| Objective Discussion on gentle childbirth technology and formation of cluster management model,To explore the effect of cluster gentle childbirth model on the self-efficacy,delivery coping ability and delivery outcome of advanced maternal age.Method This study belongs to the experimental design of class.190 cases of advanced maternal age who were examined and delivered in a third grade hospital in December 2017 ~2018 October were selected.According to the execution time of gentle delivery of cluster,the subjects were divided into control group and observation Group,92 cases in control group,traditional management mode was adopted,98 cases in observation group were carried out,and the management mode of cluster gentle delivery was implemented.The differences of maternal self-efficacy(CBSEI-C32),delivery coping ability(CCB),VAS score,cesarean section rate and non-indication cesarean section rate,labor time,postpartum 2 hours hemorrhage,perineal condition,neonatal Apgar score,hospitalization cost and satisfaction were compared between the two groups.Data using SPSS19.0 for statistical analysis,measurement data with the mean number and standard deviation(c±S),compared with T test and completely randomized design variance analysis,counting data use Cases(n)or composition ratio(%)representation,comparison with Chi-Square Inspection and Wilcoxon Rank Test.P<0.05 was statistically significant for the difference.Results1 Maternal equilibrium: There was no statistically significant difference between the two groups of women in terms of age,education level,occupation,family income,payment method of medical expenses,pregnancy and weight gain during pregnancy,etc.(P<0.05).There was no statistically significant difference between the two groups in the incidence of hypertension,gestational diabetes,premature rupture of membranes,excessive or too little amniotic fluid in pregnancy(P<0.05).2 The effect of cluster gentle childbirth model on the self-efficacy of AMA delivery: The mean value 177.98±29.51,OE-16 mean 88.34±14.99 and EE-16 mean 89.64±15.52 of the advanced maternal age before the intervention were lower than those of other hospitals in China,and there was no significant difference between the two groups before the intervention(P>0.05).After the intervention,the scores of the observation Group(CBSEI-C32 was 241.99±23.28,OE-16 was 118.47±11.94 and EE-16 123.52±12.40)were higher than those in the control group(CBSEI-C32 184.11±32.00,OE-16 was 91.93±15.81 and EE-16 as 92.17±16.99),the difference between the two groups was statistically significant(p<0.01)after the intervention,and the difference between the scores before and after the intervention was statistically significant(p<0.01).3 Effect of cluster gentle childbirth model on CCB of advanced maternal age: The CCB score(45.37±4.98)in the observation group was higher than that in the control group(37.42±3.87),and the difference was statistically significant(P<0.01).4 Effect of cluster gentle childbirth model on VAS in advanced maternal age: The VAS score(5.38±1.92)in the observation group was lower than that in the control group(7.04±1.79),and the difference was statistically significant(P<0.01).5 Effect of cluster gentle childbirth model on the outcome of AMA delivery: The rate of cesarean section,the rate of no-indication cesarean section,the degree of perineal laceration and the rate of incision were lower in the observation group than in the control group(P<0.05),There was no significant difference in labor time,2 hours postpartum hemorrhage and neonatal Apgar score between the two groups(P>0.05).6 Effect of cluster gentle childbirth model on economic and social benefits: the total hospitalization cost and medical bowel line consumables of the observation group were lower than those in the control group,and the satisfaction degree of nursing service was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion1.The gentle childbirth mode of cluster can improve the self-efficacy of AMA delivery and the ability to cope with childbirth.2.The gentle childbirth mode of cluster can reduce the rate of cesarean section without indication of AMA.3.The gentle childbirth mode of cluster can reduce the pain of childbirth,reduce the degree of perineal injury and incision rate,and will not increase the occurrence of adverse outcomes of mother and child.4.The gentle childbirth mode of cluster can reduce medical consumables and reduce maternal hospitalization costs,improve maternal satisfaction and the professional sense of accomplishment of midwives,and achieve better economic and social benefits. |
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