تأثیر ویزیت خانگی زودهنگام پس از زایمان توسط ماما بر مشکلات شیردهی: یک مطالعۀ کارآزمایی بالینی

نوع مقاله : اصیل پژوهشی

نویسندگان

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

2 استادیار گروه مامایی، مرکز تحقیقات بهداشت روان، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شیراز، شیراز، ایران.

3 مربی گروه مامایی، مرکز تحقیقات بیماری‌های غیرواگیر، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی بم، بم، ایران.

4 استادیار گروه آمار حیاتی، مرکز تحقیقات قلب و عروق، دانشگاه علوم پزشکی شیراز، شیراز، ایران.

5 استادیار گروه مامایی، مرکز تحقیقات مادر و جنین، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شیراز، شیراز، ایران.

چکیده

مقدمه: ویزیت ­های بعد از زایمان در منزل نتایج متناقضی را به همراه داشته است. یکی از چالش­ های این حوزه، اجرای آموزش مؤثر برای حمایت از مادران پس از زایمان جهت بررسی مشکلات شیردهی انحصاری است. مطالعه حاضر با هدف بررسی تأثیر ویزیت خانگی توسط ماما بر میزان مشکلات شیردهی پس از زایمان انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی در سال 1398 بر روی 100 مادر زایمان کرده در بیمارستان امام خمینی فلاورجان انجام شد. افراد به‌صورت تصادفی در دو گروه 50 نفره مداخله و کنترل قرار گرفتند. گروه کنترل مراقبت‌های روتین را از طریق مراکز بهداشتی و گروه مداخله طی 4 جلسه در منزل (در اوایل دوره پس از زایمان تا 42 روز پس از تولد) آموزش دریافت نمودند. ابزار گردآوری داده‌ها پرسشنامه دموگرافیک و مشکلات پستان بود که در منازل مادران تکمیل شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌‌افزار آماری SPSS (نسخۀ 22) و آزمون‌های تی تست مستقل و تی تست جفتی انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته ­ها: فراوانی احتقان در روزهای سوم و هفتم در گروه مداخله به‌طور معناداری کمتر از گروه کنترل (05/0p<) و در روزهای 14 و 42 بین دو گروه تفاوت معناداری نداشت (05/0p>). فراوانی شقاق در روز سوم در گروه مداخله به‌طور معناداری کمتر از گروه کنترل (05/0p<) و در روزهای هفتم و چهاردهم بین دو گروه تفاوت معناداری نداشت (05/0p>)، در روز 42 در هیچ‌یک از دو گروه شقاق مشاهده نشد.
نتیجه ­گیری: مشاوره و حمایت عملی در مورد تکنیک‌های شیردهی توسط مامای آموزش دیده احتمالاً منجر به انتقال بیشتر مهارت­ ها شده و در کاهش شقاق و احتقان پستان مؤثر است.

کلیدواژه‌ها

عنوان مقاله [English]

The effect of early postpartum home visits by midwife on breastfeeding problems: a clinical trial study

نویسندگان [English]

  • Razieh Fallahnejad 1
  • Mahnaz Zarshenas 2
  • Naeimeh Tayebi 3
  • Mehrab Sayadi 4
  • Marzieh Akbarzadeh 5
1 M.Sc. of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
2 Assistant professor, Department of Midwifery, Psychiatric Care Research Centre, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
3 Instructor, Department of Midwifery, Non-communicable Diseases Research Center, School of Nursing and Midwifery, Bam University of Medical Sciences, Bam, Iran.
4 Assistant professor, Department of Biostatistics, Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
5 Assistant professor, Department of Midwifery, Maternal–Fetal Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
چکیده [English]

Introduction: Postpartum home visits have yielded conflicting results. One of the challenges in this field is the implementation of effective training to support mothers after giving birth to investigate the problems of exclusive breastfeeding. The present study was performed with aim to investigate the impact of home visits by midwives on the amount of breastfeeding problems after delivery.
Methods: This clinical trial study was conducted on 100 mothers who gave birth in Flowerjan Imam Khomeini Hospital in 2018. The subjects were randomly divided into two groups of intervention and control (n=50 in each group). The control group received routine postpartum care through health centers and the intervention group received training in 4 sessions (in the early postpartum period up to 42 days after birth) at home. The data collection tool was a demographic and breast problems questionnaire which was completed in mothers' homes. Data was analyzed by SPSS statistical software (version 22) and independent t-test and paired t-test. P<0.05 was considered statistically significant.
Results: The frequency of engorgement on the third and seventh days was significantly lower in the intervention group than the control group (P<0.05), and there was no significant difference between the two groups on the fourteenth and forty-second days (P>0.05). The frequency of fissure on the third day was significantly lower in the intervention group than the control group (P<0.05), and there was no significant difference between the two groups on the seventh and fourteenth days (P>0.05). There was no fissure in any of the two groups on the forty-second day.
Conclusion: Practical advice and support on breastfeeding techniques by trained midwives may result in greater transfer of skills and reduced fissure and engorgement.

کلیدواژه‌ها [English]

  • Breastfeeding
  • Breast Engorgement
  • Home Visit
  • Mastitis
  • Nipple Fissure

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مجله زنان، مامایی و نازایی ایران
دوره 26، شماره 3
خرداد 1402
صفحه 53-65

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