设立助产士门诊对孕妇认知行为及分娩的影响

Influence of midwife clinic on cognitive behavior and parturition of pregnant women

目的探讨助产士门诊对孕产妇认知行为及分娩的影响。方法选取参加助产士门诊的100例孕妇为观察组，随机抽取同期参加孕妇学校大课教学的100例孕妇作为对照组。观察组采用小讲座、技能培训及模拟演练示范、一对一咨询指导、交流解疑、参观等多形式相结合的方法，同时根据孕产妇的不同阶段特点予以系统、连续地个体化健康教育。对照组采用孕妇学校大课教学模式。研究采用自行设计的问卷，两组分别在产前、产时及产后完成调查表，内容由助产士门诊成员及孕妇学校老师共同完成。比较不同教育方法对2组产妇的影响。结果观察组产前检查次数大于8次的人数（91．8％）高于对照组（58．3％），差异具有统计学意义（x^2=27．10，P〈0．01）。观察组产时分娩过程配合人数（82．7％）高于对照组（61．5％），差异具有统计学意义（x^2=10．85，P〈0．01）；观察组自然分娩人数（75．5％）高于对照组（61．5％），差异具有统计学意义（x^2=4．44，P〈0．05）。观察组产后了解新生儿大小便观察的人数为94人，高于对照组的75人，差异具有统计学意义（x^2=18．67，P〈0．01）；观察组产后了解会阴及伤口护理的人数为90人，高于对照组的67人，差异具有统计学意义（x^2=15．27，P〈0．01）。结论助产士门诊采用系统、规范、多元化、个体化的产前教育方式，可提高孕产妇围产期相关知识的认知及健康行为依从性，促进自然分娩。

Objective To discuss the influence of midwife clinic on cognitive behavior and natural parturition of pregnant women. Methods 100 pregnant women who took part in the midwife clinic were chosen as the observation group. 100 pregnant women who participated in the pregnancy class were randomly chosen as the control group. The observation group was given a comprehensive teaching of small seminars, skills training and simulation exercise demonstrations, one on one counseling, Q ＆ A, visits and other forms. Meanwhile, systematic, continuous and individual health education was given according to the characteristics of different stages of pregnancy. The control group was given traditional pregnancy class. Self-designed questionnaires were filled in with the help of midwives or teachers before, at the time of and after the delivery. Influence of the two education methods on the two groups was compared. Results The number of pregnant women who went for prenatal examinations more than 8 times in the observation group （91.8%） was higher than that in the control group （58.3%）, and the difference was statistically significant （X^2 =27.10, P 〈0. 01）. The number of women who cooperated well during the labor in the observation group （82.7%） was higher than that in the control group （61.5%）, and the difference was statistically significant （X^2 = 10.85, P 〈 0. 01 ）. The number of women who went through vaginal delivery in the observation group （75.5%） was higher than that in the control group （61.5%）, and the difference was statistically significant （X^2 =4.44, P 〈0. 05）. The number of women who knew about defecation observation of the neonates in the observation group （94 women） was higher than that in the control group （75 women）, and the difference was statistically significant （x^2 = 18.67, P 〈0. 01 ）. The number of women who knew about perineum nursing after labor in the observation group （90 women） was higher than that in the control group （67 women）, and the difference was statistically significant （ x^2 = 15.27, P 〈 0. 01 ）. Conclusions Midwife clinic provides systematic, standardized, diversified, individualized prenatal education and could increase awareness and knowledge of perinatal health behavior compliance and promote natural parturition.