Application Of Health Education Based On Transtheoretical Model And Stages Of Change In Breastfeeding For Primiparas'

Objective:To learn the status of the breastfeeing knowledge and breastfeeding self-efficacy of the Primiparas'.and to explore the effect of nursing intervention based on the transtheoretical Model and stages of change on breast-feeding knowledge,self-efficacy,exclusive breast-feeding rate and duration of breast-feeding in newly born pregnant women.Breastfeeding behavior health education model for pregnant women to provide reference.Methods:This study was implemented in two parts.first part:Through the convenient sampling method,180 pregnant women at the middle of the third trimester who had undergone an outpatient examination in a major general hospital of a Province in March2017 and selected to meet the inclusion criteria in the hospital were selected as the study subjects.The general situation questionnaire and breastmilk were used.The Self-Efficacy Scale for Self-Efficacy and the Questionnaire on Breastfeeding Knowledge were used to investigate the current status and influencing factors of breastfeeding knowledge and self-efficacy,providing a reference for subsequent breastfeeding interventions.The second part: In May 2017,130 cases of inclusion and exclusion criteria were selected as intervention targets from 180 cases of primipara in the baseline survey,and were then divided into experimental groups using the random number table method.Control group,each with 65 cases.The control group received traditional breastfeeding health education instruction.The experimental group gave a breastfeeding health education based on transtheoretical Model and stages of change of behavioral change on the basis of traditional health education guidance.The control group performed routine breastfeeding health guidance during prenatal,in-hospital,and post-hospitalization phases.The test group was involved in many aspects such as the time,frequency,intensity,content,andmethod of intervention on the basis of the control group.The feeding behavior process is divided into 5 stages according to the staged transitional theory of behavior,which is based on the different needs and psychological changes in the stages of breastfeeding behavior during the second trimester,third trimester,childbirth,puerperium and six months after childbirth.The behavioral transition phase matches the breastfeeding support program.Therefore,comprehensive and systematic improvement of breast-feeding knowledge,self-efficacy and effective promotion of the establishment of scientific and rational breast-feeding behavior.The breastfeeding knowledge,breastfeeding self-efficacy,and the three different days after the third,the 42 nd and the 6th month of the postpartum period were evaluated separately before the intervention,on the 3rd,the 42 nd and the 6th month after the intervention.Point of exclusive breastfeeding and breastfeeding rates.Results:1.Cross-sectional study results: Breastfeeding knowledge and breastfeeding self-efficacy scores were 8.23 ± 2.55 points and 83.97 ± 12.08 points,respectively.Breastfeeding knowledge breastfeeding self-efficacy was at a moderate level,and they all need to be improved.Among them,the expected mode of delivery,estimated postpartum feeding methods,whether or not consciously postpartum breast milk is sufficient,and breastfeeding knowledge are the main factors affecting the self-efficacy of breast-feeding in neonates.2.Randomized,controlled,non-blind study results:(1)Baseline survey results: There were no significant differences in general data,breastfeeding knowledge,and breastfeeding self-efficacy scores between the two groups before the intervention(P>0.05).The maternal groups were comparable;(2)The self-efficacy results of primipara breastfeeding in the two groups showed:breastfeeding self-efficacy scores and skills and inner dimension scores of primiparas in the experimental group on days 3,42 and 6 after delivery,by comparison between groups and repeated measures analysis of variance.Both were higher than the control group,and the difference was statistically significant(P<0.05).(3)The results of breastfeeding knowledge of primiparas in the two groups showed that the breastfeeding knowledge scores of the primiparas in the experimental group on the 3rd,42 nd and 6th postpartum days were higher than those in the control group by comparison between groups and repeated measures analysis of variance.Statistical significance(P<0.05);(4)The results of breastfeeding rate of primipara in the two groups showed that there was no significant difference in breastfeeding rate between the two groups of primiparas on the third day after delivery(P>0.05),and 42 days and 6 months after delivery.The breastfeeding rate test group was higher than the control group,and the difference was statistically significant(P<0.05).(5)The results of exclusive breastfeeding rates of primiparas in the two groups showed that the exclusive breastfeeding rates of the primiparas in the experimental group on the 3rd,42 nd and 6th postpartum days were higher than those in the control group,and the difference was statistically significant(P < 0.05).Conclusion:1.Current situation investigation conclusion: Breastfeeding self-efficacy at the middle of the second trimester is at an intermediate level,and the expected mode of delivery,expected postpartum feeding,whether or not to consciously postpartum breastfeeding and knowledge of breastfeeding are the main factors affecting the self-efficacy of breastfeeding in newborns.factor.2.Randomized,controlled,non-blind study Conclusion :(1)Breastfeeding nursing interventions based on Transtheoretical Model and stages of change can effectively increase breastfeeding knowledge and self-efficacy in newly born pregnant women,and help established pregnant women to establish scientific breastfeeding behaviors.(2)Breastfeeding nursing interventions based on Transtheoretical Model and stages of change can improve the breastfeeding rate and exclusive breastfeeding rate of newly born pregnant women,thereby improving the status of breastfeeding and improving maternal and child health.