以协同护理模式为指导的延续护理对产后创伤后应激障碍的预防效果

Prevention effect of collaborative care model-based continuous nursing on the postpartum posttraumatic stress disorder

目的探讨以协同护理模式为指导的延续护理对产后创伤后应激障碍(PPTSD)的预防效果,为产后临床护理提供参考。方法将首都医科大学附属北京潞河医院产科分娩的100例孕妇按照随机数字表法分为干预组和对照组各50例,对照组采用常规护理方案,干预组给予基于协同护理模式的干预策略。分别于干预前和干预后采用创伤后应激障碍平民版量表(PCL-C)评价2组PPTSD症状,心理弹性量表(CD-RISC)评价2组产妇产后心理弹性水平。结果干预前,2组产妇PCL-C和CD-RISC各维度得分及总分比较差异无统计学意义(P>0.05);干预后,干预组警觉增高反应(7.22±1.09)分、回避反应(9.77±2.41)分、反复重现反应(5.66±1.17)分,PCL-C总分(22.64±3.02)分,均明显低于对照组的(8.32±1.05)、(11.46±2.87)、(6.36±1.25)、(26.14±3.27)分,差异有统计学意义(t=2.899~5.559,P<0.01);干预组坚韧性(24.90±4.83)分、力量(14.91±2.25)分、乐观性(7.18±1.61)分、CD-RISC总分(46.99±6.30)分,明显高于对照组的(23.22±2.69)、(13.61±1.75)、(6.14±0.91)、(42.97±3.30)分,差异有统计学意义(t=2.154~4.011,P<0.05或0.01)。结论协同护理模式可以提高产妇产后心理弹性水平和降低创伤后应激障碍症状,对预防PPTSD具有积极作用。

Objective To explore the effectiveness of collaborative care model-based continuous nursing on the postpartum posttraumatic stress disorder(PPTSD),to provide reference for postpartum clinical nursing.Methods A total of 100 cases of postpartum puerpera in Beijing Luhe Hospital of Capital Medical University were assigned to the intervention group and the control group according to the random number table method with 50 cases each.In the control group,patients received continuous nursing,however,collaboration care model-based continuous nursing care was carried out in the intervention group.The PPTSD status and psychological resilience between the two groups was assessed by Posttraumatic stress Checklist-Civilian version(PCL-C)and Connor-Davidson Resilience Scale(CD-RISC),respevtively.Results Before intervention,symptoms scores and total scores of PCL-C and CD-RISC between the two group was no statistical difference(P>0.05).After intervention,the scores of increased arousal symptoms(7.22±1.09),avoidance/numbing(9.77±2.41),re-experiencing symptoms(5.66±1.17)and PCL-C total scores(22.64±3.02)were significantly decreased in the intervention group compared to the control group(8.32±1.05),(11.46±2.87),(6.36±1.25),(26.14±3.27),and there were significant differences between the two groups(t=2.899-5.559,all P<0.01).However,the scores of tenacity(24.90±4.83),strength(14.91±2.25),optimism(7.18±1.61)symptoms and CD-RISC total scores(46.99±6.30)were remakedly increased in the intervention group compared to the control group(23.22±2.69),(13.61±1.75),(6.14±0.91),(42.97±3.30),there were significant differences between the two groups(t=2.154-4.011,P<0.05 or 0.01).Conclusions Collaboration care model-based continuous nursing care can promote the psychological resilience and alliviate PPTSD.