比較產婦與護理人員對母嬰親善醫院十大政策之看法

本研究主要目的在比較產婦及護理人員對於母嬰親善醫院十大政策重要程度與困難程度之觀點差異，作為推展該項政策之參考。為描述性、比較性的研究，採立意取樣，以南部地區已通過認證之三所醫療院所產婦(n=150)及產兒科護理人員(n=150)為研究對象，以結構式問卷為研究工具，內容包括基本資料表及十大措施（含34細項）之重要程度與困難程度評量表。研究結果顯示：（1）對於「重要程度」之整體看法介於“重要”與“非常重要”之間，產婦及護理人員之間並無顯著差異。（2）對於「困難程度」之整體看法介於“不困難”與“有點困難”之間，其中有5項措施，產婦及護理人員有顯著差異，且護理人員高於產婦。（3）對於「重要程度」各細項之前3項排名，產婦及護理人員對於第8題：「工作人員熟知哺餵母乳之優點及相關知識」、第16題：「在產後8小時內有護理人員提供進一步哺乳之協助(哺餵母乳姿勢、維持泌乳、嬰兒含住乳房技巧)，給予指導，且告知他們可以得到協助」之重要性看法一致。（4）對於「困難程度」各細項之前3項排名，產婦及護理人員並無一致性的看法，但對於第1題：「醫療院所成立母嬰親善推動委員會，由副院長級以上人員擔任主任委員，並定期召開會議」、第13題：「剖腹生產之產婦，於手術清醒後半小時之內（不限地點），就能和自己的嬰兒，有10分鐘以上之皮膚接觸，在接觸時，工作人員教導如何觀察嬰兒想吃奶的表現，並且在想吃奶時協助」之執行困難度，則有趨於一致的看法。本研究結果藉由產婦及護理人員對於十大措施之觀點比較，可提升母嬰親善照護之具體實證參考，作為改善護理教育課程設計及提供在職教育的指引。

關鍵字

產婦；護理人員；母嬰親善；哺餵母乳

並列摘要

This study's main purpose is to compare the opinions between postpartum women and nurses on the importance and difficulty of implementing ten major policies in Baby-friendly Hospital Initiative. This comparative study may be used as a reference for proposed hospital policies. This descriptive, comparative study uses purposive sampling to sample 150 postpartum women and 150 nurses at three certified maternity hospitals in the southern region. This study uses a structured survey as a research tool. The 34-question survey includes a basic information table and gauges the importance and difficulty of ten major policies on rating scale. The results show four main points. First, the overall differences between "important" and "very important" between postpartum women and nurses were not significantly different. Second, for the "difficulty" portion of the range's overall scale, "not difficult" and "somewhat difficult", between which there are five measures, contains significant differences between postpartum women and nurses, who have a greater degree of difference than mothers. Third, for Question 8, "Staff familiar with the advantages of breastfeeding and related knowledge," pregnant women and nursing staff rank the question's importance equally. Similarly,postpartum women and nurses rank Question 16, "Within eight hours of delivery, there is nursing staff present to provide further assistance with breastfeeding (i.e. breastfeeding position, maintaining lactation, and baby's skill in latching onto the breast), guidance, and informing postpartum women that help is available," equally in importance. Fourth, in the breakdown of the three rankings’ "difficulty" potion, there is no consistency of opinion among postpartum women and nurses, except for the first question, which states, "The establishment of welfare committees at maternal and child health care institutions to promote welfare committees chaired by high ranking officials, such as a hospital vice president." However, there are consistent views for the ability to implement Question 13, "Within half an hour after Caesarean section surgery, the mother is awakened so that the she and the baby can have at least 10 minutes of skin contact in any hospital location. The staff teaches the mother how to observe the infant's performance and gives assistance when the infant wants to nurse." The results of this study of postpartum women and nurses’ opinions in ten major policy categories can use this specific empirical evidence to improve maternal and child care as well as the design of nursing education programs, while also providing job training guidelines.