The Knowledge,attitude,practice Status And Intervention Of Patient-controlled Analgesia After Cesarean Section

BackgroundSince the full implementation of the "two-child policy",the cesarean section rate in my country has been continuously increasing.Studies have shown that China’s cesarean section rate ranks first in the world,generally more than 40% in various cities,and even as high as 80% in some areas,which is much higher than the 10% to 15% recommended by the World Health Organization(WHO).Pain,as the most serious complication after surgery,has increasingly attracted the attention of clinicians.In recent years,with the application of new analgesics and analgesic techniques,the postoperative pain problem of patients has been greatly improved.However,a large number of patients still have poor postoperative pain relief,especially for patients undergoing cesarean section.The postoperative pain problem is particularly prominent.It is clinically believed that in addition to analgesics,correct health education can also effectively control postoperative pain.ObjectiveInvestigate the current status of knowledge,belief,practice and influencing factors of postoperative patient-controlled analgesia for cesarean section women,formulate comprehensive intervention plans for knowledge,belief,practice and application based on the survey results,and explore the effects of traditional health education and health education model of knowledge,belief and practice on self-controlled treatment of post-cesarean section women To improve the quality of pain management after cesarean section.Methods1.Current situation investigation: 378 parturients undergoing cesarean section in the department of gynecology and obstetrics of a tertiary hospital in Xinxiang City from September 2019 to January 2020 were selected to investigate the current situation with the self-made questionnaire on knowledge,belief and practice of patient-controlled analgesia after cesarean section.According to the results of the survey,a comprehensive intervention plan of knowledge,belief and practice was formulated and applied.2.Quasi-experimental study: 306 parturients undergoing cesarean section in the department of gynecology and obstetrics of a tertiary hospital in Xinxiang City from February 2020 to September 2020 were selected as the object of study,and the subjects were divided into control group and intervention group according to chronological order.The parturients in the control group received traditional routine health education during the perioperative period,while the parturients in the intervention group received knowledge,belief and practice health education besides the traditional routine health education after operation.After the intervention,the data of knowledge,belief and practice score,pain score,use of patient-controlled analgesia pump and postoperative recovery of the two groups were collected.Use Epidata3.0 software to input data and double check.Using SPSS23.0 for statistical analysis,the difference was statistically significant with P<0.05.Results1.Develop a questionnaire: After two rounds of expert letter inquirys,a questionnaire on knowledge,belief and practice of patient-controlled analgesia for parturients after cesarean section was constructed,including 43 items of knowledge,belief and behavior.The content validity of the questionnaire is 0.841 and the test-retest reliability is 0.803.It has good reliability and validity.2.Current situation investigation: The total scores of knowledge,belief,behavior and knowledge,belief and practice of 378 parturients undergoing cesarean section were(36.35±1.94),(39.49 ±0.67),(31.13 ±0.94)and(107.09 ±2.80)respectively.The factors influencing the total score of knowledge,belief and practice of patient-controlled analgesia after cesarean section were age,education level,monthly income level,side effects and children’s condition(P<0.05).The results of Pearson correlation analysis showed that there was a positive correlation among maternal knowledge,belief and behavior,and the correlation coefficients were 0.333,0.540 and 0.312 respectively.3.Quasi-experimental study: After one week of intervention,the knowledge,belief,behavior and total score of KAP of parturients in the intervention group and the control group were significantly higher than those in the control group(P< 0.05).The total scores of knowledge,belief,behavior and knowledge,belief and practice of patient-controlled analgesia after cesarean section in the intervention group were significantly higher than those in the control group(P<0.001).The VAS score,the use and recovery of patient-controlled analgesia pump in the intervention group were better than those in the control group,and the difference was statistically significant(P<0.05).Conclusions1.The questionnaire of knowledge,belief and practice of patient-controlled analgesia after cesarean section has good reliability and validity.2.The knowledge,belief and behavior related to patient-controlled analgesia after cesarean section are at a low level.At the same time,the pregnant women with older age,high education,having children,high monthly income and side effects had a high level of knowledge,belief and practice.3.Health education intervention based on the theory of knowledge,belief and practice can improve the related knowledge,belief and behavior of parturients after cesarean section.