以HAPA理论为导向的护理措施应用于初产妇护理中的价值探究  

Exploring the Value of Applying Nursing Measures Guided by HAPA Theory in Maternal Care

作　　者：瞿琴 张慧 刘晓艳 Qu Qin;Zhang Hui;Liu Xiaoyan(The No.989 Hospital of the People's Liberation Army Joint Logistics Force Luoyang,Henan,China Henan Luoyang 471000)

机构地区：[1]中国人民解放军联勤保障部队第九八九医院,河南洛阳471000

出　　处：《辽宁医学杂志》2024年第6期85-89,共5页Medical Journal of Liaoning

基　　金：河南省自然科学基金项目(212300410395)。

摘　　要：目的 探究基于健康行动过程取向(Health Action Process Approach, HAPA)理论的护理干预对产妇心理状态的影响。方法 本次研究共纳入125例初产妇作为研究对象,到本院接受产检时间均介于2020年3月—2024年3月,按照随机数字表法将纳入患者分为对照组(n=62)、研究组(n=63),分别行常规护理、基于HAPA理论的护理干预,探究不同护理措施对产妇心理应激状态、初次下床活动时间、泌乳时间、舒适度评分、分娩幸福感的影响。结果 分娩前组间收缩压、舒张压、心率及皮质醇水平对比,组间差异不具有统计学意义(P>0.05);收缩压[(114.45±13.25)mmHg]、舒张压[(84.26±6.31)mmHg]心率[(71.45±3.69)次/min]及皮质醇[(72.54±10.25)ng/ml]水平低于对照组,两组对比具有统计学意义(t=2.805,3.404,2.071,2.304;P<0.05);与对照组相比较,研究组初次下床活动时间[(32.25±2.35)h]及泌乳时间[(28.54±3.15)h]均更早、舒适度评分[(2.11±0.58)分]更低,组间对比具有统计学意义(t=3.503,3.129,3.168;P<0.05);干预后两组患者分娩幸福感评分均有所提高,且相较于对照组,研究组对情感的满足和兴趣评分[(9.72±0.66)分]、对情感及行为的控制评分[(8.12±0.44)分]、精力评分[(25.29±2.07)分]、对健康的担心评分[(17.27±2.24)分]更高(t=2.779,2.419,2.795,2.761,P<0.05)。结论 基于HAPA理论的护理干预可改善产妇心理应激状态,产妇下床时间及泌乳时间更早,改善产妇舒适度,分娩幸福感随之提升。Objective To explore the effects of nursing intervention based on the Health Action Process Approach(HA-PA)theory on maternal mental state and neonatal outcomes.Methods A total of 125 primiparas were included in this study and received treatment in the Hospital between March 2020 to March 2024.The patients were divided into control group(n=62)and study group(n=63)according to random number table method,and received routine nursing and nursing inter-vention based on HAPA theory respectively.To explore the effects of different nursing measures on maternal mental state,newborn outcome and happiness of childbirth.Results Comparison of systolic blood pressure,diastolic blood pressure,heart rate and cortisol levels between the groups before delivery,the differences between the groups were not statistically sig-nificant(P>0.05);systolic blood pressure[(114.45±13.25)mmHg],diastolic blood pressure[(84.26±6.31)mmHg]heart rate[(71.45±3.69)beats/min]and cortisol[(72.54±10.25)ng/ml]levels were lower than those of the control group,and the comparison between the two groups was statistically significant(t=2.805,3.404,2.071,2.304;P<0.05);compared with the control group,the study group showed earlier time to first bed activity[(32.25±2.35)h] and time to lactation[(28.54±3.15)h],and earlier comfort score[(2.11±0.58)score]were lower,and the comparison between groups was statistically significant(t=3.503,3.129,3.168;P<0.05);the scores of well-being in labor and delivery im-proved in both groups after the intervention,and compared with the control group,the scores of the study group were higher in the scores of satisfaction and interest in emotions[(9.72±0.66)points],control of emotions and behavior[(8.12±0.44)score],energy score[(25.29±2.07)score],and worry about health score[(17.27±2.24)score]were higher(t=2.779,2.419,2.795,2.761,P<0.05).Conclusion Nursing intervention based on HAPA theory can improve maternal psychological state and newborn outcome,and improve maternal happiness during childbirth.

关 键 词：健康行动过程取向理论 初产妇 新生儿 心理应激状态 舒适度评分 分娩幸福感 

分 类 号：R473.71[医药卫生—护理学]