ผลของโปรแกรมการพยาบาลโดยประยุกต์ใช้ทฤษฎีพฤติกรรมตามแผนต่อความตั้งใจและพฤติกรรมการเลี้ยงลูกด้วยนมแม่อย่างเดียวของมารดาที่ผ่าตัดคลอดทางหน้าท้องขณะอยู่ในโรงพยาบาล

Abstract

The purposes of this quasi-experimental research was to study the effect of nursing program applying the theory of planned behavior on intention and behavior of exclusive breastfeeding among mothers with cesarean section during postpartum period in a hospital. Fifty pregnancy womens who attended the antenatal clinic, and subsequently gave birth were recruited, and received care at the postpartum unit of a general hospital in the south. They were allocated to an experimental group (n = 25) who received the nursing program based on the theory of planned behavior or a control group (n = 25) who received routine care. The study instrument consisted of 3 parts, including (1) the intervention instrument, the nursing program applying the theory of planned behavior, (2) the monitoring research instrument: (2.1) the Breastfeeding Attitude of Cesarean Section Mothers Questionnaire, (2.2) the Breastfeeding Attitude of Subjective Norm Questionnaire and (2.3) the Perceived Behavior Control of Breastfeeding Questionnaire, and (3) the data-collecting instrument employed in the research: (3.1) the Breastfeeding Intention of Cesarean Section Mothers Questionnaire and (3.2) the Breastfeeding Behavior of Cesarean Section Mothers Questionnaire. All instruments in this study were content validated by three experts yielding content validity indices (CVI) of .93 .93.90.87 and .95, respectively. The reliabilities of the all questionnaires except (3.2) were tested using Cronbach's alpha coefficient, yielding value of .79 .75 .92 and .90, respectively. The Interrater reliability of the Breastfeeding Behavior of Cesarean Section Mothers Questionnaire yielded a values of .92 The demographic data were analyzed using frequency, percentage, mean, standard deviation, chi-square, and independent t-test. The hypotheses were tested using independent t-test and dependent t-test. The results were summarized as follows: (1) Participants in the experimental group had significantly higher mean score of breastfeeding intention after intervention (M = 52.16, SD = 3.51) than before intervention (M = 42.24, SD = 4.64) (t = 3.50, p < .01); (2) Participants in the experimental group had significantly higher mean score on breastfeeding intention after intervention (M = 52.16, SD = 3.51) than of those in the control group (M = 49.64, SD = 4.72) (t = 2.14, p < .05); (3) Participants in the experimental group had significantly higher mean score on breastfeeding behavior at 24-48 hour postpartum period (M = 18.44, SD = 2.90) than those in the control group (M = 13.88, SD = 2.92) (t = 5.54, p < .001); and (4) Participants in the experimental group had significantly higher mean score on breastfeeding behavior at 48 - 72 hour period (M = 18.68, SD = 2.95) than those in the control group (M = 13.68, SD = 2.88) (t = 6.06, p < .001). The results showed that the nursing program applying the theory of planned behavior involvement could help cesarean section mothers improve their breastfeeding intention and breastfeeding behavior after cesarean section. Therefore, the nurses should apply this nursing program based on the theory of planned behavior to promote exclusive breastfeeding among cesarean section mothers to enhance successful breastfeeding since the initiation of cesarean section.