团体心理辅导结合健康宣教对初产妇角色适应、主观幸福感和分娩方式的影响

Effects of group psychological counseling with health education on role adaptation, subjective well-being and delivery mode of primipara

目的:探究团体心理辅导结合健康宣教对初产妇角色适应、主观幸福感和分娩方式的影响。方法:将2017年10月-2018年10月入住我院产科分娩的80例初产妇随机分为观察组与对照组,各40例。对照组给予产科常规干预及健康宣教,观察组在对照组基础上给予团体心理辅导结合健康宣教。比较两组初产妇干预前后的焦虑自评量表(SAS)、抑郁自评量表(SDS)及主观幸福感量表(SWBS-CC)评分,并分析对比两组初产妇角色适应情况、分娩方式及初产妇妊娠结局与新生儿结局。结果:干预后观察组SAS、SDS评分均显著低于对照组,差异具统计学意义(t=-4.267,-6.491;P<0.05);观察组初产妇角色适应情况显著好于对照组,差异具统计学意义(Z=4.740,P<0.05);干预后观察组各维度SWBS-CC评分均显著高于对照组,差异具统计学意义(t=5.978,2.670,3.440,5.265,3.372,2.466,2.615,2.503,3.058,3.543;P<0.05);观察组阴道分娩率显著高于对照组,剖宫产率显著低于对照组,差异具统计学意义(χ~2=5.698,4.501;P<0.05);观察组初产妇早产、胎膜早破、宫内窘迫、会阴撕裂、产后大出血等不良妊娠结局发生率显著低于对照组,低出生体重儿、胎儿宫内生长受限、新生儿窒息等新生儿不良结局发生率显著低于对照组,差异具统计学意义(χ~2=5.165,4.114,3.914,4.114,5.165,6.275;P<0.05)。结论:团体心理辅导结合健康宣教有助于促进初产妇心理健康,缓解其焦虑、抑郁情绪,更好地向母亲这一角色转换,提高初产妇主观幸福感与阴道分娩率,降低初产妇不良妊娠结局及新生儿不良结局发生率。

Objective:To explore the effects of group psychological counseling with health education on role adaptation,subjective well-being and delivery mode of primipara.Methods:A toal of 80 primipara admitted to the obstetrics department of the hospital from October 2017 to October 2018 were randomly divided into observation group and control group,40 cases in each group.The control group was given routine obstetric nursing and health education.The observation group was given group psychological counseling combined with health education on the basis of the control group.The scores of self-rating anxiety scale(SAS),self-rating depression scale(SDS)and Subjective Well-being Scale for Chinese Citizens(SWBS-CC)of the two groups before and after intervention were compared.The role adaptation,delivery mode of primipara,pregnancy outcomes and neonatal outcomes of the two groups were compared and analyzed.Results:After treatment,the scores of SAS and SDS in the observation group were significantly lower than those in the control group(t=-4.267,-6.491;P<0.05).The role adaptation of the primipara in the observation group was significantly better than that in the control group(Z=4.740,P<0.05).SWBS-CC scores in all dimensions of the observation group were significantly lower than those of the control group after intervention(t=5.978,2.670,3.440,5.265,3.372,2.466,2.615,2.503,3.058,3.543;P<0.05).The vaginal delivery rate of the observation group was significantly higher than that of the control group,while the cesarean section rate was significantly lower than that of the control group(χ~2=5.698,4.501;P<0.05).The incidence rates of adverse pregnancy outcomes such as premature delivery,premature rupture of membranes,intrauterine distress,laceration of perineum and postpartum hemorrhage in the observation group were significantly lower than those in the control group,and the incidence rates of adverse neonatal outcomes such as low weight infants,intrauterine growth restriction and neonatal asphyxia were significantly lower than those in the control group(χ~2=5.165,4.114,3.914,4.114,5.165,6.275;P<0.05).Conclusion:Group psychological counseling with health education can promote the mental health of primipara,relieve anxiety and depression,make better converting to the role of mother,can improve the subjective well-being and vaginal delivery rate of primipara,and reduce the incidence of adverse pregnancy outcome of primipara and adverse neonatal outcomes.