结合社会支持的分娩自我效能增强干预对初产妇分娩的影响

摘要

Objective To evaluate the effectiveness of childbirth self-efficacy-enhancing intervention combined with social support on pain relieving during labor and the mode of delivery.Methods A randomized controlled trial design was used.110 primiparas were divided into two groups.The women in the two groups received routine prenatal care.On this basis,the women in the intervention group received the childbirth self-efficacy-enhancing intervention.Multidimensional Scale of Perceived Social Support (MSPSS) and Chinese Childbirth Self-Efficacy Inventory (CBSEI) were used for the baseline measures.The relationship between the level of perceived social support and the childbirth self-efficacy was ana-lyzed.The differences between the two groups in the level of perceived labor pain and the mode of delivery were com-pared.Results 54 women in intervention group and 53 in control group completed the trial.The average score of labor pain in intervention group (6.95 ±1.40)was lower than those of control group (8.34 ±1.43) (P <0.01 ).There was no difference in the mode of delivery between the two groups.The rate of the cesarean section without indication in intervention group was lower than that of control group (χ2 =9.429,P <0.01).The total score of MSPSS was positively correlated with the pretest outcome expectancy (OE)and efficacy expectancy (EE)(r =0.306,0.302,P <0.05).Conclusion The midwife-led childbirth efficacy-enhancing educational intervention was effective in reducing the level of pain during la-bor.Improving the level of social support of the primiparas was conductive to improve their childbirth self-efficacy.%目的 结合领悟社会支持水平,探讨助产士主导的分娩自我效能增强干预对初产妇分娩疼痛水平和分娩方式的影响.方法 采用随机分组对照、双盲实验设计,将110例初产妇分为干预组和对照组,每组55例.2组均给予常规产前护理;干预组在此基础上,接受两次分娩自我效能增强干预课程.2组均采用领悟社会支持量表(MSPSS)和简化中文版分娩自我效能量表(CBSEI)行基线评估.分析初产妇领悟社会支持水平与分娩自我效能(CBSEI)相关性,并比较2组分娩疼痛水平和分娩方式的差异性.结果 最终干预组有效样本54例,对照组有效样本53例.干预组产时分娩疼痛均分(6.95±1.40)显著低于对照组(8.34±1.43),差异有统计学意义(P<0.01);2组分娩方式差异无统计学意义,但干预组无指征剖宫产率显著低于对照组,差异有统计学意义(χ2=9.429,P<0.01);孕妇领悟社会支持水平得分与干预前结果期望(OE)和自我效能期望(EE)得分均呈正相关(r值分别为0.306、0.302,P<0.05).结论 助产士主导的分娩自我效能增强干预能有效降低分娩疼痛水平及无指征剖宫产率;提高初产妇社会支持水平有助于提高其分娩自我效能.