執行親子同室的相關因素探討

Influential Factors Related to Rooming-in Care

10.6142/VGHN.33.3.283

蔡至涵(Zhi-Han Cai)；彭台珠(Tai-Chu Peng)；賴惠玲(Hui-Ling Lai)；王淑芳(Shu-Fang Wang)

母乳哺育 ； 母乳哺育自我效能 ； 親子同室 ； breastfeeding ； breastfeeding self-efficacy ； rooming-in

榮總護理

33卷3期（2016 / 09 / 01）

283 - 292

繁體中文

親子同室可以促使建立早期親子關係，增加父母育兒的自信心與成就感，並且提高純母乳哺育率，但24小時親子同室是台灣推動母嬰親善醫院認證十大措施中執行度最低的措施。本研究探討執行親子同室的相關影響因素。採縱貫式研究，於2014年8月至2015年1月透過結構式問卷、母乳哺育自我效能簡式量表於產婦產後一至七天、一個月、三個月內進行資料蒐集，共有61位同意參與研究，完成三次問卷調查的共有51位，問卷回收率為84%。研究結果發現，執行親子同室與即刻肌膚接觸、一個月哺育方式有統計上顯著相關；有執行即刻肌膚接觸者，產後選擇親子同室的機會是未執行者的39.38倍；親子同室者在產後一個月選擇純配方奶的機會會降低0.11倍。就執行親子同室的模式來看，執行24小時親子同室及產婦疲累時才將寶寶推回嬰兒室者，較常態性夜間推回嬰兒室者更傾向選擇純母乳哺育；同時產婦的母乳哺育自我效能得分，在24小時親子同室和疲累時才將寶寶推回嬰兒室的也高於夜間常態推回嬰兒室。此外，產後住院期間配偶、父母的支持度與母乳哺育自我效能有統計上正相關。產後即刻肌膚接觸與家人的支持可以提高親子同室的機會，增加母乳哺育的自我效能，進而提升一個月純母乳哺育率。建議產前加強衛教家人產後參與親子同室與發揮家庭支持力量將有助於落實親子同室執行，進而促進持續母乳哺育率。

Rooming-in care can lead to the establishment of early parent-child relationships, increased parental self-confidence and sense of accomplishment, and increased exclusive breastfeeding rates. However, the lowest measure in the 10-steps of baby-friendly hospital certification is 24 hours of rooming-in care in Taiwan. This study aimed to determine the influential factors of rooming-in care. This was a longitudinal study conducted from August 2014 to January 2015. Data were collected with structured questionnaires and a short-form breastfeeding self-efficacy scale according to periods of hospitalization, which were the first and the third months after birth. A total of 51 mothers completed the survey, which yielded a response rate of 84%. The results show that early skin-to-skin contact and the first-month feeding mode were significantly correlated with rooming-in. Compared with rooming-in without preceding early skin-to-skin contact, mothers with early skin-to- skin contact had a 39.38-fold chance of engaging in rooming-in. Those with rooming-in care had only a 0.11-ford chance of choosing formula or feeding during the first month after birth. Compared with different types of rooming-in implementations, both types of mothers were less likely to choose formula feeding; rather, they chose 24 hours of rooming-in and returning babies to babies' rooms when exhausted. Additionally, both types of breastfeeding self-efficacy scores were higher than those for the types that returned babies to babies' rooms at night. Early skin-to-skin contact and family support can increase the rooming-in implementation rate and increase mothers' breastfeeding self-efficacy scores, thereby enhancing the exclusive breastfeeding rate during the first month after birth. Prenatal preparation for strengthening family involvement with rooming-in and play for support will contribute to the implementation of rooming-in and further contribute toward improving breastfeeding rates.

1. 林祝君、王淑芳、黃于華(2011)。哺乳對母親角色形塑—自我平衡理論。助產雜誌，53，50-60。
   連結：
2. 衛生福利部國民健康署(2015，3 月31 日)．母乳哺育率下降，國健署呼籲落實母嬰親善措施‧ 取自http://www.mohw.gov.tw/CHT/Ministry/DM2_P.aspx?f_list_no=7&fod_list_no=5310&doc_no=48876
3. 衛生福利部國民健康署(2012，8 月7 日)．母乳哺育－掌握過去、規劃未來- 母乳一指通‧ 取自http://www.hpa.gov.tw/BHPNet/Web/News/News.aspx?No=201208070001
4. 衛生福利部國民健康署(2014，3 月25 日)．母乳哺育國內現況‧ 取自http://www.hpa.gov.tw/BHPNet/WEB/Healthtopic/TopicArticle.aspx?No=201403250001&parentid=201110060004
5. Bellintxon, M.,Zaragueta, M. C.,Adrian, M. C.,Lopez-Dicastillo, O.(2011).Initiating breastfeeding: Experiences of first-time mothers.Anales del Sistema Sanitario de Navarra,34(3),409-418.
6. Chiou, S. T.,Chen, L. C.,Yeh, H.,Wu, S. R.,Chien, L. Y.(2014).Early skin-to-skin contact, rooming-in, and breastfeeding: A comparison of the 2004 and 2011 national surveys in Taiwan.Birth,41(1),33-38.
7. Dennis, C. L.(2003).The breastfeeding selfefficacy scale: Psychometric assessment of the short form.Journal of Obstetric, Gynecologic and Neonatal Nursing,32(6),734-744.
8. Dennis, C.L.,Faux, S.(1999).Development and psychometric testing of the breastfeeding self-efficacy scale.Research in Nursing and Health,22(5),399-409.
9. Fox, R.,McMullen, S.,Newburn, M.(2015).UK women's experiences of breastfeeding and additional breastfeeding support: A qualitative study of baby cafe services.BioMed Central Pregnancy Childbirth,15(147),1-12.
10. Lai, Y. L.,Hung, C. H.,Stocker, J.,Chan, T. F.,Liu, Y.(2014).Postpartum fatigue, baby-care activities, and maternal-infant attachment of vaginal and cesarean births following rooming-in.Applied Nursing Research,28(2),116-120.
11. Palmer, L.,Carlsson, G.,Mollberg, M.,Nystrom, M.(2012).Severe breastfeeding diffi culties: Existential lostness as a mother-women's lived experiences of initiating breastfeeding under severe difficulties.International Journal of Qualitative Studies on Health and Well-being,7,10846.
12. 王淑芳(2009)。博士論文(博士論文)。高雄，高雄醫學大學護理學研究所。
13. 王雅香、林雅惠、侯惠足、陳淑娟、陳繪竹(2011)。提升24 小時母嬰同室執行率之改善方案。志為護理─ 慈濟護理雜誌，10(1)，78-89。
14. 李鳳雪、王國明、高毓秀(2012)。初產婦背景因素對母乳哺育經驗與自我效能之影響。助產雜誌，54，56-67。
15. 林育靜、楊嘉玲、高美華、李靜宜(2012)。周產期母乳哺育指導與產婦執行24 小時親子同室之相關性。長庚護理，23(1)，27-40。
16. 胡蓮珍(2003)。92年度中山醫學大學教師專題研究計劃92年度中山醫學大學教師專題研究計劃,台中:中山醫學大學。
17. 胡蓮珍、曾雅玲(2015)。支持策略對哺餵母乳之成效─系統性文獻回顧。澄清醫護管理雜誌，11(1)，56-63。
18. 張靖梅、林獻鋒(2009)。產婦實施24 小時親子同室之壓力經驗。長庚護理，20(4)，429-440。
19. 楊雯如、柯惠娟(2011)。提升親子同室照護安全專案。榮總護理，28(2)，148-155。
20. 蔡永蓮、黃鈴珠、黃瓊慧(2011)。提升24 小時親子同室率方案。志為護理─ 慈濟護理雜誌，10(6)，77-86。
21. 醫策會評鑑組(2007)。2007 年母嬰親善醫療院所認證作業介紹。醫療品質雜誌，1(5)，92-93。

1. 陳俐伶,胡曉玲,李易靜,王美珍(2020).提升產後病房護理人員親子同室護理指導成效.源遠護理,14(2),48-54.
2. 施妙芳,周寶鈺(2020)。產後親子早期接觸、產後憂鬱與自傷意念之相關性探討。中華心理衛生學刊，33(1)，63-93。
3. 葉玲亞,陳昭蓉(2020)。照護一位重度聽障初產婦之護理經驗。助產雜誌，61，32-39。
4. 鄭雪玉,洪志秀(2020)。親子同室執行之挑戰與策略。長庚護理，31(2)，173-180。
5. 鍾侑倫、陳淑芬、柯惠娟(2019)。某醫學中心24小時親子同室策略對持續純母乳哺餵成效之回溯世代研究。榮總護理，36(4)，343-352。
6. (2024)。運用個案管理師角色協助一位經產婦哺乳之護理經驗。若瑟醫護雜誌，18(1)，63-74。