以家庭為中心的產科護理模式對初產婦產后抑郁的影響

[摘要] 目的 評價以家庭為中心的產科護理模式，對初產婦的產后抑郁的影響，制定新的產科護理模式。方法 2014年2月—2016年7月，整群選取該院產科分娩的542例產婦作為研究對象采用隨機數字表達法分組，對照組、觀察組各271例，對照組常規護理，觀察組聯合以家庭為中心的護理模式，各個時間段采用愛丁堡產后抑郁量表（EPDS）評價抑郁水平，統計產后3個月后攻擊行為發生情況。結果 觀察組產后第1日、出院前、產后第42日EPDS評分分別為（8.8±1.4）分、（9.8±1.3）分、（10.1±1.4）分低于對照組（10.1±2.1）分、（11.1±2.5）分、（12.2±1.7）分，組內對比觀察組與對照組出院前EPDS評分高于產后第1日，對照組產后第42日高于出院前，兩組產后3個月分別為（8.7±2.1）分、（9.0±1.3）分低于產后第42日，差異有統計學意義（P<0.05）；觀察組產后第1日、出院前、產后第42日抑郁癥發生率分別為0.0%、1.1%、1.8%低于對照組2.2%、5.2%、6.6%，產后3個月內觀察組攻擊行為發生率0.0%低于對照組3.3%，差異有統計學意義（P<0.05）。結論 以家庭為中心的產科護理模式可明顯降低初產婦的產后抑郁風險，減少產婦的攻擊行為，有助于保障產婦及新生兒的健康安全，促進每個家庭關系的和構建。

[關鍵詞] 初產婦；抑郁；產科護理；以家庭為中心

[中圖分類號] R5 [文獻標識碼] A [文章編號] 1674-0742（2016）12（c）-0124-03

[Abstract] Objective To evaluate the influence of family centered obstetric nursing model on postpartum depression and establish a new obstetric nursing model. Methods Group selection from February 2014 to July 2016， 542 cases of pregnant women in our hospital obstetric delivery as the research object by using random number expression method， control group and observation group with 271 cases in each group， the control group received routine nursing， observation and nursing mode of the united family centered， with the Edinburgh postnatal depression scale（EPDS）. Each time the evaluation the level of depression， aggressive behavior occurrence statistics after 3 months postpartum. Results The observation group after first days， before discharge， forty-second days postpartum EPDS scores were （8.8 ± 1.4）points， （9.8 ±1.3）points，（10.1 ± 1.4）points lower than that of control group （10.1± 2.1）points， （11.1± 2.5）points， （12.2 ±1.7）points in the observation group and the control group before discharge EPDS score higher than 1 days postpartum in contrast group， the control group was higher than that of postpartum forty-second day before discharge， two groups after 3 months respectively （8.7 ± 2.1）points，（9 ± 1.3）points below forty-second days postpartum， the difference was statistically significant（P < 0.05）； the observation group after first the day before discharge， forty-second days postpartum depression rate were 0.0%， 1.1%， 1.8%， 2.2%，5.2% lower than the control group 6.6%， observation of the incidence rate was 0.0% lower than 3.3% in the control group 3 months postpartum group attacks， the difference was statistically significant（P < 0.05）. Conclusion The risk of postpartum depression and family centered care model can significantly reduce the primipara， reduce maternal aggression， to help protect the maternal and neonatal health and safety， and promote the construction of each family relationship.

[Key words] Primipara； Depression； Obstetric care； Family centered

產后抑郁是產后常見并發癥，發病率約為3%～5%[1]。產后抑郁癥危害較大，不僅影響新生兒照料，還影響產后的復健、家庭幸福和諧，甚至威脅新生兒、產婦的生命安全，臨床上不乏產后抑郁產婦傷害新生兒的報道。產后抑郁癥的發生因素較復雜，普遍認為其與社會心理、生物學變化有關，其中對自身新的社會角色不適應是主要原因[2]。……