Nursing model of midwifery and postural and psychological interventions:Impact on maternal and fetal outcomes and negative emotions of primiparas

BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventions are necessary to improve maternal and fetal outcomes and alleviate primiparas’negative emotions(NEs).AIM To discusses the impact of nursing responsibility in midwifery and postural and psychological interventions on maternal and fetal outcomes as well as primiparas’NEs.METHODS As participants,115 primiparas admitted to Quanzhou Maternity and Child Healthcare Hospital between May 2020 and May 2022 were selected.Among them,56 primiparas(control group,Con)were subjected to conventional midwifery and routine nursing.The remaining 59(research group,Res)were subjected to the nursing model of midwifery and postural and psychological interventions.Both groups were comparatively analyzed from the perspectives of delivery mode(cesarean,natural,or forceps-assisted),maternal and fetal outcomes(uterine inertia,postpartum hemorrhage,placental abruption,neonatal pulmonary injury,and neonatal asphyxia),NEs(Hamilton Anxiety/Depressionrating Scale,HAMA/HAMD),labor duration,and nursing satisfaction.RESULTS The Res exhibited a markedly higher natural delivery rate and nursing satisfaction than the Con.Additionally,the Res indicated a lower incidence of adverse events(e.g.,uterine inertia,postpartum hemorrhage,placental abruption,neonatal lung injury,and neonatal asphyxia)and shortened duration of various stages of labor.It also showed statistically lower post-interventional HAMA and HAMD scores than the Con and pre-interventional values.CONCLUSION The nursing model of midwifery and postural and psychological interventions increase the natural delivery rate and reduce the duration of each labor stage.These are also conducive to improving maternal and fetal outcomes and mitigating primiparas’NEs and thus deserve popularity in clinical practice.

Mediating effect of mindfulness level on the relationship between marital quality and postpartum depression among primiparas

BACKGROUND Postpartum depression refers to a depressive episode or depressive symptoms up to 12 mo after delivery.Trait mindfulness has presented a protective factor for postpartum depressive symptoms and proved efficient in improving relationship satisfaction among couples.AIM To investigate the correlations among mindfulness,marital quality,anxiety,and depression in a large city in western China during the post-corona virus infectious disease-2019 era and determine whether trait mindfulness mediates the relationship between marital quality and postpartum anxiety and depression among primiparas.METHODS A cross-sectional study was conducted.The self-administered questionnaire was submitted online through smartphones.The levels of mindfulness,anxiety,depression,and marital quality were respectively investigated by the mindful attention awareness scale(MAAS),the self-rating anxiety scale(SAS),the selfrating depression scale(SDS),and the marriage perception scale(MPS)in these enrolled Han and Tujia primiparas.RESULTS No statistical significance was observed in the prevalence of postpartum anxiety and depression,nor scores of MAAS and MPS-Total in different regions or ethnicities(P>0.05).However,MPSMarital interaction(P<0.05),MPS-Family relationship(MPS-FR)(P<0.01),and MPS-Marital conflict(MPS-MC)(P<0.01)scores of urban primiparas were higher than those of rural primiparas.The MPS-MC score of Han primiparas was higher than that of Tujia primiparas(P<0.05).Negative correlations were observed between MAAS and SAS(r=-0.457,P<0.01),and MAAS and SDS(r=-0.439,P<0.01).SAS has revealed a highly positive correlation with SDS(r=0.720,P<0.01)and a weak negative correlation with MPS(r=-0.200,P<0.05).Besides,a weak negative correlation was observed between MAAS and MPS-MC(r=-0.184,P<0.05),and a weak positive correlation was noticed between SAS and MPS-MC(r=-0.225,P<0.01).Mediation analysis demonstrated a full mediation effect of mindfulness level on the relationship between MPS-FR and postpartum anxiety(P<0.05,95%CI:-0.384 to 0.033),MPS-MC and postpartum anxiety(P<0.01,95%CI:0.027-0.193),MPS-FR and postpartum depression(P<0.05,95%CI:-0.365 to 0.031),and MPS-MC and postpartum depression(P<0.01,95%CI:0.022-0.206).CONCLUSION Mindfulness demonstrates negative correlations with marital conflict,postpartum anxiety and depression,and it may have cross-ethnic and trans-regional characteristics.Although the mindfulness levels have revealed no significant mediating effect between the total score of marital quality and postpartum depression in this study,it demonstrates a full mediation effect on the relationships between family relationships,marital conflict,and postpartum anxiety and depression.

Features and Patterns of Primipara Delivery in a Cameroon Semi-Rural Area: The Case of Ayos Locality

Introduction: The delivery of a primipara, a woman giving birth for the first time, is challenging and may lead to complications and influence the obstetrical future of a woman. Materials and Methods: We carried out a cross-sectional and analytical study at the maternity of the regional hospital annex of Ayos, a semi-rural locality in Cameroon, for the period between January 2012 and December 2020. The objective was to determine the frequency and the determinants of primipara delivery. Results: We recruited 440 cases. The frequency of primipara delivery was 31.8%. The ages of the participants ranged from 12 to 35 years with a mean age of 18.01 ± 3.52 years. Single women contributed to 95.5% of cases while 97.5% were unemployed. The delivery occurred at term in 90.2% and 98.4% of pregnancies were singleton. The delivery was vaginal in 91.6%, while caesarean delivery was done in 8.4% (8% emergency and 0.4% elective). The most frequent maternal complications were genital tract tears (15.7%), post-partum hemorrhage (12.5%) and endometritis (2.7%). The birth weight of newborns ranged from 1070 to 4500 g with a mean of 3024.5 ± 511.4 g. The single marital status, a gestational age between 37 and 42 weeks and a birth weight between 1500 g and 2499 g were significantly associated with vaginal delivery. Conclusion: The frequency of primiparous delivery was relatively high (31.8%) in the Ayos semi-rural health district of Cameroon. Major complications associated with delivery included genital tract tears, post-partum hemorrhage, cesarean section and neo-natal infection.

Morita Therapy Combined with Transcranial Magnetic Stimulation in the Treatment of Postpartum Depression in Primiparas and its Effect on Prolactin

Objective:To explore the treatment of Morita therapy combined with transcranial magnetic stimulation in postpartum depression of primipara and its effect on prolactin.Method:From May 2018 to November 2019,92 cases of postpartum depression and postpartum women who were treated in our hospital were randomly divided into 2 groups,46 cases each.The control group was treated with transcranial magnetic stimulator,and the observation group was treated with Morita therapy on the basis of the control group.Both groups were treated continuously for 6 weeks.The degree of depression and prolactin levels of the two groups was observed.Results:After 6 weeks of treatment,the HAMD scores of the two groups were lower than before the treatment,and the observation group was the lowest.The prolactin levels of the two groups were higher than before the treatment,and the observation group was the highest.The difference was statistically significant(P<0.05).Conclusion:Morita therapy combined with transcranial magnetic stimulation can effectively improve the postpartum depression of primiparas,increase the level of prolactin,and have a good clinical effect.

Intervention Value of Unprotected Midwifery Nursing in Natural Delivery of Primipara

Objective:This paper mainly explores the application value of unprotected midwifery care for primipara natural childbirth.Methods:120 primiparas in our hospital from January 2017 to February 2019 were divided into routine group and Research Group,60 cases in each group.The routine group was given routine perineal protection midwifery,and the Research Group was given routine midwifery nursing.The nursing intervention effects of the two groups were compared statistically.Results:After statistics,VAS score and bleeding volume of perineal pain in the Research Group were lower than those in the conventional group,and the length of hospital stay in the Research Group was less than that in the conventional group,P<0.05;There was no significant difference in the time of the first stage of labor,the second stage of labor and the third stage of labor between the Research Group and the conventional group(P>0.05);The incidence of complications in the Research Group was lower than that in the conventional group(P<0.05).Conclusion:The application value of unprotected midwifery nursing intervention in primipara natural childbirth is significant.

计划行为理论无痛分娩结合接生手法对初产妇分娩出血量、会阴损伤及分娩疼痛的影响

目的:探讨计划行为理论无痛分娩结合接生手法对初产妇分娩出血量、会阴损伤、分娩疼痛的影响。方法:选取2021年8月-2022年7月拟在本院接受无痛分娩的初产妇92例,根据随机数字表法分成干预组与对照组各46例,对照组给予常规分娩护理,干预组给予基于计划行为理论无痛分娩结合接生手法,比较两组出血量、产程、会阴损伤情况、简化版McGill疼痛问卷(SF-MPQ)评分及舒适度。结果:干预组产后2h(185.96±13.47ml)、24h(216.15±21.09ml)出血量均少于对照组(243.11±25.53ml、291.66±29.25ml),第一、二、三产程及总产程短于对照组,会阴损伤情况较对照组轻,SF-MPQ量表视觉模拟评分(3.15±0.88分)、疼痛分级指数(16.32±2.57分)、疼痛强度(1.83±0.45分)均低于对照组(4.67±1.12分、20.81±5.09分、2.47±0.62分),舒适状况量表评分高于对照组(均P<0.05)。结论:实施计划行为理论无痛分娩结合接生手法,能够减少初产妇分娩出血量和会阴损伤,减轻初产妇疼痛,提高身心舒适度。

以家庭为中心的赋能健康教育模式在剖宫产初产妇早期母乳喂养中的应用

目的探讨以家庭为中心的赋能健康教育模式在剖宫产初产妇早期母乳喂养中的应用效果。方法选取2021年11月-2022年1月在我院计划行剖宫产的初产妇及其照顾者93例作为对照组,采用常规健康教育宣教方法,宣教对象主要为初产妇本人;选取2022年3-7月在我院计划行剖宫产的初产妇及其照顾者98例作为观察组,在对照组基础上实施以家庭为中心的赋能健康教育模式。比较2组初产妇及其照顾者干预前后母乳喂养知识情况;干预前后初产妇婴儿喂养态度、母乳喂养家庭支持;干预后初产妇泌乳Ⅱ期启动时间和出院时纯母乳喂养率。结果干预前2组初产妇及照顾者各指标比较,差异均无统计学意义(P>0.05);干预后,观察组初产妇及其照顾者母乳喂养知识,以及初产妇婴儿喂养态度、母乳喂养家庭支持、泌乳Ⅱ期启动时间和出院时纯母乳喂养率方面均优于对照组(P<0.05)。结论以家庭为中心的赋能健康教育模式能提高产妇及照顾者的母乳喂养知识,提升婴儿喂养态度及母乳喂养家庭支持,缩短泌乳Ⅱ期启动时间,提高产妇出院时纯母乳喂养率。

孕期盆底门诊干预在足月初产妇阴道分娩中的应用效果

目的:探讨孕期实施盆底门诊干预在足月初产妇阴道分娩中的应用效果。方法:将成都市龙泉驿区第一人民医院2021年1月至12月建卡有顺产意愿的单胎初产妇按照建档顺序单双数分组:单数组进行产科门诊常规管理及盆底门诊干预(凯格尔运动联合会阴按摩)200例(研究组),双数组进行常规产科门诊管理200例(对照组),比较两组阴道炎发生率、剖宫产率、阴道分娩率、产科裂伤情况、阴道助产率、会阴切开情况、分娩结局及分娩前及产后42天会阴体、生殖裂孔长度、阴道宽度及其他阴道分娩并发症(尿潴留和产褥期痔)等情况。结果:最终研究组纳入87例,对照组104例。研究组会阴切开率、会阴完整率、阴道助产率、会阴Ⅰ度和Ⅱ度裂伤率、产后出血量均优于对照组(P<0.05),研究组产后42天生殖裂孔长度短于对照组,差异有统计学意义(P<0.05);两组阴道炎发生率、第二产程时间、阴道壁裂伤率、新生儿Apgar评分、新生儿产伤率、尿潴留和产褥期痔、产后阴道宽度及会阴体长度比较,差异无统计学意义(P>0.05)。结论:孕期实施盆底门诊干预可在一定程度上减轻足月初产妇经阴道分娩造成的伤害,并且未增加新生儿分娩并发症,值得临床推广。

心理弹性支持结合疼痛管理在行水疗助产初产妇中的应用效果

目的 探讨对开展水疗助产的初产妇实施心理弹性支持结合疼痛管理的效果。方法 选择2020年5月至2022年5月百色市人民医院接收的86名初产妇作为研究对象,根据随机数字表法将其分为2组,即对照组和观察组,各43名。对照组在开展水疗助产的基础上实施常规护理,观察组在开展水疗助产的基础上实施心理弹性支持结合疼痛管理。比较2组初产妇在孕期各个阶段的心理弹性、产时疼痛程度、产后2 h出血量、新生儿Apgar评分、分娩控制感、各产程时间,以及护理满意度。结果 观察组在孕中期、孕晚期、分娩后的心理弹性量表得分,以及分娩控制量表评分、各方面护理满意度评分均高于对照组,产时视觉模拟评分法评分低于对照组,产后2 h出血量少于对照组,第一产程、第二产程以及总产程均短于对照组,均存在统计学差异(P均<0.05)。2组间新生儿Apgar评分未见统计学差异(P>0.05)。结论 对开展水疗助产的产妇实施心理弹性支持结合疼痛管理可有效缓解疼痛,减少出血量,提升心理弹性、分娩控制感和护理满意度,缩短产程。

气囊仿生助产联合骨盆摇摆运动在高龄初产妇分娩中的应用效果

目的探讨气囊仿生助产联合骨盆摇摆运动在高龄初产妇分娩中的应用效果。方法选取2021年3月-2022年10月于我院分娩的高龄初产妇150例,按随机数字表法分为对照组和观察组,各75例。对照组实施骨盆摇摆运动分娩,观察组予以气囊仿生助产联合骨盆摇摆运动干预。比较两组分娩方式、产程、产后2h出血情况及不良妊娠结局发生情况。结果观察组阴道分娩率高于对照组,剖宫产率、阴道助产率低于对照组(P<0.05);观察组第一、第二、第三及总产程时间均短于对照组(P<0.05);观察组产后2h出血量少于对照组(P<0.05);两组新生儿窒息发生率比较差异无统计学意义(P>0.05)。结论气囊仿生助产联合骨盆摇摆运动应用于高龄初产妇分娩中,可有效提升阴道分娩率,加快产程进展,减少产后出血量,降低不良妊娠结局发生率。

Timing theory integrated nursing combined behavior change integrated theory of nursing on primiparous influence

BACKGROUND The comprehension and utilization of timing theory and behavior change can offer a more extensive and individualized provision of support and treatment alternatives for primipara.This has the potential to enhance the psychological well-being and overall quality of life for primipara,while also furnishing healthcare providers with efficacious interventions to tackle the psychological and physiological obstacles encountered during the stages of pregnancy and postpartum.AIM To explore the effect of timing theory combined with behavior change on selfefficacy,negative emotions and quality of life in patients with primipara.METHODS A total of 80 primipara cases were selected and admitted to our hospital between August 2020 and May 2022.These cases were divided into two groups,namely the observation group and the control group,with 40 cases in each group.The nursing interventions differed between the two groups,with the control group receiving routine nursing and the observation group receiving integrated nursing based on the timing theory and behavior change.The study aimed to compare the pre-and post-nursing scores of Chinese Perceived Stress Scale(CPSS),Edinburgh Postpartum Depression Scale(EPDS),Self-rating Anxiety Scale(SAS),breast milk knowledge,self-efficacy,and SF-36 quality of life in both groups.RESULTS After nursing,the CPSS,EPDS,and SAS scores of the two groups was significantly lower than that before nursing,and the CPSS,EPDS,and SAS scores of the observation group was significantly lower than that of the control group(P=0.002,P=0.011,and P=0.001 respectively).After nursing,the breastfeeding knowledge mastery,selfefficacy,and SF-36 quality of life scores was significantly higher than that before nursing,and the breastfeeding knowledge mastery(P=0.013),self-efficacy(P=0.008),and SF-36 quality of life(P=0.011)scores of the observation group was significantly higher than that of the control group.CONCLUSION The integration of timing theory and behavior change integrated theory has been found to be an effective approach in alleviating negative mood and stress experienced by primipara individuals,while also enhancing their selfefficacy and overall quality of life.This study focuses on the key concepts of timing theory,behavior change,primipara individuals,negative mood,and quality of life.

家属陪护下温馨助产模式对初产妇分娩结局及产后恢复影响

目的:观察家属陪护下温馨助产模式对初产妇分娩结局及产后恢复的影响.方法:纳入2022年4月-2023年5月本院产科收治的115例初产妇,随机数字表法分为对照组(58例)与观察组(57例),对照组行常规分娩护理,观察组开展家属陪护下温馨助产模式护理干预,对照组脱落2例,观察组脱落1例,比较各组分娩结局、新生儿结局、产妇产后出血量以及分娩疼痛(改良面部表情疼痛评估工具,FPS-R)、产后焦虑(SAS)与抑郁(SDS)自评量表评分、总产程与住院时间、产妇护理满意率.结果:两组顺利阴道分娩率均为100.0%,观察组分娩后并发症率(0)低于对照组(7.1%),新生儿不良事件发生率(0)低于对照组(8.9%),产妇产后出血量(216.2±10.8ml)少于对照组(289.7±15.2 ml),FPS-R评分(7.9±0.4分)低于对照组(8.9±0.5分),SAS(36.5±3.0分)与SDS(34.8±5.2分)评分低于对照组(42.4±3.8分、41.8±4.8分),总产程(516.23±9.76min)与住院时间(2.14±0.22d)均短于对照组(612.34±10.65 min、2.95±0.26d),产妇护理满意率(96.4%)高于对照组(85.7%)(均P<0.05).结论:家属陪护下温馨助产模式可较好缓解产妇心理不良状态,改善分娩结局,促进产后恢复,降低不良分娩结局,产妇较为满意.

拉玛泽减痛呼吸法联合健康教育对初产妇妊娠结局影响的Meta分析

目的:运用系统评价的方法分析拉玛泽减痛呼吸法联合健康教育对初产妇妊娠结局的干预效果,为临床提出最优的助产干预方法。方法:通过计算机全面检索了12个中英文数据库,搜集拉玛泽减痛呼吸法联合健康教育的随机对照试验的文献,时间从建库起至2021年12月22日,采用Cochrane风险偏倚评估工具对纳入文献质量进行评价,通过RevMan 5.3软件和Stata 14.0软件进行纳入文献的敏感性分析和异质性检验,并采用固定效应模型或随机效应模型进行效应量的合并计算。结果:共纳入43项研究,包括11144例初产妇。经过Meta分析结果显示,与健康教育相比,拉玛泽减痛呼吸法联合健康教育能明显缩短初产妇第一产程时间[SMD=-1.63,95%CI(-1.99,-1.26)]、第三产程时间[SMD=-0.56,95%CI(-0.80,-0.32)]和总产程时间[SMD=-2.24,95%CI(-2.84,-1.64)],可减轻产痛[RR=0.94,95%CI(0.79,1.12)],提高自然分娩率[RR=1.25,95%CI(1.21,1.28)],差异有统计学意义(P<0.05)。结论 基于现有的证据表明,拉玛泽减痛呼吸法联合健康教育在初产妇分娩中具有明显的优势,可以降低妊娠不良结局,有效提高助产质量,保障母婴安全。但受到纳入研究质量和数量的限制,未来仍需要高质量大样本研究进一步验证。

围产期全程针对性营养指导对初产妇分娩的影响

目的:探讨围产期全程针对性营养指导对初产妇分娩的影响。方法:纳入2020年4月-2023年6月本院收治初产妇103例,随机数字表法分为对照组(51例)和观察组(52例),两组均常规围产期产科护理,观察组同时实施围产期全程针对性营养指导干预,干预过程中对照组和观察组各脱落1例,观察各组总产程、产后2h出血量、自然分娩、产妇并发症、新生儿并发症、分娩时产妇疼痛程度(VAS评分)、产后3d产妇爱丁堡产后抑郁量表(EPDS)评分与康纳-戴维森弹性量表(CD-RISC)评分、孕妇营养情况及产妇干预满意率。结果:观察组产妇总产程(431.49±24.19 min)短于对照组(508.18±22.17 min),产后2h出血量(123±10 ml)少于对照组(204±11 ml),自然分娩率(80.4%)高于对照组(60.0%),产妇并发症率(0)、新生儿并发症率(3.9%)均低于对照组(8.0%、16.0%);分娩时观察组VAS评分(4.85±0.94分)低于对照组(6.23±0.56分),产后3d的EPDS评分(7.29±0.69分)与CD-RISC评分(81.27±4.27分)均优于对照组(9.13±0.77分、77.62±2.65分),孕妇营养不良发生率(0)低于对照组(8.0%),产妇干预满意率(94.1%)高于对照组(78.0%)(均P<0.05)。结论:围产期全程针对性营养指导可较好改善初产妇营养状况,降低营养不良发生率,缩短总产程、减少产后出血,减轻了分娩疼痛,提高自然分娩率,降低并发症发生,产妇产后心理状态好、满意度高。

不同分娩体位对初产妇巨大儿分娩结局的影响

目的:探究不同分娩体位对初产妇巨大儿分娩结局的影响。方法:纳入2021年1月至2023年1月于本医院进行分娩的初产妇(合并巨大儿)70例为研究对象进行回顾性研究,2021年1月至2022年1月按方便抽样法抽取35例产妇为对照组,2022年2月至2023年1月按方便抽样法抽取35例产妇为观察组。比较两组产妇分娩时间等。结果:与对照组相比,观察组产妇分娩时间缩短,会阴撕裂度降低(P<0.05)。观察组分娩控制量表(LAS)评分、新生儿Apgar评分高于对照组(P<0.05)。观察组疼痛评定指数(PRI)评分、现实疼痛强度(PPI)评分及视觉模拟评分法(VAS)评分、总出血率低于对照组(P<0.05)。结论:对合并巨大儿的初产妇第二产程进行俯卧位分娩方式结局较好,产程时间缩短,分娩控制感较好,疼痛感减轻,改善母婴不良结局。

家属参与式护理对初产妇产后抑郁症状的改善探讨

目的探讨初产妇在常规护理上采用家属参与式护理对产后抑郁症状的改善影响。方法选取80例初产妇,依照护理方法不同分为对照组(采用常规护理)与观察组(采用常规护理+家属参与式护理),每组40例,比较两组护理效果。结果护理后观察组的焦虑评分、抑郁评分分别为(31.31±3.86)分、(5.83±1.47)分,对照组的焦虑评分、抑郁评分分别为(37.65±4.13)分、(8.75±2.01)分,观察组的焦虑评分、抑郁评分均较对照组低(P<0.05)。护理后观察组自我效能感评分较对照组高(P<0.05)。观察组护理满意度为97.50%,对照组护理满意度为82.50%,观察组护理满意度高于对照组(P<0.05)。结论对初产妇在常规护理上采用家属参与式护理,起到积极的作用价值,既可缓解患者的焦虑、抑郁情绪,又可提高其自我效能感,还能促进护患关系。

产房家庭协同护理对初产妇心理状况、分娩自我效能及母婴结局的影响

目的:探讨产房家庭协同护理对初产妇心理状况、分娩自我效能及母婴结局影响.方法:选取2020年5月-2021年12月在本院产检并分娩的初产妇为研究对象,按随机数字表法分为观察组和对照组各60例.对照组临产进入产房后常规护理与指导,观察组在对照组的基础上实施家庭成员协同护理.对比分析两组产妇干预前后SAS、SDS评分,分娩自我效能评分,分娩方式,产时VAS评分、产程时间及母婴结局之间的差异.结果:干预后观察组对象SAS评分、SDS评分下降显著,且低于对照组(P<0.05);结果效能、期望效能、自我效能总分提高,且高于对照组(均P<0.05);阴道分娩率显著高于对照组(91.7%比73.3%),中转剖宫产率低于对照组(8.3%比26.7%),差异有统计学意义(P<0.05).观察组经阴道分娩对象产时VAS评分、第一、二产程时间、产后2h出血量及新生儿Apgar评分均明显好于对照组(P<0.05).结论:产房家庭成员协同护理干预可有效改善初产妇心理状况,提高分娩自我效能,降低产时疼痛水平,缩短产程时间,促进阴道分娩,改善母婴结局.

互联网+护理服务模式对初产妇母乳喂养效果的影响研究

目的 探究应用互联网+护理服务模式对改善初产妇母乳喂养的效果。方法 本次研究实施时间自2021年7月开始,截至2023年8月,将东莞市虎门医院收入的128例初产妇分为观察组和对照组,各64例。其中,观察组初产妇购买了本次互联网+护理服务,对照组初产妇没有购买互联网+护理服务,应用常规电话随访。将两组初产妇的相关临床指标进行比较。结果 干预前,两组母乳喂养情况、母乳喂养知识评分、母乳喂养自我效能评分差异无统计学意义(P>0.05)。产后42 d和产后3个月,观察组母乳喂养成功率、泌乳量比对照组提升(P<0.05),观察组的母乳喂养持续时间多于对照组(P<0.05),观察组母乳喂养知识评分、母乳喂养自我效能评分比对照组提升(P<0.05)。观察组婴儿体格发育情况优于对照组(P<0.05)。结论 互联网+护理服务模式的运用可以同时提高初产妇母乳喂养成功率、母乳喂养知识技能,延长母乳喂养持续时间,以及改善初产妇的一般自我效能感。

LEARNS模式健康教育对初产妇育儿胜任感及母乳喂养的影响

目的探究LEARNS模式健康教育对初产妇育儿胜任感及母乳喂养的影响。方法2023年3-6月,采用便利抽样法选取安徽省某医院产科两个病区收治的130例初产妇为研究对象,将2023年3-4月收治的65例初产妇作为对照组,给予常规健康教育;2023年5-6月收治的65例初产妇作为观察组,采用LEARNS模式健康教育。比较两组初产妇育儿胜任感、母乳喂养情况及产后抑郁水平。结果观察组初产妇产后育儿胜任感总分及各维度分数均高于对照组(均P<0.05);观察组初产妇首次母乳喂养成功率及产后42 d内纯母乳喂养率较对照组更高(均P<0.05);观察组初产妇产后7 d的抑郁量表得分低于对照组(P<0.05)。结论LEARNS模式健康教育可提高初产妇的育儿胜任感,改善初产妇母乳喂养情况、减轻其产后抑郁情绪。

高龄初产妇妊娠晚期症状群识别及其影响因素研究

目的 了解高龄初产妇妊娠晚期症状的发生现状,识别其症状群并分析影响因素,为症状管理实践的发展提供参考。方法 采用自行设计的一般资料调查表和妊娠晚期孕妇症状自评问卷对宁夏某妇女儿童医院门诊产检的235名高龄初产妇进行调查。采用探索性因子分析提取症状群,采用多元线性回归分析明确其影响因素。结果回收有效问卷217份。本次调查发生率最高的6种症状为腰痛(87.1%)、尿频(84.8%)、乏力(82.5%)、呼吸困难(81.1%)、口干(80.2%)、睡眠障碍(78.8%)。探索性因子分析提取3个症状群分别命名为躯体-睡眠症状群、乏力-疼痛症状群、情绪相关症状群。妊娠前运动情况、妊娠前BMI是躯体-睡眠症状群和乏力-疼痛症状群的影响因素调整后R^(2)=0.126,F=6.173,P<0.001;调整后R^(2)=0.156,F=5.140,P=0.006);学历、家庭人均月收入是情绪相关症状群的影响因素(调整后R^(2)=0.107,F=2.606,P=0.045)。结论 正常高龄初产妇妊娠晚期会经历多种症状,且以症状群的形式出现,护理人员应根据该人群特征,制订症状管理方案,保障其安全舒适,促进母婴健康。