Sholikah Siti Mar'atus, Nurwulansari Fitria, Aini Elfira Nurul, Wardoyo Slamet, Pramudita Jessica Juan
Department of Midwifery, Poltekkes Kemenkes Surabaya, Surabaya, Indonesia.
Department of Environmental Health, Poltekkes Kemenkes Surabaya, Surabaya, Indonesia.
Eur J Midwifery. 2025 Jan 3;9. doi: 10.18332/ejm/195831. eCollection 2025.
High-risk pregnancies require special attention in maternal and child health services, given the high potential for complications that can affect maternal and fetal health. The continuity of care (COC) approach is expected to increase family independence and prevent pregnancy complications. This study aims to analyze the effectiveness of COC in improving the family independence of high-risk pregnant women in preventing pregnancy complications.
This study used a quasi-experimental design with a pretest-posttest approach without a control group, involving 134 high-risk pregnant women, in the target area at the Wonoayu Community Health Centre, Sidoarjo, Indonesia from February to May 2024, who were selected through purposive sampling. Data were collected through structured questionnaires before and after the COC intervention, which included assessing knowledge and family roles in supporting pregnant women's health. The COC mentoring program was implemented for three months, with a focus on family education and involvement in maternal healthcare. A validated questionnaire measured family self-reliance before and after the intervention.
The study showed a significant increase in family self-reliance, with a p<0.001 in all aspects measured, including fulfilment of physiological and psychological needs, preparation for labor, the postpartum period, and preparation after the baby is born. This increase suggests that the COC intervention is effective in empowering families to support high-risk pregnant women. Before the intervention, the mean score for physiological and psychological needs fulfilment was 17.45, which increased to 36.42 after the intervention (p<0.001). In addition, labor preparation also showed a significant increase from 11.40 to 24.38, as well as postpartum preparation from 13.00 to 28.79, and preparation after the baby is born from 13.25 to 28.75 (all p<0.001).
The consistent improvement in all measured aspects, indicated that the COC intervention not only improved families' knowledge and skills, but also contributed to their preparedness in supporting pregnant women during and after pregnancy.
鉴于高危妊娠可能引发影响母婴健康的并发症，母婴健康服务中需要对其予以特别关注。连续性照护（COC）方法有望增强家庭独立性并预防妊娠并发症。本研究旨在分析连续性照护在提高高危孕妇家庭独立性以预防妊娠并发症方面的有效性。
本研究采用类实验设计，采用无前测后测方法且无对照组，涉及134名高危孕妇，于2024年2月至5月在印度尼西亚泗水市沃诺阿尤社区卫生中心的目标区域选取，通过目的抽样法选取。在COC干预前后通过结构化问卷收集数据，问卷包括评估知识以及家庭在支持孕妇健康方面的作用。COC指导计划实施三个月，重点是家庭教育和参与孕产妇保健。使用经过验证的问卷在干预前后测量家庭自立能力。
研究表明家庭自立能力显著提高，在所有测量方面p<0.001，包括生理和心理需求的满足、分娩准备、产后阶段以及婴儿出生后的准备。这种提高表明COC干预在增强家庭支持高危孕妇的能力方面是有效的。干预前，生理和心理需求满足的平均得分是17.45，干预后增至36.42（p<0.001）。此外，分娩准备也显著提高，从11.40增至24.38，产后准备从13.00增至28.79，婴儿出生后的准备从13.25增至28.75（所有p<0.001）。
所有测量方面的持续改善表明，COC干预不仅提高了家庭的知识和技能，还促进了他们在孕期和产后支持孕妇的准备程度。
