Against all odds: a retrospective case-controlled study of women who experienced extraordinary breastfeeding problems
Against all odds: a retrospective case-controlled study of women who experienced extraordinary breastfeeding problems
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DOI：
10.1111/j.1365-2702.2008.02300.x
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发表时间：
2008-05-01
影响因子：
4.2
通讯作者：
O'Brien, Maxine L.
中科院分区：
文献类型：
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作者：
Hegney, Desley;Fallon, Tony;O'Brien, Maxine L.
目标。这项研究调查了赋予妇女权力的因素，使她们能够在经历特殊困难的情况下继续母乳喂养。这项研究记录了那些尽管遇到了极大的困难但仍然继续母乳喂养的妇女（持续队列）和那些断奶的妇女（非持续队列）的经历和特征。回顾性病例对照。这项研究于2004年在澳大利亚东南部的昆士兰州进行。在六个月内招募了40名女性（每个队列20名）。定量（母乳喂养知识问卷）和定性（半结构式访谈）的数据收集。本文描述了定性数据。这两个队列的妇女表达了对母乳喂养的理想化期望，并因母乳喂养问题而经历了心理痛苦。那些继续母乳喂养的人使用了应对策略，并表现出有助于他们克服所经历的困难的个人品质。继续母乳喂养的妇女更有可能报告依赖他们可以信任的健康专业人员提供支持。后一组人群也更有可能报告有同龄人与他们分享他们的经验。非持续的妇女表达的内疚感和不足断奶后，更有可能感到孤立。这项研究强调了妇女处理母乳喂养问题的方法。它还揭示了可以改善母乳喂养持续时间的可修改因素。研究结果表明，临床医生应该：提供准确反映母乳喂养经验的信息;确保系统到位，以便为母乳喂养困难提供有效的产后支持;考虑进行筛查，以确定母乳喂养妇女的心理困扰，悲伤和幻灭程度;设计具有认知技能要素的教育干预措施，解决问题和自我效能培训，使妇女掌握克服任何困难的技能。
Aims. The study investigated factors empowering women to continue breastfeeding despite experiencing extraordinary difficulties. The study documented the experiences and characteristics of women who continued to breastfeed (continuing cohort) and those who weaned (non-continuing cohort) despite extraordinary difficulties.Design. Retrospective case control.Methods. The study was undertaken in south-east Queensland, Australia in 2004. Forty women (20 in each cohort) were recruited over six months. Both quantitative (breastfeeding knowledge questionnaire) and qualitative (semi-structured interviews) data were collected. This paper describes the qualitative data.Results. Women from both cohorts expressed idealistic expectations about breastfeeding and experienced psychological distress due to their breastfeeding problems. Those who continued breastfeeding used coping strategies and exhibited personal qualities that assisted them to overcome the difficulties experienced. Women who continued to breastfeed were more likely to report relying on a health professional they could trust for support. This latter cohort were also more likely to report having peers with which they shared their experiences. Non-continuing women expressed feelings of guilt and inadequacy following weaning and were more likely to feel isolated.Conclusions. This study has highlighted the methods women use to deal with breastfeeding problems. It has also revealed modificable factors that can improve breastfeeding duration.Relevance to clinical pratice. The findings indicate that clinicians should:Provide information which accurately reflects the breastfeeding experience;Ensure systems are in place so that effective postnatal support for breastfeeding difficulties is available;Consider screening to ascertain levels of psychological distress, sadness and disillusionment among breastfeeding women;Design educational interventions with elements of cognitive skills, problem-solving and self-efficacy training to equip women with the skills to overcome any experienced difficulties.