积极心理暗示联合导乐陪伴分娩对初产妇心理应激反应及分娩自我效能的影响

Influence of positive psychological suggestion and doula accompanying childbirth on psychological stress response and self-efficacy of puerpera

目的探讨积极心理暗示联合导乐分娩对初产妇心理应激反应及分娩效能的影响。方法选择2018年7月—2019年6月南京医科大学附属淮安第一医院收治的初产妇168例,根据住院分娩时间分为实验组(2019年1月—6月)86例、对照组(2018年7月—12月)82例。对照组给予常规护理及导乐分娩陪伴,实验组联合应用积极心理暗示与导乐陪伴。比较两组心理应激反应、分娩自我效能、产程及术后2 h出血量、分娩方式及分娩结局。结果干预后两组初产妇焦虑自评量表(SAS)、抑郁自评量表(SDS)评分低于同组干预前,且实验组SAS、SDS评分低于对照组(P<0.01)。干预后两组初产妇分娩自我效能评分高于同组干预前,且实验组结果效能、期望效能、自我效能总分高于对照组(P<0.01)。实验组第一、二产程时间短于对照组,产后2 h出血量少于对照组(P<0.01);剖宫产率低于对照组(P<0.05),新生儿Appar评分高于对照组(P<0.01)。结论积极心理暗示联合导乐分娩有助于缓解初产妇心理应激反应,促进分娩自我效能感的养成,对于缩短产程时间、减少出血量、改善分娩结局,有积极的应用价值。

Objective To explore the effect of positive psychological suggestion combined doula delivery on psychological stress response and delivery efficacy of primipara.Methods From July 2018 to June 2019,168 primiparas were admitted to the Affiliated Huai’an No.1 People’s Hospital of Nanjing Medical University.The patients were divided into the experimental group(January 2019 to June 2019)and the control group(July 2018 to December 2018),with 86 patients in the experimental group and 82 patients in the control group.The control group was given routine nursing and doula delivery companion,and the experimental group was combined with positive psychological suggestion and doula accompaniment.Psychological stress response,labor self-efficacy,labor process,postoperative bleeding 2 h,delivery mode and delivery outcome were compared between the two groups.Results After intervention,the self-rating anxiety scale(SAS)and self-rating depression scale(SDS)in the two groups were lower than those before intervention,and the scores of SAS and SDS in the experimental group were lower than those in the control group(P<0.01).After intervention,the self-efficacy scores of the two groups were higher than those of the same group before intervention,and the results of the experimental group were higher than those of the control group in terms of efficacy,expected efficacy and total score of self-efficacy(P<0.01).The duration of labor in experimental group 1 and 2 were shorter than that in control group,and the amount of bleeding 2 h after delivery was less than that in control group(P<0.01);cesarean section rate was lower than that of the control group(P<0.05),and Appar score of newborns was higher than that of the control group(P<0.01).Conclusion Positive psychological suggestion combined with doula is helpful to relieve the psychological stress response of first-time mothers and promote the development of self-efficacy in childbirth.It has positive application value in shortening the labor process,reducing the amount of bleeding and improving the outcome of childbirth.