尹红英　江金香

[摘要] 目的 探讨产科一体化护理模式对产妇产后角色转换、情绪调节及产妇泌乳的影响。 方法 选取2011年5月～2013年5月在医院分娩的160例产妇按照随机数字表法分为观察组80例和对照组80例，对照组采用常规护理方案，观察组在对照组基础上联合一体化护理模式；比较两组产妇角色转换、情绪调节作用，并观察两组产妇泌乳始动时间、泌乳量以及血清PRL水平。 结果 观察组角色转换、新生儿照护能力评分均显著高于对照组，两组间比较差异具有统计学意义（P<0.05）；护理后两组产妇SAS、SDS评分显著降低，其中观察组SAS、SDS评分显著低于对照组（P<0.05）。观察组泌乳始动时间显著早于对照组，产后24 h、48 h、72 h泌乳量以及血清PRL水平显著高于对照组，两组间各指标比较差异均具有统计学意义（P<0.05）。 结论 一体化护理模式能够加速产妇角色转换、改善产妇负性情绪，能促进产妇尽早分泌乳汁，且该方法可操作性强、易于学习，值得临床推广。

[关键词] 一体化护理；角色转换；产妇；负性情绪；护理方案；泌乳素

[中图分类号] R473.7 [文献标识码] B [文章编号] 1673-9701（2015）35-0143-04

[Abstract] Objective To explore the role conversion， emotion regulation and maternal lactation effect of obstetrics integrated nursing model on maternal. Methods A total of 160 cases maternal delivery in our hospital from May 2011 to May 2013 were randamly divided into observation group 80 cases and control group of 80 cases， the control group was treated with routine nursing， the observation group based on the control group underwent integrated nursing model. The maternal role conversion and emotion regulation effect was compared between two groups， and lactation maternal initial time， lactation and serum PRL levels were observed. Results The role conversion and neonatal care ability score in observation group were significantly higher than the control group， and the difference between two groups with statistically significant（P<0.05）. Two groups of maternal SAS， SDS score was significantly lower， and the observation group SDS， SAS score was significantly lower than the control group（P<0.05）. The observation group in the initial time of lactation significantly earlier than the control group， postpartum 24 h， 48 h， 72 h lactation quantity and the level of serum PRL was significantly higher than that of the control group， and each index of two group with statistical significance（P<0.05）. Conclusion Integration nursing mode can be accelerate maternal role conversion， improve maternal negative emotion，promote milk secretion，the method is easy to learn， and worthy of clinical application.

[Key words] Integrated nursing； Role transition； Maternal； Negative emotion； Nursing program； Prolactin

产妇从妊娠至分娩，经历了从女性个体到母亲的身份、角色转换；这种角色转换过程中常给产妇造成焦虑、抑郁等负性情绪，给产妇的产后康复带来一定影响[1，2]。胡玉美等[3]报道称产后负性情绪会显著延长泌乳始动时间和泌乳量严重不足；部分产妇甚至出现乳房肿胀的情况，不利于母乳喂养的实施。产科一体化护理的核心思想在于将产妇、婴儿作为一个整体，通过在生理、心理上将产妇、婴儿、家庭一体化，明确个人的角色，从而加快产妇的自我调整时间。本研究对在医院分娩的产妇采用产科一体化护理模式，观察对产妇产后角色转换、情绪调节及泌乳等的影响，旨在为产妇产后护理提供一种新的路径，现报道如下。

1 资料与方法

1.1 一般资料

选择2011年5月～2013年5月在医院分娩的160例产妇作为研究对象，年龄21～34岁，平均（28.1±4.9）岁；……