新冠疫情背景下助产士门诊线上线下连续性服务模式实践探讨

Discussion on the practice of online and offline continuous service model of midwife outpatient clinic during COVID-19 outbreak

目的探讨在新冠疫情背景下助产士门诊线上线下连续性服务模式的临床实践效果。方法纳入在某三级甲等医院产检并分娩的孕产妇作为研究对象,共纳入524人,实验组230人,对照组294人。实验组采用线上免费教育课程和线下一对一助产士门诊服务相结合的健康管理模式。对照组孕妇采用常规产检和健康教育模式。结果实验组产妇阴道分娩中转剖宫产率比观察组低,差异有统计学意义(8.7%vs 14.3%,F=8.87,P=0.049)。实验组产妇的第一产程时间和第二产程时间均短于对照组的第一产程和第二产程[(403.50±263.76)min vs(464.43±328.35)min,(43.85±41.30)min vs(53.25±47.92)min],差异有统计学意义(P<0.05)。实验组产妇的会阴侧切率较对照组低,差异有统计学意义(P<0.05),且实验组的产妇分娩满意度比对照组的产妇高[(7.10±1.42)vs(6.59±1.59),F=9.91,P=0.003]。结论疫情背景下助产士门诊线上线下连续性服务模式实现了对孕妇个性化、连续性的服务,有利于孕期健康管理、改善分娩结局;人性化的服务也有利于增进产妇对助产士的依赖和信任,优化分娩体验,是可持续发展的服务模式。

Objective To explore the clinical practice effect of the continuous online and offline service model of midwives outpatient clinics during COVID-19 outbreak.MethodsA total of 524 pregnant women who had undergone obstetric examination and gave birth in a tertiary first-class hospital were included as the research objects,including 230 in the experimental group and 294 in the control group.The experimental group adopted a health management model combining free online education courses and offline one-to-one midwife outpatient services.Pregnant women in the control group were given routine obstetric examination and health education.ResultsCompared with the observation group,the rate of cesarean delivery during vaginal delivery in the experimental group was lower,and the difference was statistically significant(14.3%vs 8.7%,F=8.87,P=0.049).The time of the first stage of labor and the time of the second stage of labor in the experimental group were shorter than those in the control group,and the difference was statistically significant[(403.50±263.76)min vs(464.43±328.35)min,(43.85±41.30)min vs(53.25±47.92)min].The episiotomy rate of the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05),and the delivery satisfaction of the experimental group was higher than that of the control group[(7.10±1.42)vs(6.59±1.59),F=9.91,P=0.003].Conclusions The continuous online and offline service model of midwife clinics has realized personalized and continuous services for pregnant women during COVID 19 outbreak,which is conducive to health management during pregnancy and improving delivery outcomes;humanized services are also conducive to increasing maternal reliance and trust in midwives,optimizing the delivery experience,and is a sustainable service model.