高龄初产妇产前心理状态分析与护理

Research and Nursing Care of the Mental State of Elderly Primiparas before Labor

目的探讨高龄初产妇临产前的心理状态,了解其负性心理原因,及时给予护理干预,使其顺利渡过围生期。方法 2010年6月-2011年9月,将在待产且年龄≥35岁的60例初产妇归为高龄组,随机选取同期住院的适龄初产妇60例作为对照组,应用焦虑自评量表(SAS)、抑郁自评量表(SDS)及症状自评量表(SCL-90),对高龄初产妇进行产前心理评估及检测血中肾上腺素(E)和去甲肾上腺素(NE)水平。结果高龄初产妇产前的SAS和SDS评分及E和NE水平,SCL-90量表中总分及躯体化、强迫、焦虑、抑郁因子分与适龄组比较,差异有统计学意义(P<0.01);SAS评分与E、NE水平,SDS评分与E、NE水平均呈正相关,相关系数分别为:0.378、0.402、0.384、0.369(P<0.01)。结论高龄初产妇分娩前多数存在不同程度的负性心理,应根据其不同情况给予相应的心理干预以促进产妇顺利渡过围生期。

Objective To investigate the mental state of elderly primiparas before delivery,learn the causes of their negative mentality and give a timing nursing intervention and help them get through the perinatal period easily.Methods From June 2010 to September 2011,60 primiparas aged higher than or equal to 35 years old waiting for delivery were designated as the primipara group,and another 60 younger primiparas at the same time in our hospital were chosen to form the control group.Self-rating anxiety scale（SAS）,self-rating depression scale（SDS） and self-reporting inventory（SCL-90） were used to evaluate the mental state of all the primiparas in both groups before labor,and their serum epinephrine（E） and norepinephrine（NE） concentrations were also detected by using chemical luminescence method.Results SAS scores,SDS scores,serum E and NE concentrations,total SCL-90 scores,and scores of items including body,compulsivity,anxiety,and depression in SCL-90 of elderly primiparas were significantly different from those of younger primiparas（P〈0.01）.Positive correlations between SAS scores and serum E,SAS scores and serum NE,SDS scores and serum E,SDS scores and serum NE were found and the correlation coefficients were 0.378,0.402,0.384,and 0.369 rspectively（P〈0.01）.Conclusion Most elderly primiparas before labor have a negative mental state to some extent,and some metal intervention should be given to improve their health.