优质护理模式对妊娠期肝内胆汁淤积症产妇分娩自我效能及新生儿Apgar评分的影响

Effects of high quality nursing model on delivery self-efficacy of puerperae with intrahepatic cholestasis of pregnancy and neonatal Apgar score

目的探讨优质护理模式对妊娠期肝内胆汁淤积症产妇分娩自我效能及新生儿Apgar评分的影响。方法选取2017年1月—2019年1月笔者所在医院收治的妊娠期肝内胆汁淤积症产妇134例作为研究对象,采用信封法随机分为观察组和对照组各67例,对照组给予传统护理,观察组在此基础上给予优质护理模式干预,分析对产妇自我效能、负性情绪及妊娠结局的影响。结果干预后两组OE-16评分、EF-16评分均显著升高,且观察组干预后OE-16评分、EF-16评分均明显高于对照组(P<0.05);观察组中羊水污染、产后出血、胎儿宫内窘迫发生率均显著低于对照组,Apgar评分均显著高于对照组(P<0.05);观察组第一产程、第二产程、第三产程时间均显著短于对照组(P<0.05),观察组剖宫产、分娩镇痛患者均显著低于对照组(P<0.05);干预后两组SAS评分、SDS评分均显著降低,且观察组干预后以上评分均明显低于对照组(P<0.05);观察组在干预态度、心理指导、熟练度、健康教育等方面满意度显著高于对照组(P<0.05)。结论优质护理模式在妊娠期肝内胆汁淤积症产妇中应用较佳,可显著提高产妇分娩自我效能,改善妊娠结局及负性情绪,值得在临床上推广应用。

Objective To investigate the effects of high quality nursing model on delivery self-efficacy of puerperae with intrahepatic cholestasis of pregnancy(ICP)and neonatal Apgar score.Methods A total of 134 puerperae with ICP who were admitted to the hospital from January 2017 to January 2019 were enrolled as the research objects.They were randomly divided into observation group and control group by the envelop method with 67 cases in each group.Control group was given traditional nursing.On the basis,observation group high quality nursing model intervention.The effects on maternal self-efficacy,negative emotions and pregnancy outcomes were analyzed.Results After intervention,OE-16 scores and EF-16 scores of both groups were significantly increased,and the scores of observation group were significantly higher than those of control group(P<0.05).The incidence rates of amniotic fluid contamination,postpartum hemorrhage and intrauterine distress in observation group were significantly lower than those in control group,and Apgar score was significantly higher than control group(P<0.05).The first,second and third stages of labor of observation group were significantly shorter than those of control group(P<0.05).Patients undergoing cesarean section and labor analgesia in observation group were significantly fewer than those in control group(P<0.05).The SAS scores and SDS scores of both groups were significantly decreased after the intervention.The scores of observation group after intervention were significantly lower than those of control group(P<0.05).The satisfaction degree of observation group to intervention attitude,psychological guidance,proficiency and health education was significantly higher than that of control group(P<0.05).Conclusion The application of high quality nursing model in puerperae with ICP can significantly improve maternal delivery self-efficacy and pregnancy outcomes and relieve negative emotions.