| Objective:This study aimed at the implementation of empowerment education for the second child elderly puerpera,and evaluated its intervention effect on the exclusive breastfeeding rate,breastfeeding knowledge,behavior,self-confidence,adverse reactions of breastfeeding and breastfeeding self-management of the second child elderly puerpera,so as to provide practical basis for improving the health education mode of the second child elderly puerpera.Methods:In this study,80 cases of second child elderly puerpera who met the inclusion and exclusion criteria from July to October in 2020 were selected.They were divided into intervention group(40 cases)and control group(40 cases).The intervention group received empowerment education,that is,the researchers implemented empowerment education related to breast-feeding for the pregnant women in the intervention group,including two outpatient stages:one-to-one guidance discussion and one group study;Five times of hospitalization:four times of one-to-one guidance,namely 2 hours after delivery,1 day after delivery,3 days after delivery,the day of discharge,and one postpartum forum;Two times after discharge:one-to-one guidance and Discussion on 42days postpartum;Postpartum 4 months a one-on-one guidance discussion.The control group received health education on breastfeeding according to the standard of Baby Friendly Hospital,and the outpatient department publicized breastfeeding knowledge by pregnant women’s school;After hospitalization,nurses and midwives completed the instruction of early breast feeding;The mother and infant were followed up irregularly after discharge.Finally,40 cases of puerpera in the intervention group and the control group respectively participated in the study,and completed the investigation of maternal and infant situation 6 months after delivery.Self made questionnaire was used to calculate the exclusive breastfeeding rate of the two groups at 3 days,42 days,4 months and 6months after delivery;Breastfeeding knowledge scale,breastfeeding behavior scale,breast-feeding confidence scale(BESE)and patient perceptions of patient empowering nurse Behaviors Scale(ppp NBS)were used to analyze the breastfeeding knowledge,behavior,attitude and behavior of puerpera before intervention,3 and 42 days after delivery Self confidence and nurses’perception of empowerment;Self made questionnaire was used to analyze the incidence of adverse reactions and self-management of breastfeeding at 3 days,42 days,4 months and 6 months after delivery.Spss22.0 statistical software was used to analyze and process the data.The statistical methods used include independent sample t-test,X~2test,repeated measurement analysis of variance,etc.Results:1.The pure breast feeding rate of intervention group was higher than that of control group at 3 days,42 days,4 months and 6 months after delivery(X~2=5.333～6.561,p<0.05).2.The results of repeated ANOVA analysis of the breastfeeding knowledge scale,the breastfeeding behavior scale,BESE,and ppp NBS scores:Time effect(F=27.722～44.997,p<0.05),Between-group effect(F=5.398～9.208,p<0.05),Interaction effect(F=7.708～20.469,p<0.05),the differences were statistically significant.3.Comparison of maternal observation indexes between intervention group and control group:(1)Breastfeeding adverse reactions:incidence of nipple pain or skin rupture,breast swelling or induration,incidence of acute mastitis,and incidence of constipation at 3 days,42 days,4 months and 6 months postpartum and incidence of maternal obesity and infant bloating at 6 months postpartum were lower in the intervention group than in the control group(X~2=3.954～15.162,p<0.05),and the difference was statistically significant;(2)Self-management of breastfeeding:breastfeeding frequency at 48 h postpartum was higher in the intervention group than in the control group(t=1.210,p<0.05),and the difference was statistically significant;lactation initiation rate at 72 h postpartum was higher in the intervention group than in the control group(X~2=9.356,p<0.05),and the difference was statistically significant;the rate of restricted lactation due to contraction pain at 3 days postpartum was lower in the intervention group than in the control group(X~2=15.162,p<0.05),and the difference was statistically significant;duration of bloody malignant dew was lower in the intervention group than in the control group(t=2.763,p<0.05),and the difference was statistically significant.Conclusions:1.Health education based on empowerment theory could improve the rate of exclusive breastfeeding of second-birth parturient of advanced reproductive age.2.Health education based on empowerment theory can increase breastfeeding knowledge,and improve breastfeeding behavior and breastfeeding self-confidence of second-birth parturient of advanced reproductive age.3.Health education based on empowerment theory could reduce the incidence of adverse reactions of breastfeeding and improve the self-management of breastfeeding. |
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