Application of self-efficacy theory in nursing intervention of breastfeeding for patients with gestational diabetes mellitus / 中国实用护理杂志

ABSTRACT

Objective:To explore the intervention effect of nursing guided by self-efficacy theory on postpartum breastfeeding of patients with gestational diabetes mellitus.Methods:A total of 140 patients with gestational diabetes mellitus in Qingdao Women and Children ′s Hospital were selected as study subjects by convenient sampling method. They were divided into two groups according to the time of diagnosis. Seventy patients recruited from August to September 2019 were named as the control group, while those 70 patients from May to June 2020 were set as the intervention group. The control group took routine care and the intervention group received breastfeeding intervention based on self-efficacy theory. The rate of delayed onset of lactogenesisⅡ(DOLⅡ), breastfeeding knowledge, exclusive breastfeeding rate and breastfeeding self-efficacy in different time were compared. Results:The rate of DOLⅡ in the intervention group was 11.43% (8/70), which was lower than 25.71% (18/70) in the control group, the difference was statistically significant ( χ2=4.72, P<0.05). The score of breastfeeding knowledge in the intervention group at postpartum day 3 was 16.0 (15.0, 17.0) , which was higher than that in the control group 14.0(13.0, 16.0), the difference was statistically significant ( Z=-3.55, P<0.05). The rates of exclusive breastfeeding at postpartum day 3, month 1 and month 3 was 78.57% (55/70), 68.57% (48/70), 61.43% (43/70) in the intervention group and 61.43% (43/70), 45.71% (32/70), 37.14% (26/70) in the control group, the differences were statistically significant ( χ2=4.90, 6.60, 8.26, all P<0.05). The total scores of breastfeeding self-efficacy before intervention, 3 days, 1 month and 3 months postpartum were (48.34 ± 5.37), (50.00 ± 6.06), (52.54 ± 5.41), (52.92 ± 5.62) points in the control group and (48.96 ± 4.30), (53.32 ± 5.94), (56.91 ± 5.03), (59.11 ± 4.70) points in the intervention group. The total score of breastfeeding self-efficacy of patients in the two groups was analyzed by repeated measures of variance, and the differences in time effect, between-group effect and interaction effect were statistically significant ( Ftime=81.61, Fbetween-group=31.31, Finteraction=10.23, all P<0.05). Conclusions:Breastfeeding nursing intervention based on self-efficacy theory can improve the knowledge level of breastfeeding in patients with gestational diabetes mellitus, reduce the rate of DOLⅡ, enhance the sense of self-efficacy of breastfeeding and promote exclusive breastfeeding.