Study On The Fatigue Status Of Puerperal Women And Its Related Factors

Objective:This study aims to understand the current situation of puerperal women' fatigue,and to analysis the related factors of puerperal women' fatigue,thus to make reference for putting forward the effective intervention strategy and scheme for puerperal women' fatigue,to promote the construction of the management mode and guidelines of puerperal fatigue of our city in the end.Methods:Methods by convenient sampling,220 women were recruited while having their routine follow-up 6 weeks after delivery from June 2016 to December 2016 in three first-class hospitals of Nanchang.Adopt the method of questionnaire survey,the researcher herself distribute demographic questionnaire,Fatigue Assessment Instrument(FAI),Pittsburgh Sleep Quality Index(PSQI),Perceived Social Support Scale(PSSS),the Hospital Anxiety and Depression scale(HADS),which were filled out on the spot.Results:220 questionnaires were distributed and 215(97.73%)were taken back,and 200(93.02%)were effective among the questionnaires,resulting in 200 participants.1.The mean age of participants was(27.46±3.04);84.00% women had job;College degree or above(53.00%)was the main level of education;Most females(65.50%)had one child;Ways to pay medical expense in town worker/ residents medical insurance was main,accounting for 36.00%;Almost half of patients(46.50%)felt the economic burden was mild;The proportion of women who took the majority or half of the family and baby care workload was 40.50% and 44%.59.00%participants adopt natural birth;62.00% participants were primiparous;42.50%participants took the mixed feeding;98.00% participants did not have postpartum hemorrhage;The vast majority of children of the participants was normal full-term birth weight,ratio was 93.50% and 95.00% respectively;86.50% babies after birth were not in hospital;All crying time every day of 73.50% baby in recent one weekwas 3 hours or less;After delivery,91.50% participants did not have complication in puerperium,complications of other people was mainly anemia(4.50%),puerperal infection/mammitis(3.00%),thyroid dysfunction(1.00%).2.56.00% of participants felt fatigue,and 34.5% of participants felt mild fatigue,21.50% of participants felt moderate or heavy fatigue.Statistical analysis of average total score and each factors showed that participants displayed mild fatigue in FAIl,FAl2 dimensions and showed moderate fatigue in dimension of FAI3,FAl4.Sleep quality score was(6.75±2.73),the normal sleep quality and sleep disorders of puerperal women accounted for 58.50% and 41.50%,respectively.In every factor of PSQI,sleep disorders mainly appeared as daytime dysfunction,proportion was56.00%.Social support score of participants was(65.18±8.08),family inside support was(22.27±3.63)points,family inside support was(42.91±7.14)points,which all belonged to high levels of social support;Anxiety and depression score of participants were(5.56±2.93),(5.59±2.61),respectively.20.00% and 23.5% had possible anxiety or depression,5.50% and 3.50% had confirmed anxiety or depression respectively.3.Pearson correlation analysis showed that the fatigue of participants has a significant difference in age,education level,the number of children,the economic burden,household and baby care workload.delivery mode,parity,feeding patterns and puerperium complication,sleep,support in the family,support outside the family,anxiety and depression.4.It is found in logistic regression analysis that the incidence of fatigue among participants with more than 3 children was higher than participants with less than 3children,participants with total household and baby care work were easier to feel fatigue than patients with half or most work,participants with cesarean section had a significantly higher incidence of puerperal fatigue than women with natural childbirth;participants with bottle-feeding had a significantly lower incidence of puerperal fatigue than women with exclusive breastfeeding and mixed feeding;participants with puerperium complication had a significantly higher incidence of puerperal fatigue than women without puerperium complication;participants with poor sleep quality were higher incidence of fatigue than those with normal sleep quality,participants with better support within or outside the family had less fatigue thanthose with lower support,participants with or confirmed anxiety had more fatigue than those with possible or without anxiety.Conclusion:1.The occurrence of fatigue was common in puerperium(56.00%),So in order to improve the outcomes of postpartum mother and infant and improve the quality of life of postpartum women,medical staff should pay attention to the management of fatigue of puerperal women,systematically and effectively give prevention and intervention treatment.2.The fatigue of participants was correlated with age,education level,the number of children,the economic burden,household and baby care work,delivery mode,parity,feeding patterns and puerperium complication,sleep,social support,anxiety and depression.The results suggest that the obstetric nursing staff should especially pay attention to the knowledge and information support for young women;Encourage women to seek outside support and family members to participate in the care of infants and children,encourage women to take the natural birth and exclusive breastfeeding,strengthen maternal compliance to reduce postpartum complications.For puerperal women in the process of nursing,medical staff should accomplish the prevention and nursing for postpartum complications,psychological nursing and negative mood screening and dredge,at the same time,the professor should pay more attention to their self-care skills,increase the efficiency of the self-care and reduce the occurrence of fatigue in puerperium.3.Numbers of children,family and baby care work,delivery mode,feeding patterns,puerperium complication,sleep quality,support in the family,support outside the family and anxiety were significant influencing factors of the fatigue of puerperal women.The results suggest that the nursing personnel should pay attention to the social support state of the women in puerperium,impart some communication skills with good applicability as far as possible to let them get more support from family,relatives and friends,to reduce the workload of looking after their children,families and babies,to guarantee more time to rest and improve sleep quality.Nursing personnel should strengthen the health propaganda and education on natural childbirth and exclusive breastfeeding,strengthen maternal behavior as directed bythe medical staff,give more attention on negative emotional performance of women in puerperium,provide the way to reduce negative emotions,and encourage women according to their own circumstance to find out ways to alleviate fatigue in puerperium.