Study On The Effect Of The Birth Plan Based On The Theory Of Authorization On The Outcome Of The Birth Of Pregnant Women

Objective:In combination the theory of Authorization and birth plan,the theory of the authorization of self-help,self-reliance,self management concept is applied to the birth plan worked out,and its application to the antenatal care on pregnant women in late pregnancy care,discuss the impaction of birth plan based on the theory of the authorization for pregnant outcome and self management ability,psychological state and satisfaction.Methods:According to the inclusion and exclude criteria,176 cases of pregnant women in last trimester were selected from April to October,2017,who were enrolled in a third-level a maternal and child health care institution and underwent regular obstetric examination.The subjects were randomly divided into two groups with 88 cases in each group by random number table method and sealed envelope technology.Both groups of subjects filled in the general situation questionnaire,self-management ability scale,anxiety self-assessment scale(SAS),and depression self-assessment scale(SDS).Control group accept regular antenatal examination,regularly attend school of pregnant women during pregnancy care,experimental group on the basis of this,by a high qualification midwife unified training according to the theory of authorization for the individualized health education,making birth plan face to face.The outcomes,self-management ability,psychological status and satisfaction of the two groups of subjects were tracked and analyzed by the members of the research group.Results:1.General information of the two groups:According to inclusion and exclusion criteria,a total of 176 subjects were included in the study,including 3 missing cases,and 173 cases were included in the final group,including 87 cases in the experimental group and 86 cases in the control group.According to statistical analysis,there was no statistically significant difference(P>0.05)in the general data of the two groups in age,weight,height,educational background,occupation,etc.,which was comparable.2.The outcomes of the two groups of study subjects:The cesarean section rate(18.4%)of the experimental group was lower than that of the control group(31.4%).Episiotomy rate(18.4%),rate of perineal laceration(40.9%)were lower than the control group of episiotomy rate(32.6%)and the rate of perineal laceration(60.2%),the difference had statistical significance(P < 0.05),two groups of blood loss two hours after natural labor and neonatal apgar score difference of no statistical significance(P > 0.05).3.Self-management ability scores of the two groups of subjects:The scores of self-management ability of the experimental group and the control group at the time of enrollment were(69.2 ± 9.2)and(68.4 ± 9.5),respectively,with no statistical significance(>0.05).The score of self-management ability score(82.5 ± 7.8)of the experimental group after intervention was higher than that of the control group(70.7± 9.1),and the difference was statistically significant(P<0.05).On two groups of self-management ability score comparison before and after the intervention,intervention group after the intervention of self-management ability score(82.5 ± 7.8)higher than that of before intervention(69.2 ± 9.2),the difference was statistically significant(P <0.05);The score of self-management ability(70.7 ± 9.1)in the control group after intervention was higher than that before intervention(68.4 ± 9.5),but the difference was not statistically significant(P>0.05).4.Psychological states of the two groups:There was no statistically significant difference in the scores of anxiety self-rating scales between the two groups(P>0.05).After intervention,the anxiety score of the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05).The scores before and after intervention were compared between the two groups,The scores of anxiety in the experimental group after intervention were lower than those in the group,and the difference was statistically significant(P<0.05).There was no statistically significant difference between the anxiety score after intervention and that when the control group was enrolled(P>0.05).At the time of enrollment,there was no statistically significant difference in the scores of depression self-rating scales between the two groups(P>0.05).The depression score of the experimental group after intervention was lower than that of the control group,and the difference was statistically significant(P<0.05).On two groups of depression score comparison before and after the intervention,the experimental group after the intervention of depression score below into the group,the difference is statistically significant(P < 0.05),the control group after the intervention depression scores and differences into groups has no statistical significance(P > 0.05).The postpartum depression score of the experimental group at 42 days after the intervention was lower than that of the control group,with a statistically significant difference(P<0.05).At the time of discharge,there was no statistically significant difference between the two groups in the number of subjects with the Edinburgh postpartum depression scale greater than 13 points(P>0.05).The number of the Edinburgh postpartum depression scale score greater than 13 in the 42-day postpartum test group was lower than that in the control group,and the difference was statistically significant(P<0.05).5.Satisfaction of the two groups of subjects:Compared with the control group,the satisfaction of parturients in the experimental group was higher than that of the control group,and the difference was statistically significant(P<0.05).Observation group cesarean delivery rate,the rates of episiotomy and perineallaceration were lower than the control group and observation group of antenatal examination and birth experience satisfaction are higher than the control group,the difference is statistically significant(P < 0.05).Conclusion:On the basis of the authorization theory,it can reduce the rate of cesarean section,perineum lateral incision and perineum laceration rate when making the birth plan with the first pregnant woman one-to-one.It can improve the self-management ability of the first pregnant woman,improve the independence of the first pregnant woman during pregnancy,and better manage her weight and delivery mode during pregnancy.And to improve the early pregnant women to give delivery and postnatal psychological state,make them enjoy the process of childbirth,and satisfaction with supporting service delivery and can improve the primipara,embodies the humanized service,and help to build the midwife and the relationship between the early pregnant women.