社会支持和分娩自我效能增强干预对初产妇分娩应对能力的影响

Effective of social support and childbirth self-efficacy-enhancing intervention on primiparas′ childbirth coping ability

目的探讨社会支持和分娩自我效能增强干预对初产妇分娩自我效能、应对能力和产时疼痛的影响。方法采用随机分组对照、双盲实验设计,招募106例初产妇分为干预组和对照组,每组53例。两组均给予常规产前护理;干预组在此基础上,由家属陪伴参加两次分娩自我效能增强干预课程。干预组采用简化中文版分娩自我效能量表(CBSEI)行干预前后比较;两组自然分娩孕妇采用分娩应对量表(CCB)和视觉模拟量表(VAS)比较干预效果;采用领悟社会支持量表(MSPSS)分析社会支持水平与分娩自我效能(CBSEI)和应对能力(CCB)之间相关性。结果最终干预组有效样本52例,对照组51例。干预组干预后CBSEI得分(282.04±27.38)高于干预前(236.69±45.39);干预组CCB得分(56.78±6.95)显著高于对照组(48.03±6.26),VAS得分(6.96±1.39)显著低于对照组(8.35±1.43),差异均有统计学意义(P<0.01);两组MSPSS得分与干预前结果期望(OE)、自我效能期望(EE)、CBSEI得分均呈正相关(r=0.269、0.289、0.317,P<0.01)。结论启动社会支持系统的分娩自我效能增强干预能有效提高初产妇分娩自我效能和应对能力、降低产时疼痛水平。

Objective To investigate the effect of social support and childbirth self-efficacy-enhancing intervention on primip- aras＇ childbirth self-efficacy,coping ability and pain during labor. Methods A randomized controlled trial was used with double blindness design. One hundred and six primiparas were recruited as the intervention group and control group, 53 cases in each group. The two groups adopted the routine prenatal care. In addition, the intervention group participated in twice childbirth self-effi- cacy-enhancing educational courses. The Chinese Childbirth Self-Efficacy Inventory （CBSEI） was used to conduct the comparison between before and after intervention; the interventional effects in the natural childbirth pregnant women were compared between the two groups by adopting the Visual Analogue Scale （VAS） and Childbirth Coping Behavior Scale （CCB） ;the Multidimensional Scale of Perceived Social Support （MSPSS） was adopted to analyze correlation between the social support level with the CBSEI and CCB. Results The intervention group finally had 52 cases of effective sample and the control group had 51 cases of effective sam- ple. The CBSEI score after intervention in the intervention group was 282.04± 27.38, which was higher than 236.69 ± 45.39 before intervention. The CCB score in the intervention group was 56.78±6.95, which was significantly higher than 48.03±6.26 in the control group,and the VAS score in the intervention group was 6.96±1.39, which was lower than 8. 35 ± 1.43 in the control group, the difference was statistically significant（P〈0.01）. The MSPSS score in the two groups was positively correlated with the OE score,efficacy expectancy （EE） score and CBSEI score before intervention（r=0. 269,0. 289,0. 317,P〈0.01）. Conclusion Launching the childbirth self-efficacy-enhancing educational intervention of the social support system can effectively improve the childbirth self：efficacy and coping ability of primiparas, and reduce the intrapartum pain level.