中华护理杂志 ›› 2024, Vol. 59 ›› Issue (16): 1933-1941.DOI: 10.3761/j.issn.0254-1769.2024.16.002
收稿日期:2023-10-07
出版日期:2024-08-20
发布日期:2024-08-12
*通讯作者:
杨丽,E-mail:gxyangli622@sohu.com。作者简介:周芸:女,本科(硕士在读),主管护师,2409393625@qq.com
基金资助:
ZHOU Yun(
), YANG Li(
), LING Jing, WEI Xiaoming, HUANG Luyao, QIN Pengjing
Received:2023-10-07
Online:2024-08-20
Published:2024-08-12
摘要:
目的 探讨以泌乳生理为理论基础的基于互联网+全程母乳喂养支持的护理干预对剖宫产产妇纯母乳喂养的影响。 方法 采用便利抽样法,选取2022年7月—2023年2月在南宁市某三级甲等医院产科产检至分娩的198名产妇作为研究对象,试验组与对照组每组各纳入99名产妇。试验组采用基于互联网+全程母乳喂养支持的护理干预,对照组采用常规护理干预。比较两组6个月内纯母乳喂养率、产后3 d内哺乳或挤奶频率、乳头疼痛发生率、母乳喂养知识和母乳喂养自我效能得分的差异。 结果 两组研究对象未出现脱落。试验组产后3 d、14 d、42 d、4个月及6个月的纯母乳喂养率均高于对照组(P<0.05),不同时间点比较,组间效应、时间效应、交互效应均具有统计学意义(P<0.05);两组按是否母婴分离进行分层分析,试验组产后42 d、4个月及6个月的纯母乳喂养率均高于对照组(P<0.05)。试验组产后3 d内哺乳或挤奶频率、乳头疼痛发生率、母乳喂养知识和母乳喂养自我效能得分均高于对照组(P<0.05)。 结论 以泌乳生理为理论基础的基于互联网+全程母乳喂养支持的护理干预能提高剖宫产产妇泌乳行为的依从性,促进泌乳建立,从而显著提高其6个月内的纯母乳喂养率。
周芸, 杨丽, 凌静, 韦小明, 黄璐瑶, 覃彭静. 基于互联网+全程母乳喂养支持的护理干预在剖宫产产妇中的应用研究[J]. 中华护理杂志, 2024, 59(16): 1933-1941.
ZHOU Yun, YANG Li, LING Jing, WEI Xiaoming, HUANG Luyao, QIN Pengjing. Research on the application of nursing intervention of Internet + whole course breastfeeding support in cesarean section women[J]. Chinese Journal of Nursing, 2024, 59(16): 1933-1941.
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表3 两组产妇不同时间点纯母乳喂养率的比较[名(百分比,%)]
Table 3 Comparison of the rate of exclusive breastfeeding between the 2 groups at different time points[cases (percent,%)]
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表4 两组母婴同室产妇不同时间点纯母乳喂养率的比较[名(百分比,%)]
Table 4 Comparison of the rate of exclusive breastfeeding between the 2 groups of mother and child in the same room at different time points[cases (percent,%)]
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表5 两组母婴分离产妇不同时间点纯母乳喂养率的比较[名(百分比,%)]
Table 5 Comparison of the rate of exclusive breastfeeding between the 2 mother-infant separation groups at different time points[cases (percent,%)]
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