“互联网+”医疗护理模式在产科三位一体家庭式病房产妇中的应用效果

纪建英; 郑聪霞; 何雪妃; 叶伟娟; 吴一军

doi:10.16766/j.cnki.issn.1674-4152.002528

“互联网+”医疗护理模式在产科三位一体家庭式病房产妇中的应用效果

doi: 10.16766/j.cnki.issn.1674-4152.002528

丽水市妇幼保健院产科，浙江丽水 323000

基金项目:

浙江省基础公益研究计划项目 LGF20H040002

详细信息

通讯作者:
吴一军，E-mail：2225651616@qq.com

中图分类号: R473.71 R715
计量
- 文章访问数: 233
- HTML全文浏览量: 114
- PDF下载量: 6
- 被引次数: 0
出版历程
- 收稿日期: 2020-08-26
- 网络出版日期: 2022-09-21

Application effect of "Internet +" medical care model in the family ward of obstetrics trinity

Department of Obstetrics, Lishui Maternal and Child Health Hospital, Lishui, Zhejiang 323000, China

摘要

摘要: 目的构建适合产科三位一体家庭式病房产妇的“互联网+”医疗护理模式，以进一步提高母婴VIP健康管理服务水平。方法选择2018年12月—2020年6月在丽水市妇幼保健院产科三位一体家庭式病房分娩的足月初产妇240例，按照“互联网+”医疗护理模式建立前后分为对照组与观察组，每组120例。对照组采取常规产科VIP护理模式，观察组在对照组基础上采取以“互联网+”为基础的产科护理新模式。比较2组护理效果。结果产后24 h，观察组分娩恐惧程度得分[(28.63±7.64)分]明显低于对照组[(32.81±8.16)分]，自我效能得分[(259.04±60.15)分]明显高于对照组[(232.10±63.73)分]，差异有统计学意义(t=4.099、-3.368，均P＜0.05)；观察组产后2 h出血量[(190.13±34.98)mL]明显小于对照组[(218.07±41.19)mL]，差异有统计学意义(t=5.667，P＜0.05)；观察组产后42 d母乳喂养率为90.00%(108/120)，明显高于对照组的78.33%(94/120)，差异有统计学意义(χ²=6.128，P＜0.05)；观察组对院外护理的满意度评分[(24.57±3.44)分]明显高于对照组[(18.59±4.61)分]，差异有统计学意义(t=-11.387，P＜0.05)。结论 “互联网+”医疗护理模式在产科三位一体家庭式病房产妇中的应用效果较好，能够明显减轻产妇分娩恐惧度，提高自我效能，减少产后出血量，提高母乳喂养率及院外护理满意度。
- 互联网+ /
- 产科护理 /
- 母婴健康 /
- 护理管理
Abstract: Objective To construct an "Internet +" medical care model suitable for obstetric trinity family wards and improve the level of maternal and child VIP health management services. Methods A total of 240 full-term primiparous women who gave birth in the Trinity Family Ward of the Obstetrics Department of Lishui Maternal and Child Health Hospital from December 2018 to June 2020 were selected and divided equally into the control and observation groups. The control group adopted the routine obstetric VIP nursing model, and the observation group adopted the new model of obstetric nursing based on "Internet +". The nursing effect of the two groups was compared. Results At 24 h after delivery, the score of the intervention group [(28.63±7.64) points] was significantly lower than that of the control group [(32.81±8.16) points]. The self-efficacy score of the intervention group [(259.04±60.15) points] was significantly higher than that of the control group [(232.10±63.73) points, t=4.099, -3.368, all P < 0.05]. The bleeding volume [(190.13±34.98) mL] in the observation group at 2 h post-partum was significantly less than that in the control group [(218.07±41.19) mL, t=5.667, P < 0.05]. The 90.00% (108/120) breastfeeding rate at 42 days post-partum in the observation group was significantly higher than the 78.33% (94/120) in the control group (χ²=6.128, P < 0.05). The satisfaction score of the observation group for out-of-hospital care [(24.57±3.44) points] was significantly higher than that of the control group [(18.59±4.61) points, t=-11.387, P < 0.05]. Conclusion The "Internet +" medical care model has a good application effect in the obstetric trinity family ward, which can significantly reduce the fear of childbirth, improve self-efficacy, reduce post-partum bleeding and increase breastfeeding rate and nursing satisfaction.
- Internet + /
- Obstetric care /
- Maternal and child health /
- Nursing management

HTML全文

表 1 2组产妇一般资料比较

Table 1. Comparison of general data of puerperae in the two groups

组别	例数	年龄 (x±s, 岁)	孕期体重增长 (x>±s, kg)	职业[例(%)]				计划妊娠 [例(%)]	定期产检 [例(%)]	既往流产史 [例(%)]	文化程度[例(%)]
组别	例数	年龄 (x±s, 岁)	孕期体重增长 (x>±s, kg)	企事业单位	自由职业	家庭主妇	其他	计划妊娠 [例(%)]	定期产检 [例(%)]	既往流产史 [例(%)]	初中及以下	高中及中专	大专及以上
对照组	120	24.01±6.95	11.81±2.93	48(40.00)	34(28.33)	30(25.00)	8(6.67)	19(15.83)	99(82.50)	20(16.67)	10(8.33)	65(54.17)	45(37.50)
观察组	120	23.87±6.58	12.02±3.14	45(37.50)	36(30.00)	33(27.50)	6(5.00)	22(18.33)	102(85.00)	15(12.50)	8(6.67)	57(47.50)	55(45.83)
统计量		0.163^a	-0.536^a	0.582^b				0.265^b	0.276^b	0.836^b	-1.303^c
P值		0.870	0.591	0.900				0.607	0.600	0.360	0.193
注：^a为t值，^b为χ²值，^c为Z值。

下载: 导出CSV

表 2 2组产妇不同时间的分娩恐惧程度和自我效能得分比较(x±s, 分)

Table 2. Comparison of childbirth fear and self-efficacy scores between the two groups of puerperae at different times (x±s, points)

组别	例数	分娩恐惧程度		自我效能
组别	例数	入院时	产后24 h	入院时	产后24 h
对照组	120	38.94±9.18	32.81±8.16^a	197.90±51.23	232.10±63.73^a
观察组	120	39.11±9.83	28.63±7.64^a	197.62±49.87	259.04±60.15^a
t值		-0.138	4.099	0.047	-3.368
P值		0.893	< 0.001	0.962	0.001
注：与入院时比较，^aP＜0.05。

下载: 导出CSV

表 3 2组产妇住院相关指标及产后42 d母乳喂养情况比较

Table 3. Comparison of hospital-related indicators and breastfeeding status of puerperae on 42 days postpartum between the two groups

组别	例数	胎头拨露时间 (x±s, min)	第二产程时间 (x±s, min)	第三产程时间 (x±s, min)	产后2 h出血量 (x±s, mL)	Apgar评分 (x±s, 分)	住院时间 (x±s, d)	产后42 d母乳喂养[例(%)]
对照组	120	15.88±4.21	59.20±7.02	8.85±1.96	218.07±41.19	8.96±2.02	3.49±0.86	94(78.33)
观察组	120	15.73±4.07	57.85±6.16	9.04±2.18	190.13±34.98	9.25±1.89	3.44±0.78	108(90.00)
统计量		0.281^a	1.583^a	-0.708^a	5.667^a	-1.149^a	0.475^a	6.128^b
P值		0.775	0.115	0.478	< 0.001	0.250	0.637	0.013
注：^a为t值，^b为χ²值。

下载: 导出CSV

表 4 2组产妇护理满意度比较(x±s, 分)

Table 4. Comparison of maternal nursing satisfaction between the two groups (x±s, points)

组别	例数	产前护理	产中护理	产后护理	院外护理
对照组	120	23.27±3.02	23.76±3.31	22.31±4.76	18.59±4.61
观察组	120	23.79±3.85	24.03±5.11	22.75±4.35	24.57±3.44
t值		-1.164	-0.489	-0.747	-11.387
P值		0.249	0.623	0.453	< 0.001

下载: 导出CSV

参考文献(20)

[1]	干兴凤. 基于人性化理论的母婴床旁护理[J]. 解放军医院管理杂志, 2018, 25(4): 371-374. https://www.cnki.com.cn/Article/CJFDTOTAL-JFYG201804027.htm GAN X F. Maternal and infant bed nursing based on humanized theory[J]. Hospital Administration Journal of Chinese People's Liberation Army, 2018, 25(4): 371-374. https://www.cnki.com.cn/Article/CJFDTOTAL-JFYG201804027.htm
[2]	姚姣仙, 陈芳建, 祝霞君, 等. 风险式护理在产科中的应用效果研究[J]. 中华全科医学, 2019, 17(5): 884-886. doi: 10.16766/j.cnki.issn.1674-4152.000817 YAO J X, CHEN F J, ZHU X J, et al. Study on the effect of risk nursing in obstetrics[J]. Chinese Journal of General Practice, 2019, 17(5): 884-886. doi: 10.16766/j.cnki.issn.1674-4152.000817
[3]	郭贞, 卞翔, 马玉凤. 以家庭为中心的产科护理模式对初产妇育儿能力的影响[J]. 天津护理, 2019, 27(1): 76-78. doi: 10.3969/j.issn.1006-9143.2019.01.023 GUO Z, BIAN X, MA Y F. Effect of family-centered care on parenting skill of primipara[J]. Tianjin Journal of Nursing, 2019, 27(1): 76-78. doi: 10.3969/j.issn.1006-9143.2019.01.023
[4]	余红云, 张妮. "以人为本"的以家庭为中心的产科护理模式对产褥期产妇产后抑郁的影响[J]. 浙江医学, 2018, 40(17): 1976-1979. doi: 10.12056/j.issn.1006-2785.2018.40.17.2017-2856 YU H Y, ZHANG N. Influence of "people-oriented" family-centered obstetric nursing model on postpartum depression in puerperium[J]. Zhejiang Medical Journal, 2018, 40(17): 1976-1979. doi: 10.12056/j.issn.1006-2785.2018.40.17.2017-2856
[5]	冯世萍, 嵇秀明, 夏珊敏, 等. 基于"家庭为中心"孕产妇护理模式产科护士胜任力模型的构建[J]. 中华现代护理杂志, 2017, 23(5): 650-654. doi: 10.3760/cma.j.issn.1674-2907.2017.05.014 FENG S P, JI X M, XIA S M, et al. Development of maternity nurse competency model based on & quot; family-centered & quot; maternal care model[J]. Chinese Journal of Modern Nursing, 2017, 23(5): 650-654. doi: 10.3760/cma.j.issn.1674-2907.2017.05.014
[6]	张小燕, 林艳, 符白玲. 孕妇对"互联网+"健康教育模式感知的质性研究[J]. 当代护士(上旬刊), 2020, 27(2): 8-10. https://www.cnki.com.cn/Article/CJFDTOTAL-DDZT202002003.htm ZHANG X Y, LIN Y, FU B L. Qualitative study on pregnant women's perception of "Internet plus" health education mode[J]. Today Nurse, 2020, 27(4): 8-10. https://www.cnki.com.cn/Article/CJFDTOTAL-DDZT202002003.htm
[7]	孟群, 尹新, 梁宸. 中国"互联网+健康医疗"现状与发展综述[J]. 中国卫生信息管理杂志, 2017, 14(2): 110-118. https://www.cnki.com.cn/Article/CJFDTOTAL-WSGL201702004.htm MENG Q, YIN X, LIANG C. The current situation and development of China internet plus healthcare[J]. Chinese Journal of Health Informatics and Management, 2017, 14(2): 110-118. https://www.cnki.com.cn/Article/CJFDTOTAL-WSGL201702004.htm
[8]	危娟, 刘洁英, 张莉芳, 等. 分娩恐惧量表的汉化及信效度检测[J]. 护理学杂志, 2016, 31(2): 81-83. doi: 10.3870/j.issn.1001-4152.2016.02.081 WEI J, LIU J Y, ZHANG L F, et al. Reliability and validity of the Chinese version of Childbirth Attitudes Questionnaire[J]. Journal of Nursing Science, 2016, 31(2): 81-83. doi: 10.3870/j.issn.1001-4152.2016.02.081
[9]	危娟, 刘洁英. 孕妇分娩恐惧与自我效能的相关性分析[J]. 护理研究, 2017, 31(18): 2246-2248. doi: 10.3969/j.issn.1009-6493.2017.18.022 WEI J, LIU J Y. Correlation between fear of childbirth and self-efficacy of pregnant women[J]. Chinese Nursing Research, 2017, 31(18): 2246-2248. doi: 10.3969/j.issn.1009-6493.2017.18.022
[10]	孙曼, 侯晨颖, 何雪敬, 等. 妊娠压力和社会支持对妊娠晚期孕妇分娩自我效能感的影响[J]. 解放军护理杂志, 2019, 36(1): 60-63. https://www.cnki.com.cn/Article/CJFDTOTAL-JFHL201901017.htm SUN M, HOU C Y, HE X J, et al. Effects of Pregnancy Stress and Social Support on Self-efficacy of Women during Delivery[J]. Nursing Journal of Chinese People's Liberation Army, 2019, 36(1): 60-63. https://www.cnki.com.cn/Article/CJFDTOTAL-JFHL201901017.htm
[11]	赵燕凤, 张志群, 芦蕙, 等. 脐动脉血气分析联合Apgar评分对新生儿窒息多器官损害的诊断意义[J]. 中华全科医学, 2017, 15(2): 267-269. doi: 10.16766/j.cnki.issn.1674-4152.2017.02.026 ZHAO Y F, ZHANG Z Q, LU H, et al. Umbilical artery blood gas analysis and Apgar score for multiple organ damage after neonatal asphyxia[J]. Chinese Journal of General Practice, 2017, 15(2): 267-269. doi: 10.16766/j.cnki.issn.1674-4152.2017.02.026
[12]	PAN W L, GAU M L, LEE T Y, et al. Mindfulness-based programme on the psychological health of pregnant women[J]. Women B, 2019, 32(1): e102-e109. doi: 10.1016/j.wombi.2018.04.018
[13]	刘艳君, 上官芳芳, 郑睿敏, 等. 分娩自我效能感在孕妇正念水平与分娩恐惧间的中介作用[J]. 中华行为医学与脑科学杂志, 2019, 28(9): 783-787. doi: 10.3760/cma.j.issn.1674-6554.2019.09.004 LIU Y J, SHANGGUAN F F, ZHENG R M, et al. Mediating effect of childbirth self-efficacy between pregnant women's mindfulness level and fear of childbirth[J]. Chinese Journal of Behavioral Medicine and Brain Science, 2019, 28(9): 783-787. doi: 10.3760/cma.j.issn.1674-6554.2019.09.004
[14]	袁春蕾, 刘燕群, 刘光华, 等. 集中群组孕期健康教育对孕妇分娩恐惧的干预效果[J]. 护理学杂志, 2017, 32(18): 27-29. https://www.cnki.com.cn/Article/CJFDTOTAL-HLXZ201718011.htm YUAN C L, LIU Y Q, LIU G H, et al. The effect of health education based on centering pregnancy model on fear of childbirth[J]. Journal of Nursing Science, 2017, 32(18): 27-29. https://www.cnki.com.cn/Article/CJFDTOTAL-HLXZ201718011.htm
[15]	刘伟, 薛会平, 贾倩, 等. 移动互联网管理模式对孕产妇妊娠结局的影响[J]. 中国医药导报, 2018, 15(26): 70-73. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY201826018.htm LIU W, XUE H P, JIA Q, et al. Influence of mobile internet management mode on pregnancy outcome of maternal women[J]. China Medical Herald, 2018, 15(26): 70-73. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY201826018.htm
[16]	王坤昌, 李桂平, 周秀荣, 等. 第二产程分阶段自由体位分娩的临床研究[J]. 中国实用护理杂志, 2018, 34(29): 2267-2271. doi: 10.3760/cma.j.issn.1672-7088.2018.29.006 WANG K C, LI G P, ZHOU X R, et al. Clinical study of the second stage of labor stage free position delivery[J]. Chinese Journal of Practical Nursing, 2018, 34(29): 2267-2271. doi: 10.3760/cma.j.issn.1672-7088.2018.29.006
[17]	王秀梅, 李微, 张晨. 分娩球辅助自由体位分娩的优势[J]. 中国综合临床, 2017, 33(5): 458-461. doi: 10.3760/cma.j.issn.1008-6315.2017.05.018 WANG X M, LI W, ZHANG C. Advantage of childbirth with ball-assisted free body position[J]. Clinical Medicine of China, 2017, 33(5): 458-461. doi: 10.3760/cma.j.issn.1008-6315.2017.05.018
[18]	张爱英, 吕慧, 吴芳芳, 等. 认知行为干预对无痛分娩初产妇妊娠压力、自我效能及分娩结局的影响[J]. 浙江医学, 2017, 39(16): 1387-1389. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJYE201716028.htm ZHANG A Y, LYU H, WU F F, et al. Effects of cognitive behavioral intervention on pregnancy stress, self-efficacy and delivery outcomes in primiparas during painless delivery[J]. Zhejiang Medical Journal, 2017, 39(16): 1387-1389. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJYE201716028.htm
[19]	阚滨, 叶江红, 沈爱娣, 等. 基于互联网+新型家庭医生契约服务在孕期健康管理中的应用[J]. 中国临床研究, 2022, 35(2): 222-225. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCK202202017.htm KAN B, YE J H, SHEN A D, et al. Application of Internet+new family doctor contract service in pregnancy health management[J]. Chinese Journal of Clinical Research, 2022, 35(2): 222-225. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCK202202017.htm
[20]	王玮. 电话随访初产妇及家庭支持者对产后抑郁的影响研究[D]. 武汉: 武汉轻工大学, 2018. WANG W. Effects of telephone follow-up on primipara and family supporters on postpartum depression[D]. Wuhan: Wuhan Polytechnic University, 2018.