Gao Ping, Guo Cai-Qiong, Chen Ma-Yu, Zhuang Hui-Ping
Department of Obstetrics and Gynecology, Quanzhou Maternity and Child Healthcare Hospital, Quanzhou 362017, Fujian Province, China.
School of Nursing, Fujian Medical University, Quanzhou 350108, Fujian Province, China.
World J Psychiatry. 2023 Aug 19;13(8):543-550. doi: 10.5498/wjp.v13.i8.543.
Primiparas are usually at high risk of experiencing perinatal depression, which may cause prolonged labor, increased blood loss, and intensified pain, affecting maternal and fetal outcomes. Therefore, interventions are necessary to improve maternal and fetal outcomes and alleviate primiparas' negative emotions (NEs).
To discusses the impact of nursing responsibility in midwifery and postural and psychological interventions on maternal and fetal outcomes as well as primiparas' NEs.
As participants, 115 primiparas admitted to Quanzhou Maternity and Child Healthcare Hospital between May 2020 and May 2022 were selected. Among them, 56 primiparas (control group, Con) were subjected to conventional midwifery and routine nursing. The remaining 59 (research group, Res) were subjected to the nursing model of midwifery and postural and psychological interventions. Both groups were comparatively analyzed from the perspectives of delivery mode (cesarean, natural, or forceps-assisted), maternal and fetal outcomes (uterine inertia, postpartum hemorrhage, placental abruption, neonatal pulmonary injury, and neonatal asphyxia), NEs (Hamilton Anxiety/Depression-rating Scale, HAMA/HAMD), labor duration, and nursing satisfaction.
The Res exhibited a markedly higher natural delivery rate and nursing satisfaction than the Con. Additionally, the Res indicated a lower incidence of adverse events (, uterine inertia, postpartum hemorrhage, placental abruption, neonatal lung injury, and neonatal asphyxia) and shortened duration of various stages of labor. It also showed statistically lower post-interventional HAMA and HAMD scores than the Con and pre-interventional values.
The nursing model of midwifery and postural and psychological interventions increase the natural delivery rate and reduce the duration of each labor stage. These are also conducive to improving maternal and fetal outcomes and mitigating primiparas' NEs and thus deserve popularity in clinical practice.
初产妇通常面临较高的围产期抑郁风险，这可能导致产程延长、失血增加和疼痛加剧，影响母婴结局。因此，有必要采取干预措施以改善母婴结局并减轻初产妇的负面情绪。
探讨助产护理职责以及体位和心理干预对母婴结局及初产妇负面情绪的影响。
选取2020年5月至2022年5月在泉州市妇幼保健院住院的115例初产妇作为研究对象。其中，56例初产妇（对照组，Con）接受常规助产和常规护理。其余59例（研究组，Res）接受助产护理模式以及体位和心理干预。从分娩方式（剖宫产、自然分娩或产钳助产）、母婴结局（宫缩乏力、产后出血、胎盘早剥、新生儿肺损伤和新生儿窒息）、负面情绪（汉密尔顿焦虑/抑郁量表，HAMA/HAMD）、产程及护理满意度等方面对两组进行比较分析。
研究组的自然分娩率和护理满意度显著高于对照组。此外，研究组不良事件（宫缩乏力、产后出血、胎盘早剥、新生儿肺损伤和新生儿窒息）的发生率较低，且各产程阶段时间缩短。研究组干预后的HAMA和HAMD评分在统计学上也低于对照组及干预前水平。
助产护理模式以及体位和心理干预可提高自然分娩率，缩短各产程阶段时间。这也有助于改善母婴结局，减轻初产妇的负面情绪，因此值得在临床实践中推广。
