【作者】 丁海燕；

【导师】 任淑萍；

【作者基本信息】 吉林大学 ， 公共卫生， 2009， 硕士

【摘要】 品质圈是一种被各行各业广泛推广应用的新型的质量管理模式,它带给人们的启示是将目标管理巧妙地结合了人性管理的激励措施。母乳具有营养、防病、增进母子感情、促进产妇健康、经济卫生等优点。现在坚持4~6个月纯母乳喂养是创建爱婴医院的重要指标,但影响坚持母乳喂养的因素有很多,如分娩方式、睡眠情况、饮食情况、产妇情绪等均可直接影响泌乳量。现行的产后访视服务模式虽然在一定程度上能够解决部分产妇在出院后所遇到的一些影响母乳喂养的问题,但是随着社会的发展进步以及产妇生活水平、健康需求的不断提高,产妇对产后访视的需求及要求也随之越来越高。现行的产后访视是护理人员的一种自觉行为,缺乏管理部门的督促及检查,随着纯母乳喂养率的下降,间接反映了现行的产后访视服务模式已不能完全满足各个产妇及婴儿的需要,其内容、形式和管理方式都应有新的突破。本研究为探讨产后访视中应用品质圈对持续性母乳喂养质量的影响,将本院产科住院200例剖宫产产妇分为实验组及对照组,每组100例,实验组在产后访视中实施品质圈活动对产妇进行母乳喂养指导,对照组按照现行产后访视模式进行母乳喂养指导,在每个产妇出院后28天,两组分别对出现乳房胀痛产妇例数、乳头皲裂产妇例数及产妇母乳喂养自信心评分进行比较分析,在每个产妇出院后120天,两组分别对纯母乳喂养率、混合喂养率及人工喂养率、产妇改变喂养方式的原因及护理人员对产妇追踪服务总次数进行比较分析,结果显示产后访视中应用品质圈这种新颖的产后访视模式,提高了护理人员访视行为的依从性,可促进产后访视的有效开展,提高了纯母乳喂养率,有效的加强了母乳喂养支持组织的建设,值得在爱婴医院推广。更多还原

【Abstract】 Object:Breast feeding is a sort of natural feeding mode since human beings have existed, its advantages include nutrient, immune, enhancement of sensation between mothers and infant, healthy, economy and sanitation. 4-6months breast feeding is significant guideline of infant fonding hospital. But there are many factors influencing breast feeding, such as labor mode, dormancy, diet, mood. Though active postnatal visit can partially solve some problem in breast-feeding, with development of society, standard of living and healthy demand, the management of postnatal visit is improving now. Active postnatal visit is an consciousness behavior of paramedic which is lack of administer. And the decent of breast feeding rate indirectly reflects the discomfort of active postnatal visit and the require of maternity. This research advocates using quality control circle (QCC) in postnatal visit, it is a new quality administer pattern which guide breast feeding in time and meticulously. Aim to observe QCC’s efficiency, we prove it can improve paramedic’s compliance and disposal ability so as to elevate breast-feeding rate.Methods:Object were maternities who undergone caesarean birth in Second Hospital of Jilin University during Jan 2009 and Apr 2009. There are experimental group and control group. Every maternity was accepted breast feeding guidance. In control group, maternities are accepted breast feeding follow-up guidance in the 14th , 28th day and 2nd month , 4th month after birth while maternities in experimental group accepted QCC guidance. According to status investigation cause analysis, strategies, implement, our member could visit in time, guide at any moment and drop in guidance if necessarily. Secretary recorded: self-confidence grade, cause of breast bulge and mammilla chap in 28th day after birth. And simple breast feeding cases, fixed feeding cases, got-up feeding cases in 120th day after birth. Result to exchange feeding pattern and total frequency of visit are undergone statistics analysis.Results:(1)common insistence of infant gender, weight, maternity age, pregnant age have no statistic difference (P>0.05). (2)There is notably difference between confidence grade . (3)Instance of simple breast feeding, fixed feeding, got-up feeding in the 120th day after birth have notably difference. (4) About results of exchanging feeding pattern, influence of metal factor’s exchange have notably difference. (5) After 120 days visit degree have marked difference. (6) After 28 days , ratio of cases which undergone mammilla chap, breast bulge have marked difference.Conclusions:(1) QCC provide ensures quality, promote development of nursing administer. (2) Using QCC in postnatal visit, paramedic members can evaluate instance of infant and can promote maternity and infant’s health. It’s benefit to descend breast bulge and mammilla chap, which can promote maternities’confidence and avoid exchange of feeding pattern. (3) QCC can fill up with paramedic requirement, promote compliance of visit, impulse development of postnatal visit, promote simple breast feeding rate, descend fixed feeding rate and got-up feeding rate, ensure the duration of breast feeding, improve the quality of breast feeding.更多还原