问题解决疗法对初产妇母乳喂养自我效能和心理状态的影响

Effects of problem-solving therapy on breastfeeding self-efficacy and psychological status among primiparas

目的探讨问题解决疗法对初产妇母乳喂养自我效能和心理状态的影响,旨在为提高初产妇母乳喂养提供依据。方法选择2018年2月至2019年2月在广州市妇女儿童医疗中心产科分娩的102例初产妇作为研究对象。将102例初产妇按照随机数字表法分为试验组和对照组,每组51例。最终试验组47例,对照组49例完成研究。对照组给予常规干预,试验组在常规护理基础上实施问题解决疗法。干预前和干预6周后,采用母乳喂养自我效能量表(BSES)、爱丁堡产后抑郁量表(EPDS)、总体幸福感量表(GWB)评价干预效果。结果干预后,试验组母乳喂养认知、喂养情感、喂养技能维度得分及BSES总分分别为(21.13±2.97)、(65.47±6.63)、(31.94±2.59)、(118.53±8.47)分,明显高于对照组的(19.43±3.28)、(61.76±5.20)、(30.53±2.01)、(111.71±6.11)分,差异有统计学意义(t值为2.658~4.507,P<0.01)。干预后,试验组EPDS量表得分、GWB量表中对生活的满足和兴趣、忧郁或愉快的心境、精力、焦虑维度得分和总分分别为(6.04±1.49)、(7.51±1.71)、(20.19±2.47)、(21.68±2.32)、(17.06±2.74)、(90.45±4.96)分,明显优于对照组的(6.92±2.08)、(6.41±1.82)、(18.71±2.98)、(20.57±1.87)、(15.78±1.79)、(84.61±5.26)分,差异有统计学意义(t值为2.380~5.587,P<0.05或0.01)。结论问题解决疗法能提高初产妇母乳喂养自我效能,缓解产后抑郁情绪,增强其主观幸福感。

Objective To explore the effects of problem-solving therapy on breastfeeding self-efficacy and psychological status among primiparas,to provide basis for improving the breastfeeding of primipara.Methods A total of 102 primiparas were divided into experimental group and control group by random number table method,each group contained 51 cases.Finally,47 cases in the experimental group and 49 cases in the control group completed the study.The control group received routine nursing,while primiparas in the experimental group carried out problem-solving therapy.Before and after 6-week intervention,the effects was assessed by Breastfeeding Self-Efficacy Scale(BSES),Edinburgh Postnatal Depression Scale(EPDS)and General Well-being Schedule(GWB),respectively.Results After intervention,the scores of primapara feedig cognition,feeding feeling,feeding skills and BSES total scores were(21.13±2.97)points,(65.47±6.63)points,(31.94±2.59)points,(118.53±8.47)points in the experimental group,significantly higher than(19.43±3.28)points,(61.76±5.20)points,(30.53±2.01)points,(111.71±6.11)points in the control group(t values were 2.658-4.507,P<0.01);the scores of EPDS were(6.04±1.49)points in the experimental group,significantly lower than(6.92±2.08)points in the control group;the scores of life satisfaction and interest,depression and pleasure,energy,relaxation and tension in General Well-Being(GWB)and total scores were(7.51±1.71)points,(20.19±2.47)points,(21.68±2.32)points,(17.06±2.74)points,(90.45±4.96)points in the experimental group,significanlty higher than(6.41±1.82)points,(18.71±2.98)points,(20.57±1.87)points,(15.78±1.79)points,(84.61±5.26)points in the control group,the difference was statistically significant(t values were 2.380-5.587,P<0.05 or 0.01).Conclusion Problem-solving therapy can improve breastfeeding self-efficacy and alleviate postnatal depression as well as enhance subjective well-being of primipara women.