臺灣博碩士論文加值系統

本研究主要目的是探討人口學因素與婦女產後不同時期（生產住院期間、嬰兒出生後一個月、四個月及六個月）哺育方式之相關性，及瞭解母嬰親善措施對婦女產後不同時期哺育方式之相關性。以2004年郭氏等所做「台灣地區母乳哺育及其相關因素之探討」收集的資料庫進行次級資料分析，原始研究之個案數共計12,201位產後婦女，本研究考量回答之精確性，乃以個案自行回答者為研究對象，故共計11,529位之有效樣本。以SPSS for Windows中文版12.0版套裝統計軟體進行分析。研究結果發現各不同時期影響哺育母乳的重要預測因素，住院期間為：產婦專科以上學歷（參考組為高中及高中以下, OR=1.36）、原先計畫哺餵母乳者（OR=1.21），有早期肌膚接觸（OR=2.48, AR=12.3）、母嬰同室12小時以下（參考組為沒有母嬰同室）(OR =1.81, AR = 15.8%），母嬰同室13-24小時（參考組為沒有母嬰同室）（OR =3.80, AR=7.6%），有依需求哺乳（OR =1.40, AR=20.0%），非醫療需求不餵其他食物（OR =2.02, AR=19.9%）。
預測一個月時是否哺育母乳的重要變項如下：有工作（OR =0.71），產婦專科以上學歷（參考組為高中及高中以下, OR =1.37）、陰道生產(OR= 1.40)、原先計畫哺餵母乳（OR =3.29）、醫護人員有說明母乳哺育重要性（OR =1.28, AR=17.8%）、有早期肌膚接觸經驗（OR =1.40, AR=5.9%）、12小時母嬰同室（參考組為沒有母嬰同室）（OR =1.22, AR=6.4%）、母嬰同室13-24小時（參考組為沒有母嬰同室）（OR =2.35, AR=5.9%）、非醫療需求不餵其他食物（OR =1.23, AR=7.4%）、出院後提供母乳哺育諮詢資源（OR =1.16, AR=10.0%），產後至6個月有收到奶粉贈品或廣告（OR =0.88, AR=-4.29%）。
預測四個月時是否哺育母乳的重要變項如下：年齡（OR =1.02）、有工作的婦女（OR= 0.42）、專科以上（參考組為高中及高中以下, OR =1.39）、陰道生產（OR =1.52）、原先計畫哺餵母乳（OR =8.64）、有早期肌膚接觸經驗（OR =1.28, AR=4.5%）、有參加12小時母嬰同室（參考組為沒有母嬰同室）（OR =1.30, AR=8.1%），有13小時以上母嬰同室（參考組為沒有母嬰同室）（OR =2.23, AR=5.7%）、有依需求哺乳（OR =1.20, AR=11.6%）、不曾收到奶粉贈品或廣告之婦女哺餵母乳（OR =0.85, AR=-5.43%）。
預測六個月時是否哺育母乳的重要變項如下：年齡(OR= 1.03)、有工作（OR =0.35）、教育程度為專科以上（參考組為高中及高中以下, OR =1.42）、陰道生產（OR =1.56）、原先計畫哺餵母乳（OR =12.59）、有早期肌膚接觸（OR =1.22, AR=4.5%）、有執行12小時母嬰同室（參考組為沒有母嬰同室）（OR =1.30, AR=8.1%）、有13小時以上母嬰同室（參考組為沒有母嬰同室）（OR =2.23, AR=5.7%）、有依需求哺乳（OR =1.34, AR=11.6%）。根據本研究之結果，母嬰親善相關措施的執行對哺乳方式及哺乳持續時間確實有正面的影響，應將成功哺餵母乳的十步驟和母嬰親善醫療院所之精神積極推動，以全面提升母乳哺育率。

The purpose of this study was to investigate how demographic factors and Mother-Baby friendly hospital protocol affected women in breastfeeding decisions in the four postpartum periods, including in-patient period immediately after birth, one month, four months and six months after birth. This study used secondary data from Kuo’s 2004 research entitled “Breastfeeding Practice and related factors in Taiwan” for further analysis. The Kuo’s original data were collected from 12,201 postpartum women. For accuracy consideration, however, we selected the data from the subjects are those who answered the questions by themselves, a total of 11,529 in this study. We used the SPSS for Windows Chinese version 12.0 for statistical analysis. The results show, during the in-patient period immediately after birth, the main factors affecting breastfeeding outcomes are: education level of junior college and above (high school and below as the reference, OR=1.36), planning to breastfeed before giving birth (OR=1.21), having early skin contacts (OR=2.48, AR=12.3%), rooming-in for 12 hours and under (those did not room-in being the reference group, OR=1.81, AR=15.8%), rooming-in for 13~24 hours (those did not room-in being the reference group, OR=3.80, AR=7.6%), breastfeeding on demand (OR=1.40, AR=20.0%), no food or drink other than breastmilk unless medically indicated (OR=2.02, AR=19.9%).
Main factors that affect breastfeeding outcome prediction at one month after birth are: returning to work (OR=0.71), education level of junior college and above (senior high school and below serving as the reference group, OR=1.37), having a vaginal birth (OR=1.40), planning to breastfeed before giving birth (OR=3.29), being told by health care professionals about the importance of breastfeeding (OR=1.28, AR=17.8%), having early skin contract (OR=1.40, AR=5.9%), rooming-in for 12 hours and less than 12 hours (those did not rooming-in serving as the reference group, OR=1.22, AR=6.4%), roomed-in for 13~24 hours (those did not rooming-in serving as the reference group, OR=2.35, AR=5.9%), no food or drink other than breastmilk unless medically indicated (OR=1.23, AR=7.4%), having a breastfeeding help hotline after leaving the hospital (OR=1.16, AR=10.0%), receiving free formula samples or formula advertisements within the first six months (OR=0.88, AR=-4.29%).
Main factors that help us predict a mother breastfeed or not at four months after birth are: age (OR=1.02), returning to work (OR=0.42), education level of junior college and above that (senior high school and below serving as the reference, OR=1.39), having a vaginal birth (OR=1.52), planning to breastfeed before giving birth (OR=8.64), having early skin contact (OR=1.28, AR=4.5%), 12 hour rooming-in (those did not room-in serving as the reference, OR=1.30, AR=8.1%), rooming-in for more than 13 hours (those did not room-in serving as the reference, OR=2.23, AR=5.7%), breastfeeding on demand (OR=1.20, AR=11.6%), not receiving free formula samples or formula advertisements (OR=0.85, AR=-5.43%).
When predicting a mother breastfeeding or not at six months after birth, we found that the following factors are important: age (OR=1.03), returning to work (OR=0.35), education level of junior college and above (high school and below serving as the reference group, OR=1.42), having a vaginal birth (OR=1.56), planning to breastfeed before giving birth (OR=12.59), having early skin contact (OR=1.22, AR=4.5%), 12 hour rooming-in (those did not rooming-in serving as the reference, OR=1.30, AR=8.1%), rooming-in for more than 13 hours (those did not rooming-in serving as the reference, OR=2.23, AR=5.7%), breastfeeding on demand (OR=1.34, AR=11.6%).
In conclusion, the administration of “Mother-Baby Friendly Hospital Protocol” has a positive impact on the breastfeeding practice. The active promotion of “Ten Steps to Successful Breastfeeding” and the “Mother-Baby Friendly Hospital Protocol” will be very helpful for the increase of breastfeeding rate.

致謝 ……………………………………………………………………………
中文摘要 ……………………………………………………………………………
ABSTRACT ……………………………………………………………………………
第壹章 緒論
第一節 研究背景與動機…………………………………………………………
第二節 研究目的…………………………………………………………………
第三節 研究假設…………………………………………………………………
第四節 名詞界定…………………………………………………………………
第貳章 文獻探討
第一節 母乳哺育的重要性………………………………………………………
第二節 母乳哺育推廣政策之探討………………………………………………
第三節 影響哺乳方式與哺乳持續時間的相關因素探討………………………
第四節 實施母嬰親善醫院政策對母乳哺育之影響……………………………
第參章 研究方法
第一節 研究架構…………………………………………………………………
第二節 研究對象…………………………………………………………………
第三節 研究工具…………………………………………………………………
第四節 研究步驟…………………………………………………………………
第五節 資料分析與處理…………………………………………………………
第肆章 研究結果
第一節 研究對象之人口學屬性與母嬰親善相關措施背景資料………………
第二節 研究對象之人口學屬性與其各不同階段哺育方式之相關性…………
第三節 母嬰親善醫院與非母嬰親善醫院與其哺育方式之差異性…….….….
第四節 母嬰親善措施與各時期哺育方式之分析……………….….….………
第五節 預測不同時期哺育方式之重要影響變項………….….….……………
第伍章 討論
第一節 研究樣本個人層面變項與哺育方式之相關性……………….….….…
第二節 母嬰親善醫院與親善相關措施對不同時期哺育方式之相關性
第陸章 結論與建議
第一節 結論………………………………….….….……………………………
第二節 建議………………………………….….….……………………………
第三節 研究限制………………………………….….….………………………
參考文獻
中文文獻 ……………………………………………………………………………
英文文獻 ……………………………………………………………………………

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