DOI QR코드

DOI QR Code

임신성 당뇨병 산모를 위한 모바일 기반 모유수유 증진 프로그램의 개발 및 효과 평가

Development and Effectiveness Evaluation of Comprehensive Mobile-Based, Breastfeeding Promotion Program for Mothers with Gestational Diabetes

  • 곽은주 (충북대학교 의과대학 간호학과) ;
  • 박승미 (충북대학교 의과대학 간호학과 & 간호과학연구소)
  • Kwak, Eunju (Department of Nursing, College of Medicine, Chungbuk National University) ;
  • Park, Seungmi (Department of Nursing Science & Research Institute of Nursing Science, College of Medicine, Chungbuk National University)
  • 투고 : 2023.07.25
  • 심사 : 2023.12.06
  • 발행 : 2024.05.31

초록

Purpose: This study aimed to evaluate the effects of a mobile-based breastfeeding promotion program (M-BFGDM) that helps mothers with gestational diabetes. Methods: Forty-seven mothers participated in the study, of whom 22 were in the experimental group and 25 in the control group. To verify the effects, a lag design before and after the non-equivalence control group was used. The data collection for the experimental group was done before and after the intervention. Results: In the results, breastfeeding knowledge showed a significant difference in the interaction between measurement period and group (χ2 = 8.14, p = .017), whereas breastfeeding intention did not show a significant difference in the interaction (χ2 = 4.73, p = .094). There was no difference in self-efficacy interaction (F = 0.13, p = .856). The breastfeeding method showed no difference in interaction (F = 0.04, p = .952), whereas cross-analysis showed a significant difference in breastfeeding practice rate between the experimental group and the control group at 1 month postpartum (χ2 = 7.59, p = .006). Conclusion: A mobile-based breastfeeding promotion program was developed and applied for gestational diabetic mothers, resulting in an increase in breastfeeding knowledge and an improvement in breastfeeding practice rate one month after childbirth. In addition, M-BFGDM managed to create a breastfeeding practice environment with fewer time and place restrictions. A program study that complements motivation is needed to improve breastfeeding in pregnant diabetic mothers in the future.

키워드

과제정보

This study was supported by the National Research Foundation of Korea (NRF) fund in 2019 (No. NRF-2019R1I1 A3A0105996).

참고문헌

  1. Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Research and Clinical Practice. 2019;157:107843.  https://doi.org/10.1016/j.diabres.2019.107843 
  2. Korean Health Information Portal. Gestational diabetes mellitus [Internet]. Korea Disease Control and Prevention Agency; 2023 [cited 2023 Jun 25]. Available from: https://health.kdca.go.kr/healthinfo/biz/health/gnrlzHealthInfo/gnrlzHealthInfo/gnrlzHealthInfoView.do?cntnts_sn=5271. 
  3. Korean Society of Obstetrics and Gynecology (KSOG). Obstetrics. 6th ed. Gunja Publishing House; 2019. p. 762-763.
  4. Damm P, Houshmand-Oeregaard A, Kelstrup L, Lauenborg J, Mathiesen ER, Clausen TD. Gestational diabetes mellitus and long-term consequences for mother and offspring: A view from Denmark. Diabetologia. 2016;59(7):1396-1399. https://doi.org/10.1007/s00125-016-3985-5
  5. Park JS, Lim JY, Kim EJ, Byoun SJ, Lee SY, Chang IS, et al. The 2021 national family and fertility survey. Korea Institute for Health and Social Affairs; 2021 Dec. Report No.: 2021-50.
  6. Park S, Min D, Park J. The influence of knowledge and health beliefs about gestational diabetes on breastfeeding intention of women with gestational diabetes. Journal of Korean Academy of Community Health Nursing. 2020;31(4):427-435. https://doi.org/10.12799/jkachn.2020.31.4.427 
  7. Manerkar K, Harding J, Conlon C, McKinlay C. Maternal gestational diabetes and infant feeding, nutrition and growth: A systematic review and meta-analysis. British Journal of Nutrition. 2020;123(11):1201-1215.  https://doi.org/10.1017/S0007114520000264 
  8. Nguyen PTH, Pham NM, Chu KT, Van Duong D, Van Do D. Gestational diabetes and breastfeeding outcomes: A systematic review. Asia Pacific Journal of Public Health. 2019; 31(3):183-198. https://doi.org/10.1177/1010539519833497
  9. Finkelstein SA, Keely EJ, Feig D, Tu X, Walker M. Breastfeeding in women with diabetes: Lower rates despite greater rewards. A population-based study. Canadian Journal of Diabetes. 2012;36(5 Suppl):S73.  https://doi.org/10.1016/j.jcjd.2012.07.458 
  10. Hartmann P, Cregan M. Lactogenesis and the effects of insulin-dependent diabetes mellitus and prematurity. The Journal of Nutrition. 2001;131(11):3016S-3020S.  https://doi.org/10.1093/jn/131.11.3016S 
  11. Hirst JE, Tran TS, Do MA, Rowena F, Morris JM, Jeffery HE. Women with gestational diabetes in Vietnam: A qualitative study to determine attitudes and health behaviours. BMC Pregnancy and Childbirth. 2012;12:81.  https://doi.org/10.1186/1471-2393-12-81
  12. Park S, Yu SY. Breastfeeding experiences of women with gestational diabetes. The Journal of Korean Academic Society of Nursing Education. 2021;27(3):274-286.  https://doi.org/10.5977/jkasne.2021.27.3.274 
  13. Jagiello KP, Azulay Chertok IR. Women's experiences with early breastfeeding after gestational diabetes. Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2015;44(4): 500-509. https://doi.org/10.1111/1552-6909.12658
  14. Fisher JD, Fisher WA. Changing AIDS-risk behavior. Psychological Bulletin. 1992;111(3):455-474.  https://doi.org/10.1037/0033-2909.111.3.455 
  15. Motahari-Tabari NS, Nasiri-Amiri F, Faramarzi M, Shirvani MA, Bakhtiari A, Omidvar S. The effectiveness of information-motivation-behavioral skills model on self-care practices in early pregnancy to prevent gestational diabetes mellitus in Iranian overweight and obese women: A randomized controlled trial. Community Health Equity Research & Policy. 2023;43(3):257-264.  https://doi.org/10.1177/0272684X211020300 
  16. Tuthill EL, Butler LM, Pellowski JA, McGrath JM, Cusson RM, Gable RK, et al. Exclusive breast-feeding promotion among HIV-infected women in South Africa: An Information-Motivation-Behavioural Skills model-based pilot intervention. Public Health Nutrition. 2017;20(8):1481-1490. https://doi.org/10.1017/S1368980016003657
  17. Lee SS, Kwon MK. Effects of self-directed fundamental nursing practice using smartphone videos on self-efficacy, practice satisfaction, and skill competency. The Journal of Korean Academic Society of Nursing Education. 2016;22(3):255-263.  https://doi.org/10.5977/jkasne.2016.22.3.255
  18. Phillippi JC, Wyatt TH. Smartphones in nursing education. Computers, Informatics, Nursing. 2011;29(8):449-454. https://doi.org/10.1097/NCN.0b013e3181fc411f
  19. Fisher JD, Fisher WA. Theoretical approaches to individual-level change in HIV risk behavior. In: Peterson JL, Di-Clemente RJ, editors. Handbook of HIV Prevention. Kluwer Academic/Plenum Publishers; 2000. p. 3-55. 
  20. Min HY. The effects of hybrid application breastfeeding promotion program for premature infants [dissertation]. Seoul: Ewha Womans University; 2016. p. 1-109.
  21. Dennis CL. The breastfeeding self-efficacy scale: Psychometric assessment of the short form. Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2003;32(6):734-744. https://doi.org/10.1177/0884217503258459 
  22. Kim S, Lee H, Kim SH, Kim SY. Effects of prenatal breast self-massage education on breastfeeding self-efficacy, adaptation, and practice in primiparous women. Korean Parent-Child Health Journal. 2017;20(1):18-27. 
  23. Jeong GH. Effect of the nursing intervention program on promoting the breast-feeding practice in primipara [dissertation]. Seoul: Ewha Womans University; 1997. p. 1-133. 
  24. Helsing E. Infant feeding and infectious illness. World Health Organization Regional Office for Europe; 1985. 
  25. Molenda M. In search of the elusive ADDIE model. Performance Improvement. 2015;54(2):40-42.  https://doi.org/10.1002/pfi.21461 
  26. Kang KA, Kim SJ. The growth.developmental status of brestfed infants. Korean Parent-Child Health Journal. 2006; 9(1):33-42.
  27. Lee JY, Kim HY. Development and validation of a postpartum care mobile application for first-time mothers. Korean Journal of Women Health Nursing. 2017;23(3):210-220.  https://doi.org/10.4069/kjwhn.2017.23.3.210
  28. Loh KP, Liu J, Ganzhorn S, Sanabria G, Schnall R. Establishing a usability cut-point for the health information technology usability evaluation scale (Health-ITUES). International Journal of Medical Informatics. 2022;160:104713. https://doi.org/10.1016/j.ijmedinf.2022.104713 
  29. Kim JK, Choi HM, Ryu EJ. Postnatal breast-feeding knowledge, techniques and rates of first-time mothers depending on a prenatal breast-feeding education method. The Journal of Korean Academic Society of Nursing Education. 2011;17(1):90-99.  https://doi.org/10.5977/JKASNE.2011.17.1.090
  30. Park MK, Moon SH. Effects of an individual breast-feeding promotion program for married immigrant women. Journal of Korean Academy of Nursing. 2016;46(1):128-139.  https://doi.org/10.4040/jkan.2016.46.1.128 
  31. Suarez-Cotelo MDC, Movilla-Fernandez MJ, Pita-Garcia P, Arias BF, Novio S. Breastfeeding knowledge and relation to prevalence. Revista da Escola de Enfermagem da USP. 2019;53:e03433.  https://doi.org/10.1590/S1980-220X2018004503433
  32. Choi EJ. Breastfeeding-related social environmental factors and their policy implications. Health and Welfare Policy Forum. 2017;249:72-81. 
  33. Song SM, Park MK. Effects of breastfeeding empowerment program on breastfeeding self-efficacy, adaptation and continuation in primiparous women. Journal of Korean Academy of Nursing. 2016;46(3):409-419.  https://doi.org/10.4040/jkan.2016.46.3.409 
  34. Kang JH, Son H, Byun SY, Han G. Effect of direct breast-feeding program for premature infants in neonatal intensive care unit. Journal of Korean Academy of Nursing. 2021; 51(1):119-132. https://doi.org/10.4040/jkan.20240
  35. Choi EJ, Park EJ, Kim HR, Oh MA, Lee NH, Choi JH. Survey on breastfeeding in Korea. Korea Institute for Health and Social Affairs; 2016. Report No.: 2016-17. 
  36. Zan S, Agboola S, Moore SA, Parks KA, Kvedar JC, Jethwani K. Patient engagement with a mobile web-based telemonitoring system for heart failure self-management: A pilot study. JMIR mHealth and uHealth. 2015;3(2):e33.  https://doi.org/10.2196/mhealth.3789 
  37. Bandura A. Regulation of cognitive processes through perceived self-efficacy. Developmental Psychology. 1989;25(5): 729-735. https://doi.org/10.1037/0012-1649.25.5.729