護理干預(yù)對母嬰分離產(chǎn)婦的影響

論文編號:HL230 論文字數(shù):12816,頁數(shù):26

論文題目：護理干預(yù)對母嬰分離產(chǎn)婦的影響
摘　要
 目的：本研究調(diào)查并分析了因新生兒轉(zhuǎn)入新生兒重癥監(jiān)護病房治療導(dǎo)致的母嬰分離給高危妊娠產(chǎn)婦造成的心理影響，并在此基礎(chǔ)上探討應(yīng)用護理干預(yù)對改善此類產(chǎn)婦身心狀態(tài)的有效性及影響干預(yù)效果的相關(guān)因素。為母嬰分離高危妊娠產(chǎn)婦這一特殊群體提供科學(xué)的護理干預(yù)模式。
 方法：本研究應(yīng)用類試驗的研究方法，便利抽樣獲得母嬰分離高危妊娠產(chǎn)婦，于剖宮產(chǎn)術(shù)后1天應(yīng)用《狀態(tài)—特質(zhì)焦慮量表》和《愛丁堡產(chǎn)后抑郁量表》對研究對象進行心理評估。獲得基線資料后，對照組接受醫(yī)院常規(guī)護理，干預(yù)組在常規(guī)護理基礎(chǔ)上由研究者本人給予護理干預(yù)采取個別指導(dǎo)和發(fā)放健康手冊的方式，給予包括心理干預(yù)、信息支持、母嬰分離期間乳房護理以及產(chǎn)后周電話隨訪在內(nèi)的護理干預(yù)，并于產(chǎn)后7天、產(chǎn)后6周再次進行心理評估。運用檢驗、卡方檢驗、重復(fù)測量的方差分析、t檢驗及多元逐步回歸分析等統(tǒng)計學(xué)方法，分析母嬰分離對于高危妊娠產(chǎn)婦身心狀態(tài)的影響，對護理干預(yù)緩解母嬰分離高危妊娠產(chǎn)婦身心狀態(tài)的效果進行評價，并進一步分析干預(yù)效果的影響因素。
 結(jié)果：母嬰分離高危妊娠產(chǎn)婦剖宮產(chǎn)術(shù)后1天的心理狀態(tài)①術(shù)后1天研究對S-AI分值為43.80±7.43，明顯高于國內(nèi)正常女性人群。②術(shù)后1天產(chǎn)后抑郁評分為10.22±4.43，產(chǎn)后抑郁發(fā)生率為57.9%。
 護理干預(yù)對母嬰分離高危妊娠產(chǎn)婦心理應(yīng)激的干預(yù)效果評價①干預(yù)組和對照組在術(shù)后7天、術(shù)后6周兩個時間點的狀態(tài)焦慮的差異、抑郁發(fā)生率的差異有統(tǒng)計學(xué)意義（p<0.05）②干預(yù)組術(shù)后1天、7天、6周的狀態(tài)焦慮、抑郁分值的差異有統(tǒng)計學(xué)意義（p<0.05）對照組術(shù)后1天、7天的狀態(tài)焦慮、抑郁分值的差異無統(tǒng)計學(xué)意義（p>0.05）。③干預(yù)組與對照組術(shù)后6周抑郁分值的差異無統(tǒng)計學(xué)意義（p>0.05）。結(jié)論：對母嬰分離高危妊娠產(chǎn)婦實施護理干預(yù)，可有效減輕產(chǎn)婦心理應(yīng)激反應(yīng)、降低乳脹的發(fā)生率、提高母乳喂養(yǎng)率。
 關(guān)鍵詞: 母嬰分離、高危、妊娠產(chǎn)婦、焦慮、抑郁、護理干預(yù)
 
Title: The Nursing intervention separation of the influence of maternal maternal and infant
 ABSTRACT
 
Objective
 To investigate and analyze the physical and psychological state of high-risk pregnancy mothers after their babies being transferred to Neonatal Intensive Care Unit, evaluate the effect of nursing methods, and discuss the influential factors of this intervention. Eventually, to explore a scientific nursing Intervention model for high-risk pregnancy mothers after being separated from their newborn．
Methods
 a quasi-experiment design was conducted among 6 high-risk pregnancy mothers recruited after being separated from their newborns. For the intervention group, the researcher provided nursing intervention, while the control group was only given routine nursing care. Data were collected on the 1st, 7th and 42nd day of cesarean section (including STA-I, EPDS, HR, SBP, BS, Mammary Swelling Incidence and Breastfeeding Incidence). T-test > Chi-square test ^ Mann-Whitney U test and Multivariate stepwise regression were performed throughout the data analysis.
Results
1. On the 1st day of cesarean section, the psychological state of high-risk pregnancy mothers after being separated from their newborns: The S-AI score is 43.80±7.43 and significantly higher than the normal standard in China. The EPDS score is 10.22±4.43 and Postpartum Depression Incidence is 57.9%.
2. Effect of nursing intervention on psychological state of high-risk pregnancy mothers after being separated from their newborns: (1) on the 7th and 42nd day of cesarean incidence in intervention group decreased significantly. on the lst,7th and 42nd day of cesarean section, the S-AI score and EPDS in intervention group decreased significantly; on the 7th day of cesarean section, the control groups S-AI score and EPDS have no statistics differences. (3)on the 7th day of cesarean section, the two groups' endocrine indexes have statistics differences. on the 42nd day of cesarean section, there were no statistics differences of EPDS scores between two groups. on the 7th day of cesarean section, the two groups' physical indexes have no statistics differences.
Conclusion
Nursing intervention can effectively relieve the response intensity of the stress, decrease the Mammary Swelling Incidence and improve breastfeeding.
Key words：Mother-baby separation; High-risk pregnancy Mother; Anxiety; Depression; Nursing intervention
 
 目  錄
 
1 緒論 1
1.1 背景及意義 1
1.2目的 1
1.3關(guān)鍵詞及定義…………………………………………………………………….....2                                                     
1.4文獻回顧…………………………………………………………………………….2
2 研究設(shè)計 5
2.1研究設(shè)計 5
2.2研究對象 5
2.3研究工具 5
2.4研究步驟 7
2.5統(tǒng)計分析 7
3 研究結(jié)果 8
3．1 母嬰分離高危妊娠產(chǎn)婦剖宮產(chǎn)術(shù)后1天的心理狀態(tài) 8
3．2護理干預(yù)對母嬰分離高危妊娠產(chǎn)婦的干預(yù)效果評價 8
4 討論 10
4．1母嬰分離高危妊娠產(chǎn)婦的心理狀態(tài) 10
4．2護理干預(yù)的干預(yù)效果及相關(guān)因素分析 11
4．3 小結(jié) 11
5 推論及建議 13
5．1 結(jié)論 13
5．2 本研究局限性及展望 13
致    謝 14
參考文獻 15