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  • 學位論文

哺餵母乳自主性量表之發展與信效度檢驗

Development and Assessment of the Validity and Reliability of the Maternal Breastfeeding Autonomy Scale

指導教授 : 李淑杏

摘要


研究背景: 母乳哺育是全球重要的公共健康議題,基於母乳哺餵對於提升孩子與母親的生理健康及促進情感連結有著重要影響,其啟動及維持最終取決於母親的自主性,儘早辨識母親哺餵母乳自主性將有助於維護孩子與母親之福祉。然而目前缺乏評量母親哺餵母乳自主性的工具,因此發展一份具有信效度的問卷量表。 研究目的:發展哺餵母乳自主性量表,並進行信效度檢測。 研究方法: 哺餵母乳自主性量表初版之30個題項由文獻查證及臨床調查擬定,歷經專家內容效度檢驗與預試後形成包含25個題項之量表。採方便取樣招募中部某醫學中心孕期35週以上婦女共203名,使用一份結構式問卷收集相關資料,問卷內容包含:個人屬性、哺餵母乳自主性量表,用於檢驗婦女哺餵母乳自主性量表之建構效度。然後進行探索性分析(exploratory factor analysis, EFA)、及內在一致性、再測信度檢定考驗量表的信效度。 研究結果: 效度檢測:1.量表內容歷經兩次專家效度檢定後保留題項共25題,評定結果S-CVI/Ave值為 0.99。2.探索性因素分析以因素負荷量0.4為選取標準,獲得包含25個題項、四個面向之量表,分別命名為因素一:母乳哺餵的社會關聯性、因素二:母乳哺餵的權衡利益考量、因素三: 母乳哺餵的決策行動力、因素四:母乳哺餵的自覺情感需求,總解釋變異量為 71.19%。在效標關連效度,以皮爾森相關係數檢驗與母乳哺餵自我效能簡式量表(Breastfeeding self-efficacy scale-short form,BSES-SF)之相關性,達顯著正相關(p<.001)。信度檢測:1.整體量表之內在一致性Cronbach’s α值為.961;2.再測信度組內相關係數值(Intra-class Correlation Coefficient, ICC)為 0.594(p<.001)。量表分數越高表示研究對象的哺餵母乳自主性越高,經使用單因子變異數分析(One-way ANOVA)探討哺餵母乳自主性量表得分與產後哺餵方式的差異性,研究結果具有顯著差異性(F=15.475, p <.01),當研究對象哺餵母乳自主性得分越高,產後越有可能進行純母乳哺餵。研究結果顯示量表具有良好的信度與效度。 結論:本研究發展之哺餵母乳自主性量表已初步獲得適當的信效度,量表未來可運用於臨床照護及相關研究,並作為介入措施之成效檢測,以進一步探討哺餵母乳自主性與母乳哺育實務之關聯,提供更符合母親哺乳需求之照護。

並列摘要


Background: Breastfeeding is an important global public health issue that significantly impacts the physical health of the child and mother and promotes an emotional connection. However, initiation and maintenance of breastfeeding ultimately depend on the autonomy of mother. Promotion of autonomy among breastfeeding mothers may help to improve the well-being of children and mothers. Due to the lack of a tools to assess mothers’ breastfeeding autonomy, we aimed to develop a reliable and valid questionnaire. Purpose: To develop a breastfeeding autonomy scale and conduct reliability and validity testing. Methods: The 30 items of the first version of the Breastfeeding Autonomy Scale were identified by literature searches and clinical knowledge; a scale containing 25 items was formed after expert content validity testing and pre-tests. A total of 203 women over 35 weeks of gestation were recruited from a medical center in central Taiwan by convenience sampling. A structured questionnaire including personal attributes was used to collect relevant information. We tested the construct validity, performed exploratory factor analysis, assessed the internal consistency, and retested the reliability and validity of the scale. Results: In validity tests, a total of 25 items were retained after two expert validity verifications; the evaluation led to a S-CVI/Ave of 0.99. Exploratory factor analysis taking a factor load of 0.4 as the selection standard resulted in a scale containing 25 items and four dimensions: Factor 1, the social relevance of breastfeeding; Factor 2, Breastfeeding weighing and benefit consideration; Factor 3, Breastfeeding decision-making ability; Factor 4, The conscious emotional demand for breastfeeding. Total explained variance was 71.19%. In terms of the validity of the criteria, a significant positive correlation was achieved with the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF; p<.001, Pearson’s correlation coefficient). In reliability testing, the Cronbach’s α-value for the internal consistency of the overall Breastfeeding Autonomy Scale was .961. In re-testing, the intra-class correlation coefficient was 0.594 (p<.001). The higher the scale score, the higher the breastfeeding autonomy of the research subjects. One-way ANOVA revealed significant differences (F=15.475, p<.01) between the Breastfeeding Autonomy Scale scores and postpartum feeding methods; subjects with higher scores were more likely to breastfeed exclusively after delivery. These results indicate the scale has good reliability and validity. Conclusion: The Breastfeeding Autonomy Scale developed in this research initially achieved appropriate reliability and validity. This scale could be used in clinical care and related researches , and test the effectiveness of interventional measures for further discussion the corrlaction between breastfeeding autonomy and breastfeeding practice. The scale is relevant to practice and helps nurses provide care that better meets the needs of breastfeeding mothers.

參考文獻


談靜慧、金繼春(2004)•自主之概念分析•護理雜誌,51(3),65-70。
中文部份
中華民國教育部版(2018)‧教育部重編國語辭典修訂本‧自主。
http://dict.revised.moe.edu.tw/cgi-bin/cbdic/gsweb.cgi?ccd=CRl4X.
o=e0 sec=sec1 op=v view=0-1〔The Republic of China Mi

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