대한간호학회지 (Journal of Korean Academy of Nursing)

한국간호과학회 (Korean Society of Nursing Science)
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신생아집중치료실 미숙아를 위한 직접모유수유 프로그램의 효과: 비동등성 대조군 전후 설계

Effect of Direct Breastfeeding Program for Premature Infants in Neonatal Intensive Care Unit

  • 강지현 (부산대학교병원 간호부) ;
  • 손현미 (부산대학교 간호대학) ;
  • 변신연 (부산대학교 의학전문대학원 소아청소년과) ;
  • 한규민 (부산대학교 간호대학)
  • Kang, Ji Hyun (Department of Nursing, Pusan National University Hospital) ;
  • Son, Hyunmi (College of Nursing, Pusan National University) ;
  • Byun, Shin Yun (Department of Pediatrics, Pusan National University School of Medicine) ;
  • Han, Gyumin (College of Nursing, Pusan National University)
  • 투고 : 2020.09.29
  • 심사 : 2021.01.20
  • 발행 : 2021.02.28
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초록

Purpose: This study aimed to identify the effects of a direct breastfeeding program for premature infants in neonatal intensive care units (NICUs). Methods: This quasi-experimental study was conducted during August 2016 to April 2017. Sixty mothers of premature infants were assigned to the experimental (n = 31) or control groups (n = 29). The program was comprised of breastfeeding education and direct breastfeeding support. The experimental and control groups were provided with education and counseling on breastfeeding at the time of admission and discharge. In the experimental group, the mothers initiated oral feeding with direct breastfeeding and engaged in breastfeeding at least seven times during the NICU stay. The collected data were analyzed by the χ2-test and repeated measures ANOVA using an SPSS program. Results: The experimental group showed a higher direct breastfeeding practice rate (χ2 = 19.29, p < .001), breastfeeding continuation rate (χ2 = 3.76, p < .001), and self-efficacy (F = 25.37, p < .001) than the control group except for maternal attachment. Conclusion: The direct breastfeeding program in the NICU has significant effects on the practice and continuation rate of breastfeeding and breastfeeding self-efficacy. Therefore, this program can be applied in the NICU settings where direct breastfeeding is limited.

키워드

과제정보

We would like to express our deepest gratitude to mothers of premature infants who actively participated in this study.

참고문헌

  1. Schanler RJ. Outcomes of human milk-fed premature infants. Seminars in Perinatology. 2011;35(1):29-33. https://doi.org/10.1053/j.semperi.2010.10.005
  2. Linde K, Lehnig F, Nagl M, Kersting A. The association between breastfeeding and attachment: A systematic review. Midwifery. 2020;81:102592. https://doi.org/10.1016/j.midw.2019.102592
  3. World Health Organization (WHO). Exclusive breastfeeding for six months best for babies everywhere [Internet]. Geneva: WHO; c2011 [cited 2017 Jan 20]. Available from: https://www.who.int/news/item/15-01-2011-exclusive-breastfeeding-for-six-months-best-for-babies-everywhere.
  4. Briere CE, Lucas R, McGrath JM, Lussier M, Brownell E. Establishing breastfeeding with the late preterm infant in the NICU. Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2015;44(1):102-113. https://doi.org/10.1111/1552-6909.12536
  5. Callen J, Pinelli J. A review of the literature examining the benefits and challenges, incidence and duration, and barriers to breastfeeding in preterm infants. Advances in Neonatal Care. 2005;5(2):72-88. https://doi.org/10.1016/j.adnc.2004.12.003
  6. Giannì ML, Bezze E, Sannino P, Stori E, Plevani L, Roggero P, et al. Facilitators and barriers of breastfeeding late preterm infants according to mothers' experiences. BMC Pediatrics. 2016;16(1):179. https://doi.org/10.1186/s12887-016-0722-7
  7. Akerstrom S, Asplund I, Norman M. Successful breastfeeding after discharge of preterm and sick newborn infants. Acta Paediatrica. 2007;96(10):1450-1454. https://doi.org/10.1111/j.1651-2227.2007.00502.x
  8. Pineda R. Direct breast-feeding in the neonatal intensive care unit: Is it important? Journal of Perinatology. 2011;31(8):540-545. https://doi.org/10.1038/jp.2010.205
  9. Sinha B, Chowdhury R, Sankar MJ, Martines J, Taneja S, Mazumder S, et al. Interventions to improve breastfeeding outcomes: A systematic review and meta-analysis. Acta Paediatrica. 2015;104(467):114-134. https://doi.org/10.1111/apa.13127
  10. Jang SH. The effect of a breastfeeding self-efficacy promotion program among primiparous mothers of premature babies [master's thesis]. Busan: Pusan National University; 2014. p. 1-145.
  11. Lee B, Bang KS. A self-efficacy promotion program for the continuation of breastfeeding for mothers of premature infants. Perspectives in Nursing Science. 2020;17(2):90-98. https://doi.org/10.16952/pns.2020.17.2.90
  12. Brand E, Kothari C, Stark MA. Factors related to breastfeeding discontinuation between hospital discharge and 2 weeks postpartum. The Journal of Perinatal Education. 2011;20(1):36-44. https://doi.org/10.1891/1058-1243.20.1.36
  13. Kim HS. Guidelines for breastfeeding. Seoul: Hyunmoon Publishing Co.; 2001. p. 1-710.
  14. Briere CE, McGrath JM, Cong X, Brownell E, Cusson R. Direct-breastfeeding in the neonatal intensive care unit and breastfeeding duration for premature infants. Applied Nursing Research. 2016;32:47-51. https://doi.org/10.1016/j.apnr.2016.04.004
  15. van Veenendaal NR, Heideman WH, Limpens J, van der Lee JH, van Goudoever JB, van Kempen AAMW, et al. Hospitalising preterm infants in single family rooms versus open bay units: A systematic review and meta-analysis. The Lancet. Child & Adolescent Health. 2019;3(3):147-157. https://doi.org/10.1016/S2352-4642(18)30375-4
  16. Lucas RF, Smith RL. When is it safe to initiate breastfeeding for preterm infants? Advances in Neonatal Care. 2015;15(2):134-141. https://doi.org/10.1097/ANC.0000000000000167
  17. Casavant SG, McGrath JM, Burke G, Briere CE. Caregiving factors affecting breastfeeding duration within a neonatal intensive care unit. Advances in Neonatal Care. 2015;15(6):421-428. https://doi.org/10.1097/ANC.0000000000000234
  18. Briere CE, McGrath JM, Cong X, Brownell E, Cusson R. Direct-breastfeeding premature infants in the neonatal intensive care unit. Journal of Human Lactation. 2015;31(3):386-392. https://doi.org/10.1177/0890334415581798
  19. Dennis CL. Theoretical underpinnings of breastfeeding confidence: A self-efficacy framework. Journal of Human Lactation. 1999;15(3):195-201. https://doi.org/10.1177/089033449901500303
  20. Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review. 1977;84(2):191-215. https://doi.org/10.1037//0033-295x.84.2.191
  21. Brockway M, Benzies K, Hayden KA. Interventions to improve breastfeeding self-efficacy and resultant breastfeeding rates: A systematic review and meta-analysis. Journal of Human Lactation. 2017;33(3):486-499. https://doi.org/10.1177/0890334417707957
  22. Chan MY, Ip WY, Choi KC. The effect of a self-efficacy-based educational programme on maternal breast feeding self-efficacy, breast feeding duration and exclusive breast feeding rates: A longitudinal study. Midwifery. 2016;36:92-98. https://doi.org/10.1016/j.midw.2016.03.003
  23. McQueen KA, Dennis CL, Stremler R, Norman CD. A pilot randomized controlled trial of a breastfeeding self-efficacy intervention with primiparous mothers. Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2011;40(1):35-46. https://doi.org/10.1111/j.1552-6909.2010.01210.x
  24. Bunik M, Shobe P, O'Connor ME, Beaty B, Langendoerfer S, Crane L, et al. Are 2 weeks of daily breastfeeding support insufficient to overcome the influences of formula? Academic Pediatrics. 2010;10(1):21-28. https://doi.org/10.1016/j.acap.2009.09.014
  25. Bonacquisti A, Geller PA, Patterson CA. Maternal depression, anxiety, stress, and maternal-infant attachment in the neonatal intensive care unit. Journal of Reproductive and Infant Psychology. 2020;38(3):297-310. https://doi.org/10.1080/02646838.2019.1695041
  26. Vaerland IE, Vevatne K, Brinchmann BS. Mothers' experiences of having a premature infant due to pre-eclampsia. Scandinavian Journal of Caring Sciences. 2018;32(2):527-534. https://doi.org/10.1111/scs.12476
  27. Aagaard H, Hall EO. Mothers' experiences of having a preterm infant in the neonatal care unit: A meta-synthesis. Journal of Pediatric Nursing. 2008;23(3):e26-e36. https://doi.org/10.1016/j.pedn.2007.02.003
  28. Baley J. Skin-to-skin care for term and preterm infants in the neonatal ICU. Pediatrics. 2015;136(3):596-599. https://doi.org/10.1542/peds.2015-2335
  29. Hill PD, Ledbetter RJ, Kavanaugh KL. Breastfeeding patterns of low-birth-weight infants after hospital discharge. Journal of Obstetric, Gynecologic, & Neonatal Nursing. 1997;26(2):189-197. https://doi.org/10.1111/j.1552-6909.1997.tb02132.x
  30. Dennis CL, Faux S. Development and psychometric testing of the Breastfeeding Self-Efficacy Scale. Research in Nursing & Health. 1999;22(5):399-409. https://doi.org/10.1002/(sici)1098-240x(199910)22:5<399::aid-nur6>3.0.co;2-4
  31. Wheeler BJ, Dennis CL. Psychometric testing of the modified breastfeeding self-efficacy scale (short form) among mothers of ill or preterm infants. Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2013;42(1):70-80. https://doi.org/10.1111/j.1552-6909.2012.01431.x
  32. Muller ME. A questionnaire to measure mother-to-infant attachment. Journal of Nursing Measurement. 1994;2(2):129-141. https://doi.org/10.1891/1061-3749.2.2.129
  33. Im HS. Effects of Yakson therapy on growth and stable state of preterm infants and on maternal attachment [dissertation]. Seoul: Korea University; 2005. p. 1-107.
  34. Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Research in Nursing & Health. 2007;30(4):459-467. https://doi.org/10.1002/nur.20199
  35. Kliegman RM, Behrman RE, Jenson HB, Stanton BF. Nelson textbook of pediatrics e-book. 18th ed. Philadelphia (PA): Saunders, Elsevier; 2007. p. 706.
  36. Nyqvist KH, Färnstrand C, Eeg-Olofsson KE, Ewald U. Early oral behaviour in preterm infants during breastfeeding: An electromyographic study. Acta Paediatrica. 2001;90(6):658-663. https://doi.org/10.1111/j.1651-2227.2001.tb02430.x
  37. Colaizy TT, Morriss FH. Positive effect of NICU admission on breastfeeding of preterm US infants in 2000 to 2003. Journal of Perinatology. 2008;28(7):505-510. https://doi.org/10.1038/jp.2008.32
  38. Kim MS, Kim JU, An YM, Bae SM, Kim MJ. The research on the breast feeding and its related factors of premature infant. Journal of Korean Academy of Child Health Nursing. 2003;9(3):272-284.
  39. Kim ES, Kim EY, Lee JY, Kim JK, Lee HJ, Lee SH, et al. The effects of supportive nursing management on postpartum depression of mothers with premature infants. Journal of Korean Clinical Nursing Research. 2009;15(3):157-170.
  40. Shaffer DR, Kipp K. Developmental psychology: Childhood and adolescence. 8th ed. Belmont (CA): Wadsworth Cengage Learning; 2010. p. 341-412.
  41. Kim MY, Jang GJ. A comparative study on maternal-infant attachment and infant temperament according to the feeding methods. Journal of the Korean Society of Maternal and Child Health. 2009;13(1):107-115. https://doi.org/10.21896/jksmch.2009.13.1.107
  42. Tharner A, Luijk MP, Raat H, Ijzendoorn MH, Bakermans-Kranenburg MJ, Moll HA, et al. Breastfeeding and its relation to maternal sensitivity and infant attachment. Journal of Developmental & Behavioral Pediatrics. 2012;33(5):396-404. https://doi.org/10.1097/DBP.0b013e318257fac3
  43. Smith RL, Lucas R. Evaluation of nursing knowledge of early initiation of breastfeeding in preterm infants in a hospital setting. Journal of Neonatal Nursing. 2016;22(3):138-143. https://doi.org/10.1016/j.jnn.2015.07.009