闭环式个体化健康教育结合系统化正念训练对高危孕妇妊娠结局的影响

Effect of closed-loop individualized health education combined with systematic mindfulness training on pregnancy outcome of high-risk pregnant women

目的探讨闭环式个体化健康教育结合系统化正念训练对高危孕妇妊娠结局的影响。方法选择2019年1月—2021年6月绍兴第二医院医共体总院收治的高危孕妇120例,按照随机数字表法分为对照组与观察组,每组各60例。对照组孕妇给予常规健康教育与心理干预,观察组孕妇在此基础上给予闭环式个体化健康教育结合系统化正念训练,干预前后采用SCL-90症状自评量表评定两组孕妇心理症状情况,干预后采用该院自制健康教育知识与技能掌握度量表评定健康知识与技能掌握情况,采用巨大儿、产后出血、早产、新生儿窒息与产褥感染的发生率评定妊娠结局情况。结果干预前,两组孕妇SCL-90症状自评量表敌对、焦虑。精神病性、恐怖、偏执、强迫、饮食睡眠、躯体化、人际关系敏感及抑郁评分比较,差异均无统计学意义(均P>0.05)。干预后,观察组SCL-90症状自评量表中敌对、焦虑、强迫、饮食睡眠、人际关系敏感、抑郁因子评分较干预前下降,差异有统计学意义(均P<0.05),其中焦虑、强迫、饮食睡眠、抑郁因子评分较对照组干预后下降显著,差异有统计学意义(均P<0.05)。干预后,观察组孕妇健康教育知识与技能掌握度(91.67%)高于对照组(70.00%),差异有统计学意义(χ^(2)=-2.507,P<0.05)。干预后,观察组产后出血、新生儿窒息、早产、产褥感染及巨大儿发生率(5.00%、3.33%、6.67%、6.67%及3.33%)均低于对照组(18.33%、16.67%、21.67%、23.33%及15.00%),差异均有统计学意义(χ^(2)=5.175、5.926、7.802、6.536及5.179,均P<0.05)。结论闭环式个体化健康教育结合正念训练用于高危孕妇孕期保健中,能提高孕妇对情绪管理能力,培育孕妇的健康素养,改善不良妊娠结局,保障母婴安全。

Objective To explore the effect of closed-loop individualized health education combined with systematic mindfulness training on pregnancy outcome of high-risk pregnant women.Methods From January 2019 to June 2021,120 high-risk pregnant women treated in General Hospital of Medical Community of the Second Hospital of Shaoxing were selected and divided into control group and observation group according to random number table,60 cases in each group.The pregnant women in control group were given routine health education and psychological intervention;the pregnant women in observation group were given closed-loop individualized health education combined with systematic mindfulness training based on routine health education and psychological intervention.Before and after intervention,self-rating symptom scale(SCL-90)was used to evaluate psychological symptoms.After intervention,a self-designed health education knowledge and skill mastery scale was used to evaluate health education and skill mastery.The incidence rates of macrosomia,postpartum hemorrhage,premature delivery,neonatal asphyxia,and puerperal infection were calculated to evaluate pregnancy outcomes.Results Before intervention,there was no statistically significant difference in SCL-90(hostility,anxiety,psychotic symptom,horror,paranoid,obsession,diet and sleep,somatization,and interpersonal sensitivity)scores and depression score between the two groups(P>0.05).After intervention,the scores of hostility,anxiety,obsession,diet and sleep,interpersonal sensitivity,and depression of Symptom Checklist 90(SCL-90)in observation group were statistically significantly lower than those before intervention(P<0.05),the scores of anxiety,obsession,diet and sleep,and depression were statistically significantly lower than those after intervention in control group(P<0.05).After intervention,the mastery rate of health education knowledge and skill in observation group(91.67%)was statistically significantly higher than that in control group(70.00%)(χ^(2)=-2.507,P<0.05).After intervention,the incidence rates of postpartum hemorrhage,neonatal asphyxia,premature delivery,puerperal infection,and macrosomia in observation group(5.00%,3.33%,6.67%,6.67%,and 3.33%)were statistically significantly lower than those in control group(18.33%,16.67%,21.67%,23.33%,and 15.00%)(χ^(2)=5.175,5.926,7.802,6.536,and 5.179,P<0.05).Conclusion Closed-loop individualized health education combined with systematic mindfulness training used in health care of high-risk pregnant women can improve the ability to manage emotions,cultivate health literacy,improve adverse pregnancy outcome,and ensure maternal and infantile safety.