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論文 |
論文
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小西, 佳世乃 ; 島田, 啓子
概要:
Breastfeeding has been demonstrated to provide various health benefits for the mother and child in both the short-term a
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nd long-term. One factor, however, that impedes the continuation of breastfeeding is the perception that breast milk is insufficient. Despite good infant development drinking breast milk alone, the mother may feel anxious regarding the amount of breast milk she is producing and unnecessarily supplement with artificial milk. Cross-sectional studies have revealed many factors involved in this perception of breast milk insufficiency, such as inadequate knowledge of breastfeeding and maternal stress, especially with regard to infant’s behavior, including crying. This study was performed to clarify the relationship between mothers’ perception of breast milk insufficiency with their perception of infant’s behavior between the early postpartum period and one month postpartum. Inclusion criteria for subjects were 1） a full-term birth between 37 weeks and 42 weeks of gestation, 2） singleton birth, 3） normal pregnancy for both mother and child, and 4） infant birthweight of at least 2500 g. Data were collected from January 2012 to August 2013. Connectable anonymous self-administered questionnaire surveys were conducted twice— once during hospitalization and once at the one-month checkup. Of the 78 subjects that consented to participate in the study, 12 subjects that did not meet the requirements were excluded, leaving 66 subjects（ 84.6%） for the analysis. The perceptions of breast milk insufficiency in the early postpartum period and at the one-month checkup were 12.4±2.5 points（ mean±SD） and 12.1±3.7 points, respectively. Thus, a strong positive correlation was observed between a perception of breast milk insufficiency in the early postpartum period and at one month postpartum （r=.74, p<.01）. Mothers’ perception of their infant’s behavior changed from the early postpartum period to one month postpartum
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| 2.
論文 |
論文
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小西, 佳世乃
概要:
To support breastfeeding, which is recommended around the world, it is vital for healthcare providers to conduct accura
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te assessments when observing breastfeeding. Therefore, a means of evaluating this ability is required to improve assessment by healthcare providers. This study was performed to develop a tool for evaluating the ability to assess breastfeeding by mothers in the early postpartum period and to investigate the reliability and validity of this tool. Using seven existing assessment tools, observation items required for assessment and evaluation criteria were organized and summarized into 11 compositional elements. Content was put into two composition levels. In the first half, compositional elements were freely described, and in the second half, images of breastfeeding scenes were used to examine assessment of the 11 compositional elements. The tool was scored from 0 to 61 points, with higher scores indicating greater assessment ability. A total of 105 subjects participated in this study. They consisted of 17 International Board Certified Lactation Consultants （IBCLCs）, 57 midwives, and 31 midwifery students in the Chubu region, Japan, and the response rate was 100.0%. Scores （mean±standard deviation） for the three groups were as follows: IBCLCs, 42.9±5.4 points; midwives, 35.3 ± 5.5 points; and midwifery students, 38.2±5.5 points. Significant differences of 0.1% and 5% were observed between the groups. Scores for midwives in workplaces with IBCLCs present were significantly high. Furthermore, scores were significantly higher for midwives that worked at facilities with high rates of mothers continuing breastfeeding after hospital discharge than midwives and midwifery students working at other facilities. The reliability of the tool was supported by a consistency of 0.93 – 1.00 between scorers for the free description portion and the Kuder– Richardson formula （KR-20） alpha coefficient of 0.78. Scores for IBCLCs appeared to be higher because they had undergone continuous education as breastfeeding specialists and had a great deal of experience. The lack of significant differences between midwives and midwifery students may have been affected by subject background factors, such as whether they were undergoing continuous training and attitudes regarding breastfeeding support. The results suggest that the tool developed here has a constant level of reliability and could be utilized for evaluating the ability of healthcare providers to assess breastfeeding.
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