| ObjectiveFocusing on the needs of primipara in the process of delivery,guided by the theory of self-efficacy,the intervention program of midwife-lead analgesia delivery was constructed,and its application effect on the outcome of primipara delivery was discussed.MethodsThis study is divided into two parts.The first part:the construction of midwife-led analgesia delivery intervention program.Through literature review,semi-structured interview and expert consultation,this study proposed the intervention plan of midwife leading analgesia delivery.The second part:application effect and evaluation of midwife-led analgesia delivery intervention program.From October 2018 to June 2019,80 primiparas were selected from the obstetric perinatal health clinic of a third class a hospital for birth examination,inclusion and exclusion criteria.80 primiparas were selected for the study,40 in the control group and 40 in the intervention group.The control group received routine obstetric delivery mode.After the intervention group was admitted to the hospital for childbirth,on the basis of the routine obstetric midwifery mode,the midwife led analgesia delivery service was added:before the delivery,the knowledge of delivery was strengthened and relevant guidance was given;during the delivery,the midwife led analgesia delivery management was accepted;the pregnant women were followed up within 24 hours after the delivery.Analysis of the two groups of primipara delivery self-efficacy,delivery mode and delivery time and other indicators.All the data were processed and analyzed by IBM spss22.0 software,and the results were analyzed by variance analysis,chi square test,t-test and descriptive statistics.Results1.Midwife led analgesia delivery intervention program:through literature review and semi-structured interviews,four themes were extracted:environmental needs,related knowledge,physiological needs and psychological needs,34 items.The coefficient of variation of expert consultation results is less than 0.25,which indicates that the opinions of experts tend to be consistent.2.Comparison of delivery outcome:the cesarean section rate in the intervention group was lower than that in the control group,with a statistically significant difference(x2=7.169,p P<0.01);the total delivery time in the intervention group was lower than that in the control group,with a statistically significant difference(t=1.756,P<0.05);the first delivery time in the intervention group was lower than that in the control group,with a statistically significant difference(t=1.861,P<0.05);the second delivery and the third delivery in the intervention group and the control group There was no statistical significance(P>0.05)in the comparison of the course time,the amount of bleeding within two hours after delivery,and the neonatal Alzheimer’s score.3.Comparison of delivery self-efficacy:there was no significant difference between the delivery self-efficacy groups at 37 weeks of gestation(t=1.991,P>0.05);there was significant difference between the two groups at delivery(t=2.000,P<0.01).Before and after delivery self-efficacy comparison between the two groups:the self-efficacy score of the intervention group at delivery was higher than that at 37 weeks of pregnancy,the difference was statistically significant(t=1.993,P<0.01).Conclusion1.Literature review,qualitative interview and expert consultation were used to construct the delivery intervention program with midwife as the leading factor,so as to provide reference for improving the delivery outcome.2.The midwife led analgesia delivery can effectively improve the delivery outcome,vaginal delivery rate and delivery self-efficacy of primipara. |
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