ผลของโปรแกรมส่งเสริมสมรรถนะการบีบกระตุ้นน้ำนมต่อการไหลของน้ำนมและระยะเวลาน้ำนมเต็มเต้าในมารดาหลังผ่าตัดคลอดที่มีภาวะเบาหวานขณะตั้งครรภ์

Abstract

This study was the quasi-experimental aimed to examine the effects of a self-efficacy promoting with breast milk expression program on milk ejection and onset of lactation in cesarean mothers with gestational diabetes mellitus (GDM). The sample consisted of 70 cesarean mothers with gestational diabetes mellitus who were admitted in the postpartum ward during January to December, 2022 at Songklanagarind Hospital. They were selected according to inclusion criteria, equally randomly assigned as matched pairs based on type of GDM and parity into an experimental group and a control group, 35 subjects in each group. The experimental group received the self-efficacy promoting with breast milk expression program, while the control group received standard care service. The research instrument consisted of 3 parts: (1) the self-efficacy promoting with breast milk expression program; (2) the experimental-control instruments consisting of (2.1) the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), (2.2) the assessment tool for hand breast milk expression skill, and (2.3) the hand breast milk expression recording form; and (3) the data collecting instruments comprising of (3.1) a personal data, (3.2) the milk ejection assessment, and (3.3) the onset of lactation questionnaire. Content validity indices of the instruments were approved by three experts. The content validity indices of the self-efficacy promoting with breast milk expression program, the hand breast milk expression skill assessment, the hand breast milk expression recording, the milk ejection assessment and the onset of lactation assessment form yielded values of .78, 1, 1, 1 and .83, respectively. The reliability of BSES-SF was tested and yielded a Cronbach’s alpha coefficient value of .88. The milk ejection assessment form was examined using interrater reliability and yielded a value of .86. The data were analyzed using frequency, percent, mean and standard deviation. The hypotheses were tested using independent t-test. The results revealed that: 1. Cesarean mothers with gestational diabetes mellitus who received the self-efficacy promoting with breast milk expression program had mean score of milk ejection after receiving intervention at 72 hours (M = 3.17, SD = 0.75) significantly higher than the control group (M = 2.83, SD = 0.66) (t = 2.03, p < .05) 2. Cesarean mothers with gestational diabetes mellitus who received the self-efficacy promoting with breast milk expression program had mean hour of the onset of lactation (M = 59.11, SD = 12.61) significantly faster than the control group (M = 70.29, SD = 18.67) (t = -2.94, p < .05) The result showed that the self-efficacy promoting with breast milk expression program could effectively encourage milk ejection and the onset of lactation. Therefore, it is recommended that nurse midwives should apply this program into their services to promote breastfeeding of cesarean mothers with gestational diabetes mellitus.