摘要
目的 探讨产科护士视角下产妇住院期间母乳喂养实践的障碍因素，为母乳喂养实施与推广提供参考。方法 采用立意抽样法，选取广州市2家二级甲等爱婴医院产科护士12人进行半结构式深入访谈，运用Colaizzi现象学七步分析法对资料进行分析、提炼主题。结果 提炼出4个主题、7个次主题：①医务人员及家属对母乳喂养的重视不足和认知不到位；②多因素影响产妇产后母乳喂养的意愿（含影响休息、喂养疼痛、缺乏家庭支持）；③母乳喂养健康教育落实存在障碍（人力缺乏、产科周转快、重理论轻实践）；④护士解决母乳喂养问题的能力与用具不足。结论 为克服当前母乳喂养的障碍，需调整医务人员及家属对母乳喂养的认知与重视程度，创新母乳喂养知识在医务人员与产妇家属中的培训模式，提高产科医务人员及家属支持母乳喂养的能力。建议从政府、医院、家庭等多维度营造母乳喂养实施环境，积极探索便于母乳喂养的工具与方法，为母乳喂养提供便利。
关键词： 产科护士；母乳喂养；障碍；质性研究
Abstract
Objective To explore the barriers to breastfeeding practice during maternal hospitalization from the perspective of obstetric nurses, and to provide references for the implementation and promotion of breastfeeding. Methods Using purposive sampling, 12 obstetric nurses from two grade 2 class-A Baby Friendly Hospitals in Guangzhou were selected for semi-structured in-depth interviews. The Colaizzi’s seven-step phenomenological analysis method was used to analyze the data and extract themes. Results Four themes and seven sub-themes were identified: (1) Insufficient attention and inadequate cognition of breastfeeding among medical staff and family members; (2) Multiple factors affecting postpartum women’s willingness to breastfeed (including impaired rest, breastfeeding pain, and lack of family support); (3) Barriers to the implementation of breastfeeding health education (lack of manpower, rapid turnover in obstetrics, emphasis on theory over practice); (4) Insufficient competence and equipment among nurses to solve breastfeeding problems. Conclusion To overcome current barriers to breastfeeding, it is necessary to adjust the cognition and attention of medical staff and family members regarding breastfeeding, innovate training models for breastfeeding knowledge among healthcare providers and postpartum women’s families, and improve the ability of obstetric medical staff and family members to support breastfeeding. It is recommended to create a breastfeeding-friendly environment from multiple dimensions including government, hospital, and family, and to actively explore tools and methods that facilitate breastfeeding, thereby providing convenience for breastfeeding.
Key words： Obstetric nurses; Breastfeeding; Barriers; Qualitative research
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