应用ROC曲线确定母乳喂养自我效能量表的界值

目的应用ROC曲线确定母乳喂养自我效能量表得分的最佳界值,预测母乳喂养行为的不足人群,为尽早实施母乳喂养的支持和干预提供理论依据,促进纯母乳喂养率的提高。方法选取2016年1-4月于南京市妇幼保健院产科门诊就诊的120例患者。在妊娠36周至分娩前、产后48~72h分别进行母乳喂养自我效能量表(BESE)的测定,根据产后2个月的喂养方式绘制ROC曲线,从而确定最佳界值。结果妊娠36周的BSES分值和分娩后48~72h的BSES分值ROC曲线下有效面积分别为0.709和0.701;在妊娠36周至分娩前测量的最佳界值为100.5;在产后48~72h测量的最佳界值为100(P0.05)。结论妊娠36周的和分娩后48~72h两个时间点的BSES分值对预测产后的母乳喂养行为具有一定的准确性。因此可将测量时间提前到妊娠36周至分娩前时这一区间,提供针对性的母乳喂养护理干预,改善母乳喂养行为。同时加强对得分小于100分的人群的实绝护理干预,以提高母乳喂养率及持续时间。

Determining cut-off points for scores of the breastfeeding self-efficacy scale by using ROC curve

Objective To determine the cut-off points of breastfeeding self-efficacy scale(BSES) by using ROC curve in order to predict who breastfeeding behavior is poor and provide reference for giving breastfeeding supports and interventions.Methods A total of 120 cases were convenience sampled between from January 2016 to April 2016 in affiliated obstetrics and gynecology hospital to Nanjing medical university.BSES scores were measured after 36 weeks gestation and at postpartum 48～72 h.The ROC curves were drawn according to the feeding patterns at postpartum 2 months to determine the best cut-off points.Results The BSES score at 36 weeks of pregnancy and the BSES score at 48～72 hours after delivery were 0.709 and 0.701 for the effective area under the ROC curve (AUC)respectively.The optimal cut-off value was 100.5 (AUC=0.709,0.770 sensitivity,0.591 specificity) before delivery at 36 weeks of gestation.The optimal cut-off value for postpartum 48 ～ 72 h measurement was 100 (AUC =0.701,0.885 sensitivity,0.432 specificity),and the P values were less than 0.05.Conclusions The BSES scores after 36 weeks gestation and at postpartum 48～72 h to predict postpartum breastfeeding behavior has a certain accuracy.Therefore,We can measure the time to 36 weeks before delivery for further targeted breastfeeding nursing intervention,improving their breastfeeding behavior to provide improved space.The score of breast feeding self efficacy scale 100 is the best boundary,and the sensitivity and specificity of the comprehensive evaluation performance is the best.The breastfeeding self efficacy scale score of less than 100 points should be focused on the crowd,strengthen breastfeeding nursing intervention,in order to improve breastfeeding rate and duration.