التفاصيل البيبلوغرافية
| العنوان: |
早産児を出産した母親の産褥早期の母乳分泌を促す搾乳ケア： 文献レ... (Japanese) |
| Alternate Title: |
Care related to milk expression to promote breast milk production among mothers of preterm infants in early postpartum: A literature review. (English) |
| المؤلفون: |
田中利枝, 岡美雪, 北園真希, 丸山菜穂子, 堀内成子 |
| المصدر: |
Journal of Japan Academy of Midwifery; 2018, Vol. 32 Issue 1, p15-26, 12p |
| مصطلحات موضوعية: |
BREAST pumps, CINAHL database, DOCUMENTATION, EXPERIMENTAL design, PREMATURE infants, INFORMATION storage & retrieval systems, MEDICAL databases, LACTATION, MEDLINE, MOTHERS, SCIENTIFIC observation, ONLINE information services, PUERPERIUM, SYSTEMATIC reviews |
| مصطلحات جغرافية: |
JAPAN |
| Abstract (English): |
Purpose This study explores the care related to milk expression that promotes breast milk production, as the first step in developing an educational program for obstetric nurses to promote early postpartum breast milk production in mothers of preterm infants. Methods Five reviewers conducted a search of published manuscripts using the following databases: PubMed, CINAHL Plus with Full Text, and Ichushi Web Ver. 5 of the Japan Medical Abstracts Society. They also included manuscripts used in a literature review of breast milk expression published by Cochrane Library. The titles, abstracts and main texts of these manuscripts were used as references to extract manuscripts that included the amount of breast milk produced by mothers of preterm infants as their outcome. Two reviewers evaluated and reached agreement on the quality of each manuscript using the Cochrane Handbook for Systematic Reviews of Interventions (5.1.0), Risk of Bias Assessment Tool for Nonrandomized Studies and the GRADE Handbook. They organized the research objectives, methods and results of each manuscript to identify care related to milk expression to promote breast milk production in mothers of preterm infants. Results Meeting the inclusion criteria were 35 articles: 24 interventional and 11 observational studies. There was lowquality evidence from the randomized controlled trials for example, insufficient information about random sequence generation, allocation concealment and blinding. Also, sample size had not been calculated in most of manuscripts. There was low-quality evidence from the nonrandomized controlled trials for example, insufficient consideration of confounding variable. Evidence considered applicable in nursing practice was obtained from the observational studies. Useful methods of care related to milk expression that promoted breast milk production were: starting breast milk expression within one hour of delivery if possible, guaranteeing at least seven breast milk expression sessions and at least 100 minutes of breast milk expression per day, fully explaining both hand and electric breast pumping and adding at least six sessions of hand breast pumping to electric breast pumping per day until mothers entered stage II of milk production, and were performing kangaroo care. Conclusion Building on the findings from this review the next phase is to document mothers' actual breast expression experience and interview obstetric nurses to build an accurate data-base of about breast milk expression among mothers of preterm infants in Japan. The aim is to deepen understanding of the actual situation of support for breastfeeding among mothers of preterm infants and to develop an educational program that enables nurses working on obstetric wards to provide care related to milk expression that promotes adequate breast milk production. [ABSTRACT FROM AUTHOR] |
| Abstract (Japanese): |
目 的 産科看護者に向けた，早産児の母親の産褥早期の母乳分泌を促す教育プログラムを開発する端緒とし て，母親の母乳分泌を促すための搾乳ケアについて探索する。 対象と方法 PubMed，CINAHL Plus with Full Text，医学中央雑誌Web, Ver.5を用い文献検索を行った。さらに Cochrane Libraryに掲載されている搾乳に関するレビューに用いられている文献を追加した。その中か らタイトル，抄録，本文を参考に，早産児の母親の母乳分泌量をアウトカムとする文献を抽出し， Cochrane Handbook，RoBANS，GRADE Handbookを用い，文献の質の評価を行った。また，研究目的， 方法，結果について整理し，母親の母乳分泌を促すための搾乳ケアを抽出した。 結 果 35文献が抽出され，介入研究24件，観察研究11件であった。無作為化，隠蔽化，盲検化に関する記 述が不十分で，サンプルサイズが検討されていないなど，ランダム化比較試験の質は低く，交絡変数の 検討が不十分なために非ランダム化比較試験の質も低かったが，観察研究から実践に活用可能と考えら れるエビデンスが得られた。早産児を出産した母親の母乳分泌を促すための搾乳ケアでは，分娩後，可 能な限り1時間以内に搾乳を開始すること，1日7回以上の搾乳回数，1日100分以上の搾乳時間を確保 すること，手搾乳と電動搾乳の両方について十分な説明を行い，乳汁生成II期に入るまで電動搾乳に1 日6回以上の手搾乳を追加すること，カンガルーケアを実施することが有用だとわかった。 結 論 今後は，産科看護者による早産児を出産した母親への搾乳ケアに関する実態把握を行い，母親の母乳 分泌を促すための搾乳ケアが実践できるような教育プログラムを開発していく。 [ABSTRACT FROM AUTHOR] |
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