胎儿异常引产妇女心理因素分析及干预研究

贺琰; 余晓燕; 余幼芬; 安静娜

doi:10.16766/j.cnki.issn.1674-4152.003251

胎儿异常引产妇女心理因素分析及干预研究

doi: 10.16766/j.cnki.issn.1674-4152.003251

1.
舟山市妇女儿童医院产科，浙江舟山 316000
2.
浙江大学医学院附属妇产科医院产科，浙江杭州 310000
3.
舟山市妇女儿童医院护理部

基金项目:

浙江省医药卫生科技计划项目 2020KY173

详细信息

通讯作者:
余幼芬，E-mail: youfenyu666@126.com

中图分类号: R719.3
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- 被引次数: 0
出版历程
- 收稿日期: 2023-05-26

Analysis of psychological factors and intervention of women with abnormal fetal induction of labor

HE Yan¹,
YU Xiaoyan²,
YU Youfen^{3
, ,},
AN Jingna³

1.
Department of Obstetrics, Zhoushan Women and Children' s Hospital, Zhoushan, Zhejiang 316000, China

摘要

摘要: 目的胎儿异常引产不仅对产妇的生理造成损害，也对心理造成极大的创伤。本研究旨在探讨胎儿异常引产导致孕产妇抑郁的影响因素，并研究对其进行心理干预的临床效果。方法利用便利抽样法，选取2019年10月—2022年10月舟山市妇女儿童医院收治的142例胎儿异常引产妇女作为研究对象，利用爱丁堡产后抑郁量表调查胎儿异常引产妇女的得分情况，分析导致引产后焦虑抑郁的因素，观察心理干预后的效果。结果胎儿异常引产妇女抑郁发生率为44.37%(63/142)，对其进行心理干预后，爱丁堡产后抑郁量表评分从干预前的(10.86±2.86)分降至(9.18±3.08)分，差异有统计学意义(P<0.05)。单因素分析发现不同文化水平、既往流产次数、社会支持得分的引产妇女爱丁堡产后抑郁量表评分比较差异有统计学意义(均P<0.05)。胎儿异常引产妇女平均社会支持得分为45.33分。Logistic多因素回归分析发现文化水平、既往流产次数、社会支持是引产后焦虑抑郁的主要影响因素。结论胎儿异常引产妇女的抑郁发生率较高，文化水平、既往流产次数、社会支持是引产后焦虑抑郁的影响因素，通过心理干预可有效降低胎儿异常引产妇女的焦虑和抑郁水平。
- 胎儿异常引产 /
- 心理因素分析 /
- 焦虑 /
- 抑郁 /
- 心理干预
Abstract: Objective Abnormal fetal induction of labor not only causes damage to the mother' s physiology, but also causes great psychological trauma. The purpose of this study is to explore the factors analysis of maternal depression and anxiety caused by abnormal fetal labor induction, and to study the clinical effect of psychological intervention. Methods Using convenience sampling method, 142 cases of women with abnormal fetal labor induction admitted to Zhoushan Women and Children's Hospital from October 2019 to October 2022 were selected as research objects. Edinburgh postpartum depression scale was used to investigate the scores of women with abnormal fetal labor induction, analyze the main factors leading to anxiety and depression after labor induction, and explore the clinical effect of psychological intervention. Results The incidence of depression in women with abnormal fetal induction was 44.37% (63/142). After psychological intervention, the score of Edinburgh postnatal depression scale decreased from (10.86±2.86) points before intervention to (9.18±3.08) points, and the difference was statistically significant (P<0.05). Univariate analysis showed that there were statistically significant differences in the scores of Edinburgh postnatal depression scale among women with different education levels, number of previous abortions and social support scores (all P<0.05). The average score of social support was 45.33 points. Logistic multivariate regression analysis showed that educational level, previous number of abortions and social support were the main influencing factors of anxiety and depression after induction of labor. Conclusion The incidence of depression and anxiety is higher in women with abnormal fetal labor induction. The educational level, the number of previous abortions and social support are the influencing factors of anxiety and depression after labor induction. Psychological intervention can effectively reduce the level of anxiety and depression in women with abnormal fetal labor induction.
- Fetal abnormal induction of labor /
- Analysis of psychological factors /
- Anxiety /
- Depression /
- Psychological intervention
利益冲突 无

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表 1 胎儿异常引产妇女焦虑抑郁单因素分析(x±s，分)

Table 1. Single factor analysis of anxiety and depression in women with abnormal fetal induction (x±s, points)

项目	类别	例数	EPDS	统计量	P值
年龄(岁)	23~<35	92	10.46±2.10	0.248^a	0.804
	35~42	50	10.37±1.99
孕周(周)	<17	56	9.38±2.07	0.863^b	0.389
	17~20	54	10.01±3.18
	>20	32	9.89±2.18
BMI	<18.5	34	10.15±3.01	0.031^b	0.973
	18.5~24.0	49	10.22±2.88
	>24.0	59	10.29±2.71
文化水平	高中及以下	22	9.27±1.98	5.350^b	0.006
	本科	76	10.89±3.10
	硕士及以上	44	11.76±2.97
既往流产次数(次)	0	65	9.36±1.99	6.201^b	0.003
	1	43	10.37±2.14
	≥2	34	10.86±2.46
社会支持得分(分)	≤45.33	67	10.94±2.22	4.788^a	<0.001
	>45.33	75	9.17±2.18
注：^a为t值，^b为F值。

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表 2 胎儿异常引产妇女焦虑抑郁多因素分析

Table 2. Multi-factor analysis of anxiety and depression in women with abnormal fetal induction

项目	B	SE	Wald χ²	P值	OR值	95% CI
文化水平
本科	-2.485	1.503	12.342	0.028	0.043	0.010~0.079
硕士及以上	-2.173	1.477	13.024	0.018	0.025	0.015~0.086
既往流产次数
1次	2.870	1.267	10.394	0.044	15.483	3.008~25.398
2次及以上	2.198	1.483	11.022	0.038	8.658	2.175~10.709
社会支持得分
>45.33分	3.110	1.388	18.104	0.036	0.528	0.241~0.899
注：文化水平以高中及以下为参照，既往流产次数以0次为参照，社会支持得分以≤45.33分为参照。

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参考文献(18)

[1]	柯燕燕, 刘妮, 张小凤, 等. 育龄期女性癫痫患者妊娠期心理体验的质性研究[J]. 中华全科医学, 2023, 21(5): 821-824. doi: 10.16766/j.cnki.issn.1674-4152.002992 KE Y Y, LIU N, ZHANG X F, et al. Qualitative study on psychological experience of pregnant women with epilepsy in childbearing age[J]. Chinese Journal of General Practice, 2023, 21(5): 821-824. doi: 10.16766/j.cnki.issn.1674-4152.002992
[2]	刘海燕, 刘敏, 李艳莉, 等. 积极心理学指导下心理干预对胎儿畸形引产妇女应对方式及情绪状态的影响[J]. 中国计划生育学杂志, 2022, 30(12): 2688-2693. doi: 10.3969/j.issn.1004-8189.2022.12.005 LIU H Y, LIU M, LI Y L, et al. Effects of psychological intervention under the guidance of positive psychology on coping style and emotional state of women induced by fetal malformation[J]. Chinese Journal of Family Planning, 2022, 30(12): 2688-2693. doi: 10.3969/j.issn.1004-8189.2022.12.005
[3]	GUIGUET-AUCLAIR C, ROUZAIRE M, DEBOST-LEGRAND A, et al. Cross-cultural adaptation and psychometric properties of the french version of the EXIT to measure women' s experiences of induction of labor[J]. J Clin Med, 2022, 11(14): 4217. doi: 10.3390/jcm11144217
[4]	朱淑惠, 梁小玲, 欧小容. 正念干预对引产患者心理压力及应对方式的影响[J]. 齐鲁护理杂志, 2022, 28(12): 154-156. ZHU S H, LIANG X L, OU X R. Effect of mindfulness intervention on psychological stress and coping style of induced labor patients[J]. Journal of Qilu Nursing, 2022, 28(12): 154-156.
[5]	周小莉, 杨孟叶, 钱嘉璐, 等. 胎儿异常引产产妇产褥期心理体验的质性研究[J]. 中华护理杂志, 2019, 54(9): 1359-1363. ZHOU X L, YANG M Y, QIAN J L, et al. Qualitative study on puerperal psychological experience of women with abnormal fetal induction[J]. Chinese Journal of Nursing, 2019, 54(9): 1359-1363.
[6]	何慧慧. 精细化护理干预配合心理护理在中晚期异常妊娠引产患者护理中的价值[J]. 实用妇科内分泌电子杂志, 2019, 6(12): 149, 153. HE H H. Value of refined nursing intervention combined with psychological nursing in nursing care of patients with abnormal induced labor in middle and late pregnancy[J]. Electronic Journal of Applied Gynecology Endocrinology, 2019, 6(12): 149, 153.
[7]	易隽, 闵丽华, 彭羽, 等. 胎儿异常引产孕产妇焦虑及抑郁心理干预的效果研究[J]. 实用医院临床杂志, 2019, 16(2): 60-63. YI J, MIN L H, PENG Y, et al. Effect of psychological intervention on anxiety and depression in pregnant women with abnormal fetal induction[J]. Clinical Journal of Practical Hospital, 2019, 16(2): 60-63.
[8]	赵佳佳. 基于心理干预的中晚期异常妊娠引产患者临床护理[J]. 临床医药文献电子杂志, 2019, 6(13): 148. ZHAO J J. Clinical nursing of induced labor with abnormal pregnancy in middle and late period based on psychological intervention[J]. Electronic Journal of Clinical Medical Literature, 2019, 6(13): 148.
[9]	HE Y J, HE H W, TANG C. Effect of psychological nursing intervention on abnormal-induced labor of fetus during puerperium: study on the effects of anxiety, depression, and life events[J]. Comput Math Methods Med, 2022: 6206851. DOI: 10.1155/2022/6206851.
[10]	袁丹丹, 周静, 吴宁宁, 等. 个体化心理辅导联合耳穴压豆对产褥期产妇焦虑和抑郁的干预效果[J]. 中华全科医学, 2021, 19(9): 1539-1541, 1568. doi: 10.16766/j.cnki.issn.1674-4152.002106 YUAN D D, ZHOU J, WU N N, et al. Effect of individualized psychological counseling combined with auricular point pressure on maternal anxiety and depression[J]. Chinese Journal of General Practice, 2021, 19(9): 1539-1541.1568. doi: 10.16766/j.cnki.issn.1674-4152.002106
[11]	杨月东. 精细化护理和心理护理用于中晚期异常妊娠引产患者中的效果分析[J]. 中西医结合心血管病电子杂志, 2020, 8(35): 132-147. YANG Y D. Effect analysis of refined nursing and psychological nursing for induced labor of abnormal pregnancy in middle and late stage[J]. Journal of Cardiovascular Diseases of Integrated Chinese and Western Medicine, 2019, 8(35): 132-147.
[12]	李兰兰. 心理护理及用药护理在静脉滴注催产素引产中的应用效果[J]. 海峡药学, 2020, 32(12): 191-192. LI L L. Effect of psychological nursing and medication nursing on induction of labor by intravenous infusion of oxytocin[J]. Straits Pharmacy, 2020, 32(12): 191-192.
[13]	朱瑞茹, 吕倩宝, 蓝婷婷. 针对性心理护理用于畸胎引产患者的效果[J]. 中华灾害救援医学, 2020, 8(8): 474-475, 480. ZHU R R, LYU Q B, LAN T T. Effect of targeted psychological nursing on patients with induced labor of teratogenesis[J]. Chinese Journal of Disaster Relief Medicine, 2020, 8(8): 474-475, 480.
[14]	黄美娟. 针对性心理护理对中期异常妊娠引产孕妇心理状态的影响[J]. 实用妇科内分泌电子杂志, 2020, 7(19): 138, 140. HUANG M J. Effect of targeted psychological care on psychological state of pregnant women with abnormal induction of pregnancy in the second trimester[J]. Electronic Journal of Gynecological Endocrinology, 2019, 7(19): 138, 140.
[15]	苟媛丽. 精细化护理干预配合心理护理在中晚期异常妊娠引产患者中的应用[J]. 医学食疗与健康, 2020, 18(12): 176, 179. GOU Y L. Application of refined nursing intervention combined with psychological nursing in induced labor of middle and late abnormal pregnancy[J]. Medical Food Therapy and Health, 2020, 18(12): 176, 179.
[16]	周小莉, 余晓燕. 胎儿异常孕产妇支持性照护需求的研究进展[J]. 中华护理杂志, 2020, 55(6): 942-946. doi: 10.3761/j.issn.0254-1769.2020.06.029 ZHOU X L, YU X Y. Research progress on supportive care needs of pregnant women with fetal abnormalities[J]. Chinese Journal of Nursing, 2020, 55(6): 942-946. doi: 10.3761/j.issn.0254-1769.2020.06.029
[17]	WANG Z Y, JIA X X, AN R L. Application of psychological suggestion therapy in induced labor of mid-late pregnant women in obstetrics[J]. Panminerva Med, 2020, 12(8): 425-432.
[18]	曹娟, 王兰云, 刘林, 等. 综合护理干预对高危妊娠孕妇产后抑郁的效果研究[J]. 中华全科医学, 2019, 17(11): 1948-1950, 1972. doi: 10.16766/j.cnki.issn.1674-4152.001098 CAO J, WANG L Y, LIU L, et al. Effect of comprehensive nursing intervention on postpartum depression in high-risk pregnant women[J]. Chinese Journal of General Practice, 2019, 17(11): 1948-1950, 1972. doi: 10.16766/j.cnki.issn.1674-4152.001098