坐月子地點與母職心理和角色適應──六個月的追蹤性研究

The Influence of Confinement Location on Maternal Psychological and Role Adaptation: A Six-Month Follow-Up Study

背景：台灣現今已有七成的產後婦女選擇到產後機構坐月子；然鮮少有研究持續追蹤坐月子地點與母職心理與角色適應的關係。
目的：探討坐月子地點對產後母親心理與母職角色適應之差異，以及分析產後6個月母親母育信心及母職能力的預測因子。
方法：採比較性與追蹤性研究設計，方便取樣在產後護理之家及居家坐月子兩組婦女，以G-power估算後共收集157人，分別在產後1週、1個月以及6個月施測。研究工具包括人口學資料以及六個量表，主要以廣義估計方程式（generalized estimating equations）進行統計分析。
結果：婦女於產後隨著時間的增加、經產婦、有宗教信仰以及母嬰連結較佳者，其母育信心較高（p < .05）。此外，選擇在居家坐月子、無受僱工作、有宗教信仰、較低的壓力與憂鬱、自覺睡眠品質佳以及母嬰連結較佳者，其母職能力較高（p < .05）。
結論／實務應用：建議產後護理機構能夠積極推動提升母職能力的策略，讓入住的母親在休養與育兒準備中取得平衡。另外，產科醫療照護人員能落實現行母嬰連結相關政策，以提高母育信心與母職能力，促進母職角色的適應。

Background: Approximately 70% of postpartum women in Taiwan choose postpartum care institutions for their postpartum confinement. However, few studies have explored the follow-up relationship between confinement location and, respectively, maternal psychological and role adaptation.
Purpose: To explore the differences in psychology and maternal role adaptation between postpartum women in two different confinement locations and to analyze the predictors of maternal confidence and maternal competence at six-months postpartum.
Methods: A comparative and follow-up research design was adopted. We recruited a convenience sample of two groups of women confined, respectively, at postpartum nursing centers and at home. One hundred fifty-seven mothers recruited after G-power estimation were enrolled as participants and completed demographic data and six scales at one-week, one-month, and six-months postpartum. The statistical analysis was performed mainly using generalized estimating equations.
Results: For all participants, maternal confidence was positively associated with time, being multipara, having religious beliefs, and having better mother-infant bonding (p < .05). In addition, being confined at home, being unemployed, having religious beliefs, perceiving lower levels of stress and depression, having better sleep quality, and having better mother-infant bonding were associated with higher maternal competence (p < .05).
Conclusions/ Implications for Practice: Based on the findings of this study, postpartum nursing institutions should actively promote strategies to improve maternal competence to help mothers staying in postpartum nursing centers strike an optimal balance between recuperation and parenting preparation. Furthermore, obstetric health professionals should implement policies related to mother-infant bonding to increase maternal confidence and competence and, subsequently, facilitate maternal role adjustment.