全程优质护理对自然分娩产妇心理状态与并发症的影响

目的 探讨全程优质护理对自然分娩产妇心理状态与并发症的影响。方法 选取本院226例自然分娩产妇为研究对象,随机分为两组,各113例。对照组接受常规护理,观察组接受全程优质护理,比较两组的心理状态、分娩结局、并发症及护理满意度。结果 护理后,观察组焦虑自评量表、抑郁自评量表评分低于对照组（P<0.05）;观察组中转剖宫产率低于对照组,第一产程、第二产程、第三产程用时短于对照组（P<0.05）;观察组并发症发生率低于对照组,护理满意度高于对照组（P<0.05）。结论 全程优质护理应用于自然分娩产妇中,可以改善产妇的心理状态,降低中转剖宫产率,缩短产程用时,减少并发症,可推广使用。     

一对一全程导乐分娩护理模式对产妇的护理效果

目的 探讨一对一全程导乐分娩护理模式对产妇的护理效果。方法 回顾性分析于本院分娩的70例产妇的病历资料,根据不同护理方法分为常规组及全程组,每组35例。常规组采用常规分娩护理,全程组采用一对一全程导乐分娩护理。分析产妇的各项指标数据。结果 全程组护理质量总分为（92.01±1.89）分,高于常规组的（86.67±2.86）分,差异有统计学意义（P<0.05）。全程组分娩总时间为（381.31±28.61）min,短于常规组的（513.42±45.93）min,差异有统计学意义（P<0.05）。护理前,两组的焦虑自评量表（SAS）、抑郁自评量表（SDS）评分比较,差异无统计学意义（P>0.05）;护理后,全程组SAS、SDS评分均低于常规组,差异有统计学意义（P<0.05）。全程组不良分娩结局发生率为2.86%,低于常规组的20.00%,差异有统计学意义（P<0.05）。全程组的总满意度为100%,高于常规组的82.86%,差异有统计学意义（P<0.05）。结论 一对一全程导乐分娩护理能进一步提升护理品质,产妇分娩效率更高,心理状态更好,不良分娩结局发...     

新生儿临床护理中全程优质护理实施的效果观察

目的：分析新生儿临床护理中全程优质护理实施的效果。方法：随机将我院收治的100例新生儿患者分为对照组和观察组,临床对对照组患者主要采用常规护理,对观察组患者采用全程优质护理,并观察两组患者护理效果。结果：观察组患者护理的满意度为98．0％,对照组护理的满意度为82．O％,观察组家属的护理满意度显著高于对照组,差异有统计学意义（X2=8．56,P〈0．05）。结论：在新生儿护理中实施全程优质护理患者家属的满意度高,效果显著,值得临床推广使用。     

胎心监护仪监测联合全程助产护理在产妇分娩中的应用

目的 探讨并分析在产妇分娩中应用胎心监护仪监测联合全程助产护理的效果。方法 选取100例分娩的产妇,按照随机数字表法分为对照组与研究组,每组50例。对照组给予常规护理,研究组应用胎心监护仪监测联合全程助产护理,比较两组产妇的分娩方式、产程时间、妊娠不良结局与新生儿Apgar评分。结果 研究组产妇的自然分娩率为92.00%,高于对照组的78.00%(P<0.05)。研究组产妇的第一、第二及总产程时间分别为（628.72±44.79）min、（61.04±8.37）min、（694.53±58.63）min,短于对照组的（746.47±56.83）min、（70.97±10.46）min、（831.46±76.59）min(P<0.05)。研究组的妊娠不良结局发生率为8.00%,低于对照组的24.00%(P<0.05)。研究组新生儿出生后1 min、5 min、10 min的Apgar评分分别为（7.97±0.86）分、（9.15±0.34）分、（9.26±0.23）分,高于对照组的（6.84±1.02）分、（7.64±0.57）分、（8.91±0.31）分（P<0...     

优质护理在妊高症产妇产后出血护理中的应用效果

目的探究优质护理在妊高症产妇产后出血护理中的应用效果。方法抽选90例妊高症产后出血产妇,将其平均分为研究组45例与参照组45例,优质护理给予研究组,常规护理实施在参照组中,比较组间患者护理满意度。结果研究组护理满意度95.6%显著优于参照组75.6%,其差异呈P<0.05。结论对妊高症产后出血产妇实施优质护理干预,可有效提升患者护理满意度,促进护患关系和谐,具有一定临床应用价值。     

优质护理在剖宫产术疼痛护理中的应用体会

目的：研究分析优质护理在剖宫产术疼痛护理中的应用价值。方法：选取我院40例采用剖宫产进行分娩患者为观察对象,并随机将其分为治疗组（20例）和对照组（20例）,对采用不同护理措施护理患者的临床护理效果进行对比。结果：对采用不同护理措施护理患者的临床护理效果进行对比,采用优质护理措施进行护理的治疗组患者,其术后疼痛程度显著低于采用常规临床护理措施进行护理的对照组患者,有统计学意义（P〈0．05）。结论：优质护理在剖宫产术疼痛护理中具有显著效果,可显著显著降低患者出现的疼痛感。     

全程优质护理服务模式在妇科腹腔镜手术中的应用效果

目的 探讨全程优质护理服务模式在妇科腹腔镜手术中的应用效果。方法 选取本院112例妇科腹腔镜手术患者为研究对象,随机分为两组,各56例。对照组接受常规护理服务模式,观察组接受全程优质护理服务模式,比较两组的疼痛程度、负性情绪、临床相关指标、不良反应及护理满意度。结果 护理后,观察组视觉模拟评分法、汉密尔顿焦虑量表及汉密尔顿抑郁量表评分低于对照组,差异有统计学意义（P<0.05）;观察组肠鸣音消失时间、排气时间、下床活动时间、住院时长短于对照组,差异有统计学意义（P<0.05）;观察组不良反应发生率为3.57%,低于对照组的12.50%,差异有统计学意义（P<0.05）;观察组护理满意度为94.64%,高于对照组的78.57%,差异有统计学意义（P<0.05）。结论 全程优质护理服务模式在妇科腹腔镜手术中的应用效果显著,能改善临床相关指标、负性情绪及疼痛程度,降低不良反应发生率,提高护理满意度。     

责任助产模式的优质护理干预在无痛分娩产妇中的应用

目的 探讨责任助产模式的优质护理干预在无痛分娩产妇中的应用效果。方法 回顾性分析行无痛分娩的48名产妇资料。依据护理模式不同分为观察组和对照组,每组24名。对照组采用常规护理,观察组采用责任助产模式的优质护理。比较对两组产妇的不良事件率、自然分娩率、临床指标、焦虑、抑郁评分。结果 观察组产妇产后不良事件率为4.17%,低于对照组的33.33%;自然分娩率为79.17%,高于对照组的41.67%,差异均有统计学意义（P<0.05）。观察组产妇产程时间、住院时间均短于对照组,观察组产妇产后2 h出血量少于对照组,差异均有统计学意义（P<0.05）。护理前,两组焦虑自评量表（SAS）、抑郁自评量表（SDS）评分比较,差异无统计学意义（P>0.05）;护理后,两组SAS、SDS评分均低于护理前,且观察组均低于对照组,差异均有统计学意义（P<0.05）。结论 责任助产模式的优质护理应用于无痛分娩产妇效果较好,可以降低产妇不良事件发生率提高自然分娩率,缩短产程和住院时间,减少产妇出血量,改善产妇焦虑感、抑郁情绪。     

宫颈癌患者应用全程优质护理对生活质量及负性情绪的影响

目的 分析宫颈癌患者应用全程优质护理对生活质量及负性情绪的影响。方法 选择60例宫颈癌患者,以随机数字表法分为对照组（30例,常规护理干预）,观察组（30例,全程优质护理干预）。对比两组各项指标。结果 护理后,观察组健康知识掌握度、护理依从性,生理功能、社会功能、躯体疼痛、情感职能及护理满意度评分均高于对照组,而焦虑程度、癌痛程度评分低于对照组,差异具有统计学意义（P<0.05）。结论 宫颈癌患者应用全程优质护理可增加健康知识掌握度,缓解焦虑情绪,减轻癌痛,改善生活质量,提高护理依从性及满意度。     

助产士全程陪伴护理模式对产妇分娩质量及康复效果的影响分析

目的 探究分析分娩产妇实施助产士全程陪伴护理模式对其分娩质量和康复效果的影响。方法 选取60例分娩产妇,采取红篮球分组方法予以分组,常规组(30例)予以常规护理模式,观察组(30例)予以助产士全程陪伴护理模式。比较两组产妇的总产程、产后2 h出血量、新生儿Apgar评分、视觉模拟评分法(VAS)评分及90项症状自评量表(SCL-90)评分。结果 观察组产妇总产程短于常规组,产后2 h出血量明显少于常规组(P<0.05);两组新生儿Apgar评分对比,差异无统计学意义(P>0.05)。相比干预前,两组干预后VAS评分、SCL-90评分均低于常规组,且观察组产妇VAS评分(5.12±0.91)分、SCL-90评分(49.30±10.13)分明显低于常规组的(5.73±1.11)分、(55.73±10.11)分,差异有统计学意义(P<0.05)。结论 对分娩产妇实施助产士全程陪伴护理模式具有重要价值,不仅可以使产妇分娩过程的完整性及连续性得到保障,防止不良现象产生,保证分娩顺利进行,且可以缩短总产程,减轻产妇疼痛,给母婴安全带来促进作用。     

Comparison of outcomes of perinatal care in Slovakia and the UK

Objective

To investigate whether there are differences in maternal and perinatal outcomes between Slovakia and the UK, and whether any observed variations can be attributed to differences in perinatal care.

Methods

Data on outcomes of perinatal care in Slovakia and the UK between 2006 and 2010 were compared. Perinatal mortality figures included stillbirths weighing 1000 g or more and early neonatal deaths.

Results

In Slovakia, the perinatal mortality rate was significantly higher than that in the UK (RR 1.12; 95% CI, 1.06–1.18). Cesarean delivery was significantly more frequent in Slovakia (RR 1.05; 95% CI, 1.05–1.06); instrumental vaginal delivery was less frequent (ventouse delivery, RR 0.20; 95% CI, 0.19–0.21; forceps delivery, RR 0.09; 95% CI, 0.09–0.10). Episiotomy and peripartum hysterectomy were performed more often in Slovakia (episiotomy, RR 4.10; 95% CI, 4.07–4.12; peripartum hysterectomy, RR 2.02; 95% CI 1.65–2.47). The incidence of eclampsia was significantly higher in Slovakia (RR 1.60; 95% CI, 1.26–2.04). There were no significant differences in the rates of maternal death.

Conclusion

Perinatal care outcomes and intervention rates differ between Slovakia and UK. This may be explained by differences in outcome definitions, perinatal care, and official encouragement of medical complaints.     

Longitudinal study of perinatal maternal stress,depressive symptoms and anxiety

Objectives

to understand the trends in, and relationships between, maternal stress, depressive symptoms and anxiety in pregnancy and post partum.

Design

a prospective longitudinal survey study was undertaken to explore maternal psychological distress throughout the perinatal period. The participants were recruited after 24 completed weeks of gestation, and were followed-up monthly until one month post partum (four surveys in total).

Setting

participants were recruited from a single hospital in southern Taiwan, and asked to complete questionnaires in the hospital waiting area.

Participants

inclusion criteria were: age ≥18 years, able to read and write Chinese, ≥24 weeks of gestation, singleton pregnancy and no pregnancy complications (including a diagnosis of antenatal depression or anxiety disorder). In total, 197 women completed all four surveys (response rate 74.62%).

Measurements and findings

stress was measured with the 10-item Perceived Stress Scale, depressive symptoms were measured with the Center for Epidemiologic Studies' Depression scale, and anxiety was measured with the Zung Self-reported Anxiety Scale. Participants were followed-up at four time points: T1 (25–29 gestational weeks), T2 (30–34 gestational weeks), T3 (>34 gestational weeks) and T4 (4–6 weeks post partum). Appointments for data collection were made in accordance with the participants' antenatal and postnatal check-ups. The three types of maternal distress had different courses of change throughout the perinatal period, as levels of depressive symptoms remained unchanged, anxiety levels increased as gestation advanced but declined after birth, and stress decreased gradually during pregnancy but returned to the T1 level after birth. There was a low to high degree of correlation in maternal stress, depressive symptoms and anxiety in pregnancy and post partum.

Key conclusions

around one-quarter of the study participants had depressive symptoms during pregnancy and post partum. Stress and anxiety showed opposing courses during the perinatal period. Regardless of the trend, maternal mental distress returned to the T1 level after birth.

Implications for practice

effective survey questionnaires are suggested for use as primary screening for possible psychological distress among pregnant and post partum women. It is suggested that health care professionals involved in obstetrics and midwifery should pay attention to the psychological needs of pre- and postnatal women, provide women with sufficient information about their mental well-being, and make appropriate and timely referrals to psychiatric or psychological care.     

Advanced maternal age and adverse perinatal outcomes in an Asian population

Objective

To investigate (1) whether there is an increasing trend in the mean maternal age at the birth of the first child and in the group of women giving birth at age 35 or older, and (2) the association between advanced maternal age and adverse perinatal outcomes in an Asian population.

Study design

We conducted a retrospective cohort study involving 39,763 Taiwanese women who delivered after 24 weeks of gestation between July 1990 and December 2003. Multivariable logistic regression was used to adjust for potential confounding variables.

Results

During the study period, the mean maternal age at the birth of the first child increased from 28.0 to 29.7 years, and the proportion of women giving birth at age 35 or older increased from 11.4% to 19.1%. Compared to women aged 20–34 years, women giving birth at age 35 or older carried a nearly 1.5-fold increased risk for pregnancy complications and a 1.6–2.6-fold increased risk for adverse perinatal outcomes. After adjusting for the confounding effects of maternal characteristics and coexisting pregnancy complications, women aged 35–39 years were at increased risk for operative vaginal delivery (adjusted odds ratio [OR] 1.5, 95% confidence interval [CI] 1.2–1.7) and cesarean delivery (adjusted OR 1.6, 95% CI 1.5–1.7), while women aged 40 years and older were at increased risk for preterm delivery (before 37 weeks of gestation) (adjusted OR 1.7, 95% CI 1.3–2.2), operative vaginal delivery (adjusted OR 3.1, 95% CI 2.0–4.6), and cesarean delivery (adjusted OR 2.6, 95% CI 2.2–3.1). In those women who had a completely uncomplicated pregnancy and a normal vaginal delivery, advanced maternal age was still significantly associated with early preterm delivery (before 34 weeks of gestation), a birth weight <1500 g, low Apgar scores, fetal demise, and neonatal death.

Conclusion

In this population of Taiwanese women, there is an increasing trend in the mean maternal age at the birth of the first child. Furthermore, advanced maternal age is independently associated with specific adverse perinatal outcomes.     

Genetics in perinatal nursing: clinical applications and policy considerations

Genetics is becoming an important part of perinatal nursing care. The need for genetic counseling and referral may be identified before conception, early in pregnancy, upon the demise of a fetus with an abnormality, or after the birth of an infant with a genetic condition. Perinatal nurses often are present when parents first discover the presence of a genetic condition in their fetus or infant. Women who will be 35 at the time of their infant's birth and women who have family histories of genetic disorders should be offered appropriate screening tests.     

Ethnic differences in perinatal mortality. A perinatal audit on the role of substandard care

OBJECTIVES: The objective was to investigate the contribution of substandard care to ethnic inequalities in perinatal mortality. STUDY DESIGN: Perinatal audit in Amsterdam, the Netherlands. The study population consisted of 137 consecutive perinatal death cases (16 weeks GA-28 days after delivery). A standardized procedure to establish the cause of death and substandard care by perinatal audit was developed. The main outcome measures were perinatal mortality rates in ethnic groups, cause of death classified by extended Wigglesworth classification, presence of substandard care (unlikely to be, possibly or likely to be related to perinatal death), and component of care considered to be substandard. RESULTS: In Surinamese and other non-Western mothers (mainly from Ghana) perinatal mortality, beyond 16 weeks' gestation, was statistically significantly higher than among native Dutch mothers. (4.01, 2.50, and 1.07%, respectively). In Surinamese and Moroccan mothers, we observed a higher rate of early preterm deliveries. The prevalence of substandard care differed statistically significantly among ethnic groups (p=0.034), with the highest prevalence among Surinamese mothers. These differences were especially apparent in the prevalence of (more) maternal substandard care factors among Surinamese and Moroccan mothers. These factors consisted of a later start date for antenatal care or a later notification by the caregiver about obstetrical problems (e.g. rupturing of membranes, decrease in foetal movements). CONCLUSIONS: The higher perinatal mortality in Surinamese and other non-Western groups is mainly due to a higher rate of early preterm deliveries. No differences in care were observed among ethnic groups during labour and delivery. Among Surinamese mothers, however, the results indicate that substandard care with maternal involvement plays a role in explaining their higher perinatal mortality rates.     

Tailoring peripartum nursing care for women of advanced maternal age

Births to women of advanced maternal age have increased dramatically over the last decade in both the United States. The majority of women who deliver their first baby after age 35 are healthy and experience positive birth outcomes. According to current research, primigravidas over 35 tend to be educated consumers. Their physical and psychosocial needs differ from those of the mother in her 20s, due to advanced age and factors related to difficulty conceiving and life circumstances. This paper presents (a) an overview of the possible risks to outcomes of childbearing for women over the age of 35; (b) a discussion of how women of advanced maternal age may differ from younger women related to developmental stage, stress or anxiety or both, decision making, and support systems; and (c) an exploration of tailoring nursing care strategies during the peripartum period specifically for this age cohort.     

Cesarean delivery outcomes from the WHO global survey on maternal and perinatal health in Africa

Objective

To assess the association between cesarean delivery rates and pregnancy outcomes in African health facilities.

Methods

Data were obtained from all births over 2-3 months in 131 facilities. Outcomes included maternal deaths, severe maternal morbidity, fresh stillbirths, and neonatal deaths and morbidity.

Results

Median cesarean delivery rate was 8.8% among 83 439 births. Cesarean deliveries were performed in only 95 (73%) facilities. Facility-specific cesarean delivery rates were influenced by previous cesarean, pre-eclampsia, induced labor, referral status, and higher health facility classification scores. Pre-eclampsia increased the risks of maternal death, fresh stillbirths, and severe neonatal morbidity. Adjusted emergency cesarean delivery rate was associated with more fresh stillbirths, neonatal deaths, and severe neonatal morbidity—probably related to prolonged labor, asphyxia, and sepsis. Adjusted elective cesarean delivery rate was associated with fewer perinatal deaths.

Conclusion

Use of cesarean delivery is limited in the African health facilities surveyed. Emergency cesareans, when performed, are often too late to reduce perinatal deaths.