比較產婦與護理人員對母嬰親善醫院十大措施之看法

A Comparison of Postpartum Women's Perspectives and Nurses' Perspectives on Baby-Friendly Hospital Initiatives

本研究目的旨在比較產婦及護理人員對母嬰親善醫院十大政策重要程度與困難程度之觀點；為描述性、比較性的研究，採方便取樣，以南部地區已通過認證之三所醫療院所產婦（n=150）及產兒科護理人員（n=150）為研究對象，運用結構式問卷收集資料。結果顯示：（1）產婦與護理人員在重要程度之整體看法介於“重要”與“非常重要”之間，雖未達顯著性差異，但產婦在「提供母嬰工作人員教育訓練、提供哺乳及維持泌乳指導和依嬰兒需求哺餵母乳」等3項的重要程度最高；而護理人員則含括前2項及「實施親子同室」的重要程度較高。（2）對「困難程度」之整體看法則介於“不困難”與“有點困難”之間，其中在措施四、六、八、九、十5等項措施（如：產後即刻母嬰肌膚接觸、非醫療需求不提供哺乳嬰兒母乳之外的食物或飲料等），產婦及護理人員的觀點達顯著性差異，護理人員較產婦感到困難。（3）對「重要程度」各細項之排名，產婦及護理人員一致認為「工作人員熟知哺餵之優點及相關知誠」及「產後8小時內有護理人員提供進一步哺乳之協助」等2項相當重要。本研究顯示產婦和護理人員對於母嬰親善醫院十大措施均認為重要且可行，但部分措施仍有執行上的困難度，可作為持續改善及推展之實證參考。

This study compares the differences in the perspectives on the importance and the difficulties of implementing the ten measures of baby-friendly hospital initiatives. It is a descriptive and comparative study using convenience sampling from three certified hospitals with 150 postpartum women and 150 nurses in the southern region of Taiwan. A set of structured questionnaires was developed for data collection. The results indicated that both postpartum women and nurses believed that the important levels of the overall ten measures were between very important and important, although no significant differences existed between the two groups. The most important three measures for postpartum women were providing hospital staff with educational training, providing postpartum women with the guidelines of breastfeeding and breastmilk secretion, and breastfeeding being based on the baby's needs. For nurses, the three most important measures were the same as the first two for postpartum women, with the addition of staying in the room with babies. The difficulty level of overall perspectives fell between a little difficult and no difficulty with the exception of five measures ( ＂instant skin contact for postpartum mother with baby＂, ＂no food or drink to be provided to breastfeeding women postpartum unless medically indicated＂, etc.) These five measures were more difficult for nurses than for postpartum women, with significant differences. Both postpartum women and nurses consistently agreed that it is quite important for staff to be knowledgeable about the advantage of breastfeeding and provide further assistance in breastfeeding to women within eight hours of postpartum. The findings of this study indicate that both postpartum women and nurses think that the ten measures of baby-friendly hospital initiatives are important and feasible; however, part of these measures demonstrate difficulty in implementation. This study can be used as an evidence-based reference for continuous improvement and promotion of postpartum care.