护理SCI晨读:教育和支持干预的对初产妇母乳喂养相关结局和母乳喂养自我效能方面的有效性:系统评价和meta分析

2021
02/09

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NursingResearch护理研究前
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护理SCI晨读:

教育和支持干预的对初产妇母乳喂养相关结局和母乳喂养自我效能方面的有效性:系统评价和meta分析

 

 


 

 


摘要

背景

母乳是婴儿最营养的食品,可帮助婴儿成长并保护他们免受感染。促进母乳喂养是婴儿健康的重要课题。目前大量研究针对产前,产后或这两个时期提出了各种干预措施的教育和支持方法,以促进和维持纯母乳喂养。这项系统评价旨在确定有效的教育和支持性干预措施,以改善母乳喂养。

目的

考察教育和支持性干预措施不同方法的效果,这些方法可以帮助维持母乳喂养并提高产后初产妇女的母乳喂养自我效能;并确定有效干预措施的主要特征,包括实施时间,形式和方式,主要组成部分,理论框架的使用以及会议次数。

方法

搜索了11篇符合条件的文章的电子数据库和参考列表。确定了最近20年以英语和汉语发布的教育和支持性干预措施的随机对照试验,并根据审查标准进行筛选。评估纳入研究的偏倚风险。主要结局指标为纯母乳喂养和部分母乳喂养率。次要结果包括母乳喂养的自我效能,母乳喂养知识和其他与母乳喂养有关的结果。产后≤2个月,3-5个月和≥6个月进行meta分析。

结果

纳入符合纳入标准的13篇文章,显示出可接受的偏见风险。发现教育和支持性干预措施可有效提高≤2个月和6个月的纯母乳喂养率,≤2个月的部分母乳喂养率以及增强母乳喂养自我效能。干预措施的最佳时间,形式和结构包括:(a)从产前到产后分娩;(b)纳入产前团体教育,产后个人母乳喂养辅导和电话跟进的多方面内容;(c)个人和团体;(d)以自我效能感理论为指导;(e)进行至少3次训练。

结论

研究结果表明,在产前和产后,通过面对面的教学和电话随访进行≥3次的多成分,基于理论的干预,可以有效地增强6个月以上的纯母乳喂养,以及产后2个月部分母乳喂养和母乳喂养自我效能的疗效。

 


 

 


英文摘要

Background

Breastmilk is the most nutritious food for infants to support their growth and protect them from infection. Breastfeeding promotion is an important topic for infant health; and different educational and supportive approaches to interventions have been prompted and targeted at antenatal, postnatal or both periods to promote and sustain exclusive breastfeeding. This systematic review aimed to identify the effective approaches to educational and supportive interventions to improve breastfeeding.

Objective

To examine the effects of different approaches to educational and supportive interventions that can help sustain breastfeeding and improve breastfeeding self-efficacy for primiparous postnatal women; and to identify key characteristics of the effective interventions in terms of delivery time, format and mode, main components, use of theoretical framework, and number of sessions.

Methods

Eleven electronic databases and reference lists of the eligible articles were searched. Randomised controlled trials of educational and supportive interventions published in English and Chinese language over recent 20 years were identified and screened against the review criteria. Risk of bias of the included studies was assessed. Primary outcome measures were exclusive breastfeeding and partial breastfeeding rate. Secondary outcomes included breastfeeding self-efficacy, breastfeeding knowledge and other breastfeeding related outcomes. Meta-analysis was performed in terms of ≤2 months, 3-5 months and ≥6 months postpartum.

Results

Thirteen articles that met the inclusion criteria were included and showed an acceptable risk of bias. Educational and supportive interventions were found effective in increasing exclusive breastfeeding rate at ≤2 months and 6 months, partial breastfeeding rate as well as enhancing breastfeeding self-efficacy at ≤2 months. The optimal delivery time, format and structure of the interventions included: (a) delivering from antenatal to postnatal period; (b) multicomponent involving antenatal group education, postnatal individual breastfeeding coaching and telephone follow-ups; (c) both individual and group basis; (d) being guided by self-efficacy theory; and (e) having ≥3 sessions.

Conclusions

The findings suggest multicomponent, theory-based intervention with ≥3 sessions delivered via both face-to-face teaching and telephone follow-ups across antenatal and postnatal period can be effective to enhance exclusive breastfeeding over 6-month, partial breastfeeding and breastfeeding self-efficacy over 2-month postpartum.

 

原文链接:

https://www.sciencedirect.com/science/article/abs/pii/S0020748921000067


本文由作者自行上传,并且作者对本文图文涉及知识产权负全部责任。如有侵权请及时联系(邮箱:nanxingjun@hmkx.cn
关键词:
母乳喂养,初产妇,干预,护理,方法

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