Effect of overall nursing in the delivery room for pregnant women with hypertensive pregnancy
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摘要:目的 探讨产房整体护理对妊娠期高血压产妇的护理效果。方法 将入院的80例妊娠期高血压产妇随机分为2组，常规组产妇给予常规产科护理，整体护理组产妇则给予产房整体护理，比较2组产妇血压水平、负面情绪、压力、疲乏程度、睡眠质量、幸福感与不良妊娠结局。结果 整体护理组产妇干预后收缩压(SBP)、舒张压(DBP)、爱丁堡产后抑郁量表(EPDS)、广泛性焦虑量表(GAD7)、压力知觉量表(PSS4)、疲乏严重程度量表(FSS)评分均显著低于常规组; 干预后，匹兹堡大学医学中心制定的睡眠质量指数问卷(PSQI)总分与各项睡眠质量评分均显著低于常规组; 干预后各项幸福感评分与总体幸福感量表(GWB)总分均显著高于常规组; 子痫、胎儿窘迫、剖宫产与产后出血发生率均显著低于常规组，差异均有统计学意义(P < 0.05)。结论 产房整体护理对妊娠期高血压产妇的护理效果显著。Abstract:Objective To investigate the effect of overall nursing for pregnant women with hypertensive pregnancy.Methods A total of 80 pregnant women with gestational hypertension admitted to hospital were randomly divided into two groups. The routine group received general maternal care, and the overall nursing group was given the overall care in the delivery room. Blood pressure levels, negative emotions, stress, fatigue, sleep quality, well-being, and adverse pregnancy outcomes were compared.Results The systolic pressure(SBP), diastolic blood pressure(DBP), Edinburgh Postnatal Depression Scale (EPDS) score, Generalized Anxiety Scale(GAD7) score, Perceived Stress Scale(PSS4) score and Fatigue Severity Scale(FSS) score were significantly lower in the overall nursing group than those in the routine group. The overall scores of Pittsburgh sleep quality index (PSQI) and the sub-item scores of sleep quality in the overall nursing group were significantly lower after intervention, the sub-item scores of happiness and general well-being scale(GWB) were significantly higher after intervention, and the incidences of eclampsia, fetal distress, cesarean section and postpartum hemorrhage were significantly lower than those in the conventional group, and the differences were statistically significant (P < 0.05).Conclusion The overall nursing in delivery room has a significant nursing effect.
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表 1 2组产妇干预前后血压水平、负面情绪、压力与疲乏程度(x±s)
指标 整体护理组(n=40) 常规组(n=40) 干预前 干预后 干预前 干预后 SBP/mmHg 154.68±6.77 110.45±6.28*# 155.08±6.50 130.44±6.45* DBP/mmHg 105.10±5.14 80.43±4.75*# 104.85±5.09 87.21±4.60* EPDS评分/分 20.11±4.71 11.38±2.17*# 20.17±4.58 15.41±2.97* GAD7评分/分 15.39±3.05 9.55±1.31*# 15.48±3.19 12.05±1.50* PSS4评分/分 10.06±1.44 5.17±0.75*# 10.10±1.34 7.67±1.18* FSS评分/分 48.01±7.01 20.10±5.12*# 48.27±7.10 29.95±6.31* SBP: 收缩压; DBP: 舒张压; EPDS: 爱丁堡产后抑郁量表; GAD7: 广泛性焦虑量表; PSS4: 压力知觉量表; FSS: 疲乏严重程度量表。与干预前比较, *P < 0.05; 与常规组比较, #P < 0.05。 
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表 2 2组产妇干预前后睡眠质量(x±s)
分 指标 整体护理组(n=40) 常规组(n=40) 干预前 干预后 干预前 干预后 主观睡眠质量 1.63±0.47 0.65±0.10*# 1.66±0.40 1.18±0.38* 入睡时间 1.40±0.40 0.58±0.13*# 1.39±0.35 0.81±0.14* 睡眠效率 1.54±0.43 0.62±0.17*# 1.59±0.48 0.96±0.20* 睡眠障碍 1.23±0.37 0.46±0.15*# 1.27±0.38 0.75±0.17* 催眠药物 1.11±0.32 0.40±0.11*# 1.15±0.34 0.66±0.18* 日间功能障碍 1.35±0.35 0.49±0.10*# 1.38±0.36 0.70±0.14* PSQI总分 8.30±0.90 3.41±0.52*# 8.44±0.98 5.05±0.64* PSQI: 睡眠质量指数问卷。与干预前比较, *P < 0.05; 与常规组比较, #P < 0.05。
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表 3 2组产妇干预前后幸福感评分比较(x±s)
分 指标 整体护理组(n=40) 常规组(n=40) 干预前 干预后 干预前 干预后 对健康的担心 8.81±1.35 11.92±2.34*# 8.89±1.40 10.15±1.17* 对生活的满足与兴趣 9.40±1.43 12.84±1.61*# 9.47±1.45 10.87±1.05* 精力 17.28±3.88 20.40±2.86*# 17.37±3.80 18.03±3.22 抑郁或愉快的心境 15.09±2.90 20.14±2.43*# 15.14±2.93 17.60±2.15* 对情感与行为的控制 13.45±2.63 17.38±2.02*# 13.42±2.67 14.50±2.10 松弛与紧张 13.21±2.89 17.45±2.17*# 13.07±2.80 15.50±2.04* GWB总分 62.84±9.55 79.90±6.74*# 62.90±9.51 70.88±6.93* GWB: 总体幸福感量表。与干预前比较, *P < 0.05; 与常规组比较, #P < 0.05。
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表 4 2组产妇不良妊娠结局比较[n(%)]
组别 子痫 胎儿窘迫 胎儿死亡 剖宫产 产后出血 整体护理组(n=40) 1(2.50)* 1(2.50)* 0 11(27.50)* 4(10.00)* 常规组(n=40) 8(20.00) 7(17.50) 3(7.50) 20(50.00) 13(32.50) 与常规组比较, *P < 0.05。
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