目的 研究综合干预对初产妇孕晚期焦虑和痛阈值的影响及其相关性。方法 120名初产孕妇随机分为对照组和干预组。对照组常规产检,干预组从孕周28周至37周进行心理干预。在孕28周和37周测定两组孕妇的分娩自我效能评分、焦虑评分和痛阈值。结果 对照组孕28周和37周分娩自我效能指标评分均无统计学差异;干预组孕37周时自我效能指标评分高于孕28周(P<0.05)和对照组孕37周(P<0.05)。对照组焦虑的发生率随着孕周显著增高(32.65%,59.18%,P<0.05),干预组孕37周时焦虑的发生率(26.09%)显著低于对照组(59.18%,P<0.05)。对照组焦虑的发生与孕周有相关性;随着焦虑程度的增加,孕妇的痛阈显著下降(P<0.05)。结论 增加孕期分娩的自我效能,可降低孕期焦虑,显著增加孕晚期痛阈值。
Abstract
Objective To investigate and analyze the effects of comprehensive intervention on anxiety and pain threshold in primiparas.Methods A total of 120 primiparas were randomly divided into the control group (60 cases) and intervention group (60 cases). Between the 28th week and 37th week, primiparas in the control group received regular check-ups while those in the intervention group received comprehensive intervention. The scores of self-efficacy, anxiety and pain threshold were recorded at the 28th week and 37th week.Results All the scores of self-efficacy at the 37th week were significantly increased compared to those at the 28th week in the intervention group (P<0.05) or compared to those in the control group (P<0.05). The incidence of anxiety at the 37th week was significantly increased compared with that at the 27th week in the control group (59.13%,32.65%,P<0.05). The incidence was significantly decreased at the 37th week in the intervention group compared with the control group(26.09%, 59.18%,P<0.05). There were significant correlations between anxiety and gestational weeks in the control group (P<0.05). Pain threshold in primiparas with severe anxiety was significantly decreased compared with normal primiparas (P<0.05).Conclusions The incidence of anxiety is lower and pain threshold is higher in primiparas who receive comprehensive intervention between the 27th week and 38th week during pregnancy.
关键词
综合干预 /
自我效能 /
焦虑 /
痛阈
Key words
comprehensive intervention /
self-efficacy /
anxiety /
pain threshold
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Bandura A. Self-efficacy: toward a unifying theory of behavioral change[J]. Psyehol Rev, 1977,84(2):191-215.
[2] 赵小红. 孕期健康教育对分娩方式的影响 [J].齐鲁护理杂志,2009,15(4):103-105.
[3] 朱 海,陆智杰,缪雪蓉,等. 初产妇焦虑状态与痛阈关系对分娩镇痛的影响 [J]. 第二军医大学学报,2011,32(12):1382-1384.
[4] 李 静,叶彩眉. 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研究 [J]. 中国现代医生,2015,53(2):116-119.
[5] Ip W Y, Chung T K, Tang C S. The Chinese Childbirth Self-Efficacy Inventory: the development of a short form [J]. J Clin Nurs, 2008,17(3):333-340.
[6] 汪向东,王希林,马 弘.心理卫生评定量表手册 [J]. 中国心理卫生杂志,1999,15(3): 191-194.
[7] Tilden E L, Caughey A B, Lee C S, et al. The effect of childbirth self-efficacy on perinatal outcomes[J]. J Obstet Gynecol Neonatal Nurs,2016,45(4):465-480.
[8] Beebe K R, Lee K A, Carneri K V, et al. The effects of childbirth self-efficacy and anxiety during pregnaney on prehospitalization labor [J]. J Obstet Gynecol Neonatal Nurs, 2007,36(5):410-418.
[9] Van der Gucht N, Lewis K. Women’s experiences of coping with pain during childbirth: a critical review of qualitative research[J]. Midwifery, 2015,31(3):349-358.
[10] Callister L C, Holt S T, Kuhre M W. Giving birth: the voices of Australian women [J].J Perinat Neonatal Nurs, 2010,24(2):128-136.
[11] Gibson E L. Women’s expectations and experiences with labour pain in medical and midwifery models of birth in the United States[J].Women Birth, 2014,27(3):185-189.
[12] Lally J E, Thomson R G, MacPhail S, et al. Pain relief in labour: a qualitative study to determine how to support women to make decisions about pain relief in labour[J]. BMC Pregnancy Childbirth, 2014,14:6.
[13] Angle P,Landy C K,Charles C, et al.Phase I development of an index to measure the quality of neuraxial labour analgesia: exploring the perspectives of childbearing women [J]. Can J Anaesth,2010,57(5):468-478.
[14] Aksoy H, Yücel B, Aksoy U, et al. The relationship between expectation, experience and perception of labour pain: an observational study[J]. Springerplus,2016,5(1):1766.
[15] Awissi D K, Bégin C, Moisan J, et al. I-SAVE study: impact of sedation, analgesia, and delirium protocols evaluated in the intensive care unit: an economic evaluation[J]. Ann Pharmacother, 2012,46(1):21-28.
基金
北京市科学技术委员会资助(Z151100003915089)
PDF(721 KB)
