| Objective:To investigate the current situation of maternal breastfeeding lasting 4 to 6months,and describe the influence factors of maternal breastfeeding for the unipara.To explore the influence of intervening measure for breastfeeding, applying quality control circle activity to intervene measure for promoting the unipara breastfeeding,the aim of the measure is to support breastfeeding and provide the basis for clinical breastfeeding adviceand carrying out of quality management circle activity and impro ving the quality in obstetrics.Methods:280 cases of the primiparafrom the pregnant creating clinic documents in themat ernityclinic were included according to the inclusive criteria, and gave the random numbers 1-280, then randomly selected 90 patients into the intervention group, 190 cases into control group.Two groups before and after the intervention were issued questionnaires that were designed by the researchers themselves, including general information questionnaire, breastfeeding knowledge questionnaire, the influence factors of breastfeeding questionnaire, questionnaire on the current situation in four to six months of breastfeeding, breastfeeding ways and effect evaluation and judgme nt questionnaire and breastfeeding self-efficacy scale. We explored the breastfeeding self-efficacy situation and their revelent influencing factors. During the whole course,the intervention group on the basis of conventional nursing were intervened by the group of quality control circle team from the aspectsof unipara`s cognition, psycholog ical intervention, health, stress, etc.On the basis of the continuous improvement,PDCA cycle was conducted. In the control grouponthe basis of conventional antenatal examination and nursing, conducted the traditional healthy education patterns.Meanwhile, build a network consultation platform and call working 24 hours a day.Pregnant women may voluntarily participate in the pregnant women school, learning about healthy care during pregnancy and breastfeeding knowledge and skills.Conduct ing regular breastfeeding guidance and follow-up after discharge during awaiting deli very and 42 days after postpartum. Descriptive analysis, t-test, analysis of variance, P earson correlation analysis or Spearman correlation analysis, linear regression, Logist ic regression analysis were used in the statistic analysis(P<0.05).Results:Before the intervention, the breastfeeding self-efficacy scale was issued, total scores rangeis 30~150, including two dimensions and 30 items. The average is90.94±20.72. The competency Scale Dimension score range is 16-70, the average is44.20±11.72.The internal dimension score range is 15-69, the average is 46.73±11.28.In the influence factors of breastfeeding self-efficacy scores in the logistic regression analysis, finally just the factors of getting help or guidance or not and breastfeeding knowledge score entered the regression equation, with statistical significance. With the breastfeeding knowledge increasing 1 score, the possibility of breastfeeding self-efficacy scales getting a good score increased 0.278 times, the ORs was 1.278, 95%CI(1.116-1.464). If getting help or guidance, the possibility of breastfeeding self-efficacy scales getting a good scoreincreased2.195 times, the ORs was 3.195(1.456-7.042).After the intervention, breastfeeding self-efficacy scale(42 days after postpartum) was issued, total scores range is 32~150, the average is 100.96±20.04.The internal dimension score range is 16~75,the average is 50.21±12.41. The competency scale Dimension score range is 16-75,the average is 49.47±13.42.Regarding to the breastfeeding self-efficacy scale(42 days after postpartum), the breastfeeding self-efficacy scores,the internal dimension score and the competency scale dimension score all had statistical significance in both the intervention group and the control group(P<0.001),and the score of the intervention group was higher than the control group.Analyzing the feeding way after the intervention in two groups, results were that the distribution of feeding way in two groups had statistical significance. And the ratio of exclusive breastfeeding in intervention group was higher(70.6%) than the control group.According to the criterion of WHO about the weight and Height standard of 0-2years old children, compare the growth conditions of two groups about four months children after born, the results showed: the height and weight of boys and girls mainly was normal, but the height and weight of intervention group was higher than the control group, with statistical significance(P<0.001).Comparing the satisfaction of nursing jobs according to effect of evaluation breastfeeding scale(18 terms in the scale),the results showed that the score range was60-98,(87.88±9.01) and(78.05±6.57),in the intervention group and control group respectively,with statistical significant(P< 0.001).Conclusion:The activity of quality control circle plays a significant role in the duration of the unipara continued breastfeeding process. It can improve the continued breastfeeding rate and increase the self-efficacy of breastfeeding. It also has promoting effect to the growth and development of children who were four months old. The result about satisfaction survey shows that The activity of quality control circle can increase the satisfaction of unipara for nursing job. |
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