پديد آورندگان :
طاهري زينب دانشگاه علوم پزشكي بابل - كميته تحقيقات دانشجويي , باكوئي فاطمه دانشگاه علوم پزشكي بابل - دانشكده پرستاري و مامايي - مركز تحقيقات بهداشت باروري و ناباروري - گروه مامايي دانشكده پرستاري و مامايي
چكيده فارسي :
ﺳﺎﺑﻘﻪ و ﻫﺪف: ﺗﻐﺬﯾﻪ اﻧﺤﺼﺎري ﺷﯿﺮﺧﻮار ﺗﺎ 6 ﻣﺎﻫﮕﯽ ﺑﺎ ﺷﯿﺮ ﻣﺎدر ﺗﺎﺛﯿﺮ ﻣﺜﺒﺖ ﺑﺮ ﺳﻼﻣﺖ ﻣﺎدر و ﮐﻮدك دارد. در ﻗﺮآن ﻧﯿﺰ ﺑﻪ ﺗﻐﺬﯾﻪ ﺷﯿﺮﺧﻮار ﺑﺎ ﺷﯿﺮﻣﺎدر اﺷﺎره ﺷﺪه اﺳﺖ. ﺷﻨﺎﺧﺖ ﻋﻮاﻣﻞ ﻣﻮﺛﺮ ﺑﺮ آن ﻧﻘﺶ ﺑﺴﺰاﯾﯽ در ارﺗﻘﺎي ﺳﯿﺎﺳﺖ ﺗﻐﺬﯾﻪ اﻧﺤﺼﺎري ﺑﺎ ﺷﯿﺮ ﻣﺎدر دارد. ﻟﺬا اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻫﺪف ﺗﻌﯿﯿﻦ ارﺗﺒﺎط ﺗﻮاﻧﻤﻨﺪي ﺷﯿﺮدﻫﯽ ﻣﺎدران ﺑﺎ ﺗﻐﺬﯾﻪ اﻧﺤﺼﺎري ﺷﯿﺮ ﻣﺎدر و ﺷﻨﺎﺳﺎﯾﯽ ﻋﻮاﻣﻞ ﺟﻤﻌﯿﺘﯽ ﺑﺎروري ﻣﺮﺗﺒﻂ ﺑﺎ آن اﻧﺠﺎم ﺷﺪه اﺳﺖ.
ﻣﻮاد و روشﻫﺎ: اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻣﻘﻄﻌﯽ ﺑﺮ 370 ﻣﺎدر داراي ﺷﯿﺮﺧﻮار ﺷﺶﻣﺎﻫﻪ ﻣﺮاﺟﻌﻪﮐﻨﻨﺪه ﺑﻪ ﻣﺮاﮐﺰ ﺑﻬﺪاﺷﺘﯽ درﻣﺎﻧﯽ ﺷﻬﺮﺳﺘﺎن ﻧﻮر اﻧﺠﺎم ﺷﺪ. ﻣﺎدران ﺑﺮﺣﺴﺐ ﻧﻮع ﺗﻐﺬﯾﻪ ﺷﯿﺮﺧﻮار ﺑﻪ دو ﮔﺮوه ﺗﻐﺬﯾﻪ اﻧﺤﺼﺎري ﺑﺎ ﺷﯿﺮﻣﺎدر و ﻋﺪم ﺗﻐﺬﯾﻪ اﻧﺤﺼﺎري ﺑﺎ ﺷﯿﺮﻣﺎدر ﻃﺒﻘﻪﺑﻨﺪي ﺷﺪﻧﺪ. ﻣﺘﻐﯿﺮ ﺗﻮاﻧﻤﻨﺪي ﺷﯿﺮدﻫﯽ در ﻣﺎدران ﺑﺎ اﺳﺘﻔﺎده از ﭘﺮﺳﺸﻨﺎﻣﻪ ﺗﻮاﻧﻤﻨﺪي ﺷﯿﺮدﻫﯽ ﮐﻪ ﺷﺎﻣﻞ 7ﺣﯿﻄﻪ آﮔﺎﻫﯽ، ﻧﮕﺮش، ﻣﻬﺎرتﻫﺎي ﺗﮑﻨﯿﮏ ﺻﺤﯿﺢ ﺷﯿﺮدﻫﯽ، ﻣﻬﺎرتﻫﺎي ﭘﯿﺸﮕﯿﺮي و ﺣﻞ ﻣﺸﮑﻼت ﺷﯿﺮدﻫﯽ، ﮐﻔﺎﯾﺖ ﺷﯿﺮدﻫﯽ، ﺣﻤﺎﯾﺖ درك ﺷﺪه ﺧﺎﻧﻮاده و ﺧﻮدﮐﺎراﻣﺪي ﺷﯿﺮدﻫﯽ ﺑﺎ ﻧﻤﺮه ﮐﻞ اﺣﺘﻤﺎﻟﯽ در داﻣﻨﻪ 45 ﺗﺎ 225 ﻣﯽﺑﺎﺷﺪ، ﺑﺮرﺳﯽ ﺷﺪ.
ﯾﺎﻓﺘﻪﻫﺎ: ﻣﯿﺎﻧﮕﯿﻦ ﻧﻤﺮه ﮐﻞ ﺣﯿﻄﻪﻫﺎي ﺗﻮاﻧﻤﻨﺪي ﺷﯿﺮدﻫﯽ در ﻣﺎدران ﺑﺎ ﺗﻐﺬﯾﻪ اﻧﺤﺼﺎري ﺷﯿﺮﻣﺎدر )202/70±13/12( از ﮔﺮوه ﻋﺪم ﺗﻐﺬﯾﻪ اﻧﺤﺼﺎري ﺷﯿﺮﻣﺎدر )160/59±27/82( بطور معني داري بيشتر بود (0/015=p) شامل نگرش -2/506، p=0/009) در ﺗﺤﻠﯿﻞ ﻧﻬﺎﯾﯽ ﭘﺲ از ورود ﻣﺘﻐﯿﺮﻫﺎ در ﻣﺪل رﮔﺮﺳﯿﻮن ﻟﻮﺟﺴﺘﯿﮏ، ﺣﯿﻄﻪﻫﺎي ﺗﻮاﻧﻤﻨﺪي ﺷﯿﺮدﻫﯽ -OR=1/688 ،CI(، ﻣﻬﺎرتﻫﺎي ﺗﮑﻨﯿﮏ ﺻﺤﯿﺢ ﺷﯿﺮدﻫﯽ )0/015=OR=1/471 ،CI-95%=1/078-2/007 ،p(، ﻣﻬﺎرتﻫﺎي ﭘﯿﺸﮕﯿﺮي و ﺣﻞ ﻣﺸﮑﻼت ﺷﯿﺮدﻫﯽ )0/011=OR=1/521 ،CI-95%=1/099-2/106 ،p(، ﮐﻔﺎﯾﺖ ﺷﯿﺮدﻫﯽ )0/001=OR=5/150 ،CI-95%=2/707-9/795 ،p(، ﺣﻤﺎﯾﺖ دركﺷﺪه ﺧﺎﻧﻮاده )0/003=OR=1/636، CI-95%=1/184-2/260 ،p( و ﺧﻮدﮐﺎراﻣﺪي ﺷﯿﺮدﻫﯽ )0/001=OR=1/113 ،CI-95%=1/088-1/139 ،p( ﺑﻪ ﻋﻨﻮان ﻣﺘﻐﯿﺮﻫﺎي ﻣﺮﺗﺒﻂ ﻣﻌﻨﯽدار ﺑﺎ ﻣﯿﺰان ﺗﻐﺬﯾﻪ اﻧﺤﺼﺎري ﺷﯿﺮﻣﺎدر ﯾﺎﻓﺖ ﺷﺪﻧﺪ.
ﻧﺘﯿﺠﻪﮔﯿﺮي: ﯾﺎﻓﺘﻪﻫﺎي ﻣﻄﺎﻟﻌﻪ ﻧﺸﺎن داد ﮐﻪ داﺷﺘﻦ آﮔﺎﻫﯽ ﺑﻪ ﺗﻨﻬﺎﯾﯽ ﻧﻤﯽﺗﻮاﻧﺪ ﻣﯿﺰان ﺗﻐﺬﯾﻪ اﻧﺤﺼﺎري ﺷﯿﺮﻣﺎدر را اﻓﺰاﯾﺶ دﻫﺪ، ﺑﻠﮑﻪ ﺑﺎﯾﺪ ﺑﻪ ﺣﯿﻄﻪﻫﺎي دﯾﮕﺮ ﺗﻮاﻧﻤﻨﺪي ﻣﺎدران ﺑﻪ ﺧﺼﻮص اﯾﺠﺎد ﺑﺎور ﮐﻔﺎﯾﺖ ﺷﯿﺮدﻫﯽ در ﻣﺎدران ﺗﻮﺟﻪ ﻧﻤﻮد.
چكيده لاتين :
Exclusive breastfeeding until 6 months has a positive effect on the maternal and the child health. In the Qur'an had also been mentioned to the nutrition of infant with breastfeeding. Knowing the effective factors on it has significant role in promoting exclusive breastfeeding policy. This study aimed to investigate relationship between the mothers’ empowerment in breastfeeding with exclusive breastfeeding and identification of related demographic-reproductive factors.
METHODS
The cross-sectional study was done on 370 mothers with a six-month-old child admitted to the primary health care centers in Noor Township. Mothers were categorized according to type of breastfeeding to two the exclusive breastfeeding and the non-exclusive breastfeeding groups. The mothers’ empowerment in breastfeeding was assessed by breastfeeding empowerment questionnaire. The questionnaire includes seven domains of knowledge, attitude, skills of proper breastfeeding technique, skills of preventing and solving breastfeeding problems, breastfeeding sufficiency, receiving family support and Breastfeeding self-efficacy with probability total score in range of 45 to 225.
FINDINGS
The mean total score of the mothers’ empowerment domains in breastfeeding in the exclusive breastfeeding group (202.70±13.12) is significantly higher than the non-exclusive breastfeeding group (160.59±27.82) (p=0.015). In the final analysis after entering variables in the logistic regression model, the breastfeeding empowerment’s domains including; attitude (OR=1.688, CI-95%=1.137-2.506, p=0.009), skills of proper breastfeeding technique (OR=1.471, CI-95%=1.078-2.007, p=0.015), skills of preventing and solving breastfeeding problems (OR=1.521, CI-95%=1.099-2.106, p=0.011), breastfeeding sufficiency (OR=5.150, CI-95%=2.707-9.795, p=0.001), receiving family support (OR=1.636, CI-95%=1.184-2.260, p=0.003) and Breastfeeding self-efficacy (OR=1.113, CI-95%=1.088-1.139, p=0.001) were found as significant related factors.
CONCLUSION
The findings of the study showed that knowledge alone cannot increase the prevalence of breastfeeding, but should also focus on other domains of mothers' empowerment, especially the belief to breastfeeding sufficiency in mothers.
