Breastfeeding the Late Preterm Infant: A Grounded Theory Study

母乳喂养晚期早产儿：扎根理论研究

基本信息

批准号：
8197748
负责人：
Jill Radtke Demirci
金额：
$ 2.95万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-12-01 至 2012-06-03
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8197748
关键词：
Accounting Address Affect Anxiety Appearance Behavioral Birth Breast Breast Feeding Caring Code Complex Data Data Collection Decision Making Deglutition Dehydration Development Diagnosis Disease Employee Strikes Evaluation Excision Failure Failure to Thrive Feeding Methods Foundations Health Health Benefit Hospital Personnel Hospitalization Hospitals Human Milk Icterus Incidence Infant Infant Behavior Infant Health Intake Intervention Interview Literature Medical Methods Milk Morbidity - disease rate Mothers Nature Outcome Physiological Population Postpartum Period Pregnancy Premature Birth Premature Infant Process Readiness Regulation Research Sampling Schools Social support Stress Structure Techniques United States Video Recording Vulnerable Populations Work base body system cohort comparative design disability experience health disparity improved knowledge base premature prevent psychologic stem success sucking theories uptake vigilance

项目摘要

DESCRIPTION (provided by applicant): Late preterm infants (34-37 weeks gestation) account for the fastest growing, largest cohort of preterm births in the U.S. Despite comparable outward appearances, late preterm infants lack the developmental maturity of their term counterparts, predisposing them to unique, often unrecognized medical vulnerabilities and a concomitant high incidence of morbidity. One striking paradox emergent from these data is that late preterm infants who are breastfed tend to present with diagnoses of failure to thrive, jaundice, and dehydration at much higher rates than those who are not breastfed, a finding largely attributed to insufficient breast milk intake. Consequently, it is difficult to recommend breastfeeding as the optimal method of feeding and encourage its more widespread uptake among the late preterm population, despite the many, irrefutable long- and short-term health benefits that breastfeeding provides, particularly for infants born prematurely. While late preterm breastfeeding complications are often traced to infant-related issues, breastfeeding is a complex, reciprocal activity involving both infant and mother. It has become crucial, therefore, to understand the processes leading to both breastfeeding success and breastfeeding failure stemming from insufficient breast milk intake within the late preterm population. Accordingly, the primary aim of this qualitative, grounded theory study is to describe and explain the process of breastfeeding initiation and continuation among late preterm mother-infant dyads. Secondary aims are, 1) to place breastfeeding within the broader context of mothering a late preterm infant; and 2) to identify factors influencing the late preterm mother's decision to initiate and continue breastfeeding. Based mainly on the grounded theory techniques proposed by Strauss & Corbin, the study will utilize serial postpartum semi-structured interviews, observational field-notes, and secondary data collection methods (e.g., self-audio recordings, video review/reflection) for an estimated 10-18 mothers of late preterm infants in the development of a substantive theory. Theoretical sampling, memoing, and systematic coding utilizing the constant comparative method will be employed. This proposal satisfies two NINR objectives: 1) to identify and ameliorate the long-term consequences of prematurity, including complications of near-term infants; and 2) identify influences on decision-making that result in behavioral changes that promote health and prevent disease and disability. Results from this study are expected to provide a foundation for future research efforts seeking to narrow or eliminate breastfeeding health disparities for the late preterm populace. Additionally, this study will contribute to the currently underdeveloped knowledgebase surrounding late prematurity in general, and breastfeeding within this group, in particular.

DESCRIPTION (provided by applicant): Late preterm infants (34-37 weeks gestation) account for the fastest growing, largest cohort of preterm births in the U.S. Despite comparable outward appearances, late preterm infants lack the developmental maturity of their term counterparts, predisposing them to unique, often unrecognized medical vulnerabilities and a concomitant high incidence of morbidity.一从这些数据中出现的引人注目的悖论是，母乳喂养的晚期早产儿往往会出现诊断出未能生长，黄疸和脱水的诊断，比未母乳喂养的婴儿差异要高得多，这一发现很大程度上归因于母乳摄入量不足。因此，很难建议母乳喂养作为喂养的最佳方法，并鼓励其在早产群中更广泛的吸收，尽管母乳喂养提供了许多无可辩驳的长期和短期健康益处，尤其是对出生的早产儿提供的良好的长期健康益处。虽然早产晚期母乳喂养并发症通常被追溯到与婴儿有关的问题，但母乳喂养是一种复杂的，涉及婴儿和母亲的相互性活动。因此，了解导致母乳喂养成功的过程和母乳喂养衰竭的过程变得至关重要。因此，这项定性，扎根的理论研究的主要目的是描述和解释母乳喂养开始和延续的早产母亲二元组的过程。次要目的是，1）将母乳喂养放在孕育早产儿的更广泛背景下； 2）确定影响早产母亲决定发起和继续母乳喂养的因素。这项研究主要基于Strauss＆Corbin提出的基础理论技术，将利用估计在实物理论的发展中的早产儿的估计为10-18个早产儿的估计的10-18个早体婴儿的母亲。利用恒定比较方法的理论采样，回忆和系统编码。该提议满足了两个尼尔目标：1）确定和改善早产的长期后果，包括近期婴儿的并发症； 2）确定对决策的影响，从而导致行为改变，从而促进健康并预防疾病和残疾。预计这项研究的结果将为未来的研究工作奠定基础，旨在缩小或消除早产平民的母乳喂养差异。此外，这项研究将有助于当前欠发达的知识基础围绕晚期早产，尤其是在该组中进行母乳喂养。