2021-03-232024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/652290"研究背景：台灣母乳哺育率從2012年達到第一個月純哺乳率67.9%高峰後，開始連年下降，根據國健署資料顯示2018年降至60.6%；第六個月純母乳率更是從27.9%降至18.1%，同年份的美國六個月母乳哺育率卻上升達25.6%。面對這樣的變化，有必要對於台灣產後婦女的母乳哺育經驗進行理解與探討。 研究目的：1.理解影響產婦哺餵母乳的因素，包含：(1)母乳哺育經驗中所遇困難、(2)支持產婦持續哺餵母乳的因素、(3)產婦在醫療院所、產後護理機構執行母乳哺育相關措施的看法及感受(含醫療人員母乳衛教及指導協助、鼓勵家人參與)；2.由以下三面向彙整歸納，提出支持產婦母乳哺育的政策及建議：(1)質性訪談之綜整歸納資料、(2)文獻查證(包含實證文獻與先進國家推動政策)、(3)專家座談會。 研究方法：採質性研究設計與立意取樣，對於產前有意願哺育母乳或產後曾哺育母乳的產後婦女，徵求同意進行全程錄音之訪談，訪談後將訪談錄音轉為逐字稿，採Krippendorff (2004)所提出之內容分析法，來分析逐字稿，瞭解影響產婦哺餵母乳的因素、所遇困難、支持產婦持續哺餵母乳的因素，以及產婦在醫療院所、產後護理機構執行母乳哺育相關措施的看法及感受(含醫療人員母乳衛教及指導協助、鼓勵家人參與)。內容分析法首先透過建立互斥的編碼(coding)，並隨機抽出兩份逐字稿確認兩位編碼者間的一致性信度(inter-coder reliability，或稱再現性[reproducibility])，再經由持續比對形成主題(theme)。因Nvivo軟體可在輸出的同時仍保持原始資料的完整性，故選擇Nvivo第12版軟體輔助後續分析，最終形成影響產婦母乳哺育的因素。 預期結果：此計畫預期完成訪談方法實際探查產後母親們所遇到的切身障礙與過程中獲得的支持，再從文獻端呈現國際作法與實證證據建議切入社會層面，提出對於台灣社會層面可著力的策略，提供未來國內推動母乳哺育之參考。" "Background. The breastfeeding rate in Taiwan has been declining year after year after reaching the peak of 67.9% of exclusive breastfeeding in the first month in 2012. In 2018, the breastfeeding rates have dropped to 60.6% in Taiwan. Even worse, exclusive breastfeeding rates in the sixth month were dropped from 27.9% to 18.1%. In United States, the breastfeeding rate within the six months raise to 25.6%. Because of the trend changes, it is necessary to understand and explore the breastfeeding experience of postpartum women in Taiwan. Aims. 1. To understand the factors that affect the breastfeeding of postpartum women, including: (1) difficulties encountered in breastfeeding experience, (2) factors that support mothers to continue breastfeeding, (3) participants’ views and feelings regarding receiving interventions, including health education and guidance and assistance for medical staff, and encouragement of family participation, in medical institutions or postpartum care units; 2. To raise policy and suggestions for supporting postpartum women in breastfeeding, from the following three aspects: (1) Qualitative interview data and comprehensive summary, (2) literature verification (including empirical literature and promotion policies from developed countries), and (3) expert panel discussion. Methods. Qualitative research design and intentional sampling were adopted. For postpartum women who are willing to breastfeed before giving birth or who have breastfed after giving birth, informed consented for audio recording interview. After the interview, the interview recording will be converted into a verbatim manuscript. The Krippendorff content analysis method is proposed to analyze the verbatim manuscript to understand the considerations that affect mothers’ breastfeeding, the difficulties they encountered, the factors that support the mothers to continue breastfeeding, and mothers’ views and feelings on related breastfeeding interventions (including breastfeeding health education and assistance from health professionals and support from family members). The content analysis method firstly establishes mutually exclusive coding. Then, randomly selects two verbatim manuscripts to confirm the inter-coder reliability (or reproducibility). Themes will form through continue comparison. NVivo software was chosen to assist in content analysis because NVivo software can maintain the integrity of the original data in the output data. Ultimately, the factors affecting the breastfeeding of mothers will be emerged from the data. Expected results: This project is expected to explore the obstacles and supports encountered by postpartum mothers through interview and content analyses. We will present international practices on facilitating mothers’ breastfeeding and also empirical evidences to raise suggestions and strategies for maternal and neonatal public health. The strategies are expected to provide a reference for the promotion of breastfeeding in Taiwan in the future."母乳哺育考量因素母乳哺育困難質性研究breastfeedingconsiderationbreastfeeding difficultiesqualitative study