基于社会生态理论的医院–社区–家庭三元 联动母乳喂养干预方案的构建

Construction of a Ternary Linkage Breastfeeding Intervention Program Based on Social Ecological Theory Involving Hospitals, Communities, and Families

摘要: 目的：构建医院–社区–家庭三元联动的母乳喂养干预方案，为进一步开展母乳喂养健康干预，提高母乳喂养率提供经验借鉴。方法：以社会生态系统理论为指导，通过系统文献回顾和半结构访谈法，构建医院–社区–家庭三元联动的母乳喂养干预方案初稿，通过16名专家2轮德尔菲法函询，形成最终母乳喂养干预方案。结果：两轮专家函询中，问卷回收率均为100%，专家权威系数为0.95。两轮条目重要性评价的肯德尔和谐系数分别为0.422和0.528 (P < 0.001)，变异系数范围依次为0~0.20和0~0.19。最终形成的方案共包含8个一级条目、19个二级条目和32个三级条目。结论：本研究构建的医院–社区–家庭三元联动的母乳喂养干预方案具有必要性、科学性，能够弥补出院后居家母婴护理的不足，对于提高6个月内纯母乳喂养率有着重要意义。

Abstract: Objective: To construct a ternary linkage breastfeeding intervention program, which can provide evidence for further intervention and improve breastfeeding rate. Methods: Guided by social-ecological theory, a preliminary breastfeeding intervention program integrating hospital, community, and family was developed through a systematic literature review and semi-structured interviews. The final breastfeeding intervention program was finalized through two rounds of Delphi consultation with 16 experts. Results: After two rounds of expert consultation, the questionnaire recovery rate was 100%, and the expert authority coefficient was 0.95. The Kendall harmony coefficients of the importance of the two rounds were 0.422 and 0.528 (P < 0.001), and the variation coefficients were 0~0.20 and 0~0.19, respectively. The final program included 8 first-level items, 19 second-level items and 32 third-level items. Conclusions: A ternary linkage breastfeeding intervention program is necessary and scientific, which can address the shortcomings of home care of maternal and infant after discharge and plays an important role in increasing the rate of breastfeeding.