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：
8015259
负责人：
Jill Radtke Demirci
金额：
$ 4.06万
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/8015259
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.

描述（由申请人提供）：晚期早产儿（妊娠 34-37 周）是美国增长最快、规模最大的早产儿群体。尽管外观相似，但晚期早产儿缺乏足月儿的发育成熟度，这使得他们容易受到影响。独特的、常常未被认识到的医疗脆弱性以及随之而来的高发病率。一这些数据中出现的一个惊人的悖论是，母乳喂养的晚期早产儿往往比非母乳喂养的早产儿更容易被诊断出发育不良、黄疸和脱水，这一发现很大程度上归因于母乳摄入不足。因此，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，特别是对于早产儿，但很难推荐母乳喂养作为最佳喂养方法并鼓励晚期早产人群更广泛地采用母乳喂养。虽然晚期早产母乳喂养并发症通常可追溯到婴儿相关问题，但母乳喂养是一项涉及婴儿和母亲的复杂、相互的活动。因此，了解早产儿晚期母乳摄入不足导致母乳喂养成功和母乳喂养失败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晚期早产母婴二人组中母乳喂养开始和持续的过程。次要目标是，1）将母乳喂养置于晚期早产儿母亲的更广泛背景下； 2) 确定影响晚期早产母亲决定开始和继续母乳喂养的因素。主要基于 Strauss 和 Corbin 提出的扎根理论技术，该研究将利用系列产后半结构化访谈、观察现场笔记和二次数据收集方法（例如，自我录音、视频回顾/反思）来估计10-18岁母亲对晚期早产儿的发展有实质性理论。将采用理论采样、记忆和利用恒定比较方法的系统编码。该提案满足了 NINR 的两个目标：1）确定并改善早产的长期后果，包括近足月婴儿的并发症； 2) 确定对决策的影响，这些影响会导致行为改变，从而促进健康并预防疾病和残疾。这项研究的结果预计将为未来缩小或消除晚期早产人群母乳喂养健康差异的研究工作奠定基础。此外，这项研究还将有助于目前尚未开发的关于晚期早产的知识库，特别是该群体中的母乳喂养。