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研究生:洪喜娟
研究生(外文):Hsi-Chuan Hung
論文名稱:婦女生產支持與生產控制感、生產滿意度之相關
論文名稱(外文):Correlational Study of Labor Support, Lotus of Control and Birth Satisfaction for Parturient Women
指導教授:高美玲高美玲引用關係
指導教授(外文):Meei-Ling Gau
學位類別:碩士
校院名稱:國立台北護理學院
系所名稱:護理助產研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:中文
論文頁數:111
中文關鍵詞:生產支持生產控制感生產滿意度中介變項分析
外文關鍵詞:labor supportlotus of controlsatisfaction with laboranalysis of mediating variables
相關次數:
  • 被引用被引用:14
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  • 收藏至我的研究室書目清單書目收藏:3
本研究在探討產婦獲得的生產支持與其生產控制感、生產滿意度之間的相關性。採描述型相關性研究,資料收集採回溯性方式收案。於五家醫療院所的產後單位收案,第一胎的產後婦女符合下列條件者將予以收案:(1)沒有懷孕及生產合併症;及(2)以陰道生產方式生產且有足月正常新生兒。收案人數為184人。研究工具為結構式問卷表,項目包含:產婦個人基本屬性/產科學資料、疼痛視覺類比量表、布氏生產支持適應量表、生產控制量表中文版本及生產滿意度量表,皆於產後48小時內以問卷量表內容測量。資料以SPSS17.0 SOBEL軟體分析,統計結果在單變異分析方面,人口學之「孕期的自我照顧方法」產前教育與生產滿意度(p<.05)、產科學之「會陰部剃薙」與生產滿意度(p<.05)、生產支持與生產滿意度(p<.001)、生產控制感與生產滿意度(p<.001)之間達統計顯著相關,將其分別進入階層複回歸後發現,生產支持與生產控制感皆可降低「孕期的自我照顧方法」產前教育與「會陰部剃薙」對婦女生產滿意度的影響,因而再以生產支持及生產控制感分別進行SOBEL test,以探討其對「孕期的自我照顧方法」產前教育及「會陰部剃薙」與生產滿意度之間的中介效應,結果發現中介變項為生產支持時未達統計顯著相關;中介變項為生產控制感時達統計顯著相關(p<.05),中介效應分別為51.89%及45.62%,顯示生產控制感可以增加51.89%婦女在接受「孕期的自我照顧方法」產前教育及45.62%婦女在接受「會陰部剃薙」時的生產滿意度。期望藉由本研究結果提供醫護人員合宜的分娩照護之建議,在提供會陰部剃薙等醫療介入措施時,宜先考量婦女有無接受的必要性,經由事前詳盡的解說後由婦女自主選擇,並宜規劃設計對婦女有幫助的產前教育課程,促進婦女獲得生產控制感,以提升其生產滿意度及親子關係的建立。
This research investigated the degree of labor support perceived by new mothers and the correlation between a new mother’s lotus of control during labor and her overall satisfaction with the labor experience. The author employed a descriptive correlational approach and collected data using a retrospective method. Postpartum primapara women registered at the maternity wards of five hospitals were targeted by this research and were considered eligible for participation if 1) pregnancy and birth were free of comorbidities, and 2) delivery had been vaginal with the healthy newborn surviving to the first month. A total of 184 women met eligibility criteria and were recruited in this study. The questionnaires consisted of the Visual Analogue Scale for Pain (VASP), Bryanton Adaptation of the Nursing Supporting Labor Questionnaire (BANSILQ), Labour Agentry Scale (LAS), Mackey Childbirth Satisfaction Rating Scale, and selected demographic and obstetrical questions.
Data were analyzed using SPSS 17.0 SOBEL software. In terms of one way analysis of variance (ANOVA), results showed significant correlations between “satisfaction with labor” and the following variables: “prenatal maternity self-care education” (p<.05), “perineal shaving” (p<.05), “labor support” (p<.001) and “lotus of control during labor” (p<.001). When identified correlations were then subjected to hierarchical multiple regression analysis, the two variables of “labor support” and “lotus of control during labor” were identified as able to diminish the influence of “prenatal maternity self-care education” and “perineal shaving” on “satisfaction with labor”. Next, a SOBEL test was conducted on each of these two variables to assess their mediating effect on the respective relationships of “prenatal maternity self-care education” and “perineal shaving” with “satisfaction with labor”. When “labor support” was introduced as the mediating variable, correlations failed to reach statistical significance. However, a significant correlation was found when “lotus of control” was introduced (p<.05), with mediating effects registering 51.89% and 45.62%, respectively. Such indicates that the variable “lotus of control” is able to increase labor satisfaction in expectant mothers by 51.89% and 45.62% when, respectively, receiving prenatal maternity self-care education and perineal shaving.
It is hoped that the results of this research will provide valuable information for physicians and nurses responsible for delivering effective maternity care. In providing interventions such as perineal shaving, it is important to first determine whether the expectant mother accepts such and then, after discussing intervention particulars, allowing her to decide whether or not to proceed. Results also highlight the important role of effective prenatal education courses in helping enhance the lotus of control of expectant mothers, which can enhance labor satisfaction and lay the foundations for a healthy mother-child relationship.
致謝 I
中文摘要 II
英文摘要 III
第一章 緒論 1
第一節 研究動機與重要性 1
第二節 研究問題 2
第三節 研究目的與研究假設 2
第四節 名詞解釋 3
第二章 文獻探討 5
第一節 生產支持 5
第二節 生產控制感 14
第三節 生產滿意度 15
第四節 生產支持與生產控制感、生產滿意度之相關性 18
第三章 研究方法 22
第一節 研究架構 22
第二節 研究對象與研究場所 23
第三節 研究工具 23
第四節 研究工具信效度檢定 26
第五節 資料收集程序 27
第六節 資料分析 28
第七節 研究倫理考量 29
第四章 研究結果 31
第一節 研究對象的基本屬性 31
第二節 生產滿意度與基本屬性之相關性 34
第三節 生產支持與基本屬性之相關性 39
第四節 生產控制感與基本屬性之相關性 46
第五節 生產滿意度與生產支持、生產控制感之相關性 51
第六節 預測生產滿意度之相關因子 52
第五章 討論 67
第一節 生產支持現況 67
第二節 生產控制感現況 69
第三節 生產滿意度現況 70
第四節 生產滿意度的預測因子 73
第六章 結論與建議 76
第一節 研究結論 76
第二節 護理之應用與建議 78

第三節 研究限制 79
第四節 結論 80
中文參考文獻 81
英文參考文獻 84
附件 95
附錄一 個人基本屬性調查表 95
附錄二 布氏分娩支持適應量表 97
附錄三 生產控制量表 99
附錄四 生產滿意度量表 100
附錄五 布氏分娩支持適應量表書面同意授權書 103
附錄六 布氏分娩支持適應量表中文版本書面同意授權書 104
附錄七 生產控制量表書面同意授權書 105
附錄八 生產控制量表中文版本書面同意授權書 106
附錄九 生產滿意度量表書面同意授權書 107
附錄十 TRANSLATE & BACK-TRANSLATE效度檢定專家名單 108
附錄十一 分娩婦女參與研究同意書 109
附錄十二 醫院人體試驗倫理委員會同意研究證明書(二份) 110

圖 表 索 引
表目錄
表 3 1 樣本數分布狀況 23
表 3 2 資料統計分析法 29
表 4 1 個案基本人口學、產科學資料 32
表 4 2 生產滿意度量表各次量表及各題項得分情形 34
表 4 3 基本屬性與生產滿意度之分析結果 37
表 4 4 生產支持適應量表各題之平均值、標準差及排名 41
表 4 5 生產支持適應量表適用樣本數各題之平均值及排名 42
表 4 6 婦女經驗生產支持適應量表內容情形 43
表 4 7 基本屬性與生產支持之分析結果 44
表 4 8 生產控制感量表各題之平均值、標準差及排名 47
表 4 9 基本屬性與生產控制感之分析結果 48
表 4-10 生產支持與生產滿意度之相關性 51
表 4-11 生產控制感與生產滿意度之相關性 52
表 4-12 經相關性分析後與生產滿意度具顯著相關之自變項 53
表 4-13 以階層式複回歸分析生產滿意度的預測因子(生產支持為中介變項) 53
表 4-14 以階層式複回歸分析生產滿意度的預測因子(生產支持為中介變項) 55
表 4-15 以階層式複回歸分析生產滿意度的預測因子(情緒支持為中介變項) 56
表 4-16 以階層式複回歸分析生產滿意度的預測因子(訊息支持為中介變項) 57
表 4-17 以階層式複回歸分析生產滿意度的預測因子(實質支持為中介變項) 58
表 4-18 以階層式複回歸分析生產滿意度的預測因子(生產支持為中介變項) 58
表 4-19 以階層式複回歸分析生產滿意度的預測因子(生產控制感為中介變項) 60
表 4-20 以階層式複回歸分析生產滿意度的預測因子(技巧及知識為中介變項) 61
表 4-21 以階層式複回歸分析生產滿意度的預測因子(能力信心為中介變項) 62
表 4-22 以階層式複回歸分析生產滿意度的預測因子(分娩感受為中介變項) 63
表 4-23 中介變項對會陰部剃薙與生產滿意度之中介效應 64
表 4-24 中介變項對孕期的自我照顧方法與生產滿意度之中介效應 64
表 4-25 中介變項對會陰部剃薙與生產滿意度之中介效應 65
表 4-26 中介變項對孕期的自我照顧方法與生產滿意度之中介效應 65


圖目錄
圖 3 1 婦女生產支持與生產控制感、生產滿意度相關之概念架構圖 22
圖 3 2 研究流程圖 28
圖 4 1 個案接受醫療介入情形 34
圖 4-2 殘差分析直方圖與常態性檢定圖 53
圖 4-3 Normal P-P Plot of Regression Standardized Residual 54
圖 4-4 Scatterplot散怖圖 54
圖 4-5 殘差分析直方圖與常態性檢定圖、Normal P-P Plot of Regression Standardized Residual、Scatterplot散怖圖 55
圖 4-6 殘差分析直方圖與常態性檢定圖、Normal P-P Plot of Regression Standardized Residual、Scatterplot散怖圖 56
圖 4-7 殘差分析直方圖與常態性檢定圖、Normal P-P Plot of Regression Standardized Residual、Scatterplot散怖圖 57
圖 4-8 殘差分析直方圖與常態性檢定圖 58
圖 4-9 Normal P-P Plot of Regression Standardized Residual 59
圖 4 10 Scatterplot散怖圖 59
圖 4-11 殘差分析直方圖與常態性檢定圖、Normal P-P Plot of Regression Standardized Residual、Scatterplot散怖圖 60
圖 4-12 殘差分析直方圖與常態性檢定圖、Normal P-P Plot of Regression Standardized Residual、Scatterplot散怖圖 61
圖 4-13 殘差分析直方圖與常態性檢定圖、Normal P-P Plot of Regression Standardized Residual、Scatterplot散怖圖 62
圖 4-14 殘差分析直方圖與常態性檢定圖、Normal P-P Plot of Regression Standardized Residual、Scatterplot散怖圖 63
圖 4 15 實質支持中介變項對生產滿意度的影響 64
圖 4 16 生產控制感及能力信心中介變項對生產滿意度的影響 66
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