群组孕期保健模式对初产妇分娩情绪自我效能分娩结局及母乳喂养的影响  

Impact of group pregnancy health care model on delivery emotions,self-efficacy,delivery outcomes and breastfeeding of primiparous women

作　　者：郭芝娟 葛晓芳 Guo Zhijuan;Ge Xiaofang(Department of Obstetrics,Xi′an International Medical Center Hospital,Shaanxi 710100,China)

机构地区：[1]西安国际医学中心医院产科,710100

出　　处：《山西医药杂志》2023年第6期425-429,共5页Shanxi Medical Journal

摘　　要：目的探讨助产士主导的群组孕期保健模式对初产妇分娩情绪、自我效能、分娩结局及母乳喂养的影响。方法选取在我院产科门诊建卡且规律产检的96例初产妇作为研究对象,采用随机数字表法将其分为对照组和观察组,各48例。其中对照组实施传统孕期保健模式,观察组实施助产士主导的群组孕期保健模式,对比2组分娩情绪(分娩恐惧量表和积极心理资本量表)、自我效能(一般自我效能感量表)、分娩结局(分娩方式、新生儿体质量、新生儿1 min Apgar评分和产后24 h出血量)和母乳喂养情况(产后42 d纯母乳喂养率)。结果对照组和观察组干预前分娩恐惧、积极心理和自我效能评分比较,差异无统计学意义(P>0.05);与对照组比较,观察组孕28周和孕36周分娩恐惧评分降低、积极心理和自我效能评分升高,差异有统计学意义(P<0.05);随时间进展,观察组分娩恐惧评分呈下降趋势、积极心理和自我效能评分升高呈上升趋势,且均优于对照组(P<0.05)。与对照组比较,观察组自然分娩率升高、产后24 h出血量减少,差异有统计学意义(P<0.05),但2组总产程时间、新生儿体质量和新生儿1 min Apgar评分比较,差异无统计学意义(P>0.05);观察组产后42 d纯母乳喂养率(91%,42/48)明显高于对照组(76%,35/48),差异有统计学意义(χ^(2)=3.90,P<0.05)。结论助产士主导的群组孕期保健模式可改善初产妇分娩情绪、提高自我效能,最终优化分娩结局、提高母乳喂养率。Objective To explore the influence of the midwife-led group pregnancy care model on primipara′s delivery emotion,self-efficacy,delivery outcome and breastfeeding.Methods Ninety-six primiparas who had set up cards in the obstetric clinic of our hospital and had regular antenatal examinations were selected as the research objects.They were randomly divided into the control group and the observation group,with 48 cases in each group.The control group implemented the traditional pregnancy health care model,while the observation group implemented the group pregnancy health care model dominated by midwives.The delivery emotion(delivery fear scale and positive psychological capital scale),self-efficacy(general self-efficacy scale),delivery outcome(delivery mode,newborn weight,newborn 1 min Apgar score and postpartum 24h hemorrhage)and breastfeeding(exclusive breastfeeding rate 42 days after delivery)were compared between the two groups.Results There were no significant differences in the scores of fear of delivery,positive psychology and self-efficacy between the control group and the observation group before intervention(P>0.05).Compared with the control group,the scores of fear of delivery in the observation group at 28 weeks and 36 weeks of gestation decreased,and the scores of positive psychology and self-efficacy increased,with significant differences(P<0.05).Over time,the scores of fear of delivery in the observation group showed a downward trend,while the scores of positive psychology and self-efficacy showed an upward trend,which was significantly better than those in the control group(P<0.05).Compared with the control group,the observation group had a statistically significant increase in the rate of natural delivery and a decrease in the amount of postpartum hemorrhage within 24 hours(P<0.05),but there were no statistically significant differences between the two groups in terms of the total duration of labor,neonatal weight,and neonatal 1-minute Apgar score(P>0.05).The rate of exclusive breastfeeding in the

关 键 词：分娩 助产士 产妇卫生保健服务 

分 类 号：R473.71[医药卫生—护理学]