攀枝花市某医院二孩剖宫产产妇服务需求现状及其影响因素

Status Quo and Influencing Factors of the Maternal Service Demand of Second Child Cesarean Section Puerperae in a Hospital of Panzhihua City

目的:了解二孩剖宫产产妇围产期的需求及其影响因素,以期提高二孩剖宫产成功率和新生儿健康水平。方法:采用方便抽样的方法选取2017年11月-2018年6月在攀枝花市某医院采用剖宫产分娩二孩的产妇341名,根据初次分娩的方式将其分成顺-剖和剖-剖两组,通过单因素和多因素逻辑回归模型分析其围产期的需求。结果:单因素分析结果显示,怀孕期间孕妇对心理干预的需求强于孕期营养知识、身体锻炼知识、定期产检和胎儿早教的需求;在分娩时和术后需求方面,产妇的需求集中于术后并发症和自我护理知识。顺-剖组和剖-剖组对比显示后者对于并发症的忧虑高于前者。多因素Logistic回归分析显示心理干预和术后并发症是影响二孩剖宫产产妇需求的重要因素(P=0.011和P=0.014),可以解释产妇需求变化的36.29%。结论:二孩剖宫产产妇的护理需求更着重于心理层面。对产妇进行心理疏导,舒缓其心理负担将有助于提高护理质量,降低二孩剖宫产的风险。

Objective:To understand the perinatal needs and its influencing factors of puerperae with the second child cesarean section in order to improve the success rate of the second child cesarean section.Methods:341 Puerperae who had the cesarean section for the second delivery from November2017 to June2018 in a hospital of Panzhihua city were selected using the convenient method.They were divided into two groups according to their first delivery pattern.A questionnaire survey was designed based on the previously reported work and relevant experts' opinions.The answers to the questionnaires were analyzed by univariate and multivariate logistic regression analyses respectively.Results:The result of univariate analysis showed that pregnant women's demand for psychological intervention during pregnancy was stronger than that of nutrition knowledge, physical exercise, regular prenatal examination, and early fetal education.In terms of delivery and postoperative needs, pregnant women focused on postoperative complications and self-care knowledge.Comparison between the group whose first delivery was natural labor with the one whose first delivery was the cesarean section showed that the latter group was more worried about complications, especially the ones with the first C-section-induced scarred uterus.The result of multivariate logistic regression analysis showed that psychological intervention and post-operative complications were the key factors influencing the demand of second child cesarean section puerperae ( P =0.011 and P =0.014), which could explain 36.29% of the change of maternal demand.Conclusion:The nursing needs of the puerperae with second child cesarean section were more focused on psychological level.Psychological counseling for puerperae and relieving their psychological burden would help improve the quality of care and reduce the risk of cesarean section in the second delivery.