Study On The Influential Factors And Countermeasures Of Infant Sleep Safety Based On Theory Of Planned Behavior

ObjectiveThe study aimed to investigate the cognition of major infant caregivers on infant sleep safety based on the theory of planned behavior,analyze its influencing factors,and provide relevant suggestions accordingly,so as to provide reference for medical and health professionals to develop effective intervention measures and improve infant sleep safety effectively.Methods1.The qualitative research on influencing factors of infant safe sleep practice: This part adopted the purpose sampling method to select infant mothers who underwent health examination in the outpatient department of children’s health in three districts of a GradeIII Class A general hospital in Shandong from July 2021 to January 2022 as research objects.Directed qualitative content analysis was adopted to conduct data analysis.After the initial data preparation stage,the organization coding stage and the result report stage,the relevant topics in the infant mother’s statement were extracted,and caregivers’ experience in infant safe sleep practices and related promoting/hindering factors were explored.2.The quantitative research on influencing factors of infant safe sleep practice:According to the important influencing factors found in the qualitative research,pregnant women who underwent pregnancy examination in the obstetric clinics of four hospitals with different economic levels in a third-class Class A hospital in Shandong from December 2021 to October 2022 were selected to conduct a survey.General data questionnaire,infant sleep safety practice knowledge questionnaire and infant sleep safety planning behavior theory questionnaire were used.SPSS 24.0 software was used to analyze,and t test single factor,variance analysis,Pearson correlation analysis and multiple linear regression analysis were used for statistical processing of the collected data.3.Research on countermeasures to promote infant sleep safety: After systematic retrieval of relevant literature,relevant data were extracted and analyzed.Based on the previous research results and the theoretical framework of Theory of planned behavior,the first draft of intervention strategy was constructed.Then an expert demonstration group was established to demonstrate and finalize the scheme.Results1.The qualitative research on influencing factors of infant safe sleep practice:(1)A total of 15 infant mothers,aged between 25 and 35,and infants aged between 4 and 28 weeks,were included in this study.(2)Based on the theory of planned behavior and previous literature review,the interview results were analyzed and extracted 3 themes,8subthemes,which included behavioral attitudes(recognizing the importance of safe infant sleep practices,low risk awareness,the priority of infant comfort),perceived social subjective norms(the experience and ideas of other infant caregivers and relatives,advice from the medical staff,the influence of online media),and perceived behavioral control(care convenience,pregnancy knowledge/material availability and educational opportunities).2.The quantitative research on influencing factors of infant safe sleep practice:(1)A total of 813 questionnaires were sent out in this study,and 729 valid questionnaires were recovered,with effective recovery of 89.7%.The score of pregnant women on knowledge of infant safe sleep practices was(33.60±4.77),and 67.2% of pregnant women knew about relevant knowledge.The scores of items related to infant sleeping position,sleeping position and bedding use were all low.The score of behavioral and attitude dimension was(21.98±5.47),with a score rate of 78.5%.The score of subjective normative dimension was(16.44±4.31),the score rate was 78.3%.The perceived behavior control score was(13.21±4.30),the scoring rate was 62.9%.The score of behavioral intention dimension(20.43±5.84),and 83.1% of respondents expressed their intention to implement safe sleep practices after delivery.(2)Univariate analysis showed that there were statistical differences in the intention of implementing infant safe sleep practice at different ages,gestational weeks,occupation,educational level,residence,per capita monthly household income and whether they are the only child.Correlation analysis showed that the score of knowledge of pregnant women(r=0.235,P<0.01),attitude(r=0.611,P<0.01),subjective norm(r=0.565,P<0.01)and perceived behavior control(r=0.433,P<0.01)were positively correlated with the score of behavioral intention.(3)The results of multi-factor analysis showed that whether be the only child,age,education level,understanding of sleep safety knowledge,the subjective norms of behavioral attitude and perceived behavioral control were influencing factors of pregnant women’s intention to practice infant sleep safety.The above variables entered into the equation could explain 47.1% variation of pregnant women’s intention to practice infant safe sleep after delivery.3.Research on countermeasures to promote infant sleep safety: Eight literatures were included.After comprehensive data and group demonstration,a health education program was formed from four dimensions,including establishing a positive attitude,enhancing subjective norms,strengthening perceived behavioral control and promoting the implementation of behavioral intentions,extending from pregnancy to postpartum.Conclusions1.The qualitative study found that infant mothers do not have a deep understanding of protective parenting behaviors for infant sleep safety,lack of social support for implementing related parenting behaviors,and have low self-efficacy.There is a strong desire to get related health education during pregnancy,suggesting that pregnancy preparation has an important impact on the implementation of infant safe sleep practice.2.Further questionnaire survey found that pregnant women’s understanding of infant sleep safety related parenting knowledge and behavior intention are fine,but their behavior control ability needs to be improved,which medical and health personnel should pay attention to it.Pregnant women’s age,education level,whether be the only child,the understanding of sleep safety knowledge,behavior attitude,subjective norms and perceived behavioral control influence pregnant women’s intention to practice infant sleep safety.3.Medical and health professionals should attach importance to the health education of infants’ sleep safety during pregnancy.In order to improve the sleep safety of Chinese infants and reduce the incidence of sleep-related accidents,health education programs can be formulated from the perspectives of establishing positive attitude,enhancing subjective norms,strengthening perceived behavioral control and promoting the implementation of behavioral intention.