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作 者:钟际香 邹丹[2] 张文娟 侯幸岳 周金萍 Zhong Jixiang;Zou Dan;Zhang Wenjuan(The Fifth Affiliated Hospital of the Zunyi Medical University,Zhuhai Guangdong 519100,China)
机构地区:[1]遵义医科大学第五附属(珠海)医院,广东珠海519100 [2]珠海市妇幼保健院 [3]遵义医科大学珠海校区
出 处:《齐鲁护理杂志》2019年第22期4-8,共5页Journal of Qilu Nursing
基 金:珠海市科技计划医疗卫生项目(一般项目)(编号:20171009E030013)
摘 要:目的:构建和检测认知行为决策板在剖宫产术后再次妊娠孕产妇分娩决策中的临床应用效果,为产科分娩健康教育提供决策工具。方法:基于循证方法对剖宫产术后阴道分娩(VBAC)或选择性再次剖宫产(ERCS)的风险与益处进行证据汇总后,构建形成认知行为决策板。选取剖宫产术后再次妊娠孕产妇314例,采用问卷调查法调查其分娩方式选择的影响因素,同时采用随机数字表法分为对照组和实验组。对照组给予常规健康教育,实验组在常规健康教育的基础上采用认知行为决策板进行健康教育。比较两组健康教育前后分娩意愿、阴道分娩率及实验组孕产妇对决策板信息的理解情况。结果:分娩方式选择的影响因素排前两位的是"医生分娩建议"、占59.6%,"孕期健康教育详细情况"、占58.0%;实验组干预前后阴道分娩意愿比较差异有统计学意义(χ^2=79.704,P<0.001);实验组阴道分娩例数多于对照组(χ^2=7.884,P<0.05)。结论:基于循证方法构建的认知行为决策板,能改VBAC孕产妇对分娩方式的认知和选择意愿,提高阴道分娩率,值得临床推广应用。Objective:To construct and test the clinical application effect of cognitive behavior decision-making board on pregnant women with repregnancy after cesarean section,so as to provide decision-making tools for obstetric health education in childbirth.Methods:Based on evidence-based methods,the risk and benefit of vaginal delivery after cesarean section(VBAC)or selective second cesarean section(ERCS)were summarized,and a cognitive behavioral decision board was constructed.A total of 314 cases of pregnant women who had a second pregnancy after cesarean section were selected to investigate the influencing factors of their choice of delivery mode by questionnaire survey.Meanwhile,random number table method was used to divide them into control group and experimental group.The control group was given routine health education,while the experimental group was given cognitive behavioral decision board based on routine health education.The intention of delivery,vaginal delivery rate and understanding of the information of the decision-making board were compared between the two groups before and after health education.Results:"Doctor′s advice on delivery"(59.6%)and"detailed information on health education during pregnancy"(58.0%)ranked the top two influencing factors of choice of delivery mode.After intervention,the intention of vaginal delivery in the experimental group was higher than that before intervention(χ^2=79.704,P<0.001),and the number of vaginal delivery in the experimental group was higher than that in the control group(χ^2=7.884,P<0.05).Conclusion:The cognitive behavioral decision board constructed based on evidence can improve the cognition and choice of delivery mode of pregnant women after cesarean section,and increase the rate of vaginal delivery.It is worthy of clinical application.
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