The Study On Risk Factors And Intervention Of Sleep Quality In Rooming-in Maternal After Cesarean Section

Ojective To investigate sleep quality of rooming-in maternal after cesarean section and analyze its risk factors.To evaluate the effect of comprehensive nursing intervention on sleep quality,psychological status and milk secretion in postpartum women,and it provides a new way for clinical nurses to carry out health education.Methods We used the qualitative research methods and conducted face-to-face,semistructured in-depth interviews with 13 postnatal women to understand their sleep quality.A convenience sample of 160 postnatal women were recruited from November 2015 to April 2016.Date were collected by self-designed questionnaire of sleep quality risk factors,the Pittsburgh Sleep Quality Index Scale(PSQI)and the Edinburgh Postnatal Depression Scale(EPDS)and Self-rating Anxiety Scale(SAS).A total of 92 postnatal women were randomly divided into the control group(n=46)and the experimental group(n=46).The participants in the control group received regular postpartum care only.The participants in the experimental group were implementedcomprehensive nursing intervention during hospitalization.The Sleep quality,depression and anxiety condition,and the initial time of milk secretion,the amount of milk secretion and the incidence of breast swelling were used to assess outcomes.Results 1.Five themes were extracted: the postoperative discomfort maked postnatal women difficult to fall asleep,sleep awakening times reduced continuous sleep time,prolonged bed rest reduced sleep efficiency,uncomfortable ward environment maked sleep difficult to maintain,lacking of support increased psychological pressure.2.(1)PSQI score of postnatal women was(9.84±2.62),125/160(78.1%)reported poor sleep quality.(2)Univariate analysis showed that there were significant differences between sleep quality and EPDS scores,SAS scores,breast swelling,breastfeeding during the night,babies cry during the night,incision and uterine contraction pain,postpartum sweat,ward noise,care operation or patrol during the night and worry about not adjusting to motherhood(P<0.05).(3)Multivariate analysis showed that breastfeeding during the night,incision and uterine contraction pain,breast swelling,postpartum sweat and worry about not adjusting to motherhood were risk fators for sleep quality in postpartum women.3.After comprehensive nursing intervention,compared with the control group and before the intervention,the experimental group demonstrated significantly lower scores of sleep quality,sleep time,sleep efficiency,daytime function and PSQI(P<0.05).The experimental group demonstrated significantly lower scores of EPDS and SAS(P<0.05).Compared with the control group,the experimental group demonstrated significantly shorter the initial time of milk secretion and more cases of milk secretion in different time(<24h?24~48h?48~72h).The experimental group demonstrated significantly more milk secretion and lowerincidence of breast swelling.Conclusion 1.Poor sleep quality is prevalence of rooming-in maternal after cesarean section.2.Breastfeeding during the night,incision and uterine contraction pain,breast swelling,postpartum sweat and worry about not adjusting to motherhood are the risk fators for sleep quality in rooming-in maternal after cesarean section.3.Comprehensive nursing intervention can effectively improve the sleep quality of rooming-in maternal after cesarean section,alleviate postpartum anxiety and depression,prepose the initial time of milk secretion,promote milk secretion,reduce the incidence of breast swelling.It is conducive to maternal-child health,worthy of clinical application.