新冠疫情期间IKAP模式院外延续管理对高危孕妇妊娠结局的影响

目的 探讨基于信息(I)-知识(K)-信念(A)-行为(P)模式的院外延续管理对疫情期间高危孕妇自我管理及妊娠结局的影响。方法 选择于本院建档并定期产检且预产期在2020年4—7月的76例高危孕妇作为研究对象,随机分为研究组和对照组,疫情期间,对照组给予常规院外延续管理,研究组给予基于IKAP模式下院外延续管理,均干预3个月,评估干预前后患者自我管理效能,比较两组妊娠结局。结果 干预前,两组孕妇GSES评分比较差异无统计学意义(P值均＞0.05);干预后,对照组孕妇GSES评分为(29.52±3.76),高于干预前的(19.38±4.82),(t=3.644,P=0.001);研究组GSES评分为(35.17±2.49),高于干预前的(17.76±3.64),(t=4.459,P＜0.001);干预后,研究组GSES评分为(35.17±2.49),高于对照组的(29.52±3.76),(t=3.018,P=0.004)。研究组顺产率为84.21%,高于对照组的52.63%(χ2=8.769,P=0.003),研究组剖宫产率为10.53%,中转率为5.26%,均低于对照组的26.32%和21.05%(Fisher χ2=8.739,P=0.014);研究组新生儿1 min和5 min Apgar评分分别为(7.76±0.83)和(9.13±0.46),均高于对照组的(6.59±1.06)和(7.85±0.94),(t值分别为2.299、2.842,P值均＜0.05)。结论 基于IKAP模式的院外延续管理模式能够明显提高高危孕妇院外自我管理效能,降低剖宫产及剖宫产中转率,提高自然分娩率。

Influence of IKAP model out-of-hospital continuation management on pregnancy outcome of high-risk pregnant women during COVID-19 pandemic

Objective To explore the impact of information-knowledge-attitude-practice (IKAP) model out-of-hospital continued management on the self-management and pregnancy outcomes of high-risk pregnant women during the COVID-19 pandemic. Methods A total of 76 high-risk pregnant women who were filed in our hospital and underwent regular check-ups and whose expected delivery date was from April to July 2020 were selected as the research objects, and they were randomly divided into a study group and a control group. The control group was given the regular out-of-hospital continuation management, and the study group was given the out-of-hospital continuation management based on the IKAP model during the COVID-19 pandemic period. Both interventions were performed for 3 months. The patients' self-management efficacy was evaluated before and after the intervention, and the pregnancy outcomes were compared between the two groups. Results Before the intervention, there was no significant difference in the GSES scores between the two groups (all P>0.05). After the intervention, the average GSES score of the pregnant women in the control group was (29.52±3.76) points, higher than that before the intervention (t=3.644, P=0.001); the average GSES score of the study group was (35.17±2.49) points, which was higher than that (17.76±3.64) points before the intervention (t=4.459, P<0.001). After the intervention, the GSES score of the study group was (35.17±2.49) points, which was higher than that (29.52±3.76) points of the control group, (t=3.018, P=0.004). The normal delivery rate in the study group was 84.21%, which was higher than that (52.63%) in the control group (χ2=8.769, P=0.003). The cesarean section rate in the study group was 10.53%, and the transfer rate was 5.26%, both lower than those (26.32% and 21.05%) in the control group (Fisherχ2=8.739, P=0.014). The 1-min and 5-min Apgar scores of the newborns in the study group were (7.76±0.83) and (9.13±0.46) points, respectively, which were higher than those of the control group, (t=2.299, 2.842, both P<0.05). Conclusion The out-of-hospital continuation management model based on the IKAP model can significantly improve the out-of-hospital self-management efficiency of high-risk pregnant women, reduce the cesarean section rate and the transition rate of cesarean section, and increase the rate of natural delivery.