfeeding self-efficacy scale-Short Form)、母乳哺育態度量表 (Iowa Infant Feeding Attitude Scale)、情境焦慮量表 (State Anxiety Inventory)、親子同室率及產後一週及四週母乳哺育率。統計方式包括描述性統計及Mixed effect model 分析介入之成效。
結果：共收案93位婦女，其中實驗組50人、控制組43位初產婦，平均年齡為33歲 (Standard Deviation, SD=4.1)，多為已婚、大學畢業。二組婦女在介入措施前的基線值各項測量指標無顯著差異 (p>0.05)。接受產前母乳教育方案後，比較第三孕期、產後一週及四週的測量值，實驗組懷孕婦女具有較高的母乳哺育自我效能分數(ps<0.001)、較高的母乳哺育態度分數 (ps<0.001)，其情境焦慮分數低於控制組 (ps<0.05)。實驗組婦女比對照組婦女在住院期間有較高的親子同室比率 (34% vs 20%)比較對照組，實驗組婦女有較高的產後一週純母乳率 (60% vs 48.8%)及產後一個月純母乳率(28% vs 14%)。
結論：產前母乳教育方案有效提升母乳哺育自我效能、母乳哺育態度，降低焦慮情形，並有效提升產後一個月純母乳哺育率。本研究結果可提供未來規劃母乳哺育課程之參考，以提升母嬰健康結果與母乳哺育臨床實務之應用。
Background：Health benefits of breastfeeding for infants and mothers are well established, but achieving successful breastfeeding may be challenged for mothers and their family. Postpartum women often reported lack of breastfeeding knowledge, confidence, or professional support during breastfeeding. It is thus vital to develop an effective prenatal breastfeeding education program to empower mothers’ breastfeeding self-efficacy for optimal maternal and child health outcomes.
Aim：To evaluate the effects of theory-based breastfeeding education programs on breastfeeding self-efficacy and breastfeeding outcomes.
Methods：A randomized clinical trial was conducted among pregnant women at a teaching hospital in Taipei. Block randomization was used to allocate participants to either the intervention group receiving a theory-based prenatal breastfeeding education program or the control group receiving usual breastfeeding care. Repeated measurement was undertaken for data collection at baseline, third trimester, postpartum 1 week, and 1 month, respectively. Breastfeeding efficacy, anxiety symptoms, and breastfeeding attitude were measured using breastfeeding self-efficacy scale-Short Form, state anxiety subscale of the State-Trait Anxiety Inventory, and Iowa Infant Feeding Attitude Scale, respectively. Rooming-in were collected using medical chart. The breastfeeding outcomes were obtained using interview. Descriptive statistics and inferential statistics, mixed effect model were used to estimate the effects of breastfeeding intervention.
Results：A total of 93 primipara mothers were included in this study. Women in the intervention group (n=50) had significantly better higher scores of breastfeeding self-efficacy (ps<0.001), breastfeeding attitude (ps < 0.001), and lower anxiety score (p <0.5) than the ones in control group (n=43) (p = 0.02) in the post-intervention measurements. Women in intervention group also had higher rates of rooming-in than women in the control group. Compared to control group, mothers in the intervention group had higher exclusive breastfeeding rates at postpartum 1 week (60% vs 48.8%) and 1 month (28% vs 14%).
Conclusion：The theory-based breastfeeding program is effective in improving breastfeeding self-efficacy, breastfeeding attitude, and anxiety symptoms in mothers. Our findings provide empirical evidence for future breastfeeding program and health care for the health of women and their families. |
