| ObjectiveOn the basis of investigating the cognition of maternal kangaroo mother care,we found the factors that affect the implementation of kangaroo mother care.Through the kangaroo mother care of cesarean section,we would investigate the effect of kangaroo mother care on postpartum lactation,Uterine recovery,the impact of postpartum depression for the implementation of kangaroo mother care to provide the basis for the development of clinical applications and the promotion of kangaroo mother care to lay the theoretical basis.Methods1.The first stage,descriptive study:(1)we selected from March to May 2006 admitted to a top three hospital obstetric delivery of 231 cases of maternal as the object of investigation,through the general information questionnaire,and cognition questionnaire of kangaroo mother care,then collected Data,(2)Using the "General Health Questionnaire" [1] to measure the psychological status of maternal,to make sure that they are in good condition,and meet the inclusion of 60 cases of cesarean section as a control group to implement routine obstetric care,such as neonatal bath,vaccination of vitamin K1,vaccination(Hepatitis B and BCG),neonatal disease screening(heel blood collection),etc.;maternal daily obstetric care,including breast care,perineal care,diet guidance,medication guidance,Health education,discharge guidance.The data of physical recovery after maternal surgery were recorded,including the time of first lactation,the height of uterine descent after 24 h and 48 h.(3)In June 2016,we carried out kangaroo nursing training for obstetric nurses.Throughvideo presentation,we were given face-to-face lectures by pediatric nurses from other provinces.We had a comprehensive study of WHO's Practical Clinical Guide of the Kangaroo mother care [2],and finally conduct the training results Assessment,through the examination before they can participate in the implementation of kangaroo mother care.2.The second stage,the experimental study of the type of experiment,(1)We selected July 2016-September 2016 in a top three hospital obstetric hospital delivery of cesarean section 60 cases of primipara as the object of study.The "general health questionnaire" survey,the normal mental health score and meet the inclusion of 60 cases of cesarean section as the experimental group,the implementation of kangaroo mother care.The experimental group of maternal and newborns on the basis of routine obstetric care,at 8:00 with the implementation of kangaroo mother care for 1h daily,at 15:00 with the implementation of kangaroo mother care for 1h,2 times a day totally,at least for 3 days,at the same time we nurses should educate and urge maternal to implement kangaroo mother care in the postpartum month;to compare the two groups of mothers first lactation time;measured two groups of maternal uterine recover in 24 hours postpartum,respectively,the length from the margin of the uterus to the upper of the Pubic symphysis,compared to the height of the uterine base to assess the degree of uterine recovery The scores of postpartum depression scale were compared between the two groups of mothers at 42 days.(3)Equalization of the general situation of the two groups of pregnant women and newborns included in the study.(4)Using the SPSS17.0 statistical data package to establish the database,the data inputting,collecting,analyzing and processing,the main data of the general statistical description(percentage,mean ± standard deviation),measurement data with t-test,count data with the chi-square test.Results1.A survey of maternal general information and awareness of kangaroo mother care found that among the 231 pregnant women surveyed,92% of those who werewilling to breastfeed(211 ± 2.7)accounted for 92%(204 ± 3.1)accounted for 88.3%.Only 6.06% of people know the use of kangaroo mother care,however there are32.90% of the maternal understanding the contact of skin to skin,but the specific details of the implementation of kangaroo mother care are not clear and what they understand the posture accounted for 31.4%,duration 22.7 %,the awareness of the precautions for practicing kangaroo care are more less.2.Results of the equilibrium test2.1There were no significant differences in the age,occupation,education,monthly average income and neonatal sex,birth weight,length and 10-minute Apgar score of the two groups(P> 0.05).About the scores of the GHQ-12,there was no significant difference between the two groups(1.23 ± 1.37)and the experimental group(1.35 ± 1.51),the difference was not statistically significant,the general situation of the two groups of maternal and newborns were balanced and comparable.2.2 After a month of systematic training,32 obstetric nurses and midwives master the method of operation of the kangaroo mother care with the compliance rate of 92.11%,with the implementation of kangaroo care conditions,we can carry out this nursing practice.3.The results of kangaroo mother care interventions3.1The time of initial lactation was(43.5 ± 4.7)h in the experimental group,which was significantly lower than that in the control group(52.1 ± 6.2)h,the difference was significant(P <0.05).3.2The distance of the bottom of the uterus to the upper edge of the pubic symphysis was shortened(2.67 ± 0.62)cm,and the control group was shortened(1.32 ± 0.41)cm,and the height of the uterus was significantly better than that of the control group after 24 hours.(P <0.05).There was no significant difference in uterine descending height between the two groups in 48h(P> 0.05).3.3 The situation of review after operation for 42 days.The interview rate was88.33% in the control group and 93.33% in the experimental group.The scores of Edinburgh postnatal depression scale in the two groups was that experimental group higher than that in the control group.The number of the review accounted for 96.2%higher than 80.3% of the control group,the implementation of kangaroo mother care of maternal psychological assessment scale(EPDS)score was significantly lower than the control group,the difference was statistically significant,moderate and severe depression was not statistically significant.(P >0.05).Conclusion1.Most maternal desire to implement kangaroo mother care is positive,but they lack of understanding of the implementation of the content and process,it is necessary to kangaroo mother care as routine care to apply in obstetric hospital.2.The implementation of kangaroo care can be early cesarean section of the first day of lactation time,to speed up the uterus,reduce the occurrence of postpartum depression,which is conducive to cesarean section maternal postoperative physical and mental recovery. |
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