| ObjectivesThrough nursing intervention in the delivery process of pregnant women admitted to a third class hospital,the authors investigated the effect of(Doula on whole process-accompanied delivery)on the progress,pain and psychological state of delivery.The effects of childbirth outcome,postpartum depression and nursing satisfaction were analyzed.To explore the effect and significance of the application of Doula in the whole course of labor,to provide reference for improving the rate of natural delivery and optimizing the mode of delivery.MethodsFrom July 2016 to July 2018,1831 cases of pregnant and lying-in women admitted to gynecology and obstetrics department from July 2016 to July 2018 were selected for investigation and data collection through self-made questionnaires,records of labor process and postpartum visits,and were grouped according to their voluntary choices.Informed consent and according to the whole process of accompanying Doula intervention process were classified as the intervention group;Those without Doula intervention were classified as non-intervention group.The differences of delivery process,delivery outcome and postpartum psychology between the two groups were compared.Recorded data and data collected for comparative analysis by group,SPSS 22.0 and SAS 9.1 Statistical software was used to analyze,n or%reflection counting data,count data comparison using?~2test,grade data comparison using row average score difference test.Results1.Delivery attitude:221 people(39.25%)in the pre-delivery intervention group were never afraid of delivery,316(56.13%)were slightly nervous about delivery,but not yet afraid.Fifteen(2.67 per cent)felt that the imminent delivery had caused some annoyance,while 11(1.95 per cent)were very worried and had affected their own health;In the non-intervention group,988(77.92%)were never afraid of childbirth,244(19.24%)were slightly nervous about delivery,but not yet frightened,and 25(1.97%)felt that the impending delivery had caused some disturbance,with 11 cases.People(0.87%)are very worried and have affected their own health.2.Psychological status:the number of moderate anxiety in intervention group decreased from 125(22.20%)to 116(20.61%),and the number of severe anxiety decreased from 22(3.91%)to 13(2.31%)in 48 hours postpartum.In the non-intervention group,the number of moderate anxiety decreased from 318(25.08%)to 299(23.58%),and the number of severe anxiety increased from 84(6.62%)to 91(7.18%).3.There were 155 cases(27.53%)with excellent score(0~2 points)and 39cases(6.93%)with poor score(>8points)in the intervention group.In the non-intervention group,373 cases(29.42%)had excellent scores(0~2 points)and118 cases(9.31%)had poor scores(>8 points).4.Delivery outcome:81 cases(14.39%)in the intervention group were converted to cesarean section,35 cases(6.21%)were converted to cesarean section,46 cases(8.17%)were unplanned intervention,253 cases(19.95%)in the non-intervention group were finally converted to cesarean section.Among them,146cases(11.51%)were transferred to dissection,107 cases(8.44%)were unplanned intervention.5.The number of postpartum hemorrhage in intervention group(28 cases)was less than that in non-intervention group(85 cases),and the number of neonatal Apgar score less than 10 cases(32 cases)was less than that in non-intervention group(113cases).The incidence of urinary retention in the intervention group was less than that in the non-intervention group.6.Postpartum depression:289 cases(51.33%)in intervention group and 565cases(25.2%)in non-intervention group;There were 61 cases(10.83%)in intervention group and 245 cases(13.38%)in non-intervention group..Conclusion1.The pregnant and lying-in women in the intervention group had lower degree of fear than that in the non-intervention group before labor,and a good state of mind played a positive role in promoting the natural delivery and ensuring the smooth progress of labor.2.At different stages of labor,the use of different ways(reasonable posture,ball,music,instrument,etc.)in the whole period of labor can influence the delivery process of the parturient:it can alleviate the anxiety of the parturient.Improve the rate of natural delivery,reduce postpartum complications,reduce postpartum depression and so on.This has something to do with the full companionship,the attention to the psychophysiological feelings of the parturient,the science,the effective intervention and the guidance.3.Doula can effectively improve the feeling of delivery and promote the comfort of delivery,which can improve the rate of natural delivery,reduce the rate of cesarean section,promote the good prognosis of parturient and ensure the health of mother and child.It is of clinical significance to improve the quality of obstetrical service. |
PDF Full Text Request