| Background:Breast milk is the most suitable food for infants within 6 months of age,and the World Health Organization joint with the United Nations Children's Fund recommends exclusive breastfeeding(EBF)for infants within 6 months of age.However,the current situation of EBF is far from being satisfactory.The EBF rate of 6-month-old infants is below 40%worldwide.It's 21%in China,which fails to meet the development goal of 0-6-month-old infants' EBF rate over 50%.Fathers have an important impact on breastfeeding,which can provide mothers with support of knowledge&skills,attitudes,decision-making,emotion and assistance,but due to the insufficiency of knowledge,they can actually not play a good role.Health education is an important way to improve the level of health-caring knowledge&skills,but breastfeeding health education for fathers is still in the initial stage of development.Most fathers can only learn the relevant knowledge by attending the breastfeeding courses for pregnant women,of which the teaching is mainly performed by theoretical lecturing,and skill training needs to be improved.Experiential teaching allows learners directly perceive the teaching content through scenario experience,transposition experience,role-playing and other methods to promote the mastery of knowledge and the development of skills.It is prospectively feasible to improve the quality of breastfeeding education for fathers by adopting experiential teaching to design breastfeeding courses for them,but the effect of it needs to be further verified by scientific research.Objectives:The primary objective of this study was to examine whether the effect of father's experiential breastfeeding education on improving feeding attitude and promoting EBF is superior to the general breastfeeding education.The secondary objective is to determine the key target for paternal breastfeeding education.Methods:This study is of single-blind quasi-experimental design.The convenient sampling method was used to select the fathers who took breastfeeding course in the prenatal education center of the Affiliated Obstetrics and Gynecology Hospital of Zhejiang University School of Medicine from April to September 2018.From April to May,the participants who took general breastfeeding course designed for pregnant women were included in the control group and the course was conducted mainly in theoretical lecturing method,covering the benefits,expectations and key points of breastfeeding.From July to September,the participants in the experimental group were recruited,who received father-centred experiential breastfeeding course,which adopted experiential teaching method to impart the knowledge&skills for breastfeeding support,including feeding indicators identification,awakening techniques,infant-hugging methods,lactation preparation,lactation point verification,milk storage,nutritional status judgment and common problem prevention and management,with the teaching content in the general course covered as well.The feeding attitude of fathers was evaluated by Iowa Infant Feeding Attitude Scale(IIFAS)pre-and post-education.Student's t test was used to determine the difference of IIFAS score between groups and within groups.Through one-way analysis of variance,non-parametric test and linear regression analysis,the influencing factors of post-education IIFAS scores were determined in order to reveal the effect of teaching intervention on feeding attitude comprehensively.The analysis of influencing factors of pre-education IIFAS scores was also performed to determine the key targets of breastfeeding education.Mothers were followed up to learn about the practice of EBF during 1 to 6 months after delivery.Kaplan-Meier estimator,Log rank test and Cox proportional hazard model were employed to analyze the effect of teaching intervention on the duration of EBF,and explore the influencing factors to determine the target population of high needs for breastfeeding education.Results:A total of 188 participants were enrolled in this study,with 90 in the experimental group and 98 in the control group.The results are as follows:1.The average age of fathers was 31.28 in the experimental group and 31.56 in the control group and there were no significant differences in demographic,obstetric and breastfeeding-related characteristics between two groups(P>0.05);2.The pre-education average score of IIFAS was 63.59 in the experimental group and 61.88 in the control group without statistical difference(t=-1.748,P=0.082);after adjusting the pre-education IIFAS score,the mean post-education IIFAS score was 72.073 in the experimental group and 70.239 in the control group with significant difference(F=5.259,P=0.023);3.The type of course(P=0.196,t=2.753,P=0.006)and father's education level(?=:0.162,t=2.275,P=0.024)had notable impact on post-education IIFAS scores;4.The cumulative survival rate of EBF was 61.5%(SE=0.067)in the experimental group and 48.0%(SE=0.061)in the control group but no significant difference was found in survival distribution(?2=1.803,P=0.179);5.The predictors of EBF six months postpartum was infant's gender(HR=1.760,95%CI:1.006-3.078,P=0.048).Parents' age,education,occupation,family monthly income level and parity,pregnancy plan,trimester of father receiving education,the sequence of actual delivery date and expected one,delivery methods,analgesia during labor and fetal birth weight presented no significant influence(P>0.05);6.The influencing factors of father's feeding attitude measured by IIFAS before education included feeding intention(?=0.250,t=3.667,P<0.001),parity(P=0.211,t=3.102,=0.002)and education level(?=0.211,t=3.090,P=0.002).There were no significant impacts of occupation,family monthly income,trimester of pregnancy and pregnancy plan(P>0.05).Conclusions:1.Compared to the general breastfeeding course,the experiential breastfeeding course designed for the father is more conducive to the improvement of paternal attitude towards breastfeeding,but has no significant advantage in promoting exclusive breastfeeding;2.Paternal breastfeeding education needs to focus on fathers whose wife is primiparous,education level is undergraduate and below,attitude of exclusive breastfeeding is not positive,and infant is male,to reduce negative impacts,enhance supportive ability,and thus contributes to the promotion of exclusive breastfeeding;3.Paternal breastfeeding education is advised to be conducted during postpartum period and the experiential teaching method has certain application value.The course needs to focus on the benefits and requirements of breastfeeding,the growth and development of infants,the coping skills of breastfeeding problems and the removal of obstacles to supportive behaviors.Thus it can promisingly yield better effect than the general breastfeeding education. |
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