請用此 Handle URI 來引用此文件：
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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 張皓媛 | zh_TW |
| dc.contributor.advisor | Hao-Yuan Chang | en |
| dc.contributor.author | 邱佩珊 | zh_TW |
| dc.contributor.author | Pei-Shan Chiu | en |
| dc.date.accessioned | 2024-08-16T17:58:08Z | - |
| dc.date.available | 2024-12-27 | - |
| dc.date.copyright | 2024-08-16 | - |
| dc.date.issued | 2024 | - |
| dc.date.submitted | 2024-06-24 | - |
| dc.identifier.citation | 參考文獻
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Revista Latino-Americana de Enfermagem, 26, e3035. https://doi.org/10.1590/1518-8345.2110.3035 Webber, E., & Benedict, J. (2019). Postpartum depression: A multi-disciplinary approach to screening, management and breastfeeding support. Archives of Psychiatric Nursing, 33(3), 284-289. https://doi.org/10.1016/j.apnu.2019.01.008 Woolhouse, H., James, J., Gartland, D., McDonald, E., & Brown, S. J. (2016). Maternal depressive symptoms at three months postpartum and breastfeeding rates at six months postpartum: Implications for primary care in a prospective cohort study of primiparous women in Australia. Women Birth, 29(4), 381-387. https://doi.org/10.1016/j.wombi.2016.05.008 World Health Organization. (2018). Ten steps to successful breastfeeding. World Health Organization. https://www.who.int/nutrition/bfhi/ten-steps/en/ World Health Organization[WHO]. (2008). Indicators for assessing infant and young child feeding practices – part I: Definitions. conclusions of a consensus meeting held 6–8 November 2007 in Washington D.C. World Health Organization. Yokoyama, M., Tanaka, K., Sugiyama, T., Arakawa, M., & Miyake, Y. (2020). Cesarean section is associated with increased risk of postpartum depressive symptoms in Japan: The Kyushu Okinawa Maternal and Child Health Study. Journal of Affective Disorders, 278, 497-501. https://doi.org/10.1016/j.jad.2020.09.106 Yusuff, A. S., Tang, L., Binns, C. W., & Lee, A. H. (2016). Breastfeeding and postnatal depression: A prospective cohort study in Sabah, Malaysia. Journal of Human Lactation, 32(2), 277-281. https://doi.org/10.1177/0890334415620788 Zanardo, V., Bertin, M., Sansone, L., & Felice, L. (2017). The adaptive psychological changes of elective induction of labor in breastfeeding women. Early Human Development, 104, 13-16. https://doi.org/10.1016/j.earlhumdev.2016.10.007 | - |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/94748 | - |
| dc.description.abstract | 研究背景：產後憂鬱的影響因子多元，導致既有文獻知識對於母乳哺育型態、早期母乳哺育困難與產後憂鬱之間的關係的說法歧異，故本研究在控制已知風險因子之下，檢驗母乳哺育型態和早期母乳哺育困難對產後三個月憂鬱風險的影響。
研究方法：本研究採縱向式研究設計，於台北市某醫學中心的婦產科門診進行收案，招募對象為懷孕滿24週的新手準母親，招募98位，以自擬結構式問卷內容蒐集資料，包含中文版愛丁堡產後憂鬱量表(Edinburgh postnatal depression scale, EPDS)、人口學特性資料、孕產史、母乳哺育型態與早期母乳哺育困難。收集資料時間點分別為孕期滿24週、產後3-5天、4-6週、三個月，有效問卷回收率為92%，共90位。資料將以統計軟體SPSS 26.0版進行廣義估計模式(GEE)分析及解釋。 研究結果：如研究假設所預期，產前憂鬱高風險(OR = 1.36, p = .012)、產後子宮收縮痛(OR = 1.04, p = .037)和出院動向為返家(OR = 2.12, p = .001)皆為產後憂鬱的相關影響因子。在控制上述已知影響因素後(如產前憂鬱情形、產後疼痛狀況與出院動向)，早期母乳哺育困難中的乳頭平或凹陷(OR = 1.08, p = .039)則對於產後憂鬱高風險有顯著影響。然而，母乳哺育型態對於產後三個月的憂鬱風險無顯著影響(OR = 1.03, p = .813)。 結論：在考量產前憂鬱情形、產後疼痛狀況與出院動向後，當孕產婦發生早期母乳哺育困難中的乳頭平或凹陷時，產後憂鬱的風險會增加，但是，母乳哺育型態與產後憂鬱的風險無關。故此研究建議透過於孕期乳房評估給予適時的介入與指導，針對孕期篩檢產前憂鬱高風險群、產後子宮收縮為中強度疼痛(≧4分)者，產婦出院動向為回家者，持續追蹤產後高憂鬱風險，並早期介入，以期降低發生率。 | zh_TW |
| dc.description.abstract | Background: Postpartum depression is affected by various factors, resulting in divergent views on the relationship among breastfeeding patterns, early breastfeeding difficulties and postpartum depression. Therefore, the study aims to examine the effects of breastfeeding pattern and early breastfeeding difficulties on the risk of postpartum depression during three months after birth, while controlling the known risk factors.
Method: This study adopts a longitudinal study design. Participants were recruited in an antenatal clinic of a medical center in Taipei. Inclusion criteria were new expectant mother after gestational week 24. Data were collected by self-administrated questionnaires, including Edinburgh postnatal depression scale (EPDS), demographic characteristics, obstetric history, breastfeeding pattern, and early breastfeeding difficulties. The data were collected during the recruitment (GA 24 week), 3-5 days, 4-6 weeks and three months postpartum. Data were analyzed by statistical software SPSS version 26.0. Results: As predicted, a higher risk of antenatal depression (OR = 1.36, p = .012), postpartum uterine contraction pain (OR = 1.04, p = .037), and stayed at home (OR = 2.12, p = .001) were associated with postpartum depression. After controlling for above variables, early breastfeeding difficulties due to flat or indented nipples (OR = 1.08, p = .039) was significantly associated with higher risk of postpartum depression. However, breastfeeding pattern (OR = 1.03, p = .813) showed no significant association with the risk of postpartum depression within three months postpartum. Contribution: After considering prenatal depression, postpartum pain, and accommodation after discharge, early breastfeeding difficulties (i.e., nipple flattening or indenting) increases the risk of postpartum depression. However, breastfeeding pattern was not significantly associated with the risk of postpartum depression. Therefore, the study recommends breast assessment during pregnancy. Further, we also recommend screening and follow-up women with high-risk factors, including high-risk prenatal depression, moderate to severe pain of uterine contractions after delivery, and accommodation as back home after maternal discharge, to reduce the incidence and risk of postpartum depression. | en |
| dc.description.provenance | Submitted by admin ntu (admin@lib.ntu.edu.tw) on 2024-08-16T17:58:08Z No. of bitstreams: 0 | en |
| dc.description.provenance | Made available in DSpace on 2024-08-16T17:58:08Z (GMT). No. of bitstreams: 0 | en |
| dc.description.tableofcontents | 口試委員會審定書 i
謝辭 ii 中文摘要 iii ABSTRACT iv 目次 v 圖次 viii 表次 ix 第一章 前言 1 第一節 研究動機及重要性 1 第二節 研究目的 3 第三節 名詞定義 4 第二章 文獻查證 6 第一節 母乳哺育 6 一、台灣母乳哺育的推廣及現況 6 二、母乳哺育對產婦的影響 7 三、母乳哺育對嬰兒的影響 9 第二節 產後憂鬱 11 一、產後憂鬱症的定義 11 表 1 產後情緒低落與產後憂鬱的比較 11 二、產後憂鬱症的篩檢 12 三、產後憂鬱症的影響 13 四、產後憂鬱的相關風險因子 14 第三節 母乳哺育和產後憂鬱的相關性 20 一、母乳哺育對產後憂鬱的影響 20 二、產後憂鬱對母乳哺育的影響 21 三、早期母乳哺育困難 21 第三章 研究方法 23 第一節 研究架構 23 圖 1 研究架構 23 第二節 研究設計 24 第三節 研究測量工具 25 第四節 資料收集 27 表 2 基本屬性資料及問卷資料的收集時間 27 第五節 資料處理與統計方法 28 表 3 推論性統計 29 第六節 研究倫理 30 第四章 研究結果 31 第一節 基本屬性資料分析 31 表 4- 1 人口學基本資料分布情形(N = 90) 31 表 4- 2 產科學基本資料分布情形(N = 90) 32 表 4- 3 早期母乳哺育困難程度分布情形(N = 90) 35 表 4- 4 母乳哺育型態各階段分布情形(N = 90) 36 表 4- 5 產後憂鬱量表各階段分數及高低風險分布情形(N = 90) 37 第二節 基本屬性與各階段產後憂鬱之相關性及差異性分析 37 表5-1- 1 人口學基本屬性(類別變項)與T0-T3產後憂鬱高低風險之差異性分析(N = 90) 38 表5-1- 2 產科學基本屬性 (類別變項)與T1-T3產後憂鬱高低風險之差異性分析(N = 90) 40 表5-2- 1 基本屬性(連續變項)與T1(產後48-72小時)產後憂鬱高低風險之相關性分析(N = 90) 45 表5-2- 2 基本屬性(連續變項)與T2(產後4-6週)產後憂鬱高低風險之相關性分析(N = 90) 45 表5-2- 3 基本屬性(連續變項)與T3(產後三個月)產後憂鬱高低風險之相關性分析(N = 90) 45 第三節 影響產後憂鬱高低風險及其相關因素分析 47 表6 用GEE分析影響產後憂鬱高低風險之相關因素表6 1 48 第五章 討論 49 第一節 影響產後憂鬱高低風險的基本屬性分析與比較 49 表7 子宮收縮對受試者的影響 51 第二節 早期母乳哺育困難與產後憂鬱高低風險之分析與比較 54 第三節 母乳哺育型態與產後憂鬱高低風險之分析與比較 56 第六章 結論與建議 58 第一節 結論 58 第二節 建議 59 一、根據孕婦產前健康照護衛教指導紀錄表，將產前憂鬱篩檢納入衛教評估項目 59 二、將子宮收縮疼痛納入產後優先處置的疼痛項目，且同時評估婦女對疼痛的應對處理方式 59 三、依照第2次孕婦產前健康照護衛教指導紀錄表，納入出院規劃衛教評估項目 60 四、進行第2次孕婦產前健康照護衛教指導時，將早期母乳哺育困難處置方法納入母乳哺育衛教項目 60 第三節 研究限制與未來建議 62 參考文獻 63 中文部分 63 英文部分 64 附錄 75 附錄一 研究倫理委員會核可證明 75 | - |
| dc.language.iso | zh_TW | - |
| dc.subject | 早期母乳哺育困難 | zh_TW |
| dc.subject | 母乳哺育型態 | zh_TW |
| dc.subject | 產後憂鬱 | zh_TW |
| dc.subject | 產後 | zh_TW |
| dc.subject | 母乳哺育 | zh_TW |
| dc.subject | postpartum depression | en |
| dc.subject | breastfeeding pattern | en |
| dc.subject | postpartum | en |
| dc.subject | early breastfeeding difficulties | en |
| dc.subject | breastfeeding | en |
| dc.title | 探討母乳哺育型態和早期母乳哺育困難對產後憂鬱風險的影響 | zh_TW |
| dc.title | Effects of Breastfeeding Pattern and Early Breastfeeding Difficulties on the Risk of Postpartum Depression | en |
| dc.type | Thesis | - |
| dc.date.schoolyear | 112-2 | - |
| dc.description.degree | 碩士 | - |
| dc.contributor.oralexamcommittee | 楊雅玲;林芯伃 | zh_TW |
| dc.contributor.oralexamcommittee | Ya-Ling Yang;Shin-Yu Lin | en |
| dc.subject.keyword | 早期母乳哺育困難,產後憂鬱,母乳哺育型態,產後,母乳哺育, | zh_TW |
| dc.subject.keyword | early breastfeeding difficulties,postpartum depression,breastfeeding pattern,postpartum,breastfeeding, | en |
| dc.relation.page | 76 | - |
| dc.identifier.doi | 10.6342/NTU202401313 | - |
| dc.rights.note | 同意授權(限校園內公開) | - |
| dc.date.accepted | 2024-06-25 | - |
| dc.contributor.author-college | 醫學院 | - |
| dc.contributor.author-dept | 護理學研究所 | - |
| 顯示於系所單位： | 護理學系所 | |
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