助产士引导的全程心理干预对初产妇的影响

徐朝霞+王明喜+李渊

[摘要] 目的 探討助产士引导的全程心理干预对初产妇的影响。 方法 选取我院2014年2月～2016年11月期间住院的120例初产妇为研究对象，按照随机数字表法分为观察组（常规护理联合助产士引导的全程心理干预）与对照组（常规护理），比较两组产妇焦虑自评量表（SAS）评分、抑郁自评量表（SDS）评分、产程时间、产后2h出血量和分娩方式以及产后1～2周VAS评分、新生儿Apgar评分。 结果 观察组SAS评分、SDS评分显著低于对照组，差异具有统计学意义（P<0.05）；观察组第一产程、第二产程时间显著短于对照组（P<0.05），第三产程时间比较无显著差异（P>0.05）；观察组术后2h出血量显著少于对照组（P<0.05）；观察组自然分娩率（91.67%）显著高于对照组（70.00%），差异具有统计学意义（P<0.05）；观察组产妇产后1～2周VAS评分显著低于对照组（P<0.05）；观察组新生儿Apgar评分显著高于对照组（P<0.05）。 结论 助产士引导的全程心理干预可以有效调节产妇不良情绪，缩短产程时间，减少术后2h出血量，降低分娩风险，提高自然分娩率和分娩质量。

[关键词] 助产士；心理干预；初产妇；分娩

[中图分类号] R473.71 [文献标识码] A [文章编号] 2095-0616（2017）08-182-03

[Abstract] Objective To explore the effect of whole-course psychological intervention guided by midwives on primipara. Methods 120 primipara who were hospitalized in our hospital from February 2014 to November 2016 were selected as research objects and they were divided into the observation group and the control group， according to random number table method. The observation group was given routine nursing combined with whole-course psychological intervention guided by midwives while the control group was given routine nursing. Self-rating Anxiety Scale （SAS） score， Self-rating Depression Scale （SDS） score， duration of labor， blood loss of postpartum 2h， mode of delivery， Visual Analogue Scale （VAS） score and neonatal Apgar score of primipara in two groups were compared. Results The SAS score and SDS score of observation group were significantly lower than those of the control group and the difference was statistical significant （P<0.05）. Time of the first and second stage of labor of the observation group was significantly shorter than that of control group （P<0.05） but there was no significant difference in time of the third stage of labor （P>0.05）. Blood loss of postpartum 2h of observation group was significantly less than that that of control group （P<0.05）. The rate of natural delivery of the observation group was 91.67%， significantly higher than that of the control group 70.00%. The difference was statistical significant （P<0.05）. VAS scores of postpartum 1 week and 2 weeks of the observation group were significantly lower than those of the control group （P<0.05）. Neonatal Apgar score of the observation group was significantly higher than that of the control group （P<0.05）. Conclusion Whole-course psychological intervention guided by midwives can effectively regulate the negative emotions of primipara， shorten duration of labor， reduce blood loss of postpartum 2h and the risk of delivery， improve the rate of natural delivery and the quality of delivery.

[Key words] Midwife； Psychological intervention； Primipara； Delivery

分娩是一个连续的生理过程，持续时间较长，并伴随有剧烈疼痛，产妇的精神和心理状况对整个分娩过程和妊娠结局有着重要影响[1]。由于初产妇没有经验，且大多数年纪较轻，对妊娠和分娩认知度较低，临产时往往处于慌乱状态，不知所措。较多产妇因过分害怕宫缩疼痛而产生紧张、恐惧、焦虑等不良情绪导致剖宫产率上升，影响产程正常进展和妊娠结局[2]。多项研究显示，剖宫产可能对产妇和新生儿造成不同程度危害，如产妇术后恢复慢易导致多种妊娠并发症、再次妊娠时宫外孕几率增加及新生儿呼吸系统疾病等[3]。因此，在产程中对初产妇进行心理干预非常有必要，本文旨在探讨助产士引导的全程心理干预对初产妇的影响，现报道如下。

1 资料与方法

1.1 一般资料

选取我院2014年2月～2016年11月住院的单胎头位初产妇排除妊娠合并症后共计120例纳入本次研究，按照随机数字表法分为观察组与对照组，各60例。……