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研究生:李孟蓉
研究生(外文):Mung-Jung Lee
論文名稱:親子同室對產後婦女疲憊感及其睡眠品質之相關性
論文名稱(外文):Effect of Rooming-in on Postpartum Fatigue and Sleep Quality
指導教授:高美玲教授
指導教授(外文):Meei-Ling Gau, PhD
口試委員:謝碧晴副教授林寬佳教授
口試委員(外文):Bi-Cing Hsieh, PhDKuan-Chia Lin, PhD
口試日期:2014-01-13
學位類別:碩士
校院名稱:國立臺北護理健康大學
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:2014
畢業學年度:102
語文別:中文
論文頁數:134
中文關鍵詞:親子同室睡眠品質疲憊感
外文關鍵詞:mother-infant rooming inquality of sleepfatigue
相關次數:
  • 被引用被引用:5
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研究背景:親子同室雖然對母嬰身心發展及成功哺餵母乳有諸多的優點,然而國內自90年推行親善醫院以來,在措施七「實施24小時親子同室」一直是十大措施中執行程度較不好且分數偏低的措施。醫院多半擔心執行親子同室會影響導致婦女疲憊且影響其睡眠品質,然而文獻中有關親子同室型態與產後疲憊感、睡眠品質之相關性卻有不一致性的結果。
研究目的:旨在探討產後住院期間親子同室之型態與產婦疲憊感、睡眠品質之相關性。
方法:本研究採描述相關性研究,資料收集期間為102年4月至7月,採方便取樣選取懷孕37週以上、單胞胎,於懷孕、待產期間及產後之新生兒與產婦皆無異常及合併症,
沒有親子同床的禁忌,排除嬰兒出養及受性侵害之產婦,共計121位產後婦女。研究工具包括自行建構的基本屬性問卷、改良式疲憊量表、中文睡眠品質量表,以及偵測睡眠
時間長短、深睡期及淺睡期的監測器(Cadiopulmonary Coupling, CPC)。個案於住院期間在每天入睡時,於母親胸前貼上CPC監測器,每天早上填寫改良式疲憊量表及中文匹茲堡睡眠品質量表。
研究結果:在人口學資料方面,本研究結果顯示專科以下教育程度(χ2(1) = 11.08, p < .001)、有執行即刻肌膚接觸者(χ2(1) = 6.40, p < .05),在懷孕時即想採取24小時親子同室者(χ2(3) = 24.17, p < .001),有較高比例選擇夜間親子同室。在產科學相關因子方面,採陰道產(χ2(1) = 4.81, p < .05)、會陰撕裂傷程度低者(p < .05)、`生產失血量較少者(t(119) = 2.11, p < .05)、哺乳次數較多者(p < .001)有較高比例選擇夜間親子同室。
以概似化估算基準模式、時間模式及改變模式分析,在陰道產產婦之主觀睡眠品質之預測因素,有親子同室者比無親子同室者有較佳的主觀睡眠品質總分(B = -1.97, p < .001),妊娠週數越多則主觀睡眠品質越好(B = -0.35, p < .01),疲憊程度越高則主觀睡眠品質越差(B = 0.11, p < .001),哺餵次數越多則主觀睡眠品質越差(B = 0.33, p < .001),時間每多一天則主觀睡眠品質越好(B = -0.42, p < .05),疲憊程度有所改善則主觀睡眠品質也會變好(B = 0.11, p < .01),哺餵次數變少則主觀睡眠品質也會變好(B = 0.38, p < .001);陰道產產婦在客觀睡眠品質之預測因素,有親子同室者比無親子同室者有較佳的客觀睡眠品質總分(B = 34.49, p < .001),住單人房比住多人房有較差的客觀睡眠品質總分(B = -20.40, p < .001),有使用減痛分娩會比沒有使用者有更好的客觀睡眠品質(B = 8.59, p < .05),哺餵次數越多則客觀睡眠品質越差(B = -4.93, p < .001),前一天的疲憊程度與哺餵次數與後一天的客觀睡眠品質無關,哺餵次數變少則客觀睡眠品質也會變得越好(B = -4.89, p < .001),疲憊程度的改變則與客觀睡眠品質的改變無關。
在剖腹產產婦之主觀睡眠品質之預測因素,疲憊程度越高則主觀睡眠品質越差(B = 0.20, p < .001),疲憊程度變低則主觀睡眠品質越好(B = 0.28, p < .001);在客觀睡眠品質之預測因素,有親子同室者比無親子同室者有較佳的客觀睡眠品質總分(B = 23.47, p < .001),時間每多一天則客觀睡眠品質越好(B = 3.06, p < .05),前一天的疲憊程度與哺餵次數與後一天的客觀睡眠品質無關,疲憊程度與哺餵次數的改變與客觀睡眠品質與無關。
結論/護理應用:本研究在不同生產方式中有無親子同室睡眠品質與疲憊感預測因子上,陰道產產後主客觀睡眠品質皆以有親子同室為較佳,但疲憊感會影響主觀睡眠品質,客觀睡眠品質則無,哺餵次數多則主客觀睡眠品質愈差;在剖腹產產後客觀睡眠品質,有親子同室者有較好的睡眠品質,疲憊程度越高則主觀睡眠品質越差,哺餵次數與睡眠無關。以往總覺得親子同室的母親其睡眠時間較短或品質較差,結果顯示在執行親子同室的母親其睡眠時間與品質有其正面的意義,產後疲憊的因素有母乳哺餵及睡眠失調,尤其在剖腹產產婦需積極解決其產後疲憊感,因此建議臨床護理助產人員應給予產婦生產過程足夠的支持及協助,可以減少產後的疲憊程度,有好的睡眠品質,建議日後在產前教育及臨床護理指導之內容,應強化親子同室目的、重要性,讓產婦覺得有足夠的精神及體力實施親子同室,此結果將可提供臨床產兒科人員於照護上參考。
關鍵詞:親子同室、睡眠品質、疲憊感
Background: The practice of rooming-in has been shown to help new mothers and their newborn infants adjust physically and mentally and to increase breastfeeding success. Although “24-hour rooming-in” is one of the 10 key objectives of baby-friendly hospitals promoted in Taiwan since 2000, this objective has fallen significantly short of expectations in terms of both the number and the success of hospital implementations. In general, hospitals are concerned that rooming-in may increase fatigue and decrease sleep quality in postpartum mothers. Findings in the literature related to the impact of rooming-in on these two variables are inconclusive.
Purpose: This study examines the correlations between the practice of rooming-in and the levels of fatigue and sleep quality in postpartum mothers.
Methodology: This descriptive correlational study collected data from April to July 2013. Convenience sampling recruited primipara women who delivered after 37 or more weeks of pregnancy; experienced no abnormalities or complications during pregnancy, labor, or the postpartum period; and had no clinical contraindications for rooming-in. New mothers who planned to release their child for adoption or who had experienced sexual abuse were excluded from consideration. A total of 121 postpartum mothers met the above criteria and were enrolled as participants. Research instruments included a self-designed questionnaire, the Modified Fatigue Symptoms Checklist (MFSC), the Chinese version of the Pittsburg Sleep Quality Index (CPSQI), and cardiopulmonary coupling (CPC) analysis. Participants had a CPC monitor affixed to their upper chest prior to going to sleep each day of their hospital stay. Further, each participant filled in an MFSC and CPSQI every morning of their hospital stay.
Results: In terms of demographic variables, participants with an associate degree or lower level of education (χ2(1) = 11.08, p < .001), those who practiced early skin-to-skin contact (χ2(1) = 6.40, p < .05), and those who planned during their pregnancy to practice 24-hour rooming-in (χ2(3) = 24.17, p < .001) were all more likely to adopt nighttime rooming-in. In terms of OB/GYN variables, vaginal birth (χ2(1) = 4.81, p < .05), a relatively mild degree of perineal laceration (p < .05), relatively mild blood loss during birth (t(119) = 2.11, p < .05), and relatively high breastfeeding frequency (p < .001) were all correlated with a higher likelihood of practicing nighttime rooming-in.
Analysis using the baseline-tracking model, time-lag model, and change model found that among participants who gave vaginal birth, those who roomed-in had better subjective sleep quality than those who did not (B = -1.97, p < .001), number of gestational weeks related positively to subjective sleep quality (B = -0.35, p < .01), degree of weariness related negatively to subjective sleep quality (B = 0.11, p < .001), higher breastfeeding frequency related negatively to subjective sleep quality (B = 0.33, p < .001), number of days postpartum related positively to subjective sleep quality (B = -0.42, p < .05), improvements in the degree of weariness improved subjective sleep quality (B = 0.11, p < .01), reductions in breastfeeding frequency improved subjective sleep quality (B = 0.39, p < .001). In terms of objective-sleep-quality predictive factors among vaginal-birth participants those who roomed-in earned higher overall objective sleep quality scores than those who did not (B = 34.49, p < .001), those who stayed in single-occupancy hospital rooms earned lower overall objective sleep quality scores than those who stayed in multiple-occupancy rooms (B = -20.40, p < .001), those who used analgesics had better objective sleep quality than those who did not (B = 8.59, p < .05), those with higher breastfeeding frequencies had lower objective sleep quality than their peers (B = -4.93, p < .001), reducing breastfeeding frequency improved objective sleep quality (B = -4.81, p < .001). Furthermore, this study found no relationship between current objective sleep quality and either degree of weariness or breastfeeding frequency as measured on the previous day. Finally, no relationship was found between changes in degree of weariness and changes in objective sleep quality.
A similar analysis of predictive factors among cesarean-birth participants found degree of weariness related negatively to subjective sleep quality (B = 0.20, p < .001), reducing weariness improved subjective sleep quality (B = 0.28, p < .001), those who roomed-in earned better overall subjective sleep quality scores than those who did not (B = 23.47, p < .001), number of days postpartum related positively to subjective sleep quality (B = 3.06, p < .05), improvements in degree of fatigue related positively to improvements in objective sleep quality (B = -0.83, p < .05). Similar to vaginal-birth participants, this study found no relationship between current objective sleep quality and either degree of fatigue or breastfeeding frequency as measured on the previous day in cesarean-birth participants. Finally, changes in breastfeeding frequency did not impact objective sleep quality in this group.
Conclusions / Application to Nursing: The present study assessed the impact of predictive factors related to quality of sleep and degree of fatigue in a sample of postpartum mothers who had either given vaginal or cesarean birth and either did or did not practice rooming-in. For vaginal-birth participants, rooming-in impacted subjective and objective sleep quality; degree of fatigue impacted subjective sleep quality but not objective sleep quality; and high breastfeeding frequencies degraded both subjective and objective sleep quality. For cesarean-birth participants, rooming-in improved sleep quality; degree of fatigue related negatively to subjective sleep quality; and breastfeeding frequency was not significantly related to sleep quality. Our findings contradict the widely held assumption that mothers who room-in with their infant sleep less and have a lower quality of sleep than their non-room-in peers. Conversely, the room-in participants in our study reported improvements in terms of both sleep duration and sleep quality attributable to their practice of rooming-in. Factors found to affect postpartum fatigue include breastfeeding and irregular sleep schedule. In light of the importance of helping new mothers, especially cesarean-birth mothers, quickly overcome postpartum fatigue, the author suggests that clinical nurses and midwives provide adequate support and assistance to patients through the birthing process in order to minimize postpartum fatigue and improve patient quality of sleep. Furthermore, prenatal patient education and nursing-care guidelines should be revised to promote rooming-in, underscore its importance to postnatal health and recovery, and raise the confidence of new mothers in their emotional and physical capacities to undertake rooming-in responsibilities. The results of this study provide a reference for clinical obstetrics and pediatrics care staffs.
Key Words: mother-infant rooming in, quality of sleep, fatigue

致謝 Π
中文摘要 Ⅳ
英文摘要 Ⅶ
目錄 XI
附錄 XII
圖表目次 XIV
第一章 緒論 1
第一節 研究動機及重要性 1
第二節 研究目的 3
第三節 名詞界定 4
第二章 文獻查證 6
第一節 親子同室 6
第二節 產後睡眠品質 11
第三節 產後疲憊 22
第四節 親子同室和母親睡眠及其疲憊的相關性 23
第三章 研究方法 26
第一節 研究概念架構 26
第二節 研究設計及研究對象 27
第三節 研究工具 28
第四節 研究場所 31
第五節 研究倫理 32
第六節 統計分析 33
第四章 研究結果 36
第一節 研究對象基本人口學與產科學因素之分布 36
第二節 有無親子同室與各時間點的主客觀睡眠品質與疲憊程度分布 41
第三節 主、客觀睡眠品質之預測因子分析 53
第伍章 討論 64
第一節 研究對象基本人口學及產科學 64
第二節 產後主、客觀睡眠品質及相關探討 66
第三節 產後疲憊程度及相關因素 70
第四節 產後主客觀睡眠品質與產後疲憊程度及預測因子 71
第六章 結論與建議 75
第一節 結論 75
第二節 研究結果的應用與建議 76
第三節 研究限制與建議 78
參考文獻 81
中文部份 81
英文部份 84
附錄
附件一 個人資料問卷 92
附件二 產科資料問卷 94
附件三 匹茲堡睡眠品質量表 95
附件四 疲憊量表 105
附件十三 人體實驗審查委員會申請通過書 110

圖目錄
圖一 概念架構 26
圖二 有無親子同室的自然產產婦在各項分數之趨勢圖 62
圖三 有無親子同室的剖腹產產婦在各項分數之趨勢圖 63

表目錄
表1.有無全程親子同室在背景資料之分布 37
表2.有無全程親子同室在產科史資料之分布 40
表3.有無全程親子同室在生產當天之主客觀睡眠品質與疲憊程度分布 41
表4.有無全程親子同室在生產當天之主觀睡眠品質之細項分布 42
表5.有無全程親子同室在產後第一天之主客觀睡眠品質與疲憊程度分佈 44
表6.有無全程親子同室在產後第一天之主觀睡眠品質之細項分布 45
表7.有無全程親子同室在產後第二天之主客觀睡眠品質與疲憊程度分布 46
表8.有無全程親子同室在產後第二天之主觀睡眠品質之細項分布 47
表9.有無全程親子同室在產後第三天之主客觀睡眠品質與疲憊程度分布 49
表10.有無全程親子同室在產後第三天之主觀睡眠品質之細項分布 50
表11.有無全程親子同室在產後第四天之主客觀睡眠品質與疲憊程度分布 51
表12.有無全程親子同室在產後第四天之主觀睡眠品質之細項分布 52
表13.產後當天至產後第四天之疲憊量表(MFSC)各題平均分數 53
表14.自然產產婦從生產當天至產後第二天之主觀睡眠品質(PSQI)影響因素 58
表15.自然產產婦從生產當天至產後第二天之客觀睡眠品質(CPC)影響因素 59
表16.剖腹產產婦從生產當天至產後第四天之主觀睡眠品質(PSQI)影響因素 60
表17.剖腹產產婦從生產當天至產後第四天之客觀睡眠品質(CPC)影響因素 61

中文部份
戈依莉(2004).產後疲倦.護理雜誌,51(6),75-79。
王肇齡、黃志中、楊俊毓、莊弘毅(2000).個人疲勞強度問卷中文版之效度及信度的評估.台灣家醫誌,10(4),192-201。
行政院衛生福利部國民健康署(2013).102年母嬰親善醫療院所認證通過名單.2014年 1 月 14 日取自
http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/TopicBulletin.aspx?id=201401140003&Class=0&parentid=200712250002
江漢光、李政育 (2001).失眠.台北市:書泉。
李小璐(2005).婦女之睡眠品質、疲憊及憂鬱:產後二週及四週時間序列 研究.未發表之碩士論文,國立臺北護理學院護理研究所。
李宇宙(2000).睡眠醫學.台北市:健康世界。
李碧娥、林秋菊(2002).疲憊的概念分析.長庚護理,13(4),339-343。
林嘉玲(2000).自費安養機構老人睡眠品質及其相關因素之探討.未發表之碩士論文,國立臺灣大學護理研究所。
林麗珠、李從業、郭素珍、穆佩芬、許洪坤(2004).產後接受母嬰同室護理的生活經驗.護理雜誌,51(1),35-43。
林育靜、楊嘉玲、高美華、李靜宜(2012) .周產期母乳哺育指導與產婦執行24小時親子同室之相關性.長庚護理,23(1),27-39。
柯淑華(2010) .產後婦女睡眠品質的探討:質量交叉研究.未發表之博士論文,高雄醫學大學護理研究所。
邱曉彥、邱豔芬(2010).睡眠品質之概念分析.護理雜誌,57(4),106-111。
高美華、林育靜(2006) .提升24小時母嬰同室執行率之方案.長庚護理,18(1),74-83。
洪志秀、張素鳳、金繼春(1993).產褥期婦女之壓力與其相關因素.公共衛生,20(1),29-43。 張春興(1998)張氏大字典。台北,東華。
洪靜琦(2008) .母嬰親善醫院醫療服務品質與產婦忠誠度探討.未發表之碩士論文,台北:亞洲大學。
張靖梅、林獻鋒(2009).產婦實施 24 小時親子同室之壓力經.長庚護理,20(4),429-440。
陳彰惠、劉瓊宇(1995).中國文化和產後憂鬱症.護理雜誌,42(1),91-94。
陳昭惠、高美玲、盧玉嬴、潘履嵐(2001).台灣地區嬰兒親善醫院實施現況與未來展望.長庚護理,12(1),64-70。
陳淑娟(2004).比較職業婦女與家庭主婦的哺餵型態、知識、態度及其相關因素.未發表之碩士論文,國立臺北護理學院護理研究所。
孫嘉玲、林佳靜、蔡佩珊、周桂如(2008).失眠之概念分析.護理雜誌,55(5),79-84。
曾英珍(2012) .親子同室護理指導方案對執行時間及哺乳相關指標之成效.未發表之碩士論文,國立臺北護理學院護理助產研究所。
許淳森、高美玲、林志翰(2008).九十七年度台灣地區醫療院所母 嬰親善醫院評鑑結果分析報告.行政院衛生署國民健康局委託計 畫報告書(計畫編號:9612005A).台北:財團法人醫院評鑑暨 醫療品質策進會。
許淳森、高美玲、陳昭惠(2003).九十二年度台灣地區醫療院所嬰親善醫院評鑑結果分析報告.行政院衛生署國民健康局委託計 畫報告書.台北:台灣婦產科醫學會。
常晶晶(2011).產後婦女選擇親子同室行為相關因素探討-橫斷面決策樹分析.未發表之碩士論文,國立臺北護理健康大學護理助產研究所。
黃文玲(2004).公費安養機構老人憂鬱與睡眠品質之探討.未發表 之碩士論文,桃園:長庚大學護理研究所。
馮容莊(1992).產科母嬰同室護理模式之運用與評值.榮總護理,9(4),419-427。
馮容莊(1993).母嬰同室護理臨床實施護理效益之探討,護理研究,1(1),71-81。
楊建銘(2000).失眠的行為及心理治療.台灣醫學,4(6),694-703。
楊友仕、鍾翰其、高美玲、李素華、李惠玉(2010).九十九年度台灣地區醫療院所母嬰親善醫院評鑑結果分析報告.行政院衛生 署國民健康局委託計畫報告書(計畫編號:9808001A-1).台北: 財團法人醫院評鑑暨醫療品質策進會。
楊友仕、鍾翰其、高美玲、李素華、曾佩儀(2009).九十八年度台 灣地區醫療院所母嬰親善醫院評鑑結果分析報告.行政院衛生署 國民健康局委託計畫報告書(計畫編號:9808001A).台北:財團法人醫院評鑑暨醫療品質策進會。
鄧素文、蘇燦煮、楊雅玲、張桂玲(1995).探討母嬰同室照護對哺母乳產婦之困擾及滿月哺乳方式的影響.護理研究,3(2),181-192。
鄧鳳苓、史麗珠、鄭博仁、李絳桃(2007).產褥期婦女之睡眠品質及其相關因素.長庚護理,18(4)499-510。
葉淨雅(2002).比較母嬰同室與非母嬰同室之照護成效.未發表碩士論文,台北醫學大學護理研究所。
劉勝義(2004).臨床睡眠檢查學.台北:合記。
藍逸梅、李從業、陳嘉琦(2001).概念分析-親子依附.榮總護理,18(2),125-130。
蘇東平(2000).睡眠障礙症之診斷分類及臨床評估.台灣醫學,4(6),665-672。

英文部份
Aaronson, L. S., Teel, C. S., Cassmeyer, V., Neuberger, G. B., Pallikkathayi, L., Pierce, J. et al. (1999). Defining and measuring fatigue. Image: The Journal of Nursing Scholarship, 31(1), 45-50.
Alapin, I., Fichten, C. S., Libman, E., Creti, L., Bailes, S., & Wright, J. (2000).How is good and poor sleep in older adults and college students related to daytime sleepiness, fatigue, and ability to concentrate? Journal of Psychosomatic Research, 49(5), 381-390.
Akerstedt, T., Knutsson, A., Westerholm, P.,Theorell, T., Alfredsson, L., & Kecklund, G. (2002). Sleep disturbances, work stress and work hours: A cross-sectional study. Journal of Psychosomatic Research, 53(3), 741-8.
Ball, H. L. (2002). Breastfeeding, bed-sharing and infant sleep. Birth, 30(3), 181-188.
Batal, M., Boulghourjian. C., Abhallah, A., & Afifi, R (2006). Breastfeeding and feeding practices of infants in a developing country: A nationa1 survey in Lebanon. Public Health Nutrition, 9(3), 313-319.
Bastien, C. H., Fortier-Brochu, E., Rioux, I., LeBlanc, M., Daley, M., & Morin, C. M.(2003). Cognitive performance and sleep quality in the elderly suffering from chronic insomnia: Relationship between objective and subjective measures. Journal of Psychosomatic Researsh, 54(1), 39-49.
Berger, A. M., & Higginbotham, P. (2000). Correlates of fatigue during and following djuvant breast cancer chemotherapy: A pilot study. Oncology Nursing Forum, 27(9), 1443-1448.
Buysse, D. J., Renolds, C. F., Monk, T. H., Berman, S, R., & Kupter, D. J. (1989).The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practices and Research. Psychiatry Research, 28(2), 193-213.
Buysse, D. J., Renolds , C. F., Monk, T. H., Hoch, C. C., Yeager, A. l., & Kupfer, D. J. (1991). Quantification of subjective sleep quality in healthy elderly men and woman using the Pittsburgh Sleep Quality Index. Sleep,14(4), 331-338.
Cahill, C.A., (1999). Differential diagnosis of fatigue in women. Journal of Obstetric, Gynecology, and Neonatal Nursing, 28(1), 81-86.
Carpenter, J. S., & Andrykowski, M. A. (1998). Psychosometric evaluation of the Pittsburgh Sleep Quality Index. Journal of Psychosomatic Research,45(1), 5-13.
Chien, L. Y., & Ko, Y. L. (2004). Fatigue during pregnancy predicts casesarean deliveries. Journal of Advanced Nursing, 45(5), 487-494.
Chen, C. H., Wu H.Y., Tseng,Y. F., Chou, F. H., & Wang, S. Y. (1999). Psychosocial aspects of Taiwanese postpartum depression henomenological approach: Apreliminary report. Kaohsing Journal Medical Science, 15, 44-51.
Cohen, D. C., Eisdorfer, C., Prize, P., Breen, A., Davis, M., & Dadsby, A. (1983). Sleep disturbances in the institutionalized aged. Journal of the American Geriatrics Society,31(2), 79-82.
Cronin, C. (2003). First-time mothers-identifying their needs, perceptions and experiences. Journal of Clinical Nursing, 12(1), 260-267.
Cutler N.R. & Cohen H.B. (1979). The effect of one night’s sleep loss on mood and memory in normal subjects. Comprehensive Psychiatry, 20(1), 61-66.
Driver, H., & Shapiro, C. M. (1992). Clinical research a longitudinal study of sleep stages in young women during pregnancy and postpartum. Sleep, 15(5), 449-453.
Edelson, E., & Koop, C. (1992). Sleep. New York: Chelsea House.
Errante, J. (1985). Sleep deprivation or postpartum blues. Topics in clinical nursing Journal, 9-17.
Gay, C. L., Lee, K. A., & Lee, S. Y. (2004). Sleep patterns and fatigue in new mothers and fathers. Biological Research for Nursing, 5(4),311-318.
Gift , A. G., & Pugh, L.C. (1993). Dyspnea and fatigue . Advances in Clinical Nursing Research, 28(2), 373-384.
Gislason,T., Reynisdottir, H., Kristbjarnarson, H., & Benediktsdottir, T. (1993). Sleephabits and sleep disturbances among the elderly –An epidemiological survey. Journal of Interntional Medicine, 234, 31-39.
Greenberg, M., & Morris, N. (1974). Engrossment: The newborn’s impact upon the father. American Journal Pathology, 44(6), 520-531.
Groer, M., Davis, M., Casey, K., Short, B., Smith, K., & Groer, S. (2006).Neuroendocrine & immune relationship in postpartum fatigue.American Journal of maternal-child nursing, 30(2), 133-138.
Huang, C. H.(2004). Sleep and sleepiness in first –mothers during early postpartum inTaiwan. Unpublished Doctoral dissertation, Texas Austin University.
Hong, T. M., Callister, L. C., & Schwartz. R (2003). First time mothers' view of breastfeeding support from nurses. The American Joumal of Maternal Child Nursing, 28(1), 10-15.
Jackson, E. B. (1955). New trends in maternity care. The American Journal of Nursing, 55(5), 584-587.
Johnson, R. B., & Onwuegbuzie, A. J. (2004). Mixed methods resrarch: A Research paradigm whose time has come. Educational Research, 33(7), 14-26.
Karni, A., Tanne, D., Rubenstein, B. S., Askenasy, J. M., & Sagi, D. (1994). Dependence on REM sleep of overnight improvement of a perceptual skill. Science, 26(5), 679-682.
Keefe, M. R.(1988). The impact of infant rooming-in on maternal sleep at night. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 17(2), 122-126.
Lai, M. L.,Lin, K.C., Li, H. Y., Shey, K. S., & Gau. M. L. (2009). Effects of delayed pushing during the second stage of labor on postpartum fatigue and birth outcomes in nulliparous women. The Journal of Nursing Research,17(1), 62-72.
Lee, K. A., & Dejoseph, J. F. (1992). Sleep disturbances, vitality, and fatigue among a select group of employed childbearing women. Birth, 19(4), 208-213.
Lee, K. A., & Zaffke, M. E. (1999). Longitudinal changes in fatigue and energy during pregnancy and the postpartum. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 28(2), 183-191.
Lee, K. A., Zaffke, M. E., & Mcenany, G. (2000). Parity and sleep patterns during and after pregnancy. Obstetrics & Gynecology, 95(1), 14-18.
Leger, D. (1994). The cost sleep-related accidents: A report for the National Commission on Sleep Disorders Research. Sleep, 17(3), 84-93.
Lindenberg, C. S., Artola, R. C., & Jimenez, V. (1990). The effect of early postpartum other-infant contact and breastfeeding. International Journal of Nursing Studies, 27(3), 179-186.
Lin, K-C., Chen, P.-C., Twisk, J.W. R., Lee, H.-L., & Chi, L.-Y.(2010).Time-varying nature of risk factors for the longitudinal development of disability in older adults with arthritis Journal of Epidemiology, 20(6), 460-467.
Lvoff, N. M., Lvoff, V., & Klaus, M. (2000). Effect of the baby-friendly initiative on infant abandonment in a Russian hospital. Archives Pediatric Adolescent Medical, 154(5), 474-477.
Martell, L. K. (1999). Maternity care during the post-world war II baby boom: The experience of general duty nurse. Western Journal of Nursing Research, 21(3), 387-403.
Martell, L. K. (2000).The hospital and the postpartum experience: A historical analysis. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 29(1),65-72.
Matsumoto, K., Shinkoda, H., Kang, M. J., & Seo, Y. J. (2003).Longitudinal study of mothers’ sleep-wake behaviors and circadian time patterns from late pregnancy to postpartum-Monitoring of wrist actigraphy and sleep logs. Biological Rhythm Research, 34(3), 265-278.
Mayberry, I. J., Gennaro, S., Strange, L., Williams, M., & De, A. (1999). Maternal fatigue: Implications of second stage labor nursing care. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 28(2), 175-181.
McVeigh, C. (1997). Motherhood experiences from the perspective of first- timemothers. Clinical Nursing Research, 6(4), 335-348.
Meinir, K. (2000). Fatigue in advanced cancer---meaning before measurement? International Journal of Nursing Studies, 37(3), 401-414.
Milligan, R. A., Parks, P., Kitzman, H., & Lenz, E. (1997). Measuring woman’s fatigue during the postpartum period. Journal of Nursing Measurement, 5(1),3-16.
Milligan, R. A., Flenniken, P. M., & Pugh, L. C. (1996). Positioning Intervention to minimize fatigue in breast-feeding women. Applied Nursing Research, 9(1), 67-71.
Moldofsky, H. (2001). Sleep and pain. Sleep Medicine Reviews, 5(5),385-396.
Morgan, K., Dallosso, H., Ebrahim, S., Arie, T., & Fentem, P. H. (1988). Characteristics of subjective insomnia in the elderly living at home. Age and Ageing, 17(4), 1-7.
Mosko, S., Mckenna, J., Dichael, M., & Hunt, L.(1993). Parent-infant cosleeping: The appropriate on text for the study of infant sleep and pications for Sudden . Journal of Behavioral Medicine,16(6), 589-609.
NiShihara, K., & Horiucbi, S. (1998). Changes in sleep patterns of young women from late pregnancy to postpartum: Relationships to their infants’ movements. Perceptual & Motor Skills, 87(2), 1043-1056.
Nordin, M., Knutsson, A., Sundbom, E., & Stegmayr, B. (2005). Psychosocial factors, gender, and sleep. Journal of Occupational Health Psychology,10(1), 54-63.
Nysaether, H., Baerug, A., Nylander, G., & Klepp, K. I.(2002). Rooming-in in the maternity ward –are mothers satisfied?Tidsskift for Den Norske Laegeforening. 122(12). 1206-1209.
Powell, D. R. (2001). Rooming-in. Prairie Schooner, 75(1), 63-64.
Pugh, L.C., & Milligan, R. (1993). A framework for the tudy of childbearing fatigue. Advances in Nursing Science,15, 60-70.
Pugh, L. C., Milligan, R., Park, P. L, Lenz, E., & Kitzman, H. (1999). Clinical approaches in the assessment of childbearing fatigue. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 28(1), 74-80.
Quillin, S. I. (1997). Infant and mother sleep patterns during 4th postpartum week. Issues in Comprehensive Pediatric Nursing, 20(2), 115-123.
Quillin, S. I., & Gleun, L. (2004). Interaction between feeding method and co-sleep on maternal-newborn sleep. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 33(5), 580-588.
Ruchala P. L., Halstead, L. (1994). The postpartum experience of low-risk women: a time of adjustment and change. Maternal-Child Nursing Journal,22(3), 83-88.
Scott, J. A., Shaker, I., & Reid, M. (2004). Parental attitudes toward breastfeeding: Their association with feeding outcome at hospital discharge. Birth, 31(2), 125-131.
Shaker, I., Scott, J. A., & Reid, M. (2004). Infant feeding attitudes of expectant parents: Breastfeeding and formula feeding. Journal of Advanced Nursing. 45(3), 260-268.
Sharifah, H., Lee, K. S., & Ho, J. J. (2007). Separate care for new mother and infant versus rooming-in for increasing the duration of breastfeeding. Cochrane Database of Systematic Reviews, 3, 1-7.
Shinkoda, H., Matsumoto, K., & Park, Y. M. (1999). Changes in sleep-wake cycle during the period from late pregnancy to puerperium identified through the wrist actigraphy and sleep logs. Psychiatry and Clinical Neurosciences, 53(2), 133-135.
Signal, T. L., Gander, P. H., Sangalli, M. R., Travier, N., Firestone, R. T.,& Tuohy, J. F. (2007). Sleep duration and quality in healthy nulliparous and multiparous women across pregnancy and post-partum. The Australian & New Zealand Journal of Obstetrics & Gynaecology, 47(1), 16-22.
Smith-Hanrahan, C., Deblois, D. (1995). Postpartum early discharge impact on maternal fatigue functional ability. Clinical Nursing Research,4(1), 50-66.
Swain, A. M., O' Hara, M. W., Star, K. R., & Gorman, L. L. (1997). A prospective study of sleep‚ mood‚ and cognitive function in postpartum and nonpostpartum woman. Sleep Patterns, 90(3), 381-386.
Svensson, K., Mattiesen,A.S., & Widstorm, A, M. (2005). Night rooming-in: Who decides? An example of staff influence on mother’s attitude. Birth,32(2), 99-106.
Terzano, M. G., Parrino, L., Fioriti, G., Orofiamma, B., & Depoortere, H. (1990).Modifications of sleep structure induced by increasing levels of acoustic perturbation in normal subjects. Electroencephalography and Clinical Neurophysiology, 76(1), 29-38.
Thomas, K. A. (2000). Differential effects of breast and formula feeding on preterm infants’ sleep wake patterns. Journal of Obstetrics, Gynecology, and Neonatal Nursing, 29(4), 145-152.
Troy, N.W., & Dalgas-Pelish, P. (1997). The natural evolution of postpartum fatigue among a group of primiparous women. Clinical Nursing Research, 6(2), 126-141.
Troy, N. W. (2003). Is the significance of postpartum fatigue being overlooked in the lives of women? American Journal of Maternal-Child Nursing, 28(4), 252-257.
Tsai, P. S.*, Wang, S. Y., Wang, M. Y., Su, C. T., Yang, T. T., Huang, C. J., & Fang, S. C. (2005). Psychometric evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in primary insomnia and control subjects. Quality of Life Research, 14, 1943-1952.
Tsai, S. Y., Barnard, K. E., Lentz, M. J., & Thomas, K. A. (2010). Mother-infant activity synchrony as a correlate of the emergence of circadian rhythm. Biological Resrarch For Nursing, 13(1). 80-88.
Tulman, L., & Fawcett, J. (1988). Return of functional ability after childbirth. Nursing Research, 37(2), 77-81.
Varner, B., Ossenkop, D., & Lyon, J. (1980). Prematures, too need rooming-in and care-by-parent program. American Journal of Maternal Child Nursing,5(6), 431-432.
Waters, M. A., & Lee, K. A. (1996). Differences between primigravidae and multigravidae mother in sleep disturbances, fatigue, and functional status. Journal of Nursing Midwifery, 41,364-367.
Walther, V. N. (1997). Postpartum depression: A review for perinatal social workers. Social Work in Health Care, 24(3), 99-111.
Wambach, A., & Lee, M.A. (1998). Maternal fatigue in breastfeeding primiparae during the first nine week s postpartum. Journal of Human Lactation, 14(3), 219-229.
Yang, A. C., Hong, C. L., Kuo,C. H.,Kuo, C. H., Chen, T. J., et al. (2010). Profiling objective sleep quality in a healthy Taiwanese sample: Using a novel electrocadiogram-based ardiopulmonary coupling analysis. Taiwanese Journal of Psychiatry, 24(3), 201-209.

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9. 3.李明書,工作壓力及其管理策略之探討,勞工行政,第74期,1994。
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11. 馮容莊(1992).產科母嬰同室護理模式之運用與評值.榮總護理,9(4),419-427。
12. 馮容莊(1993).母嬰同室護理臨床實施護理效益之探討,護理研究,1(1),71-81。
13. 鄧素文、蘇燦煮、楊雅玲、張桂玲(1995).探討母嬰同室照護對哺母乳產婦之困擾及滿月哺乳方式的影響.護理研究,3(2),181-192。
14. 鄧鳳苓、史麗珠、鄭博仁、李絳桃(2007).產褥期婦女之睡眠品質及其相關因素.長庚護理,18(4)499-510。
15. 藍逸梅、李從業、陳嘉琦(2001).概念分析-親子依附.榮總護理,18(2),125-130。