| BackgroundCongenital heart disease(CHD)seriously affects the health level and quality of life of children,and even causes death or disability,which brings huge economic burden and mental pressure to the mothers whose children with congenital heart disease.Studies at home and abroad have shown that mothers of children with CHD have more negative emotional experience,which can last for one year or even longer after the children are discharged from hospital,which is adverse to the mother’s own health and family atmosphere,and affects the recovery process of children.Foreign scholars have found that kangaroo mother care(KMC)can increase the emotional communication between mother and child,and alleviate the negative emotions of mother.Literature review found that domestic research on KMC mainly focused on children,and the observation indicators were mostly pain degree,crying time,sleep quality or some physiological indicators of children.There were few studies on the intervention of KMC on the mothers of children with congenital heart disease,and less on the mothers of children with congenital heart disease.ObjectiveTo explore the influence of KMC on the anxiety,parenting pressure and self-efficacy of mothers whose child with CHD.Objective to expand the application scope of KMC in China,so as to provide practical nursing methods for nurses in clinical nursing work to relieve mother’s anxiety,parenting pressure and improve mother’s self-efficacy.MethodThe convenience sampling method was used to select 80 mothers from Henan children’s heart center from June to September 2019 who met the standard of Inclusion and exclusion criteria as the control group,and 80 mothers from October 2019 to January next year who met the standard of Inclusion and exclusion criteria were selected as the intervention group to carry out the similar experimental study.Before the intervention,the general data of the two groups were collected,and the anxiety score,parenting stress score and self-efficacy score of the two groups were measured by SAS,Psi-sf and GSES respectively.In the intervention stage,the control group adopted the responsibility system holistic nursing during hospitalization,provided discharge guidance to the children’s mother before discharge,and paid a regular telephone return visit to the children’s recovery situation after 1 month and 3 months after discharge;During the period of hospital,the intervention group added kangaroo nursing in the overall responsibility system nursing,and kangaroo mother nursing was providded by mothers untel 3 months after discharge.The researchers conducted home-based nursing guidance every two weeks.The main contents of the guidance were the growth and development of infants,nutrition demand and feeding,supplementary food addition,fine action and big action development characteristics,language development characteristics,The deciduous teeth sprout and maintain,family upbringing attitude and children’s character.The study period was conducted 6 times,from the discharge of the child to 3 months after the discharge.The intervention lasted until 3 months after discharge.Due to the age limit of the children,the objects of education and communication in hospital and after discharge are the mothers of the children.The observation indexes were mainly divided into anxiety score,parenting stress score and self-efficacy score.SAS,psi-sf and GSES were used for measurement.The observation indexes of the two groups were measured on the day of discharge,1 month and3 months after discharge.SPSS 23.0 statistical software was used to analyze the data.The measurement data in accordance with normal distribution were expressed as(? x ? s),standard deviation by t-test;the measurement data not in accordance with normal distribution were expressed as median and quartile by Mann Whitney U-test.The counting data were expressed by the number of cases and percentage(%),and were tested by Chi square test or Fisher exact probability method.Repeated measurement data were compared by repeated measurement analysis of variance,with bilateral P < 0.05 as the difference was statistically significant.Result1.There was no significant difference in general demographic data between the two groups(P > 0.05).2.Compare the anxiety score,parenting pressure score and self-efficacy score of the two groups before intervention.The anxiety scores of the control group and the intervention group were(59.70 ± 4.27)(60.73 ± 3.75)and parenting stress score were(110.00 ± 8.82)(110.63 ± 7.28),and the self-efficacy scores were(22.66 ± 3.07)(22.10 ±3.76).Before the intervention,there was no significant difference in the three indexes between the two groups(P > 0.05).3.Repeated measurement ANOVA was used to analyze the anxiety score,parenting stress score and self-efficacy score of the two groups at the time of discharge,January and March.The results showed that the anxiety score,parenting stress score and self-efficacy score of the two groups were affected by time effect,grouping effect and interaction of time and grouping.The anxiety score and parenting pressure score of the intervention group were lower than the baseline data at discharge,1 month and 3 months after discharge,and the difference was statistically significant(P < 0.05);The scores of self-efficacy at discharge,1 month and 3 months after discharge were higher than the baseline data at admission,and the difference was statistically significant(P < 0.05).4.The anxiety scores of the control group were(54.81 ± 3.94)(53.04 ± 3.65)(46.95 ±4.67)at three time points of discharge,1 month and 3 months after discharge,respectively.The anxiety scores of intervention group were(49.55 ± 4.18)(44.16 ± 4.27)(42.36 ± 3.51)respectively,which were lower than those of the control group(P < 0.05).5.The parenting pressure scores of the control group were(121.23 ± 6.64)(111.74 ±6.55)(86.34 ± 6.97)at three time points of discharge,1 month and 3 months after discharge,respectively,while those of the intervention group were(109.50 ± 7.92)(100.64± 7.30)(80.68 ± 7.01),which were lower than those of the control group(P < 0.05).6.The self-efficacy scores of the control group were(24.00 ± 4.20)(26.36 ± 3.34)(28.46 ± 4.61)at the time of discharge,1 month and 3 months after discharge,respectively,and the self-efficacy scores of the intervention group were(25.99 ± 2.85)(28.79 ± 2.25)(30.83 ± 2.96)respectively,which were higher than those of the control group(P < 0.05).ConclusionKMC can effectively reduce the anxiety level and parenting pressure of mothers whose child with congenital heart disease,improve their self-efficacy and reduce their negative emotions. |
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