| Objective:Exploring the effects of targeted health education and Doula delivery that were carried out on maternal according to the questionnaire of their needs on maternal psychology(anxiety at different stages)and physiology delivery outcome,and understanding the trend of anxiety during pregnancy and delivery.Promoting the effective implementation of “one-to-one” Doula delivery and health education in clinical practice,and improving the professional literacy of midwives,thereby reducing maternal anxiety and improving the outcome of delivery to promote natural delivery and ensure the safety of mother and child.Methods:The experimental research method was used to select the pregnant women who were interested in vaginal delivery during the period of 2017.5-2017.10 in the delivery room of a top three hospital in Shanxi Province.According to the trait-state anxiety scale(STAI)at the 36 th week of the pregnant women,the patients with score < 39 were included in the non-anxiety group and continued to be selected to 66 cases;the patients with a score of ?39 were included in the anxiety group and continued to be selected to 66 cases which were divided into anxiety control group(n=33)and anxiety intervention group(n=33)by using a random number table Methods.The non-anxiety group and the anxious control group both received a regular pregnant women school curriculum,then they were given routine nursing and midwifery services when they entered the delivery room for delivery.The anxiety intervention group started to get target health education after 36 weeks of gestation,then received continuous and professional “one-to-one” Doula delivery after entering the delivery room.The state anxiety scale was scored at admission,delivery and postpartum in three groups.The final physiology delivery outcomes of maternal was collected and the final statistical analysis was carried out.Results:1.The results of the maternal demand survey showed: the main reason why pregnant women choose natural delivery is that natural delivery has more benefits than cesarean section.And the main concern is uterine contraction pain.They hope that midwives can accompany their delivery process,and they can obtain the relevant knowledge about delivery process,analgesia methods and neonatal care at the same time.2.Baseline survey results showed: evaluating the baseline anxiety status of maternal by STAI that the use of STAI to assess maternal baseline anxiety status,123 maternal TAI score was(35.77 ± 6.440)points,and 36 weeks gestation SAI score was(35.43 ± 7.711)points.One-factor analysis of variance and independent sample t-test showed that: TAI and SAI score at 36 weeks gestation were related to age and place of residence(P<0.05),and postpartum SAI scores were related to final delivery mode(P<0.05).3.Paired sample t-test was used to compare the 36 weeks gestation SAI score(before intervention)with the SAI scores at admission,delivery and postpartum(after intervention)of three groups.The results showed that: when the pregnant woman was admitted to hospital,the SAI scores of admission and delivery was higher than that the 36 weeks gestation SAI score before intervention the difference was statistically significant;the postpartum SAI score was lower than before intervention and the difference was statistically significant(P<0.05).4.Survey of psychology delivery outcome(maternal anxiety): Using one-factor analysis of variance,the differences between the SAI at 36 weeks gestation and the SAI at admission,the SAI at delivery,and the postpartum SAI were compared between the three groups.The results are as follows:(1)In the anxiety intervention group,the difference between SAI score at admission and delivery with SAI score at 36 weeks gestation was lower than that in the non-anxiety group and the anxiety control group(P<0.05);(2)In the non-anxiety group the difference between the postpartum SAI score and the 36 weeks gestation SAI score was lower than that in the anxiety control group and the anxiety intervention group(P<0.05).5.The results of the survey on physiology delivery outcome showed that:(1)There was no significant difference in pain scores between the non-anxiety group and the two anxiety groups;The pain scores of the anxiety intervention group were lower than those of the anxiety control group,and the difference was statistically significant(P<0.05);(2)Thetime of total stage of labor and first stage of labor in the anxiety intervention group was less than the anxiety control group,and the difference was statistically significant(P<0.05).(3)The blood loss during 2 hours postpartum in the three groups from low to high were the anxiety intervention group,the non-anxiety group and the anxiety control group,and the difference was statistically significant(P<0.05);(4)There was no statistical difference in the cesarean section rate,the perineum integrity,the 1-min birth Apgar score of the newborn,the second stage of labor time and third stage of labor time of the natural delivery(P>0.05).Conclusion:Most maternal want midwives or professionals to accompany them in childbirth.Targeted health education can give maternal relative knowledge about the specific process of delivery,analgesic methods during delivery and methods of neonatal care,and increase their self-confidence;Doula delivery can provide continuous psychological support and spiritual encouragement to maternal.The combination of these two helps to relieve the maternal negative emotions,reduce the painful feelings in maternal delivery,promote the natural delivery process,reduce the total stage of labor and the first stage of labor time,reduce blood loss during 2 hours postpartum,and avoid the occurrence of various adverse delivery outcomes. |
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