问题解决护理模式对高危妊娠产妇身心状态和应对方式的影响

Effect of problem-solving nursing on physical and mental state and coping style of high-risk pregnant women

目的探讨问题解决护理模式对高危妊娠产妇身心状态和应对方式的影响,以期为高危妊娠产妇的临床护理提供参考。方法选取2021年4月—2022年5月于安徽省阜阳市人民医院分娩的86例高危妊娠产妇,采用随机数字表法分为对照组和观察组,每组43例。对照组产妇给予常规护理干预,观察组产妇采用问题解决护理模式进行干预,比较2组产妇心理状况、应对方式及不良妊娠结局发生情况、护理满意度等指标。结果干预前,2组产妇焦虑自评量表(SAS)及抑郁自评量表(SDS)评分比较,差异均无统计学意义(P>0.05);干预后,2组产妇SAS及SDS评分均低于干预前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。干预前,2组产妇简易应对方式量表(SCSQ)的积极应对及消极应对维度评分比较,差异均无统计学意义(P>0.05);干预后,2组产妇SCSQ量表的积极应对维度评分高于干预前,且观察组高于对照组,消极应对维度评分低于干预前,且观察组低于对照组,差异均有统计学意义(P<0.05)。观察组产妇的剖宫产率为13.95%(6/43),低于对照组的32.56%(14/43),差异有统计学意义(χ^(2)=4.170,P=0.041);观察组产妇的不良妊娠结局发生率为2.33%(1/43),低于对照组的25.58%(11/43),差异有统计学意义(χ^(2)=9.685,P=0.002)。观察组产妇的护理满意度为97.67%(42/43),高于对照组的83.72%(36/43),但差异无统计学意义(χ^(2)=3.446,P=0.063)。结论问题解决护理模式应用于高危妊娠产妇护理中,可有效缓解产妇的不良情绪,改善产妇身心状态,帮助产妇培养积极的应对方式,降低不良妊娠结局的发生风险,提高产妇的护理满意度。

Objective This paper aims to explore the effect of the problem-solving nursing model on the physical and mental state and coping style of high-risk pregnant women to provide evidence for clinical nursing of these parturients.Methods Eighty-six high-risk pregnant women who delivered in Fuyang People's Hospital from April 2021 to May 2022 were randomly assigned to the control group(n=43)and observation group(n=43).The parturients in the control group received routine nursing intervention;the parturients in the observation group,the problem-solving nursing model for intervention.The psychological status,coping style,occurrence of adverse pregnancy outcomes,degree of satisfaction with nursing,and other indicators of the parturients in the two groups were compared.Results Before intervention,there was no significant difference in the scores of the Self-Rating Anxiety(SAS)and Self-Rating Depression(SDS)scales between the groups(P>0.05).After intervention,the scores of SAS and SDS in the two groups were significantly decreased,and the observation group was significantly lower than the control group(P<0.05).Before intervention,there was no significant difference in the positive and negative coping subscale scores of the Simplified Coping Style Questionnaire(SCSQ)between the groups(P>0.05).After intervention,the positive coping subscale scores of SCSQ between the groups were increased and were higher in the observation group than in the control group;the negative coping subscale scores were decreased and were lower in the observation group than in the control group,all with statistical significance(P<0.05).The cesarean section rate of parturients in the observation group was significantly lower than that in the control group[13.95%(6/43)vs.32.56%(14/43);χ^(2)=4.170,P=0.041].The incidence rate of adverse pregnancy outcomes of parturients in the observation group was significantly lower than that in the control group[2.33%(1/43)vs.25.58%(11/43);χ^(2)=9.685,P=0.002].The degree of satisfaction with nursing in the observation group was higher than that in the control group,but without statistical significance[97.67%(42/43)vs.83.72%(36/43);χ^(2)=3.446,P=0.063].Conclusion The application of problem-solving nursing in the nursing of high-risk pregnant women can effectively alleviate adverse emotions,improve the physical and mental state of parturients,help them establish a positive coping style,reduce the risk of adverse pregnancy outcomes,and raise the degree of satisfaction with nursing.