赋权激励模式在单胎首次自然分娩孕妇第二产程护理中的应用

The application of empowerment and incentive model in the second stage of labor nursing for the first natural delivery of single fetus

目的探讨赋权激励模式在单胎首次自然分娩孕妇第二产程护理中的应用价值。方法选择2021年2月至2022年1月期间复旦大学附属妇产科医院产科自然分娩的初产妇208例作为观察对象。随机将208例产妇分为对照组和观察组,对照组103例,予以常规心理激励方法干预,观察组105例,在对照组基础上予以赋权激励模式干预,比较两组产妇分娩相关指标(第二产程时间、总产程时间和总住院时间),采用心理应激反应问卷(SRQ)和产妇舒适状况量表(GCQ)比较两组产妇的心理状态和舒适程度,对比两组母婴结局(产后出血量和产后出血例数,新生儿Apgar评分和新生儿窒息例数)。结果观察组产妇第二产程时间、总产程时间和住院时间均较对照组缩短(P<0.05);分娩前,两组产妇SRQ和GCQ各维度评分差异无统计学意义(P>0.05),分娩后,两组产妇SRQ各维度评分均较分娩前降低,GCQ评分较分娩前升高(P<0.05),且观察组产妇SRQ各维度评分均低于对照组,GCQ评分高于对照组(P<0.05);观察组产妇出血量低于对照组,且新生儿Apgar评分高于对照组(P<0.05);观察组母婴不良结局的发生率为0.95%,低于对照组的6.80%,两组差异无统计学意义(P>0.05)。结论赋权激励模式能够缩短单胎首次自然分娩产妇第二产程的时间和住院时间,缓解产妇心理应激反应并提高舒适度,改善母婴结局。

Objective To explore the application value of empowerment and incentive model in second stage of labor nursing for the first time natural delivery of single pregnancy.Methods A total of 208 primiparas who gave birth naturally in the department of obstetrics from February 2021 to January 2022 were selected as the observation objects.They were randomly divided into control group and observation group.The control group(103 cases)received conventional psychological stimulation,and the observation group(105 cases)received empowerment-stimulation intervention.Indicators related to delivery(time of second labor,total labor time and total hospital stay)were compared between the two groups.Stress response questionnaire(SRQ)and general comfort questionnaire(GCQ)were used to compare the psychological state and comfort level of the two groups,and the maternal and infant outcomes(postpartum bleeding volume and number of postpartum bleeding cases,neonatal Apgar score and neonatal asphyxia cases)were compared between the two groups.Results The second labor time,total labor time and hospital stay in observation group were shorter than those in control group(P<0.05).Before delivery,there was no significant difference in SRQ and GCQ scores between the two groups(P>0.05).After delivery,SRQ scores in all dimensions were lower than before delivery,GCQ scores were higher than before delivery(P<0.05),and the maternal SRQ scores in observation group were lower than those in control group,and GCQ scores were higher than those in control group(P<0.05).Maternal blood loss in observation group was lower than that in control group,and neonatal Apgar score was higher than that in control group(P<0.05).The incidence of adverse outcomes in the observation group was 0.95%,which was lower than that of the control group(6.80%),there was no significant difference between the two groups(P>0.05).Conclusions Empowerment and incentive model can shorten the second stage of labor and hospital stay of women who give birth naturally for the first time,alleviate maternal psychological stress response,improve comfort level,and improve maternal and infant outcomes.