[[alternative]]Exploring the association of the feeding type and relevant factors with mother-infant attachment during postpartum

[[abstract]]本研究於產後第三天比較三組餵食方式(母奶餵食、配方奶餵食及混合餵食)及相關因素對於產後初期母嬰依附關係之相關性探討。採觀測性回溯世代研究設計法，以方便取樣方式收集樣本，於台北縣市教學醫院及婦產科診所進行收案，採用填答問卷方式進行資料收集，共計發出130份問卷，回收有效問卷113份。測量工具包括「產婦及新生兒基本資料表」、「產後社會支持量表」、「愛丁堡產後憂鬱量表」、「親子依附量表」。統計分析發現，因母嬰依附關係具異質性，不同程度的母嬰依附關係會受到不同的相關變項所影響，故將連續性的依變項轉換成多類別資料（polychotomous），並從資料分析中找出符合適合度檢定且解釋力較高的切點，將母嬰依附分數分成三個不同切點，進而探討影響每個切點的母嬰依附關係之相關因素。研究結果顯示，母嬰依附關係會因為部分屬性不同而有部分差異，有妊娠合併症與產後社會支持度較低者，其母嬰依附關係較差。在單變量分析中，結果顯示餵食方式與母嬰依附關係呈現無顯著差異。在多變量分析中，則發現不同程度的母嬰依附關係分別受到不同的相關因素所影響：已婚者、母嬰同室、混合餵食有助於母嬰依附關係發展，而妊娠合併症則對第一個切點之依附關係有負向的影響；嬰兒性別符合期待者具有較佳的母嬰依附關係，而專業性的工作及有憂鬱傾向則對第二個切點之依附關係產生負面影響；產後憂鬱會對第三個切點的母嬰依附關係產生負面影響。因此，臨床護理人員應針對不同程度的母嬰依附關係來提供產婦適切需求的照護，期望本研究結果可提供護理實務與護理教育的參考。[[abstract]]AbstractThe purpose of this study was to explore the association of the feeding type and relevant factors with mother-infant attachment over the first 3 days during postpartum. An observational retrospective cohort study design was used. A convenience sample was recruited from the teaching hospitals and clinics located in Taipei. Questionnaires were used to collect data needed for this study. 130 questionnaires were distributed, and 113 questionnaires were returned. The instruments include “maternal and infant demographic characteristics”, “postpartum social support scale”, “Edinburgh Postnatal Depression Scale”, and “Maternal Attachment Inventory” Due to the heterogeneity of the data on mother-infant attachment, the continuous data were transformed into polychotomous data, and then three cut-off points were found by statistics to form three categories of mother-infant attachment. The results indicated some demographic characteristics had an impact on mother-infant attachment, that is, mothers with complications and lower social support had the less level of mother-infant attachment. Furthermore, the results indicated there was no significant difference on mother-infant attachment among three feeding types. In addition, regarding the first cut-off point, marital status, rooming-in, feeding type, and pregnancy complications significantly affected mother-infant attachment. Regarding the second cut-off point, job style, expectancy on infant’s sex, and postpartum depressive symptoms significantly affected mother-infant attachment. Regarding the third cut-off point, postpartum depression significantly affected mother-infant attachment.Nurses should provide appropriate nursing care to those mothers who are at different levels of mother-infant attachment, and hopefully these results is helpful for nursing education and practice