Effect of Narrative Nursing on Keeping Normal Lactation State of Hospitalized Puerpera after the Separation of Mother and Infant
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摘要:
目的 探讨叙事护理在住院期间母婴分离产妇保持正常泌乳状态的应用效果。 方法 选取2020年1月-12月在同济大学附属第十人民医院分娩，其新生儿分娩后即刻转科的产妇随机分成实验组和对照组。实验组在常规护理的模式下增加了叙事护理模式。分析两组的护理相关结局指标。 结果 采用χ2检验，叙事护理组的产后首次挤奶时间、住院期间产后平均挤奶次数、泌乳Ⅱ期启动时间、产后抑郁评分等均优于对照组（P < 0.01）；多元线性回归分析显示，泌乳II期启动时间与产后抑郁呈正相关，解释的总变异量为67.00%。 结论 叙事护理有利于住院期间母婴分离产妇保持正常泌乳，且能提升纯母乳喂养水平。 Abstract:Objective To explore the application effect of narrative nursing in maintaining normal lactation state of parturients with mother infant separation during the hospitalization. Methods Parturients delivered in the Tenth People’ s Hospital Affiliated to Tongji University from January to December 2020 and transferred immediately after the delivery were randomly divided into the experimental group and the control group. The experimental group added narrative nursing mode under the routine nursing mode. The nursing related outcome indexes of the two groups were analyzed. Results The first time of milking, average times of milking during the hospitalization, start time of lactation phase II and postpartum depression score of the narrative nursing group were better than those of the control group （P < 0.01）; Multiple linear regression analysis showed that the start time of lactation phase II was positively correlated with the postpartum depression, and the total variance explained was 67.00%. Conclusion Narrative nursing is beneficial to keep the normal lactation of parturients with mother infant separation during the hospitalization, and can improve the level of pure breast feeding. -
Key words:
- Narrative nursing /
- Mother infant separation /
- Breast feeding
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图 1 母婴分离状态下保持正常泌乳的叙事护理流程图
Figure 1. Narrative nursing flow chart of keeping normal lactation in the state of mother infant separation
表 1 两组产妇的一般资料比较（
$\bar x \pm s$ ）（n = 187）Table 1. Comparison of general information of two groups of puerpera （
$\bar x \pm s$ ）（n = 187）组别 年龄（岁） 文化程度[n（%）] 婴儿性别（n） 胎次（n） 分娩方式（n） 分娩孕周（周） 专科及以下 本科 研究生及以上 男 女 初产妇 经产妇 阴道分娩 剖宫产 实验组 28.69 ± 4.09 54（56.25） 34（35.42） 8（8.33） 46 50 82 14 54 42 38.41 ± 1.79 对照组 27.98 ± 3.85 51（56.04） 32（35.16） 8（8.79） 44 47 79 12 50 41 38.01 ± 1.52 t/χ2 1.129 0.013 0.004 0.076 0.032 1.624 P 0.224 0.994 0.953 0.835 0.884 0.105 
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表 2 两组产妇住院期间的母乳喂养依从性比较（
$\bar x \pm s$ ）Table 2. Comparison of the compliance of breastfeeding between two groups of women in hospital （
$\bar x \pm s$ ）组别 产后首次
挤奶时间（h）住院期间平均每日
挤奶次数（次）实验组 6.29 ± 3.46 7.31 ± 1.76 对照组 12.81 ± 6.48 4.81 ± 1.07 t −8.653 11.669 P < 0.001* < 0.001* *P < 0.05。
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表 3 两组产妇的相关结局指标比较[
$\bar x \pm s$ /n（%）]Table 3. Comparison of related outcome indicators between the two groups [
$\bar x \pm s$ /n（%）]组别 泌乳Ⅱ期启动时间（h） 爱丁堡产后抑郁得分（分） 产后42 d母乳喂养情况[n（%）] 纯母乳喂养 混合喂养 人工喂养 实验组 50.53 ± 14.97 5.11 ± 1.74 51（53.13） 35（36.46） 10（10.42） 对照组 58.42 ± 14.22 7.14 ± 1.96 23（25.27） 43（47.25） 25（27.47） t/χ2 −3.665 −7.495 17.723 P < 0.001* < 0.001* < 0.001* *P < 0.05。
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表 4 产后抑郁的多元线性回归分析
Table 4. Multiple linear regression analysis of postpartum depression
模型 未标准化系数 标准化系数Beta t P B 标准错误 （常量） 1.301 0.614 2.118 0.036 产后首次挤奶时间 0.047 0.030 0.135 1.569 0.118 平均每天挤奶次数 −0.095 0.060 −0.086 −1.582 0.115 泌乳Ⅱ期启动时间 0.091 0.011 0.655 8.485 < 0.001 注：R = 0.822，R2 = 0.675，调整后的R2 = 0.670，F = 126.940，P < 0.001。
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[1] 曹孟莹,云婷,李平,等. 早产儿母乳喂养的研究进展[J]. 护士进修杂志,2017,32(1):31-33. [2] Helena W,Marie B. Health care professionals’ experiences of parental presence and participation in neonatal intensive care unit[J]. Qualitative Studies Health and Well-being,2007,2(1):45-54. doi: 10.1080/17482620600979195 [3] 刘建鹏,张宇翔,陈佳欣,等. 母婴分离影响母亲心理健康 状况的研究简述[J]. 中国妇幼健康研究,2016,27(5):665- 667. doi: 10.3969/j.issn.1673-5293.2016.05.039 [4] 潘婷,刘欣,白利颖. 母婴分离早产儿母亲护理干预的研究进展[J]. 中华现代护理杂志,2018,24(4):490-493. doi: 10.3760/cma.j.issn.1674-2907.2018.04.031 [5] 顾晓英,曹志娟,赵敏慧. 住院新生儿母亲泌乳状况及其影响因素分析[J]. 中国妇幼健康研究,2016,27(11):1312-1314. doi: 10.3969/j.issn.1673-5293.2016.11.008 [6] 黄辉,刘义兰. 叙事护理临床应用的研究进展[J]. 中华护理杂志,2016,51(2):70-74. [7] 杨艳,姜安丽. 叙事护理临床实践的国内外研究现状[J]. 中国实用护理杂志,2017,33(24):1917-1920. doi: 10.3760/cma.j.issn.1672-7088.2017.24.019 [8] Jung S Y,Shin S Y,Lee K H,et al. Analysis of mandibular structure using 3D facial computed tomography[J]. Otolaryngol Head Neck Surg,2014,151(5):760-764. doi: 10.1177/0194599814546460 [9] 赵晓娟,杜春玲. 1例尤文肉瘤的叙事护理个案报告[J]. 心理医生,2017,23(35):281-282. [10] 方晓敏,林艳. 产后抑郁筛查工具及影响因素的研究进展[J]. 护理学报,2017,24(21):23-27. [11] Alves E,Rodrigues C,Fraga S,et al. Parents’ views on factors thathelp or hinder breast milk supply in neonatal care units:systematic review[J]. Arch Dis Child Fetal Neonatal Ed,2013,98(6):F511-F517. doi: 10.1136/archdischild-2013-304029 [12] 刘珊珊,杨晓敏,龚文艳,等. 产科护士支持纯母乳喂养信念的现象学研究[J]. 解放军护理杂志,2019,36(6):15-17. doi: 10.3969/j.issn.1008-9993.2019.06.005 [13] 胡晓静,张玉侠,李丽玲,等. 极低出生体质量早产儿NICU住院期间母乳喂养模式的构建[J]. 中国护理管理,2020,20(S1):14-17. [14] Orster D A,Johns H M,McLachlan H L,et a1. Feeding infants directly at the breast during the postpartum hospital stay is associated with increased breastfeeding at 6 months postpartum:a prospective cohort study[J]. BMJ Open,2015,5(5):e007512. doi: 10.1136/bmjopen-2014-007512 [15] Parker L A,Sullivan S,Krueger C,et al. Effect of early breast milkexpression on milk volume and timing of lactogenesis stage Ⅱamongmothers of very low birth weight infants:A pilot study[J]. J Perinatol,2012,32(3):205-209. doi: 10.1038/jp.2011.78 [16] 黄蓉,侯燕文,刘宏,等. 早期母婴皮肤接触1小时对初产妇产后6个月母乳喂养的影响[J]. 中华护理杂志,2015,50(12):1420-1424. doi: 10.3761/j.issn.0254-1769.2015.12.002 [17] 李文先,杜莉,胡淑怡,等. 上海市0~6月龄婴儿母亲纯母乳喂养知信行调查[J]. 中华疾病控制杂志,2018,22(5):490-493. [18] 肖婷婷,廖太秀,钟琳,等. 赣州市600例孕产妇的健康素养及母乳喂养知信行调查[J]. 中国妇幼保健,2018,33(23):5569-5572. [19] 董小英,商祯茹,王娟,等. 新生儿重症监护病房早产儿母婴分离期内母亲泌乳量不足影响因素分析[J]. 中国妇幼保健,2020,35(15):2756-2759. [20] Thang V V,Duong H T K,Dinh H T. Postpartum depressive symptoms and associated factors in married women:A cross-sectional study in danang city,Vietnam[J]. Frontiers in Public Health,2017,5(4):93-100. [21] 张艳. 信息支持对产后抑郁的单亲初产妇泌乳及子宫复旧的影响[J]. 中华现代护理杂志,2014,49(3):309-311. doi: 10.3760/j.issn.1674-2907.2014.03.024 [22] 黄星,杨丽,郑睿敏,等. 产后抑郁预测的研究进展[J]. 中国妇幼保健,2019,34(14):3385-3387. [23] 栾丹丹,于秀荣,王云芳,等. NICU住院早产儿母亲在母婴分离期的泌乳量及相关因素研究[J]. 中华护理杂志,2018,53(1):65-70. doi: 10.3761/j.issn.0254-1769.2018.01.012 [24] 张鲁敏,顾芬,任皎皎,等. 叙事护理对COPD患者焦虑抑郁及生活质量的影响[J]. 护理学报,2019,26(7):65-69. -
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