| Objective:Based on the guidance of the Transtheoretical Model of Behavior Change,the researcher constructed the framework of breastfeeding health education contents through literature research and qualitative research,and evidence-based nursing methods are used to integrate the current evidences related to breastfeeding health education and to fill in the framework of health education contents.Finally,we build a systematic,continuous and scientific step-bystep breastfeeding health education contents,which is suitable for women from pregnancy to 6 months postpartum.The purpose of this study is to provide scientific breastfeeding health education information that can meet their needs extremely for pregnants and puerperae,and to provide scientific reference for researchers to design stage behavioral intervention of breastfeeding education,as well as for obstetric nurses and maternal and child health workers to breastfeeding health education practice.Methods:This research includes two parts:building educational content framework and building educational content.1.Building the framework of educational content:① By reading the literature on the application of the Transtheoretical Model of Behavior Change in the field of breastfeeding and combining with the characteristics of breastfeeding behavior,we divided the breastfeeding health education into five stages and determined the duration of each stage.②We searched the literatures related to breastfeeding health education published in domestic and foreign core journals and SCI journals in the past five years,analyzed the research status of breastfeeding health education in the past five years through content analysis,and extracted the health education content mentioned in the included literatures as the educational theme of this study,which was used to construct the educational content framework.③ Through the semi-structured interview method,the demands and problems of breastfeeding health education of pregnant and puerpera in different stages from pregnancy to 6 months postpartum were deeply excavated,then the theme of breastfeeding health education was further enriched,and the categories of health education were summarized.④Combining the results of literature research and semi-structured interviews,we divided education categories and themes into five stages of health education on breastfeeding,forming the content framework of health education on breastfeeding in this study.2.Building the educational content:By searching the existing evidences related to breastfeeding health education,and screening,evaluating,translating,extracting and integrating them,the content framework of breastfeeding health education was filled,and the content of breastfeeding health education was preliminarily constructed.② The rationality of the framework and content was evaluated by experts.According to the opinions of experts,we modified the unreasonable and improperly expressed contents,and corresponding educational themes and contents were added,then we determined the final contents of breastfeeding health education.Results:1.Building the framework of educational content:① Based on the guidance of the Transtheoretical Model of Behavior Change,we divided the breastfeeding health education into five stages,precontemplation stage(breastfeeding awareness awakening stage:middle stage of pregnancy,week 24-27+6 of gestation),contemplation stage(breastfeeding awareness strengthening stage:late stage of pregnancy,week 28-31+6 of gestation),preparation stage(breastfeeding knowledge reserves stage:late stage of pregnancy,week 3240 of gestation),action stage(breastfeeding practices stage:confinement and puerperium,admitted to the hospital for delivery-day 43 after delivery),maintenance stage(Breastfeeding maintenance stage:day 43 after delivery-month 6 after delivery).②A total of 139 literatures were included to preliminarily extract the theme of breastfeeding health education,by extracting the demand or theme of breastfeeding health education from the literature,then 35 health education topics were obtained and 5 education categories were summarized.(Through interviews with 42 pregnant and parturients,to explore their needs for health education and breastfeeding problems that they hope to help solve,a total of 28 health education themes were extracted and formed into 12 education categories.④Further classifying and integrating the topics extracted from literature research and interviews,the education categories and topics obtained were divided into education stages to form the basic framework of breastfeeding health education,which included 5 education stages,12 education categories and 36 education themes.2.Building the educational content:① 6 guidelines,20 evidence summaries and 1 publication were included as the first draft of the breastfeeding health education contents.②After the modification combined with the expert advice,the construction of the stagechanging breastfeeding health education contents was finally completed and the health education manual was produced.Conclusions:Based on the guidance of the Transtheoretical Model of Behavior Change,five stages of breastfeeding health education were divided and the time of education was determined.By reviewing the current situation of breastfeeding health education,the theme of breastfeeding health education was preliminarily extracted,but the specific needs of pregnant and puerpera were almost not considered in these studies.Through interviews,we found that pregnant and puerpera had a high demand for breastfeeding health education,which was more extensive,but mainly focused on self-management of breastfeeding related issues,the systematic and scientific health education was urgently needed.The evidence-based method is used to construct health education content,which is rich in content and scientific,and can meet the needs of maternal breastfeeding health education.However,due to time constraints,the education content has not been applied,and its practicality and effectiveness need to be further explored in the later stage. |
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