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DC 欄位 | 值 | 語言 |
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dc.contributor.advisor | 張皓媛(Hao-Yuan Chang) | |
dc.contributor.author | Wan-Yu Hsieh | en |
dc.contributor.author | 謝婉瑜 | zh_TW |
dc.date.accessioned | 2023-03-19T23:37:52Z | - |
dc.date.copyright | 2022-10-05 | |
dc.date.issued | 2022 | |
dc.date.submitted | 2022-09-07 | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/86122 | - |
dc.description.abstract | 研究背景:乳汁淤積型乳房問題的發生,是造成產後婦女停止哺餵母乳最大的因素,但是,既有知識對於乳汁淤積型乳房問題的發生率與嚴重程度的相關因素,尚無完整了解。因此,本研究目的是探討北部某醫學中心產後一個月婦女發生乳汁淤積型乳房問題的發生率、發生率與嚴重程度的相關因素(尤其在飲食成分與內衣穿著型態方面的影響),以及初次發生乳汁淤積型乳房問題的時間點。 研究方法:以北部某醫學中心婦產科門診產檢之婦女,採方便取樣方式進行,研究取樣條件為20-45 歲懷孕滿37 週以上婦女、婦女於產前訪談即有意願產後哺餵母乳、有意願參與本研究並簽署研究同意書者即收案,排除條件為孕產合併症及新生兒入住新生兒加護病房者。共招募84 名產後婦女為研究對象,於陰道產產後第三天或剖腹產產後第四天、產後一個月回診當天,皆追蹤婦女是否發生乳汁淤積型乳房問題,透過填寫問卷、布尺量測乳房體積及三日全日飲食紀錄收集資料,分析方法採取羅吉斯迴歸與多重線性迴歸。 研究結果:乳汁淤積型乳房問題發生率,在84 名研究對象中,發生乳汁淤積型乳房問題的有58名(69%),獨立t 檢定顯示水份攝取量(g)、脂質攝取量(g)與產後一個月平均飲食卵磷脂攝取量(mg)與乳汁淤積型乳房問題者發生率有顯著相關性,但在羅吉斯迴歸結果顯示,水分攝取量較低(OR = 0.997, p< .001),脂質攝取量較高者(OR = 1.035, p = .03),乳汁淤積型乳房問題者發 生率顯著較高;但與產後一個月乳汁淤積型乳房的嚴重程度的相關因素為產婦於產後一個月有感覺到乳房改變(β = 2.83, p = .008),產婦自覺乳房體積增加越多,產後一個月乳汁淤積型乳房的嚴重程度也會越高。然而,產後一個月發生乳汁淤積型乳房問題並不會因為穿戴鋼圈胸罩而有差異。本研究也發現,產後一個月穿戴鋼圈內衣的比例為9.5%,相較於產前大幅下降。初次發生乳汁淤積型乳房 問題的時間點方面,平均初次發生乳汁淤積型乳房問題的時間點為100.48 小時(約產後4.17 天,標準差為131.89 小時),相較於剖腹產,陰道生產者較快發生乳汁淤積型乳房問題,但剖腹產雖然較晚發生,但發生率較高(78.9%);此外,有哺餵經驗者在產後初期,也較快發生乳汁淤積型乳房問題。 結論:飲食成分(如:水份較少與脂質較高)確實會提高塞奶風險,但是一旦發生,在此問題的嚴重程度上,卻是與產婦產後一個月內感覺到的乳房改變有關。平均初次發生乳汁淤積型乳房問題的時間點為產後4天左右。此研究建構國內乳汁淤積型乳房問題發生率,提供臨床醫護人員參考,同時作為護理指導飲食即內衣穿著之指標與依據。 | zh_TW |
dc.description.abstract | Background: A milk stasis is the primary cause that prompts postpartum women to discontinue breastfeeding. However, existing knowledge of factors associated with the incidence and severity of milk stasis is limited. Therefore, the purpose of this study is to explore the factors, particularly those concerning diet composition and brassiere choice, related to the incidence and severity of milk stasis in women who were early postpartum in a medical center in northern Taiwan. In addition, the onset of their first milk stasis was examined. Method: Convenience sampling was used to recruit women who received prenatal checkups at a medical center in northern Taiwan. They were aged 20–45 years and were 37 weeks pregnant or more. During a prenatal interview, the women expressed the intention to breastfeed their baby, and before the study, they signed a written consent to participate in the research and exhibited maternal or neonatal comorbidity (e.g., being admitted to the neonatal intensive care unit). A total of 84 postpartum women were recruited, who were asked about their experience of milk stasis on the third (vaginal delivery) or fourth (cesarean delivery) day after childbirth and during the early postpartum follow-up visit to the medical center. Collected data by filling in questionnaires, measuring breast volume with cloth ruler, and three-days dietary records, the statistical analysis used Logistic regression and multiple linear regression. Results: Among the 84 participants, 58 experienced a milk stasis, yielding an incidence of 69%. The independent t-test indicated a significant correlation of the incidence of milk stasis with water intake (g), fat intake (g), and the monthly average lecithin intake (mg) in the month following childbirth. According to the logistic regression analysis, the incidence of milk stasis was significantly higher in participants with low water intake (odds ratio = 0.997, p < .001) and high fat intake (odds ratio =1.035, p = .03). The severity of milk stasis early postpartum was associated with participants’ perception of changes in their breasts (β = 2.83, p = .008); specifically, the more they perceived the extent of increase in their breast size, the more severe their duct blockage became. However, the severity of milk stasis early postpartum did not vary with the types of brassiere worn by participants. Additionally, 9.5% of participants wore an underwire brassiere 1 month following their childbirth, which was much lower than the prenatal percentage. On average, the onset of participants’ first experience of milk stasis occurred 100.48 hours (approximately 4.17 days, with a standard deviation of 131.89 hours) after childbirth. Participants who underwent a cesarean section experienced milk stasis later but more frequently (78.9%) than did those who delivered vaginally. During the early postpartum period, participants who had experiences in breastfeeding exhibited milk stasis earlier than did those who had no such experiences. Conclusions: Inadequate less water and more fat increased the risk of milk stasis. Among participants who experienced a milk stasis, the blockage severity was associated with their perception of changes in their breasts in the month following childbirth. On average, milk stasis developed approximately 4 days after childbirth. This study offered clinical workers an insight into the incidence of milk stasis in Taiwanese women and provided indicators and references for nursing instructions on diet and brassiere choice for postpartum women. | en |
dc.description.provenance | Made available in DSpace on 2023-03-19T23:37:52Z (GMT). No. of bitstreams: 1 U0001-1708202207512000.pdf: 3238646 bytes, checksum: a8ef7625084a6ad7e82c9f7e677644a6 (MD5) Previous issue date: 2022 | en |
dc.description.tableofcontents | 摘要 II ABSTRACT IV 目錄 VI 表目錄 IX 圖目錄 XI 第一章 緒論 1 第一節 研究動機與重要性 1 第二節 研究目的 2 第三節 研究問題 3 第二章 文獻查證 4 第一節 哺育母乳期間常見的乳汁淤積型乳房問題 4 第二節 產後一個月飲食的特性 9 第三節 哺育期建議的飲食攝取 15 第四節 飲食評估方法 17 第五節 產後一個月的乳房變化與內衣 24 第六節 產後一個月飲食與乳汁淤積型乳房問題的相關性 29 第三章 研究方法 32 第一節 研究設計 32 第二節 研究架構 33 第三節 研究對象 34 第四節 樣本數 35 第五節 研究工具 36 第六節 研究流程 39 第七節 資料處理與分析 41 第八節 研究倫理考量 43 第四章 研究結果 44 第一節 基本資料 44 第二節 乳汁淤積型乳房問題發生情形 63 第三節 乳汁淤積型乳房問題發生率的風險因素 76 第四節 乳汁淤積型乳房問題嚴重程度的相關因素 78 第五章 討論 81 第一節 產後一個月乳汁淤積型乳房問題發生率 81 第二節 產後一個月婦女穿著鋼圈內衣與乳汁淤積型乳房問題相關性 84 第三節 產後一個月飲食型態與乳汁淤積型乳房問題的發生率 85 第四節 乳汁淤積型乳房問題與產後乳房改變之關聯 87 第六章 結論與建議 89 第一節 結論 89 第二節 護理之應用與建議 89 第三節 研究限制與建議 90 第七章 參考文獻 91 中文文獻 91 英文文獻 92 第八章 附錄 107 | |
dc.language.iso | zh-TW | |
dc.title | 產後一個月乳汁淤積型乳房問題與飲食、內衣的相關性 | zh_TW |
dc.title | Association between Milk Stasis and Food Intak/Brassiere during the First Month Postpartum | en |
dc.type | Thesis | |
dc.date.schoolyear | 110-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 高美玲(Meei-Ling Gau),董家堯(Jia-Yau Doong) | |
dc.subject.keyword | 哺乳問題,產後一個月,乳汁淤積,飲食攝取,內衣, | zh_TW |
dc.subject.keyword | lactation problem,early postpartum,milk stasis,food intake,brassiere, | en |
dc.relation.page | 114 | |
dc.identifier.doi | 10.6342/NTU202202480 | |
dc.rights.note | 同意授權(全球公開) | |
dc.date.accepted | 2022-09-08 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 護理學研究所 | zh_TW |
dc.date.embargo-lift | 2022-10-05 | - |
顯示於系所單位: | 護理學系所 |
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