Study On The Influence Of Motivational Interviewing Based On Trans-theoretical Model To Maternal Negative Emotion Management

Objective:To understand the depression and influence factors of pregnant women in the third trimester in Chengde city,and evaluate the effect of Motivational Interviewing based on Trans-theoretical Model in the management of negative emotion during pregnancy duration.Method:This study included two parts.The first stage was a cross-sectional survey,276 pregnant women in the third trimester（37 weeks to 42 weeks）from a tertiary first-class hospital in Chengde completed the questionnaires which included General situation questionnaire（self-made）,Edinburgh Postpartum Depression Scale（EPDS）,Self-Rating Anxiety Scale（SAS）and General self-efficacy scales（GSES）.The second stage,104 pregnant women who with depression diagnosed in the first stage of the study were randomly assigned to the experimental group（52 cases）and the control group（52 cases）,was conducted a quasi-experimental study.The control group was given routine nursing,and the experimental group was given the intervention method of Motivational Interviewing based on Trans-theoretical Model of change.The two groups maintained consistent nursing contents（prenatal,delivery and postpartum knowledge education and psychological nursing）with the same period.After completing 4 interventions,the levels of anxiety,depression and self-efficacy were remeasured at 42 days after delivery.SPSS21.0 was used for data collation and analysis.Counting data was described by frequency and percentage（%）,and（（?）±s）、median and quartile,non-parametric rank sum test or two independent sample t test were used for measurement data.Univariate analysis was performed by chi-square test or Fisher’s exact probability method,while multivariate analysis was performed by binary Logistic regression analysis(α_in=0.05,α_out=0.10).P < 0.05 was considered statistically significant.Results:1 276 pregnant women in the third trimester completed the survey,the average score of EPDS was（8.16±4.73）.and 126（45.65%）participants’ score of EPDS is higher than 9.2 Univariate and multivariate Logistic regression analysis showed that existed more than two weeks of depression during pregnancy（OR=5.849,95%CI: 1.564～21.879）,existed more than two weeks of anxiety and irritability during pregnancy（OR=5.849,95%CI: 1.564～21.879）,frequently worried about the dysplasia of fetal（OR=5.749,95%CI:1.321～25.018）were the risk factors of depression in the third trimester pregnancy and planned pregnancy（OR=0.151,95%CI:0.056～0.407）was a protective factor for depression.3 Before the intervention,the scores of EPDS were 11.0（9.0-13.75）in the experimental group and 12.0（10.0-14.0）in the control group.There was no statistical difference between the two groups（P > 0.05）.The SAS score of pregnant women in the experimental group was 48.13（42.5-55.94）,while that of pregnant women in the control group was 48.75（42.5-56.25）,there was no significant difference between the two groups（P>0.05）.The GSES score of pregnant women in the experimental group was（2.525±0.597）,while that of pregnant women in the control group was（2.598±0.612）.There was no significant difference between the two groups（P >0.05）.4 After intervention,the score of EPDS in the experimental group was 8.0（8.0-9.0）,and that in the control group was 11.0（9.0-12.0）.The SAS scores of the experimental group were 38.13（36.25-43.75）,and that of the control group was 46.25（40.31-50.0）.The GSES’s score of the experimental group was（2.917±0.521）,and that of the control group was（2.462±0.516）,the differences were statistically significant（P < 0.05）.The differences of EPDS,SAS and GSES scores between the two groups before and after intervention were statistically significant（P < 0.05）,and the differences between the two groups before and after intervention were statistically significant（P < 0.05）.After the intervention,the results showed that the EPDS and SAS scores of the experimental group decreased significantly,while the GSES scores increased significantly,and the variation was larger than those of the control group.Conclusion:1 The detection rate of depression in the third trimester of pregnancy in Chengde is relatively high.Black mood,anxiety and irritability lasting tow weeks during pregnancy,worried about the dysplasia of fetal and unplanned pregnancy may be the influence factors of depression in pregnant women in the third trimester.2 Motivational Interviewing based on Trans-theoretical model can decrease anxiety and depression,increase the maternal self efficacy.