以家庭为中心的产科优质护理对产后抑郁的影响

Effects of family centered maternity care nursing on puerperal depression of delivery women during puerperal period

目的探讨以家庭为中心的产科护理对产褥期产妇产后抑郁的预防效果,减轻产妇自然分娩的负担,减少产妇产后抑郁的机会。方法选取2011年7月—2012年7月哈尔滨医科大学附属第一医院产科自然分娩的产妇100例,随机分为2组:对照组(n=50)给予传统的常规护理,给予产妇产前检查、临产指导和产褥期常规护理。试验组(n=50)在对照组的基础上实施以家庭为中心的产科优质护理,2组产妇在年龄、妊娠周期、教育程度、个人收入和妊娠次数等方面差异无统计学意义(P>0.05),具有可比性。在护理前和产后1个月分别采用焦虑自评量表和爱丁堡产后抑郁量表进行效果评定。观察和比较2组孕妇产后抑郁症发生率的变化。结果通过2组在护理前后焦虑自评量表和爱丁堡产后抑郁测量表评分的比较,2组产妇在护理前差异无统计学意义(P>0.05),但2组产妇在产后的评分均较护理前有所降低,且试验组显著低于对照组(P<0.05);对照组的抑郁率可高达50%,而试验组的产后抑郁率仅为36%,试验组发生抑郁者的人数明显少于对照组,2组比较差异有统计学意义(χ2=9.7,P<0.05)。结论以家庭为中心的产科护理对减轻产后抑郁情绪,提高产妇的生活质量具有重要作用。使产妇没有压力地度过分娩期和产褥期,对于临床上应用以家庭为中心的产科护理有重要的指导意义。

Objective To explore the preventive effects of family centered maternity care nursing on puerperal depression of delivery women during puerperal period to decrease the burden of delivery and the chances of postpartum depression during puerperal period for delivery women. Methods All 100 natural delivery women who were in the obstetrics of our hospital from July 2011 to July 2012 were randomly divided into two groups： a control group（ n = 50） received the con- ventional care nursing（ examination of prepartum and direction of delivery）, the experimental group（ n = 50） received the family centered maternity care nursing on the basis of the control group care nursing. The difference of both groups was no statistically significant on age, cycle of gestation, education level, personal income and frequency of gestation （ P 〉 0.05 ）. All subjects were assessed respectively by Self-Rating Anxiety Scale （SAS） and Edinburgh Postnatal Depression Scale （EPDS） to observe and compare the changes in the incidence of puerperal depression at Pre-care nursing and one month after childbirth. Results The difference of both groups at Pre-care nursing was no statistically significant on the scores of the SAS and EPDS. But the scores of the SAS and EPDS of both groups at one month after childbirth were lower than the scores of them at Pre-care nursing（P 〈 0.05 ）. The experimental group was significantly lower than the control group （P 〈 0.05） ;the incidence of puerperal depression of the experimental group was 36% and that of the control group was 50%. The incidence of puerperal depression of the experimental group at one month after childbirth were significantly less than that of the control group, the difference was statistically significant （ X^2 = 9.7, P 〈 O. 05 ）. Conclusion The family cen- tered maternity care nursing management played an important role in reducing puerperal depression of delivery women and improving the living quality of delivery women. It made delivery women pass the puerperal period with no burden and played an important role in clinical direction.