心理护理干预对中晚期妊娠孕妇分娩方式的影响

目的探讨中晚期孕妇不同意向分娩方式的心理状态以及心理护理干预对其分娩方式的影响。方法将184例中晚期妊娠孕妇随机分为干预组及对照组各92例，分别在首次建卡及预产期前2周进行焦虑自评量表（SAS）、抑郁自评量表（SDS）、症状自评量表（SCL-90）问卷调查，并在建卡时调查意向性分娩方式；干预组主要采用“合理情绪疗法”进行心理干预，对照组采用常规心理护理。观察所有孕妇心理状态，比较两种不同的意向性分娩方式孕妇心理状态，比较两组孕妇实际分娩方式。结果184例孕妇SAS、SDS、SCL-90指标均高于中国常模，两者比较差异有统计学意义[（41．11±7．64）分比（29．78±10．07）分，（53．29±10．04）分比（41．59±10．54）分，（182．52±30．65）分比（129．96±38．76）分；t分别为20.12，15．80，23．25；P〈0.01]；而意向性选择剖宫产的孕妇SAS、SDS、SCL-90指标均高于意向性选择自然分娩，两者比较差异有统计学意义[（44．54±9．23）分比（36．67±7．45）分，（57．95±11．65）分比（47．36±10．67）分，（192．83±31．51）分比（169．73±28．54）分；t分别为5．29，642，4．98；P〈Q01]；心理护理干预后，干预组意向性剖宫产43例，实际剖宫产33例，对照组意向性剖宫产41例，实际剖宫产47例，两组比较差异有统计学意义（x^2=4．33，P〈n05）。结论中晚期妊娠孕妇焦虑及抑郁因素可能是影响孕妇选择分娩方式的重要因素之一，合理的心理干预可能有利于降低剖宫产率。

Effect of psychological nursing intervention on delivery patterns of middle-late pregnant women

Objective To explore the mental status of middle-late pregnant women with different intentions toward delivery pattern and the effect of the psychological nursing intervention on their delivery pattern. Methods Totals of 184 middle-late pregnant women were randomly divided into intervention group and control group and they were investigated with self-rating anxiety scale（ SAS）, self-rating depression scale（SDS） and symptom checklist 90（SCL-90） in the first time of got perinatal health care card and two weeks before the expected date of childbirth. The main psychological nursing intervention of intervention group was＇ rational emotive therapy＇, while control group received traditional psychological nursing intervention. Then, the status of pregnant women＇ mental was observed and two difference intension of delivery pattern among pregnant women and their delivery pattern were compared. Results The SAS score （41.11 ± 7.64 ）, SDS score （53.29 ± 10.04） ,SCL-90 score（ 182.52 ± 30.65） of 184 pregnant women was higher than that of China norms, which score in order was （29.78 ± 10.07 ）, （41.59 ± 10.54 ） and （ 129.96 ± 38.76）, the difference between them was statistically significant （ t = 20. 12,15.80,23.25, respectively; P 〈 0.01 ）. The score of SAS, SDS, SCL-90 of pregnant women with the intention of cesarean in order was （44.54 ± 9.23 ）, （ 57.95 ± 11.65 ）, （ 192.83 ± 31.51 ） higher than that of pregnant women with the intention of spontaneous labor ,which score in order was （36.67 ± 7.45）, （47.36 ± 10. 67） , （169.73 ± 28.54）, and the difference was statistically significant （t = 5. 29,6.42,4.98, respectively;P 〈0. 01 ）. After psychological intervention, 43 cases of intervention group had intention of caesarean section and 33 cases selected caesarean section in fact,totals of 41 cases of control group had intention of caesarean section and 47 cases selected , in fact, and the difference was statistically significant （ X2 = 4. 33, P 〈 0. 05 ）. Conclusions Anxiety and depression of middle-late pregnant women maybe are important influencing factors for their delivery selection, and reasonable psychological nursing intervention maybe good for reducing the ratio of cesarean.