Discontinuity of Breastfeeding Care: "There's No Captain of the Ship''
Discontinuity of Breastfeeding Care: "There's No Captain of the Ship''
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DOI：
10.1089/bfm.2015.0142
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发表时间：
2016-01-01
影响因子：
2.7
通讯作者：
Rasmussen, Kathleen M.
中科院分区：
文献类型：
--
作者：
Garner, Christine D.;Ratcliff, Stephannie L.;Rasmussen, Kathleen M.
背景：美国的母乳喂养率不理想。卫生专业人员（HP）有一个独特的机会来支持母乳喂养，因为他们访问母亲和婴儿的频率和时间，以及他们的呼吁，由专业组织这样做。本研究的目的是了解保健员对提供母乳喂养相关护理的角色和经验。材料与方法：深入的定性访谈进行了34位卫生保健（产科医生，助产士，儿科医生，护士和哺乳顾问）谁照顾孕妇或哺乳期妇女。访谈录音，转录，并核实准确性;内容分析被用来确定主题使用扎根理论的方法。结果：总体主题是整个连续体中母乳喂养护理的不连续性。大多数保健服务提供者依赖其他保健服务提供者提供母乳喂养护理，这是报告的护理方面的问题差距造成的，也是造成这种差距的原因。少数卫生保健人员试图弥补母乳喂养护理方面的差距或提高连续性。造成这种不连续性的原因是缺乏时间、缺乏技能、信息不一致以及各护理阶段之间的沟通不足。HP不确定他们的帮助是否有效，以及是否完成了所需的随访。结论：尽管卫生保健人员认识到母乳喂养是婴儿喂养的最佳选择，但母乳喂养护理可能是脱节的，也是实现母乳喂养建议的障碍。这些问题应在未来的研究中进行调查和系统地解决，以便改善母婴二对母乳喂养护理。
Background: Breastfeeding rates in the United States are suboptimal. Health professionals (HPs) have a unique opportunity to support breastfeeding because of the frequency and timing of their visits with mothers and infants as well as their call by professional organizations to do so. The objective of this study was to understand HPs' perceived roles and experiences with providing breastfeeding-related care. Materials and Methods: In-depth qualitative interviews were conducted with 34 HPs (obstetricians, midwives, pediatricians, nurses, and lactation consultants) who care for pregnant or lactating women. Interviews were audio-recorded, transcribed, and verified for accuracy; content analysis was used to identify themes using a grounded theory approach. Results: The overarching theme was discontinuity in breastfeeding care across the continuum. Most HPs relied on other HPs to provide breastfeeding care, which resulted from and contributed to problematic gaps in care that were reported. A minority of HPs attempted to bridge gaps in breastfeeding care or improve continuity. Contributing to the discontinuity were a lack of time, lack of skills, inconsistent messages, and low communication across stages of care. HPs were unsure whether their help was effective and whether required follow-up was completed. Conclusions: Despite HPs' recognition of breastfeeding as the best choice for infant feeding, breastfeeding care may be disjointed and a barrier to achieving breastfeeding recommendations. These problems should be investigated and systemically addressed in future research so that maternal-infant dyad breastfeeding care can be improved.