探討早產兒母親育兒健康識能之研究-以自我效能及問題解決為中介變項

Abstract

目的：為瞭解早產兒母親背景變項對於自我效能、問題解決、健康識能之現況及影響，並探討自我效能與問題解決對於早產兒母親背景變項與健康識能作為中介變項的可能性。 方法：立意取樣北部某醫學中心之新生兒加護病房以及新生兒中重度病房，早產兒母親為研究對象，共113位參與。資料以描述性統計、獨立樣本t檢定、單因子變異數分析、皮爾森相關及多元階層迴歸等統計方法進行分析。 結果：(1)研究對象以早產兒母親為主要照顧者，發現約35歲以上已婚(占9成)居多，教育程度大學以上占8成左右，家管占2成，第一次懷孕占6成，採剖腹產占8成，配偶占9成為最大支持者，育兒知識來源為育兒書籍/雜誌/網站最多，早產兒以男生居多(占5成)，多胞胎近6成，出生週數以34-36週最多占6成。(2)本研究量表採用百分等第分法，整體來看早產兒母親自我效能、問題解決、健康識能各層面之得分分別為74.71%、70.35%、83.87%。(3)多元階層迴歸結果模式可解釋量達到29.1% (F＝4.541, p＜.001)，即對早產兒母親的健康識能具統計顯著影響。 結論：(1)早產兒母親背景變項對健康識能有顯著正向影響﹔(2)早產兒母親背景變項對自我效能與問題解決有顯著正向影響﹔(3)自我效能與問題解決對健康識能有顯著正向影響﹔(4)自我效能與問題解決在早產兒母親背景變項與健康識能間沒有證據顯示有中介效果。 希望本研究之結果可以喚起研究者和臨床工作者，作為未來對於早產兒母親自我效能、問題解決和健康素養能力之重視。Aims: To explore the sociodemographic variables of preterm infants’ mothers on self-efficacy, problem solving, and health literacy and the possibility of self-efficacy and problem solving as mediating variables between demographic variables and health literacy. Methods: purposive sampling was used in the neonatal intensive care unit and intermediate care nursery of a medical center in the northern Taiwan. A total of 113 mothers with preterm infants were recruited. A cross-sectional questionnaire was administered when the participants stayed at the medical center. The data were analyzed by descriptive statistics, independent t-test, one-way analysis of variance (ANOVA), Pearson correlation and multiple hierarchical regression. Results: Approximately 80% of participants were working women, with college education and had a Cesarean section. 90% of them were married, over 35 years old and their spouses were the most important supporters. 60% of the participants were the first-time pregnancy. Participants’ parenting knowledge sources are parenting books/magazines/websites. Approximately 50% of their preterm children were boys. Multiple births and 34-36 weeks gestation (GA) of preterm children were approximately 60%. If the score of each scale is converted into a percentile ranking, the scores of self-efficacy, problem solving, and health literacy of mothers of premature infants were 74.71%, 70.35%, and 83.87%, respectively. Multiple hierarchical regression model could explain 29.1% of the total variance (F = 4.541, p ＜.001), which indicated that the significant variables such as marital and occupational status, spouse’ support and self-efficacy were statistically significant on the health literacy of participants. Conclusion: Some of Participants’ sociodemographic variables were significant predictors on their health literacy, self-efficacy and problem solving. In addition, self-efficacy and problem solving were significant predictors on participants’ health literacy. However, self-efficacy and problem solving did not reveal a mediation effects between participants’ sociodemographic variables and health literacy. It is critical for researchers and practitioners to pay attention to health literacy, self-efficacy and problem solving of the mothers with preterm infants.