刘蓓 蔡锋成 雷霞

[摘要] 目的 探讨家庭协同护理模式对初产妇分娩结局的影响，为该护理模式的临床实践提供理论支持。 方法 将2017年7～12月期间我院产科收治的140例初产妇为研究对象，均分为对照组（常规护理模式）和观察组（家庭协同护理模式），每组各70例，比较两组初产妇产程（第一产程、第二产程、第三产程）时间和分娩结局及心理状况、生活质量。 结果 观察组第二产程、第三产程短于对照组，差异具有统计学意义（P<0.05）；观察组会阴撕裂、会阴侧切率低于对照组，差异具有统计学意义（P<0.05）；观察组干预后抑郁和焦虑评分明显低于对照组，差异具有统计学意义（P<0.05）。观察组PSQI得分、生活质量评分均明显优于对照组，差异具有统计学意义（P<0.05）。结论 家庭协同模式应用于初产妇围生期护理，能够有效缩短产程，改善分娩结局，同时有助于产妇情绪改善，提升其生活质量。

[关键词] 家庭协同护理；初产妇；分娩结局；心理状况；生活质量

[中图分类号] R473.2 [文献标识码] B [文章编号] 1673-9701（2018）30-0152-04

[Abstract] Objective To explore the effect of family collaborative nursing model on the outcome of primipara delivery and provide theoretical support for the clinical practice of this nursing model. Methods A total of 140 primiparas who were admitted to our department of obstetrics from July to December 2017 were selected as the study subjects， and they were evenly divided into the control group （normal nursing mode） and observation group（family collaborative nursing mode）， with 70 cases in each group. The time of labor（first， second and third trimesters）， the outcome of pregnancy， the mental conditions and quality of life were compared between the two groups of primipara. Results The second trimester and the third trimester in the observation group were shorter than those in the control group， and the difference was statistically significant（P<0.05）； the laceration of perineum and lateral episiotomy rate in the observation group were lower than those in the control group， and the difference was statistically significant（P<0.05）； the scores of depression and anxiety in the observation group after intervention were significantly lower than those in the control group， and the difference was statistically significant （P<0.05）. The PSQI score and quality of life score in the observation group were significantly better than those in the control group， and the difference was statistically significant（P<0.05）. Conclusion The family collaborative model can be applied to primipara perinatal care， which can effectively shorten the labor process， improve the outcome of childbirth， help puerpera's emotional improvement and improve their quality of life.

[Key words] Family collaborative nursing care； Primipara； Pregnancy outcome； Mental conditions； Quality of life

女性從妊娠到分娩的过程是一个角色转变的过程，简单来说从社会上的个体附加了“母亲”的新身份，然而由于初产妇对分娩知识的不了解，导致产妇出现一系列焦虑或恐惧症状，严重影响到产妇的分娩过程[1-3]。同时，伴随人们对优生优育意识的不断强化，产妇家庭对临床医师和产妇的关注和期待也不断增加，这种意识也无形中给产妇造成极大心理负担[4，5]。从科学角度来讲，产妇在生产后自我管理能力有所下降，需要一定的休养才能完全恢复，同时由于兼任婴儿照护责任，部分婴儿照护技能缺失的产妇若不能及时适应将会影响产妇生产过程或产后的康复进程，更甚者严重影响到婴儿的生命健康[6]。协同护理模式是属于社会支持的一种护理方法，采用现有资源最大的发挥患者、家属参与健康护理，让产妇积极主动掌握自我护理能力，让家属积极协调护士护理工作，提高护理质量，并减轻护理人员工作量。……