| ObjectiveTo explore the status of self-care ability,quality of life,and parenting sense of competence of primiparous women during puerperium,analyze the influencing factors of self-care ability,and explore the correlation among self-care ability,parenting sense of competence and quality of life of primiparous women.According to the survey results,the impact of nursing intervention based on the PRECEDE-PROCEDE Model on the self-care ability and parenting sense of competence of primiparous women during puerperium was explored,and it provided reference in innovating puerperium health education content and models for staffs of clinical obstetrics and community maternal and child health workers.Methods1 The random sampling method is adopted in the study.From November 2018 to February 2019,in order to investigate the status of self-care ability,quality of life,and parenting sense of competence of primiparous women during puerperium,we conducted a survey on 254 puerperium women in three third-level grade-A hospitals in Hengyang by using general information questionnaires(including health questionnaires),self-assessment scale for women during puerperium,WHO Quality of Life Assessment Instrument Brief Version,and Chinese version of Parenting Sense of Competence Scale.2 80 primiparas who met the research requirements of in-patient delivery in a third-level grade-A hospital in Hengyang,Hunan,were selected as the research subjects,and were divided into control group(40)and intervention group(40)according to different wards.The control group received routine postnatal care,including general care,special care,and routine telephone follow-up after discharge.The intervention group adopted PRECEDE-PROCEDE Model nursing intervention on the basis of routine postpartum nursing.Related data were collected before the intervention,3 weeks postpartum and 6 weeks postpartum.SPSS18.0 statistical software was used to perform statistical analysis on the obtained data.The measurement data was described by mean± standard deviation,and the count data was expressed by frequency and composition ratio.Statistical analysis used t test,one-way analysis of variance,multiple stepwise regression analysis,spearman correlation analysis,chi-square test,rank sum test,and repeated measures analysis of variance.Results1 The total score of self-care ability of primiparous women during puerperium was(151.75±16.38)points,which is at a medium level.After the score of the three dimensions were converted to standard points,the score of self-care skills is the lowest,which is(68.24±10.34)points.The total score of quality of life was(55.86±8.58)points,and the score of parenting sense of competence was(69.79±9.19)points.2 One-way analysis of variance or t test analysis showed that there was a statistically significant difference in the scores of self-care ability of primiparous women during the puerperium for different ages,education levels,occupations,home addresses,marital status,total monthly family income,feeding methods,whether to participate in pregnant women’s schools,whether there is post-natal hospital/ community telephone follow-up/home visit guidance(P<0.05).The results of multiple stepwise regression analysis showed that marital status,educational level,participation in pregnant women’s school,total monthly household income,and home address were the main influencing factors influencing the self-care ability of primiparous women during the puerperium.The results of spearman correlation analysis showed that the quality of life of primiparous women during the puerperium was positively correlated with self-care ability(r=0.463,P<0.01)and parenting competence was also positively correlated with self-care ability(r =0.402,P<0.01).3 Before the intervention,the general demographic data,the scores of self-care ability,quality of life and parenting sense of competence between the two groups of primiparous women were not statistically significant(P>0.05),and were comparable.4 After the intervention,the scores of primiparous women’s self-care ability,quality of life,and parenting sense of competence in the intervention group at 3 weeks and 6 weeks after delivery were higher than those in the control group,and the differences were statistically significant(P<0.05);Repeated measurement analysis of variance results showed that the two groups of subjects had statistically significant differences in the scores of self-care ability,quality of life,and parenting sense of competence at different times and in different groups(P<0.05),and there was an interaction between time and groups(P<0.05).5 After the intervention,at 6 weeks postpartum,the number of cases of postpartum constipation,nipple cleft palate,breast swelling,lack of sleep,and lack of parenting knowledge in the intervention group were less than that in the control group.Peri-umbilical infection,red buttocks,eczema,constipation,and diarrhea were lower in the intervention group than in the control group.The number of neonatal umbilical infections,red buttocks,and eczema in the two groups was significantly different(P <0.05).There were more breastfeeding cases in the intervention group than in the control group,and the difference was statistically significant(P<0.01).Conclusions1 The self-care ability of primiparous women during the puerperium are generally at a medium level,marital status,education,participation in pregnant women’s school,total monthly family income,and home address are the main influencing factors on the self-care ability of primiparous women during the puerperium,and self-care ability is positively related to quality of life and parenting sense of competence.2 Nursing intervention based on the PRECEDE-PROCEDE Model can improve the self-care ability of primiparous women during puerperium,reduce the incidence of maternal and child health problems during puerperium,improve their quality of life,enhance their parenting sense of competence,and promote maternal and child health. |
