臺灣博碩士論文加值系統

本研究旨在探討孕期婦女憂鬱與產前母乳哺餵自我效能的現況，及兩者之間的相關性，並建立產前母乳哺餵自我效能量表之中文版信效度。立意取樣中部一所區域教學醫院婦產科門診之孕期婦女為研究對象。研究工具包括社會人口學資料、愛丁堡產後憂鬱量表與產前母乳哺餵自我效能量表。於婦產科產前門診進行問卷之填答，共得有效問卷208份。以次數分佈、百分率、平均值、標準差、t檢定、ANOVA、皮爾森相關係數等統計方法分析資料，並以內部一致性(Cronbach’s α )檢定、內容效度指標(Content Validity Index, CVI)及建構效度(construct validity)之因素分析(factor validity)檢定產前母乳哺餵自我效能量表之中文版的信度及效度。
研究發現：(1)以愛丁堡產後憂鬱量表12分為憂鬱的分割點，14.9%的孕婦有憂鬱情形；教育程度較低、沒有工作及非計畫中懷孕者，與產前憂鬱情形達顯著差異。(2)產前母乳哺餵自我效能量表平均得分80.52±11.84分；第一胎、沒有參加產前母乳課程、無哺餵母乳意願及沒有哺餵母乳經驗者，與母乳哺餵自我效能達顯著差異。(3)產前憂鬱與產前母乳哺餵自我效能，達顯著負相關。(4)產前母乳哺餵自我效能量表經因素分析後呈現四個因素，因素負荷為0.470-0.858，解釋變異量為67.10%；Cronbach’s α 值為 .94；CVI值為0.85。本研究建議：(1)臨床醫護人員在母乳哺餵在職教育中，應考量納入孕期憂鬱症狀之辨識與處理，及孕婦母乳哺餵自我效能的提升與諮詢技巧，以加強護理關懷的核心價值，提供完善的照護品質。(2)中文版產前母乳哺餵自我效能量表具有良好的信效度，未來可運用於孕期婦女母乳哺餵自我效能的相關研究。

This research was dedicated to investigate the relationship between self-efficacy of breastfeeding and depression in pregnant women, and to assess the accuracy and precision of the Chinese Mandarin version of Prenatal Breastfeeding Self-efficacy Scale (PBSES). Study subjects were recruited from a local teaching hospital in middle Taiwan. Materials of the study included social demographic data, Edinburgh Postnatal Depression Scale (EPDS) and PBSES. Questionnaire survey was conducted when patients attended the obstetric clinic, and a total of 208 valid questionnaires were retrieved. Data were presented as frequency distribution, percentage mean and standard deviation. Data analysis was performed with independent-sample t-test, one-way analysis of variance (ANOVA), and Pearson's correlation. Cronbach’s alpha (Cronbach’s α), content validity index (CVI), construct validity and factor validity analysis were applied to evaluate the reliability and validity of the Chinese Mandarin version of PBSES.
The study discovered that (1) Using a score of 12 as a cut-off point, 14.9% of the pregnant women had depression. Pregnant women with lower educational status, without job and with unintended pregnancy had a significantly higher rate of depression. (2) The average score of PBSES was 80.52±11.84, and women who were primipara, who did not attend prenatal breastfeeding classes, who did not want to breastfeed and those without experience of breastfeeding had significantly lower PBSES scores. (3) There was an inverse correlation between PBSES and prenatal depression. (4) Factor validity study showed four main factors affecting PBSES, including a factor loading of 0.470-0.858, a variance explained of 67.10%, a Cronbach’s α value of 0.94, and a CVI value of 0.85. The result of this study suggested that (1) Health care workers should include evaluation and treatment of prenatal depression, and education for pregnant women about prenatal breastfeeding in in-service education in order to strengthen the quality of health care. (2) The Chinese Mandarin version of PBSES had good reliability and validity, and could be applied in future studies related to self-efficacy of breastfeeding in pregnant women.

摘要 I
目錄 V
圖目錄 VIII
表目錄 IX
第一章 前言
第一節 研究重要性與動機 1
第二節 研究目的 3
第三節 研究問題 4
第四節 研究假設 4
第五節 名詞界定 5
第二章 文獻查證
第一節 產前憂鬱 7
第二節 母乳哺餵與自我效能 14
第三節 量表翻譯之過程 21
第四節 產前憂鬱與母乳哺餵自我效能相關性 28
第三章 研究方法
第一節 研究架構 33
第二節 研究設計 33
第三節 研究對象 35
第四節 研究工具 35
第五節 研究倫理考量 38
第六節 資料統計分析方法 38
第四章 研究結果
第一節 研究對象基本資料描述分析 41
第二節 個人背景因素對產前憂鬱及產前母乳哺餵自我效能之差異分析 50
第三節 產前憂鬱與產前母乳哺餵自我效能之相關分析 54
第四節 產前母乳哺餵自我效能量表之中文版的信效度檢定 56
第五節 個人背景因素對產前母乳哺餵自我效能量表各因素的差異分析 60
第五章 討論
第一節 影響產前憂鬱、產前母乳哺餵自我效能相關因素之討論 69
第二節 個人背景因素對產前憂鬱、產前母乳哺餵自我效能之差異討論 72
第三節 產前憂鬱與產前母乳哺餵自我效能之相關討論 74
第四節 產前母乳哺餵自我效能量表之中文版的信效度檢定討論 74
第五節 個人背景因素對產前母乳哺餵自我效能量表各因素的差異討論 80
第六章 結論與建議
第一節 結論 83
第二節 建議 84
參考文獻
中文部分 86
英文部分 88
附錄
附錄一 Prenatal Breast-feeding Self-efficacy Scale 104
附錄二 使用量表同意書 106
附錄三 孕期婦女憂鬱與產前母乳哺餵自我效能之問卷 107
附錄四 人體試驗委會審查同意書 110
附錄五 知情同意書 111
附錄六 產前母乳哺餵自我效能量表兩階段式翻譯專家審查表 112
附錄七 產前母乳哺餵自我效能量表兩階段式翻譯專家審查結果 118
附錄八 專家效度名單 119
附錄九 專家效度調查問卷 120
附錄十 專家內容效度 123

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