健康产妇分娩计划书的构建

Construction of birth-giving plan for healthy parturients

目的构建健康产妇分娩计划书,为临床产科开展人性化分娩服务提供切实可行的工具。方法通过文献回顾、小组讨论方法构建健康产妇分娩计划书的具体内容条目,选择15名专家进行两轮专家函询及开展预试验对内容修改、完善,最终确立健康产妇分娩计划书。结果本研究两轮德尔菲法中专家积极系数均为100.00%,两轮问卷回收率均为100.00%;两轮专家的权威程度(Cr)均为0.92,第一轮、第二轮专家函询中各条目的变异系数分别为0.07~0.55、0~0.26,一级指标肯德尔系数(Kendall's W)分别为0.350、0.382,非参检验均P<0.05;第一轮、第二轮函询各条目重要性赋值均数及标准差分别为2.27~4.87、0.40~1.42与3.43~5.00、0~1.00。最终形成包含分娩环境、分娩陪伴、待产运动、分娩体位、分娩饮食、医疗措施、分娩镇痛与母婴关系8个分娩主题,29项分娩需求以及81条具体服务措施的健康产妇分娩计划书。结论本研究构建的健康产妇分娩计划书经统计分析结果可信,专家的积极程度、权威程度、协调程度与集中程度均较高,可为临床规范化开展分娩计划书服务提供参考。

Objective To make a birth-giving plan for healthy parturient and provide a practical instrument for clinical obstetrics to carry out humanized nursing service.Methods Based on WHO improving birth-giving experience by intrapartum management,the specific contents of the birth-giving plan for healthy pregnant women were constructed through literature review and group discussion.Expert consultations on the plan were done for two rounds among a group of 15 experts using Delphi method to determine the specific content items of the initial draft,which was finalized as the plan after improvement on the items based on the preliminary test results.Results For the two rounds of consultations with Delphi method,the positive coefficients of experts were 100%,the effective recovery rates of questionnaire were 100%,the authority degree of experts was 0.92,the variation coefficient of each item in the first and second rounds of expert consultation was 0.07-0.55,0.00-0.26,respectively.Kendall's W of the first level index was 0.350 and 0.832,respectively,with the nonparametric test P<0.05 for both two rounds and the Kendall's W in the second round was greater than that in the first round.The mean and standard deviation of the importance assignment of each item in the first round of correspondence were 2.27-4.87 and 0.40-1.42,respectively,and those of the second round 3.43-5.00 and 0.00-1.00,respectively.After the contents and the form of indicators were adjusted and improved based on the results of pre-test,the plan was determined,including 8 birth-giving themes(first-class indicators)of birth-giving environment,birth-giving accompany,in-labor exercises,birth-giving position,birth-giving diet,medical measures,birth-giving analgesia and mother-infant relationship,29 birth-giving needs and 81 nursing measures.Conclusions The birth plan for healthy pregnant women we constructed in this study are reliable,and the enthusiasm,authority,coordination and concentration of experts are al at high level.Therefore,the plan can provide reference for standardized birth-giving nursing.