家属共同参与护理计划对足月、单胎头位初产妇经阴道分娩率及总产程的影响

Effect of family members participating nursing plan on the vaginal delivery rate and total labor in full-term and single fetal head position primiparas

目的:分析家属共同参与护理计划对足月、单胎头位初产妇经阴道分娩率及总产程的影响。方法:选取2017年8-12月收治的186例足月、单胎头位初产妇,按照入院顺序分组,对照组(93例)实施常规护理,观察组(93例)在此基础上实施由家属共同参与的护理计划,比较2组分娩结局(经阴道分娩率、剖宫产率)、护理满意度、产程时间(第一产程、第二产程、第三产程、总产程时间)、产后2 h内出血量、分娩知识掌握度,采用抑郁、焦虑自评量表(SDS、SAS)、一般自我效能感量表(GSES)评估入院时、分娩前负性情绪、自我效能。结果:观察组护理满意度优于对照组(P<0.01),剖宫产率明显低于对照组(P<0.01)。观察组第一产程、第二产程、第三产程、总产程时间均明显短于对照组(P<0.01)。观察组住院时间短于对照组(P<0.01),产后2 h出血量、住院费用均低于对照组(P<0.05和P<0.01)。入院时2组SDS、SAS评分、GSES、分娩知识掌握度评分比较,差异无统计学意义(P>0.05);分娩前观察组SDS、SAS评分均明显低于对照组(P<0.01),GSES、分娩知识掌握度评分均高于对照组(P<0.01)。结论:家属共同参与护理计划能提高足月、单胎头位初产妇经阴道分娩率,改善负性情绪,缩短产程时间,减少产后出血量与住院费用,促进产妇早期恢复,提高护理满意度与自我效能。

Objective:To analyze the influence of family members participating nursing plan on the vaginal delivery rate and total labor in full-term and single fetal head position primiparas.Methods:A total of 186 fullterm head position,single fetal head position primiparas from August 2017 to December 2017 were divided into the control group(treated with rountine nursing)and observation group(treated with family members participating nursing plan based on control group)according to the order of admission(93 cases each group).The delivery outcome(including vaginal delivery rate and cesarean section rate),nursing satisfaction,labor time(first,second and third stage of labor and total labor time),postpartum haemorrhage amount within 2 h and childbirth knowledge mastery between two groups were compared,and the negative emotions and self-efficacy in two groups were evaluated using the self-rating scale for depression and anxiety(SDS and SAS)and general self-efficacy scale(GSES).Results:The nursing satisfaction and cesarean section rate in observation group were better and lower than that in control group,respectively(P<0.01).The first,second and third stage of labor time,total labor time and hospitalization time were significantly shorter than those in control group(P<0.01).The postpartum blood loss within 2 h and hospitalization expense in observation group were lower than those in control group(P<0.05 and P<0.01).The differences of the scores of SDS,SAS,GSES and childbirth knowledge mastery between two groups on admission were not statistically significant(P>0.05).The scores of SDS and SAS in observation group before delivery were significantly lower than those in control group(P<0.01),and the scores of GSES and childbirth knowledge mastery in observation group before delivery were higher than those in control group(P<0.01).Conclusions:Family members participating nursing plan can improve the vaginal delivery rate of primiparas with full-term and single fetal head position,improve the negative emotion,shorten the time of labor,reduce postpartum hemorrhage and hospitalization expense,promote early maternal recovery,and improve nursing satisfaction and self-efficacy.