مقایسه تأثیر حمایت همتا و آموزش توسط مراقبین بهداشتی بر زمان شروع اولین تغذیه با شیر مادر در زنان نخست زای مشهد در سال 1389

نوع مقاله: اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 کارشناس ارشد مامایی، معاونت بهداشتی، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران

3 . دانشیار گروه نوزادان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

4 کارشناس ارشد آمار زیستی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: زمان شروع شیردهی تأثیر قابل توجهی بر عملکرد شیردهی دارد. آغاز شیردهی در نیم ساعت اول زندگی و
تغذیه انحصاری با شیرمادر عامل مهمی در کاهش عوارض و میزان مرگ و میر نوزادان می باشد. عوامل مختلفی نظیر
حمایت روانی و آموزش بر زمان شروع شیردهی مؤثر می باشند. به همین دلیل دو گروه استراتژی بیمارستان محور و
جامعه محور برای شروع زودرس شیردهی توصیه شده است. از آنجا که تاکنون مطالعه ای جهت مقایسه آن انجام
نشده، لذا مطالعه حاضر با هدف مقایسه تأثیر حمایت همتا (جامعه محور) و آموزش توسط مراقبین بهداشتی
(بیمارستان محور) بر زمان شروع اولین شیردهی در زنان نخست زا انجام شد.
روشکار: این مطالعه کارآزمایی بالینی 3 گروهه در سال 1389 بر روی 105 زن نخست باردار انجام شد. 16 مرکز و
پایگاه بهداشتی به صورت خوشهای انتخاب و به طور تصادفی در 3 گروه حمایت همتا، آموزش توسط مراقبین
بهداشتی و کنترل قرار گرفتند. 16 نفر از افراد واجد شرایط گروه همتا انتخاب و به مدت 15 ساعت آموزش دیدند و
7 نفر از گروه مراقب بهداشتی 2 ساعت آموزش دریافت کردند. در گروه حمایت همتا یک بار حمایت توسط همتا و
در گروه آموزش یک جلسه آموزش انفرادی توسط مراقبین بهداشتی در هفتههای 36-38 بارداری انجام شد و گروه
کنترل مراقبت های معمول را دریافت کردند. گردآوری داده ها توسط پرسشنامه و تجزیه و تحلیل آن با استفاده از
نرم افزار آماری SPSS (نسخه 11/5) و آزمون های کراسکال والیس و دقیق فیشر انجام شد.
یافتهها: تنها 20% از افراد گروههای حمایت همتا، 14/7% از افراد آموزش توسط مراقبین بهداشتی و 19/4% گروه
کنترل در نیم ساعت اول پس از زایمان، شیردهی را شروع کردند. 51/4% از افراد گروههای حمایت همتا، 61/8%
آموزش توسط مراقبین بهداشتی و 55/6% گروه کنترل، اولین شیردهی را در فاصله زمانی 1 -24 ساعت پس از زایمان
شروع کردند. افراد 3 گروه از نظر زمان شروع اولین شیردهی تفاوت معنیداری نداشتند (p 0/852).
 نتیجهگیری: حمایت همتا و آموزش توسط مراقبین بهداشتی در دوران بارداری بر شروع شیردهی تآثیری ندارد.

کلیدواژه‌ها


عنوان مقاله [English]

Comparing the Effect of Peer Support and the Education of Health Care Providers on Breastfeeding Initiation Time among Primiparous Women in Mashhad

نویسندگان [English]

  • Mahin Tafazzoli 1
  • Asieh moudi 2
  • Hasan Boskabadi 3
  • Saeid Ebrahim zadeh 4
1 M.Sc. of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical sciences, Mashhad, Iran.
2 M.Sc. of Midwifery, Vice Chancellor of Health, Zahedan University of Medical sciences, Zahedan, Iran.
3 Associate Professor of Neonatology, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran.
4 M.Sc. of Biostatistics, Faculty of Nursing and Midwifery, Mashhad University of Medical sciences, Mashhad, Iran.
چکیده [English]

Introduction: Breastfeeding initiation time has a significant effect on lactation performance. Breastfeeding initiation within a half-hour of birth and exclusive breastfeeding are important strategies to reduce neonatal morbidity and mortality. Different factors such as psychosocial support and received education affect breastfeeding initiation time. Therefore, hospital-based and community-based strategies are recommended for early breastfeeding initiation. So far, no study has been conducted to compare these two methods. Therefore, this study has been performed to compare the effect of peer support (community-based) and the education received by health care providers (Hospital-based) on the time of breastfeeding initiation among primiparous women.
Methods: This clinical trial was performed on 3-group with 105 primigravida women participants. 16 health care centers were selected via cluster selection method and then were allocated randomly into 3 different groups: peer support receivers, education receiver by health care provider and control group. 16 eligible volunteers were selected as peer support receivers and trained for 15 hours. 7 women were selected as education receivers by health care providers and were trained for 2 hours. For peer support receivers, a single peer support was received by peer support providers, and educational group participants received one individual training session in 36-38 weeks of pregnancy by health care provider. The control group received only routine care. Data were collected by a questionnaire and were analyzed by SPSS software version 11.5. Kruskal-Wallis and Fisher’s Exact tests were used to analyze data.
 
Results: Only 20% of peer support receivers, 14.7% of education receivers (by health care providers) and 19.4% of control group members initiate breastfeeding within the half-hour of delivery. 51.4% of peer support receivers, 61.8% of education receivers and 55.6% of control group member began their first breastfeeding within the period of 1- 24 hours after delivery. There were no significant difference at the time of breastfeeding initiation among three groups (p=0.852).
 
Conclusion: The present study did not provide any evidence in terms of impact of peer support and education received by health care providers on the time of breastfeeding initiation; Whereas, some studies have shown positive effect of peer support during labor on breastfeeding initiation time. So, it seems that further study regarding effect of peer support during labor and effect of medication during labor may be needed.

کلیدواژه‌ها [English]

  • Breastfeeding initiation time
  • Education received by health care providers. Peer support
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