以家庭為中心的賦能教育對妊娠糖尿病孕產(chǎn)婦血糖控制及母乳喂養(yǎng)自我效能的影響

梁世芳 毛瑩

[摘要] 目的 探究以家庭為中心的賦能教育對妊娠糖尿病孕產(chǎn)婦血糖控制及母乳喂養(yǎng)自我效能的影響。方法 選擇2017年10月—2018年7月在該院進(jìn)行定期孕前檢查的76例妊娠期糖尿病孕產(chǎn)婦為研究對象，以隨機(jī)抽簽法將其分為兩組，每組各38例，對照組予以常規(guī)孕期保健，觀察組在對照組的基礎(chǔ)上實(shí)施以家庭為中心的賦能教育，比較兩組干預(yù)前后孕產(chǎn)婦的血糖水平及其母乳喂養(yǎng)情況。 結(jié)果 干預(yù)前，兩組孕產(chǎn)婦的空腹血糖、餐后2 h血糖差異無統(tǒng)計(jì)學(xué)意義（P>0.05），干預(yù)12周后，觀察組孕產(chǎn)婦的上述各項(xiàng)血糖指標(biāo)均顯著優(yōu)于對照組，且患者血糖控制達(dá)標(biāo)率也顯著高于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組初產(chǎn)婦分娩后42 d的母乳喂養(yǎng)自我效能評分以及純母乳喂養(yǎng)率均明顯高于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 以家庭為中心的賦能教育能夠有效控制妊娠糖尿病孕產(chǎn)婦的血糖水平，改善妊娠結(jié)局，同時還可以提高產(chǎn)婦的母乳喂養(yǎng)自我效能，促進(jìn)其母乳喂養(yǎng)行為。

[關(guān)鍵詞] 妊娠糖尿病;以家庭為中心的賦能教育;血糖控制;母乳喂養(yǎng)

[中圖分類號] R473? ? ? ? ? [文獻(xiàn)標(biāo)識碼] A? ? ? ? ? [文章編號] 1672-4062（2020）01（b）-0015-03

[Abstract] Objective To investigate the effect of family-centered empowerment education on maternal glycemic control and breastfeeding self-efficacy in gestational diabetes. Methods 76 pregnant women with gestational diabetes who underwent regular pre-pregnancy examinations from October 2017 to July 2018 were enrolled in the study. They were divided into two groups by random lottery， 38 in each group. During pregnancy， the observation group implemented family-centered empowerment education on the basis of the control group， and compared the maternal blood glucose levels and breastfeeding before and after the intervention. Results Before intervention， there was no significant difference in fasting blood glucose and 2 h postprandial blood glucose between the two groups （P>0.05）. After 12 weeks of intervention， the above-mentioned blood glucose indexes of the pregnant women in the observation group were significantly better than the control group. The patient's blood glucose control compliance rate was also significantly higher than the control group，the difference was statistically significant（P<0.05）. The breastfeeding self-efficacy score and the exclusive breastfeeding rate of the primiparas in the observation group 42 days after delivery were significantly higher than those in the control group，the difference was statistically significant，the difference was statistically significant（P<0.05）. Conclusion Family-centered empowerment education can effectively control the blood glucose level of pregnant women with gestational diabetes， improve pregnancy outcomes， and improve maternal breastfeeding self-efficacy and promote breastfeeding behavior.

[Key words] Gestational diabetes; Family-centered empowerment education; Blood glucose control; Breastfeeding

妊娠糖尿病是妊娠期較為常見的一種妊娠合并癥，主要是指孕產(chǎn)婦在妊娠期首次發(fā)生或發(fā)現(xiàn)的糖耐量異常。妊娠糖尿病是妊娠、分娩的高危因素，若本病孕產(chǎn)婦血糖控制不佳不僅會引發(fā)羊水過多、酮癥酸中毒、胎兒畸形、胎兒生長受限、早產(chǎn)等，還會使產(chǎn)婦產(chǎn)后康復(fù)速度變慢，母乳喂養(yǎng)率低，對母嬰健康造成不良影響。以家庭為中心的賦能教育主要是通過利用相關(guān)家庭系統(tǒng)理論對患者實(shí)施切實(shí)可行的以家庭為中心的護(hù)理措施，給患者及其家庭予以充分的支持[1]。該科為改善妊娠糖尿病孕產(chǎn)婦的血糖水平，提高其母乳喂養(yǎng)效能，選取2017年10月—2018年7月妊娠糖尿病者實(shí)施以家庭為中心的賦能教育，具體報(bào)道如下。