论文编号:HL230 论文字数:12816,页数:26

论文题目：护理干预对母婴分离产妇的影响
摘　要
 目的：本研究调查并分析了因新生儿转入新生儿重症监护病房治疗导致的母婴分离给高危妊娠产妇造成的心理影响，并在此基础上探讨应用护理干预对改善此类产妇身心状态的有效性及影响干预效果的相关因素。为母婴分离高危妊娠产妇这一特殊群体提供科学的护理干预模式。
 方法：本研究应用类试验的研究方法，便利抽样获得母婴分离高危妊娠产妇，于剖宫产术后1天应用《状态—特质焦虑量表》和《爱丁堡产后抑郁量表》对研究对象进行心理评估。获得基线资料后，对照组接受医院常规护理，干预组在常规护理基础上由研究者本人给予护理干预采取个别指导和发放健康手册的方式，给予包括心理干预、信息支持、母婴分离期间乳房护理以及产后周电话随访在内的护理干预，并于产后7天、产后6周再次进行心理评估。运用检验、卡方检验、重复测量的方差分析、t检验及多元逐步回归分析等统计学方法，分析母婴分离对于高危妊娠产妇身心状态的影响，对护理干预缓解母婴分离高危妊娠产妇身心状态的效果进行评价，并进一步分析干预效果的影响因素。
 结果：母婴分离高危妊娠产妇剖宫产术后1天的心理状态①术后1天研究对S-AI分值为43.80±7.43，明显高于国内正常女性人群。②术后1天产后抑郁评分为10.22±4.43，产后抑郁发生率为57.9%。
 护理干预对母婴分离高危妊娠产妇心理应激的干预效果评价①干预组和对照组在术后7天、术后6周两个时间点的状态焦虑的差异、抑郁发生率的差异有统计学意义（p<0.05）②干预组术后1天、7天、6周的状态焦虑、抑郁分值的差异有统计学意义（p<0.05）对照组术后1天、7天的状态焦虑、抑郁分值的差异无统计学意义（p>0.05）。③干预组与对照组术后6周抑郁分值的差异无统计学意义（p>0.05）。结论：对母婴分离高危妊娠产妇实施护理干预，可有效减轻产妇心理应激反应、降低乳胀的发生率、提高母乳喂养率。
 关键词: 母婴分离、高危、妊娠产妇、焦虑、抑郁、护理干预
 
Title: The Nursing intervention separation of the influence of maternal maternal and infant
 ABSTRACT
 
Objective
 To investigate and analyze the physical and psychological state of high-risk pregnancy mothers after their babies being transferred to Neonatal Intensive Care Unit, evaluate the effect of nursing methods, and discuss the influential factors of this intervention. Eventually, to explore a scientific nursing Intervention model for high-risk pregnancy mothers after being separated from their newborn．
Methods
 a quasi-experiment design was conducted among 6 high-risk pregnancy mothers recruited after being separated from their newborns. For the intervention group, the researcher provided nursing intervention, while the control group was only given routine nursing care. Data were collected on the 1st, 7th and 42nd day of cesarean section (including STA-I, EPDS, HR, SBP, BS, Mammary Swelling Incidence and Breastfeeding Incidence). T-test > Chi-square test ^ Mann-Whitney U test and Multivariate stepwise regression were performed throughout the data analysis.
Results
1. On the 1st day of cesarean section, the psychological state of high-risk pregnancy mothers after being separated from their newborns: The S-AI score is 43.80±7.43 and significantly higher than the normal standard in China. The EPDS score is 10.22±4.43 and Postpartum Depression Incidence is 57.9%.
2. Effect of nursing intervention on psychological state of high-risk pregnancy mothers after being separated from their newborns: (1) on the 7th and 42nd day of cesarean incidence in intervention group decreased significantly. on the lst,7th and 42nd day of cesarean section, the S-AI score and EPDS in intervention group decreased significantly; on the 7th day of cesarean section, the control groups S-AI score and EPDS have no statistics differences. (3)on the 7th day of cesarean section, the two groups' endocrine indexes have statistics differences. on the 42nd day of cesarean section, there were no statistics differences of EPDS scores between two groups. on the 7th day of cesarean section, the two groups' physical indexes have no statistics differences.
Conclusion
Nursing intervention can effectively relieve the response intensity of the stress, decrease the Mammary Swelling Incidence and improve breastfeeding.
Key words：Mother-baby separation; High-risk pregnancy Mother; Anxiety; Depression; Nursing intervention
 
 目  录
 
1 绪论 1
1.1 背景及意义 1
1.2目的 1
1.3关键词及定义…………………………………………………………………….....2                                                     
1.4文献回顾…………………………………………………………………………….2
2 研究设计 5
2.1研究设计 5
2.2研究对象 5
2.3研究工具 5
2.4研究步骤 7
2.5统计分析 7
3 研究结果 8
3．1 母婴分离高危妊娠产妇剖宫产术后1天的心理状态 8
3．2护理干预对母婴分离高危妊娠产妇的干预效果评价 8
4 讨论 10
4．1母婴分离高危妊娠产妇的心理状态 10
4．2护理干预的干预效果及相关因素分析 11
4．3 小结 11
5 推论及建议 13
5．1 结论 13
5．2 本研究局限性及展望 13
致    谢 14
参考文献 15