支持性心理治疗配合健康教育在行期待疗法治疗的前置胎盘孕妇中的应用

Application of Supportive Psychotherapy Combined with Health Education in Expectant Treatment on Pregnant Women with Placenta Previa

目的:探讨支持性心理治疗配合健康教育在接受期待疗法治疗的前置胎盘(PP)孕妇中的应用效果。方法:选择2016年3月～2017年3月收治的37例PP孕妇作为对照组,以期待疗法进行治疗,给予常规护理;选择2017年4月～2018年3月收治的37例PP孕妇作为研究组,以期待疗法进行治疗,在常规护理基础上加以支持性心理干预配合健康教育。比较两组孕妇心境状态[采用心境状态量表(POMS)]、PP影响度自评[采用意外事件影响量表(IES-R)]结果、三维评估[采用三维筛选评估模型(TAS)]结果及分娩后的母儿情况结果:干预后,研究组POMS中紧张-焦虑、抑郁-沮丧、疲乏-迟钝、愤怒-敌意、迷惑-混乱维度及总分得分均显著低于对照组(P <0. 01,P <0. 05),精力-活力维度得分显著高于对照组(P <0. 01);干预后,两组IES-R中的逃避、侵扰、唤醒3个维度得分均显著低于干预前(P <0. 05),且研究组低于对照组同期(P <0. 01);干预后,两组TAS中情感、认知、行为3个维度得分显著低于干预前(P <0. 05),且研究组低于对照组同期(P <0. 01);研究组孕妇孕周、新生儿Apgar评分高于对照组(P <0. 01),孕妇产后抑郁发生率低于对照组(P <0. 05)。结论:支持性心理治疗配合健康教育能够有效改善接受期待疗法治疗的PP孕妇身心状态,促进母婴情况良好转变,值得临床推广。

Objective:To explore the application effect of supportive psychotherapy combined with health education in expectant treatment on pregnant women with placenta previa(PP).Methods:A total of 37 pregnant women with PP admitted from March 2016 to March 2017 were selected as the control group to be treated with expectant therapy and were given routine nursing care.A total of 37 PP pregnant women admitted from April 2017 to March 2018 were selected as the study group to be treated with expectant therapy,implement supportive psychological intervention combined with health education on the basis of routine nursing.The mood state[using Profile of Mood States(POMS)],the self-assessment results of PP influence[using accident impact scale(IES-R)],three-dimensional assessment results[using three dimensional screening evaluation model(TAS)]and maternal-infant status after delivery between the two groups were compared.Results:After the intervention,the scores of tension-anxiety,depression-dismay,fatigue-dullness,anger-hostility,puzzle-chaos dimension and total scores in the research group were significantly lower than those of the control group(P<0.01),and the scores of the energy-vitality dimension were significantly higher than those of the control group(P<0.01).After the intervention,the three-dimensional scores of escape,intrusion and wake-up of IES-R in the two groups were significantly lower than those of before intervention(P<0.05),and the scores of study group were lower than that of control group in the same period(P<0.01).After the intervention,the three-dimensional scores of emotion,cognition and behavior of TAS in the two groups were significantly lower than those of before the intervention(P<0.05),and the scores of study group were lower than that of control group in the same period(P<0.01).The gestational age of pregnant woman and Apgar score of newborn in study group were significantly higher than those of control group(P<0.01),and the postpartum depression rate of pregnant women was significantly lower than that of control group(P<0.05).Conclusion:Supportive psychotherapy combined with health education can effectively improve the physical and mental state of PP pregnant women with expectant therapy,and promote the good transformation of mother and baby,which is worthy popularizing application in clinic.