Weighing worth against uncertain work: the interplay of exhaustion, ambiguity, hope and disappointment in mothers breastfeeding late preterm infants.
Weighing worth against uncertain work: the interplay of exhaustion, ambiguity, hope and disappointment in mothers breastfeeding late preterm infants.
复制标题
DOI：
10.1111/j.1740-8709.2012.00463.x
复制
发表时间：
2015-01
影响因子：
3.4
通讯作者：
Cohen SM
中科院分区：
文献类型：
--
作者：
Radtke Demirci J;Happ MB;Bogen DL;Albrecht SA;Cohen SM
晚期早产儿（lpi）的不良母乳喂养结果归因于生理不成熟导致的母乳输送不足。然而，母乳喂养不仅仅是一种生物学现象，目前尚不清楚lpi的母亲如何管理其他可能影响母乳喂养过程的因素。采用扎根理论方法，结合一系列产后访谈和一些新颖的数据收集技术，我们从美国宾夕法尼亚州匹兹堡的一家妇产医院招募了10对晚期早产儿母子，在6-8周的时间里研究了母乳喂养的建立。我们发现，在LPI人群中，母乳喂养是一个波动的、级联式的试验和错误过程，受一系列环境因素和事件的影响，最终以母乳喂养的继续（有或没有对母乳喂养的持续时间或专一性的未来警告）或停止而告终。这一轨迹可以通过基本的社会心理过程来解释，即权衡价值与不确定工作之间的关系，其中包括母乳喂养动机、母乳喂养工作的强度以及围绕婴儿行为和喂养线索的模糊性之间的紧张关系。还确定了几个子过程：玩游戏；让他做审判官vs.迁就我们两个；质疑价值vs.坚持希望如果我们的理论模型有效，则表明需要为晚期早产儿的母亲提供更早、更广泛和更合格的母乳喂养支持，强调早产与观察到的喂养行为之间的联系。
Poor breastfeeding outcomes among late preterm infants (LPIs) have been attributed to inadequate breast milk transfer stemming from physiological immaturities. However, breastfeeding is more than a biological phenomenon, and it is unclear how mothers of LPIs manage other factors that may also impact the breastfeeding course. Using grounded theory methods and incorporating serial postpartum interviews with several novel data collection techniques, we examined breastfeeding establishment over a 6–8 week period among 10 late preterm mother-infant dyads recruited from a maternity hospital in Pittsburgh, Pennsylvania, USA. We found that breastfeeding in the LPI population was a fluctuating, cascade-like progression of trial and error, influenced by a host of contextual factors and events and culminating with breastfeeding continuation (with or without future caveats for duration or exclusivity of breastfeeding) or cessation. The trajectory was explained by the basic psychosocial process Weighing Worth against Uncertain Work, which encompassed the tension between breastfeeding motivation, the intensity of breastfeeding work, and ambiguity surrounding infant behavior and feeding cues. Several sub-processes were also identified: Playing the Game; Letting Him be the Judge vs. Accommodating Both of Us; and Questioning Worth vs. Holding out Hope. If valid, our theoretical model indicates a need for earlier, more extensive, and more qualified breastfeeding support for mothers of late preterm infants that emphasizes the connection between prematurity and observed feeding behaviors.
登录
查看更多内容
影响因子：
1.9
作者：
Larsen, Jette Schilling;Hall, Elisabeth O. C.;Aagaard, Hanne
通讯作者：
Aagaard, Hanne
DOI：
10.1097/00005721-200003000-00004
发表时间：
2000-03-01
期刊：
MCN. The American journal of maternal child nursing
影响因子：
--
作者：
Medoff-Cooper, B;McGrath, J M;Bilker, W
通讯作者：
Bilker, W
影响因子：
5.1
作者：
NEIFERT, M;LAWRENCE, R;SEACAT, J
通讯作者：
SEACAT, J
DOI：
10.1177/089033449901500410
发表时间：
1999-12-01
期刊：
Journal of human lactation : official journal of International Lactation Consultant Association
影响因子：
--
作者：
Schmied, V;Barclay, L
通讯作者：
Barclay, L
DOI：
10.1016/j.pedn.2007.02.003
发表时间：
2008-06-01
期刊：
Journal of pediatric nursing
影响因子：
--
作者：
Aagaard, Hanne;Hall, Elisabeth O C
通讯作者：
Hall, Elisabeth O C