助产士全程陪护配合心理干预对初产妇负性情绪及产程的影响

The effect of continuous midwife care combined with psychological intervention on negative emotions and the birth process of primipara effect of on primiparas' negative emotion

目的探讨助产士全程陪护配合心理干预对初产妇负性情绪及产程的影响。方法选取2014年6月~2015年12月入住本院的156例初产妇作为研究对象,随机分成观察组和对照组,每组各78例。对照组产妇给予常规助产、护理模式;观察组给予用助产士全程陪护配合心理干预。观察两组的分娩结局与初产妇分娩的各产程时间。应用焦虑自评量表（SAS）、抑郁自评量表（SDS）于入院时与分娩后24h对患者情绪状态进行评估。并对比分析两组产妇并发症发生率。结果观察组中71例初产妇为自然分娩,7例剖宫产,自然分娩率为91.23%;对照组初产妇43例自然分娩,35例剖宫产,自然分娩率为55.13%。两组初产妇自然分娩率比较,差异有统计学意义（χ^2=5.386,P〈0.05）。观察组初产妇自然分娩的总产程用时（7.89±1.52）h,明显低于对照组初产妇自然分娩的总产程用时（12.47±2.07）h,差异均有统计学意义（χ^2=5.386,P〈0.05）。两组产妇入院时,均有轻中度的焦虑、抑郁,两组的SAS、SDS评分无统计学意义（P〉0.05）。分娩后两组患者焦虑、抑郁情况均有明显好转（P〈0.05）,且观察组SAS评分与SDS评分明显低于对照组,差异有统计学意义（P〈0.05）。比较两组初产妇产后并发症发生率,观察组明显低于对照组,差异有统计学意义（χ^2=8.482,P〈0.05）。结论助产士全程陪护配合心理干预可以有效缓解初产妇的负性情绪,提高自然分娩率,缩短产程,降低产后并发症发生率,建议在实际工作中推广使用。

Objective To investigate the influence of continuous midwife care combined with psychological intervention on negative emotions and the birth process of primipara. Methods 156 primiparas were selected as the research object.They were in hospital from June 2014 to December 2015. According to the random method,they were divided into observation group and control group,each group of 78 cases.The control group was given routine nursing and midwifery model,and the observation group was given continuous midwife care combined with psychological intervention.The outcome of delivery and birth process were observed.At admission and 24 hours after delivery, the self rating Anxiety Scale（SAS） and self rating Depression Scale（SDS） were used to assess the emotional state of the patients.The incidence of maternal complications in two groups were compared and analyzed. Results In the observation group,71 cases were spontaneous delivery,7 cases were cesarean section,with the natural childbirth rate of 91.23%.There were 43 cases of natural childbirth and 35 cases of cesarean section in the control group,the natural childbirth rate was 55.13%.The natural childbirth rate was compared between two groups,and the difference was statistically significant（χ^2=5.386,P〈0.05）.In the observation group,the total production process of natural childbirth was（7.89±1.52）h,significantly lower than the control group at the beginning of the total output of natural childbirth（12.47±2.07）h,and the difference was statistically significant（χ^2=5.386,P〈0.05）.When admitted to hospital,the two groups had mild to moderate anxiety,depression.SAS and SDS score had no significant difference between two groups（P〈0.05）.After delivery,anxiety and depression of two groups were significantly improved（P〈0.05）.SAS score and SDS score of the observation group were significantly lower than that of the control group（P〈0.05）.The incidence rate of primipara postpartum complications were compared between the two groups,the observation group was significantly lower than the control group,the difference was statistically significant（χ^2=8.482,P〈0.05）. Conclusion Continuous midwife care combined with psychological intervention can effectively alleviate the negative emotions,improve the natural delivery rate,shorten the birth process, and reduce the incidence of postpartum complications.It is recommended to promote the use of the actual work.