舒适护理与分娩期妇女的心理状态

Comfortable nursing and the mental state in parturient women

目的:对分娩期妇女实施持续而有效的舒适护理,降低其负性心理的发生和减少分娩期并发症。方法:将2004-07/2005-02入住遵义医学院附属医院产科的240例产妇随机分为两组,以实施舒适护理的120例为观察组,为产妇提供舒适环境,心理沟通及家属陪护;对照组120例,仅按常规产科监护和处理整个产程。比较两组产妇出现焦虑、恐惧、偏执、敌对、抑郁、正常等表现的人数;比较两组第一产程活跃时间情况;比较生产过程中两种护理对产程及分娩方式的影响;比较两组产妇产时及产后的出血量;比较两组新生儿窒息的发生率。结果:240例孕妇全部进入结果分析,无脱落。①两组产妇的心理状态比较:正常者分别为87例、21例;两组焦虑、恐惧、偏执、敌对、抑郁阳性例数,总阳性率差异有非常显著性(21,42;2,13;7,21;0,9;3,14;27.50%,82.50%;χ2=73.3,P<0.001)。②两组产妇产程比较:观察组第一产程活跃期均值、总产程均值显著低于对照组犤(145.6±34.9),(275.3±74.6)min;(436.6±128.7),(648.3±134.6)min;t=17.25,12.45,P<0.001犦③两组产妇分娩方式、自然分娩及难产情况比较:观察组阴道自然分娩109例,剖宫产8例,产钳及胎吸助产3例;对照组阴道自然分娩69例,剖宫产42例,产钳及胎吸助产9例,两组比较差异有显著性(χ2=34.8,P<0.001)。④两组产妇产时及产后出血量比较:观察组均值明显低于对照组犤(169±43.5),(192±31.6)mL;t=4.68,P<0.001犦。⑤两组新生儿Apgar评分比较:观察组新生儿Apgar评分≥8分明显高于对照组(115,97例,χ2=13.1,P<0.001)。结论:对分娩期妇女实施持续有效的舒适护理,能使其保持处于轻松、愉快、舒适、自信的正常心态,从而有效降低分娩并发症。

AIM： To determine of continuous, effective and comfortable nursing care can lower the occurrence of negative psychology and reduce complications during the parturient period. METHODS： 240 parturient women hospitalized at Department of Obstetrics and Gynecology, Affiliated Hospital, Zunyi Medical College from July 2004 to February 2005 were divided into two groups at random： 120 patients treated with comfortable nursing as observation group, providing comfortable environment, psychological communication for parturient with accompanying of family members. 120 patients in the control group received routine care to dispose the whole birth process. The numbers of the people who had the manifestation of anxiety, fear, adamancy, rivalry, depression and common etc. were compared between the two groups. The condition of active time in the first birth process was compared between the two groups. The effects of the two kinds of nursing cares on the birth process and parturition manner in the process of birth were compared. The quantity of bleeding was compared between the time of birth and the time after birth of the two groups. The incidence was compared between the anoxia of newborn in the two groups. RESULTS： Totally 240 gravidas were involved in the result analysis without drop. ①Comparison of the mental state in the parturient of the two groups： Common people were 87 cases and 21 cases, respectively. The number of anxiety , fear, adamancy, rivalry, depressive positive people, and there was significant difference of the general positive rate （21, 42; 2, 13; 7, 21; 0, 9; 3, 14; 27.50%,82.50%;x^2=73.3, P〈 0.001）.② Comparison of the birth process between the parturient in the two groups： The average value in active phase of the first stage of birth and the general process of birth in the observation group was lower than that in the control group [（ 145.6±34.9 ）, （275.3±74.6 ） minutes; （436.6±128.7）, （648.3±134.6） minutes; t=17.25, 12.45, P 〈 0.001].③ Comparison of the parturition manners, natural parturition and condition of birth difficulty of the parturient in the two groups： 109 cases were natural parturient by vagina, 8 cases were dissected the womb to birth and 3 cases were aided to birth by cephalotracter and suck the placenta in the observation group. Sixty-nine cases were natural parturient by vagina, 42 cases were dissected the womb to birth and 9 cases were aided to birth by cephalotracter and suck the placenta in the control group, and there were significant differences between the two groups （x^2=34.8, P 〈 0.001 ）.④Comparison of the quantity of bleeding between the time of birth and the time after birth of the two groups： The average value in the observation group was significantly lower than that in the control group [（169±43.5）, （192±31.6） mL;t=4.68, P 〈 0.001].⑤Comparison of the Apgar score in the neonates of the two groups： The Apgar score was ≥8 points of the neonates in the observation group, which was higher than that in the control group （115, 97 cases, x^2=13.1, P 〈 0.001）. CONCLUSION： Continuous, effective and comfortable nursing can keep parturients in a relaxing, pleasant, comfortable and confident state-of-mind, thus, it is beneficial to reduce the parturition complication.