應用計畫行為理論於早期斷奶之研究---統合分析與結構方程式模式
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Date
2012/8-2013/7
Authors
郭鐘隆
黃久美
簡莉盈
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Abstract
母乳哺餵的重要性已經由世界衛生組織所公認，也有足夠的實證研究支持， 但是影響母親哺餵母乳的因素眾多，難以簡單歸納。計畫行為理論是一個簡潔且 廣為研究者應用的理論，也常見於母乳哺餵研究，因此本研究針對國內外過去二 十年來以TPB為理論架構探討母乳哺餵行為的研究，探討TPB各變項對於母乳哺 餵意圖與行為的成效值與模式的預測力。 預定搜尋的資料庫包含PubMed, Medline, CINAHL, PsychoINFO, Google Scholar 等知名文獻資料庫，挑選應用計畫行為理論於母乳哺餵的觀察研究，針 對所蒐集到的研究，由兩位研究人員根據收尋策略檢視研究是否合適，若有意見 不一致，則由住持人或研究諮商小組來論定。兩位研究人員並依據研究團隊所發 展的資料萃取表格與研究方法品質表格來執行研究品質評定與萃取相關資料。並 計算評分者間信度以確保資料輸入的一致性。 統計分析則預定使用心理計量統計分析與結構方程模式來進行，研究異質性 以Q and I² 統計來檢核，如果發現異質性存在，則進一步以次分群分析來探討 研究特質的影響，而且以敏感性分析來檢視統合分析結果的穩定性有無改變？本 研究的結論，將有利於未來研究者做為應用TPB 與母乳哺餵介入研究的參考。
The health benefits of breastfeeding are widely acknowledged. The extensive evidence of short-term and long-term health benefits of breastfeeding for infants and mothers were well documented. However, there are many factors that might influence the early weaning of breastfeeding. Theory of Planned Behavior was parsimonious and was frequently applied to investigate various health behaviors, including breastfeeding. Thus, this meta-analysis study examined the effect sizes and model fitness of the constructs of Theory of Planned Behavior to breastfeeding behavior. Electronic databases (PubMed, Medline, CINAHL, PsychoINFO and Google Scholar) will be searched from January 1, 1990 through December 31, 2011. We will select all observational studies applied the Theory of Planned Behavior to exclusive or almost breastfeeding. Two review authors independently read articles identified via the search strategies to determine inclusion or exclusion. The differences in code data were resolved in consultation with principle investigator or research consulting team. The two reviewers will extract data based on predesigned protocol and evaluate the methodological quality using appraisal forms independently. Interraters’ reliablity will be calcuated to secure the consistensy of data coding. We will execute research synthesis using psychometric meta-analysis and structural equation model. We will assess studies’ heterogeneity in each meta-analysis using the Q statistics and I². If we identify substantial heterogeneity, we will explore the differences of study characteristics using subgroup analyses. Sensitivity analyses will be used to test the robustness of conclusions. The implication of this study will contribute deep understanding for applying the Theory of Planned Behavior to predicting postpartum breastfeeding.
The health benefits of breastfeeding are widely acknowledged. The extensive evidence of short-term and long-term health benefits of breastfeeding for infants and mothers were well documented. However, there are many factors that might influence the early weaning of breastfeeding. Theory of Planned Behavior was parsimonious and was frequently applied to investigate various health behaviors, including breastfeeding. Thus, this meta-analysis study examined the effect sizes and model fitness of the constructs of Theory of Planned Behavior to breastfeeding behavior. Electronic databases (PubMed, Medline, CINAHL, PsychoINFO and Google Scholar) will be searched from January 1, 1990 through December 31, 2011. We will select all observational studies applied the Theory of Planned Behavior to exclusive or almost breastfeeding. Two review authors independently read articles identified via the search strategies to determine inclusion or exclusion. The differences in code data were resolved in consultation with principle investigator or research consulting team. The two reviewers will extract data based on predesigned protocol and evaluate the methodological quality using appraisal forms independently. Interraters’ reliablity will be calcuated to secure the consistensy of data coding. We will execute research synthesis using psychometric meta-analysis and structural equation model. We will assess studies’ heterogeneity in each meta-analysis using the Q statistics and I². If we identify substantial heterogeneity, we will explore the differences of study characteristics using subgroup analyses. Sensitivity analyses will be used to test the robustness of conclusions. The implication of this study will contribute deep understanding for applying the Theory of Planned Behavior to predicting postpartum breastfeeding.