About PAC Application Research In Unplanned Pregnant Women Post Abortion Nursing

Background:World Health Organization(WHO) reported there were 400-600 million people did induced l abortion in the world every year. In our country there were 140 million people did induced abortion each year, and the recurrent abortion rate was nearly 50%. However induced abortion, especially recurrent abortion has lots of complications and sequelae, and would has harmful effects to families and society. From 1990 s, Post Abortion Care(PAC) became the focus to solve the induced abortion. In 2011 the Family Planning Branch of CMA, the China Women’s Development Foundation and the National Population and Family Planning Commission organized “ Care about her & PAC” program, aimed to establish standard PAC mode in hospital, and provide contraception knowledge to patients and their families, to help them comprehend contraceptive method, to avoid harmful effects, to reduce induced abortion rate and recurrent abortion rate, to enhance reproductive health in our country. However it is lack of systematic PAC in all class of abortion institutions in our country, and still need to accumulate more experiences in the future work.Objective:1.To comprehend women’s veritably needs to PAC, to identify care contents, to modify consult services. 2.To explore PAC effect to recurrent rate.Method:Research object: the unplanned pregnant patients treated by induced abortion in The First People’s Hospital of Taicang from Feb. 2015 to Mar. 2015. The patient withproperties of menolipsis with 6-12 weeks, urine EIPT positive, intrauterine pregnancy through B-ultrasound, without mental disorder and disturbance of consciousness. This research include qualitative research and randomized controlled intervention study. The first part: qualitative research. In the way qualitative research, we use phenomenological approach to select 13 women after induced abortion and their male companions in purposive sampling methods to have interviews with them. We assess outcome in Colaizzi analytic technique, in order to investigate patients and their families’ feelings, cognition and veritably needs. The second part: randomized controlled intervention study. 122 voluntary participants randomized divided into intervention group and control group. And 1 month before and after operation, participants filled the same Post Abortion Questionnaire. Intervention group assessed post abortion needs before operation, implemented personalized PAC, provided Post Abortion Health Care pamphlet, meanwhile encouraged them to choose one of receptible efficient contraception method. And followed up at 2 weeks, 1 month, 3 month, 6 month, to guide contraception method and its implementation. In control group, we just provided conventional nursing when followed up, and answered their unprompted questions. In both group, participants filled follow-up tables, to acknowledge during 6 months, participants’ contraception methods and incidence of recurrent abortion, and then assess the PAC effect.Results: 1.Research objects and their companions need contraception knowledge, induced abortion method and nursing after operation for PAC. 2.There is no statistics difference( p>0.05) between two groups in basic data, contraception knowledge, implementation of contraception and the rate of efficient contraception method. One month after operation, besides these knowledge such as “induced abortion many times would induce barrenness incidence”, “induced abortion one of contraception methods”, “take oval contraceptive in menstrual period from day 5 to day 7, for 3 weeks”, “take emergency contraceptive should before sexual life, and the condomfunctions.”, there is higher correct rate in intervention group in rest of items. And it has statistical difference(P<0.05). 6 months after operation, there is higher follow-up rate in intervention group(98.36%) than control group(88.52%), it has statistical difference(P<0.05). There is higher implement of contraception rate in intervention group(96.67%) than control group(85.19%), it has statistical difference(P<0.05). In intervention group(48.28%) and control group(28.26%) have higher efficient contraception method 6 months after operation than before operation(intervention group 24.44%, control group 19.51%). And intervention group has higher increase, it has statistical difference( P<0.05). Intervention group(1.67%) has lower recurrent abortion rate than control group(7.02%).(P<0.05). Both groups participants didn’t have genital tract inflammation.Conclusion: 1.There are lots of problems after induced abortion, personalized PAC is the first choice to avoid recurrent abortion. 2.Through PAC, provide women after induced abortion with contraception knowledge, to promote implementation of efficient contraception, reduce recurrent abortion in 6 months post abortion, to promote reproductive health. 3.After PAC to help women to use accurate contraception and method, reduce the rate of repeat abortion, improve family care, so as to improve the physical and mental health of women.