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住院產(chǎn)婦母乳捐獻(xiàn)知信行問卷的構(gòu)建與應(yīng)用研究

發(fā)布時(shí)間:2018-08-13 09:46
【摘要】:目的:構(gòu)建住院產(chǎn)婦母乳捐獻(xiàn)知識、態(tài)度及行為的知信行問卷,調(diào)查住院產(chǎn)婦母乳捐獻(xiàn)知信行現(xiàn)狀并分析其影響因素,旨在提高產(chǎn)婦母乳捐獻(xiàn)知識水平,幫助產(chǎn)婦建立母乳捐獻(xiàn)行為,并為今后改進(jìn)母乳捐獻(xiàn)的宣傳工作提供科學(xué)的理論依據(jù),以推進(jìn)我國母乳庫事業(yè)的發(fā)展。方法:1.通過查閱文獻(xiàn),了解當(dāng)前國內(nèi)外母乳捐獻(xiàn)知信行的研究現(xiàn)狀、研究進(jìn)展及最新的研究成果,在此基礎(chǔ)上初步制定住院產(chǎn)婦母乳捐獻(xiàn)知信行(KAP)問卷。2.實(shí)行德爾菲專家函詢,經(jīng)過2輪專家函詢,初步構(gòu)建包含知識、態(tài)度及行為3個(gè)維度的住院產(chǎn)婦母乳捐獻(xiàn)知信行(KAP)問卷。3.問卷預(yù)調(diào)查,驗(yàn)證問卷信效度:對125名住院產(chǎn)婦進(jìn)行初始問卷預(yù)調(diào)查,通過內(nèi)容效度分析、內(nèi)部一致性檢驗(yàn)、相關(guān)系數(shù)和因子降維分析,形成正式問卷。4.運(yùn)用構(gòu)建的問卷對該院250名產(chǎn)婦進(jìn)行母乳捐獻(xiàn)知信行現(xiàn)狀調(diào)查與分析。結(jié)果:1.通過專家函詢及統(tǒng)計(jì)驗(yàn)證,形成母乳捐獻(xiàn)知識、母乳捐獻(xiàn)態(tài)度、母乳捐獻(xiàn)行為3個(gè)維度25個(gè)條目的住院產(chǎn)婦母乳捐獻(xiàn)KAP調(diào)查問卷。調(diào)查問卷中知識維度分值為0-11分,態(tài)度維度采用Likert5級評分,分值9-45分,行為維度采用Likert4級評分法,分值5-20分,合計(jì)總分為14-76分。2.本次調(diào)查問卷的內(nèi)容效度較好,CVI為0.98,內(nèi)在一致性較高,問卷總Cronbach' s α 信度系數(shù)為 0.89。3.該醫(yī)院住院產(chǎn)婦母乳捐獻(xiàn)KAP調(diào)查問卷總分值51.03± 12.57分,最高得分74分,最低得分32分,其中知識維度分值為5.25±2.24分,態(tài)度維度分值為35.46±13.48分,行為維度分值為12.35±6.76分,知識維度和行為維度的分值較低。4.本次調(diào)查中僅有70名(28%)住院產(chǎn)婦聽說過母乳捐獻(xiàn),產(chǎn)婦獲得母乳捐獻(xiàn)知識的主要途徑為醫(yī)院官方宣傳(73%)和醫(yī)務(wù)工作者(43%),從網(wǎng)絡(luò)、廣播等媒體途徑的知識來源較少。5.不同特征住院產(chǎn)婦母乳捐獻(xiàn)知信行水平:5.1年齡:不同年齡組之間的產(chǎn)婦在知識維度上差異有統(tǒng)計(jì)學(xué)意義(P0.05),年齡越大知識得分越高。5.2教育程度:KAP問卷總得分、各維度得分與住院產(chǎn)婦的受教育程度成正比,教育程度越高其得分越高。5.3家庭月收入:僅家庭月收入小于5000元組的住院產(chǎn)婦在母乳捐獻(xiàn)問卷總得分、知識及行為維度得分低于其他三組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),其余三組間比較差異無統(tǒng)計(jì)學(xué)意義(P0.05),不同家庭月收入組在態(tài)度得分上差異無統(tǒng)計(jì)學(xué)意義(P0.05)。5.4經(jīng)產(chǎn)婦母乳捐獻(xiàn)知信行各維度得分和總得分均高于初產(chǎn)婦;有早產(chǎn)兒組住院產(chǎn)婦母乳捐獻(xiàn)知信行各維度得分和總得分均高于無早產(chǎn)兒組;純母乳喂養(yǎng)的住院產(chǎn)婦在KAP問卷總得分、各維度得分上高于混合喂養(yǎng)組,其差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。5.5新生兒體重:3組不同新生兒體重住院產(chǎn)婦在調(diào)查問卷各維度及總分值上比較結(jié)果顯示:小于2500g,2500g-4000g分別與大于4000g組間比較在知識維度,態(tài)度維度差異無統(tǒng)計(jì)學(xué)意義,僅在行為維度分值及總分值上差異有統(tǒng)計(jì)學(xué)意義(均P0.05)。5.6分娩方式和新生兒性別:經(jīng)t檢驗(yàn),分娩方式和新生兒性別對知識得分、態(tài)度得分、行為得分及總得分的影響無統(tǒng)計(jì)學(xué)差異(P0.05)。6.住院產(chǎn)婦母乳捐獻(xiàn)知識、態(tài)度及行為3個(gè)維度得分之間有較好的正相關(guān)性,經(jīng)檢驗(yàn)P0.01。7.多元回歸分析顯示是否首次分娩、有無早產(chǎn)兒對住院產(chǎn)婦母乳捐獻(xiàn)各維度得分和總得分影響較大,該變量在本研究中的存在有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1.構(gòu)建的住院產(chǎn)婦母乳捐獻(xiàn)知信行(KAP)調(diào)查問卷,具有較好的信效度,可用于臨床現(xiàn)狀調(diào)查。2.母乳捐獻(xiàn)知曉率低,知識、態(tài)度和行為之間有顯著的相關(guān)性,提高母乳捐獻(xiàn)知識水平有助于增強(qiáng)母乳捐獻(xiàn)意識,進(jìn)一步提高母乳捐獻(xiàn)率。問卷顯示居住地、家庭收入、教育程度對產(chǎn)婦母乳捐獻(xiàn)知識和行為有較大的影響,因此除了在以醫(yī)院母乳庫為中心的城市開展母乳捐獻(xiàn)宣傳外,同時(shí)也應(yīng)該將宣傳工作深入基層,建立更多的母乳采集點(diǎn),全面推動(dòng)我國母乳庫事業(yè)的發(fā)展。
[Abstract]:OBJECTIVE:To construct a questionnaire on knowledge,attitude and behavior of breast milk donation among in-patients,investigate the status quo of knowledge,attitude and behavior of breast milk donation among in-patients and analyze its influencing factors,so as to improve the knowledge level of breast milk donation,help lying-in women to establish breast milk donation behavior,and provide scientific theoretical basis for improving the propaganda of breast milk donation in the future. Methods: 1. Through consulting the literature, the current research status, research progress and the latest research results of breast milk donation knowledge and belief at home and abroad were understood. On this basis, a questionnaire on breast milk donation knowledge and belief (KAP) was initially formulated. 2. Delphi expert inquiry was carried out. After two rounds of expert inquiry, the preliminary study was carried out. To construct a KAP questionnaire including three dimensions of knowledge, attitude and behavior. 3. Questionnaire pre-survey to verify the reliability and validity of the questionnaire: 125 in-patient mothers were preliminarily investigated by content validity analysis, internal consistency test, correlation coefficient and factor dimensionality reduction analysis to form a formal questionnaire. The questionnaire was used to investigate and analyze the status quo of knowledge, belief and practice of breast milk donation among 250 parturients in this hospital. Results: 1. Through expert's inquiry and statistical verification, a KAP questionnaire was developed for inpatients with breast milk donation knowledge, attitude and 25 items of breast milk donation behavior. Likert grade 5 was used to evaluate the degree, with a score of 9-45, and Likert grade 4 was used to evaluate the behavior dimension. The score was 5-20, with a total score of 14-76.2. The content validity of the questionnaire was good, CVI was 0.98, and the internal consistency was high. The total Cronbach's alpha reliability coefficient of the questionnaire was 0.89.3. The total score of the KAP questionnaire for breast milk donation was 51.0. The score of knowledge dimension, attitude dimension, behavior dimension, knowledge dimension and behavior dimension were 5.25 (+ 2.24), 35.46 (+ 13.48), 12.35 (+ 6.76), respectively. The score of knowledge dimension and behavior dimension was lower than that of behavior dimension. The main ways of knowledge were hospital official propaganda (73%) and medical workers (43%). There were fewer sources of knowledge from internet, radio and other media channels. 5.2 Educational Level: The total score of KAP questionnaire was positively correlated with the educational level of inpatients. The higher the educational level, the higher the score was. 5.3 Family monthly income: Only the inpatients whose monthly family income was less than 5000 yuan scored lower than the other three groups in the total score of breast milk donation questionnaire, and the scores of knowledge and behavior dimensions were significantly lower (P 0.05). There was no significant difference among the other three groups (P Premature infants group; exclusive breast-feeding in-patient maternal KAP Questionnaire total score, each dimension score higher than the mixed feeding group, the difference was statistically significant (P 0.05). 5.5 Neonatal weight: three groups of different neonatal weight in-patient maternal questionnaire dimensions and total score: less than 2500g, 2500g-4000g and more than 4000g respectively There was no significant difference in knowledge dimension and attitude dimension between group G, except in behavior dimension and total score (all P 0.05). 5.6 Delivery mode and neonatal sex: t test, delivery mode and neonatal sex had no significant difference in knowledge score, attitude score, behavior score and total score (P 0.05). There was a good positive correlation among the scores of knowledge, attitude and behavior of breast milk donation among inpatients. The multiple regression analysis showed that whether the first delivery or not, whether premature infants had a greater impact on the scores of each dimension and the total score of breast milk donation of inpatients. The variables had statistical significance in this study (P 0.05). Conclusion: 1. The KAP questionnaire has good reliability and validity and can be used to investigate the clinical status quo. 2. The awareness rate of breast milk donation is low, and there is a significant correlation between knowledge, attitude and behavior. The paper shows that the place of residence, family income and educational level have a great influence on the knowledge and behavior of breast milk donation. Therefore, besides the propaganda of breast milk donation in the city centered on the hospital breast milk bank, the propaganda work should be carried out at the grass-roots level, and more breast milk collection sites should be established to promote the development of breast milk bank in China.
【學(xué)位授予單位】:南京中醫(yī)藥大學(xué)
【學(xué)位級別】:碩士
【學(xué)位授予年份】:2017
【分類號】:R473.71

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