个体化健康教育对降低社会因素剖宫产率效果分析

Role of individualized antepartum health education in decreasing the rate of cesarean delivery due to social factors

目的：探讨个体化健康教育对降低社会因素剖宫产率的效果。方法：将某三甲医院2009年待分娩的1 922孕妇设为对照组,接受一般孕期知识健康教育;2010年的2 089例行门诊定期产检和分娩的孕妇作为研究组,在常规健康教育基础上,于孕37周后,通过问卷调查对产前门诊选择剖宫产和不确定分娩方式者及住院期间提出社会因素剖宫产的孕妇,了解具体想法和原因,并给予一对一健康教育。比较2组分娩方式和社会因素剖宫产产妇一般资料及具体原因,分析个体化健康教育对减少社会因素剖宫产的效果及相关影响因素。结果：研究组剖宫产821例,低于对照组的889例（P〈0.01）;研究组社会因素剖宫产159例,低于对照组的388例（43.6%）（P〈0.01）。2组社会因素剖宫产产妇的一般资料和具体原因比较差异有统计学意义（P〈0.05-P〈0.01）。结论：个体化健康教育可以降低社会因素剖宫产率,但要贯穿于入院前后,健康教育对不同年龄、学历、职业及选择剖宫产具体原因不同,其效果存在差异。

Objective：To investigate the role of individualized antepartum health education in decreasing the rate of cesarean delivery due to social factors.Methods：Two thousand and eighty-nine pregnant women who had their routine prenatal examinations and labors during 2010 in a Three-A hospital were studied and 1 922 pregnant women who had their labors during 2009 in the same hospital acted as control.The control group received only the antepartum health education,while the study group received one-to-one individual antepartum health education.A questionnaire was conducted in the pregnant women having chosen cesarean delivery,not confirmed about the delivery style and requiring for cesarean delivery due to social factors during hospital stay.The delivery patterns and the constituent ratio of cesarean delivery due to social factors were compared,and the influence of individualized antepartum health education was analyzed.Results：There were 821 cesarean deliveries in the study group（39.3%） and 889 in the control group（46.3%）（P〈0.01）.The number of cesarean delivery amounted to 159 in the study group（19.4%） and 388 in the control group（43.6%）（P〈0.01）.There were also some differences in the demographic data and the constituent ratio of specific social factors for cesarean deliveries between the two groups（P〈0.05-P〈0.01）.Conclusions：Individualized antepartum health education could decrease the rate of cesarean delivery due to social factors and should be carried out before and after hospital admission.The effect of individualized antepartum health education is influenced by the age,educational background,occupation and specific social factors leading to cesarean delivery.