支持性心理治疗配合健康教育在行期待疗法治疗的前置胎盘孕妇中的应用
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摘要
目的:探讨支持性心理治疗配合健康教育在接受期待疗法治疗的前置胎盘(PP)孕妇中的应用效果。方法:选择2016年3月～2017年3月收治的37例PP孕妇作为对照组,以期待疗法进行治疗,给予常规护理;选择2017年4月～2018年3月收治的37例PP孕妇作为研究组,以期待疗法进行治疗,在常规护理基础上加以支持性心理干预配合健康教育。比较两组孕妇心境状态[采用心境状态量表(POMS)]、PP影响度自评[采用意外事件影响量表(IES-R)]结果、三维评估[采用三维筛选评估模型(TAS)]结果及分娩后的母儿情况结果:干预后,研究组POMS中紧张-焦虑、抑郁-沮丧、疲乏-迟钝、愤怒-敌意、迷惑-混乱维度及总分得分均显著低于对照组(P <0. 01,P <0. 05),精力-活力维度得分显著高于对照组(P <0. 01);干预后,两组IES-R中的逃避、侵扰、唤醒3个维度得分均显著低于干预前(P <0. 05),且研究组低于对照组同期(P <0. 01);干预后,两组TAS中情感、认知、行为3个维度得分显著低于干预前(P <0. 05),且研究组低于对照组同期(P <0. 01);研究组孕妇孕周、新生儿Apgar评分高于对照组(P <0. 01),孕妇产后抑郁发生率低于对照组(P <0. 05)。结论:支持性心理治疗配合健康教育能够有效改善接受期待疗法治疗的PP孕妇身心状态,促进母婴情况良好转变,值得临床推广。
Objective: To explore the application effect of supportive psychotherapy combined with health education in expectant treatment on pregnant women with placenta previa( PP). Methods: A total of 37 pregnant women with PP admitted from March 2016 to March2017 were selected as the control group to be treated with expectant therapy and were given routine nursing care. A total of 37 PP pregnant women admitted from April 2017 to March 2018 were selected as the study group to be treated with expectant therapy,implement supportive psychological intervention combined with health education on the basis of routine nursing. The mood state [using Profile of Mood States( POMS) ],the self-assessment results of PP influence [using accident impact scale( IES-R) ],three-dimensional assessment results [using three dimensional screening evaluation model( TAS) ] and maternal-infant status after delivery between the two groups were compared. Results: After the intervention,the scores of tension-anxiety,depression-dismay,fatigue-dullness,anger-hostility,puzzle-chaos dimension and total scores in the research group were significantly lower than those of the control group( P < 0. 01),and the scores of the energyvitality dimension were significantly higher than those of the control group( P < 0. 01). After the intervention,the three-dimensional scores of escape,intrusion and wake-up of IES-R in the two groups were significantly lower than those of before intervention( P < 0. 05),and the scores of study group were lower than that of control group in the same period( P < 0. 01). After the intervention,the three-dimensional scores of emotion,cognition and behavior of TAS in the two groups were significantly lower than those of before the intervention( P < 0.05),and the scores of study group were lower than that of control group in the same period( P < 0. 01). The gestational age of pregnant woman and Apgar score of newborn in study group were significantly higher than those of control group( P < 0. 01),and the postpartum depression rate of pregnant women was significantly lower than that of control group( P < 0. 05). Conclusion: Supportive psychotherapy combined with health education can effectively improve the physical and mental state of PP pregnant women with expectant therapy,and promote the good transformation of mother and baby,which is worthy popularizing application in clinic.
Objective: To explore the application effect of supportive psychotherapy combined with health education in expectant treatment on pregnant women with placenta previa( PP). Methods: A total of 37 pregnant women with PP admitted from March 2016 to March2017 were selected as the control group to be treated with expectant therapy and were given routine nursing care. A total of 37 PP pregnant women admitted from April 2017 to March 2018 were selected as the study group to be treated with expectant therapy,implement supportive psychological intervention combined with health education on the basis of routine nursing. The mood state [using Profile of Mood States( POMS) ],the self-assessment results of PP influence [using accident impact scale( IES-R) ],three-dimensional assessment results [using three dimensional screening evaluation model( TAS) ] and maternal-infant status after delivery between the two groups were compared. Results: After the intervention,the scores of tension-anxiety,depression-dismay,fatigue-dullness,anger-hostility,puzzle-chaos dimension and total scores in the research group were significantly lower than those of the control group( P < 0. 01),and the scores of the energyvitality dimension were significantly higher than those of the control group( P < 0. 01). After the intervention,the three-dimensional scores of escape,intrusion and wake-up of IES-R in the two groups were significantly lower than those of before intervention( P < 0. 05),and the scores of study group were lower than that of control group in the same period( P < 0. 01). After the intervention,the three-dimensional scores of emotion,cognition and behavior of TAS in the two groups were significantly lower than those of before the intervention( P < 0.05),and the scores of study group were lower than that of control group in the same period( P < 0. 01). The gestational age of pregnant woman and Apgar score of newborn in study group were significantly higher than those of control group( P < 0. 01),and the postpartum depression rate of pregnant women was significantly lower than that of control group( P < 0. 05). Conclusion: Supportive psychotherapy combined with health education can effectively improve the physical and mental state of PP pregnant women with expectant therapy,and promote the good transformation of mother and baby,which is worthy popularizing application in clinic.
引文
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[11]霍宁,宋慧娜,张利岩.应激与抑郁对妊娠期糖尿病妇女影响的研究进展[J].中华现代护理杂志,2014,49(2):134-135.
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[13]孟云琴.护理干预改善孕妇产时认知行为及分娩结局的效果[J].海南医学,2017,27(8):1375-1376.
[14]王瑞,申庆文,张瑜,等.前置胎盘期待疗法的综合护理与效果观察[J].蚌埠医学院学报,2014,39(5):669-670.
[2]符凤晖,钟宜.期待疗法治疗前置胎盘的临床观察及可行性研究[J].中国临床研究,2014,27(1):62-63.
[3]王瑞,申庆文,张瑜,等.前置胎盘期待疗法的综合护理与效果观察[J].蚌埠医学院学报,2014,39(5):669-670.
[4]高秀君,王建女,王颖. PDCA护理模式在改善抑郁症患者不良情绪及心境状态中的效果[J].中华现代护理杂志,2016,22(4):490-492.
[5]曹淑殷,李君琴,王虹,等.胎儿异常引产孕妇创伤后应激反应及与大五人格的相关性分析[J].中国实用护理杂志,2016,32(2):81-85.
[6]唐海花,王宇波,卢玲,等.心理疏导联合知信行模式干预对门诊胎心监测异常孕妇心理状态的影响[J].国际精神病学杂志,2017,44(5):918-921.
[7]张利玲,孙文涛.妊娠合并血小板减少对产妇分娩方式和母婴结局的影响[J].血栓与止血学,2015,21(3):184-186.
[8]付晨薇,刘俊涛,杨剑秋,等.前置胎盘所致产后出血病例分析[J].生殖医学杂志,2014,23(3):224-228.
[9]陆新妹,王志坚.前置胎盘发病因素及其妊娠结局的临床分析[J].中国妇幼保健,2014,29(24):3892-3894.
[10]赵晓蓓,张芙萍.心理支持对肝癌介入治疗患者心理需求和主观幸福感的影响分析[J].现代消化及介入诊疗,2016,21(6):848-850.
[11]霍宁,宋慧娜,张利岩.应激与抑郁对妊娠期糖尿病妇女影响的研究进展[J].中华现代护理杂志,2014,49(2):134-135.
[12]白玉琴,覃悦.高危妊娠孕妇产前护理需求与护理干预研究[J].世界中医药,2016,11(6):1861-1862.
[13]孟云琴.护理干预改善孕妇产时认知行为及分娩结局的效果[J].海南医学,2017,27(8):1375-1376.
[14]王瑞,申庆文,张瑜,等.前置胎盘期待疗法的综合护理与效果观察[J].蚌埠医学院学报,2014,39(5):669-670.