Doğumda kanguru bakımının sadece anne sütü ile beslenme durumuna ve bebeğin büyüme-gelişmesine etkisinin bağlanma kuramına göre incelenmesi
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Tarih
2019
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Ege Üniversitesi, Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Sağlıklı çocuk gelişimi yenidoğan döneminden başlayarak yaşam boyu süren sağlığın temel belirleyicisidir. Anne sütü ile beslenme de bebeğin büyüme gelişmesinde en önemli etmenlerden biri ve bebeğin optimal gelişimini destekleyen eşsiz bir besin maddesidir. Kanguru bakımı prematüre bebeklerin yaşam kalitelerini arttırmak amacıyla ortaya çıkmış bir gelişimsel bakım yöntemidir. Kanguru bakımının prematüre bebekler üzerinde, anne sütü ile beslenme ve büyüme gelişmeye yararları göz önünde bulundurulduğunda; term bebeklerin de kanguru bakımı alması ve doğumdan hemen sonra kanguru bakımına başlanması gerektiği vurgulanmaktadır. Bu araştırma ile doğumda kanguru bakımının sadece anne sütü ile beslenme durumuna ve bebeğin büyüme-gelişmesine etkisinin bağlanma kuramına göre incelenmesi amaçlanmıştır.
Araştırma; randomize kontrollü, deneysel,prospektif bir araştırmadır.Araştırmanın örneklemini, Mart 2017 – Şubat 2019 tarihleri arasında Buca Kadın Doğum ve Çocuk Hastanesi gebe polikliniğine başvuran, 36-38. gestasyonel haftalar arasında olan ve araştırmaya dahil edilme kriterlerini sağlayan gebeler oluşturmuştur (n:132). Gebelerin protokol numaralarına göre randomizasyon yapılmış ve bilgilendirilmiş gönüllü olur formu imzalatılarak, tanıtıcı özelliklerine ilişkin soru formu uygulanmıştır. Müdahale grubunda yer alan gebelere “kanguru bakımı ve emzirme” eğitimi verilmiş ve bebeklerine doğumda kanguru bakımı uygulanmıştır. Kontrol grubunda yer alan anne ve bebeklerine ise rutin bakım uygulanmıştır. Doğumdan sonra her iki grupta yer alan annelerin maternal bağlanma düzeyleri ve bebeklerin birinci, üçüncü, altıncı ve dokuzuncu aylarda sadece anne sütü alma durumları ve bebeklerin büyüme- gelişmeleri değerlendirilmiştir. Araştırmanın verilerinin analizi Statistical Package for Social Science 21 (SPSS 21.0) paket programında sayı, yüzde (%), ki kare, ölçek puan ortalamaları, t-testi ile analiz edilmiştir. Araştırmada istatistiksel anlamlılık düzeyi p<0.05 kabul edilmiştir.
Kanguru bakımı uygulanan bebeklerin, ilk altı ay sadece anne sütü ile beslenme oranı, birinci, üçüncü, altıncı ve dokuzuncu ay izlem büyüme parametleri, kanguru bakımı uygulanmayan bebeklerin ilk altı ay sadece anne sütü ile beslenme oranı, birinci, üçüncü, altıncı ve dokuzuncu ay izlem büyüme parametlerine göre istatistiksel açıdan fark anlamlı derecede daha yüksek bulunmuştur (p<0,05).Kanguru bakımı uygulanan bebeklerin, birinci, üçüncü, altıncı ve dokuzuncu ay izlem gelişim parametleri ile kanguru bakımı uygulanmayan bebeklerin birinci, üçüncü, altıncı ve dokuzuncu ay izlem gelişim parametleri arasında istatistiksel açıdan anlamlı fark saptanmamıştır (p>0,05).Kanguru bakımı uygulayan annelerin birinci, üçüncü, altıncı ve dokuzuncu ay maternal bağlanma ölçek puan ortalamaları, kanguru bakımı uygulamayan annelerin birinci, üçüncü, altıncı ve dokuzuncu ay maternal bağlanma ölçek puan ortalamalarından yüksek bulunmuştur (p<0,05).
Çalışma sonucunda doğumda kanguru bakımının sadece anne sütü ile beslenme ve bebeğin büyümesine olumlu etkisi olduğu saptanmıştır. Kanguru bakımının doğumdan hemen sonra başlatılması ve sürdürülmesi ve bu konuda primer sorumlu olan ebelere eğitim verilerek uygulanabilirliğin arttırılması önerilmektedir.
Healthy child development is the main determinant of lifelong health starting from neonatal period. Breastfeeding is also one of the most important factors in the growth of the baby and a unique nutrient that supports the optimal development of the baby. Kangaroo care is a developmental care method developed to improve the quality of life of premature babies. When the benefits of kangaroo care on development and feeding with breast milk on premature babies are considered; term babies should also receive kangaroo care and kangaroo care should be started immediately after birth. The aim of this research is to investigate the effect of kangaroo care at birth only on breast milk feeding status and infant growth and development according to attachment theory. This is a randomized controlled, experimental, prospective study. The sample of the study consisted of pregnant women between 36-38 gestational weeks who met the pregnant outpatient clinic of Buca Maternity and Children Hospital between March 2017 and February 2019 (n: 132). Randomized consent forms were signed according to the protocol numbers of the pregnant women, and a questionnaire was applied regarding their introductory characteristics. Pregnant women in the intervention group received “kangaroo care and breastfeeding“ training and their babies were given kangaroo care at birth. Routine care was given to the mothers and their babies in the control group.Maternal attachment levels of mothers in both groups after birth and infants' only breastfeeding status and infant growth and development in the first, third, sixth and ninth months were evaluated. The analysis of the data obtained from the study was analyzed by statistical package number, percentage, chi-square, scale mean scores and t-test in Statistical Package for Social Science 21 package program. Statistical significance level was accepted as p <0.05. Breastfeeding rate of the babies who received kangaroo care only during the first six months, follow-up growth parameters of the first, third, sixth and ninth month follow-up of babies who did not receive kangaroo care, breastfeeding rate of the first six months only, first, third, sixth and ninth months. It was found to be statistically higher than the growth parameters (p <0.05).There was no statistically significant difference between the first, third, sixth and ninth month follow-up development parameters of the infants receiving kangaroo care and the first, third, sixth and ninth month follow-up development parameters of the infants without kangaroo care (p> 0.05). The maternal attachment scale scores of the mothers who applied kangaroo care were found to be higher than the mean maternal attachment scale scores of the mothers who did not care for kangaroo at the first, third, sixth and ninth months (p <0.05). As a result of the study, it was found that kangaroo care at birth had a positive effect only on breast milk feeding and baby growth. It is recommended that kangaroo care should be started and maintained immediately after birth and training should be given to midwives who are primarily responsible in this regard to improve applicability.
Healthy child development is the main determinant of lifelong health starting from neonatal period. Breastfeeding is also one of the most important factors in the growth of the baby and a unique nutrient that supports the optimal development of the baby. Kangaroo care is a developmental care method developed to improve the quality of life of premature babies. When the benefits of kangaroo care on development and feeding with breast milk on premature babies are considered; term babies should also receive kangaroo care and kangaroo care should be started immediately after birth. The aim of this research is to investigate the effect of kangaroo care at birth only on breast milk feeding status and infant growth and development according to attachment theory. This is a randomized controlled, experimental, prospective study. The sample of the study consisted of pregnant women between 36-38 gestational weeks who met the pregnant outpatient clinic of Buca Maternity and Children Hospital between March 2017 and February 2019 (n: 132). Randomized consent forms were signed according to the protocol numbers of the pregnant women, and a questionnaire was applied regarding their introductory characteristics. Pregnant women in the intervention group received “kangaroo care and breastfeeding“ training and their babies were given kangaroo care at birth. Routine care was given to the mothers and their babies in the control group.Maternal attachment levels of mothers in both groups after birth and infants' only breastfeeding status and infant growth and development in the first, third, sixth and ninth months were evaluated. The analysis of the data obtained from the study was analyzed by statistical package number, percentage, chi-square, scale mean scores and t-test in Statistical Package for Social Science 21 package program. Statistical significance level was accepted as p <0.05. Breastfeeding rate of the babies who received kangaroo care only during the first six months, follow-up growth parameters of the first, third, sixth and ninth month follow-up of babies who did not receive kangaroo care, breastfeeding rate of the first six months only, first, third, sixth and ninth months. It was found to be statistically higher than the growth parameters (p <0.05).There was no statistically significant difference between the first, third, sixth and ninth month follow-up development parameters of the infants receiving kangaroo care and the first, third, sixth and ninth month follow-up development parameters of the infants without kangaroo care (p> 0.05). The maternal attachment scale scores of the mothers who applied kangaroo care were found to be higher than the mean maternal attachment scale scores of the mothers who did not care for kangaroo at the first, third, sixth and ninth months (p <0.05). As a result of the study, it was found that kangaroo care at birth had a positive effect only on breast milk feeding and baby growth. It is recommended that kangaroo care should be started and maintained immediately after birth and training should be given to midwives who are primarily responsible in this regard to improve applicability.
Açıklama
Anahtar Kelimeler
Kanguru Bakımı, Büyüme, Gelişme, Anne Sütü ile Beslenme, Maternal Bağlanma, Kangaroo Care, Growth, Development, Breastfeeding, Maternal Attachment
