季晓颖 程丽森 郭树东

摘 要 目的：研究对孕早期、孕中期、孕晚期进行健康教育干预指导的效果。方法：采用分层随机抽样法抽取2016-2017年在上海宝山路街道社区早孕建册的454孕妇随机分为试验组和对照组各227人。对照组按照常规管理方法进行管理，试验组在孕早、中、晚期各个阶段加强健康教育指导。通过问卷调查和症状自评量表，评估两组孕产妇的产检次数，剖宫产率，并发症率、服务满意度和心理健康水平。结果：试验组产检5次和8次以上的比例和孕期服务满意度高于对照组（P<0.05），剖宫产率和并发症率低于对照组（P<0.01），心理量表的强迫、抑郁、焦虑、偏执因子得分低于对照组（P<0.05）。结论：在社区孕产妇管理工作过程中，分阶段加强健康教育干预指导，可提高社区孕产妇孕期管理依从性和服务满意度，改善孕产妇心理健康水平。

关键词 健康教育指导；孕产妇管理；效果

中图分类号：R173 文献标志码：A 文章编号：1006-1533（2018）12-0054-03

Study of effect of health education guidance on community maternal management

JI Xiaoying， CHENG Lisen， GUO Shudong（Preventive and Health Care Department of Baoshanlu Community Health Service Center of Jingan District， Shanghai 200071， China）

ABSTRACT Objective： T o study the effect of health education intervention guidance on the first， second and third trimesters of pregnancy. Methods： A stratified random sampling method was used to select 454 pregnant women who set up an early pregnancy manual in Baoshanlu Community Health Service Center from 2016 to 2017， and then randomly divided into an experimental group and a control group with 227 people each. The control group was managed according to the routine management method and the health education guidance was strengthened at various stages of early， middle and late pregnancy for the experimental group. Through questionnaire survey and symptom checklist， the number of pregnancy tests， cesarean section rate， complication rate， service satisfaction and mental health were evaluated in the pregnant and lying in women in the two groups. Results： The proportions of 5 times and more than 8 times of antenatal examination and satisfaction of pregnancy services in the experimental group were higher than those in the control group（P<0.05）. The rates of cesarean section and complication were lower in the experimental group than those in the control group（P<0.01）. The scores of compulsion， depression， anxiety and paranoid factors in mental scale were lower in the experimental group than those in control group（P<0.05）. Conclusions： In the process of pregnant and lying in women management in the community， strengthening the guidance of health education intervention in the different stages can improve the compliance of maternal pregnancy management， service satisfaction and improvement of the level of maternal mental health.

KEY WORDS health education guidance； maternal management； effect

嬰儿死亡率、人均期望寿命和孕产妇死亡率是衡量国民健康水平的重要指标，也是社会、经济和文化综合协调发展的敏感指标。做好社区孕产妇管理工作对促进社会和经济发展，提高人民群众的健康水平至关重要[1]。健康教育是一项有计划、有系统的教育活动，其核心是促使人们自愿地改变影响健康的行为因素。因此在社区孕产妇管理过程中，通过健康教育的手段，能使管理对象掌握更多有关生育的健康知识，了解应该注意的事项，提升管理质量[2]。本研究旨在评估健康教育指导社区孕产妇管理的效果。

1 对象与方法

1.1 对象

采用随机整群抽样法抽取2016年1月至2017年3月在宝山路街道社区早孕建册的孕产妇454人，再采用随机数法分为试验组和对照组各227人。对照组的孕产妇年龄为23～39岁，平均（27.5±2.4）岁；……