中心群组化孕期保健模式对初产妇分娩恐惧及妊娠结局的影响

目的探讨中心群组化孕期保健模式对初产妇分娩恐惧及妊娠结局的影响。方法本研究为类实验研究。采用便利抽样法,选取2019年12月—2020年4月在湖南省某三级甲等医院产科门诊建卡并存在分娩恐惧的60名初产妇,按随机数字表法分为干预组和对照组各30名。对照组初产妇实施常规护理,干预组初产妇实施中心群组化孕期保健模式,采用分娩恐惧量表、妊娠结局评价两组产妇干预前后的效果。采用SPSS 22.0软件进行数据分析。结果干预1个月及干预结束时,干预组分娩恐惧总分分别为(24.93±3.27)、(22.93±2.29)分,分别低于对照组的(35.30±8.58)、(34.47±8.70)分,重复测量方差分析结果显示,两组总分存在时间效应、分组效应、交互效应,差异有统计学意义(F时间=36.117,F组间=15.990,F交互=26.802;P<0.05)。干预组自然分娩率为86.7%(26/30),高于对照组的63.3%(19/30),干预组会阴损伤率为16.7%(5/30),低于对照组的43.3%(13/30),差异均有统计学意义(χ²值分别为4.356、5.079;P<0.05)。两组初产妇的产后2 h出血量、新生儿1 min Apgar评分比较,差异均无统计学意义(P>0.05)。结论中心群组化孕期保健模式应用到存在分娩恐惧的初产妇中,有助于缓解初产妇的分娩恐惧,改善初产妇的不良妊娠结局,对临床实践有一定借鉴意义。

Effects of Group Prenatal Care model on the fear of childbirth and pregnancy outcome of primipara

Objective To explore the effects of Group Prenatal Care(GPC)model on the fear of childbirth and pregnancy outcome of primiparas.Methods This study was a quasi-experiment study.Totally 60 primiparas with fear of childbirth who established medical records in the Department of Obstetrics of a ClassⅢGrade A hospital in Hunan Province between December 2019 and April 2020 were selected by convenient sampling and divided into the intervention group and control group,with 30 cases in each group.Primiparas in the control group received routine care,while primiparas in intervention group received the central groupbased pregnancy care model.The Childbirth Attitudes Questionnaire and pregnancy outcome evaluation were used to evaluate the effects in the two groups before and after intervention.SPSS 22.0 was used for data analysis.Results After 1 month of intervention and at the end of the intervention,the total scores of fear of childbirth in the intervention group were(24.93±3.27)and(22.93±2.29),which were lower than(35.30±8.58)and(34.47±8.70)in the control group,respectively.Repeated measurement variance analysis showed that there were temporal,grouping and interaction effects in the total scores of the two groups,and the differences were statistically significant(F_time=36.117,Fgroup=15.990,Finteraction=26.802;P<0.05).The natural delivery rate in the intervention group was 86.7%(26/30),which was higher than 63.3%(19/30)in the control group;the perineal injury rate in the intervention group was 16.7%(5/30),which was lower than 43.3%(13/30)in the control group,and the differences were statistically significant(χ²=4.356,5.079;P<0.05).There was no statistically significant difference in 2 h postpartum blood loss of primiparas and 1min Apgar score of newborns between the two groups of primipara(P>0.05).Conclusions GPC model in primiparas with fear of childbirth can help to relieve the fear of childbirth in primiparas,and improve their negative pregnancy outcome,which is of significance for clinical practice.