Analysis Of Maternal Patient Perioperative Mindfulness Level Of Termination Of Pregnancy For Fetal Abnormality And Development Of Mindfulness Training Intervention Model

Objective1.To explore the inner experience and coping strategies of the maternal patient who had to end the pregnancy for fetal abnormality through phenomenological research during preoperative period.2.To investigate the maternal patient who had to end the pregnancy for fetal abnormality in six cities of Fujian Province, to know their mindfulness, depression and anxiety score during preoperative period and to explore the factors which could impact on the level of mindfulness.3.To construct a normalized, scientific and reasonable mindfulness training intervention model which including the time, method, intensity and frequency based on the result of qualitative interview and current survey.Methods1.The qualitative research of the maternal patient who had to end the pregnancy for fetal abnormality during preoperative period. The study used semi-structured, in-depth interview and participant observation. Then applied Colaizzid to encode and refine the topic with Nivo10 software.2.The descriptive study which was about the current status of mindfulness and mental health level of the maternal patient who had to end the pregnancy for fetal abnormality during preoperative period. The study investigated the level of their mindfulness, depression and anxiety.Then used convenience sampling method to choose patients in maternity wards of six cities in Fujian Provincial during March to November in 2014.227 cases were collected. Five Factors Mindfulness Scale(FFMQ), Self-rating Anxiety Scale(SAS), Self-rating Depression Scale(SDS) and Campbell Index of Well-being Scale(CTW) were chosen. Data was analyzed by using descriptive, univariate and multiple linear regression methods to provide a reference for the construction of clinical intervention model.3.The construction of intervention model which was on the basis of the former two parts of the study.The model was made via literature review and Delphi consultation letter.Results1.According to the results of qualitative research, 12 maternal patients had different negative and neutral experience which mainly including post-traumatic stress disorder, guilt, loneliness, depression, anxiety and other negative emotions from the time of been diagnosed fetal abnormality. These feelings were dynamically changed on the entire stage and had different psychological characteristics.2.Results of the current status:(1) Mindfulness score(106.04±15.83), anxiety score(48.36±10.03), depression score(54.81±9.66) and overall well-being index score(7.37±2.28).(2) The influential factors of mindfulness level were analyzed by multivariate linear regression. The factors of mindfulness total score included maternal age, their husband’s age, family economic condition, mindfulness experience and anxiety score(R2=0.252).The factors of mindfulness observing dimension included maternal age, their husband’s age, their husband’s occupation,participation in counseling and mindfulness experience(R2=0.206). Mindfulness describing dimension had factors included maternal age, their husband’s age, anxiety score and depression score(R2=0.165). Mindfulness acting with awareness dimension had factors included anxiety score and depression score(R2=0.266). Mindfulness not judging dimension had factors which were family economic condition and mindfulness experience(R2=0.062).Mindfulness not reactivity dimension had factors included mindfulness experience and depression score(R2 = 0.214).(3) Mindfulness total score and the score of each dimension were negatively related to anxiety and depression score.3.Mindfulness intervention model: The theoretical basis of this study was Jon Kabat-Zinn mindfulness training. The mindfulness intervention of maternal admissions was divided into three phases,11 processes based on dimension of admission time and frame of nursing process, the content of which is specific and comprehensive.Conclusion1. From individual perspective of the maternal patient, different types of the maternal patient had diverse inner experience.Nurses should make personalized care program to help the maternal patient learning how to manage negative emotions. From the perspective of maternal group, some common inner experience can be summarized from each personality. According to the conclusion, nurses and charges of health services can provide care service for this population.2. The level of mindfulness and the happiness index score of women who had to end the pregnancy for fetal abnormality are in the mid-low level. Anxiety level and depression level are high. Clinical nurses should set up different schedule of mindfulness training and psychological care for the maternal patient so that their level of mindfulness can be improved and can keep physical and mental health on the basis of degree of anxiety and depression, age, whether taken training in the mental counseling or experienced of mindfulness or not.