Barriers to following the supine sleep recommendation among mothers at four centers for the women, infants, and children program
Barriers to following the supine sleep recommendation among mothers at four centers for the women, infants, and children program
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DOI：
10.1542/peds.2005-2517
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发表时间：
2006-08-01
期刊：
影响因子：
8
通讯作者：
Corwin, Michael J.
中科院分区：
文献类型：
--
作者：
Colson, Eve R.;Levenson, Suzette;Corwin, Michael J.
目标.黑人婴儿患婴儿猝死综合症的风险是白色婴儿的两倍，他们的父母不太可能让他们仰卧睡觉。我们以前确定了父母遵循睡眠姿势建议的障碍。我们这项研究的目的是量化这些障碍，特别是在低收入，主要是黑人母亲。我们对671位母亲进行了面对面的采访，其中64%是黑人，她们参加了波士顿、马萨诸塞州、得克萨斯州达拉斯、加州洛杉矶和康涅狄格州纽黑文的妇女、婴儿和儿童项目中心。我们使用单变量分析来量化与睡姿选择相关的因素，并使用多变量逻辑回归来计算2个结果变量的调整后比值比：“曾经”（意思是通常、有时或昨晚）让婴儿俯卧位睡觉和“通常”让婴儿仰卧位睡觉。59%的母亲报告仰卧，25%侧，15%俯卧，1%其他作为通常的位置。34%的人说他们曾经把婴儿放在俯卧位。72%的人表示，护士，53%的医生和38%的女性朋友或亲戚提供了建议。只有42%的人表示护士、只有36%的医生、只有15%的女性朋友或亲戚建议仰卧位睡觉。当一位女性朋友或亲戚推荐俯卧位时，与那些没有从朋友或亲戚那里得到建议的母亲相比，母亲更有可能将婴儿置于俯卧位，而通常不太可能选择仰卧位。当医生或护士建议非仰卧位时，与那些没有得到医生或护士建议的母亲相比，母亲选择仰卧位的可能性更小。相信医生或护士关于婴儿睡姿的意见的母亲更有可能将婴儿置于仰卧位。一半的母亲认为婴儿在仰卧时更容易窒息，她们不太可能让婴儿仰卧。认为婴儿俯卧姿势更舒适的母亲（36%）更有可能让婴儿俯卧。29%的人认为让婴儿与成人同睡有助于预防婴儿猝死综合症，只有43%的人认为婴儿猝死综合症与睡姿有关。我们确定了将婴儿置于仰卧位睡眠的具体障碍（缺乏或错误的建议，缺乏对提供者的信任，对安全和舒适性的知识和担忧）在低收入，主要是黑人母亲中，在设计干预措施时应该考虑让更多的婴儿仰卧睡眠。
OBJECTIVES. The risk for sudden infant death syndrome in black infants is twice that of white infants, and their parents are less likely to place them in the supine position for sleep. We previously identified barriers for parents to follow recommendations for sleep position. Our objective with this study was to quantify these barriers, particularly among low-income, primarily black mothers.DESIGN/METHODS. We conducted face-to-face interviews with 671 mothers, 64% of whom were black, who attended Women, Infants, and Children Program centers in Boston, Massachusetts, Dallas, Texas, Los Angeles, California, and New Haven, Connecticut. We used univariate analyses to quantify factors that were associated with choice of sleeping position and multivariate logistic regression to calculate adjusted odds ratios for the 2 outcome variables: "ever" (meaning usually, sometimes, or last night) put infant in the prone position for sleep and "usually" put infant in the supine position to sleep.RESULTS. Fifty-nine percent of mothers reported supine, 25% side, 15% prone, and 1% other as the usual position. Thirty-four percent reported that they ever placed infants in the prone position. Seventy-two percent said that a nurse, 53% a doctor, and 38% a female friend or relative provided source of advice. Only 42% reported that a nurse, only 36% a doctor, and only 15% a female friend or relative recommended the supine position for sleep. When a female friend or relative recommended the prone position, mothers were more likely ever to place their infants in the prone position and less likely usually to choose supine compared with those who received no advice from friends or relatives. When a doctor or a nurse recommended a nonsupine position, the mothers were less likely to choose supine compared with those who received no advice from a doctor or a nurse. Mothers who trusted the opinion of a doctor or a nurse about infant sleeping position were more likely to place their infants in the supine position. Half of the mothers believed that infants were more likely to choke when supine, and they were less likely to place their infants supine. Mothers who believed that infants are more comfortable in the prone position (36%) were more likely to place their infants prone. Twenty-nine percent believed that having their infants sleep with an adult helps prevent sudden infant death syndrome, and only 43% believed that sudden infant death syndrome is related to sleeping position.CONCLUSIONS. We identified specific barriers to placing infants in the supine position for sleep (lack of or wrong advice, lack of trust in providers, knowledge and concerns about safety and comfort) in low-income, primarily black mothers that should be considered when designing interventions to get more infants onto their back for sleep.