Intervention Study Of Health Education On Maternal Self-efficacy,Anxiety And Depression In Delivery After Cesarean Section Based On KAP Model

Objective: To construct a health education program for pregnant women with second pregnancy after cesarean section;To understand the delivery self-efficacy,anxiety and depression of pregnant women after cesarean section;To evaluate the effect of health education on maternal self-efficacy,anxiety and depression in delivery after cesarean section based on KAP model.Methods:(1)In study 1,18 experts were included as the theoretical framework to construct a health education program for pregnant women after cesarean section through Delphi method.The experts have a wide range of research fields,including obstetrics and gynecology nursing,obstetrics and gynecology medical treatment,obstetrics and gynecology teaching,nursing education,nursing management,medical management,psychology,rehabilitation science and technology.The expert positive coefficient was expressed by the questionnaire recovery rate,the degree of expert authority was determined by the expert judgment basis and expert familiarity,and the degree of expert opinion concentration and coordination was expressed by the item mean,standard deviation,coefficient of variation and Kendall's coefficient of coordination.(2)Study 2 was a randomized controlled trial to investigate the effects of health education on maternal self-efficacy,anxiety and depression in childbirth after cesarean section.Counting data are frequency and percentage;The measurement data conforming to the normal distribution were(±S),while the measurement data not conforming to the normal distribution were median,P25 and P75.Statistical data were provided by chi-square test;For measurement data,independent sample T-test was used for inter-group comparison in each group in accordance with normal distribution,while independent sample rank sum test was used for non-conforming normal distribution.Paired sample T-test was used for in-group comparison for normal distribution,and paired sample rank sum test was used for non-normal distribution.P?0.05 was considered statistically significant.Results:(1)After two rounds of expert consultation,a health education program for pregnant women with second pregnancy after cesarean section was constructed,with a total of 87 items.The recovery rate was 100% and the expert authority coefficient was 0.878.The coordination coefficient of the first round is 0.12~0.38,and that of the second round is 0.26~0.31.The contents of health education include the indications,contraindications and success of the second pregnancy vaginal trial after cesarean section.Pregnancy weight management;Dietary guidance during pregnancy;The risks of elective cesarean section and the advantages and disadvantages of vaginal delivery after cesarean section;Cesarean section operation process,vaginal delivery process;Labor analgesia;Emergency capacity support.(2)Study 2 included 116 subjects,and there were no statistically significant differences in general information,delivery self-efficacy score,anxiety score and depression score between the two groups before intervention(P > 0.05).After intervention,the self-efficacy of childbirth in the intervention group was higher than that in the control group,and the difference between the two groups was statistically significant(P < 0.05).The scores of anxiety and depression in the intervention group were better than those in the control group,and the difference between the two groups was statistically significant(P < 0.05).Conclusion:(1)Based on the Delphi method,a health education program was constructed for pregnant women with second pregnancy after cesarean section,with good coordination of expert opinions and desirable results.(2)The knowledge and practice health education program based on Delphi method is simple,scientific,reasonable and rich in contents.The acceptance rate of pregnant women after cesarean section is good.(3)The anxiety and depression of pregnant women after cesarean section is fair,but the space to improve anxiety and depression is still large.(4)Health education based on KAP model can improve the maternal self-efficacy of childbirth after cesarean section.(5)health education can improve the anxiety and depression of pregnant women after cesarean section.