跨专业共享决策在双胎妊娠孕妇中的应用研究  

Application of interprofessional shared decision-making model for twin pregnancy

作　　者：王凤英[1] 章翀 尹宗智[1] 江楠 钱悦 赵保静[1] 司方圆[1] WANG Fengying;ZHANG Chong;YIN Zongzhi;JIANG Nan;QIAN Yue;ZHAO Baojing;SI Fangyuan(The Second Ward of Obstetrics,the First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China)

机构地区：[1]安徽医科大学第一附属医院产科二病区,安徽合肥230022

出　　处：《中华全科医学》2025年第2期198-202,共5页Chinese Journal of General Practice

基　　金：国家重点研发计划“生育健康及妇女儿童健康保障”重点专项(2023YFC2705904);安徽医科大学校科研基金立项资助项目(2021xkj281)。

摘　　要：目的 探讨双胎孕妇参与跨专业共享决策方案的应用效果,为促进孕产妇参与共享决策提供参考。方法 选取2022年3—9月在安徽医科大学第一附属医院产科门诊孕检的108例双胎妊娠孕妇作为研究对象,追踪至入院分娩。将孕妇按产检时间分为对照组与观察组,各54例,对照组采用常规干预方法实施指导,观察组在对照组的基础上参与跨专业共享决策方案。比较分析2组围产儿的不良结局、临床决策参与程度、医疗决策参与满意度与医院焦虑抑郁情绪。结果 干预后,2组胎儿的双胎生长不一致、低出生体重儿和低血糖发生率比较,差异有统计学意义(P<0.05)。对照组医患共同决策问卷患者版得分为(25.24±4.18)分,观察组为(40.50±6.25)分,差异有统计学意义(P<0.001)。观察组医疗决策参与满意度得分为(68.17±9.50)分,对照组为(45.83±11.38)分,差异有统计学意义(P<0.001)。观察组医院焦虑抑郁得分为[3.00(2.00,4.00)分],对照组为[7.00(6.00,8.00)分],差异有统计学意义(P<0.001)。结论 双胎孕妇在参与跨专业共享决策后,可以改善围产儿不良结局,提高临床决策参与程度、提升医疗决策参与满意度,降低产后焦虑和抑郁情绪。Objective To explore the effectiveness of interprofessional shared decision-making model for pregnant women with twins and to provide reference for promoting shared decision-making in clinical practice.Methods A total of 108 cases of pregnant women with twins in the Second Ward of Obstetrics,the First Affiliated Hospital of Anhui Medical University were selected as research objects and divided into a control group and an observation group randomly,with 54 cases in each group.The control group was guided by conventional intervention methods during pregnancy,while the observation group participated in the interprofessional shared decision-making model in addition to the standard care.The adverse outcomes of perinatal infants,level of participation in clinical decision-making,satisfaction with medical decision-making,and hospital anxiety and depression were compared between the two groups.Results After the intervention,the incidence of inconsistent twin growth,low birth weight,and hypoglycemia showed significant differences between the two groups(P<0.05).The SDM-Q-9 scores were significantly higher in the observation group(40.50±6.25)than in the group(25.24±4.18,P<0.001).The satisfaction score of medical decision-making participation in the observation group was also significantly higher,with a score of 68.17±9.50 compared to 45.83±11.38 in the control group(P<0.001).The hospital anxiety and depression scores were significantly lower in the observation group[3.00(2.00,4.00)]compared to the control group[7.00(6.00,8.00),P<0.001].Conclusion Participation in the interprofessional shared decision-making model can improve perinatal adverse outcomes,increase participation in clinical decision-making and satisfaction in medical decisions,and reduce anxiety and depression in pregnant women.

关 键 词：双胎妊娠 跨专业共享决策 决策参与 满意度 焦虑抑郁 

分 类 号：R714.23[医药卫生—妇产科学]