미숙아를 위한 하이브리드 앱 기반 모유수유 증진 프로그램 개발 및 효과

Abstract

본 연구는 하이브리드 앱을 이용하여 재태연령 33주 이상 37주 미만의 미숙아를 출산한 어머니를 대상으로, 모유수유 증진 프로그램을 개발하여, 4주 동안 중재를 적용한 비동등성 대조군 전후 시차설계 유사 실험연구이다. 모유수유의 성공률이 낮은 미숙아 출산 산모들을 대상으로 프로그램 중재 효과로, 미숙아 어머니의 모유수유 지식, 모유수유 자기효능감, 모유수유 실천율(모유수유 횟수, 모유 유축 횟수, 유축 양)의 증가와 미숙아의 신체적 성장(생리적 체중 감소, 체중, 신장, 머리둘레)을 검증하였다. S시 소재 1개의 대학병원 신생아 중환자실에서, 대조군은 2015년 7월30일부터 12월5일까지 15명, 실험군은 2015년 12월 16일부터 2016년 4월20일까지 15명으로 총 30명에게 적용하였다. 수집된 자료는 SPSS 21.0 통계 프로그램으로 분석하였으며, Chi-square test, Fisher’s exact test, Mann-whitney test, Wilcoxon signed rank test, Repeated measures ANOVA를 실시하였다. 본 연구 결과는 다음과 같다. 1. 프로그램 중재 4주 후, 모유수유 지식 정도는 실험군이 사후에 유의하게 증가하였으며, 실험군과 대조군의 모유수유 지식 정도의 차이는 통계적으로 유의하게 나타났다. 즉, 모유수유 증진 프로그램은 모유수유 지식 정도를 높이는데 효과적으로 나타났다. 2. 프로그램 중재 4주 후, 모유수유 자기효능감 정도는 실험군이 사후에 유의하게 증가하였으며, 실험군과 대조군의 모유수유 자기효능감 정도의 차이는 통계적으로 유의하게 나타났다. 즉, 모유수유 증진 프로그램은 모유수유 자기효능감 정도를 높이는데 효과적으로 나타났다. 3. 프로그램 중재 1주 후, 4주 후, 실험군과 대조군의 모유수유 실천율은 통계적으로 유의한 차이가 있었다. 즉, 모유수유 증진 프로그램은 모유수유 실천율을 높이는데 효과적으로 나타났다. 4. 프로그램 중재 1주 후, 4주 후, 실험군과 대조군의 모유 유축 양은 통계적으로 유의한 차이가 있었다. 즉, 모유수유 증진 프로그램은 모유 유축양 증가에 효과적으로 나타났다. 5. 프로그램 중재 1주 후, 4주 후, 실험군과 대조군의 모유 유축 횟수는 통계적으로 유의한 차이가 있었다. 즉, 모유수유 증진 프로그램은 모유 유축 횟수 증가에 효과적으로 나타났다. 6. 프로그램 중재 1주 후, 4주 후, 실험군과 대조군 미숙아의 생후 7일째 체중 감소량(생리적 체중감소), 체중, 신장, 머리둘레의 증가량 또한 통계적으로 유의한 차이가 없었다.;A breastfeeding promotion program using a hybrid application was developed. A quasi-experimental study of nonequivalent control group pretest-posttest design that applied the program for 4 weeks on mo thers who gave birth to a premature infant of gestational age between 33 and 37 weeks was conducted. Also, this study intended to verify the effect of the intervention program as knowledge in breastfeeding of mothers of premature infant, self-efficacy of breastfeeding, increase in practice rate of breastfeeding(number of breastfeeding, number of breast pumping, amount of breast pump), and growth of premature infant(physiological decrease of body weight, weight, height, head circumference). The program was applied on total 30 premature infants of 15 control group from Jul 30 to Dec 5, 2015 and 15 experimental group from Dec 16, 2015 to Apr 20, 2016 in a neonatal intensive care unit of a university hospital located in Seoul. The collected data was analyzed using SPSS 21.0 Statistical Program, and conducted Wilcoxon signed rank test, Mann-whitney test, Chi-square test, Fisher’s exact test, and Repeated measures ANOVA. The results of this study are as follows. 1. According to the result of measuring knowledge in breastfeeding at birth and 4 weeks after the intervention by appling the breastfeeding promotion program for premature infant using hybrid application developed in this study, it was identified that the degree of knowledge in breastfeeding significantly increased in experimental group after the application, and experimental group and control group showed statistically significant difference in degree of knowledge in breastfeeding before and after the program. Meaning, the experimental group showed higher degree of knowledge in breastfeeding than the control group. 2. According to the result of measuring self-efficacy of breastfeeding at birth and 4 weeks after the intervention by appling the breastfeeding promotion program for premature infant using hybrid application, it was identified that self-efficacy of breastfeeding significantly increased in experimental group after the application, and experimental group and control group showed statistically significant difference in self-efficacy of breastfeeding before and after the program. Meaning, the experimental group showed higher self-efficacy of breastfeeding than the control group. 3. According to the result of measuring practice rate of breastfeeding at birth, when discharged from hospital, 1 week after the intervention, and 4 weeks after the intervention by appling the breastfeeding promotion program for premature infant using hybrid application, it was identified that both groups showed statistically significant difference 1 week after the intervention and 4 weeks after the intervention. Meaning, the experimental group showed higher practice rate of breastfeeding than the control group. 4. According to the result of measuring the amount of breast pump at birth, when discharged from hospital, 1 week after the intervention, and 4 weeks after the intervention by appling the breastfeeding promotion program for premature infant using hybrid application, it was identified both 1 week after the intervention and 4 weeks after the intervention showed statically significant difference. Meaning, the experimental group showed increased amount of breast pump than the control group 5. According to the result of measuring the number of breast pump at birth, when discharged from hospital, 1 week after the intervention, and 4 weeks after the intervention by appling the breastfeeding promotion program for premature infant using hybrid application, it was identified both 1 week after the intervention and 4 weeks after the intervention showed statically significant difference. Meaning, the experimental group showed increased number of breast pump than the control group. 6. According to the result of measuring the weight, height, and head circumference of premature babies at birth, when discharged from hospital, 1 week after the intervention, and 4 weeks after the intervention by appling the breastfeeding promotion program for premature infant using hybrid application, it was identified that loss in weight(physiological decrease of body weight) 7 days after the birth did not show statistically significant difference between the experimental group and control group. Weight, height, and head circumference of premature babies at investigation period and interaction between the two groups did not show statistically significant difference. According to the result of applying the breastfeeding promotion program for premature infant using hybrid application developed in this study, it is considered to be used as an effective intervention in promoting breastfeeding of mothers of premature babies who were discharged from hospital because it was identified to be effective in increasing knowledge in breastfeeding of mothers of premature infant. self-efficacy of breastfeeding, practice rate of breastfeeding, amount of breast pump, and number of breast pumping.