提升產後機構護理人員觀察嬰兒暗示行為能力

Improving the Ability of Nurses in Postpartum Institutions to Observe Infant Cues

背景：嬰兒暗示是新生兒期肢體語言，嬰兒會表現暗示行為傳達特定需求。護理人員閱讀嬰兒暗示給予回應，可協助父母與嬰兒建立聯繫進行有意義互動之橋梁。現況發現護理師觀察嬰兒飢餓、飽足、壓力暗示行為的知識、態度及行為能力不足，餵食皆以定時定量、哭泣為餵食依據。當餵食過程嬰兒出現飽足暗示，護理師無法分辨飽足暗示，皆以餵完原定奶量，導致嬰兒出現不吸吮及溢吐奶等壓力暗示發生。
目的：提升產後機構護理人員觀察嬰兒暗示行為知識、態度、行為之能力。
方法：以嬰兒暗示行為訓練課程包含講授、圖片、影片教學，說明觀察嬰兒暗示行為知識重要性，並成立種子教師群，以嬰兒暗示行為達到教學共識。制定「觀察嬰兒暗示行為（infant cues）mini-CEX教案-學員評量表」，透過情境模擬，觀察嬰兒暗示行為過程，並可立即澄清問題及給予回饋指導及協助。同時以嬰兒飢餓暗示分期圖，供護理人員及母親可隨時觀看對照。本專案單組前後測設計，針對11位護理人員接受觀察嬰兒暗示行為訓練課程、小組分組教學及實作，以自擬嬰兒暗示行為知識、態度、行為問卷，評量前後，並以成對t檢定驗證此訓練課程成效。
結果：護理人員接受嬰兒暗示行為課程、小組分組教學及實作，以「觀察嬰兒暗示行為（infantcues）mini-CEX教案評量表」進行評值，平均數為90，標準差為5.91。於護理人員觀察嬰兒暗示行為知識、態度、行為，其知識後測顯著高於前側；態度後測顯著高於前側；行為後測顯著高於前側，達統計上顯著。
結論：嬰兒暗示行為訓練課程，能有效提升產後機構護理人員觀察嬰兒暗示行為能力，護理師於臨床傳授予產後母親，提升母親育兒信心。此結果可做為其他產後機構進行觀察嬰兒暗示行為訓練課程規劃之參考。

Background: Baby cues are forms of body language exhibited during the newborn period through which infants communicate their needs. When nurses are able to accurately read and respond to these cues, they can help parents recognize their infants’signals, thereby promoting meaningful bonding and interaction. However, current observations show that nurses have insufficient knowledge, attitudes, and skills regarding the identification of newborns’hunger, satiety, and stress cues. Feeding is often based on fixed schedules or crying alone. When infants display fullness cues during feeding, nurses may be unable to recognize these signals and proceed with prescribed feeding volumes, which can lead to stress responses such as non-sucking or milk regurgitation.
Purpose: To enhance the knowledge, attitudes, and behaviors of nurses in postpartum care institutions regarding the observation and interpretation of infant cue behaviors.
Method: An infant cue behavior training program was implemented using a combination of lectures, visual aids, and video-based instruction to explain the knowledge and importance of observing infant cues. A group of seed instructors was established to standardize teaching content and reach consensus on instructional methods. A“Mini-CEX Lesson Plan—Infant Cue Observation Student Evaluation Form”was developed. Using scenario-based simulations, participants observed infant cues and received immediate feedback, clarification of misunderstandings, and guidance when needed. A visual chart depicting stages of infant hunger cues was also provided for nurses and mothers to reference at any time. This project adopted a single-group pretest–posttest design involving 11 nurses who participated in the training course, group teaching, and hands-on practice. A self-developed questionnaire measuring knowledge, attitudes, and behaviors related to infant cue observation was administered before and after the training. A paired t-test was used to evaluate training effectiveness.
Results: Nurses who completed the infant cue training course, group instruction, and practice achieved an average score of 90 (SD = 5.91) on the“Infant Cue Observation Mini-CEX Teaching Evaluation Scale.”Posttest scores for knowledge were significantly higher than pretest scores; attitude posttest scores were also significantly higher; and behavioral posttest scores showed significant improvement as well.
Conclusion: The infant cue behavior training course effectively improved nurses’abilities to observe and interpret infant cues in postpartum institutions. With improved competency, nurses can better support and teach postpartum mothers to recognize infant signals, thereby enhancing maternal parenting confidence. These findings may serve as a reference for planning similar infant cue behavior training programs in other postpartum care institutions.