产-儿科合作连续性护理对NICU早产儿母亲焦虑、抑郁及育儿胜任感的影响

Effect of continuous obstetric-pediatric cooperative nursing on anxiety, depression and the parenting sense of competence in NICU premature mothers

目的探讨产—儿科合作连续性护理对NICU早产儿母亲焦虑、抑郁及育儿胜任感的影响。方法选取2018年1月至2019年12月NICU早产儿的母亲140名作为研究对象,采用随机数字表法将受试者分为对照组和干预组,每组各70例。对照组采用常规护理模式,干预组在常规护理基础上,采用产—儿科合作连续性护理。比较两组住院早产儿母亲的焦虑、抑郁水平、育儿效能感评分、早产儿住院天数、早产儿出院1个月内门诊就诊率及再次入院率。结果干预组住院早产儿母亲在早产儿住院期间、早产儿出院1周、出院1个月的产后焦虑、抑郁水平分别是(43.17±6.89)和(8.96±2.67)、(34.65±6.87)和(7.65±1.92)、(34.97±6.06)和(6.29±1.54)分,均低于对照组的(47.03±8.06)和(10.97±3.34)、(45.44±7.72)和(9.43±2.61)、(41.46±7.26)和(8.28±2.23)分,差异有统计学意义(t值为2.331~6.097,P<0.05),干预组早产儿母亲育儿胜任感评分中育儿效能感和育儿满足感两个维度得分为(31.47±4.97)、(43.38±4.21)分,均高于对照组的(25.91±5.42)、(39.43±5.91)分,差异有统计学意义(t值为-6.314、-4.528,P<0.001);干预组早产儿住院天数、早产儿出院1个月内门诊就诊率和再次入院率分别为(13.25±3.27)d、8.57%(6/70)、2.86%(2/70),均低于对照组的(15.59±2.79)d、24.29%(17/70)、12.86%(9/70),差异有统计学意义(t值为2.909,χ^(2)值为6.295、4.834,P<0.05)。重复测量方差分析数据结果显示交互效应、时间效应和组间效应均差异有统计学意义(F值为4.921~99.310,P<0.01)。结论产—儿科合作连续性护理有利于减轻早产儿母亲焦虑和抑郁水平,提高早产儿母亲育儿胜任感,减少早产儿住院天数、降低门诊就诊率和再次入院率,有利于早产儿母亲心理健康和早产儿康复。

Objective To explore the effect of continuous obstetric-pediatric cooperative nursing on anxiety,depression and the parenting sense of competence in NICU premature mothers.Methods Totally 140 mothers of NICU preterm infants in hospital from January 2018 to December 2018 were selected and randomly divided into the control group and intervention group according to the method of random number table,and each group 70 cases.The control group received the routine nursing mode in obstetrics and paediatrics and the intervention group received the continuous obstetric-pediatric cooperative nursing based on routine nursing.To compare the anxiety level,depression level,the score of parenting sense of competence,hospitalization days of preterm infants,the outpatient rate and the readmission rate of preterm infants within 1 months of discharge between two groups.Results The levels of anxiety and depression of the mothers of premature infants in the intervention group during hospitalization,1 week after discharge and 1 month after discharge were(43.17±6.89),(8.96±2.67),(34.65±6.87),(7.65±1.92),(34.97±6.06),(6.29±1.54)points,lower than control group(47.03±8.06),(10.97±3.34),(45.44±7.72),(9.43±2.61),(41.46±7.26),(8.28±2.23)points,the differences between the two groups showed statistical significance(t value was 2.331-6.097,P<0.05).The two dimensions of parenting efficacy and parenting satisfaction were(31.47±4.97),(43.38±4.21)points,which were higher than(25.91±5.42),(39.43±5.91)points of the control group,there were significant statistical differences among the two groups(t value was-6.314 and-4.528,P<0.01).The hospitalization days of premature infants,outpatient and readmission rate within 1 month of discharge were(13.25±3.27)days,8.57%(6/70),2.86%(2/70),which were shorter or lower than(15.59±2.79)days,24.29%(17/70),12.86%(9/70)in the control group,the differences were statistically significant(t value was 2.909,χ^(2) values were 6.295,4.834,P<0.05).There were significant statistical differences among interaction effect,time effect and intergroup effect(F values were 4.921-99.310,P<0.05).Conclusion Obstetrical-pediatric cooperative nursing can effectively to lower the anxiety and depression level of preterm mothers,improve the parental competence,promote the mental health of preterm mothers,and ultimately shorten hospital days and decrease the rate of outpatient and readmission of premature infants,which is conducive to preterm infants′rehabilitation.