本研究旨在探討產後持續六個月母乳哺餵之相關因子研究。運用病歷回顧研究，以中部某醫學中心生產之產婦為研究對象調查來源，分析自2009年1月1日起至2010年12月31日止。產婦在產後一個月、產後兩個月及產後六個月進行電話訪查。以階層線性架構，Level 2為20位接生醫師為研究對象，Level 1則符合選樣條件者均納入本研究中，共計1908名產婦為研究對象。
研究結果顯示：產後一個月時，產婦年齡越大、身為家庭主婦、產後未選擇做月子機構產後、有家人同住者，產婦為職業婦女且工作場所有擠乳設備，較會採行母乳哺餵。產後二個月時，產婦的教育程度在大專以上、身為家庭主婦，產婦為職業婦女且工作場所有擠乳設備，較會採行母乳哺餵。產後六個月時，產婦教育程度在大專以上、產婦為職業婦女且工作場所有擠乳設備，較會採行母乳哺餵。接生醫師因素中，在產後一個月母乳哺餵無顯著影響。在產後二個月母乳哺餵預測因子為「母嬰親善委員會委員」。在產後六個月母乳哺餵預測因子為，「醫師性別」、「母嬰親善委員會委員」及「母嬰親善認證特約講師」。
本研究之結果可做為臨床產科人員母乳哺餵在職教育及臨床母乳哺
餵衛教之參考，以期提升產婦母乳哺餵率持續性。

The purpose of this study was to explore factors related to continuine breastfeeding for six months postpartum. This study obtained via chart revi- ew survey. The study population consisted of mothers who delivered at a medical center of middle Taiwan from January 2009 to December 2010. Data collection was using telephone interviewing at one month, two months and six months postpartum.
The study used hierarchical general linear modeling (HGLM) to examine the relationships both individual and obstetrician levels exploring factors related to continue breastfeeding for six months postpartum. The recruited subjects were 1908 women and under second levels of 20 obstetrician.
The results of this study indicate that one month after childbirth, women of advanced maternal age, housewives, women who do not attend postnatal care institutions, women who live with more family members, and employed mothers whose workplaces have breast pump facilities are more likely to breastfeed their children. Regarding two months after childbirth, women with a college level or higher education, housewives, and employed mothers whose workplaces have breast pump facilities are more likely to breastfeed their children. Six months after childbirth, women with a college level or higher education and employed mothers whose workplaces have breast pump facilityies are more likely to breastfeed their children. The results of this study indicate that one month after childbirth, obstetrician level hadn’t significant predictors of breastfeeding behavior. Regarding two months after childbirth, obstetrician with a「baby-friendly hospital policies stuff」is more likely to breastfeed their children. Six months after childbirth, obstetrician with「obstetrician gender」、「baby-friendly hospital policies stuff」and「baby-friendly hospital authentication lecturer」are more likely to breastfeed their children.
The results of this study can serve as a reference for on-the-job education about breastfeeding for nurse practitioners and could help to increase the rates of breastfeeding in mothers who have given birth.

目錄
論文電子檔著作權授權書…………………………………………………………………………..i
論文審定同意書………………………………………………………………………………………….ii
誌謝…………………………………………………………………………………………………………….iii
中文摘要…………………………………………………………………………………………………....iv
英文摘要.........................................................................................................v
目錄…………………………………………………………………………………………………………...vii
圖目錄………………………………………………………………………………………………………..ix
表目錄………………………………………………………………………………………………………..x
第一章 緒論
研究動機與重要性………………………………………………………1
研究目的…………………………………………………………………8
研究問題……………………………………………………………………………………………….8
第二章 文獻探討
第一節 個人層次因素與持續性母乳哺餵關係 ……………………….………….9
第二節 接生醫師層次與持續性母乳哺餵關係 ………………………………...26
第三節 階層線性模式理論…………………………………………………………........38
第三章 研究方法
第一節 研究設計與研究架構 …………………………………………………………….42
第二節 研究對象 ……………………………………………………………………………….43
第三節 研究工具 ……………………………………………………………………………….44
第四節 資料處理與分析步驟 ………………………………………………………......45
第五節 研究步驟 ……………………………………………………………………………….51
第六節 研究之倫理考量 ……………………………………………………………………………….52

第四章 研究結果
第一節 個人層次與接生醫師層次之資料分布情形………………. 53
第二節 探討個人層次之社會人口因素與產後一、二、六月純
母乳哺餵關係……………………………………………………………………...57
第三節 探討個人層次之待產相關因素與產後一、二、六月純
母乳哺餵關係..........................................................................60
第四節 探討個人層次之嬰兒相關因素與產後一、二、六月純
母乳哺餵關係………………………………………………………………………62
第五節 探討接生醫師與產後一、二、六月純母乳哺餵關係………..65
第六節 探討影響產後一、二、六月純母乳哺餵行為預測因子…..67
第五章 討論
第一節 個人層次影響母乳哺餵的顯著因素…………………………………..80
第二節 醫師層次影響母乳哺餵的顯著因素……………………………….....85
第三節 探討影響母乳哺餵之預測因子…………………………………….…….88
第六章 結論、建議及限制
第一節 研究結論………………………………………………………………………………94
第二節 研究建議……………………………………………………………………………..95
第三節 研究限制………………………………………………………………………………98
參考文獻
中文部分……………………………………………………………………………………………99
英文部分………………………………………………………………………………………….105



圖目錄
圖 3-1-1 研究架構圖……………………………………………………………………………42
圖 3-4-1修正後之研究架構…………………………………………………………………47
圖 3-5-1 研究流程……………………………………………………………………………….51





























表目錄
表 2-1-1 影響持續性母乳哺餵之顯著因素……………………………………………..22
表 2-1-2 影響持續性母乳哺餵顯著因素之結果統整…………………… 25
表 2-2-1 醫師對母乳哺餵之影響文獻…………………………………… 33
表 3-4-1 研究目的與統計方法…………………………………………………………….….46
表 3-4-2 階層線性模式之研究層次變項…………………………………………………48
表 3-4-3 兩階層線性模式分析步驟............................................................50
表 4-1-1 Level 1 個人層次基本資料表.......................................................55
表 4-1-2 Level 2 接生醫師基本資料表.......................................................56
表 4-2-1 個人層次之社會人口因素與產後一、二、六月之純母乳
哺餵關係……………………………………………………………………………….…..59
表 4-3-1 個人層次之待產相關因素與產後一、二、六月之純母乳
哺餵關係……………………………………………………………………………….…..61
表 4-4-1 個人層次之嬰兒相關因素與產後一、二、六月之純母乳
哺餵關係……………………………………………………………………………….…..64
表 4-5-1 接生醫師因素與產後一、二、六月之純母乳哺餵關係…..……..66
表 4-6-1 產後一個月純母乳哺餵情形之隨機效果ANOVA模型………......68
表 4-6-2 產後二個月純母乳哺餵情形之隨機效果ANOVA模型………......68
表 4-6-3 產後六個月純母乳哺餵情形之隨機效果ANOVA模型………......69
表 4-6-4 個人因素與產後一個月母乳哺餵情形隨機係數迴歸模式……..70
表 4-6-5 個人因素與產後二個月母乳哺餵情形隨機係數迴歸模式……..71
表 4-6-6 個人因素與產後六個月母乳哺餵情形隨機係數迴歸模式……..73
表 4-6-7 產後一個月母乳哺餵之截距為結果模式………….……………….......75
表 4-6-8 產後二個月母乳哺餵之截距為結果模式………….……………….......76
表 4-6-9 產後六個月母乳哺餵之截距為結果模式………….…………….………78
表 5-3-1 產後一、二、六月持續性純母乳哺餵的顯著因素整理………..93

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