Nolan Anne, Lawrence Carol
School of Nursing, Florida Gulf Coast University, 10501 FGCU Boulevard South, Fort Myers, FL 33965-6565, USA.
J Obstet Gynecol Neonatal Nurs. 2009 Jul-Aug;38(4):430-42. doi: 10.1111/j.1552-6909.2009.01039.x.
To pilot test a standardized intraoperative and postoperative nursing intervention protocol to minimize maternal-infant separation after Cesarean.
Randomized-controlled trial.
A 250-bed acute care community hospital labor/delivery/recovery/postpartum unit with approximately 150 repeat Cesarean deliveries per year.
Fifty women having a live, term, singleton, repeat Cesarean delivery and their newborns.
A standardized nursing intervention protocol was designed and administered to minimize the amount of maternal-infant spatial, tactile, olfactory, auditory, and visual separation post-Cesarean.
Maternal outcomes included maternal pain, anxiety, and childbirth perception. Infant outcomes included respiratory rate, temperature, stress (infant salivary cortisol), and breastfeeding rates.
Compared with the control group, the intervention group experienced earlier first physical contact and feedings and a longer interval until the infant first bath. Differences were found between treatment groups for infant temperatures and respiratory rates. Three infants in the control group experienced suboptimal temperatures. Infants in the intervention group had significantly higher salivary cortisol levels but were within the normal upper level range. No differences were noted in maternal pain, maternal anxiety, or perception of birth experience among treatment groups.
The pilot was valuable in examining intervention feasibility, appropriate outcome measures, and data collection strategies. The standardized intervention protocol shows promise for positively affecting maternal-infant outcomes after Cesarean delivery and merits further testing.
对一项标准化的术中及术后护理干预方案进行试点测试，以尽量减少剖宫产术后母婴分离的情况。
随机对照试验。
一家拥有250张床位的急症护理社区医院的分娩/接生/恢复/产后病房，每年约有150例再次剖宫产分娩。
50名进行足月、单胎、再次剖宫产分娩的产妇及其新生儿。
设计并实施一项标准化护理干预方案，以尽量减少剖宫产术后母婴在空间、触觉、嗅觉、听觉和视觉上的分离。
产妇结局包括产妇疼痛、焦虑和分娩感受。婴儿结局包括呼吸频率、体温、应激（婴儿唾液皮质醇）和母乳喂养率。
与对照组相比，干预组首次身体接触和喂奶时间更早，婴儿首次洗澡的间隔时间更长。治疗组在婴儿体温和呼吸频率方面存在差异。对照组有3名婴儿体温不理想。干预组婴儿的唾液皮质醇水平显著更高，但在正常上限范围内。各治疗组在产妇疼痛、产妇焦虑或分娩体验感知方面未发现差异。
该试点对于检验干预的可行性、合适的观察指标和数据收集策略具有重要价值。标准化干预方案有望对剖宫产术后的母婴结局产生积极影响，值得进一步测试。
