摘要
目的 探讨基于信息-动机-行为技巧模型（IMB模型）的干预对初产妇住院期间母乳喂养的影响。方法 选择2022年1~6月于广州市增城区妇幼保健院产科住院的初产妇作为研究对象，其中2022年1月~2022年3月纳入的121名初产妇为对照组，2022年4月~2022年6月纳入标准的134名初产妇为干预组。对照组给予常规护理，干预组在对照组基础上给予基于IMB模型的母乳喂养干预方案，比较两组产妇母乳喂养知识、自我效能以及纯母乳喂养率。结果 出院时干预组纯母乳喂养率高于对照组，差异有统计学意义（P＜0.05）。干预前两组母乳喂养知识得分比较，差异无统计学意义（P＞0.05），干预后干预组的母乳喂养知识得分高于对照组，差异有统计学意义（P＜0.05）。干预前两组母乳喂养效能比较，差异无统计学意义（P＞0.05），干预后干预组的母乳喂养效能高于对照组，差异有统计学意义（P＜0.05）。结论 基于IMB模型的干预可以提高产妇母乳喂养知识，增强母乳喂养自我效能，形成良好的喂养行为，提高纯母乳喂养率。
关键词： 信息-动机-行为技巧模型；初产妇；母乳喂养；影响
Abstract
Objective: Exploring the impact of interventions based on the Information-Motivation-Behavioral Skill Model (IMB model) on breastfeeding during hospitalization in primiparous women. Methods We selected primiparous women who were hospitalized in Zengcheng District maternity and child health hospital in Guangzhou from January to June 2022 as the research subjects. 121 primiparas included from January 2022 to March 2022 as the control group, and 134 primiparas included from April 2022 to June 2022 as the intervention group. The control group received routine care, while the intervention group received a breastfeeding intervention plan based on the IMB model on the basis of the control group. The breastfeeding knowledge, self-efficacy, and pure breastfeeding rate of the two groups of mothers were compared. Results The pure breastfeeding rate of the intervention group was higher than that of the control group at discharge, and the difference was statistically significant (P<0.05). Before the intervention, there was no statistically significant difference in the scores of breastfeeding knowledge between the two groups (P>0.05). After the intervention, the scores of breastfeeding knowledge in the intervention group were higher than those in the control group, and the difference was statistically significant (P<0.05). Before the intervention, there was no statistically significant difference in the effectiveness of breastfeeding between the two groups (P>0.05). After the intervention, the effectiveness of breastfeeding in the intervention group was higher than that in the control group, and the difference was statistically significant (P<0.05). Conclusion Interventions based on the IMB model can improve maternal breastfeeding knowledge, enhance breastfeeding self-efficacy, form good feeding behaviors, and increase the rate of pure breastfeeding.
Key words： Information-Motivation-Behavioral skills model; Primiparous women; Breast-feeding; Influence
参考文献 References
[1] 席俊彦,秦杨芬,贺莉萍.母乳喂养现状及影响因素[J].中国妇幼保健,2021,36(06):1460-1462.
[2] 国家卫生健康委员会.关于印发母乳喂养促进行动计划(2021-2025年)的通知[EB/OL].(2021-11-24)[2023-01-16].http://www.gov.cn/zhengce/zhengceku/2021-11/24/content_5653169.htm.
[3] UNICEF. From the First Hour of Life: Making the Case for Improved Infant and Young Child Feeding Everywhere. [R]. New York: NY: UNICEF., 2016a.
[4] 李玲,王小青,魏满荣等.中国6个月内婴儿纯母乳喂养影响因素Meta分析[J].中国妇幼保健,2021,36(22): 5359-5363.
[5] 张立芳,穆铭,聂蔚,宋书仪,高秋风,聂景春.奶粉推荐、试用对农村贫困地区0～6月龄婴幼儿母亲母乳喂养行为影响[J].中国公共卫生,2021,37(02):280-285.
[6] Fang Z, Liu Y, Wang H, Tang K, et al. The Patterns and Social Determinants of Breastfeeding in 12 Selected Regions in China: A Population-Based Cross-Sectional Study. J Hum Lact. 2020 Aug;36(3):436-447.
[7] Fisher JD, Fisher WA. Changing AIDS-risk behavior. Psychol Bull. 1992 May;111(3):455-74.
[8] 赵旻.北京地区初产妇母乳喂养自我效能及其影响因素的研究[D].中国协和医科大学, 2008.
[9] Dennis CL, Faux S. Development and psychometric testing of the Breastfeeding Self-Efficacy Scale. Res Nurs Health. 1999 Oct;22(5):399-409.
[10] Dennis CL. The breastfeeding self-efficacy scale: psychometric assessment of the short form. J Obstet Gynecol Neonatal Nurs. 2003 Nov-Dec;32(6):734-44.
[11] 刘延锦,王敏,董小方.中文版母乳喂养自我效能简式量表的信效度研究[J].中国实用护理杂志, 2016, 32(18): 1361-4.
[12] 吴建敏, 张胡, 杜勇. 信息-动机-行为技巧模型护理干预对初产妇纯母乳喂养的影响[J].实用妇科内分泌电子杂志,2020, 7(35): 114+7.
[13] 初剑英, 蒋宝, 高元鹏, 等. 基于信息-动机-行为技巧模型干预对初产妇纯母乳喂养效果评价研究[J].中华流行病学杂志, 2019, (12): 1639-40-41-42-43-44.
[14] Khullar N, Bhatti JS, Singh S, et al. Insight into the liver dysfunction in COVID-19 patients: Molecular mechanisms and possible therapeutic strategies. World J Gastroenterol. 2023 Apr 14;29(14):2064-2077.
[15] Renfrew MJ, McCormick FM, Wade A, et al. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev. 2012 May 16;5(5):CD001141.
[16] 孙小嫡,李智慧,孔燕等.基于助推理论的医院-社区-家庭三联动母乳喂养干预[J].护理学杂志,2023,38(09):81-84+90.
[17] Khan MMI, Kabir MR. Prevalence and Associated Factors of Early Cessation of Exclusive Breastfeeding Practice in Noakhali, Bangladesh: A Mixed-Method Study. J Pediatr Nurs. 2021 May-Jun;58:e44-e53.
[18] 李乡梅,朱怡雯,郝美佳.阴道分娩初产妇产后母乳喂养自我效能影响因素调查分析[J].护理实践与研究, 2020, 17(20): 81-83.
[19] 戴亚端,张小玲,汪小灵,石慧.基于IMB模型的初产妇及配偶双主体母乳喂养健康教育[J].护理学杂志,2021, 36(17):82-85.
[20] 邹琼洁,王良英,吴淑芳.集束化管理对无陪护病房新生儿的干预效果[J].护理实践与研究,2022,19(12):1833-1837.
[21] Wu SV, Chen SC, Liu HY, et al. Knowledge, Intention, and Self-Efficacy Associated with Breastfeeding: Impact of These Factors on Breastfeeding during Postpartum Hospital Stays in Taiwanese Women. Int J Environ Res Public Health. 2021 May 9;18(9):5009.
[22] 刘贤婷.多角度护理对降低产妇剖宫产率、提高产妇分娩自我效能感的作用[J].中国医药指南,2023,21(15):166-168.