Effects of acupressure on the childbirth satisfaction and experience of birth: A randomized controlled trial

BackgroundComplementary and alternative medicines have been used to increase comfort and relaxation in mothers during labor. Comforting and preparing the mother in labor can create a positive birth experience. The aim of this study was to evaluate the effect of acupressure on childbirth satisfaction and the experience of giving birth in women with full-term pregnancy, before the onset of labor.MethodsIn 2016, a randomized clinical trial study was conducted in Shahid Akbar Abadi Hospital, Tehran, Iran, enrolling 120 pregnant women at 39–40 gestational weeks with no signs of the onset of labor. They were divided randomly into acupressure, sham acupressure, and control groups. Acupressure points including SP6, BL 60, and BL 32 were pressured bilaterally. Interventions were performed by the researcher, the mother and her relative (husband). Childbirth satisfaction was measured 24 h after delivery. The collected data were analyzed by SPSS software and comparing tests were Chi-squared, Kruskal-Wallis, ANOVA tests (P ≤ 0.05).ResultsThe total childbirth satisfaction did not differ significantly among the three groups (P = 0.460), but the acupressure group had a higher level of satisfaction than the other two groups. Moreover, statistical tests regarding the expectations of the childbirth experience showed a significant difference among the groups (P = 0.033). The actual birth was closest to the expectations of subjects in the acupressure group.ConclusionThis study demonstrated that acupressure may be used as a method in order to attempt to provide a good birth experience and satisfaction of childbirth.     

妊娠期高血压综合征的预后因素分析

目的 探讨不同因素对罹患妊娠期高血压综合征(妊高症)孕妇预后及围生儿的影响.方法 入组妊高症患者及正常产妇各173例,记录年龄、受教育年限,测量血钙、血镁、血清脂联素、平均收缩压、平均舒张压,同时记录分娩方式、孕妇并发症及围生儿状况,做两组间比较.在研究组内采用多因素分析,分析8种不同因素对妊高症预后的影响.结果 (1)研究组的围生儿窒息、胎儿窘迫、早产、尿酸、平均收缩压、平均舒张压高于对照组,研究组的血钙、血镁、血清脂联素显著低于对照组.低体重儿、产后出血、剖宫产在20～35岁年龄的孕妇中研究组多于对照组.(2)尿酸浓度影响围生儿窒息、早产、低体重儿(SE=0.359、0.621、0.486,P＜0.05);血钙浓度影响胎儿窘迫、胎盘早剥(SE=0.361、0.473,P＜0.05),血镁浓度影响围生儿死亡(SE=0.732,P＜0.05);血清脂联素水平影响产后出血(SE=0.348,P＜0.05);平均舒张压和平均收缩压影响胎儿窘迫、胎盘早剥、剖宫产(P＜0.05);受教育年限和年龄影响剖宫产(SE=0.441、0.651,P＜0.05).结论 妊高症的预后与年龄、受教育年限、血压、血钙、血镁、尿酸、血清脂联素密切相关.     

分娩护理虚拟仿真实验项目的设计与应用

目的 探讨分娩护理虚拟仿真实验教学项目的设计和应用.方法 以教学内容为基础,利用3D虚拟仿真技术,构建分娩护理虚拟仿真教学系统,学习内容涵盖第一产程护理、第二产程护理、第三产程护理3个模块.在护理本科妇产科护理课程及助产方向的助产学课程中应用,对该系统在2015级121名护理本科生中的应用情况及效果进行分析.结果 学生在线操作时长平均1.39 h.学生对虚拟仿真系统及教学模式的主观评价分别为平均94.24%持赞成或中立态度、88.84%持赞成或中立态度.结论 该教学项目的设计和实施,为今后虚拟仿真实验教学在护理专业各课程教学中的开展提供了借鉴.     

围产期综合护理干预对产妇产程及产后康复情况的影响

目的:探讨围产期综合护理干预对产妇分娩情况与产后康复的影响。方法:选取2012年3月~2013年3月我院住院待产的产妇196例,将其随机分为试验组和对照组各98例,试验组产妇接受围产期综合护理干预措施,对照组产妇接受常规产前教育和护理。记录并比较两组产妇的总产程、产后出血、排尿情况等指标。结果:试验组产妇产程明显短于对照组(P0.05),产后出血率低于对照组(P0.05),自主排尿率高于对照组(P0.05)。结论:围产期综合护理干预有利于产程进展及产后康复。     

产前分娩预演对初产妇自然分娩成功率及产后并发症的影响

[目的]探讨产前分娩预演对初产妇自然分娩成功率和产后并发症的影响.[方法]收集2016年9月至2018年10月在本院妇产科分娩的初产妇86例,按产前分娩教育方式分为观察组(n=42)和对照组(n=44).对照组孕妇产前接受常规产前健康教育课程培训,观察组在对照组的基础上进行分娩预演实践.比较两组自我效能感量表(GSES)、抑郁自评量表(SDS)和焦虑自评量表(SAS)评分及自然分娩成功率和产后并发症发生率等.[结果]与对照组相比,观察组分娩总产程和第一、二、三明显缩短;新生儿窒息率和产后SDS、SAS评分均明显降低;自然分娩成功率、GSES评分均明显提高,其差异均有统计学意义(P<0.05).观察组产后出血、感染、尿潴留、乳汁淤积发生率及总并发症发生率均低于对照组(P<0.05).[结论]采用常规产前健康教育培训结合产前分娩预演实践的产前管理方式,可有效提高初产妇自然分娩成功率,缩短产程,减少产后并发症的发生,值得临床推广应用.     

The effects of a childbirth psychoeducation program on learned resourcefulness, maternal role competence and perinatal depression: A quasi-experiment

Background

Learned resourcefulness plays a significant role in facilitating maternal coping during the transition to motherhood. Given the growing evidence of perinatal depression and the frequent feeling of incompetence in the maternal role, the implementation of an effective intervention to promote maternal role competence and emotional well-being is essential.

Objectives

To determine the impact of a childbirth psychoeducation program based on the concept of learned resourcefulness on maternal role competence and depressive symptoms in Chinese childbearing women.

Design

A pretest-posttest, control group quasi-experimental design with repeated measures was used.

Setting

The study was conducted in two regional public hospitals in Hong Kong that provide routine childbirth education programs with similar content and structure. One hospital was being randomly selected as the experimental hospital.

Participants

A convenience sample of 184 Chinese pregnant women attending the childbirth education was recruited between October 2005 and April 2007. Inclusion criteria were primiparous with singleton and uneventful pregnancy, at gestation between 12 and 35 weeks, and did not have a past or familial psychiatric illness.

Methods

The intervention was a childbirth psychoeducation program that was incorporated into the routine childbirth education in the experimental hospital. The experimental group (n = 92) received the childbirth psychoeducation program and the routine childbirth education. The comparison group (n = 92) received the routine childbirth education alone in the comparison hospital. Outcomes were measured by the Self-Control Schedule, Parenting Sense of Competence Scale-Efficacy subscale and Edinburgh Postnatal Depression Scale at baseline, immediately post-intervention, at 6 weeks and 6 months postpartum. Analysis was by intention to treat.

Results

Women receiving the childbirth psychoeducation program had significant improvement in learned resourcefulness at 6 weeks postpartum (p = 0.004) and an overall reduction in depressive symptoms (p = 0.01) from baseline to 6 months postpartum compared with those who only received the routine childbirth education after adjusting for baseline group differences on age and social support. No significant group difference was found on maternal role competence.

Conclusions

The childbirth psychoeducation program appears to be a very promising intervention for promoting learned resourcefulness and minimizing the risk of perinatal depression in first-time Chinese childbearing women. Future empirical work is required to determine the effectiveness of extending the childbirth psychoeducation program into the early postpartum for the promotion of maternal role competence in Chinese childbearing women.     

产妇分娩疼痛的临床护理

分娩是一个迎接新生命到来的自然生理现象,对每一个产妇来说是喜悦的过程,同时这一过程所带来的疼痛,会使产妇产生恐惧的心理。分娩疼痛的原因很多,有来自生理和心理的因素。在分娩的全过程中通过各种护理干预可以使分娩时的应激反应减弱和消失,提高产妇的痛阈,降低其对疼痛的感受,增强其乐观面对分娩过程及从容应对分娩疼痛的能力,达到缓解分娩疼痛的目的;同时也可以减少催产药物和麻醉药物的使用,降低不必要的剖宫产率,增加自然分娩率,从而提高产科质量。     

Quality of maternity care for adolescent mothers in Mbabane, Swaziland

Early pregnancy and unplanned childbirth may have far-reaching physical, psychological and social consequences for the adolescent girl and her offspring and are therefore public health issues of concern. A number of evidence-based maternity practices might, if properly applied, prevent unnecessary health-related problems in mothers and newborns, postnatally. In order to identify the areas of maternity practice that require improvement in Swaziland, the overall aim of this study was to generate systematic data on the maternity care and social support provided by health professionals (for adolescent mothers and their children) on admission, in the labour ward, and during and after delivery. The study was carried out during a 3-month period from April to June 1998. All pregnant adolescents with an uneventful term pregnancy, admitted to the Mbabane Government Hospital maternity ward in the morning of the study days, were informed about the purpose of the study and asked if they would like to participate. A total of 33 pregnant adolescents agreed and in-depth interviews were conducted with those participants. Observations and checklists were used to assess the maternity care given to the study participants. Results revealed that on admission to the labour ward, verbal communication and interaction between the midwife and the adolescent were minimal, and none of the adolescents was encouraged to bring a social support person to remain with them during labour. During the progress of labour, nearly 50% of the adolescent mothers developed complications and approximately 27% had a lower-segment Caesarean section. Special attention should therefore be paid to adolescent sexual and reproductive health service needs. These should include contraceptive counselling in order to prevent pregnancy at a young age and also to improve their sexual and reproductive health statuses.     

缩短产程的护理干预

目的缩短产程，提高产程的护理质量，减轻产妇痛苦。方法观察A、B两组二组产妇的产程进展情况，A组为实验组，当产妇宫颈口扩张至3-4cm时，既使用654-2 10mg缓慢静脉注射，扩张至5-6cm时，用0．2％的利多卡因行宫颈封闭：产妇宫颈完全扩张后，催产素1-3u行合谷或内关穴位封闭：同时做好心理护理；阵缩时帮助产妇按摩子宫或按压腰骶部酸胀处等。B组不做产程护理干预。结果使用这一方法，大大缩短了产程，从而减轻了产妇的痛苦。结论认真观察产程，选择适当的时机，进行一些产程护理干预，并做好心理护理和产程对症护理是提高产程护理质量的有效方法。