以时效性激励理念为中心的延续性干预模式对硬膜外程控间歇脉冲式分娩镇痛产妇疼痛应激及生活质量的影响

Effect of continuous nursing intervention based on timeliness incentive concept on pain stress and quality of life in parturients receiving programmed intermittent epidural bolus for labor analgesia

目的 分析时效性激励理念为中心的延续性干预模式对硬膜外程控间歇脉冲式(PIEB)分娩镇痛产妇疼痛症状、心理状况、分娩结局及生活质量的影响。方法 纳入2021年1月至2022年6月沧州市人民医院行PIEB分娩镇痛的初产妇共100例为研究对象,按照数字表法分为观察组与对照组,每组50例。对照组实施常规PIEB镇痛及围产期护理,观察组在常规护理基础上建立以时效性激励理念为中心的延续性干预模式。对比不同护理方案下初产妇分娩疼痛症状、心理状况、分娩结局及生活质量差异。结果 观察组产妇第一产程与第二产程时间短于对照组(P<0.05),2组新生儿不良结局率差异无统计学意义(P>0.05);在产程潜伏期观察组产妇疼痛程度评分低于对照组(P<0.05);在不同时间节点2组产妇的焦虑与抑郁得分差异有统计学意义,PIEB前较入院6 h内高,产后3个月较出院时高,分娩结束后2 h及出院时较PIEB介入前低,产后6个月较产后3个月低(P<0.05),且观察组焦虑与抑郁得分在各个时间节点均低于对照组(P<0.05);2组产妇在不同时间节点幸福感差异有统计学意义,入院6 h内较产后2 h、产后3个月得分高,产后6个月较产后2 h、产后3个月得分更高,且观察组在各个时间节点得分均高于对照组(P<0.05)。结论 以时效性激励理念为中心的延续性干预模式能够缩短PIEB干预产妇的产程时间,减轻分娩疼痛症状,并能够改善产妇围产期及产后6个月的焦虑、抑郁症状,提高产妇幸福感。

Objective To analyze the effect of continuous nursing intervention based on timeliness incentive concept on pain symptoms,psychological status,delivery outcome and quality of life in parturients receiving programmed intermittent epidural bolus(PIEB)for labor analgesia.Methods One hundred primiparae who received PIEB for labor analgesia in Cangzhou People's Hospital from January 2021 to June 2022 were enrolled,and they were randomly assigned into the observation group(n=50)and the control group(n=50)according to a number table.All primiparae were managed by conventional care,and those in observation group were additionally given continuous nursing intervention based on timeliness incentive concept.The aim was to compare pain symptoms,psychological status,delivery outcome and quality of life.Results The durations of the first and second stage of labor were significantly shorter in the observation group than those of control group(P<0.05).There was no significant difference in the rate of adverse neonatal outcomes between the two groups(P<0.05).The pain score during the labor incubation period was significantly lower in the observation group than that of the control group(P<0.05).There were significant differences in the anxiety and depression scores at different time points between the two groups.The scores before the programmed intermittent epidural bolus(PIEB)were significantly higher than those within 6 hours of admission,which were significantly higher at 3 months of delivery than those at discharge.The anxiety and depression scores at 2 hours of delivery and at discharge were significantly lower than those before PIEB,which,at 6 months of delivery were significantly lower than those at 3 months(P<0.05).The scores of anxiety and depression at all time points were significantly lower in the observation group than those of the control group(P<0.05).There was a significant difference in the well-being score at different time points between groups.The scores within 6 hours of admission were significantly higher than those at 2 hours and 3 months of delivery,which,at 6 months of delivery were significantly higher than those at 2 hours and 3 months of delivery(P<0.05).The well-being scores at all time points were significantly higher in the observation group than those of the control group(P<0.05).Conclusion The continuous nursing intervention based on timeliness incentive concept can shorten the delivery process time in primiparae receiving PIEB,relieve the pain symptoms of delivery,improve the anxiety and depression symptoms during the perinatal period and 6 months after delivery,and improve the happiness of the women.