目的 探讨预见性护理联合AIDET沟通对产妇产后出血的预防及对血流动力学的影响,以有效控制产妇产后出血,稳定产妇分娩期间的生命体征稳定.方法 选取92例濮阳市妇幼保健院2019年1月-2022年9月进行分娩的初产妇作为研究对象,均为单胎头位,按照分娩期间的护理方法不同分为观察组和对照组,各46例.两组均实施阴道或剖宫产分娩,同时对照组实施产科常规护理管理,观察组则在对照组的基础上实施预见性护理联合AIDET沟通进行护理管理.护理结束后,统计2组产妇产后2h、24h的出血量,并统计产后出血的发生率;监测2组产妇产前和产后24h的血流动力学指标,包括收缩压和舒张压,以及心率水平;评估产妇产前和产后24h的焦虑评分和自我效能感评分;统计产后产妇出现的并发症情况.结果 2组产妇产后2h-24h出血量逐渐升高,观察组低于对照组(P＜0.05),观察组产后出血率为4.35％(2/46),较对照组17.39％(8/46)降低(P＜0.05).产后24 h 2组产妇的收缩压和舒张压降低(P＜0.05),心率加快(P＜0.05),但是观察组的血压更高,心率更低P＜0.05).与产前比较,产后24h 2组SAI评分降低(P＜0.05),GESE评分总分升高(P＜0.05),且观察组GESE评分低于对照组(P＜0.05),GESE评分高于对照组(P＜0.05).观察组尿潴留、阴道血肿、感染例数少于对照组,但是发生率与对照组无明显差异(P＞0.05),观察组并发症少于对照组(P＜0.05).结论 对于进行分娩的初产妇,在常规产科护理模式的基础上,应用预见性护理联合AIDET沟通进行护理管理能够有助于预防产后出血,产妇分娩期间的血流动力学更稳定,自我效能感更高,进而有助于提高产妇产后生活质量.
The effect of predictive nursing combined with AIDET communication on the prevention of postpartum hemorrhage and hemodynamics
Objective To explore the effect of predictive nursing combined with AIDET communication on the prevention of postpartum hemorrhage and hemodynamics in order to effectively control postpartum hemorrhage and stabilize the vital signs during delivery.Methods 92 primipara who delivered in Puyang maternal and child health hospital from January 2019 to September 2022 were selected as the study subjects.They were all in single head position.They were divided into observation group and control group according to different nursing methods during delivery,with 46 cases in each group.Both groups performed vaginal or cesarean delivery.The control group performed routine obstetric nursing management,while the observation group performed predictive nursing combined with AIDET communication on the basis of the control group.After the end of nursing care,the amount of postpartum hemorrhage of two groups of puerperas at 2 hours and 24 hours after delivery was counted,and the incidence of postpartum hemorrhage was also calculated;the hemodynamic indexes of two groups were investigated including systolic and diastolic blood pressure,and heart rate level before delivery and 24 hours after delivery.The anxiety score and self-efficacy score of the puerpera before and 24 hours after delivery were assessed.The complications of postpartum women were observed.Results The amount of postpartum hemorrhage in two groups increased gradually from 2 to 24 hours after delivery,and the rate of postpartum hemorrhage in the observation group was 4.35％(2/46),which was lower than that in the control group 17.39％(8/46)(P＜0.05).The systolic and diastolic blood pressure decreased(P＜0.05)and the heart rate increased(P＜0.05)in two groups at 24 hours after delivery,but the blood pressure in the observation group was higher and the heart rate was lower(P＜0.05).Compared with antepartum,the SAI score of the 24 h post-partum group decreased(P＜0.05),and the total score of the GESE score increased(P＜0.05).The GESE score of the observation group was lower than that of the control group(P＜0.05),and the GESE score was higher than that of the control group(P＜0.05).The number of cases of urinary retention,vaginal hematoma,vaginal hematoma and infection in the observation group was less than that in the control group,but there was no significant difference in the incidence between the observation group and the control group(P＞0.05).The complications in the observation group were less than those in the control group(P＜0.05).Conclusion For primipara undergoing delivery,on the basis of conventional obstetric nursing model,applying predictive nursing combined with AIDET communication for nursing management can help prevent postpartum hemorrhage,the hemodynamics of puerpera during delivery are more stable,and the sense of self-efficacy is higher,which is helpful to improve the quality of life of puerpera after delivery.
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