孕早期应用黄体酮联合依诺肝素钠治疗复发性流产患者心理健康状况调查及社会-家庭支持干预分析

Mental Health Status of Patients with Recurrent Spontaneous Abortion Treated with Progesterone Combined with Enoxaparin Sodium in Early Pregnancy and Social-family Support Intervention

目的:调查复发性流产(RSA)患者心理健康状况,并分析社会-家庭支持干预的效果。方法:选取2016年3月至2017年3月海南省文昌市人民医院收治的120例孕早期应用黄体酮联合依诺肝素钠治疗的RSA患者,采用90项症状自评量表(SCL-90)调查患者心理健康状况;并将患者随机分为对照组(n=60)和观察组(n=60),对照组予以常规护理,观察组予以社会-家庭支持干预;比较两组干预效果。结果:RSA患者SCL-90量表中躯体化、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性等因子评分及总均分均明显高于常模(P>0.05)。干预后,观察组社会支持、家庭亲密度、家庭适应性及生活质量(生理功能、生理职能、总体健康、精神活力、社会功能、情感职能、心理卫生)评分均明显高于对照组(P<0.05),SCL-90总均分明显低于对照组(P<0.05)。随访显示,观察组治疗成功率为83.33%,明显高于对照组的73.33%,差异有统计学意义(P<0.05)。结论:RSA患者存在心理健康问题,而采用社会-家庭支持干预能够改善患者心理健康水平及生活质量,提高妊娠成功率。

Objective: To investigate the health status of patients with recurrent spontaneous abortion (RSA) and analyze the effects of social-family support intervention. Methods: One hundred and twenty patients with RSA treated with progesterone combined with enoxaparin sodium during early pregnancy in People’s Hospital of Wenchang City, Hainan Province from March 2016 to March 2017 were enrolled in the study. The patient’s mental health status was investigated by the 90-item Symptom Checklist (SCL-90). The patients were randomly divided into the control group (n=60) and the observation group (n=60). The control group was given routine nursing while the observation group was given social-family support intervention. Effects of the intervention were compared between the two groups. Results: Scores of somatization, interpersonal sensitivity, depression, anxiety, hostility, horror, paranoid and psychoticism in the SCL-90 scale and the total score of patients with RSA were significantly higher than those of norms (P>0.05). Scores of social support, family intimacy, family adaptability and quality of life (physiological function, physiological role, general health, spiritual vitality, social function, emotional role, mental health) of the observation group after the intervention were significantly higher than those of the control group (P<0.05), while the total score of SCL-90 was significantly lower than the control group (P<0.05). Follow-up showed that the success rate of treatment in the observation group was significantly higher than that in the control group (83.33% vs 73.33%)(P<0.05). Conclusion: RSA Patients have mental health problems. Social-family support intervention can improve the patients’ mental health and quality of life, and improve the success rate of delivery.