基于健康信念模式的集束化护理对择期剖宫产产妇泌乳的影响

Effect of cluster nursing based on health belief model on lactation of parturients undergoing elective cesarean section

目的探讨择期剖宫产产妇实施基于健康信念模式的集束化护理干预后对泌乳的影响。方法选取2019年6月至2020年12月在桂林医学院附属医院产科住院、行剖宫产手术的孕妇232例为研究对象,使用随机数字表法分为接受基于健康信念模式的集束化护理干预的干预组(n=117)以及接受常规护理干预的对照组(n=115)。对所有产妇干预前后对母乳喂养的应对方式评分、干预后泌乳启动时间、产后泌乳量和0~6个月纯母乳喂养率进行统计。结果干预后两组产妇面对、乐观、情感宣泄、依靠自我评分明显升高,且干预组高于对照组,而逃避、宿命、姑息、寻求支持评分降低,且干预组低于对照组,差异有统计学意义(P<0.05)。干预组产妇平均泌乳启动时间少于对照组,产后泌乳量充足者的比例高于对照组,产后泌乳量不足的比例低于对照组,差异有统计学意义(P<0.05)。随访结果显示干预组产妇0~6个月纯母乳喂养率为32.48%,高于对照组的17.39%,差异有统计学意义(P<0.05)。结论基于健康信念模式的集束化护理,能够改变择期剖宫产产妇对母乳喂养的应对方式,改善产后泌乳情况,提高0~6个月纯母乳喂养率。

Objective To explore the influence of cluster nursing intervention based on the health belief model(HBM)on lactation of parturients undergoing elective cesarean section.Methods A total of 232 parturients who were hospitalized in the Obstetrics Department of the Affiliated Hospital of Guilin Medical University and underwent cesarean section from June 2019 to December 2020 were randomly divided into the intervention group(117 cases)that received cluster nursing intervention based on HBM and the control group(115 cases)that received routine nursing intervention.All parturients were scored on the breastfeeding coping style before and after the intervention,and the starting time of lactation,postpartum lactation amount and 0 to 6 months exclusive breastfeeding rate after the intervention were counted.Results The scores of confrontation,optimism,emotional catharsis and self-reliance significantly increased after the intervention,and these scores in the intervention group were higher than those in the control group.The scores of evasion,fatalism,appeasement and support-seeking decreased after the intervention,and these scores in the intervention group were lower than those in the control group,with statistically significant differences(P<0.05).The average starting time of lactation in the intervention group was shorter than that in the control group,the proportion of parturients with adequate postpartum lactation in the intervention group was higher than that in the control group,and the proportion of parturients with inadequate postpartum lactation in the intervention group was lower than that in the control group,with statistically significant difference(P<0.05).The follow-up showed that the 0 to 6 months exclusive breastfeeding rate was 32.48%in the intervention group,which was higher than 17.39%in the control group,with statistically significant difference(P<0.05).Conclusion Cluster nursing based on HBM can change the coping style of parturients who have elective cesarean sections to breastfeeding, improve postpartum lactation and increase the 0 to 6 months exclusive breastfeeding rate.