产前综合干预对初产妇分娩自我效能及分娩结局的影响
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摘要
目的
了解初产妇的分娩自我效能现状及影响因素,探讨以增强分娩自我效能的产前综合干预模式对初产妇分娩应对能力及分娩结局的影响。
方法
本研究属于临床类实验研究设计。2010年8月～2010年11月期间,在中南大学湘雅三医院产科门诊随机抽取93名初产妇,按照随机数字表法分为干预组44例,对照组49例。采用《一般情况问卷》、《简化中文版分娩自我效能量表》(CBSEI-C32)、《分娩应对量表》(CCB)、《视觉模拟量表》(VAS)对初产妇的一般情况、分娩自我效能、分娩应对能力和产时疼痛程度进行评估,选取总产程时间、新生儿1分钟Apgar评分、剖宫产率为分娩结局的客观指标。对照组予以常规产检及护理,干预组在常规产检及护理的基础上给予以自我效能理论为基础的产前综合干预。两组分别在孕28周、孕38周、产后48小时内收集客观与主观指标。对所得数据进行整理、复核,录入SPSS13.0统计软件进行统计分析。
结果
1.CBSEI-C32的自我效能期望EE-16平均分为(92.51+28.67)分,结果期望OE-16平均分为(94.20+28.15)分,CBSEI-C32平均分为(186.71+54.40)分。结果表明初产妇分娩自我效能期望水平EE-16低于结果期望OE-16。文化程度、职业、医疗费用来源、家庭人均月收入、居住地及体重增长不同分类情况下CBSEI-C32得分差异无统计学意义(P>0.05)
2.干预前两组OE-16、EE-16、CBSEI-C32得分差异无统计学意义(P>O.05)。经过产前综合干预后,干预组初产妇OE-16、EE-16、CBSEI-C32得分的上升幅度大于对照组(P<0.05)
3.干预组初产妇分娩应列能力高于对照组(P<0.05)；组间相比较,干预组产时感知疼痛水平低于对照组,差异有统计学意义(P<0.01)。
4.干预组初产妇总产程时间短于对照组(P<0.01)；干预组剖宫产率低于对照组(P<0.05)；干预后两组新生儿1分钟Apgar评分差异没有统计学意义(P>0.05)。
结论
1.初产妇的自我效能预期低于结果预期。
2.产前综合干预可提高初产妇的分娩自我效能感水平,提高分娩应对能力,降低初产妇对产时疼痛的感知水平。
3.产前综合干预可缩短总产程时间,降低剖宫产率。
Objectives
To understand the current childbirth self-efficacy situation of Primipara; to explore the factors related to childbirth self-efficacy; to test the effectiveness of an efficacy-enhancing prenatal comprehensive intervention to promote women's self-efficacy for childbirth and coping ability during labour and childbirth outcomes.
Methods
This study is quasi-experimental clinical design. This study randomly selects 93 primiparas in the Third Xiangya Hospital, Central South University from August,2010 to November,2010, and allocated them randomly to two groups:intervention group(44 cases),control group(49 cases).At the general survey beginning, the CBSEI-C32,the CCB,the VAS are applied to assess the general situation of maternal childbirth self-efficacy, coping ability during labour capabilities and assess the degree of pain produced in labour. Select the total stages of labour time,l minute Apgar score of Neonate,cesarean section rate as objective indicators to measure childbirth outcomes. The control group received routine prenatal examination and care, intervention group received regular care and prenatal comprehensive intervention based on self-efficacy theory. The data were analyzed using the SPSS 13.0 statistical software.
Results:
l.The results show that the initial level of maternal self-efficacy expectations (EE-16)were lower than the outcome expectations (OE-16).
2.At the beginning,OE-16,EE-16,CBSEI-C32 scores of two groups were no significant differences(P>0.05). After prenatal comprehensive intervention, the intervention group OE-16, EE-16, CBSEI-C32 scores increased more than the control group (P<0.05).
3. Intervention group reported a significantly higher level of coping behavior during labour than the control group (P<0.05); the control group produced significantly higher perception of pain compared with the intervention group, the difference has statistic meaning(P<0.01).
4. The total stages of labor time of the intervention group is shorter than that of the control group(P<.01); The cesarean section rate of intervention group was lower the control group (P<0.05); The two groups were no difference in 1 minute Apgar score of Newborn (P> 0.05).
Conclusions
1. Self-efficacy expectations of primiparas were lower than the outcome expectations.
2.The prenatal comprehensive intervention based on Bandura's self-efficacy theory is effective in promoting pregnant women's self-efficacy for childbirth and reducing their perceived pain.
3. Prenatal comprehensive intervention can reduce the total stages of labor time and the rate of cesarean section.
了解初产妇的分娩自我效能现状及影响因素,探讨以增强分娩自我效能的产前综合干预模式对初产妇分娩应对能力及分娩结局的影响。
方法
本研究属于临床类实验研究设计。2010年8月～2010年11月期间,在中南大学湘雅三医院产科门诊随机抽取93名初产妇,按照随机数字表法分为干预组44例,对照组49例。采用《一般情况问卷》、《简化中文版分娩自我效能量表》(CBSEI-C32)、《分娩应对量表》(CCB)、《视觉模拟量表》(VAS)对初产妇的一般情况、分娩自我效能、分娩应对能力和产时疼痛程度进行评估,选取总产程时间、新生儿1分钟Apgar评分、剖宫产率为分娩结局的客观指标。对照组予以常规产检及护理,干预组在常规产检及护理的基础上给予以自我效能理论为基础的产前综合干预。两组分别在孕28周、孕38周、产后48小时内收集客观与主观指标。对所得数据进行整理、复核,录入SPSS13.0统计软件进行统计分析。
结果
1.CBSEI-C32的自我效能期望EE-16平均分为(92.51+28.67)分,结果期望OE-16平均分为(94.20+28.15)分,CBSEI-C32平均分为(186.71+54.40)分。结果表明初产妇分娩自我效能期望水平EE-16低于结果期望OE-16。文化程度、职业、医疗费用来源、家庭人均月收入、居住地及体重增长不同分类情况下CBSEI-C32得分差异无统计学意义(P>0.05)
2.干预前两组OE-16、EE-16、CBSEI-C32得分差异无统计学意义(P>O.05)。经过产前综合干预后,干预组初产妇OE-16、EE-16、CBSEI-C32得分的上升幅度大于对照组(P<0.05)
3.干预组初产妇分娩应列能力高于对照组(P<0.05)；组间相比较,干预组产时感知疼痛水平低于对照组,差异有统计学意义(P<0.01)。
4.干预组初产妇总产程时间短于对照组(P<0.01)；干预组剖宫产率低于对照组(P<0.05)；干预后两组新生儿1分钟Apgar评分差异没有统计学意义(P>0.05)。
结论
1.初产妇的自我效能预期低于结果预期。
2.产前综合干预可提高初产妇的分娩自我效能感水平,提高分娩应对能力,降低初产妇对产时疼痛的感知水平。
3.产前综合干预可缩短总产程时间,降低剖宫产率。
Objectives
To understand the current childbirth self-efficacy situation of Primipara; to explore the factors related to childbirth self-efficacy; to test the effectiveness of an efficacy-enhancing prenatal comprehensive intervention to promote women's self-efficacy for childbirth and coping ability during labour and childbirth outcomes.
Methods
This study is quasi-experimental clinical design. This study randomly selects 93 primiparas in the Third Xiangya Hospital, Central South University from August,2010 to November,2010, and allocated them randomly to two groups:intervention group(44 cases),control group(49 cases).At the general survey beginning, the CBSEI-C32,the CCB,the VAS are applied to assess the general situation of maternal childbirth self-efficacy, coping ability during labour capabilities and assess the degree of pain produced in labour. Select the total stages of labour time,l minute Apgar score of Neonate,cesarean section rate as objective indicators to measure childbirth outcomes. The control group received routine prenatal examination and care, intervention group received regular care and prenatal comprehensive intervention based on self-efficacy theory. The data were analyzed using the SPSS 13.0 statistical software.
Results:
l.The results show that the initial level of maternal self-efficacy expectations (EE-16)were lower than the outcome expectations (OE-16).
2.At the beginning,OE-16,EE-16,CBSEI-C32 scores of two groups were no significant differences(P>0.05). After prenatal comprehensive intervention, the intervention group OE-16, EE-16, CBSEI-C32 scores increased more than the control group (P<0.05).
3. Intervention group reported a significantly higher level of coping behavior during labour than the control group (P<0.05); the control group produced significantly higher perception of pain compared with the intervention group, the difference has statistic meaning(P<0.01).
4. The total stages of labor time of the intervention group is shorter than that of the control group(P<.01); The cesarean section rate of intervention group was lower the control group (P<0.05); The two groups were no difference in 1 minute Apgar score of Newborn (P> 0.05).
Conclusions
1. Self-efficacy expectations of primiparas were lower than the outcome expectations.
2.The prenatal comprehensive intervention based on Bandura's self-efficacy theory is effective in promoting pregnant women's self-efficacy for childbirth and reducing their perceived pain.
3. Prenatal comprehensive intervention can reduce the total stages of labor time and the rate of cesarean section.
引文
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