背景：諸多國內外研究指出推行母嬰親善十大步驟能有效的提升母乳哺育率，至於產婦母嬰親善滿意度對於母乳哺育率之影響著墨不多。母乳哺餵率受到產婦與醫療機構層次的交互作用所影響著。目的：以跨層次邏輯斯廻歸分析產婦對於醫療院所推行母嬰親善的滿意度與哺餵母乳的意願之關聯。方法：本研究對象為同意參加本研究之27家母嬰親善醫療院所之產後無合併症住院產婦，且新生兒無先天異常者。每家醫療院所收集25份問卷，共回收有效問卷673份。以結構式問卷收集產婦滿意度、經因素分析、邏輯斯廻歸縮減變項，再利用跨層次邏輯斯廻歸分析。結果：跨層次固定參數模式檢驗結果得到產婦母嬰同室，禁用奶嘴及哺餵時間依需求等滿意度對母乳哺餵率有顯著的正向關聯，並發現不同醫院間哺餵母乳率有差異存在且具隨機效果。醫院平均哺餵時間依需求滿意度對母乳哺餵率具直接效果。醫院平均哺餵時間依需求滿意度與母嬰同室滿意度的交互作用效果。結論：醫院應多關注產婦對母嬰同室、禁用奶嘴、及哺餵時間依需求等執行的感受，特別要注意產婦哺餵時間依需求是否受到尊重，協助母親順利哺餵母乳。 Background: Baby- Friendly Hospital Initiative (BFHI) is known to have a profound improvement on breastfeeding rate. Relatively few studies, however, have examined the relationship between maternal satisfaction toward BFHI and breastfeeding intention. Patients were nested with hospitals. Objectives: To investigate how maternal breastfeeding intention with BFHI satisfaction relates to either the individual characteristics of mothers or the characteristics of hospitals in which they deliver the baby. Methods: Cross-sectional study of mothers from 27 hospitals that voluntarily consent to join the study. Random sample of 25 mothers delivering normal neonate were from each hospital during. A total of 673 mothers responded to the questionnaire effectively. Patient satisfaction and breastfeeding intention were measured by a validated questionnaire. Principal components analysis was used to determine the dimensions. Primary logistic regression analyzed the mother’s breastfeeding intention affecters from the individual aspect. Then a random intercept logistic model was used as the analyzing technique or analyzing the influence of individual, hospital-level characteristics on a mother's breastfeeding intention. Results: Multilevel analysis revealed that breastfeeding rate was different among hospitals. Mother’s satisfaction with rooming-in, no artificial pacifiers and breastfeeding on demand practices by hospitals were play important roles in breastfeeding intention among mothers. Further, mother’s satisfaction with breastfeeding on demand practices aggregated to hospital level was significantly associated with breastfeeding intention of mothers. Greater the interaction of aggregated mother’s satisfaction with breastfeeding on demand and rooming-in was associated with more positive mother’s breastfeeding rate. Conclusions: These findings suggest that hospital should be aware of patients’ perception of the practices for rooming-in, no pacifier and breastfeeding on demand, especially should be carefully considered on the breastfeeding on demand that interact with rooming-in positively at hospital level
