Current status and influencing factors of discharge readiness among high-risk pregnant women and their spouses
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摘要:
目的 了解高危产妇及配偶的出院准备度现状，分析其影响因素，为制订个性化的出院健康教育及延续性护理计划提供理论依据。 方法 采用便利抽样法, 选取2024年8—11月在蚌埠医科大学第一附属医院产科住院的230对高危产妇及配偶为研究对象。采用产妇一般资料调查表、配偶一般资料调查表、产妇出院准备度量表、照顾者准备度量表进行问卷调查。对高危产妇出院准备度得分及配偶照顾者准备度得分进行统计分析，采用单因素分析及多元线性逐步回归分析探讨高危产妇出院准备度及配偶照顾准备度的影响因素。 结果 高危产妇出院准备度得分为（112.46±15.59)分，其中产次、分娩方式、妊娠合并症和并发症数量、是否参加孕妇学校或课程是高危产妇出院准备度的影响因素（P < 0.01）；配偶照顾者准备度得分为（24.48±3.51）分，其中产妇产次、受教育程度、妊娠合并症和并发症数量、产妇出院准备度总分是照顾者准备度的影响因素（P < 0.05）。 结论 高危产妇及配偶的出院准备度水平仍有待提高，临床医护人员应重点关注高危产妇及配偶的出院准备度情况、需求和担忧，并针对以上影响因素，制订针对性及多样性的延续性护理服务方案，以提高其出院准备度水平，促进母婴健康。 Abstract:Objective To understand the current status of discharge readiness among high-risk pregnant women and their spouses, analyze the influencing factors, and provide a theoretical basis for developing personalized discharge health education plans and continuous care plans. Methods A total of 230 pairs of high-risk parturients and their spouses hospitalized in the Department of Obstetrics at the First Affiliated Hospital of Bengbu Medical University from August to November 2024 were selected as the study subjects using a convenience sampling method. Questionnaires were administered using the parturient general information questionnaire, spouse general information questionnaire, parturient readiness for hospital discharge scale, and caregiver readiness scale. Statistical analysis was conducted on the discharge readiness scores of high-risk parturients and the preparedness scores of their spousal caregivers. Univariate analysis and multiple linear stepwise regression analysis were employed to explore the influencing factors of discharge readiness among high-risk parturients and caregiving preparedness among their spouses. Results The discharge readiness score of high-risk pregnant women was (112.46±15.59) points, with parity, mode of delivery, number of pregnancy complications and comorbidities, and participation in prenatal education courses identified as influencing factors (P < 0.01). The caregiver readiness score of spouses was (24.48±3.51) points, with maternal parity, education level, number of pregnancy complications and comorbidities, and total maternal discharge readiness score identified as influencing factors (P < 0.05). Conclusion The level of discharge readiness among high-risk pregnant women and their spouses still needs improvement. Clinical healthcare professionals should focus on the discharge readiness status, needs, and concerns of high-risk pregnant women and their spouses. Targeted and diversified continuous nursing care service plans should be developed based on the influencing factors mentioned above to enhance their discharge readiness level and promote maternal and infant health. -
Key words:
- High-risk pregnant /
- Caregivers /
- Discharge readiness /
- Influencing factor
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表 1 高危产妇出院准备度单因素分析
Table 1. Univariate analysis of discharge readiness among high-risk pregnant women
项目 例数(%) 得分(x±s，分) 统计量 P值 年龄(岁) 0.447a 0.656 < 35 177(77.0) 112.21±15.10 ≥35 53(23.0) 113.30±17.30 受教育程度 2.350b 0.073 初中及以下 60(26.1) 108.57±16.49 高中 38(16.5) 112.05±14.95 专科 32(13.9) 111.69±17.73 本科及以上 100(43.5) 115.20±14.21 职业 3.179b 0.025 个体 36(15.7) 109.28±15.45 其他职业 19(8.3) 116.89±11.98 企事业单位 112(48.7) 114.84±15.44 无业 63(27.4) 108.71±16.10 人均月收入(元) 0.243b 0.866 ＜2 000 10(4.3) 112.60±18.69 >2 000~3 000 43(18.7) 111.77±15.09 >3 000~4 000 68(29.6) 111.44±15.55 >4 000 109(47.4) 113.36±15.70 居住地 1.180a 0.239 城镇 112(48.7) 113.71±15.89 农村 118(51.3) 111.28±15.29 产次 2.682a 0.008 初产妇 107(46.5) 109.54±14.97 经产妇 123(53.5) 115.00±15.75 分娩方式 3.570a ＜0.001 自然分娩 73(31.7) 117.71±14.28 剖宫产 157(68.3) 110.02±15.63 妊娠合并症和并发症数量(种) 4.854b 0.009 1 92(40.0) 115.35±15.01 2 84(36.5) 112.70±15.02 ≥3 54(23.5) 107.17±16.38 妊娠期住院次数(次) 2.210b 0.088 0 127(55.2) 114.33±14.86 1 76(33.0) 111.37±16.42 2~3 19(8.3) 108.37±16.19 ≥4 8(3.5) 102.88±13.99 参加孕妇学校或课程 4.208a ＜0.001 是 73(31.7) 118.59±15.09 否 157(68.3) 109.61±15.05 注：a为t值, b为F值。 
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表 2 高危产妇出院准备度影响因素的多元线性回归分析
Table 2. Multiple regression analysis of influencing factors on discharge readiness among high-risk pregnant women
变量 B SE β t值 P值 产次 7.619 1.920 0.244 3.969 ＜0.001 分娩方式 -7.304 2.078 -0.218 -3.515 0.001 妊娠合并症和并发症数量 -3.222 1.248 -0.161 -2.581 0.010 参加孕妇学校或课程 -7.948 2.027 -0.238 -3.920 ＜0.001 注: R2=0.189, 调整后R2=0.175, F=13.128, P < 0.001。本表仅列出差异有统计学意义的结果。
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表 3 配偶的照顾者准备度单因素分析
Table 3. Single factor analysis of spouse caregiver readiness
项目 例(%) 得分(x±s，分) 统计量 P值 年龄(岁) 2.006a 0.046 ＜35 158(68.7) 24.17±3.44 ≥35 72(31.3) 25.17±3.60 受教育程度 6.506b ＜0.001 初中及以下 56(24.3) 23.25±3.53 高中 36(15.7) 23.53±3.65 专科 27(11.7) 24.30±4.04 本科及以上 111(48.3) 25.46±3.05 职业 11.170b ＜0.001 个体 57(24.8) 24.33±2.86 其他职业 48(20.9) 22.90±3.40 企事业单位 117(50.9) 25.48±3.38 无业 8(3.5) 20.50±4.41 人均月收入(元) 3.977b 0.009 ＜2 000 10(4.3) 22.90±3.76 >2 000~3 000 43(18.7) 23.56±2.94 >3 000~4 000 68(29.6) 24.04±3.71 >4 000 109(47.4) 25.27±3.43 居住地 3.920a ＜0.001 城镇 112(48.7) 25.38±3.16 农村 118(51.3) 23.63±3.63 产妇产次 2.303a 0.022 初产妇 107(46.5) 23.92±3.17 经产妇 123(53.5) 24.98±3.73 产妇分娩方式 2.645a 0.009 自然分娩 73(31.7) 25.37±3.15 剖宫产 157(68.3) 24.07±3.61 妊娠合并症和并发症数量(种) 3.724b 0.026 1 92(40.0) 25.12±3.13 2 84(36.5) 24.42±3.86 ≥3 54(23.5) 23.50±3.40 妊娠期住院(次) 0.444b 0.722 0 127(55.2) 24.69±3.33 1 76(33.0) 24.14±3.94 2~3 19(8.3) 24.63±2.54 ≥4 8(3.5) 24.00±4.34 参加孕妇学校或课程 3.832a ＜0.001 是 61(26.5) 25.92±3.30 否 169(73.5) 23.96±3.45 注：a为t值, b为F值。
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表 4 配偶照顾者准备影响因素多元线性回归分析
Table 4. Multivariate stepwise linear regression analysis of factors affecting spouse caregivers' preparedness
变量 B SE β t值 P值 受教育程度 0.889 0.173 0.319 5.136 ＜0.001 产妇产次 1.611 0.450 0.229 3.580 ＜0.001 妊娠合并症和并发症种数 -0.541 0.274 -0.120 -1.976 0.049 产妇出院准备度总分 0.060 0.014 0.266 4.345 ＜0.001 注: R2=0.237, 调整后R2=0.223, F=17.456, P < 0.001，本表仅列出差异有统计学意义的变量。
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