基于信息–知识–信念–行为模式的个性化护理干预对超重产妇泌乳启动的影响
The Effect of a Personalised Nursing Intervention Based on an Information-Knowledge-Attitude-Practice Model on Initiation of Lactation in Overweight Mothers
DOI: 10.12677/acm.2025.1551491, PDF,   
作者: 李澳雪, 桂周莉, 谷勤燕, 黄一琴：南华大学护理学院，湖南 衡阳；廖红伍*：南华大学附属南华医院基础护理教研室，湖南 衡阳；核工业卫生学校基础护理教研室，湖南 衡阳；杨 叶：南华大学护理学院，湖南 衡阳；常德市第一人民医院重症医学科，湖南 常德
关键词: 信息–知识–信念–行为理论；超重；泌乳启动；母乳喂养；Information-Knowledge-Attitude-Practice Theory； Overweight； Lactation Initiation； Breastfeeding
摘要: 目的：探讨基于信息–知识–信念–行为(Information-Knowledge-Attitude-Practice, IKAP)模式的个性化护理干预对超重产妇泌乳启动的影响。方法：采取方便抽样的方法，选取2023年4月~12月在衡阳市某三级甲等医院建档立卡并分娩后的120名超重产妇作为研究对象，根据入院时间分为对照组(60例)和观察组(60例)。对照组实施常规的护理干预，观察组在常规护理的基础上实施基于IKAP的个性化护理干预，比较两组产妇在干预前后母乳喂养简化量表、泌乳启动率及纯母乳喂养率得分的变化。结果：观察组母乳喂养简化量表得分高于对照组，差异具有统计学意义(P < 0.001)；观察组产后72 h泌乳启动率高于对照组，观察组产后7天、3个月、6个月纯母乳喂养率高于对照组，差异均具有统计学意义(P < 0.05)。结论：基于IKAP模式的个性化护理干预能够显著提升超重产妇母乳喂养自我效能水平，提高其母乳喂养技能、泌乳启动率及纯母乳喂养率。
Abstract: Objective: This study explores the impact of personalized nursing interventions based on the Information-Knowledge-Attitude-Practice (IKAP) model on the initiation of lactation in overweight parturients. Methods: Adopting a convenience sampling method, 120 overweight women who were enrolled and delivered after delivery in a tertiary hospital in Hengyang City from April to December 2023 were selected as the study subjects, and were divided into a control group (60 cases) and an observation group (60 cases) according to the time of admission to the hospital. The control group implemented conventional nursing interventions, and the observation group implemented IKAP-based personalised nursing interventions based on conventional nursing care, comparing the changes in breastfeeding simplification scale, lactation initiation rate and exclusive breastfeeding rate scores before and after the interventions in the two groups. Results: The observation group scored higher than the control group on the Breastfeeding Simplicity Scale, and the difference was statistically significant (P < 0.001); the initiation rate of lactation in the observation group was higher than that of the control group in the 72 h postpartum period, and the rate of exclusive breastfeeding in the observation group was higher than that of the control group in the 7-day, 3-month, and 6-month postpartum periods, and the difference was statistically significant in all of these cases (P < 0.05). Conclusion: Individualised nursing interventions based on the IKAP model can significantly increase the level of breastfeeding self-efficacy, breastfeeding skills, lactation initiation and exclusive breastfeeding rates in overweight women.
文章引用：李澳雪, 桂周莉, 谷勤燕, 廖红伍, 黄一琴, 杨叶. 基于信息–知识–信念–行为模式的个性化护理干预对超重产妇泌乳启动的影响[J]. 临床医学进展, 2025, 15(5): 1275-1283. https://doi.org/10.12677/acm.2025.1551491

参考文献

[1] 陈霞, 袁云兰, 张焱, 等. 孕前超重肥胖者妊娠期增重过度对妊娠结局和新生儿情况的影响[J]. 上海预防医学, 2024, 36(3): 255-261.
[2] 张莹莹, 蒲丛珊, 王义婷, 等. 孕前体质量指数和孕期体质量增加对早期母乳喂养行为建立的影响[J]. 中国护理管理, 2022, 22(10): 1503-1508.
[3] Ballesta-Castillejos, A., Gomez-Salgado, J., Rodriguez-Almagro, J., Ortiz-Esquinas, I. and Hernandez-Martinez, A. (2020) Relationship between Maternal Body Mass Index with the Onset of Breastfeeding and Its Associated Problems: An Online Survey. International Breastfeeding Journal, 15, 1-13. [Google Scholar] [CrossRef] [PubMed]
[4] Spatz, D.L., Rodríguez, S.Á., Benjilany, S., Finderle, B., von Gartzen, A., Yates, A., et al. (2024) Having Enough Milk to Sustain a Lactation Journey: A Call to Action. Nursing for Women’s Health, 28, 256-263. [Google Scholar] [CrossRef] [PubMed]
[5] Prentice, A.M. (2022) Breastfeeding in the Modern World. Annals of Nutrition and Metabolism, 78, 29-38. [Google Scholar] [CrossRef] [PubMed]
[6] Haas, M.R.C., Landry, A. and Joshi, N. (2020) Breast Practices: Strategies to Support Lactating Emergency Physicians. Annals of Emergency Medicine, 75, 681-690. [Google Scholar] [CrossRef] [PubMed]
[7] 张玉敏, 汪元浚. IKAP模式在健康教育应用中的研究进展[J]. 临床医学进展, 2021, 11(4): 1975-1980.
[8] Dennis, C. (2003) The Breastfeeding Self‐Efficacy Scale: Psychometric Assessment of the Short Form. Journal of Obstetric, Gynecologic & Neonatal Nursing, 32, 734-744. [Google Scholar] [CrossRef] [PubMed]
[9] 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): 1361-1364.
[10] Pang, W.W. and Hartmann, P.E. (2007) Initiation of Human Lactation: Secretory Differentiation and Secretory Activation. Journal of Mammary Gland Biology and Neoplasia, 12, 211-221. [Google Scholar] [CrossRef] [PubMed]
[11] 袁水琴, 李秋芳, 徐鑫芬. 早产儿母亲泌乳启动延迟影响因素的研究进展[J]. 中国护理管理, 2019, 19(8): 1244-1247.
[12] Farah, E., Barger, M.K., Klima, C., Rossman, B. and Hershberger, P. (2021) Impaired Lactation: Review of Delayed Lactogenesis and Insufficient Lactation. Journal of Midwifery & Women’s Health, 66, 631-640. [Google Scholar] [CrossRef] [PubMed]
[13] Fok, D., Aris, I., Ho, J., Chan, Y., Rauff, M., Lui, J., et al. (2019) Early Initiation and Regular Breast Milk Expression Reduces Risk of Lactogenesis II Delay in at-Risk Singaporean Mothers in a Randomised Trial. Singapore Medical Journal, 60, 80-88. [Google Scholar] [CrossRef] [PubMed]
[14] 方晋. 中国母乳喂养影响因素调查报告(会议版) [R]. 北京: 中国发展研究基金会, 2019: 1-11.
[15] Sattari, M., Serwint, J.R. and Levine, D.M. (2019) Maternal Implications of Breastfeeding: A Review for the Internist. The American Journal of Medicine, 132, 912-920. [Google Scholar] [CrossRef] [PubMed]
[16] Shafaei, F.S., Mirghafourvand, M. and Havizari, S. (2020) The Effect of Prenatal Counseling on Breastfeeding Self-Efficacy and Frequency of Breastfeeding Problems in Mothers with Previous Unsuccessful Breastfeeding: A Randomized Controlled Clinical Trial. BMC Women’s Health, 20, Article No. 94. [Google Scholar] [CrossRef] [PubMed]
[17] Pezley, L., Cares, K., Duffecy, J., Koenig, M.D., Maki, P., Odoms-Young, A., et al. (2022) Efficacy of Behavioral Interventions to Improve Maternal Mental Health and Breastfeeding Outcomes: A Systematic Review. International Breastfeeding Journal, 17, Article No. 67. [Google Scholar] [CrossRef] [PubMed]
[18] Grant, A., Pell, B., Copeland, L., Brown, A., Ellis, R., Morris, D., et al. (2022) Views and Experience of Breastfeeding in Public: A Qualitative Systematic Review. Maternal & Child Nutrition, 18, e13407. [Google Scholar] [CrossRef] [PubMed]
[19] Miller, J.D., Collins, S.M., Boateng, G.O., Widen, E.M., Natamba, B., Achoko, W., et al. (2022) Pathways Linking Social Support, Self-Efficacy, and Exclusive Breastfeeding among Women in Northern Uganda. Global Public Health, 17, 3506-3518. [Google Scholar] [CrossRef] [PubMed]
[20] 陈锡红, 李萍. 集中群组保健模式对产妇母乳喂养自我效能及知信行水平的影响[J]. 当代护士(中旬刊), 2022, 29(9): 35-38.
[21] Mullen, A.J., O’Connor, D.L., Hanley, A.J., Piedimonte, G., Wallace, M. and Ley, S.H. (2022) Associations of Metabolic and Obstetric Risk Parameters with Timing of Lactogenesis II. Nutrients, 14, Article 876. [Google Scholar] [CrossRef] [PubMed]
[22] 叶萍珍. 产后早期泌乳启动联合个性化护理对初产妇产后乳汁分泌及母乳喂养率的影响[J]. 实用中西医结合临床, 2021, 21(22): 153-154.
[23] Čatipović, M. (2023) Parental Breastfeeding Behavior and Attitude Questionnaire. Acta Clinica Croatica, 62, 45-57. [Google Scholar] [CrossRef] [PubMed]
[24] Dukuzumuremyi, J.P.C., Acheampong, K., Abesig, J. and Luo, J. (2020) Knowledge, Attitude, and Practice of Exclusive Breastfeeding among Mothers in East Africa: A Systematic Review. International Breastfeeding Journal, 15, Article No. 70. [Google Scholar] [CrossRef] [PubMed]
[25] Huang, P., Yao, J., Liu, X. and Luo, B. (2019) Individualized Intervention to Improve Rates of Exclusive Breastfeeding. Medicine, 98, e17822. [Google Scholar] [CrossRef] [PubMed]

为你推荐