俞凌芳

[摘要] 目的 探討以自我效能理论为指导护理干预对自我效能与分娩方式的影响。 方法 选择2013年10月～2016年10月在我院待产的产妇80例，按照随机数字表法将产妇分为观察组和对照组，各40例。对照组采取常规方式进行护理，观察组在常规护理基础上同时采取以自我效能理论为指导的护理干预。观察两组的自我效能感量表评分、分娩应对量表评分、疼痛评分及分娩结局。 结果 与干预前相比，观察组干预后的自我效能感量表评分明显更高，差异有统计学意义（t=4.625，P<0.05）。与对照组相比，观察组干预后的自我效能感量表评分明显更高，差异有统计学意义（t=3.849，P<0.05）。观察组干预后的分娩应对量表评分均显著更高，差异有统计学意义（t=12.909，P<0.05）。观察组的疼痛结果更优，差异有统计学意义（χ2=34.760，P<0.05）。观察组的阴道分娩率更高，胎儿窘迫、产后出血、新生儿窒息百分比更小，差异有统计学意义（χ2=3.102、6.690、9.240、6.451，P<0.05），而新生儿死亡率对比并无显著差异（χ2=1.090，P>0.05）。 结论 以自我效能理论为指导对产妇进行护理干预，有助于提高产妇的自然分娩率，降低剖宫产率，帮助产妇积极面对临产的疼痛及心理压力，提高产妇的应对应激及分娩结局，值得临床推广。

[关键词] 自我效能理论；护理干预；分娩方式

[中图分类号] R473 [文献标识码] B [文章编号] 1673-9701（2018）10-0147-04

Effect of nursing intervention on self-efficacy and mode of delivery guided by self-efficacy theory

YU Lingfang

Department of Obstetrics， Fuyang District Maternal and Child Health Care Hospital of Hangzhou， Hangzhou 311400， China

[Abstract] Objective To observe the effect of nursing intervention on self-efficacy and mode of delivery guided by self-efficacy theory. Methods 80 cases of maternal in our hospital from October 2013 to October 2016 were selected. And they were divided into observation group and control group with 40 cases respectively according to the random number table method. The control group was treated in a routine manner. The observation group was followed by nursing intervention under the guidance of self-efficacy in routine nursing. The scores of self-efficacy scale， the score of childbirth score， the pain score and the outcome of delivery were observed. Results Compared with before intervention， the scores of self-efficacy scale were significantly higher in the observation group（t=4.625， P<0.05）. Compared with the control group， the self-efficacy scale score of the observation group was significantly higher than that of the control group（t=3.849， P<0.05）， and the scores of the treatment scores were significantly higher in the observation group（t=12.909， P<0.05）， the pain in the observation group was better， with a significant difference（χ2=34.760， P<0.05）. The incidence of vaginal delivery was higher in the observation group， with a smaller percentage of fetal distress， postpartum hemorrhage and neonatal asphyxia， the differences were statistically significant（χ2=3.102， 6.690， 9.240， 6.451， P<0.05）. There was no significant difference in neonatal mortality（χ2=1.090， P>0.05）. Conclusion Care intervention by self-efficacy theory can help to improve the maternal natural delivery rate， reduce the rate of cesarean section. It can also help maternal actively face the pain and psychological stress and improve maternal response to stress and childbirth outcome. So it is worthy of clinical promotion.

[Key words] Self-efficacy theory； Nursing intervention； Delivery mode

产妇对自然分娩存在着一定的恐惧感及误解，认为自然分娩痛苦难以忍受，从而选择剖宫产[1，2]。但剖宫产术后并发症发生率较高，术后恢复效果远不如阴道分娩[3]。在我国，孕妇的剖宫产率处于世界最高水平，其控制效果较差[4]。因此，有效降低剖宫产率、促进孕妇的自然分娩成为医护人员的关注焦点。自我效能感是指个体对自身完成某一行为的预测以及判断，个体的情绪、经验、自身行为结果等各方面均会影响患者的自我效能感[5，6]。有研究表明，自我效能理论对于临产妇分娩的护理具有重要的效果[7，8]。在分娩中的自我效能分析是指产妇在分娩时采用应对策略对分娩疼痛进行管理，促进患者的分娩。……