基于母乳喂养三核心概念模型以哺乳顾问为主导的综合干预方案实施及效果评价  

Effect of the comprehensive intervention in lactation consultant-led Tri-Core Breastfeeding Conceptual Model

作　　者：周菲菲 王靖[1] 张俊平[1] 盛洁静[1] 盛佳[1] Zhou Feifei;Wang Jing;Zhang Junping;Sheng Jiejing;Sheng Jia(Obstetrics&Gynaecology Hospital,Fudan University,Shanghai 200092,China)

机构地区：[1]复旦大学附属妇产科医院,上海200092

出　　处：《现代临床护理》2021年第11期27-33,共7页Modern Clinical Nursing

基　　金：上海市卫健委面上项目,项目编号为201640322;复旦大学-复星护理科研基金,项目编号为FNF202033。

摘　　要：目的探讨基于母乳喂养三核心概念模型哺乳顾问为主导的综合干预方案对改善母乳喂养结局的影响。方法采用前后对照研究方法,通过方便抽样法,选取200例在上海某三级甲等专科医院建档的孕妇作为研究对象,其中2019年7月—8月建档符合纳入标准的100例孕妇设为对照组,2019年9月—10月建档符合纳入标准的100例孕妇设为试验组。对照组由产科护士采用常规母乳喂养支持管理,试验组在对照组基础上,实施由国际认证哺乳顾问(international board certified lactation consultant,IBCLC)负责的基于母乳喂养三核心概念模型的综合干预方案进行母-婴母乳喂养管理。比较两组产妇出院时至产后6个月纯母乳喂养率、哺乳问题发生率、母乳喂养自我效能得分情况。结果试验组98例完成研究,对照组92例完成研究。试验组出院时,产后42d、3个月、6个月纯母乳喂养率均高于对照组,哺乳问题发生率均低于对照组(均P<0.05),产妇出院时母乳喂养自我效能得分略高于对照组(P<0.05)。结论基于母乳喂养三核心概念模型以哺乳顾问为主导的综合干预方案可以有效提高纯母乳喂养率与减少哺乳问题的发生。Objective To explore the impact of the lactation consultant-led Tri-Core Breastfeeding Model in comprehensive intervention on the outcomes of breastfeeding.Methods In this comparative study,a total of 200 pregnant women who had registered in a tertiary hospital in Shanghai between July and October,2019 were included according to the inclusion criteria by convenient sampling method:the 100 women who were included between July and August were assigned as the control group and the other 100 women who were included between September and October were assigned as the intervention group.The control group was supported with routine breastfeeding programs by obstetric nurses,while the intervention group was managed with the Tri-Core Breastfeeding Model for compre hensive intervention led by a certified lactation consultants(IBCLC)in addition to the same support received by the control group.The two groups were compared with the rate of exclusive breastfeeding,breastfeeding problems and scores of breastfeeding self-efficacy.Results A total of 98 women completed all follow-ups in the intervention group,and that was 92 in the control group.At the time of discharge,on 42 days,in 3 months and 6 months,the rates of exclusive breastfeeding in the intervention group were significantly higher than that of the control group(P<0.05),with significantly lower rates in breastfeeding problems than that in the control group(P<0.05).At discharge,the score of self-efficacy breastfeeding in the intervention group was slightly higher than that in the control group(P<0.05).Conclusions The lactation consultant led Tri-Core Breastfeeding Model for comprehensive intervention could effectively increase the rate of breastfeeding and reduce the problems in breastfeeding.

关 键 词：母乳喂养 三核心概念模型 国际认证泌乳顾问 

分 类 号：R473.71[医药卫生—护理学]