| Objective:Pregnancy is a special experience for women during pregnancy.During this period,due to the influence of physiological,psychological,social environment and other factors,the psychological bearing capacity of pregnant women decreases,resulting in a variety of negative emotions,and the fear of childbirth is one of the most common.PERMA nursing intervention is based on the theory of positive psychology to guide the research object to focus on the positive side of things,so as to improve their negative emotions and enhance their happiness of life.At present,a relatively mature PERMA nursing intervention model has been formed in foreign countries,but it is still in its infancy in China with few applications,and the traditional health education is mostly used in the form,which is often limited in clinical application due to factors such as single intervention form and boring content.With the rise of "Internet + medical and health" service model,psychological nursing based on Internet platform has become a current research hotspot.Based on literature,books and guidelines,the research results of cross-sectional survey were used as reference,and combined with expert opinions and psychological characteristics of pregnant women,the PERMA nursing intervention program of offline teaching,discussion and online communication and sharing was formulated,and the intervention effect on the fear of childbirth and overall happiness of pregnant women was tested.To form a systematic standard,scientific and effective PERMA nursing intervention to lay a certain theoretical basis.Methods:1.Choose April 2021-June in shanxi Province maternal and child health care(cardiac care unit,maternity department,midwives outpatient)regular prenatal 453 pregnant women,after the informed consent,in pregnant women to hospital prenatal by the researchers on the questionnaire survey,for pregnant women to demographic characteristics,psychological status,obstetric factors,degree of social support,and other information,univariate analysis and Logistic regression analysis were used to find the influencing factors of childbirth fear.2.PERMA nursing intervention program was formulated based on literature,books,guidelines review and cross-sectional investigation results,combined with expert opinions and psychological characteristics of pregnant women,for clinical application.From July2021,118 pregnant women in shanxi Provincial Maternal and Child Health Care Hospital(perinatal health care clinic)were selected as the research objects,and divided into control group and intervention group according to the principle of random control.The control group was given routine psychological guidance and health education,while the intervention group was given PERMA nursing intervention for 6 weeks on the basis of routine psychological guidance and health education.Wijma delivery expectation and experience score and GWBS overall happiness score were respectively evaluated before intervention,immediately after intervention and 7 days after delivery,and a database was established.T test was used to compare the scores of pregnant women scale between the two groups.Repeated measures an OVA was used to compare the scale scores of the two groups at different time points,and P < 0.05 was considered as statistically significant difference.Objective sampling method was adopted to select 10 pregnant women from the intervention group as interviewees for semi-structured in-depth interviews to further evaluate the intervention effect of this study.Colaizzi analysis method was used to analyze the interview data.Results:1.Analysis of influencing factors of pregnant women’s fear of childbirth(1)In this study,a total of 453 pregnant women were investigated,and the incidence of fear of childbirth was 62%.(2)Univariate analysis showed that the factors influencing the fear of childbirth were self-distrust,lack of understanding of delivery service mode,general relationship with midwives,counseling history and poor self-rated health status(P< 0.05).(3)Logistic regression analysis showed that the self-rated health status was poor(OR=2.841,95%CI: 1.752-4.607),no understanding of the delivery service mode(OR=2.023,95%CI: 1.252-3.271),counseling history(OR=5.991,95%CI: 3.769-9.524)was an independent risk factor for fear of childbirth.2.Effect evaluation of PERMA nursing intervention on fear of childbirth and general happiness(1)Before intervention: there were no significant differences in general data,fear of childbirth score and overall happiness score between the two groups before intervention(P>0.05).(2)Immediately after intervention: there were statistically significant differences in the scores of fear of childbirth and general happiness between the two groups immediately after intervention(P<0.001);(3)7 days after delivery: there were statistically significant differences in fear of delivery and overall happiness between the two groups(P<0.001).(4)Multiple comparison before and after intervention: before intervention,immediately after intervention,and 7 days after delivery,there were statistically significant differences in the scores of fear of childbirth and overall happiness between the two groups in time factor,inter-group factor and inter-group interaction factor(P < 0.001).(5)Interview results: A total of 10 pregnant women were interviewed in this study.Starting from the real experience of pregnant women participating in this intervention,the deficiencies of this intervention and suggestions for this intervention,three themes were extracted,which were: reducing the fear of childbirth and improving the overall happiness;To meet the psychological care needs of pregnant women;The intervention cycle is tight.Conclusion:1.Poor self-rated health status,lack of understanding of delivery services and a history of consultation were independent risk factors for fear of delivery.2.PERMA nursing intervention can reduce the fear of childbirth and improve the overall well-being of pregnant women.3.The subjects generally recognized the intervention,believing that it explained the correct perspective and reasonable solution to the problem in a simple and popular way,which could meet their needs for psychological care during pregnancy. |
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