妊娠晚期孕妇症状群及其影响因素研究

Symptoms clusters and their influencing factors in pregnant women in the third trimester

目的探讨妊娠晚期孕妇症状群组成,分析其影响因素,为妊娠晚期孕妇的症状管理提供参考。方法采用记忆症状量表对223例妊娠晚期孕妇进行问卷调查,采用探索性因子分析探索症状群,通过多元线性回归分析探讨症状群的影响因素。结果妊娠晚期孕妇发生频率最高的5个症状分别为夜尿增多(93.7%)、睡眠不好(66.4%)、腿部抽搐(64.1%)、气促或呼吸困难(58.7%)、出汗(56.1%)。探索性因子分析得出4个症状群,分别为身体形象障碍症状群、活动无耐力症状群、肠道相关症状群和睡眠相关症状群。年龄、孕周、孕前BMI、妊娠前运动情况是症状群发生的预测因子(P<0.05,P<0.01)。结论妊娠晚期孕妇会经历不同严重程度的症状,症状之间相互影响,以症状群的形式存在。临床医护人员需全面评估妊娠晚期孕妇的不适症状,开展以症状群为干预单位的妊娠晚期症状管理。

Objective To explore the constituents of symptom clusters,and identify the influencing factors in pregnant women in the third trimester,and to provide references for symptom management in late gestation.Methods A total of 223 pregnant women in the third trimester were enrolled and asked to fill the Memorial Symptom Assessment Scale.Exploratory factor analysis was applied to identify symptom clusters,and multiple linear regression analysis was used to determine the factors affecting symptom clusters.Results The five most common symptoms in pregnant women in the third trimester were nocturnal urination(93.7%),difficulty sleeping(66.4%),leg cramp(64.1%),shortness of breath(58.7%)and sweats(56.1%).Four symptom clusters were identified,including body image disorder symptom cluster,activity intolerance symptom cluster,intestinal related symptom cluster,and sleep related symptom cluster.Age,gestational weeks,BMI and physical exercise level before pregnancy were predictive factors for the occurrence of symptom clusters(P<0.05,P<0.01).Conclusion Pregnant women in the third trimester expe-rience many symptoms,which act in concert with each other and appear in the form of symptom clusters.It is suggested that health care professionals should comprehensively assess the discomfort symptoms of pregnant women in the third trimester,and provide symptom-cluster-based symptom management in late gestation.