基于医护合作聚焦解决模式调节初次IVF-ET患者自我效能及焦虑抑郁水平的应用分析  

Application analysis of self-efficacy,anxiety and depression level in patients with initial IVF-ET based on the focused solution approach via physician-nurse collaboration

作　　者：徐丽[1] 沈亚 褚蓓 季林玉 王丽[1] 陈秀云[1] 丁家怡[1] XU Li;SHEN Ya;CHU Bei;JI Linyu;WANG Li;CHEN Xiuyun;DING Jiayi(Department of the Reproductive Medical Center,Affiliated Maternity and Child Health Care Hospital of Nantong University,Nantong 226018)

机构地区：[1]南通大学附属妇幼保健院生殖医学中心,南通226018

出　　处：《南通大学学报（医学版）》2020年第4期350-353,361,共5页Journal of Nantong University(Medical sciences)

基　　金：南通市科技计划项目(GJZ16031)。

摘　　要：目的:探讨医护合作聚焦解决模式对初次体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)患者自我效能及焦虑抑郁水平的干预效果。方法:选择2017年1月—2018年10月在南通大学附属妇幼保健院生殖医学中心就诊因单纯输卵管因素进行初次IVF-ET的患者86例,采用随机数字表分成两组,各43例。由心理咨询师、主治医师和主管护师组成研究小组,医护合作对研究对象实施聚焦解决模式策略进行干预。在进周期日、人绒毛膜促性腺激素(human choronic gonadotropin,HCG)注射日(HCG日)、胚胎移植后12 d对两组患者一般自我效能感量表、焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)进行测试,比较两组获卵数、优胚数、获胚总数、生化妊娠率、临床妊娠率、流产率等。结果:两组进周期日自我效能、SAS、SDS评分比较差异均无统计学意义(均P>0.05);两组HCG日、胚胎移植后12 d的自我效能评分、SAS评分差异均有统计学意义(均P<0.01);随着治疗的进展,两组自我效能得分均逐渐下降(均P<0.01),观察组HCG日SAS评分有所下降,但移植后SAS评分有所增加(P<0.01);对照组随着治疗的进展,SAS评分逐渐增加(P<0.001)。SDS评分组间和组内各时间点比较差异均无统计学意义(均P>0.05)。不同时间点LSD多重比较结果显示,两组自我效能及SAS评分在进周期日与HCG日、移植后12 d两两比较差异均有统计学意义(均P<0.05);SDS评分两两比较差异无统计学意义(P>0.05)。两组临床质控获卵数、优胚率、获肧总数差异无统计学意义,对照组流产率高于观察组。结论:医护合作应用聚焦解决模式参与初次IVF-ET治疗,可最大限度地发挥医护不同的专业特点,为患者提供医疗、心理、护理全方位的有效支持,提高患者自我效能,改变患者应对方式及心态,提升了依从性,改善妊娠结局,显著降低流产率。Objective:To explore the intervention effect of the focused solution approach via physician-nurse collaboration on self-efficacy,anxiety and depression level among patients with primary in vitro fertilization-embryo transfer(IVF-ET).Methods:86 patients with primary IVF-ET were enrolled between January 2017 to October 2018 from the Reproductive Medical Center,Affiliated Maternity and Child Health Care Hospital of Nantong University.All patients were randomly divided into two groups by random number table(43 patients in each group).The research group was composed of psychological counselors,attending physicians and supervisor nurses.The focused solution model strategy for subjects was performed by physician-nurse collaboration.Self-efficacy,self-rating anxiety scale(SAS),and self-rating depression scale(SDS)were tested on day of ovulation induction cycle,human choronic gonadotropin(HCG)day,and 12 days after embryo transfer,respectively.The number of oocyt,favorable embryos and embryos,biochemical pregnancy rate,clinical pregnancy rate and abortion rate were analyzed between the experimental group and the control group,respectively.Results:There were no significant differences in self-efficacy,SAS,and SDS scores between two groups on the day of ovulation induction cycle(all P>0.05),while significant differences in self-efficacy and SAS scores were observed on HCG day,and 12 days after embryo transfer(all P<0.01),respectively.With the progress of treatment,the self-efficacy score of the two groups decreased gradually(all P<0.01),the SAS score of the observation group decreased on HCG day,but the SAS score increased after embryo transfer(P<0.01).The SAS score of the control group gradually increased with the progress of treatment(P<0.001).There were no significant differences in SDS scores between two groups and within the group at each time point(all P>0.05).Multiple comparisons of LSD at different time points showed that the self-efficacy and SAS scores of the experimental group and the control group were different

关 键 词：医护合作 聚焦解决模式 初次体外受精-胚胎移植 自我效能 

分 类 号：R714.8[医药卫生—妇产科学]