An Action Research for Promoting Breast Feeding Care in the Hospital

行动研究是1)发现问题，2)收集数据，3)澄清原因，4)有计划的改变，5)数据分析的循环。我们采用了这样的方法来改善医院对那些希望在正常分娩后母乳喂养婴儿的母亲的护理。现场为广岛市一家医院的普通病房，母乳喂养护理主要由护士助产士提供，其中包括4名带头干预的协查人员。干预前的数据是通过对12名护士助产士和9名护士的访谈和对137名接受母乳喂养护理的母亲的问卷调查收集的。根据这些数据的分析结果，我们计划改变(干预)1)工作人员促进她们对BFC现状的了解，2)母亲学习乳头按摩，3)工作人员让母亲放松，4)在较少的公共场所做乳房按摩，5)护士在BFC配合。通过对136名接受改变后护理的母亲进行问卷调查，收集BFC的评价数据。分析结果显示：1)BFC的评价有统计学意义的改善；2)更多的母亲对提供的乳房按摩次数表示满意，有统计学意义；3)进行乳头护理的母亲数量变化不显著。这些结果表明，通过我们的行动研究，网站的BFC有了改善。

The action research is the cycle of 1)identifying problems, 2)collecting the data, 3)clarifying the causes, 4)planned changes, and 5)data analyses. We employed such an approach to improve the hospital care for mothers who want to breastfeed their babies after normal delivery. The site was the general ward of a hospital in Hiroshima City, where the breast feeding care (BFC) was provided mainly by nurse-midwives including the four co-investigators who took the leadership in the intervention.The data before the intervention were collected by interviews with 12 nurse-midwives and 9 nurses and the questionnaire survey of 137 mothers who had received BFC. The results of the analyses of these data led us to plan the change (intervention) for 1)the staff to promote the understanding of their present status of BFC, 2)mothers learn the nipple massage, 3)the staff to relax mothers, 4)the breast massages to be done in less public places, and 5)the nurses to cooperate in the BFC.The data for evaluation of the BFC were collected by a questionnaire survey of 136 mothers who received the care after the change. The analysis showed the following results.1)The evaluation of the BFC improved with statistical significance.2)More mothers, with statistical significance, reported their satisfaction with the number of breast massages provided.3)The change of the number of the mothers who practiced nipple care was not statistically significant.These results show that the BFC of the site improved by our action research.