82例孕产妇对新型冠状病毒肺炎疫情防控认知的心理干预及常态化疫情防控应对要点

Psychological intervention on cognition of pregnant women on epidemic prevention and control during the period of corona virus disease 2019 and the key points of normalizing countermeasures

目的了解新型冠状病毒肺炎(COVID-19)疫情下孕产妇对疫情防控的认知及心理状况,并针对现状探讨干预要点。方法2020年2月19日至2020年3月6日,通过微信对于首都医科大学附属北京地坛医院妇产科建档产检孕产妇进行COVID-19防控认知及心理状况问卷调查。产检时采用现场宣教方式结合微信推送疫情防控材料及心理疏导,1周后再进行第2次问卷调查,对比分析干预前后疫情防控的认知、疫情期间产检的认知、干预前后心理变化的特点。于2022年12月20日对该人群行第3次心理变化问卷调查,对比随时间推移孕产妇心理变化特点。结果共收集82位孕产妇的调查问卷246份,结果提示入组孕产妇均关注COVID-19进展,对疫情防控有一定认知,但部分孕产妇对防护用品选择(7.31%、6/82)和出行方式选择(4.88%、4/82)认知不够准确。几乎所有调查对象(98.78%、81/82)对产检的安全性存在担忧,部分人打算延期产检(35.37%、29/82)以期降低潜在感染风险。通过产检现场和线上方式宣教后计划延期产检的比例显著降低(17.07%、14/82:χ^(2)=7.092、P=0.008)。调查对象宣教前对必要产检项目有较高认知比例(85.37%、70/82),宣教后此比例升高至100%(Fisher’s确切概率法:P<0.001)。部分孕妇(74.39%、61/82)知晓居家自我监测胎儿方法,宣教后此比例亦升高至100%(Fisher’s确切概率法:P<0.001)。疫情导致绝大多数(96.34%、79/82)孕产妇产生不同程度的心理影响,对其进行心理疏导干预后心理负担有所缓解(Fisher’s确切概率法:P<0.001),焦虑和抑郁程度有所减轻(Fisher’s确切概率法:P<0.001、P=0.0006)。第3次随访显示入组孕产妇均无焦虑、抑郁等负面认知。结论心理干预措施对孕产妇疫情防控认知和心理建设起到正向激励作用。

Objective To investigate the cognition and psychological status of pregnant women on the prevention and control of corona virus disease 2019(COVID-19),and to explore the key intervention points.Methods From February 19th,2020 to March 6th,2020,a questionnaire about COVID-19 prevention and control cognition and psychological status of pregnant women in Department of Gynaecology and Obstetrics,Beijing Ditan Hospital,Capital Medical University was conducted through WeChat.During the prenatal examination,on-site education and WeChat promotion of epidemic prevention and control and psychological counseling were conducted.The second questionnaire survey was conducted one week later,and a comparative analysis was conducted on the cognition of epidemic prevention and control before and after intervention,the cognition of prenatal examination during the epidemic,and the characteristics of psychological changes before and after intervention.On December 20th,2022,the third psychological questionnaire survey was conducted to analyze the psychological changes of these postpartum women.Results Total of 246 survey questionnaires from 82 pregnant women were collected,indicating that all enrolled pregnant women were concerned about the progress of COVID-19 and had a certain level of understanding of epidemic prevention and control.However,some pregnant women did not have accurate understanding of protective equipment selection(7.31%,6/82)and travel mode selection(4.88%,4/82).Most pregnant women(98.78%,81/82)were worried about the safety of prenatal examination,and some planned to postpone the prenatal examination(35.37%,29/82)in order to reduce the potential infection risk.The proportion of planned delayed production inspections significantly decreased after on-site and online education through production inspections(17.07%,14/82;χ^(2)=7.092,P=0.008).The survey subjects had a high proportion of awareness on necessary prenatal examination items before education(85.37%,70/82),and this proportion increased to 100%(Fisher’s exact probability test:P<0.001)after education.Some pregnant women(74.39%,61/82)were aware of home based self-monitoring fetal methods,and this proportion also increased to 100%through education(Fisher’s exact probability test:P<0.001).The epidemic has caused a psychological burden on the vast majority of pregnant women(96.34%,79/82),and after psychological counseling intervention,the psychological burden has been alleviated(Fisher’s exact probability test:P<0.001).The anxiety and depression scale indicated that 20(24.39%)pregnant women had anxiety before or after intervention,and 5(6.09%)pregnant women had depression.After psychological counseling,the levels of anxiety and depression were alleviated(Fisher’s exact probability test:P<0.001,P=0.0006).The third follow-up showed that all the enrolled pregnant women had no negative cognition such as anxiety and depression.Conclusions Intervention measures have a positive motivating effect on the awareness and psychological construction of epidemic prevention and control for pregnant and postpartum women.